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Direct suicide assessment ensures safety. Other options delay or minimize the risk. This reflects Psychosocial Integrity—Crisis Intervention and Client Safety.

Furosemide, a loop diuretic, promotes potassium loss, increasing the risk of hypokalemia. The normal potassium range is about 3.5–5.0 mEq/L. A level of 2.8 mEq/L is critically low and explains the client’s symptoms of muscle weakness and cramping. Severe hypokalemia can cause life-threatening cardiac arrhythmias, decreased respiratory muscle function, and ileus. Sodium, calcium, and chloride values here are within normal limits. The PN should hold further doses, notify the RN/provider, anticipate potassium replacement, and monitor cardiac status closely. Ongoing assessment and client education regarding dietary potassium intake are part of safe medication administration. This reflects Physiological Integrity—Pharmacological and Parenteral Therapies and Reduction of Risk Potential.

Approaching calmly, maintaining safety, and using simple communication de-escalates agitation. Confrontation, isolation, or detailed probing may worsen behavior. This reflects Psychosocial Integrity—Crisis Intervention.

Command hallucinations are a psychiatric emergency. The PN must remain with the client, ensure safety, and notify the RN/provider immediately. Options B–D fail to prioritize safety. This reflects Psychosocial Integrity—Crisis Intervention and Client Safety.

Immediate correction ensures safety. Reporting or documenting comes later. Ignoring is unsafe. This reflects Safe and Effective Care Environment—Delegation and Safety.