Exam 23: Anger, Aggression, and Violence

A patient has a history of impulsively acting out anger by striking others. Select the most appropriate intervention for avoiding similar incidents.

The staff development coordinator plans to teach physical management techniques for use when patients become assaultive. Which topic should the coordinator emphasize?

An adult patient assaulted another patient and was then restrained. One hour later, which statement by the restrained patient requires the nurse's immediate attention?

An emergency code was called after a patient pulled a knife from a pocket and threatened, "I will kill anyone who tries to get near me." The patient was safely disarmed and placed in seclusion. What was the justification for use of seclusion?

Which behaviour best demonstrates aggression?

A cognitively impaired patient has been a widow for 30 years. This patient frantically tries to leave the facility, saying, "I have to go home to cook dinner before my husband arrives from work." To intervene with validation therapy, the nurse will say which of the following?

Which assessment finding presents the greatest risk for violent behaviour directed at others?

Because an intervention was required to control a patient's aggressive behaviour, the nurse plans a critical-incident debriefing with staff members. Which topics should be the primary focus of this discussion?

Which scenario predicts the highest risk for directing violent behaviour toward others?

A patient with multi-infarct dementia lashes out and kicks at people who walk past in the hall of a nursing home. Intervention by the nurse should begin by which of the following?

A patient was arrested for breaking windows in the home of a former domestic partner. The patient's history also reveals childhood abuse by a punitive parent, torturing family pets, and an arrest for disorderly conduct. Which nursing diagnosis has priority?

Which is an effective nursing intervention to assist an angry patient to learn how to manage anger without violence?

Which information from a patient's record would indicate marginal coping skills and the need for careful assessment of the risk for violence?

Which indications warrant the use of seclusion?

A nurse directs the intervention team that is placing an aggressive patient in seclusion. Before approaching the patient, which actions will the nurse direct team members to take?

A new patient acts out so aggressively that seclusion is required before the admission assessment is completed or orders written. Immediately after safely secluding the patient, which action is the nurse's priority?

After an assault by a patient, a nurse has difficulty sleeping, startles easily, and is preoccupied with the incident. The nurse says, "That patient should not be allowed to get away with that behaviour." Which of the following responses poses the greatest barrier to the nurse's ability to provide therapeutic care?

A patient is pacing the hall near the nurses' station, swearing loudly. An appropriate initial intervention for the nurse would be to address the patient by name and say which of the following?

Which central nervous system structures are most associated with anger and aggression?

A patient who was responding to auditory hallucinations earlier in the morning now approaches the nurse shaking a fist and shouts, "Back off!" and then goes to the day room. While following the patient into the day room, the nurse should do which of the following?