A geriatric client is confused and wandering in and out of every door. Which scenario reflects the least restrictive alternative for this client?
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A
The client is placed in seclusion.
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B
The client is placed in a geriatric chair with tray.
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C
The client is placed in soft Posey restraints.
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D
The client is monitored by an ankle bracelet.
In this situation, the nursing judgment that fits the stem is The client is monitored by an ankle bracelet..
A. The client is placed in seclusion.
This sounds reasonable when the idea in “The client is placed in seclusion.” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.
B. The client is placed in a geriatric chair with tray.
This reflects a related idea, but it fits best when the idea in “The client is placed in a geriatric chair with tray.” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.
C. The client is placed in soft Posey restraints.
This might be chosen when the idea in “The client is placed in soft Posey restraints.” addresses a different mechanism or priority than the one emphasized by the stem The wording does not track the stem’s main cue, so selecting it would shift the nurse away from the most precise interpretation or priority.
D. The client is monitored by an ankle bracelet.
This matches the stem because The least restrictive alternative for this client would be monitoring by an ankle bracelet. The client does not pose a direct dangerous threat to self or others, so neither physical restraints nor seclusion would be justified. Need: Safe and Effective Care Environment The underlying principle in the stem is best addressed by choosing the response that is both specific to the cue provided and consistent with evidence-informed psychiatric nursing practice. From a nursing standpoint, this selection guides assessment and interventions toward what is most clinically meaningful in the moment—risk reduction, safety, accurate appraisal, and support for adaptive coping.
Conclusion
The scenario is best handled by identifying what the nurse must interpret or prioritize first and then choosing the statement that fits that requirement with the least distortion. The distractors have surface appeal, but they do not align as tightly with the clinical cue embedded in the stem.