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A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. Which would be the best approach for the nurse to use?
- A. Have a sense of humor to show a lack of fear.
- B. Provide close contact to increase the client's sense of safety.
- C. Use brief statements and questions to obtain information.
- D. Use open-ended questions, so the client can elaborate.
Correct Answer: C
Rationale: Brief statements and questions facilitate communication with an aggressive client who may struggle to express themselves, unlike humor or open-ended questions, which may escalate tension.
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The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse?
- A. Take an authoritative step between the two clients.
- B. Comfort the client huddled in the corner.
- C. Directly address both clients and ask what is going on.
- D. Engage the attention of the client who is still yelling and ask what is happening.
Correct Answer: D
Rationale: Engaging the dominant client de-escalates the situation by redirecting their focus, avoiding physical intervention or ignoring the aggressor's behavior.
A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately to prevent the client from moving to which phase of the aggression cycle?
- A. Triggering
- B. Escalation
- C. Crisis
- D. Recovery
Correct Answer: B
Rationale: The client's behaviors (pacing, clenched fists, swearing) indicate the escalation phase, and intervention aims to prevent progression to the crisis phase of physical aggression.
The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize which of the following?
- A. Decreased problem-solving ability
- B. Restlessness and irritability
- C. Remorse
- D. Severe muscle tension
Correct Answer: B
Rationale: Restlessness and irritability are early signs of anger, enabling proactive management, unlike decreased problem-solving or remorse, which occur later.
Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients?
- A. Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution.
- B. Nurses must not allow themselves to become angry, under any circumstances.
- C. Nurses must know that a client's anger or aggressive behavior is preventable by a skilled nurse.
- D. Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses.
- E. Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.
Correct Answer: A,D,E
Rationale: Self-awareness, consultation with experienced nurses, and a calm, nonjudgmental approach are critical for managing aggressive clients effectively, unlike preventing all anger or suppressing personal emotions.
Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses?
- A. Alzheimer's dementia
- B. Schizophrenia
- C. Anorexia nervosa
- D. Acute alcohol intoxication
- E. Generalized anxiety disorder
Correct Answer: A,B,D
Rationale: Clients with Alzheimer's dementia, schizophrenia, or acute alcohol intoxication may exhibit aggression due to cognitive impairments or delusions, requiring anger management, unlike anorexia or anxiety.