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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.
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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.
The nurse is caring for an older patient in a residential care facility. The patient has been extremely irritable the entire day. When modifying the patient?s plan of care, which of the following would be an appropriate snack to offer the patient to decrease the irritability?
- A. Chocolate candy bar
- B. Handful of raisins
- C. Granola bar
- D. Glass of milk
Correct Answer: D
Rationale: A glass of milk is an appropriate snack for an older patient experiencing irritability. Milk contains tryptophan, which can promote calmness by aiding serotonin production. Chocolate candy bars and granola bars may contain high sugar, potentially worsening irritability, while raisins, though healthy, lack the calming nutrients found in milk.
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.
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.
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.