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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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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.
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.
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.
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.
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.