The nurse is assessing an inpatient client with a known history of violence. The client suddenly displays clenched fists. What additional behavior by the client would suggest that the aggression is escalating? The client:

refuses to eat lunch.

requests prn medications.

is pacing around the milieu.

sits in a group with their peers.

Answer and Explanation

The Correct Answer is C

a. refuses to eat lunch. Refusal to eat lunch might indicate displeasure or upset but does not directly suggest escalating aggression.
b. requests prn medications. Requesting prn (as needed) medications typically indicates the client is aware of their distress and is seeking help, not escalating aggression.
c. is pacing around the milieu. Pacing can be a sign of increasing agitation and is often observed in clients who are escalating towards aggressive behavior. This physical activity can indicate restlessness and an inability to calm down.
d. sits in a group with their peers. Sitting in a group with peers suggests a level of social engagement and does not indicate escalating aggression.

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Correct Answer is C

Explanation

a. Avoidance: Avoidance is a coping mechanism, not a symptom itself.
b. Obsessive-compulsive disorder (OCD): OCD involves intrusive thoughts and repetitive behaviours, not physical symptoms like limb weakness.
c. a conversion disorder: Conversion disorder is a psychological condition where emotional distress manifests as physical symptoms, like limb weakness, with no medical explanation.
d. A fracture: A fracture is a physical injury with a demonstrable cause, unlike the unexplained weakness in conversion disorder.

A. Encourage the client to ignore these thoughts and feelings. B. Promote safety and immediately terminate the relationship with the client. C. Immediately reassign the client to another staff member. D. Help the client to clarify the meaning of the relationship, based on the present situation.

Correct Answer is D

Explanation

a. Encourage the client to ignore these thoughts and feelings: This invalidates the client's experience and might hinder the therapeutic relationship.
b. Promote safety and immediately terminate the relationship with the client: Termination is a last resort, and transference can be a valuable tool for therapy if addressed constructively.
c. Immediately reassign the client to another staff member: This avoids the issue and doesn't address the underlying cause of transference.
d. Help the client to clarify the meaning of the relationship, based on the present situation. (Correct) Transference is a phenomenon where a client unconsciously redirects emotions and feelings from significant figures in their past onto the nurse. A therapeutic response involves acknowledging these feelings and helping the client explore them in a safe and supportive environment

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The nurse is assessing an inpatient client with a known history of violence. The client suddenly displays clenched fists. What additional behavior by the client would suggest that the aggression is escalating? The client:

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Correct Answer is C

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Correct Answer is D

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