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Exam 20: Management of Anger, Aggression, and Violence

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Question 1

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A client has been admitted to the detoxification unit after binge drinking. The client is combative and exhibits altered thought processes even though the client is not currently intoxicated. Which nursing diagnosis would be the priority?

A) Risk for injury related to effects of alcohol abuse
B) Risk for self-mutilation related to alcohol withdrawal and altered thought processes
C) Risk for other-directed violence related to alcohol withdrawal
D) Risk for delayed development related to chronic effects of alcohol intoxication

E) B) and D)
F) A) and B)

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Question 2

Multiple Choice

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An advanced practice psychiatric nurse is preparing to conduct a support group for psychiatric-mental health nurses who have been assaulted by clients. What would the nurse need to keep in mind with this group?

A) Nurses experience a conflict between the role of caregiver and victim.
B) Nurses who are victims often go on to prosecute the client attackers.
C) Nurses actively express the feelings associated with client assaults.
D) Nurses as victims of client assaults rarely experience guilt or shame.

E) None of the above
F) A) and D)

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Question 3

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A nurse is caring for an older client in a residential care facility who has a history of alcohol abuse. The client has been extremely irritable the entire day. When modifying the client's plan of care, what would be an appropriate snack to offer the client to decrease the irritability?

A unit in an inpatient psychiatric facility is experiencing an increase in violence episodes by clients. A group of nurses working on this unit is developing a plan to address this issue. When developing this plan, which would the nurses address as the problem areas? Select all that apply.

An adult child brings a parent to the clinic and tells the nurse that the parent has begun to act strangely in the past few days, with unprovoked outbursts of anger. After the incidents, the parent expresses remorse for the outburst. The person says, "I've never seen my parent act this way." Which question would be most appropriate for the nurse to ask next?

A nurse is caring for a family whose older parent diagnosed with dementia is living in their home. The nurse has instructed the family about how to decrease the parent's agitation. The nurse determines that the child of the parent has understood the instructions when what statement is made?

A nurse is caring for an older adult client in a nursing home who has no history of violence but is agitated and appears ready to strike out at a staff member. The nurse would assess the client for which condition?

A group of nurses who are reviewing information about maladaptive anger demonstrate a need for additional study when they identify which physical condition as being linked to suppressed anger?

After working with a client who has a history of violent behavior to identify possible clues that suggest the behavior is escalating, the nurse and client develop a plan for prevention. Which strategy would they be least likely to include?

A nurse is reading a journal article about anger and violence. Which would the nurse expect to see as being linked to excessive, outwardly directed anger?

Which part of the history for a client who has been admitted to an inpatient psychiatric unit would the nurse identify as the strongest indicator of risk for violence?

After teaching a class about the general aggression model, a nurse determines that additional education is needed when the class identifies what as an interactive component of the model?

A nurse working with a potentially violent client in a community clinic would implement what intervention to minimize personal risk?

A psychiatric-mental health nurse is teaching a class of colleagues about anger, aggression, and violence. Which statement by the nurse would be most appropriate to include?

When assessing a client's anger, which would be important for a nurse to obtain? Select all that apply.

While talking with a client who has been experiencing aggression and intense anger, a nurse identifies that the client feels isolated and anxious. Which statement by the nurse would be most appropriate?

When assessing a client experiencing aggression, a nurse applies the general aggression model. What would the nurse assess as the person factors? Select all that apply.

The plan of care for a client demonstrating frequent anger includes behavioral interventions. What would the nurse be likely to find?

While interviewing a client, a nurse asks, "What do you do when you get angry?" Which client response would indicate to the nurse that the client engages in anger suppression?

A nurse is presenting an in-service program about aggression and violence to a group of newly hired nurses who will be working in an inpatient psychiatric facility. When describing characteristics that may predict the risk for violence and aggression in clients, which of the following would the nurse include? Select all that apply.