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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.
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The nurse is working with a potentially violent patient in a community clinic. Which of the following would the nurse implement to minimize personal risk?
- A. Using protective devices
- B. Staying close to a door
- C. Keeping the door closed to ensure privacy
- D. Wearing inexpensive jewelry to distract the patient
Correct Answer: B
Rationale: Staying close to a door allows the nurse to exit quickly if the situation escalates, minimizing personal risk. Protective devices may not be practical, closing the door reduces escape options, and wearing jewelry could increase risk by attracting attention.
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.
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.
After working with a patient who has a history of violent behavior to identify possible clues that suggest that his behavior is escalating, the nurse and patient develop a plan for prevention. Which strategy would they be least likely to include?
- A. Counting to 10
- B. Taking slow deep breaths
- C. Turning up the music loud
- D. Taking a voluntary time out
Correct Answer: C
Rationale: Turning up the music loud could overstimulate the patient and escalate agitation, making it an ineffective prevention strategy. Counting to 10, deep breathing, and voluntary time-outs are calming techniques that help de-escalate potential violence.
A group of nursing students is reviewing information about maladaptive anger. The students demonstrate a need for additional study when they identify which condition as being linked to suppressed anger?
- A. Coronary heart disease
- B. Arthritis
- C. Hypertension
- D. Breast cancer
Correct Answer: B
Rationale: Suppressed anger is linked to coronary heart disease, hypertension, and some cancers, but arthritis is not typically associated with it. The students? identification of arthritis indicates a misunderstanding, as it is more related to physical or autoimmune factors than emotional suppression.