Chapter 24: Anger, Aggression, and Violence

Question 1

Pt, hx command hallucinations, yells obscenities, mumbles, walks away. Nurse follows. Nursing actions deescalate (SATA)

Accepted Answer

Speak in a firm but calm, caring voice., Offer to provide the pt with medication to help, State the expectation that the pt will stay in control

Question 2

Which action is an example of anger?

Accepted Answer

Slapping spouse in face during argument abt family budget

Question 3

Which client-focused change will nurse identify as sign possible escalation of anger?

Accepted Answer

A quiet client becomes talkative and loud.

Question 4

Pt broke window former partner. Hx childhood abuse, torturing pets, disorderly conduct. Priority nursing diagnosis?

Accepted Answer

Risk for other-directed violence

Question 5

IM antiphyscotic to be admin. Pt in dayroom where other pts are. When entering day room what response should nurse make?

Accepted Answer

With 3 staff, Please come to your room, can give you med that will help.

Question 6

Pt hx anger/impulsivity. When in pain, loudly scolds nurse, "not knowing enough to give meds when needed" Intervention?

Accepted Answer

Urge provider to change script for pain med from PRN to regular schedule

Question 7

Which scenario predicts highest risk for directing violent behavior toward others?

Accepted Answer

Paranoid delusions of being followed by a military attack team

Question 8

Which behaviors most consistent with the clinical picture of pt who is becoming increasingly aggressive? (SATA)

Accepted Answer

Pacing, Rigid posture with clenched jaw, Staring with narrowed eyes into the eyes into the eyes of another

Question 9

Pt burn injuries good coping skills. New nurse poorly organized, disrupts norm, angers pt. Best response nurse manager?

Accepted Answer

Acknowledge, validate pts distress, ask, "What would you like have happen"

Question 10

Which CNS structures are most associated with anger and aggression? (SATA)

Accepted Answer

Amygdala, Temporal lobe

Question 11

Pt has knife, "Will kill anyone who tries to get near." Code, disarmed, put in seclusion. Justification for seclusion?

Accepted Answer

Pts actions present a clear and present danger to others.

Question 12

Confirmation hx what scenario pts record indicates compromised coping skills, need for assessment of risk for violence?

Accepted Answer

Daily substance abuse

Question 13

Which statement, by client diagnosed with poor impulse control, indicates improved prognosis?

Accepted Answer

I've learned to walk away when I start feeling angry

Question 14

Pt hx of impulsively acting out anger striking others. Appropriate plan for avoiding these incidents?

Accepted Answer

Help pt identify incidents that trigger impulsive acting out

Question 15

Client angry, throwing objects. Question asked of staff to address goals of debriefing incident focuses on client care?

Accepted Answer

Were the unit's policies on managing violence followed?

Question 16

Which behavior best demonstrates aggression?

Accepted Answer

Stomping away, darting to another room, grabbing snack from another pt

Question 17

Med admin, immediate intervention psychotic pt aggressive behavior continues to escalate despite verbal intervention?

Accepted Answer

Olanzapine

Question 18

Client hx being bullied admitted hosp txt anger issues. Classic reaction will nurse address in clients POC?

Accepted Answer

Suicidal ideations

Question 19

Adult pt assaulted another pt, was restrained. Hr later, statement by pt necessitates immediate attention?

Accepted Answer

My fingers are tingly.

Question 20

Pt, cognitively impaired, widow 30 yrs. "Have to go home, cook dinner for husband". Validation therapy, said first?

Accepted Answer

You want to go home to prepare your husband's dinner?

Question 21

Staff plans to use physical management techniques when pts become assaultive. Topics to be emphasized?

Accepted Answer

Practice and teamwork

Question 22

New pt requires seclusion. Assessment incomplete, provider not exam pt. Immediately after secluding, priority action?

Accepted Answer

Notify health care provider and obtain a seclusion order.

Question 23

Which assessment finding presents greater risk for violent behavior?

Accepted Answer

Hx of intimate partner violence

Question 24

Spouse of pt becomes irritable while waiting. Intervention nurse uses to prevent escalation of anger?

Accepted Answer

Periodically provide update and progress report on pt

Question 25

Pt sits silent, tense, vigilant. Abruptly stands, paces, clenches/unclenches fists, stops, stares at staff. Behavior?

Accepted Answer

Pt exhibiting clues to potential aggression.

Question 26

Family describes pt as "difficult, finds fault with everyone". Pt verbally abuses. Most likely explanation for behavior?

Accepted Answer

Personality style that externalizes problems.

Question 27

Nurse assaulted by pt. "Dread facing violent pts, make me so angry". Response most urgent for nurse seek supervision?

Accepted Answer

Expression of anger

Question 28

Critical incident debriefing r/t intervention control pts aggressive behavior. Topics should focus on discussion. (SATA)

Accepted Answer

Intervention techniques used by staff, Pt behavior associated with the incident, Effect of environmental factors

Question 29

Pt to go to seclusion, other pts removed from area. Before approaching pt, which actions to be taken by staff? (SATA)

Accepted Answer

Select the person who will communicate with the pt, Remove jewelry, glasses, and harmful items from pt and staff members., Appoint a person to clear a path and open, close, or lock doors.

Question 30

Pt, auditory hallucinations, shakes fist at nurse, "Back off" goes to day room. Nurse follows, takes what precaution?

Accepted Answer

Making sure adequate physical space exists between nurse and pt.

Question 31

Pt confused, sleeping. Worker enters room, touches bed to see if wet. Pt awakens, hits worker. Explains pts action?

Accepted Answer

Pt interpreted health care worker's behavior as potentially harmful

Question 32

When pts aggression quickly escalates, principle applies to selection of nursing interventions?

Accepted Answer

Begin with the least restrictive measure possible

Question 33

Pt severe physical injuries, irritable, angry, belittles nurse. Intervention uses cognitive technique to help pt?

Accepted Answer

Continue drsg change, "Do you know this needed so will not get infected?"

Question 34

Pt pacing hall near nurses' station, swearing loudly. Appropriate initial intervention, address pt by name and say what?

Accepted Answer

I'd like to talk with you abt how you're feeling right now.

Question 35

Effective nursing intervention to assist an angry pt to learn to manage anger without violence?

Accepted Answer

Help pt identify thought increases anger, find proof for/against belief

Chapter 24: Anger, Aggression, and Violence

Questions 35

Chapter 24: Anger, Aggression, and Violence

Questions 35