Exam 25: Anger, Aggression, and Violence

An intramuscular dose of antipsychotic medication needs to be given to a patient who is becoming increasingly more aggressive.The patient is in the day room.Which intervention would be safest and most appropriate?

Which characteristics of the unit milieu are most likely to result in a low incidence of violent behavior?

A patient on a medical unit has a history of hostile and menacing behavior toward staff and sometimes even strikes them.Which plan would be best for forestalling such incidents?

Which situation would involve the highest risk for violence?

A patient is ready to be released from leather four-point restraints (restraints on both wrists and both ankles).Place the following actions involved in releasing a patient from restraints in their correct order. A) Maintain the patient in seclusion and reassess. B) Complete the removal of the restraints. C) Continue to observe the patient closely. D) Reassess the patient for safety. E) Release one ankle from restraint. F) Remove the patient from seclusion.

When a patient's aggression quickly escalates,on which principle should nursing intervention be based?

The emergency department nurse realizes that the husband of a patient appears increasingly irritable as he waits alone in the waiting room.Which intervention would best prevent further escalation?

A patient is pacing the hall near the nurses' station,swearing loudly.An appropriate initial intervention for the nurse would be to address the patient by name and say:

A nurse deciding whether or not to place an agitated patient in seclusion or restraints would need to keep in mind that:

A patient being treated in the burn injury unit has demonstrated good coping skills for several weeks.Today,a new nurse is assigned to care for him and has proven to be poorly organized.The patient's usual schedule has not been followed,and by midafternoon,he is angry and raises his voice to complain to the nurse clinician.Which course of action for the nurse clinician would be best?

A cognitively impaired patient who has been a widow for 30 years is frantically trying to leave the unit,saying,"I have to go home to start dinner before my husband comes home from work." To intervene with validation therapy,the nurse should say:

An elderly patient with multi-infarct dementia is striking out with her arms and kicking at people who walk past in the hall.The nurse determines that the patient believes she is at home and that the other patients have broken into her home.The clinical nurse specialist suggests that staff use validation.Which of the following responses reflect this intervention?

A patient who is known to be angry and impulsive is hospitalized after an automobile accident in which he sustained severe orthopedic injuries.When in pain,he loudly berates nursing staff,saying,"You jerks don't even know enough to give a patient pain medicine when he needs it." The patient's nursing diagnosis is Ineffective coping.Which nursing intervention would best address this situation?

A patient who has been seen responding to auditory hallucinations earlier in the morning approaches the nurse and shakes his fist,saying,"Back off,bitch!" and then goes into the day room.Which intervention would be most important to undertake before the nurse follows the patient into the day room?

An elderly patient with multi-infarct dementia is striking out with her arms and kicking at people who walk past in the hall.Intervention by the nurse should begin by:

A patient with severe orthopedic injuries after an automobile accident is irritable,angry,and belittles the nurses who provide his care.While the nurse is changing the dressing over a deep laceration,the patient screams,"Don't touch me! You are so stupid;you're only making it worse!" Which intervention would be most therapeutic?

Which information noted in a patient's history most suggests a need for careful assessment of risk for violence in a newly admitted medical patient?

A patient who has been seen responding to auditory hallucinations earlier in the morning approaches the nurse and shakes his fist,saying,"Back off,bitch!" and then goes into the day room.The nurse follows the patient into the day room.Which intervention would be best at this time?

A patient is admitted for psychiatric observation after being arrested for breaking windows in the home of his former girlfriend,who had refused to see him.His history reveals abuse as a child by a punitive father,torturing family pets,and one arrest for disorderly conduct.The priority nursing diagnosis that should be considered is:

A patient has sat in stony silence in the day room for 20 minutes after her appointment with her psychiatrist.She appears tense and vigilant.The nurse sees the patient abruptly stand up and pace back and forth across the day room,clenching and unclenching her fists.She then stops and stares intently into the face of the psychiatric technician seated at a table.The priority assessment that should be made is that the patient is: