Deck 11: Anger, Hostility, and Aggression

Question 1

A nurse is working with a client who has frequent angry outbursts. Which of the following statements is most helpful when working with this client?

A) Anger is a normal feeling, and you can use it to solve problems.
B) You need to learn to suppress your angry feelings.
C) You can reduce your anger by hitting a punching bag.
D) You need to learn how to be less assertive in your communications.

Answer 1

Anger is a normal feeling, and you can use it to solve problems.

Question 2

Which of the following statements about anger, hostility and aggression are accurate? Select all that apply.

A) Anger is an emotional response to a real or perceived provocation.
B) Hostility stimulates the sympathetic nervous system.
C) Physical aggression involves harming other persons or property.
D) Anger, hostility, and physical aggression are normal human emotions.
E) Hostility is also referred to as verbal aggression.
F) Physical aggression often progresses to hostility.

Answer 2

Anger is an emotional response to a real or perceived provocation.
Physical aggression involves harming other persons or property.
Hostility is also referred to as verbal aggression.

Question 3

A married man expresses to the nurse that his wife's frequent nagging angers him. The nurse role-plays assertive communication techniques with the husband. Which of the following indicates the husband understands how to use assertive techniques effectively?

A) I really wish you would stop nagging me.
B) You are not perfect either.
C) I feel unappreciated when you criticize me.
D) Are you telling me you want me to change?

Answer 3

I feel unappreciated when you criticize me.

Question 4

Which one of the following statements about anger is most accurate?

A) Anger is an abnormal human emotion that is always negative.
B) It is best to express anger by whatever means possible to minimize its consequences.
C) Most men are socialized to suppress anger.
D) Anger awareness and expression are necessary for women's growth and development.

Question 5

At which point in the stages of aggressive incidents is intervention least likely to be effective in preventing physically aggressive behavior?

A) Triggering
B) Escalation
C) Crisis
D) Postcrisis

Question 6

Anger management is likely to be included in the care of clients with which of the following psychiatric diagnoses? Select all that apply.

A) Alzheimer's dementia
B) Schizophrenia
C) Anorexia nervosa
D) Acute alcohol intoxication
E) Generalized anxiety disorder

Question 7

Which is most likely to be the subject of an aggressive attack from a client with mental illness?

A) Other people
B) The client
C) Animals
D) Objects

Question 8

Which psychiatric disorder makes a person most susceptible to anger attacks that do not result in physical aggression?

A) Delusions
B) Depression
C) Dementia
D) Delirium

Question 9

A client is observed pacing the hall with clenched fists and swearing at others. The nurse intervenes immediately to prevent the client from moving to which phase of the aggressing cycle?

A) Triggering
B) Escalation
C) Crisis
D) Recovery

Question 10

The client's son is yelling and is hitting his hand with a rolled up newspaper. Which stage of aggression does the nurse identify that the client's son is exhibiting?

A) Triggering
B) Escalation
C) Crisis
D) Recovery

Question 11

The nurse is teaching a client to recognize early signs of anger and aggression. The nurse explores ways that the client can recognize which of the following?

A) Decreased problem-solving ability
B) Restlessness and irritability
C) Remorse
D) Severe muscle tension

Question 12

A client suddenly jumps up from the chair and begins yelling and cursing at the nurse. Which would be the best response by the nurse?

A) I can see that you need attention; you should calmly ask for what you want.
B) I don't want to hear that kind of language; don't ever do that again.
C) I will limit your smoking privileges if you can't control yourself.
D) You seem angry. Tell me more about how you're feeling.

Question 13

A client approaches the nurse and loudly states, I'm not putting up with this anymore! The most appropriate response by the nurse would be which of the following?

A) I can see you are angry. Tell me what's going on.
B) You are not allowed to make threats. Please keep your voice down.
C) Why do you say that?
D) You are here voluntarily. You can leave if you want.

Question 14

A client is clenching his fists and yelling at another client on the unit. He appears to be close to losing control of his anger. Which of the following actions by the nurse is appropriate at this time?

A) Clear others out of the immediate area.
B) Prepare a PRN sedative.
C) Tell the client to stop and take a time-out.
D) Alert the security department of an impending aggressive outburst.

Question 15

In the psychiatric setting, what is the most effective intervention in preventing the hostile client's behavior from escalating to physical aggression?

A) Getting as far away from him or her as possible
B) Engaging the hostile person in dialogue
C) Yelling at the client to settle down now
D) Ensuring that the client gets his or her way

Question 16

An angry client has just thrown a chair across the room and is racing to pick up another chair to throw. The most appropriate action by the nurse would be which of the following?

A) Call for an emergency response from trained personnel.
B) Approach the client and firmly say, Stop, put it down.
C) Calmly call the client by name and encourage verbal expression of anger.
D) Assist the client to use problem-solving techniques instead of aggression.

Question 17

A client who has been physically aggressive arrives at the emergency room for a psychiatric assessment. Which would be the best approach for the nurse to use?

A) Have a sense of humor to show a lack of fear.
B) Provide close contact to increase the client's sense of safety.
C) Use brief statements and questions to obtain information.
D) Use open-ended questions, so the client can elaborate.

Question 18

The nurse is interviewing a client with a history of physical aggression. Which of the following should the nurse avoid?

A) Anticipating that a loss of control is possible and planning accordingly
B) Explaining the consequences the client will face if control is lost
C) Interviewing the client with another staff member present
D) Responding to verbal threats by terminating the interview and obtaining assistance

Question 19

When interacting with a client in the day room, the nurse determines that a violent outburst is imminent. Which of the following should the nurse do first?

A) Call for assistance.
B) Give the client choices.
C) Remove the other clients.
D) Talk to the client calmly.

Question 20

The client with a history of explosive outbursts becomes angry and states, I am really getting angry. The nurse sees this as

A) controlling.
B) manipulation.
C) progress.
D) regression.

Question 21

The client identifies anger management as a problem. What is the next step in planning therapeutic interactions?

A) Give the client a variety of choices on how to express anger.
B) Give the client permission to be angry.
C) Point out the senselessness of anger.
D) Tell the client not to be angry all the time.

Question 22

The nurse decides to place an aggressive and violent client in mechanical restraints. The nurse bases this decision on which of the following?

A) Client's mood
B) Client's safety
C) Court order
D) Physician's order

Question 23

The nurse observes two clients in the day room arguing. One client runs into the corner and huddles while the other follows and continues with verbal abuse. Which is the best action by the nurse?

A) Take an authoritatively step between the two clients.
B) Comfort the client huddled in the corner.
C) Directly address both clients and ask what is going on.
D) Engage the attention of the client who is still yelling and ask what is happening.

Question 24

Which of the following interventions would assist the client with the appropriate expression of anger?

A) Encourage catharsis
B) Encourage verbalization
C) Improve self-esteem
D) Isolate the client from others

Question 25

A client lost control of his behavior, broke a window, and made verbal threats to staff and other clients. The client was placed in mechanical restraints. Which statement should the nurse make to explain the use of restraints to the client?

A) The length of time you'll be in restraints is undetermined.
B) The staff will monitor your behavior closely.
C) This is what happens when you lose control.
D) This is a means of keeping you and others safe.

Question 26

Which of the following interventions are most effective in managing the environment to reduce or eliminate aggressive behavior? Select all that apply.

A) Planning group activities such as playing games
B) Scheduling one-to-one interactions with the client
C) Providing structure and consistency in the unit
D) Avoiding discussions among clients on the unit
E) Discouraging clients from negotiating solutions

Question 27

Which of the following statements about the crisis phase of aggression when the client becomes physically aggressive is true?

A) All staff should act to take charge of the situation.
B) The client must be restrained or sedated at once.
C) Staff should avoid communicating with the client.
D) Four to six trained staff members are needed to restrain.

Question 28

After an angry outburst, a client quickly appears more calm and rational. The nurse approaches the client. Which of the following is the most helpful response to the client at this time?

A) We will have to talk about this later.
B) You really scared me. I'm glad you are okay.
C) What happened that got you so upset?
D) What can you do differently next time you get angry?

Question 29

After an angry outburst, the client is tearful and remorseful. Which statement by the nurse would be most supportive?

A) You still need to work on your problem-solving skills.
B) I will not allow you to get that angry again.'
C) You should not have let your anger buildup like you did.
D) What could you have done when you first started to feel angry?

Question 30

One of the first steps that a nurse should take to deal effectively with aggressive clients is which of the following?

A) Reflect on abilities to handle own feelings of anger
B) Learn professional skills of anger management
C) Become proficient using reflective communication techniques
D) Understand how to activate crisis response teams

Question 31

Which of the following is most important to maintain therapeutic boundaries when working with aggressive clients?

A) Encourage clients to express how the nurse can avoid causing emotional irritation.
B) Discuss difficult patient care situations with a supervisor.
C) Reflect on your actions that may have instigated the client's anger,
D) Do not personalize a client's anger

Question 32

Which of the following are important issues for nurses to be aware of when working with angry, hostile, or aggressive clients? Select all that apply.

A) Nurses must be aware of their own feelings about anger and their use of assertive communication and conflict resolution.
B) Nurses must not allow themselves to become angry under any circumstances.
C) Nurses must know that a client's anger or aggressive behavior is preventable by a skilled nurse.
D) Nurses must discuss situations or the care of potentially aggressive clients with experienced nurses.
E) Nurses must be calm, nonjudgmental, and nonpunitive when using techniques to control a client's aggressive behavior.

Question 33

What a culture considers acceptable strongly influences the expression of anger. Which culture-bound syndrome is a dissociative episode characterized by a period of brooding followed by an outburst of violent, aggressive, or homicidal behavior directed at other people and objects?

A) Hwa-Byung
B) Hwabyeong
C) Amok
D) BouffÈe delirante