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A nurse is presenting an in-service program about aggression and violence to a group of newly hired nurses who will be working in an inpatient psychiatric facility. When describing characteristics that may predict the risk for violence and aggression in patients, which of the following would the nurse include? Select all that apply.
- A. Age
- B. Impulsivity
- C. Substance withdrawal
- D. Gender
- E. Suspiciousness
Correct Answer: A,B,C,D,E
Rationale: Age, impulsivity, substance withdrawal, gender, and suspiciousness are all predictors of violence risk. Younger age, male gender, impulsivity, withdrawal symptoms, and paranoia or suspiciousness increase the likelihood of aggressive behavior in psychiatric settings.
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While talking with a patient who has been experiencing aggression and intense anger, the nurse identifies that the patient feels isolation and anxious. Which statement by the nurse would be most appropriate?
- A. This must be scary for you.
- B. Once you relax, things will improve.
- C. I really understand how you feel.
- D. If you calm down, I can help you.
Correct Answer: A
Rationale: Acknowledging the patient?s fear validates their emotions and builds rapport, which is therapeutic for someone feeling isolated and anxious. The other statements may dismiss the patient?s feelings or imply they must change before receiving help, which could escalate agitation.
The nurse is caring for a family whose older father with dementia is living in their home. The nurse has instructed the family about how to decrease the father?s agitation. The nurse determines that the son has understood the nurse?s instructions when he states which of the following?
- A. Restraints can help reduce my father?s agitation.
- B. I should place my father in the bedroom with me so I can watch him more closely.
- C. It?s important that he gets out shopping with me or my wife.
- D. If I simplify our home environment, my father may be less agitated.
Correct Answer: D
Rationale: Simplifying the home environment reduces sensory overload, which can decrease agitation in patients with dementia. Restraints can increase agitation, close monitoring in a bedroom may not address triggers, and shopping outings may overstimulate the patient.
The plan of a care for a patient with anger includes behavioral interventions. Which of the following would the nurse be likely to find?
- A. Self-monitoring of cues
- B. Anger management
- C. Relaxation training
- D. Response disruption
Correct Answer: A
Rationale: Self-monitoring of cues is a common behavioral intervention to help patients recognize triggers and manage anger before it escalates. While anger management and relaxation training are also relevant, self-monitoring is a specific, proactive strategy likely included in the care plan.
The nurse is assessing a group of patients on an inpatient psychiatric unit. The patient?s history for which of the following would the nurse identify as the strongest indicator of risk for violence?
- A. Panic disorder
- B. Problematic anxiety
- C. Somatoform disorder
- D. Violent behavior
Correct Answer: D
Rationale: A history of violent behavior is the strongest indicator of future violence risk, as past behavior is a reliable predictor of future actions in psychiatric assessments. Panic disorder, problematic anxiety, and somatoform disorder may contribute to emotional distress but are not as directly correlated with violent behavior.
A son brings his father to the clinic and tells the nurse that his father has begun to act strangely in the past few days and has unprovoked outbursts of anger. After the incidents, the father expresses remorse for his outburst. The son says, I?ve never seen him act this way. Which question would be most appropriate for the nurse to ask next?
- A. Does your father have a history of an anxiety disorder such as panic disorder?
- B. Has your father exhibited previous problems expressing anger appropriately?
- C. Has your father suffered any traumatic injury to his brain recently?
- D. Has your father injured the back of his head or neck in the past week?
Correct Answer: C
Rationale: Asking about recent traumatic brain injury is most appropriate, as sudden behavioral changes, such as unprovoked anger outbursts in an older adult with no prior history, may indicate a neurological issue, such as a brain injury. The other options are less likely to explain the sudden onset of symptoms.