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A unit in an inpatient psychiatric facility is experiencing an increase in violence episodes by patients. A group of nurses working on this unit is developing a plan to address this issue. When developing this plan which of the following would the nurses most likely address as the problem areas? Select all that apply.
- A. Inconsistent unit activities
- B. Medication power struggles
- C. Empathetic staff response
- D. Clear set boundaries
- E. Little patient participation in treatment plan
Correct Answer: A,B,E
Rationale: Inconsistent unit activities, medication power struggles, and little patient participation in treatment plans can contribute to increased violence by creating uncertainty, conflict, or disengagement. Empathetic staff responses and clear boundaries are protective factors, not problem areas.
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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.
An advanced practice psychiatric nurse is preparing to conduct a support group for psychiatric-mental health nurses who have been assaulted by patients. Which of the following would the nurse need to keep in mind with this group?
- A. Nurses experience a conflict between the role of caregiver and victim.
- B. Nurses who are victims often go on to prosecute the patient attackers.
- C. Nurses actively express the feelings associated with patient assaults.
- D. Nurses as victims of patient assaults rarely experience guilt or shame.
Correct Answer: A
Rationale: Nurses assaulted by patients often experience a conflict between their caregiver role and victim status, leading to emotional distress. Prosecution is uncommon, feelings may not always be actively expressed, and guilt or shame are common, making A the most accurate.
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.
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.
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.