349 - Chap 14 Management of Anger and Aggression

A nurse is working with a client who has frequent angry outbursts. Which statement is most helpful when working with this client? "Anger is a normal feeling, and you can use it to solve problems." "You need to learn to suppress your angry feelings." "You can reduce your anger by hitting a punching bag." "You need to learn how to be less assertive in your communications.

"Anger is a normal feeling, and you can use it to solve problems."

What is a characteristic of unit culture that predicts client violence? rigid unit rules client autonomy client's control of the treatment plan conveyance of empathy

rigid unit rules

psychaitric-mental health nurse is assessing a nurse who was a victim of assault. Which finding would the nurse categorize as abehavioral, personal response to assault? Social withdrawal Depression Anger Apathy

social withdrawel

After teaching a class about aggression and violence, the instructor determines that the education was successful when the class states which of the following? All violence is aggressive. Aggression involves behavior directed inwardly. Aggression is primarily physical. Violence involves less forceful than aggression.

All violence is aggressive.

A psychiatric-mental health nurse is conducting a class for a community group about anger and violence. Which information would the nurse most likely include as a cultural myth about anger? Anger is a knee-jerk reaction to external events. Women experience anger as frequently as men. In societies that believe anger can be controlled, there are far fewer violent crimes than in America. Making an assertive request is more likely to lead to the desired outcome

Anger is a knee-jerk reaction to external events. Explanation: A cultural myth about anger is that anger is a knee-jerk reaction to external events. The other answer options are facts regarding anger.

Some people try to express their angry feelings by engaging in aggressive but safe activities, such as hitting a punching bag or yelling. Which of the following terms is used to describe an activity used to release anger? Hostility Anger Catharsis Physical aggression

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.

Which is a true statement regarding anger? Humans can choose to slow their reactions and to think and behave differently in response to various events. Men are angrier than women. People have to behave aggressively to get what they want. Anger behavior in adulthood is determined by temperament and childhood experiences.

Humans can choose to slow their reactions and to think and behave differently in response to various events.

A psychiatric-mental health nurse is assessing a fellow nurse who has been a victim of an assault. Which finding would the nurse identify as reflecting a physiologic professional response? Increased absenteeism with somatic issues Reduced confidence in judgment Consideration of job change Fear of potentially violent clients

Increased absenteeism with somatic issues

Which of the following statements is true about aggression and violence? Aggression is a manifestation of extreme violence. Instrumental aggression is premeditated and unrelated to immediate feelings. Aggression is only physical. All aggression is violent, but all violence is not aggressive.

Instrumental aggression is premeditated and unrelated to immediate feelings. Explanation: Instrumental aggression is premeditated and unrelated to immediate feelings of frustration or threat, as in acts committed in cold blood. Violence is extreme aggression and involves the use of strong force or weapons to inflict bodily harm to another person, sometimes fatally. Violence connotes greater intensity and destruction than aggression. Aggression can be verbal (sarcasm, insults, threats) or physical (property damage, slapping, hitting). All violence is aggressive, but not all aggression is violent.

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

When interacting with a client in the day room, the nurse determines that a violent outburst is imminent. Which would be most important for the nurse to do? Offer the client choices Obtain assistance from other staff members Confront the client Tell the client to calm down

Obtain assistance from other staff members

The nurse is demonstrating de-escalation techniques on an aggressive client in a forensic setting. Which is the best explanation of this technique? Stopping dangerous behavior by pointing out unacceptable behavior Increasing self-awareness of early signs of aggression Role modeling expected behavior by staff Resolution of anger in nonviolent ways

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.

A client is diagnosed with intermittent explosive disorder. A nurse would expect to administer what as part of the treatment plan? Serotonin norepinephrine reuptake inhibitors Selective serotonin reuptake inhibitors Monoamine oxidase inhibitors Atypical antipsychotics

Selective serotonin reuptake inhibitors

What would be appropriate for a client who is not a suitable candidate for psychoeducational anger management interventions? electroconvulsive therapy cognitive-behavioral therapy restraints relaxation therapy

cognitive-behavioral therapy Individuals who are not suitable candidates for a psychoeducational anger management intervention may benefit from cognitive-behavioral therapy (CBT) delivered by an advanced practice nurse or psychologist. CBT involves avoidance of provoking stimuli, self-monitoring regarding cues of anger arousal, stimulus control, response disruption, and guided practice of more effective anger behaviors. Relaxation training is often introduced early in the treatment because it strengthens the therapeutic alliance and convinces clients that they can indeed learn to calm themselves when angry. Electroconvulsive therapy would be used for clients with depression. Restraints are an option of last resort.

Usually there are precursors to aggression and violence. Which behaviors indicate an impending aggressive episode? Select all that apply. staring and eye contact raised tone and volume or voice anxiety pacing lethargy

staring and eye contact raised tone and volume or voice anxiety pacing

x According to Johnson's systematic review of the literature about violence on inpatient psychiatric units, what is a predictor of violence? suspiciousness age gender race

suspiciousness

The nurse is utilizing the general aggression model to determine what may have contributed to one client's violence toward a roommate. Which would be considered a situational factor? the client being called lazy by the roommate the client's work ethic the client's previous disagreement with the roommate the client feeling depressed about own progress

the client being called lazy by the roommate Explanation: The general aggression model is a framework that accounts for the interaction of cognition, affect, and arousal during an aggressive episode, which in this case is the client's violence toward a roommate. The situational factor is the actual insult- in this scenario, the client being called lazy. Cognition includes hostile thoughts and scripts; with this situation, this involves the client having a previous disagreement with the roommate. The client's affect involves the client feeling depressed; this could have contributed to the roommate thinking the client was lazy. The client's work ethic is a person factor that also could have contributed.