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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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A nurse is presenting an in-service program about aggression and violence to a group of newly hired nurses who will be working in an inpatient psychiatric facility. When describing characteristics that may predict the risk for violence and aggression in patients, which of the following would the nurse include? Select all that apply.
- A. Age
- B. Impulsivity
- C. Substance withdrawal
- D. Gender
- E. Suspiciousness
Correct Answer: A,B,C,D,E
Rationale: Age, impulsivity, substance withdrawal, gender, and suspiciousness are all predictors of violence risk. Younger age, male gender, impulsivity, withdrawal symptoms, and paranoia or suspiciousness increase the likelihood of aggressive behavior in psychiatric settings.
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.
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.
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.