Question 1

The nurse has just been notified that a client is to be admitted from the emergency department (ED) with a diagnosis of alcohol intoxication. The ED nurse says they have been unable to obtain much history because of the client's lethargic state. Which action is an appropriate intervention by the nurse?

Accepted Answer

Approaching the client with caution when obtaining vital signs and shift assessments is an appropriate intervention. It is important to assess the client's vital signs and level of consciousness to ensure that there are no immediate threats to their health. However, caution should be taken due to the client's lethargic state and possible alcohol-induced confusion or aggression. Restraints and armed security are not appropriate interventions unless the client becomes physically aggressive or poses a danger to themselves or others. Placing the client farthest from the nurse's station may not be necessary and could delay interventions in the event of an emergency.

Question 2

The nurse appears in the nursing station with multiple facial lacerations and says, "A visitor hit me." What is the manager's priority action?

Accepted Answer

The priority action is to ensure the nurse receives immediate medical attention for the injuries sustained.

Question 3

A nurse hears screaming from a client's room. A male visitor leaves the client's room. Which is the nurse's priority action?

Accepted Answer

The nurse's priority is to ensure the safety and well-being of the client. The first step in achieving this is to check on the client to assess their condition and address any immediate concerns. While it may be important to involve the police or notify the client's physician depending on the situation, the nurse's first priority is to provide immediate care to the client. Following the visitor may also be appropriate in certain situations, such as if there is reason to believe that the visitor posed a threat to the client's safety. However, this should not take precedence over checking on the client.

Question 4

A newly formed task force is addressing the prevention of violence in the health care organization. Which group of employees is most likely to experience violence?

Accepted Answer

The answer of A newly formed task force is addressing...

Question 5

An ICU unit has experienced an influx of aggressive behaviors by visitors against nurses The ICU manager has instituted a policy to limit visiting hours. An employee asks the manager why the change in visiting hours has been implemented. Which response is likely the most accurate?

Accepted Answer

1. It is true that nurses need time to care for clients, but this is probably not the real reason for the change.
2. Visiting hours are not changed simply because they have not been changed in years.
3. There is no indication that the physicians have anything to do with changing these hours.
4. Open visiting hours do allow for added stress and commotion. When visitors are aggressive toward nurses, restricting visiting hours may be essential.

Question 6

The nurse is talking to a client who has a history of aggressive outbursts. What strategies should this nurse use?

Accepted Answer

It is important for the nurse to remain calm and speak in a moderate tone to avoid escalating the situation. Speaking in simple terms can help the client understand and feel heard. Allowing the client to speak can also help them feel heard and understood, which may help to diffuse the aggressive behavior. Using powerful body language or an aggressive demeanor can further escalate the situation and should be avoided.

Question 7

An ICU nurse has just assisted the physician in placing a central line in a client. Over the past few days the client's son has been increasingly verbally abusive to the nursing staff. The unit secretary tells the nurse that the son is at the nurse's station demanding to see the client. Which action by the nurse is most important?

Accepted Answer

1. Healthcare staff should be aware when and where to store medical instruments that may be used as weapons.
2. The son should be informed of the client's condition, but with the history and the escalation of his behavior, the nurse should take action to protect staff.
3. Ignoring the son may cause the violent behavior to escalate.
4. Limiting visitation may cause the violent behavior to escalate.

Question 8

A manager is following up on an employee's injuries. The manager has contacted human resources to initiate the process of worker's compensation. Which action would be appropriate by the manager?

Accepted Answer

Following up with the employee to express concern and answer any questions regarding the situation is appropriate as it shows compassion and care towards the employee. It also helps in creating a positive work environment and maintains a good relationship between the manager and the employee. Additionally, it ensures that the employee is aware of the steps being taken to address their injuries and can provide any necessary information. While the other options may also be necessary, they are not the most appropriate action for the manager to take in this situation.

Question 9

A nurse manager has required that all nursing staff attend an in-service on dealing with verbal threats. A staff nurse wonders why this is necessary since, "Words don't hurt me. I just ignore them." What is the nurse manager's most appropriate response to this statement?

Accepted Answer

Verbal threats often precede physical violence, so it's important for nursing staff to know how to de-escalate situations and prevent them from escalating into physical violence.

Question 10

When a nurse enters the room, the client states, "He has a gun," and points toward a male visitor. The nurse does not see a gun. What should the nurse do?

Accepted Answer

If a client states that someone has a gun, even if the nurse doesn't see a gun, it is important to take the statement seriously and notify security immediately. The safety of the client and staff should be the nurse's top priority.

Question 11

The ICU staff has been dealing with several distractions over the last week. There was a scheduling error caused by a change in the staffing matrix and miscommunication between management and administration. The staff is also caring for a client whose family has been verbally abusive and threatening. The manager notes an increase in absenteeism with the staff over the past 2 days. To which of these distractions is the absenteeism most likely related?

Accepted Answer

The absenteeism is most likely related to the hostile environment created by the verbally abusive and threatening family of the client. This can lead to a decline in staff morale and motivation, resulting in increased absenteeism. The other distractions may also contribute to the overall stress and workload of the staff, but the hostile environment is likely the main factor affecting absenteeism.

Question 12

The hospital operator announced over the paging system, "Dr. Strong, fourth floor, A-wing, Dr. Strong, fourth floor, A-wing." A newly hired nurse asks another nurse, "Who is Dr. Strong?" The nurse replies, "This is the announcement that alerts security there is violent behavior on that unit." Which statement would be an appropriate report to this unit's manager?

Accepted Answer

This statement addresses the issue of the newly hired nurse not understanding the significance of the announcement and suggests a solution to educate staff through an in-service on the policy.

Question 13

An OB nurse is caring for an unmarried woman who is in labor. The nurse learns the client is unwilling to name the baby's father. A male visitor who comes to visit the client raises the nurse's concern that he might be violent. Which behavior would raise this concern?

Accepted Answer

The visitor moving into the nurse's personal space when asking about the client's status is an invasion of personal boundaries and raises concerns about potential violence. Option A could potentially be a red flag, but it is not enough information to make a definitive judgment. Option B is understandable given the situation, and option D does not necessarily raise any red flags.

Question 14

The emergency department (ED) staff has been caring for a client who exhibited violent behavior when pain medication was denied. Once the situation was resolved, which action by the ED manager would be appropriate?

Accepted Answer

Organizing a training program to educate staff on how to manage violent behavior is the most appropriate action that the ED manager can take. This will not only help equip the staff with the necessary skills to handle such incidents in the future but will also ensure the safety of both staff and clients. While arranging an agreement with law enforcement for rapid response and developing a team of staff for these situations could be helpful, it is not as effective as providing staff with proper training. Posting a sign stating that pain medication is not given unless the client is admitted to the hospital is not an appropriate action as it may not always be possible to admit clients to the hospital immediately, and they may require pain management while awaiting admission.

Question 15

A nurse manager is investigating a report made by a staff nurse. The nurses states that a visitor backed the nurse up against a wall and was verbally abusive but did not touch the nurse. How should the manager describe this incident to the human resources (HR) director?

Accepted Answer

The incident involves verbal abuse and intimidation, which falls under the category of workplace violence, even though there was no physical contact.

Question 16

A hospital's safety committee has been asked to make recommendations to administration regarding methods to improve employee safety. Which suggestions should be made?

Accepted Answer

Security cameras and curved mirrors can help to improve employee safety by providing increased visibility and reducing blind spots.

Question 17

The nurse is caring for a client who is aggressive, demanding, and verbally abusive toward staff and visitors. The client says, "I'm getting out of here. I'm going to end it all." What immediate action should the nurse take?

Accepted Answer

The client has made a statement indicating a potential for self-harm, so the nurse should prioritize the safety of the client and others. Calling security is the best immediate action to ensure the client's safety and prevent harm to oneself or others. Attempting to block the exit door may escalate the situation and put the nurse in danger. Administering a sedative without an order from a healthcare provider would be considered a restraint and could result in harm to the client. Notifying the client's family may be necessary, but it is not the most important immediate action in this scenario.

Question 18

An emergency department (ED) client is demanding pain medication and threatening to harm staff if they do not provide it. The ED physician calmly continues to ask the client about the level and location of pain as the nurse steps away and notifies security. What is the physician attempting to do by asking these questions?

Accepted Answer

The physician is attempting to de-escalate the situation by remaining calm and asking questions about the client's pain, which can help redirect the client's focus away from their demands and towards their actual health needs. This approach can reduce the potential for violence or harm towards staff.

Question 19

A chief nurse officer (CNO) is contacted by the organization's supervisor on a Saturday night regarding a problem in the hospital's emergency department. The supervisor describes an incident in which an orderly was assaulted. Why is the CNO not surprised about this report?

Accepted Answer

Research has shown that health care violence is more likely to occur in emergency departments due to factors such as high patient volumes, long wait times, and the presence of patients with aggressive or violent behaviors.

Question 20

A nursing supervisor is seeking staff input while developing policies regarding violence prevention. A staff nurse says, "We have lots of threatening behaviors on our unit." What is the most important question for the supervisor to ask?

Accepted Answer

This question addresses the effectiveness of the reporting system in place and whether action is taken quickly in response to threats. Understanding this information will help the supervisor identify any potential gaps that need to be addressed to improve violence prevention policies. Choice A may not provide actionable information, and choice B assumes that the staff nurse has not reported incidents, which may not be accurate. Choice C is irrelevant to the topic at hand.

Quiz 23: Preventing Workplace Violence