The nurse is caring for several clients on the behavioral health unit. Which client will be assessed as demonstrating aggression?

A client who bursts into tears, leaves the group meeting, and sits on the bed hugging a pillow and sobbing

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

A client who tells the primary nurse "When you told me that I could not have a pass. I felt angry."

A client who tells the medication nurse, "I am not going to take that, or any other, medication."

The correct answer is B. 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.

Answer and Explanation

The Correct Answer is B

Aggression is a behavior characterized by hostility, anger, or violent actions toward others or objects. In the scenario described in option B, the client demonstrates aggressive behavior by stomping away from the nurses' station and grabbing a pool cue from another client. This behavior indicates hostility and potential violence towards others, which is a clear example of aggression.

Options A, C, and D do not describe aggressive behavior. Option A describes a client expressing sadness and seeking comfort by hugging a pillow and sobbing. Option C describes a client expressing anger verbally but not exhibiting aggression. Option D describes a client refusing to take medication, which may not necessarily involve aggressive behavior.

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Correct Answer is A

Explanation

When a nurse observes another nurse acting flirtatiously and bringing small gifts to a client in the behavioral health unit, it raises concerns about professional boundaries and the potential for unethical behavior. The priority action for the observing nurse is to protect the rights and well-being of the client.

Option A, reporting the behavior to the supervisor, is the appropriate course of action. Reporting the observed behavior to the supervisor ensures that the situation is investigated and addressed by the appropriate authorities within the healthcare facility. This action helps maintain the integrity of the therapeutic relationship between the client and healthcare team and protects the client from any potential exploitation or manipulation.

Options B, C and D are not appropriate actions:

B. Ignoring the behavior is not appropriate as it does not address the concerns about professional boundaries and the potential for unethical behavior. Ignoring such behavior may allow it to continue, potentially putting the client at risk.

C. Confronting the nurse directly without first reporting the behavior to the supervisor may not be the most appropriate course of action. It is essential to involve the appropriate authorities within the healthcare facility to conduct a proper investigation and address the situation professionally.

D. Discussing the situation with the client and making assumptions about emotional manipulation may not be appropriate or accurate. It is not the observing nurse's role to discuss such matters with the client. Instead, the appropriate course of action is to report the observed behavior to the supervisor or appropriate authority within the healthcare facility.

A. An ability to feel remorse for the abuse B. Needy and possessive of the partner C. An inflated sense of self-esteem D. Encourages the partner to have a life outside the intimate relationship

Correct Answer is B

Explanation

Explanation: When completing a family assessment for a victim of intimate partner violence, the nurse may identify characteristics of the abuser that contribute to the abusive behavior. Among the options provided, "Needy and possessive of the partner" is the characteristic of the abuser. Abusers often display controlling behavior, which includes possessiveness and excessive need for control over their partners. This possessiveness may manifest as jealousy, isolation, and an attempt to limit the victim's freedom and independence.

A. An ability to feel remorse for the abuse - This characteristic is less likely to be present in an abuser. Abusers often exhibit a lack of remorse for their abusive behavior and may blame the victim or external factors for their actions.

C. An inflated sense of self-esteem - While some abusers may exhibit arrogance and an inflated sense of self-importance, it is not a defining characteristic of all abusers.

D. Encourages the partner to have a life outside the intimate relationship - Abusers typically do the opposite; they often seek to isolate their victims from their support systems and limit their social interactions outside the abusive relationship.

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The nurse is caring for several clients on the behavioral health unit. Which client will be assessed as demonstrating aggression?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse observes another nurse acting flirtatiously and bringing small gifts, such as candy, to a client in the behavioral health unit. Which action is a priority by the observing nurse?

Correct Answer is A

Explanation

The nurse is completing a family assessment for a victim of intimate partner violence. Which characteristic of the abuser will the nurse identify when completing the assessment?

Correct Answer is B

Explanation

A client with depression is found to have attempted suicide in the bathroom and sustained injury. There is no documentation that the client was assessed every hour as prescribed. Which issue will the nursing staff and hospital potentially have to defend against?

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?

A nurse is caring for a child who is on a clear liquid diet. At lunch, the child consumed ½ cup of juice, 3 oz gelatin. 1 oz of an ice pop, and 20 mL ginger ale. How many mL should the nurse record as the child's fluid intake?

After an Angry outburst, a client quickly appears calmer and receptive to input from the nurse. Which is the most helpful response to the client at this time?

The nurse is working with an adolescent client that is argumentative with staff and peers on the behavioral health unit. Which therapeutic response will be most beneficial for the client to decrease acting out behavior?

A nurse cared for a terminally ill client for over a month and developed a therapeutic nurse-client relationship. After the client's death, feelings of sadness. sleeping poorly, and feeling mildly depressed were experienced by the nurse. Which is the best action to improve the resolution of grief?

A nurse is questioning another nurse about whether it is ethical to seclude a client because of loud and intrusive behavior on the unit. Which is the ethical principle that will best guide the nurse's decision on the appropriate use of seclusion?

An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. Which is the most appropriate action by the nurse?