220 PrepU chpt 11

A client asks the nurse for a date with them when they are discharged. The nurse tells the client that it is against policy to date clients. The client yells obscenities at the nurse and hits the counter before stomping away. Which defense mechanism does the nurse document that the client is using? a. acting out b. repression c. denial d. projection

a

A new nurse asks the nurse manager about the best intervention to use when trying to de-escalate a potentially violent client. Which response would be most appropriate? a. "What works best is what fits the client and the situation." b. "You need to confront the client to show you are in charge." c. "Make sure that another colleague knows where you are at all times." d. "I've always had good results with medications."

a

A nurse's response to aggressive behavior on the unit is influenced by which characteristic of the nurse? a. Self-awareness of reactions to aggression by others b. Recognition of the reasons for the client's behavior c. Understanding the importance of non-response to escalating behavior d. Appreciation of the value of matching anger with anger

a

An adult client is being counseled in the clinic for anger outbursts. Which nursing intervention would be most effective at decreasing anger when the client is currently angry? a. walking or talking with the client b. instructing the client to punch a pillow c. instructing the client to punch a punching bag d. encouraging the client to yell at the wall

a

The nurse is caring for a client with dementia who has become increasingly agitated. Which is the best action for the nurse to perform? a. Provide a snack and fluids frequently. b. Place the client in their room with the door closed. c. Place the client in restraints in a chair by the nurse's station. d. Sedate the client with medication.

a

The recreational therapist plans to offer clients a punching bag to release tension in the exercise group. Which client should be counseled to participate in this activity with caution? a. client with a history of hostile behavior b. client with a diagnosis of borderline personality disorder (BPD) c. client with a diagnosis of major depressive disorder (MDD) d. client with visual hallucinations

a

Which behavior is considered inconsistent with the clinical picture of a client who is becoming increasingly aggressive? a. sobbing inconsolably b. staring with narrowed eyes into the eyes of another c. rigid posture with a clenched jaw d. pacing

a

An aggressive client has obtained a piece of sharp glass and holds it threateningly to prevent anyone from entering the room. What interventions can the nurse reasonably perform to ensure safety of the client, staff, and other clients? Select all that apply. a. Shift other clients to a safe place. b. Order the client to drop the glass in a firm, loud voice. c. Summon help from others. d. Remove the piece of glass from client. e. Step into the doorway to keep the aggressive client from leaving.

a, c

Anger management is likely to be included in the care of clients with which psychiatric diagnoses? Select all that apply. a. Alzheimer's dementia b. Anorexia nervosa c. Delirium d. Generalized anxiety disorder e. Acute alcohol intoxication

a, c, e

A nurse is beginning the process of providing therapy to a client with anger management problems. When implementing this therapy, which should occur first to promote optimal effectiveness? a. Avoidance of stimuli that provoke the anger b. Development of a therapeutic relationship c. Identification of measures to disrupt the anger response d. Client self-monitoring for anger cues

b

A client with aggressive behavior shows no psychotic symptoms. Which medication should the nurse expect to be ordered for this client? a. Valproate b. Lorazepam c. Carbamazepine d. Haloperidol

b

A nurse educator has executed an in-service about preventing workplace violence on a psychiatric mental-health unit. Which statement made by a nurse would indicate the need for further education? a. "We should be receiving ongoing education for violence precautions in our clients." b. "It is okay to feel angry when confronted with an angry client." c. "We will be practicing safe techniques when clients require seclusion or restraints." d. "It's important for nurses to remain nonjudgmental and nonpunitive when dealing with escalating clients."

b

A nurse has been a victim of assault by a client. Which physiologic response would the nurse exhibit to indicate that there was a more long-term consequence for this event? a. The nurse eats lunch alone every day at work. b. The nurse discusses the difficulty of being able to sleep at night. c. The nurse is seeking a job in another hospital. d. The nurse expresses that fear and anxiety are daily emotions.

b

The nurse on a mental health care area is concerned that the clients will react negatively to additional personnel who will be on the unit to paint the walls in the hallways. Which action would the nurse take to prevent clients from acting out? a. Tell the clients that until the work is done in the hallways, everyone is confined to their rooms. b. Explain the purpose of the extra personnel during a group session in the recreation room. c. State the reason for the workmen and ask the clients to treat them respectfully. d. Limit hallway traffic by permitting clients to walk to the recreation room one at a time.

b

The nurse states "I know this must be frightening for you" to a client who is angry and has a potential for violence. Which communication technique is the nurse utilizing with this statement? a. confrontation b. validation c. acceptance d. reflection

b

A nurse is working with a client who has lost unit privileges due to inappropriate behavior. Which statement by the nurse demonstrates appropriate offering of choices? a. "Would you like to have your family come visit you in your room today?" b. "Can you select an outfit to wear to group therapy?" c. "Would you rather go to the cafeteria or have dinner in the dayroom?" d. "Which activity would you like to participate in today?"

c

In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly? a. Escalation b. Triggering c. Crisis d. Recovery

c

The charge nurse on the inpatient psychiatric unit is considering how best to assign clients with a low potential for aggression to a nurse who is seven months pregnant. What client factor is most significant for the nurse to consider? a. feeling victimized or bullied b. content of visual or auditory hallucinations c. a history of violent or aggressive behavior d. pattern of substance abuse

c

The client with a history of explosive outbursts becomes angry and states, "I am really getting angry." The nurse sees this as what? a. controlling b. manipulation c. progress d. regression

c

The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on what? a. Physician's order b. Client's mood c. Client's safety d. Court order

c

The nurse is caring for a 17-year-old male client admitted for diagnosis and control of anger. Based upon the information in the medical record, for which condition would the nurse plan care for this client? a. borderline personality disorder b. low self-esteem c. intermittent explosive disorder d. chronic frustration

c

The nurse is caring for a group of clients on the behavioral health unit. Which client will the nurse prepare to intervene with seclusion and restraint? a. a client refusing to take a PRN medication when offered for agitation b. a client with a history of violence who is shouting at another client c. a client for whom all other measures of safety have failed d. a client observed pacing quickly on the unit

c

The nurse is planning education for a client who has exhibited aggression on techniques to manage anger. Which situation would be best for providing this education? a. The client is threatening to hit another client. b. The client is having lunch with family members. c. The client is sitting in the dayroom reading a book. d. The client is having an argument with a roommate.

c

The nurse leads an education session regarding the effect of suppressing anger on the body. Which statement by the client indicates a need for further teaching? a. "Being angry all the time overstimulates my nervous system." b. "Managing my anger might help my depression get better." c. "I need to stop feeling angry or I won't be healthy." d. "If I figure out how to lower my anger, it's healthier for me."

c

The nurses on a mental health unit are reviewing aspects of the unit environment in a staff meeting. Which factor would be predictive of a client becoming aggressive or violent? a. scheduled unit activities b. flexible unit rules c. strict hierarchy of authority d. reduced use of restraints

c

A client with a recent history of violence is admitted to a mental health facility for treatment. Which client statement indicates to the nurse that the client uses aggressive behavior to achieve a goal? a. "That man continues to nag me and I can't stand it anymore." b. "He provoked me to punch him." c. "She kept saying something that she knows pushes my buttons." d. "Breaking windows is the only way anyone pays any attention to me."

d

A parent of a child with poor impulse control is being counseled in an outpatient setting to adopt socially acceptable behavior. Which statement made by the parent demonstrates effective understanding? a. "I will do everything for my child so they can focus on better behavior." b. "I should be isolating my child until they learn better impulse control." c. "I will punish my child when they behave poorly." d. "I will encourage my child to be age-appropriate independent."

d

An adult client in the emergency department (ED) is being treated for acute pancreatitis. Upon assessment, the client is yelling, swearing, and demanding the staff to various tasks. Which phase in the aggression cycle does the nurse identify that the client is in? a. crisis b. recovery c. triggering d. escalation

d

The nurse is caring for a client hospitalized in an inpatient psychiatric setting for a history of violent behaviors and delusions. The nurse should instruct the client's family that aggression has been linked to low levels of which bodily chemical? a. Acetylcholine b. Endorphin c. Estrogen d. Serotonin

d

What is an important nursing consideration when administering antipsychotic medications for the treatment of aggression in clients experiencing psychosis? a. Benztropine should be administered with benzodiazepines. b. Benzodiazepines are best for psychosis. c. Conventional antipsychotics are considered more effective. d. Antipsychotic medications are associated with the development of extrapyramidal side effects.

d

Which personality trait is associated with aggressive behavior? a. Pessimism b. Lying c. Self-centeredness d. Impulsivity

d

Which term is used to describe an activity used to release anger? a. Hostility b. Physical aggression c. Anger d. Catharsis

d