Deck 14: Violent Behavior in Institutions

Question 1

Denial by both staff and institutions contributes to institutional violence.​

Answer 1

True

Question 2

Sun-up syndrome is so called because people become violent as they wake up in institutions,are not sure of their surroundings,and become confused and agitated.​

Answer 2

False

Question 3

Education of a client is the first stage of violence prevention in institutions.​

Answer 3

True

Question 4

Reminiscence therapy allows clients to reflect on their lives and restore credibility to them.​

Question 5

The safest way to monitor and control new clients for potential violence in a clinic or institution is for the admissions worker to check the client in and monito the client closely while waiting for unit staff to collect the client.​

Question 6

While the potential for people diagnosed with a mental illness to become violent is not high,there are some diagnoses,such as organic brain disease,that are associated with higher risk for violent actions.​

Question 7

A counseling office should be arranged so the therapist can keep the client confined if necessary.​

Question 8

When making a home visit where a potentially violent client may reside,once the door is opened it is best to stride purposively into the room stating clearly who you are and why you are there.​

Question 9

The major reason to conduct a security analysis is to determine what kind of alarm systems will be needed.​

Question 10

A past family history of violence is not a very good predictor of violence that a client may have in a larger,community,social context.​

Question 11

University counseling centers are prone to sacrifice safety concerns in an attempt to create a warm,caring,confidential atmosphere.​

Question 12

Drug use has not been found to be associated with violent behavior.​

Question 13

There is no clear way to predict when,where,and which clients will become violent,but the pooled clinical judgment of experienced human service workers is one of the better prediction tools.​

Question 14

When threatening conditions occur,at times,doing nothing may be the best approach.​

Question 15

The first step in preventing client-initiated violence in an institution is to obtain expert consultants to teach staff to physically control agitated persons.​

Question 16

Females are becoming more violent and in some studies have been found to be as likely to assault staff as males.​

Question 17

Workplace violence has become so bad that the National Center for Disease Control views it as a national health problem.​

Question 18

One of the best predictors of violence is past violence.​

Question 19

Workers who use validation therapy with the elderly believe that its use may resolve past issues and reduce stress even though the client may not make sense.​

Question 20

Staying physically close,within an arm's length of a client is safer because it psychologically anchors the client to the worker.​

Question 21

A primary component of option therapy is:​

A)deciding what medication will be used.
B)​deciding who will have control over the client's behavior.
C)​that it is only used in emergencies.
D)that it is completely up to the worker as to when it will be used.

Question 22

Validation therapy is used to indicate that the client:​

A)has valid concerns.
B)​is lucid and in touch with reality.
C)​affirms what s/he is saying even though it may have little basis in reality.
D)is about to become violent.

Question 23

The human service worker who wishes to deescalate a potentially violent confrontation with a client will:​

A)treat the client in a permissive fashion so as to avoid an incident.
B)​take an offensive posture that lets the client know the worker will not be intimidated.
C)​obtain support staff as a show of strength.
D)stay calm and relaxed while monitoring the client's movements and validating the client's perspective.

Question 24

Factors contributing to increased violence against human service workers are increased numbers of:​

A)drug abusing clients.
B)​hyperactive,attention deficit disordered clients.
C)​clients in poverty.
D)clients seeking quick solutions.

Question 25

Workers who experience a physical assault are best supported by giving them time off,giving staff new safety tips based on the incident,and moving beyond the incident compassionately but quickly.​

Question 26

Typical feelings of most clients who are "first timers" in a residential treatment facility might be:​

A)angry,but feeling that they are in control of the situation because they are tough.
B)​angry,frightened,and feeling that they are out of control.
C)​frightened,but compliant to treatment if dealt with fairly.
D)psychotic,out of touch with reality,and out of control.

Question 27

Appeasement is most appropriate:​

A)if client behavior is so bad that time out is necessary.
B)​if all else has failed.
C)​in emergency situations where the worker knows little about the client.
D)when the client has previously been friendly with workers.

Question 28

Confronting an agitated client:​

A)will only make the situation worse.
B)​is a therapeutic action to teach clients their place.
C)​should be done in a problem-solving manner.
D)should be avoided at all costs.

Question 29

Deflection of angry feelings may be accomplished by:​

A)physical activity and writing down feelings.
B)​going to time out and considering consequences.
C)​understanding such feelings are transitory in nature.
D)moving to less threatening topics.

Question 30

Research indicates that which of the following is generally not an antecedent to violent behavior?

A)Distraught family members who do not believe the client's needs are being met
B)​Certain times of day such as bedtime
C)​Release from a mental health treatment facility
D)A history of violent behavior

Question 31

Institutional culpability for poorly controlling violent behavior may be attributed to:​

A)much stronger client rights.
B)​a fear of being sued.
C)​too much publicity about violent events which are then "copycatted" by others.
D)restricted monetary expenditures.

Question 32

About the only major difference in safety considerations between a crisis worker in an office building and a crisis worker who makes home visits is that the worker who goes out to homes needs to be acutely aware of her or his surroundings.​

Question 33

One of the best and simplest questions to determine if the client may be violent is to ask,"Have you ever lost your temper in a violent manner?"​

Question 34

​In assessing for potential violence,the admissions worker in an institution should first:

A)make a fast visual assessment of the client's behavior.
B)​give the client a battery of psychological tests.
C)​ask the client what the problem is.
D)obtain biographical data.

Question 35

An appropriate response to a severely agitated client would include:​

A)"the staff is right,you've got to accept their judgment.They are professionals and know what is best for you."
B)​"I'll see what can be done about the problem.Just calm down!"
C)​"it's clear somebody has messed up.They have no right to treat you that way.You've a right to complain."
D)"I understand how angry you must be.Before I can do anything though,I need to hear you calmly and clearly tell me what's bothering you so I can determine what needs to be done."

Question 36

Reality orientation is:​

A)indicating what the consequences of clients' actions will be.
B)​reflecting clients' concerns about current problems.
C)​apprising clients of the rules of the institution.
D)anchoring clients as to who they are,where they are,and why they are there.

Question 37

Shifting away from angry feelings to less threatening topics is:​

A)validation.
B)​reminiscence.
C)​deflection.
D)avoidance.

Question 38

While both validation and reminiscence therapy are used extensively with the elderly,they are actually two very different approaches.

Question 39

Legal liability for the consequences of a violent act by an institutionalized client:​

A)may be commenced against a human service worker even if the worker was the one hurt.
B)​cannot be commenced if "Informed Consent" is issued and acknowledged.
C)​is generally only against the institution and seldom against the worker.
D)may happen only when the behavior is viewed as potentially lethal.

Question 40

After a violent incident,the institution may want to:​

A)do a disciplinary investigation to determine if there was negligence.
B)​conduct both Critical Incidents Stress Debriefing and a psychological autopsy.
C)​use flooding procedures to immediately get the staff member back on the job.
D)immediately return to business as usual and ignore this rare event.

Question 41

The two critical building areas to consider when checking for safety problems in an institution are:​

A)day rooms and hallways.
B)​admission areas and offices.
C)​client rooms and bathrooms.
D)parking lots and recreation areas.

Question 42

You have been tabbed by your boss to create a comprehensive institutional safety plan.Discuss how you will go about this task and what needs to be included in the plan.​

Question 43

You are a worker in a residential treatment program for behaviorally disruptive adolescents.Briefly describe the stages of intervention with a potentially violent individual.​

Question 44

When doing outreach,the best place to park your car for safety's sake would be:​

A)directly in front of the house.
B)​in the driveway of the house.
C)​just beyond the front of the house.
D)across the street and down the block.

Question 45

Of the following assumptions about the potential for violence,which does not belong? Assume that the individual:​

A)understands and conforms when negative contingencies are stated and used.
B)​feels a number of debilitating emotions.
C)​needs to have limits set and provide options that define consequences for violence.
D)is experiencing disconnectedness and rootlessness.

Question 46

You are a member of a mobile crisis unit.You have been dispatched to visit with a client in their home.What are the ways you will protect yourself in the field that are different from when you see clients in the hospital emergency department?​

Question 47

One of the best ways to assess for violent behavior when face-to-face with a client is to:

A)monitor motoric cues.
B)​obtain a family history of violent acts.
C)​find out about drug use.
D)determine if he or she is mentally ill.

Question 48

The best predictor of violence is:​

A)mental illness.
B)history of earlier violent behaviors.​
C)​time frames,such as during a full moon.
D)an understanding of each clients' personality.

Question 49

Of the following intervention strategies,which would be least likely to help prevent violence?​

A)Management's commitment to budgetary efficiency
B)​Management's commitment to security planning
C)​Doing a work-site analysis to boost staff morale
D)Providing inconsistent staff training in de-escalation

Question 50

An adequate and comprehensive security plan for an institution should:​

A)be simple enough to use.
B)​cover every possible contingency.
C)​ignore the needs and concerns of staff.
D)identify who,what,and where for disasters.

Question 51

Of the following drugs,which has been associated with more than half the violence in Emergency Rooms?​

A)Alcohol
B)​Barbiturates
C)​Cocaine and crack
D)Amphetamines