Question 1

The patient on the mental health unit who should be assessed as being at highest risk for directing violent behavior toward others is the patient who has:

Accepted Answer

A)  obsessive-compulsive disorder and performs many rituals. 
B)  paranoid delusions of being followed by the Mafia. 
C)  severe depression with feelings of worthlessness and self-loathing. 
D)  completed alcohol withdrawal and is now in a rehabilitation program. 
A)  obsessive-compulsive disorder and performs many rituals. 
B)  paranoid delusions of being followed by the Mafia. 
C)  severe depression with feelings of worthlessness and self-loathing. 
D)  completed alcohol withdrawal and is now in a rehabilitation program.

Question 2

A newly admitted patient required seclusion immediately on entering the inpatient unit.His assessment was incomplete,and no medical orders had been written.Immediately after secluding the patient,the priority action of the nurse should be to:

Accepted Answer

A)  provide a chance for the patient to use the bathroom. 
B)  notify the physician and obtain an order for seclusion. 
C)  complete necessary forms and notify the unit manager. 
D)  debrief the staff and any witnesses to the incident. 
A)  provide a chance for the patient to use the bathroom. 
B)  notify the physician and obtain an order for seclusion. 
C)  complete necessary forms and notify the unit manager. 
D)  debrief the staff and any witnesses to the incident.

Question 3

A head nurse is concerned about the frequency of patient violence on her unit.Which of the following actions would be likely to reduce such incidents? Select all that apply.

Accepted Answer

A)  Encourage staff to have numerous,brief,nondirective interactions with all patients starting at admission. 
B)  Increase the percentage of males working on the unit so that the male presence will inhibit violent behavior. 
C)  Make sure a thorough assessment of risk for violence is completed on all patients at admission. 
D)  Train staff to implement seclusion and restraint promptly when a patient shows signs of escalating aggression. 
E)  In supervision,facilitate self-awareness regarding staff's feelings about violence and any possible nontherapeutic responses that might result from these feelings. 
A)  Encourage staff to have numerous,brief,nondirective interactions with all patients starting at admission. 
B)  Increase the percentage of males working on the unit so that the male presence will inhibit violent behavior. 
C)  Make sure a thorough assessment of risk for violence is completed on all patients at admission. 
D)  Train staff to implement seclusion and restraint promptly when a patient shows signs of escalating aggression. 
E)  In supervision,facilitate self-awareness regarding staff's feelings about violence and any possible nontherapeutic responses that might result from these feelings.

Question 4

A newly admitted patient required seclusion immediately on entering the inpatient unit.What criteria would the nurse use to decide when to discontinue the use of seclusion?

Accepted Answer

A)  Seclusion can be discontinued when the patient seems calm. 
B)  Discontinuation is based on outcomes developed for each patient. 
C)  Seclusion continues until the patient has been calm for at least 4 hours. 
D)  Seclusion lasts until the physician orders its discontinuation. 
A)  Seclusion can be discontinued when the patient seems calm. 
B)  Discontinuation is based on outcomes developed for each patient. 
C)  Seclusion continues until the patient has been calm for at least 4 hours. 
D)  Seclusion lasts until the physician orders its discontinuation.

Question 5

An elderly patient with multi-infarct dementia is striking out with her arms and kicking at people who walk past in the hall.After making contact with the patient,which intervention would be most appropriate?

Accepted Answer

A)  Administering PRN sedation to calm the patient. 
B)  State: "You may not hit others;you are safe here." 
C)  Distract the patient into playing a board game. 
D)  State: "I notice you are trying to hit people." 
A)  Administering PRN sedation to calm the patient. 
B)  State: "You may not hit others;you are safe here." 
C)  Distract the patient into playing a board game. 
D)  State: "I notice you are trying to hit people."

Question 6

Which statement about aggression would accurately serve as a basis for care planning?

Accepted Answer

A)  Brain injury or disorders are often blamed for,but rarely contribute to,violence. 
B)  Some people are biologically predisposed to become irritated or angry more easily. 
C)  Aggression is an innate behavior rather than a learned response to frustration. 
D)  Mature persons with patterns of effective coping almost never behave violently. 
A)  Brain injury or disorders are often blamed for,but rarely contribute to,violence. 
B)  Some people are biologically predisposed to become irritated or angry more easily. 
C)  Aggression is an innate behavior rather than a learned response to frustration. 
D)  Mature persons with patterns of effective coping almost never behave violently.

Question 7

A patient who had abdominal surgery has been hospitalized for 4 days.He has no history of psychiatric disorder but is described by his family as having "always been a difficult person who blames others for everything that goes wrong." From the day of admission,he has verbally abused the nurses for their inability to provide care that keeps him pain free and comfortable.Which history most likely explains this style of coping?

Accepted Answer

A)  Child-rearing that did not teach respect for others 
B)  Exposure to violent role models in the media 
C)  A personality style that externalizes problems 
D)  Increased levels of the neurotransmitter serotonin 
A)  Child-rearing that did not teach respect for others 
B)  Exposure to violent role models in the media 
C)  A personality style that externalizes problems 
D)  Increased levels of the neurotransmitter serotonin

Question 8

A patient requires as-needed sedation.What would the nurse keep in mind when choosing a PRN sedative for an agitated patient?

Accepted Answer

A)  Intramuscular injection can be traumatic,so oral meds should be used where possible. 
B)  Benzodiazepines are less sedating but have the advantage of no side effects. 
C)  Lithium carbonate works well but only for those already taking regular daily dosages. 
D)  Diazepam (Valium)is the preferred benzodiazepine because it is a short-acting sedative. 
A)  Intramuscular injection can be traumatic,so oral meds should be used where possible. 
B)  Benzodiazepines are less sedating but have the advantage of no side effects. 
C)  Lithium carbonate works well but only for those already taking regular daily dosages. 
D)  Diazepam (Valium)is the preferred benzodiazepine because it is a short-acting sedative.

Exam 25: Anger, Aggression, and Violence

The patient on the mental health unit who should be assessed as being at highest risk for directing violent behavior toward others is the patient who has:

A newly admitted patient required seclusion immediately on entering the inpatient unit.His assessment was incomplete,and no medical orders had been written.Immediately after secluding the patient,the priority action of the nurse should be to:

A head nurse is concerned about the frequency of patient violence on her unit.Which of the following actions would be likely to reduce such incidents? Select all that apply.

A newly admitted patient required seclusion immediately on entering the inpatient unit.What criteria would the nurse use to decide when to discontinue the use of seclusion?

An elderly patient with multi-infarct dementia is striking out with her arms and kicking at people who walk past in the hall.After making contact with the patient,which intervention would be most appropriate?

Which statement about aggression would accurately serve as a basis for care planning?

A patient requires as-needed sedation.What would the nurse keep in mind when choosing a PRN sedative for an agitated patient?

Mental Health and Mental Illness

Relevant Theories and Therapies for Nursing Practice

Biological Basis for Understanding Psychotropic Drugs

Psychiatric Mental Health Nursing in Acute Care Settings

Psychiatric Mental Health Nursing in Community Settings

Cultural Implications for Psychiatric Mental Health Nursing

Legal and Ethical Guidelines for Safe Practice

The Nursing Process and Standards of Care for Psychiatric Mental Health Nursing

Therapeutic Relationships

Communication and the Clinical Interview

Understanding Responses to Stress

Anxiety and Anxiety Disorders

Depressive Disorders

Bipolar Disorders

Schizophrenia

Eating Disorders

Cognitive Disorders

Addictive Disorders

Personality Disorders

Sleep Disorders

Sexual Dysfunction and Sexual Disorders

Somatoform, Factitious, and Dissociative Disorders

Crisis and Disaster

Suicide

Child, Older Adult, and Intimate Partner Abuse

Sexual Assault

Disorders of Children and Adolescents

Psychosocial Needs of the Older Adult

Serious Mental Illness

Psychological Needs of Patients With Medical Conditions

Care for the Dying and for Those Who Grieve

Forensic Psychiatric Nursing

Therapeutic Groups

Family Interventions

Integrative Care

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