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An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following?
- A. Call for an emergency response from trained personnel.
- B. Approach the client and firmly say, 'Stop, put it down'
- C. Calmly call the client by name and encourage verbal expression of anger.
- D. Assist the client to use problem-solving techniques instead of aggression.
Correct Answer: A
Rationale: In the crisis phase, calling for trained personnel ensures safety, as verbal interventions or problem-solving are ineffective when physical aggression has begun.
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When interacting with a client in the day room, the nurse determines that a violent outburst is imminent. Which of the following should the nurse do first?
- A. Call for assistance.
- B. Give the client choices.
- C. Remove the other clients.
- D. Talk to the client calmly.
Correct Answer: A
Rationale: Calling for assistance prioritizes safety when a violent outburst is imminent, enabling subsequent interventions like removing others or calming the client.
Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior?
- A. Planning group activities such as playing games
- B. Scheduling one-to-one interactions with the client
- C. Providing structure and consistency in the unit
- D. Avoiding discussions among clients on the unit
- E. Discouraging clients from negotiating solutions
Correct Answer: A,B,C
Rationale: Group activities, one-to-one interactions, and consistent structure foster a calm environment and reduce aggression, unlike avoiding discussions or negotiation.
After an angry outburst, the client is tearful and remorseful. Which statement by the nurse would be most supportive?
- A. If you still need to work on your problem-solving skills
- B. I will not allow you to get that angry again.
- C. If you should not have let your anger buildup like you did
- D. What could you have done when you first started to feel angry?
Correct Answer: D
Rationale: Encouraging reflection on early anger management in the postcrisis phase supports learning, unlike lecturing or blaming the client.
A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. Which statement should the nurse make to explain the use of restraints to the client?
- A. The length of time you'll be in restraints is undetermined.
- B. The staff will monitor your behavior closely.
- C. This is what happens when you lose control.
- D. This is a means of keeping you and others safe.
Correct Answer: D
Rationale: Explaining restraints as a safety measure clarifies their purpose without implying punishment, unlike vague or punitive statements.
Which of the following statements about anger, hostility and aggression are accurate?
- A. Anger is an emotional response to a real or perceived provocation.
- B. Hostility stimulates the sympathetic nervous system.
- C. Physical aggression involves harming other persons or property.
- D. Anger, hostility, and physical aggression are normal human emotions.
- E. Hostility is also referred to as verbal aggression.
- F. Physical aggression often progresses to hostility.
Correct Answer: A,C,E
Rationale: Anger is an emotional response to provocation, physical aggression involves harm to people or property, and hostility is verbal aggression, but only anger is a normal emotion, and hostility may precede, not follow, aggression.