126 prepu ch 11

A client is attending anger management class and wants to know how the class will help. What is the nurse's best response? "We need to explore what makes you want to hit people when you are angry." "It will help you to learn how to control the arousal of anger." "You will learn how to control your violent behavior." "You will be able to stop feeling angry when incidents happen out of your control."

"It will help you to learn how to control the arousal of anger." Explanation: It is unrealistic for someone to stop feeling angry altogether; however, the goal of anger management therapy can help a client learn how to control the arousal of anger. Anger management therapy is not utilized for clients who are violent when angry because it has not been found to be effective in modifying violent behavior.

Which term is used to describe an activity used to release anger? Anger Physical aggression Hostility Catharsis

Catharsis Explanation: Catharsis includes activities that provide a release of the anger. Hostility is an emotion expressed through verbal abuse, lack of cooperation, violation of rules or norms, or threatening behavior. Anger is a strong, uncomfortable, emotional response to a real or perceived provocation. Physical aggression is behavior in which a person attacks or injures another person or that involves destruction of property.

In which phase of the aggression cycle can techniques of seclusion or restraint be used to deal with the aggression quickly? Triggering Crisis Recovery Escalatio

Crisis Explanation: In the crisis phase, seclusion or restraint may be used to deal with aggression quickly

A client visits the clinic and tells the nurse that no matter how difficult the client's child acts, the client simply cannot express any anger. The nurse should plan to assess the client for symptoms of which mental health condition? Depression Panic disorder Manic behaviors Meneire's disease

Depression Explanation: Anger turned inward has frequently been associated with mood disorders, particularly depression. It has also been associated with essential hypertension, migraine headaches, psoriasis, rheumatoid arthritis, and Raynaud's disease.

The nurse is assessing a client who is aggressive. Which safety measures must the nurse ensure are in place prior to continuing the assessment? Select all that apply. Request the presence of additional staff. Give the client plenty of space. Encourage the client to talk about this situation Restrain the client. Sit in an open area

Give the client plenty of space. Sit in an open area Request the presence of additional staff. Explanation: While assessing an aggressive client, the nurse should give the client plenty of space, sit in an open area, and request the presence of another staff person. The nurse should not restrain the client by him- or herself, but rather get the client restrained by trained personnel. Encouraging the client to talk about the situation in which he or she has been aggressive should be done in the recovery phase of the anger cycle.

A nurse must assess for characteristics that are predictive of violent behavior. Research suggests violent behavior is influenced by possession of which attribute? Therapeutic relationship Mindfulness Assertive behavior Low self-esteem

Low self-esteem Explanation: Research suggests that particular characteristics are predictive of violent behaviors. Low self-esteem that may be further eroded during hospitalization or treatment may influence a client to use force to meet his or her needs or to experience some sense of empowerment.

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 Appreciation of the value of matching anger with anger Recognition of the reasons for the client's behavior Understanding the importance of non-response to escalating behavior

Self-awareness of reactions to aggression by others Explanation: Nurses' beliefs about themselves as individuals and professionals influence their responses to aggressive behaviors. The nurse's self-awareness of responses to anger, including fear of others' anger and any tendency to become angry, will help the nurse maintain composure and use good judgment. The nurse should not respond to negative emotions with similar emotions; the nurse must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior. The nurse can become more skilled in these techniques through practice and by observing more experienced staff. The response to aggression does not depend on understanding the client's thought processes.

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. The client is threatening to hit another client. The client is having an argument with a roommate. The client is having lunch with family members.

The client is sitting in the dayroom reading a book. Explanation: When the client is reading a book, the client may be amenable to the nurse's opening communication about managing anger. The optimal time to provide education for a client on techniques to manage anger and aggression is not when anger and violence are being exhibited. In those cases, the priority is to deescalate the situation and ensure the safety of everyone involved. Therefore, when the client is having an argument or threatening to hit someone else, that is not the best time to provide teaching. It is possible that the client will be receptive to teaching after an incident has resolved, when they may coached to reflect on the outcomes of their behavior and how things could have gone better. Eating lunch with family members is a social situation, and the client should not be interrupted for education until through socializing.

The nurse is demonstrating de-escalation techniques on an aggressive client in a forensic setting. Which is the best explanation of this technique?

You Selected: Increasing self-awareness of early signs of aggression Correct response: Resolution of anger in nonviolent ways Explanation: The primary goal of de-escalation is to resolve angry or violent conflicts in nonviolent ways. Stopping dangerous behavior by pointing out unacceptable behavior is behavior correction. Role modeling is one part of behavior correction. Early recognition involves increase client self-awareness of early signs of their aggressive behavior and reinforces self-management skills that decrease the likelihood of using aggression in future situations.

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? scheduled unit activities reduced use of restraints flexible unit rules strict hierarchy of authority

strict hierarchy of authority Explanation: Having a strict hierarchy of authority can be predictive of a client being aggressive or violent; others include having rigid, not flexible, unit rules. The unit having a lack of autonomy for clients which would include use of restraints or locked doors is also predictive of client aggression or violence. Another contributing factor would be having a lack of predictable and meaningful ward activities so if there are scheduled activities this would help reduce this potential for clients.