A charge nurse is teaching new staff members about factors that increase a client’s risk to become violent.

Which of the following risk factors should the nurse include as the best predictor of future violence?

A history of being in prison.

Previous violent behavior.

Experiencing delusions.

Male gender.

Answer and Explanation

The Correct Answer is B

Previous violent behavior. According to the web search results, this is the best predictor of future violence among the given risk factors.
Other risk factors include past history of aggression, poor impulse control, and violence. Comorbidity that leads to acts of violence (psychotic delusions, command hallucinations, violent angry reactions with cognitive disorders).
Choice A is wrong because a history of being in prison is not a direct cause of violence, but rather a possible consequence of it.
Choice C is wrong because male gender is not a sufficient factor to predict violence, as there are many other variables involved.
Choice D is wrong because experiencing delusions is not necessarily associated with violence unless they are of a paranoid or persecutory nature.
Normal ranges for violence risk assessment are not standardized, but some tools that can be used include the Historical Clinical Risk Management-20 (HCR-20), the Violence Risk Appraisal Guide (VRAG), and the Psychopathy Checklist-Revised (PCL-R). These tools use different scales and criteria to evaluate the likelihood of violent behavior in individuals.

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Correct Answer is C

Explanation

Malaise is a general feeling of discomfort, weakness, or illness that can be a sign of infection. According to the health search result from Focus Medica , bacterial pneumonia is an infection of the air sacs in one or both lungs that causes symptoms such as cough with phlegm, fever, chills, and difficulty breathing. Malaise is one of the symptoms that may follow these signs of infection.

Choice A is wrong because it is not a typical symptom of bacterial pneumonia.

Drooling can be caused by other conditions, such as sore throat, dental problems, or neurological disorders.

Choice B is wrong because it is not a symptom of bacterial pneumonia either.

Tinnitus is a ringing or buzzing sound in the ears that can be caused by exposure to loud noise, ear infections, or other ear problems.

Choice D is wrong because it is not specific to bacterial pneumonia.

Rhinorrhea is a runny nose that can be caused by many factors, such as allergies, colds, or sinus infections.

Rhinorrhea can sometimes occur with viral pneumonia, but not usually with bacterial pneumonia.

A. Measure gastric residual volumes every 4 hr. B. Advance the rate of the feeding every 2 hr. C. Maintain the head of the bed at a 20° angle. D. Flush the NG tube with 30 mL 0.9% sodium chloride before and after medication.

Correct Answer is A

Explanation

This is because continuous enteral feedings through an NG tube can increase the risk of aspiration, which is the inhalation of food or fluids into the lungs. Measuring gastric residual volumes (GRV) can help monitor the tolerance and absorption of the feedings and prevent overfeeding. GRV is the amount of fluid aspirated from the stomach via an enteral tube to check for gastric emptying. The normal range of GRV is less than 200 ml.

Choice B is wrong because advancing the rate of the feeding every 2 hr can lead to overfeeding, abdominal distension, nausea, vomiting and diarrhea.

The rate of the feeding should be adjusted according to the client’s nutritional needs and tolerance.

Choice C is wrong because maintaining the head of the bed at a 20° angle is not enough to prevent aspiration. The head of the bed should be elevated at least 30° to 45° during and for at least one hour after feeding.

Choice D is wrong because flushing the NG tube with 30 mL 0.9% sodium chloride before and after medication is not related to continuous enteral feedings. This is a practice to prevent clogging of the tube and ensure proper delivery of medication. Flushing the tube with water before and after feeding is also recommended to maintain patency and hydration.

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A charge nurse is teaching new staff members about factors that increase a client’s risk to become violent. Which of the following risk factors should the nurse include as the best predictor of future violence?

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A charge nurse is teaching new staff members about factors that increase a client’s risk to become violent.

Which of the following risk factors should the nurse include as the best predictor of future violence?