NSG 322 EXAM 4 QUESTIONS AND CORRECT ANSWERS WITH
COMPLETE SOLUTION | LATEST UPDATE 2026/2027 | GRADED
A+ | bRAND NEW | 100% GUARANTEED PASS
anger, violence, aggression - ANSWER-ANGER
emotional response to frustration
AGGRESSION
an action or behavior that results in verbal or physical attack
-it is not always inappropriate when used for self defense
VIOLENCE
the intentional use of force that results in injury or damage
-never appropriate
mc settings for violence - ANSWER--psychiatric units
-emergency department
-ICU
-geriatric units
co occuring disorders - ANSWER-1. substance use
2. PTSD
3. bipolar
4. chronic illness: anger and hostility can lead to chronic illness like HTN, CV disease, and resp
distress
>these behaviors also lead to increased inflammation
risk factors - ANSWER-BIOLOGICAL
-aggression associated with brain tumor, TBI, Alzheimer's, and epilepsy
-aggression is associated with serotonin, GABA, dopamine, and glutamate
,>serotonin can both inhibit or cause aggression
>dopamine produces reward seeking behavior and if their goals are not met it can cause
aggression
>GABA is an inhibitory NT. It inhibits aggression but if there is not enough GABA, aggression can
occur
-children who experience violence are more likely to be more aggressive. increased risk of child
plays violent video games or sees violence at home
COGNITIVE
1. behavioral theory: emotions are learned responses to external stimuli
>the stimulus is a threat that causes an act
2. social learning theory: children learn aggression from observing and imitating others,
especially if it is rewarded. this can lead to bullying
trauma informed care - ANSWER-disruptive patients often have a history of violence and
victimization. this trauma in their past leads them to be vulnerable and impedes their ability to
cope
predicators of violence - ANSWER--history of violence
-hyperactive: restless, pacing
-increased anxiety and tension: clenched fists or jaw, rigid, mumbling
-intense or no eye contact
-verbal abuse, loud voice or very soft, or stone silence
-intoxicated
-possession of object or weapon
THINGS IN HOSPITAL THAT CAUSE THIS
-overcrowding
-staff inexperience
-provocative or controlling staff
-arbitrary revocation of privileges !!
-poor limit setting
-warm and loud
THINGS TO ASK
-do you wish to cause harm?
-do you have a plan?
,-do they have the means?
-do they fit the demographic?
>male, 14-24, low socioeconomic status, poor social support, prison time
diagnosis and s/s - ANSWER-RISK FOR VIOLENCE
-s/s: clenching fist or jaw, rigid, history of violence
-goal: ID feelings, self control
RISK FOR SUICIDE
-s/s: impulsive, hope/worthless, SI
-goal: plans for the future, no suicide
INEFFECTIVE COPING
-s/s: cant complete simple tasks, cant problem solve
-goal: ID how they are coping rn, try new ways to cope
STRESS OVERLOAD
-s/s: anger, impatience, tension
-goal: calm
seclusion and restraint - ANSWER-SECLUSION
-confinement of a patient to a room alone
RESTRAINT
-use of physical or mechanical device, material, or chemical that prevents the free movement of
the patients arms, legs, body, or head
GUIDELINES
-these are only used when least restrictive alternatives have failed. must attempt to de-escalate
first
1. indications: to prevent self harm or assault to others
2. doc: behaviors leading to restraint and the least restrictive alternatives used
3. legal: providers signature, notify pt family or advocate, discontinue asap
4. assess: why they needed restraint and not seclusion, physical exam to see if there is a medical
cause mental status at time of restraint
5. observation: must have staff observing whole time, doc every 15 mins, vs, blood flow to hands
and feet, restraint is not rubbing, provide for elimination/hydration/nutrition
6. release: pt must follow directions and stay in control
, -debrief after: pt must be invited to join
TIPS
-physical holding of the patient is restraint
-all 4 side rails up is restraint (unless for seizure)
-tucking in sheets too tight is restraint
-keeping them in room with physical intervention is restraint
-there are no PRN
CONTRAINDICATION
-copd, pregnant, spinal injury, seizure
-unstable psych or medical issue
-delirium or dementia may make it intolerable
de-escalation techniques - ANSWER--calm manner, speak soft slow and simple
-be honest
-be genuine and show empathy
-respond as soon as possible
-maintain their dignity
-maintain personal space, dont stant directly infront of the door, stand at an angle
-avoid arguing
-be assertive
-ID stressors, the situation, and what they need
-give several clear options
-invest time
-quiet place to talk
-open ended ?
-confront the behavior once the patient is calm. when they are escalating provide verbal
feedback
-tell them you are on their side
-ask "what will help now"
-set clear limits
treatment - ANSWER-PHARMACOLOGIC
COMPLETE SOLUTION | LATEST UPDATE 2026/2027 | GRADED
A+ | bRAND NEW | 100% GUARANTEED PASS
anger, violence, aggression - ANSWER-ANGER
emotional response to frustration
AGGRESSION
an action or behavior that results in verbal or physical attack
-it is not always inappropriate when used for self defense
VIOLENCE
the intentional use of force that results in injury or damage
-never appropriate
mc settings for violence - ANSWER--psychiatric units
-emergency department
-ICU
-geriatric units
co occuring disorders - ANSWER-1. substance use
2. PTSD
3. bipolar
4. chronic illness: anger and hostility can lead to chronic illness like HTN, CV disease, and resp
distress
>these behaviors also lead to increased inflammation
risk factors - ANSWER-BIOLOGICAL
-aggression associated with brain tumor, TBI, Alzheimer's, and epilepsy
-aggression is associated with serotonin, GABA, dopamine, and glutamate
,>serotonin can both inhibit or cause aggression
>dopamine produces reward seeking behavior and if their goals are not met it can cause
aggression
>GABA is an inhibitory NT. It inhibits aggression but if there is not enough GABA, aggression can
occur
-children who experience violence are more likely to be more aggressive. increased risk of child
plays violent video games or sees violence at home
COGNITIVE
1. behavioral theory: emotions are learned responses to external stimuli
>the stimulus is a threat that causes an act
2. social learning theory: children learn aggression from observing and imitating others,
especially if it is rewarded. this can lead to bullying
trauma informed care - ANSWER-disruptive patients often have a history of violence and
victimization. this trauma in their past leads them to be vulnerable and impedes their ability to
cope
predicators of violence - ANSWER--history of violence
-hyperactive: restless, pacing
-increased anxiety and tension: clenched fists or jaw, rigid, mumbling
-intense or no eye contact
-verbal abuse, loud voice or very soft, or stone silence
-intoxicated
-possession of object or weapon
THINGS IN HOSPITAL THAT CAUSE THIS
-overcrowding
-staff inexperience
-provocative or controlling staff
-arbitrary revocation of privileges !!
-poor limit setting
-warm and loud
THINGS TO ASK
-do you wish to cause harm?
-do you have a plan?
,-do they have the means?
-do they fit the demographic?
>male, 14-24, low socioeconomic status, poor social support, prison time
diagnosis and s/s - ANSWER-RISK FOR VIOLENCE
-s/s: clenching fist or jaw, rigid, history of violence
-goal: ID feelings, self control
RISK FOR SUICIDE
-s/s: impulsive, hope/worthless, SI
-goal: plans for the future, no suicide
INEFFECTIVE COPING
-s/s: cant complete simple tasks, cant problem solve
-goal: ID how they are coping rn, try new ways to cope
STRESS OVERLOAD
-s/s: anger, impatience, tension
-goal: calm
seclusion and restraint - ANSWER-SECLUSION
-confinement of a patient to a room alone
RESTRAINT
-use of physical or mechanical device, material, or chemical that prevents the free movement of
the patients arms, legs, body, or head
GUIDELINES
-these are only used when least restrictive alternatives have failed. must attempt to de-escalate
first
1. indications: to prevent self harm or assault to others
2. doc: behaviors leading to restraint and the least restrictive alternatives used
3. legal: providers signature, notify pt family or advocate, discontinue asap
4. assess: why they needed restraint and not seclusion, physical exam to see if there is a medical
cause mental status at time of restraint
5. observation: must have staff observing whole time, doc every 15 mins, vs, blood flow to hands
and feet, restraint is not rubbing, provide for elimination/hydration/nutrition
6. release: pt must follow directions and stay in control
, -debrief after: pt must be invited to join
TIPS
-physical holding of the patient is restraint
-all 4 side rails up is restraint (unless for seizure)
-tucking in sheets too tight is restraint
-keeping them in room with physical intervention is restraint
-there are no PRN
CONTRAINDICATION
-copd, pregnant, spinal injury, seizure
-unstable psych or medical issue
-delirium or dementia may make it intolerable
de-escalation techniques - ANSWER--calm manner, speak soft slow and simple
-be honest
-be genuine and show empathy
-respond as soon as possible
-maintain their dignity
-maintain personal space, dont stant directly infront of the door, stand at an angle
-avoid arguing
-be assertive
-ID stressors, the situation, and what they need
-give several clear options
-invest time
-quiet place to talk
-open ended ?
-confront the behavior once the patient is calm. when they are escalating provide verbal
feedback
-tell them you are on their side
-ask "what will help now"
-set clear limits
treatment - ANSWER-PHARMACOLOGIC
