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    ATI LPN Mental Health Proctored Exam 2023

    A nurse is caring for a client who becomes extremely agitated and asks if they can go to a separate room to be alone for an hour.The nurse should document which of the following de-escalation techniques in the client's medical record?

    Explanation & Rationale

    Choice A rationaleTherapeutic holds involve physical restraint, which is not a de-escalation technique. It is a last resort when a client poses immediate harm.Choice B rationaleRestraints are not de-escalation techniques; they are measures taken when other interventions have failed.Choice C rationaleDiversion involves redirecting the client's attention, but it does not allow the client to process their emotions in a controlled environment.Choice D rationaleTimeout allows the client to have a moment away from stimuli to regain control and calm down, which is a recognized de-escalation technique.

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