Week 7.1

Question 1

anger

Answer 1

emotional response to frustration of desires, threat to one’s need or challenge

Question 2

aggression

Answer 2

action/behavior resulting in physical or verbal attack

intended to threaten victims security

Question 3

violence

Answer 3

always an objectionable use of force that results in injury

Question 4

predisposing factors of violence

Answer 4

*modeling
operant conditioning
biochem: decreased serotonin, thiamine, etc.
medical issues: UTI, BS, electrolytes
SES: poverty
Alc/drugs
access to weapons

Question 5

assessment of violence

Answer 5

*History of past violence
close ended questions
evidence based screening tools

Question 6

predictors of violence

Answer 6

hyperactivity
stone silence
increased tension
intense eye contact
weapon possession
recents acts
profanity

Question 7

interventions

Answer 7

escape route
speak slowly
allow 1 feet of space with arm extended
give them options
avoid arguing
obtain baseline behavior
PRN meds to alleviate sx
remain honest
invest time

Question 8

staff responsibilities

Answer 8

no dangling earrings, necklaces
ensure backup staff
never block doorway
keep hands visible
stand at angle, not toe to toe
avoid confrontation
confident posture

Question 9

level 1 actions

Answer 9

answer questions
avoid jargon
reflect emotions
initiate dialogue
acknowledge feelings

Question 10

level 2 actions

Answer 10

redirect to request
set limits
give choices
safety
isolate interaction
decrease stimuli
explain consequences

Question 11

level 3 actions

Answer 11

call for help
protect self
limit words and actions
avoid agreeing to agree
“please __”
consequences to behavior

Question 12

seclusion

Answer 12

last resort with restraints
safety by policy and state law

involuntary confinement of a patient alone in an area

prevented from leaving

Question 13

guidelines for mechanical restraints

Answer 13

indication for use
legal requirement
documentation q15min
clinical assessment
observation
release procedure

Question 14

are restraints ever PRN order?

Answer 14

never

Question 15

contraindications for restraints

Answer 15

pregnancy
extremely unstable
seizures
spinal cord injury
dementia/delirium
COPD

Question 16

chemical restraint

Answer 16

medication to restrict clients movement or behavior

single dosage for emergency

combo IM cocktail, 2 sep injections

Question 17

level 4 action

Answer 17

decrease in energy
rationality returns
teachable moment
reestablish therapeutic rapport
mandatory briefing within 24 hours

Question 18

medical mimics

Answer 18

disorder that presents with psychologic symptoms resulting from underlying medical condition

Question 19

diagnostic overshadowing

Answer 19

attributing sx of a physical illness to the mental illness

Question 20

what are two disorders that mimic mood, psychotic, and anxiety disorders?

Answer 20

cushing’s disease
hypo/hyperthyroidism

Question 21

medical mimic risk factors

Answer 21

hx head injury
waxing/waning
abnormal VS
visual, tactile, olfactory hallucinations
disturbance of gait and balance
known underlying condition
worsening sx after med admin
recent memory loss

Question 22

high risk populations

Answer 22

elderly
hx substance abuse
without hx of psych illness
preexisting conditions
lower SES

Question 23

labs/assessments

Answer 23

pulse OX
CMP, CBC
therapeutic drug levels
UA, UDS
thyroid fx
ESR
AIDS/HIV
CT
Vitamine B12
screen for STD
thiamine
blood, urine cultures

question females about diet pills and eating patterns