Nokea
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.
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A client is clenching his fists and yelling at another client on the unit. He appears to be close to losing control of his anger. Which of the following actions by the nurse is appropriate at this time?
- A. Clear others out of the immediate area.
- B. Prepare a PRN sedative.
- C. Tell the client to stop and take a time-out.
- D. Alert the security department of an impending aggressive outburst.
Correct Answer: C
Rationale: Directing the client to take a time-out during the escalation phase is a least restrictive intervention to regain control, prioritizing de-escalation over sedatives or security.
At which point in the stages of aggressive incidents is intervention least likely to be effective in preventing physically aggressive behavior?
- A. Triggering
- B. Escalation
- C. Crisis
- D. Postcrisis
Correct Answer: C
Rationale: During the crisis phase, the client's loss of control makes intervention least effective for preventing physical aggression, unlike earlier triggering or escalation phases.
Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients?
- A. Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution.
- B. Nurses must not allow themselves to become angry, under any circumstances.
- C. Nurses must know that a client's anger or aggressive behavior is preventable by a skilled nurse.
- D. Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses.
- E. Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.
Correct Answer: A,D,E
Rationale: Self-awareness, consultation with experienced nurses, and a calm, nonjudgmental approach are critical for managing aggressive clients effectively, unlike preventing all anger or suppressing personal emotions.
A nurse is working with a client who has frequent angry outbursts. Which of the following statements is most helpful when working with this client?
- A. Anger is a normal feeling, and you can use it to solve problems
- B. You need to learn to suppress your angry feelings
- C. You can reduce your anger by hitting a punching bag
- D. You need to learn how to be less assertive in your communications
Correct Answer: A
Rationale: Validating anger as a normal emotion and encouraging its constructive use promotes problem-solving, unlike suppressing feelings, catharsis, or reducing assertiveness, which can worsen outcomes.
Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses?
- A. Alzheimer's dementia
- B. Schizophrenia
- C. Anorexia nervosa
- D. Acute alcohol intoxication
- E. Generalized anxiety disorder
Correct Answer: A,B,D
Rationale: Clients with Alzheimer's dementia, schizophrenia, or acute alcohol intoxication may exhibit aggression due to cognitive impairments or delusions, requiring anger management, unlike anorexia or anxiety.