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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.
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A patient has been admitted to the detoxification unit after binge drinking. Even though the patient is not currently intoxicated, he is combative and exhibits altered thought processes. Which nursing diagnosis would be the priority?
- A. Risk for Injury related to effects of alcohol abuse
- B. Risk for Self-Mutilation related to alcohol withdrawal and altered thought processes
- C. Risk for Other-Directed Violence related to alcohol withdrawal
- D. Risk for Delayed Development related to chronic effects of alcohol intoxication
Correct Answer: C
Rationale: The priority nursing diagnosis is 'Risk for Other-Directed Violence related to alcohol withdrawal,' as the patient?s combative behavior and altered thought processes pose an immediate risk to others. Safety is the primary concern in this scenario, outweighing risks for injury, self-mutilation, or developmental delays.
The nurse is reviewing the medical record of a patient who is experiencing aggressive and violent behavior for possible risk factors. Which of the following would the nurse identify? Select all that apply.
- A. Damage to the frontal lobe of the brain
- B. Low testosterone levels
- C. Family history of aggression
- D. Gender
- E. High level of competitiveness
Correct Answer: A,C
Rationale: Damage to the frontal lobe can impair impulse control, increasing aggression risk. A family history of aggression suggests genetic or environmental predisposition. Low testosterone is less associated with aggression, gender alone is not a specific risk factor, and competitiveness is not a direct predictor.
A nursing instructor is teaching a class of nursing students about anger, aggression, and violence. Which statement by the instructor would be most appropriate to include?
- A. Anger, aggression, and violence are points along a continuum.
- B. The terms used to describe anger are very precise.
- C. Anger is a knee-jerk reaction to external events.
- D. Women experience anger as frequently as men do.
Correct Answer: A
Rationale: Anger, aggression, and violence exist along a continuum, where anger can escalate to aggression and potentially violence if not managed. The other statements are less accurate: anger terms are not always precise, anger is not solely a knee-jerk reaction, and gender frequency is not the focus.
When assessing a patient experiencing aggression, the nurse applies the general aggression model. Which of the following would the nurse assess as the person factors? Select all that apply.
- A. Patient?s personality traits
- B. Insult initiating the behavior
- C. Previous behavior patterns
- D. Patient?s shouting
- E. Patient?s mood
- F. Patient?s gender
Correct Answer: A,C,E,F
Rationale: The general aggression model identifies person factors as internal characteristics, including personality traits, previous behavior patterns, mood, and gender. Insults are situational factors, and shouting is a behavior, not a person factor.
While interviewing a patient, a nurse asks, What do you do when you get angry? Which patient response would indicate to the nurse that the patient engages in anger suppression?
- A. I?ve been known to fly off the handle when I?m angry.
- B. People say I withdraw and pout about the problem.
- C. I usually approach the person directly to talk about it.
- D. I try to discuss how I?m feeling about it with a close friend.
Correct Answer: B
Rationale: Withdrawing and pouting indicate anger suppression, as the patient avoids expressing anger directly. Flying off the handle suggests explosive anger, while direct discussion or confiding in a friend indicates healthier anger expression.