BSN 2 -B8

NUR 145 - LECTURE

SESSION 41

1.ANSWER: A
RATIO: The manic client is hyperactive and may engage in injurious activities. A quiet environment and
consistent and firm limits should be set to ensure safety. B. Clear, concise directions are given because of the
distractibility of the client but this is not the priority. C. The manic client tends to externalize hostile feelings,
however only non-destructive methods of expression should be allowed D. Nurses set limit as needed.
Assigning a staff to be with the client always is not realistic.

2.ANSWER: B
RATIO: Painting and drawing, for instance, are great mediums for creative expression, but crafts such as
origami, weaving, and knitting can also keep you busy and turn out projects you'll be proud of. Grow a garden.
Gardening requires a lot of time and energy, and it can be used as a constructive activity during manic phases.

3.ANSWER: B
RATIO: The unstable. aggressive client should be assigned to the most experienced nurse.Options A. C. and D.
A shy. inexperienced. soft-spoken nurse may feel intimidated by the angry patient.

4.ANSWER: A
RATIO: Taking a directive role in the client’s verbalization of feelings can decrease the client’s anger.Option
B: A confrontational approach can be threatening and adds to the client’s tension. Options C and D: Use of
restraints and isolation may be required if less restrictive interventions are unsuccessful.

5.ANSWER: A
RATIO: In a non-violent aggressive behavior. help the client identify the stressor or the true object of hostility.
This helps reveal unresolved issues so that they may be confronted.Option B: Pacing is a tension relieving
measure for an agitated client.Option C: This is a threatening statement that ca heighten the client’s
tension.Option D: Seclusion is used when less restrictive measures have failed.

6.ANSWER:D
RATIO: The proper procedure for dealing with harmful behavior is to first try to calm patient verbally. When
verbal and psychopharmacologic interventions are not adequate to handle the aggressiveness. seclusion or
restraints may be applicable. Options A, B and C are appropriate approaches during the escalation phase of
aggression.

7.ANSWER: B
RATIO: A mature experienced nurse. The munstable, aggressive client should be assigned to the most
experienced nurse. A, C and D. A shy, inexperienced, soft-spoken nurse may feel intimidated by the angry
patient.

8. ANSWER: A
RATIO: Taking a directive role in verbalizing feelings Taking a directive role in the client’s verbalization of
feelings can deescalate the client’s anger. B. A confrontational app roach can be threatening and adds to the
client’s tension. C and D. Use of restraints and isolation may be required if less restrictive interventions are
unsuccessful.

9.ANSWER:D
RATIO: The staff carried out less restrictive measures but were unsuccessful. This documentation indicates that
the client has been placed on restraints after the least restrictive measures failed in containing the client’s
violent behavior.

10.ANSWER:C
RATIO: Manifest enduring patterns of inflexible behaviors Personality disorders are characterized by inflexible
traits and characteristics that are lifelong. This disorder is manifested by life-long patterns of behavior. The
client with this disorder will not likely present himself for treatment unless something has gone wrong in his life
so he may not recover from therapeutic intervention. B. Medications are generally not recommended for
personality disorders.