Nokea
A nurse is working with a client who has frequent angry outbursts. Which of the following statements is most helpful when working with this client?
- A. Anger is a normal feeling, and you can use it to solve problems
- B. You need to learn to suppress your angry feelings
- C. You can reduce your anger by hitting a punching bag
- D. You need to learn how to be less assertive in your communications
Correct Answer: A
Rationale: Validating anger as a normal emotion and encouraging its constructive use promotes problem-solving, unlike suppressing feelings, catharsis, or reducing assertiveness, which can worsen outcomes.
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Which of the following is most important to maintain therapeutic boundaries when working with aggressive clients?
- A. Encourage clients to express how the nurse can avoid causing emotional irritation.
- B. Discuss difficult patient care situations with a supervisor.
- C. Reflect on your actions that may have instigated the client's anger.
- D. Do not personalize a client's anger
Correct Answer: D
Rationale: Not personalizing the client's anger maintains therapeutic boundaries, ensuring objectivity, unlike shifting responsibility to the client or assuming personal fault.
Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior?
- A. Planning group activities such as playing games
- B. Scheduling one-to-one interactions with the client
- C. Providing structure and consistency in the unit
- D. Avoiding discussions among clients on the unit
- E. Discouraging clients from negotiating solutions
Correct Answer: A,B,C
Rationale: Group activities, one-to-one interactions, and consistent structure foster a calm environment and reduce aggression, unlike avoiding discussions or negotiation.
Which is most likely to be the subject of an aggressive attack from a client with mental illness?
- A. Other people
- B. The client
- C. Animals
- D. Objects
Correct Answer: B
Rationale: Clients with mental illness are more likely to harm themselves than others, animals, or objects due to internal distress or self-directed aggression.
In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression?
- A. Getting as far away from him or her as possible
- B. Engaging the hostile person in dialogue
- C. Yelling at the client to settle down now
- D. Ensuring that the client gets his or her way
Correct Answer: B
Rationale: Engaging in dialogue de-escalates hostility by addressing the client's concerns, unlike yelling or conceding, which may escalate or reinforce negative behavior.
The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on which of the following?
- A. Client's mood
- B. Client's safety
- C. Court order
- D. Physician's order
Correct Answer: B
Rationale: Restraints are used when the client's safety is at risk and less restrictive measures fail, not based on mood, court, or physician orders alone.