Question 1

A nurse enters a client's room and sees a visitor threatening the client. The nurse questions the visitor in a nonthreatening manner. The visitor begins to threaten the nurse. What should the nurse do in this situation?

Accepted Answer

1. The nurse should recognize threatening behavior and keep a safe distance from the visitor exhibiting the behavior.
2. The nurse should obtain assistance, but yelling may increase the visitor's aggression.
3. The nurse should not leave the client unless it is absolutely necessary to obtain assistance.
4. Threatening the visitor with assault charges may further escalate the situation.

Question 2

A night shift supervisor has been called to the emergency department to assist in managing a violent situation with a visitor. Once the violent person has been contained and security and police have responded, what should be the supervisor's next action?

Accepted Answer

1. The violent person is contained and security and police have arrived, so it is not necessary to alert other staff regarding the situation.
2. It is inappropriate to call the violent person's physician.
3. An incident report is a part of the reporting process for violent events.
4. The supervisor does have duties following a violent episode.

Question 3

Two nurses are in the day room when a visitor approaches and starts yelling about the care his mother is receiving. One nurse says, "I'm sorry you are upset. What can I do for you?" The visitor continues to complain more loudly. What should the other nurse do? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. Isolating a person who is angry and aggressive is helped by taking away part of the audience. This is also a strategy to protect others.
2. It may be that the visitor is just upset and will calm down quickly with the other nurse's verbal intervention, but that is not assured.
3. This question may further infuriate the visitor because the nurses don't know him or his mother. Also, one nurse should carry the conversation.
4. The nurse should not make a move toward the visitor or demean him.
5. The nurse should move away and out of the room to call security.

Question 4

The emergency department (ED) has seen an increase in violent behavior over the past year. The manager has voiced concerns to the chief nurse officer (CNO) regarding the safety of the ED staff. What should be done as a first step in addressing this issue?

Accepted Answer

1. It might be beneficial to discuss the organization's policies and procedures with local law enforcement, but this is not the first step.
2. The first step should be to review and revise policies and procedures so that they are reflective of effectively managing the types of incidents seen in the department.
3. The CNO should certainly discuss the request with hospital security, but this is not the first step.
4. The CNO should not delegate this concern but should personally manage the issue.

Question 5

A highly intoxicated client is brought to the emergency department. Paramedics report that the client was violent during transport and tried to kick the door out of the ambulance. How should the nurse prepare before seeing this client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The nurse should remove any potential weapons.
2. A stethoscope hung around the neck is a convenient "handle" for anyone who would like to gain control of the nurse.
3. The nurse should not ask the paramedics to perform this intervention.
4. Being calm and pleasant can help defuse potentially violent situations.
5. The nurse should not wait 20 minutes to see a client who is highly intoxicated.

Question 6

Potential violence in healthcare organizations can include what risk factors?

Accepted Answer

1. Risk factors for potential violence in healthcare organizations include working understaffed especially at mealtimes and visiting hours, long wait times, overcrowded waiting rooms, working alone, inadequate security, unlimited public access, and poorly lit corridors, rooms, and parking lots.
2. Risk factors for potential violence in healthcare organizations include working understaffed especially at mealtimes and visiting hours, long wait times, overcrowded waiting rooms, working alone, inadequate security, unlimited public access, and poorly lit corridors, rooms, and parking lots.
3. Risk factors for potential violence in healthcare organizations include working understaffed especially at mealtimes and visiting hours, long wait times, overcrowded waiting rooms, working alone, inadequate security, unlimited public access, and poorly lit corridors, rooms, and parking lots.
4. Risk factors for potential violence in healthcare organizations include working understaffed especially at mealtimes, and visiting hours, long wait times, overcrowded waiting rooms, working alone, inadequate security, unlimited public access, and poorly lit corridors, rooms, and parking lots.
5. Risk factors for potential violence in healthcare organizations include working understaffed especially at mealtimes and visiting hours, long wait times, overcrowded waiting rooms, working alone, inadequate security, unlimited public access, and poorly lit corridors, rooms, and parking lots.

Question 7

An emergency department (ED) has doubled its client visits within the past year. This has led to increased wait times and overcrowding in the ED waiting room. Which recommendation by the ED nurse manager to the chief nurse officer (CNO) would be most effective?

Accepted Answer

1. Simply adding space and beds will not help with the rapidity in which clients are seen and discharged, if there are not enough nurses to staff the additional area.
2. The department has doubled in volume of clients, so it is necessary to increase staff to manage this volume. Increased wait times and overcrowding may lead to violent behavior.
3. Hiring an additional ED physician will not be helpful if there are not enough ED nurses to provide care.
4. Hiring another registration employee may speed up client registration, but it will not decrease wait times.

Question 8

Incivility includes which of the following behaviors?

Accepted Answer

1. Incivility is aggressive behavior including ignoring a person, treating in a belittling manner, disparaging remarks purposely within hearing distance, ridiculing a person, speaking sarcastically about a person, direct verbal abuse, sexual harassment, and physical attack.
2. Incivility is aggressive behavior including ignoring a person, treating in a belittling manner, disparaging remarks purposely within hearing distance, ridiculing a person, speaking sarcastically about a person, direct verbal abuse, sexual harassment, and physical attack.
3. Incivility is aggressive behavior including ignoring a person, treating in a belittling manner, disparaging remarks purposely within hearing distance, ridiculing a person, speaking sarcastically about a person, direct verbal abuse, sexual harassment, and physical attack.
4. Incivility is aggressive behavior including ignoring a person, treating in a belittling manner, disparaging remarks purposely within hearing distance, ridiculing a person, speaking sarcastically about a person, direct verbal abuse, sexual harassment, and physical attack.
5. Incivility is aggressive behavior including ignoring a person, treating in a belittling manner, disparaging remarks purposely within hearing distance, ridiculing a person, speaking sarcastically about a person, direct verbal abuse, sexual harassment, and physical attack.

Question 9

As part of a presentation on healthcare workplace violence, the speaker says, "Injuries to nurses from violent acts in the workplace are probably underreported." What rationale should the speaker offer for this statement? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The definition of workplace violence may not be clear.
2. Reporting policies may not be in place.
3. For many years, violence was tolerated in healthcare.
4. Some believe that being the target of a violent act is the result of poor job performance.
5. Most violence against nurses is from clients.

Question 10

A geriatric client in a long-term-care facility becomes increasingly confused and verbally aggressive as evening approaches. Which actions would the nurse interpret as potentially signaling a violent episode? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The client may be about to flee the room or may be blocking the nurse's exit.
2. A blank stare could be related to pathology such as dementia or may signal a violent episode.
3. Alertness and orientation do not signal impending violence.
4. Preparing for battle signals impending violence.
5. It is fairly unlikely that a geriatric client in a long-term-care facility has access to a gun. The nurse must be aware of the statement but should consider the context.

Question 11

A staff nurse is known for having temper tantrums when the unit is stressful. The nurse slams doors, grumbles, and is demeaning to coworkers. The behavior has never been violent, but today it is becoming more threatening. The nurse just came into the station and said, "My nurse assistant is stupid. I'm not going to put up with that much longer. She needs to be put in her place." How should the manager respond to this situation? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

Accepted Answer

1. The nurse should be removed from the situation.
2. This behavior should be documented.
3. Making excuses for this nurse is not appropriate. The nurse's temper is escalating and may grow out of control. Excuses violate the zero-tolerance policy.
4. As the behaviors are escalating, security should be notified.
5. The nurse should not be allowed to remain on the unit for the rest of the shift.

Quiz 24: Preventing Workplace Violence