Exam 23: Preventing Workplace Violence

An emergency department (ED) client is demanding pain medication and threatening to harm staff if they do not provide it. The ED physician calmly continues to ask the client about the level and location of pain as the nurse steps away and notifies security. What is the physician attempting to do by asking these questions?

As part of a presentation on health care workplace violence, the speaker says, "Injuries to nurses from violent acts in the workplace are probably underreported." What rationale should the speaker offer for this statement?

A nurse enters a client's room and sees a visitor threatening the client. The nurse questions the visitor in a nonthreatening manner. The visitor begins to threaten the nurse. What should the nurse do in this situation?

The emergency department (ED) staff has been caring for a client who exhibited violent behavior when pain medication was denied. Once the situation was resolved, which action by the ED manager would be appropriate?

A nursing supervisor is seeking staff input while developing policies regarding violence prevention. A staff nurse says, "We have lots of threatening behaviors on our unit." What is the most important question for the supervisor to ask?

A hospital's safety committee has been asked to make recommendations to administration regarding methods to improve employee safety. Which suggestions should be made?

When a nurse enters the room, the client states, "He has a gun," and points toward a male visitor. The nurse does not see a gun. What should the nurse do?

A staff nurse is known for having temper tantrums when the unit is stressful. The nurse slams doors, grumbles, and is demeaning to coworkers. The behavior has never been violent, but today it is becoming more threatening. The nurse just came into the station and said, "My nurse assistant is stupid. I'm not going to put up with that much longer. She needs to be put in her place." How should the manager respond to this situation?

The ICU staff has been dealing with several distractions over the last week. There was a scheduling error caused by a change in the staffing matrix and miscommunication between management and administration. The staff is also caring for a client whose family has been verbally abusive and threatening. The manager notes an increase in absenteeism with the staff over the past 2 days. To which of these distractions is the absenteeism most likely related?

The nurse appears in the nursing station with multiple facial lacerations and says, "A visitor hit me." What is the manager's priority action?

A highly intoxicated client is brought to the emergency department. Paramedics report that the client was violent during transport and tried to kick the door out of the ambulance. How should the nurse prepare before seeing this client?

A nurse manager has required that all nursing staff attend an in-service on dealing with verbal threats. A staff nurse wonders why this is necessary since, "Words don't hurt me. I just ignore them." What is the nurse manager's most appropriate response to this statement?

The nurse has just been notified that a client is to be admitted from the emergency department (ED) with a diagnosis of alcohol intoxication. The ED nurse says they have been unable to obtain much history because of the client's lethargic state. Which action is an appropriate intervention by the nurse?

A newly formed task force is addressing the prevention of violence in the health care organization. Which group of employees is most likely to experience violence?

Two nurses are in the day room when a visitor approaches and starts yelling about the care his mother is receiving. One nurse says, "I'm sorry you are upset. What can I do for you?" The visitor continues to complain more loudly. What should the other nurse do?

The nurse is caring for a client who is aggressive, demanding, and verbally abusive toward staff and visitors. The client says, "I'm getting out of here. I'm going to end it all." What immediate action should the nurse take?

A chief nurse officer (CNO) is contacted by the organization's supervisor on a Saturday night regarding a problem in the hospital's emergency department. The supervisor describes an incident in which an orderly was assaulted. Why is the CNO not surprised about this report?

An OB nurse is caring for an unmarried woman who is in labor. The nurse learns the client is unwilling to name the baby's father. A male visitor who comes to visit the client raises the nurse's concern that he might be violent. Which behavior would raise this concern?

A geriatric client in a long-term-care facility becomes increasingly confused and verbally aggressive as evening approaches. Which actions would the nurse interpret as potentially signaling a violent episode?

A nurse hears screaming from a client's room. A male visitor leaves the client's room. Which is the nurse's priority action?