Nokea
A patient with a history of anger and impulsivity is hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolds the nurse for 'not knowing enough to give me pain medicine when I need it.' Which intervention would best address this problem?
- A. Tell the patient to notify the nurse 30 minutes before the pain returns so the medication can be prepared.
- B. Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.
- C. Tell the patient that verbal assaults on nurses will not shorten the wait for pain medication.
- D. Have the clinical nurse leader request a psychiatric consultation.
Correct Answer: B
Rationale: Scheduling the medication at specific intervals will help the patient anticipate when the medication can be given. Receiving the medication promptly on schedule, rather than expecting nurses to anticipate the pain level, should reduce anxiety and anger. The patient cannot predict the onset of pain before it occurs.
You may also like to solve these questions
The staff development coordinator plans to teach use of physical management techniques when patients become assaultive. Which topic should be emphasized?
- A. Practice and teamwork
- B. Spontaneity and surprise
- C. Caution and superior size
- D. Diversion and physical outlets
Correct Answer: A
Rationale: Intervention techniques are learned behaviors that must be practiced to be used in a smooth, organized fashion. Every member of the intervention team should be assigned a specific task to carry out before beginning the intervention. The other options are useless if the staff does not know how to use physical techniques and how to apply them in an organized fashion.
Because an intervention is required to control a patient's aggressive behavior, a critical incident debriefing takes place. Which topics should be the focus of the discussion? (Select all that apply.)
- A. Patient behavior associated with the incident
- B. Genetic factors associated with aggression
- C. Intervention techniques used by staff
- D. Effect of environmental factors
- E. Review of theories of aggression
Correct Answer: A,C,D
Rationale: The patient's behavior, the intervention techniques used, and the environment in which the incident occurred are important to establish realistic outcomes and effective nursing interventions. Discussing the views about the theoretical origins of aggression is less effective.
An adult patient assaulted another patient and was restrained. One hour later, which statement by this restrained patient necessitates the nurse's immediate attention?
- A. I hate all of you!'
- B. My fingers are tingly.'
- C. You wait until I tell my lawyer.'
- D. It was not my fault. The other patient started it.'
Correct Answer: B
Rationale: The correct response indicates impaired circulation and necessitates the nurse's immediate attention. The incorrect responses indicate that the patient has continued aggressiveness and agitation.
Which scenario predicts the highest risk for directing violent behavior toward others?
- A. Major depressive disorder with delusions of worthlessness
- B. Obsessive-compulsive disorder; performing many rituals
- C. Paranoid delusions of being followed by a military attack team
- D. Completion of alcohol withdrawal and beginning a rehabilitation program
Correct Answer: C
Rationale: The correct answer illustrates the greatest disruption of ability to perceive reality accurately. People who feel persecuted may strike out against those believed to be persecutors. The patients identified in the distractors have better reality-testing ability.
A cognitively impaired patient has been a widow for 30 years. This patient is frantically trying to leave the unit, saying, 'I have to go home to cook dinner before my husband arrives from work.' To intervene with validation therapy, what should the nurse first say?
- A. You must come away from the door.'
- B. You have been a widow for many years.'
- C. You want to go home to prepare your husband's dinner?'
- D. Was your husband angry if you did not have dinner ready on time?'
Correct Answer: C
Rationale: Validation therapy meets the patient 'where she or he is at the moment' and acknowledges the patient's wishes. Validation does not seek to redirect, reorient, or probe. The incorrect options do not validate the patient's feelings.