A registered nurse in the United States is caring for a patient who becomes physically aggressive and threatens to strike staff. Verbal de-escalation has failed. Which action is most appropriate?
Correct answer: B. Use the least restrictive intervention that protects everyone
- A. Apply restraints without assessing the immediate danger
- B. Use the least restrictive intervention that protects everyone
- C. Ask the family to hold the patient's arms in bed
- D. Leave the patient alone until the behavior stops
Explanation
Restraints may be used only when necessary to prevent harm and after less restrictive measures are ineffective, following facility policy and legal requirements. The nurse continues assessment, obtains the required order, and monitors the patient. Family members should not be used as substitutes for authorized staff.
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US nursing law and ethics include state nurse practice acts, scope of practice, standards of care, negligence, malpractice, documentation, confidentiality under HIPAA and informed consent. Ethical reasoning applies autonomy, beneficence, nonmaleficence, justice and fidelity to conflicts such as refusal of treatment, advance directives, privacy breaches and mandatory reporting, which are not the same as legal liability.
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