Chapter 20 Safety and De-Escalation Practices Exam Questions and Answers

Chapter 20 Safety and De-Escalation Practices Exam Questions and Answers

1. The nurse is caring for an older patient in a residential care facility. The patient has been extremely irritable the entire day. When modifying the patient’s plan of care, which of the following would be an appropriate snack to offer the patient to decrease the irritability? A) Chocolate candy bar B) Handful of raisins C) Granola bar D) Glass of milk 2. The nurse is assessing a group of patients on an inpatient psychiatric unit. The patient’s history for which of the following would the nurse identify as the strongest indicator of risk for violence? A) Panic disorder B) Problematic anxiety C) Somatoform disorder D) Violent behavior 3. A son brings his father to the clinic and tells the nurse that his father has begun to act strangely in the past few days and has unprovoked outbursts of anger. After the incidents, the father expresses remorse for his outburst. The son says, I’ve never seen him act this way. Which question would be most appropriate for the nurse to ask next? A) Does your father have a history of an anxiety disorder such as panic disorder? B) Has your father exhibited previous problems expressing anger appropriately? C) Has your father suffered any traumatic injury to his brain recently? D) Has your father injured the back of his head or next in the past week? 4. The nurse is caring for an older adult patient who has no history of violence but is agitated and appears ready to strike out at a staff member. The nurse would assess the patient for which of the following? A) Panic disorder B) Epilepsy C) Bipolar disorder D) Sensory losses 5. A patient has been admitted to the detoxification unit after binge drinking. Even though the patient is not currently intoxicated, he is combative and exhibits altered thought processes. Which nursing diagnosis would be the priority? A) Risk for Injury related to effects of alcohol abuse B) Risk for Self-Mutilation related to alcohol withdrawal and altered thought processes C) Risk for Other-Directed Violence related to alcohol withdrawal D) Risk for Delayed Development related to chronic effects of alcohol intoxication