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NUR 205 TEST 2
| Question | Answer |
|---|---|
| Are the following statements about anger, hostility, and aggression are accurate? Anger is an emotional response to a real or perceived provocation. Physical aggression involves harming other persons or property. Hostility is also referred to as verbal aggression. | YES |
| Which would be the best approach for the nurse to use for a client who has been physically aggressive arrives at the emergency room for a psychiatric assessment? | Use brief statements and questions to obtain information. |
| A malpractice lawsuit was filed after a nurse restrained the client for screaming at and attempting to strike anyone who was within striking distance. The nurse followed agency procedures that were consistent with Joint Commission Standards. For which reason is this malpractice lawsuit most likely to be unsuccessful? | The nurse did not breach duty. |
| A nurse in the emergency department is planning for a client with mental illness to be placed in an inpatient hospitalization. Which is a condition of this type of admission? | present a clear danger to self or others |
| A nurse is performing safety assessments on a client in mechanical restraints as required by policy. Which action by the nurse demonstrates the ethical principle of non-maleficence? | Assuring that the restraints are not causing injury to the client |
| A student nurse is assigned to administer oral medications to a client. Which of these actions should a student nurse take if a client refuses to take prescribed oral medications? | Ask the client's reason for refusing and report it to the primary care nurse |
| An adolescent on the unit is argumentative with staff and peers. The nurse tells the adolescent, "Arguing is not allowed. One more word and you will have to stay in your room the rest of the day." The nurse's directive is... | Inappropriate; room restriction is not treatment in the least restrictive environment. |
| An adult client is put in restraints after all other attempts to reduce aggression have failed. What is required now that restraints have been instituted? | A face-to-face evaluation by a licensed independent practitioner within 1 hour of restraint. |
| During rounds, the depressed client is discovered to have completed a suicide attempt in the bathroom. The staff on the inpatient psychiatric unit have been very busy and fell behind on periodic assessment for this client. Which type of lawsuit could the client's family file? | Malpractice |
| Ensuring that the client has provided informed consent for a treatment regimen displays which of the following ethical principles? | Autonomy |
| The client feels his rights have been violated. Placing a client in restraints before using other methods of intervention violates which of the client's rights? | Receive treatment in the least restrictive environment |
| Under which conditions would it be in the client's best interest for the court to appoint a conservator, or legal guardian? | Gravely disabled Mentally incompetent Unable to provide basic needs when resources exist |
| Which nursing intervention constitutes false imprisonment? | The client has been “pesky,” seeking the attention of nurses in the nurses' station much of the day. Now the nurse escorts the client to the room and tells the client to stay there or be put into seclusion. |
| The following are criteria for instituting the short-term use of restraint or seclusion: | The client is aggressive. The client is imminently dangerous to himself or herself or to others. All other means of calming the client have been unsuccessful. |
| What client situation would urgently requires the nurse to break confidentiality and warn a third party? | A jealous man states, "I am getting my gun and going to shoot my wife's lover!" |
| A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately in a calm manner to prevent the client from moving to which phase of the aggression cycle? | Crisis |
| A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints by the nursing team. Which statement should the nurse make to explain the use of restraints to the client? | "This is a means of keeping you and others safe." |
| A nurse is working with a client who has frequent angry outbursts. What statement is most helpful when working with this client? | "Anger is a normal feeling, and you can use it to solve problems." |
| What phase would the client be in after an angry outburst, and the client is tearful and remorseful? | Post-crisis |
| An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following? | Call for an emergency response from trained personnel. |
| As the nurse is performing an assessment on the client, the client's son is yelling and is hitting his hand with a rolled up newspaper. Which stage of aggression does the nurse identify that the client's son is exhibiting? | Escalation |
| At which point in the stages of aggressive incidents is intervention least likely to be effective in preventing physically aggressive behavior? | Crisis |
| The nurse should assess clients' risks for anger or aggression in the care of clients with which of the following psychiatric diagnoses: | Alzheimer's dementia Schizophrenia Acute alcohol intoxication |
| What type of client on the mental health unit should be assessed as being at highest risk for directing violent behavior toward others? | a client who has paranoid delusions and believes is being followed by members of the mafia |
| Should the following patient be assessed as demonstrating aggression? A client who stomps away from the nurses' station, goes into the day room, and grabs a pool cue from another client standing at the pool table | YES |
| Are the following statements about anger, hostility, and aggression are accurate? Anger is an emotional response to a real or perceived provocation. Physical aggression involves harming other persons or property. Hostility is also referred to as verbal aggression. | YES |
| Is the following statements about the crisis phase of aggression when the client becomes physically aggressive true? Four to six trained staff members are needed to restrain. | TRUE |
| Grief | the subjective emotions and affect that are a normal response to the experience of loss |
| Grieving | the process by which a person experiences grief |
| Mourning | the outward expression of grief |
| Dissociation | a subconscious defense mechanism that helps a person protect their emotional self from recognizing the full effects of some horrific or traumatic event by allowing the mind to forget or remove itself from the painful situation or memory |
| Kubler-Ross Five stages of Grieving | Denial, Anger, Bargaining, Depression and Acceptance |
| True or False The first stage of grieving according to Kubler Ross is Anger | FALSE-First stage is Denial. |
| Disenfranchised grief | grief over a loss that is not or cannot be mourned publicly or supported socially.. |
| True or False Nurses commonly experience complicated grief | FALSE-Nurses experience Disenfranchised grief |
| Complicated grieving | a response outside the norm and occurring when a person is void of emotion, grieves for prolonged periods, or has expressions of grief that seem disproportionate to the event |
| Four universal reactions to loss | Initial response of shock and social disorientation Attempts to continue relationship w/deceased Anger with those perceived as responsible for death Time for mourning |
| Stress | the wear and tear that life causes on the body |
| posttraumatic stress disorder (PTSD) | a disturbing pattern of behavior demonstrated by someone who has experienced a traumatic event; for example, a natural disaster, a combat, or an assault; begins 3 months or more following the trauma |
| Symptoms of PTSD | Dreams, Intrusive, recurrent thoughts; Avoidance, Negative cognition/thoughts, Being on guard/hyperarousal |
| Adjustment disorder | a group of symptoms, such as stress, feeling sad, or hopeless, and physical symptoms that occur following a stressful life event; the reaction is stronger than would be expected for the event that occurred. |
| Adjustment disorder | Symptoms occur within a month and last no longer than 6 months. |
| Acute stress disorder | symptoms appear within the first month after the trauma and do not persist longer than 4 weeks |
| Acute stress disorder | Can be precursor to PTSD |
| Bereavement | refers to the process by which a person experiences grief |
| Reactive Attachment Disorder (RAD)/Disinhibited social engagement disorder (DSED) | occur before 5 years of age in response to the trauma of child abuse or neglect, called grossly pathogenic care. |
| What is the largest population of PTSD patients? | Adolescent females with repeated sexual trauma |
| Peri-trauma dissociation | when the brain separates realty from our consciousness for a short period of time |
| ADHD are often found in patients with PTSD | |
| True or False Persons who witness a traumatic event are likely to develop PTSD. | FALSE |
| Dissociative disorders | they include amnesia, fugue, and dissociative identity disorder |
| Dissociative Identity Disorder (formerly know as multiple personality disorder) | The client displays two or more distinct identities or personality states that recurrently take control of their behavior. This is accompanied by the inability to recall important personal information. |
| Dissociative amnesia | The client cannot remember important personal information (usually of a traumatic or stressful nature). This category includes a fugue experience where the client suddenly moves to a new geographic location with no memory of past events and often the assumption of a new identity. |
| Depersonalization/derealization disorder | depersonalization-The client has a persistent or recurrent feeling of being detached from their mental processes or body. derealization-sensation of being in a dream-like state in which the environment seems foggy or unreal. The client is not psychotic or out of touch with reality. |
| What type of person is more likely to experience a dissociative disorder? | A survivor of childhood sexual abuse |
| Exposure therapy | a treatment approach designed to combat the avoidance behavior that occurs with PTSD, help the client face troubling thoughts and feelings, and regain a measure of control over their thoughts and feelings. The client confronts the feared emotions, situations, and thoughts associated with the trauma rather than attempting to avoid them |
| Survivor | view of the client as a survivor of trauma or abuse rather than as a victim; helps to refocus client’s view of themselves as being strong enough to survive the ordeal, which is a more empowering image than seeing oneself as a victim |
| Cognitive processing therapy | Has been used with rape survivors with PTSD as well as combat veterans. The therapy course involves structured sessions that focus on examining beliefs that are erroneous or that interfere with daily life, such as guilt and self-blame |
Created by:
shondell1971
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