Ch. 11: Anger, Hostility, and Aggression (Videbeck)

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?

"I will encourage my child to be age-appropriate independent." Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Psychosocial Theories, p. 177.

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?

"It is okay to feel angry when confronted with an angry client." Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Self-Awareness Issues, p. 185.

A client is attending anger management class and wants to know how the class will help. What is the nurse's best response?

"It will help you to learn how to control the arousal of anger." Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, RELATED DISORDERS, p. 177.

The nurse is assessing a client of an Eastern culture who is admitted due to the need for anger management. What question should the nurse ask to determine the effect of culture on the client's expression of anger?

"What did you learn about anger when growing up?" Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, COMMUNITY-BASED CARE, p. 184.

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?

"What works best is what fits the client and the situation." Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 183.

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?

Acting out Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Related Disorders, p. 177.

The nurse is planning the environment for a newly-admitted client with a history of violence toward others. Which modification would the nurse implement?

Confirm that the utility and storage rooms are kept locked. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 182.

What is an important nursing consideration when administering antipsychotic medications for the treatment of aggression in clients experiencing psychosis?

Antipsychotic medications are associated with the development of extrapyramidal side effects. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Treatment, p. 178.

Which term is used to describe an activity used to release anger?

Catharsis Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

The nurse in the inpatient mental health facility is caring for a new client with a history of aggressive behavior. Which action would the nurse take to promote safety and prevent violent behavior from this client?

Create a therapeutic milieu. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 181.

A client has lost emotional and physical control. The client is shouting, screaming, hitting others, and throwing objects. Which phase of the aggression cycle is this client expressing?

Crisis Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 177.

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?

Development of a therapeutic relationship Reference: Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

A nurse is leading an anger management group in an inpatient program. A client says, "I'm feeling really tense, and I'm fidgety today." What is the nurse's most appropriate response to the client's comment?

Explore what is underlying the client's physical and emotional state Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 183.

A client with aggressive behavior shows no psychotic symptoms. Which medication should the nurse expect to be ordered for this client?

Lorazepam Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, TREATMENT, p. 178.

A client with schizophrenia has been brought to the hospital in an agitated state. In order for the nurse to perform the initial assessment, which approaches should the nurse use to manage the situation? Select all that apply.

Monitor facial expressions, Monitor emotional responses, Ensure availability of assistance Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, TREATMENT, p. 181.

The client with a history of explosive outbursts becomes angry and states, "I am really getting angry." The nurse sees this as what?

Progress Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 183.

The nurse is caring for a client with dementia who has become increasingly agitated. Which is the best action for the nurse to perform?

Provide a snack and fluids frequently. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, TREATMENT, p. 178.

During which phase of the aggression cycle does the client regain physical and emotional control?

Recovery Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 182.

A nurse's response to aggressive behavior on the unit is influenced by which characteristic of the nurse?

Self-awareness of reactions to aggression by others Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, COMMUNITY-BASED CARE, p. 185.

Which behavior is considered inconsistent with the clinical picture of a client who is becoming increasingly aggressive?

Sobbing inconsolably Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

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?

The client is sitting in the dayroom reading a book. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

The nurse has been working with the client to develop impulse control over the previous 3 days. Which assessment finding supports that the plan of care was successful?

The client walks away from another client who insulted them. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Psychosocial theories, pp. 177-178.

The nurse is explaining the importance of expressing anger to a client. What should the nurse mention as the possible physical complications associated with suppressing anger? Select all that apply.

Ulcers, Coronary artery disease, Migraine headaches Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

To defuse a critical situation, the nurse can use the therapeutic communication techniques for which reason?

Try to clarify what has upset the client Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, COMMUNITY-BASED CARE, p. 185.

A nurse is considering using restraint and seclusion for a client who is acting out. Which is the primary guideline for the use of restraint and seclusion?

Use should be limited to emergencies in which the risk of a client physically harming self, staff, or others is imminent. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 183.

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?

Validation Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 183.

The nurse working in a psychology clinic finds that suppression of anger is more common in women than in men. What is the possible explanation for such a finding? Choose the best answer.

Women are expected not to express so-called negative feelings like anger. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ONSET AND CLINICAL COURSE, p. 176.

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 client for whom all other measures of safety have failed Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, TREATMENT, p. 178.

A psychiatric-mental health nurse is assessing a group of clients. Which client would be at the highest risk for violence towards others?

a client having paranoid delusions that others are out to get them Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Related Disorders, p. 177.

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 history of violent or aggressive behavior Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Assessment data, pp. 181-182.

The nurse is caring for a client with bipolar I disorder that is in the manic phase. Which sign of escalating behavior requires immediate intervention?

banging their head against the wall Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 182.

Which characteristics should a nurse observe a client for that may be predictive of aggression and violence? Select all that apply.

being suspicious, breaking unit rules, cting impulsive Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, TREATMENT, p. 179.

The psychiatric nurse is working in the triage area and has four clients to assess and transfer to the inpatient area for care. Which client should the nurse assess first?

client who is pacing the lobby stating "I am afraid of losing it" Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Plan of Care for a Client: Aggressive Behavior, pp. 180-181.

The nurse performs an admission assessment on a client who has been diagnosed with intermittent explosive disorder. The nurse anticipates which treatment will be part of the client's treatment plan?

cognitive-behavioral therapy Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Anger, p. 176.

After working with a client who has a history of violent behavior to identify possible clues that suggest the behavior is escalating, a nurse and the client develop a plan for prevention. Which strategies will the nurse be most likely to include? Select all that apply.

counting to 10, taking slow, deep breaths, taking a voluntary time out Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression.

The nurse is caring for a client diagnosed with depression. Which behavior(s) is anticipated when the client displays anger towards the nurse? Select all that apply.

expresses anger verbally, feels guilty for inappropriate anger reaction Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, CARE OF CLIENTS AT RISK FOR AGGRESSIVE BEHAVIOR, p. 177.

A nurse is caring for an older client in a residential care facility. The client has been extremely irritable the entire day. When modifying the client's plan of care, which snack(s) are appropriate to offer the client in order to decrease the irritability?

glass of milk, deviled eggs Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression.

The nurse is orienting a new staff member in an inpatient mental health unit when a client begins to act in a violent manner. The nurse should explain to the new staff member that some clients use violence and aggression to ...

have their needs met. Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, INTRODUCTION, p. 176.

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?

intermittent explosive disorder Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, RELATED DISORDERS, p. 177.

The nurse is assigned to care for a client who assaulted another nurse the previous day. Which behavior indicates that the nurse is having an issue providing care to the client?

limits contact with the client Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, COMMUNITY-BASED CARECOMMUNITY-BASED CARE, p. 184.

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?

strict hierarchy of authority Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, ETIOLOGY, p. 177.

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?

walking or talking with the client Videbeck, S, Psychiatric-Mental Health Nursing, 9th ed., Philadelphia, Wolters Kluwer, 2023, Chapter 11: Anger, Hostility, and Aggression, Anger, p. 176.