Answer Choices:
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
Question: A new patient immediately requires seclusion on admission. The assessment is incomplete, and the health care provider has not examined the patient. Immediately after safely secluding the patient, which action has priority?
Answer Choices:
a. Provide an opportunity for the patient to go to the bathroom.
b. Notify the health care provider and obtain a seclusion order.
c. Notify the hospital risk manager.
d. Debrief the staff.
Answer:
b. Notify the health care provider and obtain a seclusion order.
Question: A patient is hospitalized after an arrest for breaking windows in the home of a former intimate partner. The history reveals childhood abuse by a punitive parent, torturing family pets, and an arrest for disorderly conduct. Which nursing diagnosis has priority?
Answer Choices:
a. Risk for injury
b. Post-trauma response
c. Disturbed thought processes
d. Risk for other-directed violence
Answer:
D
Question: Which is an effective nursing intervention to assist an angry patient to learn to manage anger without violence?
Answer Choices:
a. Help the patient identify a thought that increases anger, find proof for or against the belief, and substitute reality-based thinking.
b. Provide negative reinforcement such as restraint or seclusion in response to angry outbursts, whether or not violence is present.
c. Use aversive conditioning, such as popping a rubber band on the wrist, to help extinguish angry feelings.
d. Administer an antipsychotic or antianxiety medication when the patient feels angry.
Answer:
a
Question: Because an intervention is required to control a patient’s aggressive behavior, a critical incident debriefing takes place. Which topics should be the focus of the discussion? (Select all that apply.)
Answer Choices:
a. Patient behavior associated with the incident
b. Genetic factors associated with aggression
c. Intervention techniques used by staff
d. Effect of environmental factors
e. Review of theories of aggression
Answer:
a. Patient behavior associated with the incident
c. Intervention techniques used by staff
d. Effect of environmental factors
Question: A nurse assesses the health status of soldiers returning from a war zone. Screening for which health problems will be a priority? (Select all that apply.)
Answer Choices:
a. Schizophrenia
b. Eating disorder
c. Traumatic brain injury
d. Oppositional defiant disorder
e. Posttraumatic stress disorder
Answer:
C, E
Question: Which scenario predicts the highest risk for directing violent behavior toward others?
Answer Choices:
a. Major depressive disorder with delusions of worthlessness
b. Obsessive-compulsive disorder; performing rituals to prevent tragedy
c. Schizophrenic schizophrenia paranoid type, currently experiencing auditory hallucinations
d. Completion of alcohol withdrawal and beginning a new job
Answer:
C
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 Choices:
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 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 Choices:
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
Question: Which central nervous system structures are most associated with anger and aggression? (Select all that apply.)
Answer Choices:
a. Amygdala
b. Cerebellum
c. Basal ganglia
d. Temporal lobe
e. Parietal lobe
Answer:
a. Amygdala
d. Temporal lobe
Question: A patient with severe physical injuries is irritable, angry, and belittles the nurses. As a nurse changes a dressing, the patient screams, “Don’t touch me! You are so stupid. You will make it worse!” Which intervention uses a cognitive technique to help this patient?
Answer Choices:
A. Discontinue the dressing change without comments and leave the room.
B. Stop the dressing change, saying, “Perhaps you would like to change your own dressing.”
C. Continue the dressing change, saying, “Do you know this dressing change is necessary?”
D. Complete the dressing change quickly.
Answer:
C
Question: An emergency department nurse realizes that the spouse of a patient is becoming increasingly irritable while waiting. Which intervention should the nurse use to prevent escalation of anger?
Answer Choices:
a. Explain that the patient’s condition is not life-threatening.
b. Periodically provide an update and progress report on the patient.
c. Explain that all patients are treated in order, based on their medical needs.
d. Suggest that the spouse return home until the patient’s treatment is completed.
Answer:
b. Periodically provide an update and progress report on the patient.
Question: A patient who is angry and has demonstrates good coping skills is angry at the end of the shift because of the disorganization and loud complaints in the general ward. Which is a proper nursing intervention?
Answer Choices:
a. Explain the reasons for the disorganization and take the patient’s care for the rest of the shift.
b. Acknowledge and validate the patient’s distress and ask, “What would you like to have happen?”
c. Apologize and explain that the patient will have to accept the situation for the rest of the shift.
d. Ask the patient to control the anger and explain that allowances must be made for new staff members.
Answer:
b. Acknowledge and validate the patient’s distress and ask, “What would you like to have happen?”
Question: An intramuscular dose of antipsychotic medication needs to be administered to a patient who is becoming increasingly more aggressive. The patient is in the day room where there are other patients. When entering the day room what response should the nurse make?
Answer Choices:
a. States, “Would you like to come to your room and take some medication your doctor prescribed for you?”
b. Accompanied by three staff members and states, “Please come to your room so I can give you some medication that will help you feel more comfortable.”
c. Initiates process to place the patient in a basket-hold and then state, “I am going to take you to your room to give you an injection of medication to calm you.”
d. Accompanied by two security guards and tell the patient, “You can come to your room willingly so I can give you this medication or the security guards will take you there.”
Answer:
b