NUR 3450 EXAM 4 COMPREHENSIVE
REVIEW QUESTIONS AND ANSWERS
VERIFIED SET
●● Aggression
Answer: Action or behavior that results in verbal or physical attack. It is
not okay to be aggressive.
●● Which units see the most violence from patients?
Answer: Psychiatric units, geriatric units, and intensive care units,
Emergency Room.
●● Risk Factors for Anger, Aggression, and Violence.
Answer: Hypertension and cardiovascular disease including myocardial
infarctions and ischemic strokes.
●● Comorbidity for anger, aggression, and violence
Answer: Individuals with PTSD and substances abuse have issues with
aggression. Individuals with bipolar disorder have difficulty with anger
and aggression during remission. It coexists in individuals with
depression, anxiety, psychosis, and personality disorders.
●● Etiology: Neurobiological factors to anger, aggression, and violence
,Answer: Brain tumors, Alzheimers, disease, temporal lobe epilepsy, and
traumatic injury to certain parts of the brain result in changes to
personality that could include increased violence.
●● Which area of the brain is associated with aggression?
Answer: The limbic system which is located beneath the cerebrum on
both sides of the thalamus. It is responsible for combining higher mental
functions and primitive emotions into one system, learning, and the
formation of memories.
●● What is the emotional center of the brain?
Answer: The amygdala! it helps evaluate the emotional content of
experiences. It helps the brain to recognize potential threats and whether
to activate the fight or flight response.
●● Which cortex is an important role in aggressive behavior?
Answer: The prefrontal cortex is the area of the brain that is responsible
for executive functions. Executive functions allows us to distinguish
between good and bad, consequences of actions, goal-directed
behaviors, and suppressing socially unacceptable activities.
●● Which neurotransmitters play a role in anger and aggression?
Answer: Serotonin can both inhibit and stimulate aggressive behavior,
depending on the part of the brain being measured.
,Dopamine's impact on reward-seeking behaviors may increase
aggression. Serotonin and dopamine can sometimes enhance aggression
and sometimes reduce impulsivity that leads to aggression. GABA the
main inhibitory neurotransmitter may reduce aggressiveness, its absence
may increase impulsivity and aggressive responses.
●● Anger Behavioral Theory
Answer: Is a learned response to environmental stimuli.
●● Anger Social Learning Theory
Answer: Researchers demonstrated that children learn aggression by
observing and imitating behaviors of others, especially if that that
behavior is rewarded.
●● Predictors of Violence (Signs and Symptoms)
Answer: Hyperactivity: most important predictor of imminent violence
(pacing or restlessness). Increase anxiety and tension, clenched jaw or
fist, rigid posture, fixed or tense facial expression, mumbling to self
(patient may have shortness of breath, sweating, and rapid pulse). Verbal
abuse: profanity, argumentativeness. Loud voice, change of pitch, or
very soft voice, forcing others to strain to hear. Stone silence. Intense
eye contact or avoidance of eye contact. Recent acts of violence,
including property violence. Alcohol or drug intoxication. Possession of
a weapon or object that may be used as a weapon (fork or knife).
Isolation that is uncharacteristic. Milieu characteristics conducive to
violence: Overcrowding, staff inexperience, provocative or controlling
staff, poor limit setting, arbitrary revocation of privileges.
, ●● General Assessment for a patient experiencing anger.
Answer: Patient will exhibit increased demands, irritability, frowning,
redness in the face, pacing, twisting of the hands, or clenching and
unclenching of the fists are all signs of irritation. Speech may either be
increased in rate and volume or may be slowed, pointed, and quite.
●● Trauma-informed Care
Answer: It is based on the notion that disruptive patients often have
histories that include violence and victimizations. This care focuses on
the patients past experiences of violence or trauma and on the role these
experiences currently play in their lives.
●● Anger and Aggression Assessment Guidelines
Answer: A history of violence is the single best predictor of future
violence. Patients who are delusional, hyperactive, impulsive or
predisposed to irritability are at higher risk for violence. Major factors
associated with violence can be assessed with these questions (Does the
pt have a wish or intent to harm?, Does the pt have plan?, Does the
patient have demographic risk factors: male, aged 14-24, low
socioeconomic status, inadequate support system, and prison time).
Aggression by patient occurs most often in the context of limit-setting
by the nurse. History of limited coping skills, including lack of
assertiveness or use of intimidation, indicates a higher risk of using
violence.
REVIEW QUESTIONS AND ANSWERS
VERIFIED SET
●● Aggression
Answer: Action or behavior that results in verbal or physical attack. It is
not okay to be aggressive.
●● Which units see the most violence from patients?
Answer: Psychiatric units, geriatric units, and intensive care units,
Emergency Room.
●● Risk Factors for Anger, Aggression, and Violence.
Answer: Hypertension and cardiovascular disease including myocardial
infarctions and ischemic strokes.
●● Comorbidity for anger, aggression, and violence
Answer: Individuals with PTSD and substances abuse have issues with
aggression. Individuals with bipolar disorder have difficulty with anger
and aggression during remission. It coexists in individuals with
depression, anxiety, psychosis, and personality disorders.
●● Etiology: Neurobiological factors to anger, aggression, and violence
,Answer: Brain tumors, Alzheimers, disease, temporal lobe epilepsy, and
traumatic injury to certain parts of the brain result in changes to
personality that could include increased violence.
●● Which area of the brain is associated with aggression?
Answer: The limbic system which is located beneath the cerebrum on
both sides of the thalamus. It is responsible for combining higher mental
functions and primitive emotions into one system, learning, and the
formation of memories.
●● What is the emotional center of the brain?
Answer: The amygdala! it helps evaluate the emotional content of
experiences. It helps the brain to recognize potential threats and whether
to activate the fight or flight response.
●● Which cortex is an important role in aggressive behavior?
Answer: The prefrontal cortex is the area of the brain that is responsible
for executive functions. Executive functions allows us to distinguish
between good and bad, consequences of actions, goal-directed
behaviors, and suppressing socially unacceptable activities.
●● Which neurotransmitters play a role in anger and aggression?
Answer: Serotonin can both inhibit and stimulate aggressive behavior,
depending on the part of the brain being measured.
,Dopamine's impact on reward-seeking behaviors may increase
aggression. Serotonin and dopamine can sometimes enhance aggression
and sometimes reduce impulsivity that leads to aggression. GABA the
main inhibitory neurotransmitter may reduce aggressiveness, its absence
may increase impulsivity and aggressive responses.
●● Anger Behavioral Theory
Answer: Is a learned response to environmental stimuli.
●● Anger Social Learning Theory
Answer: Researchers demonstrated that children learn aggression by
observing and imitating behaviors of others, especially if that that
behavior is rewarded.
●● Predictors of Violence (Signs and Symptoms)
Answer: Hyperactivity: most important predictor of imminent violence
(pacing or restlessness). Increase anxiety and tension, clenched jaw or
fist, rigid posture, fixed or tense facial expression, mumbling to self
(patient may have shortness of breath, sweating, and rapid pulse). Verbal
abuse: profanity, argumentativeness. Loud voice, change of pitch, or
very soft voice, forcing others to strain to hear. Stone silence. Intense
eye contact or avoidance of eye contact. Recent acts of violence,
including property violence. Alcohol or drug intoxication. Possession of
a weapon or object that may be used as a weapon (fork or knife).
Isolation that is uncharacteristic. Milieu characteristics conducive to
violence: Overcrowding, staff inexperience, provocative or controlling
staff, poor limit setting, arbitrary revocation of privileges.
, ●● General Assessment for a patient experiencing anger.
Answer: Patient will exhibit increased demands, irritability, frowning,
redness in the face, pacing, twisting of the hands, or clenching and
unclenching of the fists are all signs of irritation. Speech may either be
increased in rate and volume or may be slowed, pointed, and quite.
●● Trauma-informed Care
Answer: It is based on the notion that disruptive patients often have
histories that include violence and victimizations. This care focuses on
the patients past experiences of violence or trauma and on the role these
experiences currently play in their lives.
●● Anger and Aggression Assessment Guidelines
Answer: A history of violence is the single best predictor of future
violence. Patients who are delusional, hyperactive, impulsive or
predisposed to irritability are at higher risk for violence. Major factors
associated with violence can be assessed with these questions (Does the
pt have a wish or intent to harm?, Does the pt have plan?, Does the
patient have demographic risk factors: male, aged 14-24, low
socioeconomic status, inadequate support system, and prison time).
Aggression by patient occurs most often in the context of limit-setting
by the nurse. History of limited coping skills, including lack of
assertiveness or use of intimidation, indicates a higher risk of using
violence.
