Deck 25: Workplace Violence and Incivility

Question 1

Residents in a new long-term care facility attend meals in a large dining hall.In reviewing reports of aggression and violence,you note that behaviours such as hitting or attempts to hit staff are increasing.Further investigation suggests that this behaviour occurs most often at mealtimes.A possible intervention would be to

A) seat residents with the highest potential for violence next to those with the lowest potential for aggression.
B) feed residents earlier in the day.
C) restrain residents who are violent or aggressive during meal times.
D) establish a smaller dining area that is away from the main area that is for residents who have potential for aggression/violence.

Answer 1

establish a smaller dining area that is away from the main area that is for residents who have potential for aggression/violence.

Question 2

Many inaccurately believe workplace violence to be related specifically to

A) verbal abuse.
B) physical injury.
C) incivility.
D) harassment.

Answer 2

physical injury.

Question 3

As indicated by Shield and Wilkins for Statistics Canada (2014),abuse in the health care setting is most often perpetrated by someone who

A) is male.
B) has more experience.
C) consistently works day shifts.
D) has high co-worker support.

Answer 3

is male.

Question 4

In addressing a high staff turnover rate that results from violence on a nursing unit,you are

A) confirming the high correlation between managerial incompetence and violence.
B) demonstrating awareness that workplace violence, if present, has significant costs.
C) aware that staff and manager experiences contribute to high turnover.
D) aware that violence is a rare but present factor in the workplace.

Question 5

You are part of a multidisciplinary team that is charged with designing a workplace safety plan for your health care organization.This team has been established in response to increases in reports of violence and aggression.You begin designing the safety plan by

A) surveying staff about levels of satisfaction with the workplace and management, collegial, and patient relations.
B) offering training sessions in self-defence.
C) developing a policy that outlines zero tolerance for bullying.
D) offering education sessions on recognizing behaviours with potential for violence.

Question 6

In which of the following situations would you,as the head nurse,be concerned about potential safety issues?

A) Jordan comes to your office to complain about inadequate staffing on the unit. He says that he is concerned because he attributes a recent incident to the staffing levels.
B) Heinrich, a long-standing RN on the unit, has begun to miss work regularly. He calls in but is vague about his reasons for the absences.
C) Carla, RN, has just ended a relationship with Jake, RN, and he will not leave her alone. You are meeting with Jake today because colleagues on night shifts have reported that Jake seems to have been intoxicated last night and the previous night.
D) Sarah is very quiet and says almost nothing in team meetings. Lately, she has been much more animated since becoming friendly with a couple of other RNs on the unit.

Question 7

Caroline asks family members to leave while she cares for the 16-year-old victim of a recent car accident.The father screams at her and tells her that she has no right to ask his family to leave,and that if she continues to do so,he will "throw her out of the room." Caroline is shaken and tells her head nurse,who tells her that this kind of thing is just part of the job.The guidance of the head nurse

A) is reasonable. No physical violence was involved.
B) is related to why incidents of violence in health care probably underreported.
C) acknowledges the deep distress and fear of the family.
D) acknowledges the concern of the nurse.

Question 8

During coffee and other breaks,Rosalie,the new RN,is excluded from conversations with the other staff.When she approaches other staff on the unit to ask questions,they turn and walk off in the other direction.The behaviour of the staff is characteristic of

A) dislike.
B) lack of trust in Rosalie's abilities.
C) horizontal violence.
D) cultural incompetence.

Question 9

Reza,RN,works as a staff nurse in the mental health department; Sharon works as a data entry clerk in the admissions department; Sarah is an emergency room physician; and Donna is a housekeeper in the geriatrics department.Which of the four is most likely to be a perpetrator of violence?

A) Reza
B) Sarah
C) Sharon
D) Donna

Question 10

In the emergency department waiting room,you notice a patient sitting,with his head in his hands,who has been waiting for about 5 hours for relief of his headache.When you approach him to ask him how he is doing,he says,"I can't believe that I have to wait this long for help! Do you know what it is like to be in pain for 10 hours?" Your response to him would be

A) "It is frustrating to wait when you are in pain and when you are expecting to receive relief right away."
B) "Don't talk to me. If you are going to be rude, then you will not receive treatment here."
C) "We are very busy and don't have enough staff to deal with problems such as yours."
D) "Perhaps you should go elsewhere. We do not have time for you here, as many more sick patients are waiting."

Question 11

Canadian knowledge of the scale of workplace violence in health care remains incomplete because

A) collected data are inflated.
B) no consistent system of data collection for workplace violence exists.
C) data is collected only in relation to physical injuries.
D) the classification of workplace violence is unclear.

Question 12

A patient who has a history of involvement with drugs and weapons comes up to you in the hallway and asks you a question regarding directions in treatment.When you respond,he moves closer in to you and puts both hands up on either side of your neck.No one else is in the hallway.Your best response at this point is to

A) yell at him to stop.
B) calmly ask the patient to remove his hands.
C) hit the patient in the midsection.
D) use pepper spray.

Question 13

Jorge and Carol,two of the RNs on Unit 22,are discussing recent incidents on the unit in which patients and visitors uttered threats or made demeaning remarks to staff during evening hours.Jorge observes that unless someone shoots at him,he is not concerned because "words can't hurt you." Jorge's remarks

A) illustrate common misperceptions about the nature of violence.
B) accurately depict the difference between violence and aggression.
C) are partially correct because verbal remarks do not cause injury.
D) reveal possible issues that Jorge relates to violence in his personal life.

Question 14

The Canadian Nurses Association (CNA)cites studies that suggest that intimidating and disruptive behaviours in the nursing profession contribute to

A) low morale.
B) preventable adverse outcomes.
C) an increase in power for leaders.
D) citations of leaders for not addressing workplace violence.

Question 15

At 3 a.m.,a man walks into your emergency department.He paces back and forth in the waiting area before he approaches staff to ask if he can see his wife,who is a patient on another floor.He speaks rapidly,his face is flushed,he glances around often,and he keeps his hand in his jacket pocket.A best initial response would be to

A)assess your situation and your surroundings.
B)ask two or three staff to assist in confronting the individual.
C)ask what floor his wife is on and remind him that visiting hours are over.
D)remain calm as there is no potential for violence here.

Question 16

Reza,RN,works as a staff nurse in the mental health department; Sharon works as a data entry clerk in the admissions department; Sarah is an emergency room physician; and Donna is a housekeeper in the geriatrics department.Which of these four is most at risk for violence and aggression?

A) Reza
B) Sarah
C) Sharon
D) Donna

Question 17

Delaney,one of your staff nurses,confides that Marjorie,another nurse,has been actively telling others that you are incompetent,that you do not know what you are doing in relation to patient care,and that you lie to the staff about attempts to get more staffing.Through telephone calls and conversations during breaks,she is recruiting other staff to her position.Delaney confides that most staff members find you fair,honest,and knowledgeable.Marjorie's behaviour can best be characterized as

A) political action.
B) bullying.
C) building alliances.
D) disgruntlement.

Question 18

Your health care organization places a high value on workplace safety and integrates this into all aspects of administrative and patient care processes.As a unit manager,you thoroughly endorse this direction,and during the selection and hiring of new staff,you consistently

A) refuse to hire applicants who are pushy during interviews.
B) thoroughly follow up with all references before offering a position.
C) ask applicants during the interview whether drug or alcohol abuse is a problem.
D) refuse to interview applicants with sporadic work histories.

Question 19

Jay,a newly graduated registered nurse (RN),has just begun work on an acute care nursing unit.As a nurse manager,you know that new graduates are most likely to experience

A) aggression.
B) horizontal violence.
C) physical violence.
D) vertical violence.

Question 20

Sabotage is an example of which type of violence?

A) Threatening behaviour
B) Written threat
C) Harassment
D) Verbal abuse

Question 21

A safety and security plan is important to a health care organization because it

A) specifies preventive measures in relation to violence.
B) provides direction as to changes in facilities that protect staff.
C) establishes expectations in relation to behaviour and tolerance of violence.
D) establishes policies and practices that guide prevention of violence and expectations in the workplace.

Question 22

Aishwarya is involved in intervening when a patient attempts to harm herself on the unit.During the interaction,the patient slaps Aishwarya across the face.It is important that the head nurse

A) offer Aishwarya immediate education and training in self-defence.
B) assist with follow-up documentation and offer access to counselling.
C) provide access to a lawyer.
D) encourage Aishwarya to perceive the incident as a normal part of care.

Question 23

In designing a new health care facility,it is particularly important to pay close attention to safety elements related to violence and aggression in which of the following settings? (Select all that apply)

A) Emergency
B) Psychiatry
C) Gerontology
D) Maternity-pediatric