Answer Options:
a. The patient expresses frustration verbally instead of physically.
b. The patient explains the rationale for behaviors to the victim.
c. The patient identifies three personal strengths.
d. The patient agrees to seek counseling.
Answer: a. The patient expresses frustration verbally instead of physically.
Question: A patient being admitted suddenly pulls a knife from a coat pocket and threatens, “I will kill anyone who tries to get near me.” An emergency code is called. The patient is safely disarmed and placed in seclusion. What is the justification for the use of seclusion?
Answer Options:
a. Patient demonstrates a thought disorder, rendering rational discussion ineffective.
b. Patient’s actions present a clear and present danger to others.
c. Patient demonstrates an apparent and plausible escape risk.
d. Patient’s actions display features of psychotic thinking.
Answer: b. Patient’s actions present a clear and present danger to others.
Question: The father of a child diagnosed with schizophrenia says, “I lost my job, so we have no health insurance.” The mother says, “I must watch this child all the time. Without supervision, our child becomes violent and destructive.” A sibling says, “My parents don’t pay attention to me.” These comments signify what related stress?
Answer Options:
a. Life-cycle stressors
b. Psychobiological issues
c. Family burden of mental illness
d. Stigma associated with mental illness
Answer: C
Question: Which behaviors are most consistent with the clinical picture of a patient who is becoming increasingly aggressive? (Select all that apply.)
Answer Options:
a. Pacing
b. Crying
c. Withdrawn affect
d. Rigid posture with clenched jaw
e. Staring with narrowed eyes into the eyes of another
Answer: a. Pacing
d. Rigid posture with clenched jaw
e. Staring with narrowed eyes into the eyes of another
Question: Which behavior best demonstrates aggression?
Answer Options:
a. Stomping away from the nurses’ station, darting to another room, and grabbing a snack from another patient
b. Bursting into tears, leaving the community meeting, and sitting on a bed hugging a pillow and sobbing
c. Telling the primary nurse, “I felt angry when you said I could not have a second helping at lunch”
d. Telling the medication nurse, “I am not going to take that or any other medication you try to give me”
Answer: a. Stomping away from the nurses’ station, darting to another room, and grabbing a snack from another patient
Question: A patient diagnosed with pneumonia has been hospitalized for 4 days. Family members describe the patient as “a difficult person who finds fault with everyone.” The patient verbally abuses nurses for providing poor care. What is the most likely explanation for this behavior?
Answer Options:
a. Poor child-rearing that did not teach respect for others.
b. Automatic thinking, leading to cognitive distortion.
c. Personality style that externalizes problems.
d. Delusions that others wish to deliver harm.
Answer: c. Personality style that externalizes problems.
Question: A patient is pacing the hall near the nurses’ station and swearing in a loud voice. Which intervention for the nurse would be to address the patient by saying:
Answer Options:
a. “What is going on?”
b. “Quiet down immediately. You are disturbing everyone.”
c. “I’d like to talk with you about what is going on. Can we sit here and talk?”
d. “You must go to your room and try to get control of yourself.”
Answer: c. “I’d like to talk with you about what is going on. Can we sit here and talk?”
Question: Which medication should a nurse administer to provide immediate intervention for a psychotic patient whose aggressive behavior continues to escalate despite verbal intervention?
Answer Options:
a. Lithium
b. Trazodone
c. Olanzapine
d. Valproic acid
Answer: c. Olanzapine
Question: A health care provider writes these new prescriptions for a resident in a skilled care facility: 2 g sodium diet; restraint as needed; Imodium 2 tabs PO every 1 day; 1 dose of milk of magnesia 30 mL orally if no bowel movement occurs for 3 days.” Which prescription should the nurse question?
a. Restraint
b. Fluid restriction
c. Milk of magnesia
d. Sodium restriction
Answer: A
Question: A 10-year-old child cares for siblings while the parents work because the family cannot afford a babysitter. This child says, “My father doesn’t like me. He calls me stupid all the time.” The mother says the father is easily frustrated and has trouble disciplining the children. The community health nurse should consider which resources to stabilize the home situation? (Select all that apply.)
Answer Options:
a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support
Answer: a. Parental sessions to teach child-rearing practices
b. Anger management counseling for the father
c. Continuing home visits to provide support
Question: Which central nervous system structures are most associated with anger and aggression? (Select all that apply.)
Answer Options:
a. Amygdala
b. Cerebellum
c. Basal ganglia
d. Temporal lobe
e. Parietal lobe
Answer: a. Amygdala
d. Temporal lobe
Question: If an older adult patient must be physically restrained, who is responsible for the patient’s safety?
a. Nurse assigned to care for the patient.
b. Nursing assistant who applies the restraint.
c. Health care provider who ordered the application of the restraint.
d. Family member who agrees to the application of the restraint.
Answer: A
Question: Confirmation of a history of what scenario from a patient’s record indicates compromised coping skills and the need for careful assessment of the risk for violence?
Answer Options:
a. Childhood trauma
b. Family involvement
c. Academic problems
d. Daily substance abuse
Answer: d. Daily substance abuse
Question: A confused older adult patient in a skilled care facility is sleeping. A health care worker enters the room quietly and touches the bed to see if it is wet. The patient awakens and hits the health care worker in the face. Which statement best explains the patient’s action?
Answer Options:
a. Older adult patients often demonstrate exaggerations of behaviors used earlier in life.
b. Crowding in skilled care facilities increases individual tendencies toward violence.
c. The patient interpreted the health care worker’s behavior as potentially harmful.
d. This patient learned violent behavior by watching other patients act out.
Answer: c. The patient interpreted the health care worker’s behavior as potentially harmful.
Question: Which of the following statements is CORRECT?
a. Net working capital is defined as current assets minus the difference between current liabilities and notes payable, and any increase in the current ratio automatically indicates that net working capital has increased.
b. Although short-term interest rates have historically averaged less than long-term rates, the heavy use of short-term debt is considered to be an aggressive strategy because of the inherent risks associated with using short-term financing.
c. If a company follows a policy of “matching maturities,” this means that it matches its use of common stock with its use of long-term debt as opposed to short-term debt.
d. Net working capital is defined as current assets minus the difference between current liabilities and notes payable, and any decrease in the current ratio automatically indicates that net working capital has decreased.
e. If a company follows a policy of “matching maturities,” this means that it matches its use of short-term debt with its use of long-term debt.
Answer Options:
a. Net working capital is defined as current assets minus the difference between current liabilities and notes payable, and any increase in the current ratio automatically indicates that net working capital has increased.
b. Although short-term interest rates have historically averaged less than long-term rates, the heavy use of short-term debt is considered to be an aggressive strategy because of the inherent risks associated with using short-term financing.
c. If a company follows a policy of “matching maturities,” this means that it matches its use of common stock with its use of long-term debt as opposed to short-term debt.
d. Net working capital is defined as current assets minus the difference between current liabilities and notes payable, and any decrease in the current ratio automatically indicates that net working capital has decreased.
e. If a company follows a policy of “matching maturities,” this means that it matches its use of short-term debt with its use of long-term debt.
Answer: b
Question: A nurse directs the intervention team to seclude an aggressive patient to seclusion. Other patients were removed from the area. Before approaching the patient, the nurse should ensure that which actions are taken by staff? (Select all that apply.)
Answer Options:
a. Remove jewelry, glasses, and harmful items from the patient and staff members.
b. Appoint a person to clear a path and open, close, or lock doors.
c. Quickly approach the patient and grab the closest extremity.
d. Select the person who will communicate with the patient.
e. Move behind the patient to use the element of surprise.
Answer: a. Remove jewelry, glasses, and harmful items from the patient and staff members.
b. Appoint a person to clear a path and open, close, or lock doors.
d. Select the person who will communicate with the patient.
Question: A patient with a history of command hallucinations approaches the nurse, yelling obscenities. The patient mumbles and then walks away. The nurse follows. Which nursing actions are most likely to be effective in de-escalating this scenario? (Select all that apply.)
Answer Options:
a. State the expectation that the patient will stay in control.
b. State that the patient cannot be understood when mumbling.
c. Tell the patient, “You are behaving inappropriately.”
d. Offer to provide the patient with medication to help.
e. Speak in a firm but calm, caring voice.
Answer: a. State the expectation that the patient will stay in control.
d. Offer to provide the patient with medication to help.
e. Speak in a firm but calm, caring voice.
Question: When admitting older adult patients, health care agencies receiving federal funds must provide written information about what topic?
a. Advance health care directives
b. The financial status of the institution
c. How to sign out against medical advice
d. The institution’s policy on the use of restraints
Answer: A
Question: A patient with a history of anger and impulsivity is hospitalized after an accident resulting in injuries. When in pain, the patient loudly scolds the nurse for “not knowing enough to give me pain medicine when I need it.” Which intervention would best address this problem?
Answer Options:
a. Tell the patient to notify the nurse 30 minutes before the pain returns so the medication can be prepared.
b. Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.
c. Tell the patient that verbal assaults on nurses will not shorten the wait for pain medication.
d. Have the clinical nurse leader request a psychiatric consultation.
Answer: b. Urge the health care provider to change the prescription for pain medication from as needed to a regular schedule.