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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.
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Which one of the following statements about anger is most accurate?
- A. Anger is an abnormal human emotion that is always negative.
- B. It is best to express anger by whatever means possible to minimize its consequences
- C. Most men are socialized to suppress anger
- D. Anger awareness and expression are necessary for women's growth and development.
Correct Answer: D
Rationale: Anger awareness and expression are essential for women's growth, as they are often socialized to suppress it, unlike men; anger is normal, not always negative, and catharsis can escalate it.
A married man expresses to the nurse that his wife's frequent nagging angers him. The nurse role-plays assertive communication techniques with the husband. Which of the following indicates the husband understands how to use assertive techniques effectively?
- A. I really wish you would stop nagging me
- B. If you are not perfect either
- C. I feel unappreciated when you criticize me
- D. Are you telling me you want me to change?
Correct Answer: C
Rationale: Assertive communication uses 'I' statements to express specific feelings, like feeling unappreciated, fostering productive dialogue, unlike vague wishes or defensive questions.
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.
In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression?
- A. Getting as far away from him or her as possible
- B. Engaging the hostile person in dialogue
- C. Yelling at the client to settle down now
- D. Ensuring that the client gets his or her way
Correct Answer: B
Rationale: Engaging in dialogue de-escalates hostility by addressing the client's concerns, unlike yelling or conceding, which may escalate or reinforce negative behavior.
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.