When a resident is combative and trying to hit the nurse aide, the most appropriate action for the nurse aide is (D) step back to protect self from harm while speaking in a calm manner.

Resident combativeness can occur for various reasons, such as confusion, pain, or an underlying medical condition. In such situations, the safety of the nurse aide and the resident is of utmost importance.

Option A (showing the resident that the nurse aide is in control) may escalate the situation and should be avoided, as it can be perceived as confrontational or intimidating.

Option B (calling for help to make sure there are witnesses) may be appropriate if the situation escalates and additional staff assistance is required, but it should not be the initial response.

Option C (explaining that a restraint may be applied if the resident is not calm) should be avoided, as it can be perceived as a threat and may further agitate the resident.

By stepping back (option D), the nurse aide creates a safe distance and avoids escalating the situation. Speaking in a calm manner can help de-escalate the resident’s agitation and potentially prevent further aggression or harm. This approach prioritizes the safety of both the resident and the nurse aide while allowing for a non-confrontational response.

If the resident remains combative after attempting de-escalation techniques, the nurse aide should seek immediate assistance from other staff members and follow the facility’s protocols for managing aggressive behaviors.