Exam 21: Variables Affecting the Therapeutic Environment: Violence and Suicide

Which principle guides nursing intervention in the assault cycle?

An experienced staff nurse describes feeling emotionally burdened and yet engages actively in gossip and spreading rumors about other staff members. The clinical nurse leader can assess these behaviors as consistent with:

A student tells the school nurse, "My friend threatened to take an overdose of pills." The nurse talks to the friend who verbalized the suicidal threat. Select the most critical question for the nurse to ask.

Sequence these expressions of suicidality from least to most acute. A) Threat B) Gesture C) Ideation D) Attempt E) Completion

A patient has entered the escalation phase of the assault cycle. Select the most appropriate nursing intervention.

Social-psychological models describe aggression as:

A patient with suicidal impulses is placed on suicide precautions. Which measures will the nurse incorporate into the plan of care? Select all that apply.

A tearful patient at the mental health center says, "I should be dead." What is the most important first task for the nurse in assessing this patient?

Which characteristic of an inpatient unit organizational culture predisposes the highest risk for patient violence and aggression?

A patient is becoming increasingly tense, pacing the hall, alternately whispering and shouting. Other patients receive hostile, suspicious glares as they walk by. Which phase of the assault cycle is the patient demonstrating?

A nurse counsels a patient who made a suicide attempt 3 days ago. Select the nurse's most therapeutic comment.

The nurse cares for a patient who was verbally aggressive upon admission. Three days later the patient says, "My family put me here. They wanted to get rid of me." When should the nurse be most vigilant for signs of escalating aggression?

Four individuals have suicide plans. Which plan evidences the highest risk for completed suicide?

The nurse in charge of a crisis team determines that a patient who has lost control requires restraint. What is the most important factor in the safe and effective use of physical restraint?

Which management practice should the clinical nurse leader of a psychiatric unit institute to enhance the therapeutic environment?