The nurse is in the dayroom of the psychiatric unit observing the clients. Which client behavior would the nurse interpret as exhibiting inadequate coping?

  1. A client is sitting in a chair coloring in a coloring book.
  2. A client is arguing about a TV program with another client.
  3. A client is playing a new card game with a group for the first time.
  4. A client is in the corner alone, rocking and pulling out her eyelashes.
Number 4 is correct.
Rationale: Pulling out hair or eyelashes, picking compulsively at the skin, and rocking back and forth are signs of unaddressed anxiety or stress. The nurse should intervene and ask the client what is bothering her. Open-ended questions allow the client to verbalize her feelings without a simple yes-or-no answer. Options 1 and 3 show clients engaging in healthy outlets. Two clients arguing over the TV does not necessarily indicate inadequate coping. In a group environment, clients will have different tastes in entertainment. As long as a compromise is reached without physical or verbal violence, this situation does not reflect anxious behavior like self-harm does. While pulling out one’s hair or other “picking” behavior does not constitute suicidal behavior, it is still considered self-harm.