Question 1

Which indications warrant the use of seclusion? Select all that apply.

Accepted Answer

A)  To protect from self-harm 
B)  To increase self-isolation 
C)  To decrease environmental stimulation 
D)  To prevent assault 
E)  To encourage self-reflection 
A)  To protect from self-harm 
B)  To increase self-isolation 
C)  To decrease environmental stimulation 
D)  To prevent assault 
E)  To encourage self-reflection

Question 2

A patient with a history of anger and impulsivity was hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolded nursing staff for "not knowing enough to give me pain medicine when I need it." Which nursing intervention would best address this problem?

Accepted Answer

A)  Teach the patient to use coping strategies such as deep breathing and progressive relaxation to reduce the pain. 
B)  Talk with the health care provider about changing the pain medication from PRN to patient-controlled analgesia. 
C)  Tell the patient that verbal assaults on nurses will not shorten the wait for analgesic medication. 
D)  Talk with the patient about the risks of dependency associated with overuse of analgesic medication. 
A)  Teach the patient to use coping strategies such as deep breathing and progressive relaxation to reduce the pain. 
B)  Talk with the health care provider about changing the pain medication from PRN to patient-controlled analgesia. 
C)  Tell the patient that verbal assaults on nurses will not shorten the wait for analgesic medication. 
D)  Talk with the patient about the risks of dependency associated with overuse of analgesic medication.

Question 3

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

Accepted Answer

A)  Practice and teamwork 
B)  Spontaneity and surprise 
C)  Caution and superior size 
D)  Diversion and physical outlets 
A)  Practice and teamwork 
B)  Spontaneity and surprise 
C)  Caution and superior size 
D)  Diversion and physical outlets

Question 4

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?

Accepted Answer

A)  Risk for injury 
B)  Ineffective coping 
C)  Impaired social interaction 
D)  Risk for other-directed violence 
A)  Risk for injury 
B)  Ineffective coping 
C)  Impaired social interaction 
D)  Risk for other-directed violence

Question 5

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?

Accepted Answer

A)  Gently touching the patient's arm 
B)  Asking the patient, "What do you need?" 
C)  Saying to the patient, "This is a safe place." 
D)  Directing the patient to cease the behaviour 
A)  Gently touching the patient's arm 
B)  Asking the patient, "What do you need?" 
C)  Saying to the patient, "This is a safe place." 
D)  Directing the patient to cease the behaviour

Question 6

Which behaviour best demonstrates aggression?

Accepted Answer

A)  Stomping away from the nurses' station, going to the hallway, and grabbing a tray from the meal cart. 
B)  Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and sobbing. 
C)  Telling the primary nurse, "I felt angry when you said I could not have a second helping at lunch." 
D)  Telling the medication nurse, "I am not going to take that, or any other, medication you try to give me." 
A)  Stomping away from the nurses' station, going to the hallway, and grabbing a tray from the meal cart. 
B)  Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and sobbing. 
C)  Telling the primary nurse, "I felt angry when you said I could not have a second helping at lunch." 
D)  Telling the medication nurse, "I am not going to take that, or any other, medication you try to give me."

Question 7

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

Accepted Answer

A)  Severe agoraphobia 
B)  Substance abuse disorder 
C)  Bizarre somatic delusions 
D)  Verbalized hopelessness and powerlessness 
A)  Severe agoraphobia 
B)  Substance abuse disorder 
C)  Bizarre somatic delusions 
D)  Verbalized hopelessness and powerlessness

Question 8

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

Accepted Answer

A)  Major depression with delusions of worthlessness 
B)  Obsessive-compulsive disorder; performs many rituals 
C)  Paranoid delusions of being followed by alien monsters 
D)  Completed alcohol withdrawal; beginning a rehabilitation program 
A)  Major depression with delusions of worthlessness 
B)  Obsessive-compulsive disorder; performs many rituals 
C)  Paranoid delusions of being followed by alien monsters 
D)  Completed alcohol withdrawal; beginning a rehabilitation program

Exam 26: Anger, Aggression, and Violence

Which indications warrant the use of seclusion? Select all that apply.

A patient with a history of anger and impulsivity was hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolded nursing staff for "not knowing enough to give me pain medicine when I need it." Which nursing intervention would best address this problem?

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

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?

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?

Which behaviour best demonstrates aggression?

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

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

Mental Health and Mental Illness

Historical Overview of Psychiatric Mental Health Nursing

Relevant Theories and Therapies for Nursing Practice

Psychotropic Drugs

Psychiatric Mental Health Nursing in Acute Care Settings

Psychiatric Mental Health Nursing in Community Settings

Cultural Implications for Psychiatric Mental Health Nursing

Ethical Responsibilities and Legal Obligations for Psychiatric Mental Health Nursing Practice

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Understanding Responses to Stress

Anxiety, Obsessive-Compulsive, and Related Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia Spectrum and Other Psychotic Disorders

Eating Disorders

Cognitive Disorders

Substance Use and Addictive Disorders

Personality Disorders

Sleep–Wake Disorders

Sexual Dysfunction, Gender Dysphoria, and Paraphilias

Somatic Symptom Disorders and Dissociative Disorders

Crisis and Disaster

Suicide

Interpersonal Violence: Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Living With Recurrent and Persistent Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative Care

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