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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.
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Which of the following is most important to maintain therapeutic boundaries when working with aggressive clients?
- A. Encourage clients to express how the nurse can avoid causing emotional irritation.
- B. Discuss difficult patient care situations with a supervisor.
- C. Reflect on your actions that may have instigated the client's anger.
- D. Do not personalize a client's anger
Correct Answer: D
Rationale: Not personalizing the client's anger maintains therapeutic boundaries, ensuring objectivity, unlike shifting responsibility to the client or assuming personal fault.
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.
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.
The nurse is interviewing a client with a history of physical aggression. Which of the following should the nurse avoid?
- A. Anticipating that a loss of control is possible and planning accordingly
- B. Explaining the consequences the client will face if control is lost
- C. Interviewing the client with another staff member present
- D. Responding to verbal threats by terminating the interview and obtaining assistance
Correct Answer: B
Rationale: Explaining consequences may provoke hostility, unlike proactive safety measures like anticipating loss of control or having support, which are appropriate.
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.