Unit 2 Flashcards
What are warren fundamentals point about anger
Anger is not a primary emotion, it is learned
Anger is physiological aroussal
Anger and aggression are significantly different
The expression of anger is learned
The expressions f anger can come under personal control
A client has not received what was expressed for lunch and directs an angry verbal outburst at the nurse. What is an accurate description of this display
The expression of anger can come under personal control and is a learned behavior
What is modeling
Role modeling is one of the strongest forms of learning
Role models can be positive or negative
Earliest role models are the primary caregivers
Role models are not always in the home
evidence supports the role of television and video violence as a predisposing factor to later aggressive
Is this biological or learned
Learned
What is operant conditioning
Operant conditioning is a learning method that uses reward and punishments to modify behavior
-positive reinforcement is a response to the specific behavior that is pleasurable
A negative reinforcement is a response to the specific behavior that prevents and undesireable result from occurring
What is serotonin do in response of neurobiology of anger and aggression
Serotonin lower levels of serotonin are related to the inability to control impulses, anxiety, and aggression
What does dopamine do in response in neurobiology of anger and aggression
Dopamine lower levels of depressed patients may produce anger
T/F neurobiology of anger and aggression areas of the brain involved temporal lob e amygdala
T
How is serotonin associated with impulsivity
Deficits in serotonin have been associated with an increase in impulsivity
What is the priority assessment of possibility of violence
History of violence
A patient with a history of chronic heart failure is admitted with shortness of breath and edema. Which assessment finding would the nurse expect?
A) Crackles in the lungs
B) Increased urine output
C) Bradycardia
D) Dry skin
A
Which side effect should a nurse monitor for in a patient receiving lithium?
A) Weight gain
B) Hypotension
C) Constipation
D) Insomnia
A
A patient diagnosed with major depressive disorder has been prescribed an SSRI. Which statement by the patient indicates the need for further teaching?
A) “I will take my medication first thing in the morning.”
B) “I will avoid drinking alcohol while on this medication.”
C) “I might feel relief from symptoms within 3 days.”
D) “I should not abruptly stop taking this medication.”
C
You observe that a postoperative patient is reluctant to perform deep breathing exercises due to pain. How should the nurse respond?
“I understand it’s uncomfortable, but deep breathing helps prevent complications like pneumonia. Let’s work together to manage your pain so that you can do these exercises safely.”
A patient expresses anxiety about their recent diagnosis of Type 2 diabetes. What is the best response by the nurse?
“It’s normal to feel this way. Let’s discuss your questions and review how we can manage diabetes together. I’m here to support you.”
“It’s normal to feel this way. Let’s discuss your questions and review how we can manage diabetes together. I’m here to support you.”
“Patients with dementia are more prone to falls due to cognitive and mobility changes. The assessment helps us create a safer environment for them.”
How does providing culturally sensitive care improve patient outcomes in a diverse population?
Culturally sensitive care promotes trust, enhances communication, and encourages patient engagement in their own health, leading to better health outcomes and patient satisfaction.
Why is it important for nurses to involve families in the care of patients with chronic illnesses?
Involving families in care can provide emotional support to the patient, ensure continuity of care, and help family members understand the patient’s needs and care plan, leading to improved management and outcomes
Describe how a holistic approach to pain management can benefit a patient with chronic pain.
A holistic approach, integrating physical, emotional, and psychological support, addresses more than just the physical symptoms. It can reduce stress, improve mental well-being, and potentially lower pain levels, enhancing overall quality of life.
The nurse is providing education to a patient on the side effects of benzodiazepines like diazepam (Valium). Which symptoms should the patient be instructed to report to the healthcare provider? (Select all that apply.)
A) Drowsiness
B) Difficulty breathing
C) Headache
D) Muscle spasms
E) Confusion
B E
A nurse is educating a patient who is starting lithium therapy. Which instructions should be included to help prevent lithium toxicity? (Select all that apply.)
A) Maintain a consistent salt intake.
B) Avoid drinking excessive amounts of water.
C) Report any symptoms of tremors or excessive thirst.
D) Take lithium with food to prevent stomach upset.
E) Avoid nonsteroidal anti-inflammatory drugs (NSAIDs) unless prescribed.
A C E
The nurse is reviewing the common side effects of SSRIs with a patient. Which of the following are typical side effects? (Select all that apply.)
A) Nausea
B) Increased libido
C) Weight gain
D) Dry mouth
E) Orthostatic hypotension
A C D
A patient on lithium presents with symptoms of nausea, diarrhea, and hand tremors. What is the nurse’s priority intervention?
A) Hold the next dose and notify the provider immediately.
B) Instruct the patient to drink a sports drink to replenish electrolytes.
C) Reassure the patient that these symptoms are expected.
D) Monitor vital signs and reassess symptoms in one hour.
A
A patient taking SSRIs reports feeling agitated and experiencing insomnia. Which of the following interventions should the nurse consider?
A) Instruct the patient to avoid caffeine and take the medication in the morning.
B) Suggest taking the SSRI before bedtime to reduce agitation.
C) Encourage the patient to increase water intake.
D) Advise the patient to skip doses until the symptoms resolve.
A
When educating a patient on lithium therapy, the nurse should emphasize the importance of monitoring for signs of toxicity, which include symptoms like ________, ________, and ________.
Tremors, confusion, nausea
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
C
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
A
A patient expresses anger after not receiving the lunch they expected and directs a verbal outburst at the nurse. How should the nurse interpret this behavior?
A) Anger is a primary emotion that is automatically expressed.
B) Anger is physiological arousal that needs immediate intervention.
C) The expression of anger can come under personal control and is a learned behavior.
D) Anger and aggression are always closely related and require intervention.
B
A nurse observes that a patient with aggressive tendencies has clenched fists, rapid speech, and a rigid posture. The nurse recognizes these as:
A) Characteristics of anger
B) Indicators of improved behavior
C) Early signs of violent behavior
D) Signs of satisfaction
C
A nurse observes that a patient with aggressive tendencies has clenched fists, rapid speech, and a rigid posture. The nurse recognizes these as:
A) Characteristics of anger
B) Indicators of improved behavior
C) Early signs of violent behavior
D) Signs of satisfaction `
A, B, D
Which neurophysiological conditions are associated with increased aggression and violent behavior? (Select all that apply.)
A) Brain tumors
B) Encephalitis
C) Loss of function in the cortex
D) Chronic fatigue syndrome
E) Stroke
A, B, C, E
A nurse is educating a patient on managing anger effectively. Which strategies should be included in the teaching? (Select all that apply.)
A) Practice deep breathing exercises
B) Use of assertive communication
C) Engage in physical exercise regularly
D) Suppress feelings of anger
E) Focus on relaxation of tense muscles
A, B, C, E
A client is demonstrating signs of prodromal syndrome, including pacing and clenched fists. What is the nurse’s priority action?
A) Remove any potential weapons from the area.
B) Document the behavior in the patient’s chart.
C) Ignore the patient to avoid escalation.
D) Provide the patient with positive reinforcement.
A
A patient who was recently placed in restraints for aggressive behavior has now calmed down. After removing the restraints, what should the staff do next?
A) Debrief with the patient and discuss guidelines for future behavior.
B) Reprimand the patient to discourage future aggression.
C) Avoid any discussion about the incident to prevent agitation.
D) Assign a new nurse to the patient to prevent a repeat incident.
A
A patient who was recently placed in restraints for aggressive behavior has now calmed down. After removing the restraints, what should the staff do next?
A) Debrief with the patient and discuss guidelines for future behavior.
B) Reprimand the patient to discourage future aggression.
C) Avoid any discussion about the incident to prevent agitation.
D) Assign a new nurse to the patient to prevent a repeat incident.
B C
What are the physiological and biological changes in anger
Increased HR, BP, and levels of the energy hormones adrenaline and noradrenaline
What are warren’s outlines fundamentals points of anger?
Anger is not a primary emtion; it is learned
Anger is physiological arousal
Anger and aggression are significantly different
The expression of anger is learned
The expression of anger can come under personal control
A client has not received what was expected for lunch and directs an angry verbal outburst at the nurse. What is an accurate description this display of emotion?
A anger is a primary emotion that is automatically experienced
B anger is a psychological arousal
C expression of anger can come under personal control
D Expression of anger and aggression are closely related
C
The expression of anger can come under personal control and is a learned behavior
The term anger often takes on a negative connotation because of its link with aggression
What is aggression?
Is one way that individuals express anger
Is a behabior that is intended to threaten or injure the victim’s security or self-esteem
Can cause damage with words, fists, or weapon, but it is virtually always designed to punish
Predisposing factors to anger and aggression.
What is modeling
Role modeling is one of the strongest forms of learning
Role modeling can be positive or negative
Earliest role modeling are the primary caregivers
Role models are not always in the home
Evidence supports the role of television and video violence as a predisposing factor to later aggressive behavior (Learned, not biological)
Predisposing factors to anger and aggression
What is Operant conditioning
Operant conditioning is a learned method that uses reward and punishments to modify behavior
-a positive reinforcement is a response to the specific behavior that is pleasureable or produces the desired results
-a negative reinforcement is a response to the specific behabior that prevents and undesirebale results from occurring
—-anger and aggression can be learned through operant conditioning
Which of the following statements about anger are true? (Select all that apply)
A. Anger is always a negative emotion.
B. Anger is a normal human emotion when expressed appropriately.
C. Anger can lead to problem-solving and decision-making.
D. Anger is a primary emotion that is not learned.
E. Anger becomes a problem when expressed assertively.
Correct Answer: B, C
Rationale: Anger is a normal emotion that can be used positively when expressed appropriately. It can lead to problem-solving and decision-making. However, it becomes a problem when it is not expressed or when expressed aggressively.
Which of the following factors may predispose a client to anger and aggression? (Select all that apply)
A. Modeling negative behavior by role models
B. Operant conditioning, especially with positive reinforcement
C. Neurological disorders such as brain trauma
D. Increased serotonin levels in the brain
E. Environmental factors like noise and crowding
Correct Answer: A, B, C, E
Rationale: Anger and aggression can be learned through modeling and operant conditioning. Neurophysiological disorders, such as brain trauma or loss of cortical function, can increase aggression. Environmental factors like noise, crowding, and discomfort can also predispose individuals to aggressive behaviors.
A nurse is caring for a client who is showing signs of increasing agitation, such as pacing, clenched fists, and a raised voice. What should be the nurse’s priority intervention?
A. Ignore the behavior to avoid reinforcing it.
B. Confront the client and demand that they calm down.
C. Offer support through therapeutic communication and empathy.
D. Administer a PRN sedative to calm the client.
Correct Answer: C
Rationale: The priority intervention is to offer support using therapeutic communication and empathy. Confronting or ignoring the behavior would not address the underlying issue, and sedation should only be considered after assessing the situation thoroughly.
Which of the following are common characteristics of aggression in a client? (Select all that apply)
A. Intense discomfort
B. Restlessness and pacing
C. Soft, gentle tone of voice
D. Use of profanity and threats
E. Increased agitation and overreaction to stimuli
Correct Answer: A, B, D, E
Rationale: Aggression typically includes restlessness, pacing, verbal threats, profanity, intense discomfort, and increased agitation. A soft, gentle tone of voice would not be characteristic of aggression
A nurse is assessing a client for signs of impending violence. Which of the following are key warning signs? (Select all that apply)
A. Rigid posture and clenched fists
B. Calm demeanor and low energy
C. Hyperactive patterns and pressured speech
D. Recent history of violence or verbal abuse
E. Clear, logical thinking
Correct Answer: A, C, D
Rationale: Signs of impending violence include hyperactive patterns, pressured speech, rigid posture, clenched fists, and a recent history of violence. A calm demeanor and clear thinking are not indicative of impending violence.
A nurse notices that a client in the psychiatric unit is exhibiting a “prodromal syndrome,” which includes agitation, profanity, and pacing. What is the nurse’s most appropriate action?
A. Attempt to reason with the client to calm them down.
B. Wait for the client to express their anger before intervening.
C. Immediately intervene to prevent escalation and ensure safety.
D. Ignore the behavior until the client is no longer upset.
Correct Answer: C
Rationale: Prodromal syndrome is an early indicator of potential violence, characterized by agitation and verbal abuse. Immediate intervention is necessary to prevent escalation and ensure safety.
Which of the following are appropriate interventions for managing a client’s anger and aggression? (Select all that apply)
A. Set clear, consistent limits for behavior.
B. Use therapeutic touch to calm the client.
C. Offer reasonable choices and consequences.
D. Use humor to defuse the situation.
E. Avoid discussing the behavior to prevent conflict.
Correct Answer: A, C
Rationale: Setting clear, consistent limits and offering reasonable choices and consequences are effective interventions for managing anger and aggression. Therapeutic touch may be appropriate in some situations, but humor and avoiding discussions about behavior may escalate the situation.
A nurse is discussing an incident with a client who had to be restrained. Which unit procedure is the nurse implementing?
A. Milieu reenactment
B. Treatment planning
C. Crisis intervention
D. Debriefing
Correct Answer: D
Rationale: Debriefing is a process used after an incident, such as the use of restraints, to review the event, discuss triggers, and establish guidelines for future behavior. It helps the patient return to the therapeutic milieu.
Which of the following environmental factors can increase the risk of aggression? (Select all that apply)
A. Overcrowding
B. Low noise levels
C. High environmental temperature
D. Physical discomfort
E. Staff inexperience
Correct Answer: A, C, D, E
Rationale: Overcrowding, high environmental temperature, physical discomfort, and staff inexperience can all increase the risk of aggression in a healthcare setting.
Which of the following are important nursing interventions when managing a client’s aggression? (Select all that apply)
A. Avoid power struggles by defending your position.
B. Use active listening to show understanding.
C. Consistently enforce consequences for inappropriate behavior.
D. Ignore the client’s feelings of anger.
E. Establish clear objectives and limits for behavior.
Correct Answer: B, C, E
Rationale: Active listening, enforcing consistent consequences, and establishing clear limits are essential interventions when managing aggression. Avoiding power struggles and ignoring the client’s anger would not be effective in this situation.
After a client’s restraints are removed, the nurse should assess whether the client can:
A. Recognize when they are angry and take responsibility for their feelings.
B. Immediately return to the therapeutic milieu without any assistance.
C. Rely on others to control their anger during emotional outbursts.
D. Maintain complete control over their behavior without any further intervention.
Correct Answer: A
Rationale: After restraints are removed, the nurse should assess whether the client is able to recognize when they are angry, take responsibility for their feelings, and manage their anger in a constructive way.
Which of the following behaviors indicate that a client may be at risk for violence? (Select all that apply)
A. Hyperactive behavior and rapid speech
B. Aggressive verbal threats and use of obscenities
C. Calm demeanor with minimal agitation
D. Recent history of violence or a threat of harm to others
E. Ability to maintain control over emotions without frustration
Correct Answer: A, B, D
Rationale: Hyperactivity, rapid speech, aggressive verbal threats, and a history of violence are indicators that a client may be at risk for violence. A calm demeanor and ability to manage emotions indicate a lower risk.
Which of the following is a characteristic of a self-help group?
A. Members are required to have a professional leader.
B. The group focuses on teaching social norms.
C. Leadership is often rotated among group members.
D. The purpose is to provide information to a large group of individuals.
Correct Answer: C Self-help groups are typically led by members, and leadership may rotate. They provide support for individuals with similar problems.
What is the main goal of group therapy?
A. To provide information and education about a specific topic.
B. To facilitate personal insight and improve interpersonal coping strategies.
C. To teach group members social norms and appropriate behaviors.
D. To focus on problem-solving and decision-making related to specific tasks.
Correct Answer: B Group therapy helps individuals gain personal insight and improve interpersonal coping strategies.
During the orientation phase of group development, the nurse should focus on:
A. Facilitating the completion of the group’s tasks.
B. Encouraging members to express feelings of loss.
C. Establishing rules, goals, and trust within the group.
D. Promoting conflict resolution between group members.
Correct Answer: C In the orientation phase, the group’s rules and goals are established, and trust between members is developed.
Which of the following statements best describes the curative factor of universality in group therapy?
A. Members develop new social skills through interaction with others.
B. Members assist each other and experience personal growth.
C. Members realize that others share similar problems and feelings.
D. Members have the opportunity to express both positive and negative emotions.
Correct Answer: C Universality occurs when group members realize they are not alone in their experiences, which helps reduce feelings of isolation.
Which leadership style is characterized by limited group member participation, with the leader making decisions and providing direction?
A. Democratic
B. Laissez-faire
C. Autocratic
D. Supportive
Correct Answer: C Autocratic leadership involves the leader taking control, making decisions, and providing direction, limiting group participation.
Which of the following are functions of a therapeutic group? (Select all that apply.)
A. To provide socialization through the teaching of social norms.
B. To complete tasks that are beyond the capacity of an individual.
C. To teach specific skills to enhance individual productivity.
D. To empower individuals to create change when alone they cannot.
E. To provide leadership to govern the group.
A, B, D Therapeutic groups provide socialization, support, task completion, and empowerment. They do not typically focus on individual productivity or leadership for governance.
Which of the following group conditions influence dynamics and interaction among members? (Select all that apply.)
A. Group size.
B. Seating arrangements.
C. Open-ended vs. closed-ended group formats.
D. Group member level of education.
E. Presence of external distractions.
A, B, C Group size, seating arrangements, and whether the group is open-ended or closed-ended are all factors that can affect group dynamics.
True or False: In an autocratic leadership style, group members are encouraged to participate in decision-making and problem-solving.
Correct Answer: False Autocratic leadership is characterized by the leader making decisions independently, with limited input from group members.
True or False: A self-help group is led by a professional therapist who guides the group through structured exercises.
Correct Answer: False Self-help groups are often led by the members themselves, rather than by a professional therapist.
