DEMENTIA/PHYSICAL
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Dementia/Physical Aggression
Suggested Answer Guidelines
Ron Jackson, 87 years old
Primary Concept
COGNITION
Interrelated Concepts (In order of emphasis)
Psychosis
Mood and Affect
Coping
Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
, DEMENTIA/PHYSICAL
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
, DEMENTIA/PHYSICAL
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Ron Jackson is an 87-year-old Caucasian male with a medical history of hypertension and Alzheimer's disease who was
brought to the emergency department (ED) by paramedics for evaluation of hallucinations, increased agitation, and
aggressive behavior toward Shirley, his elderly wife. His daughter was visiting and witnessed Ron becoming angry for no
apparent reason, telling Shirley she had to leave the house. He then pushed her, causing her to fall to the ground.
Ron has become progressively more agitated the past year and was started on quetiapine. Shirley confirms that Ron
has been more verbally abusive the past week, believing that she divorced him and that she needs to get out of the house,
but no physical aggression took place until today. Ron currently complains of a headache and insists that he got this
because “the Koreans beat me up real good in the ambulance!”
Personal/Social History:
Ron lives at home with Shirley, his wife of 62 years and has three children. Ron is a Korean War veteran who saw active
duty and is a retired salesman. Because his wife has been struggling to care for him, his family is in the process of making
arrangements for him to reside at a local memory care unit.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Dementia/Physical Aggression
Suggested Answer Guidelines
Ron Jackson, 87 years old
Primary Concept
COGNITION
Interrelated Concepts (In order of emphasis)
Psychosis
Mood and Affect
Coping
Clinical Judgment
NCLEX Client Need Categories Percentage of Items from Each Covered in
Category/Subcategory Case Study
Safe and Effective Care Environment
Management of Care 17-23%
Safety and Infection Control 9-15%
Health Promotion and Maintenance 6-12%
Psychosocial Integrity 6-12%
Physiological Integrity
Basic Care and Comfort 6-12%
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
, DEMENTIA/PHYSICAL
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Pharmacological and Parenteral Therapies 12-18%
Reduction of Risk Potential 9-15%
Physiological Adaptation 11-17%
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
, DEMENTIA/PHYSICAL
AGGRESSION SUGGESTED
ANSWER GUIDELINES RON
JACKSON, 87 YEARS OLD
Part I: Recognizing RELEVANT Clinical Data
History of Present Problem:
Ron Jackson is an 87-year-old Caucasian male with a medical history of hypertension and Alzheimer's disease who was
brought to the emergency department (ED) by paramedics for evaluation of hallucinations, increased agitation, and
aggressive behavior toward Shirley, his elderly wife. His daughter was visiting and witnessed Ron becoming angry for no
apparent reason, telling Shirley she had to leave the house. He then pushed her, causing her to fall to the ground.
Ron has become progressively more agitated the past year and was started on quetiapine. Shirley confirms that Ron
has been more verbally abusive the past week, believing that she divorced him and that she needs to get out of the house,
but no physical aggression took place until today. Ron currently complains of a headache and insists that he got this
because “the Koreans beat me up real good in the ambulance!”
Personal/Social History:
Ron lives at home with Shirley, his wife of 62 years and has three children. Ron is a Korean War veteran who saw active
duty and is a retired salesman. Because his wife has been struggling to care for him, his family is in the process of making
arrangements for him to reside at a local memory care unit.
What data from the histories are RELEVANT and must be interpreted as clinically significant by the nurse?
(Reduction of Risk Potential)
RELEVANT Data from Present Problem: Clinical Significance:
Copyright © 2019 Keith Rischer, d/b/a KeithRN.com. All Rights
reserved
