NSG 3450 Exam 4 with
questions and well verified
answers actual exam!!!
2026
Anger - ANSWER -An emotional response to frustration of desires, threat to one's needs
(emotional or physical), or a challenge.
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.
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.
Nursing Diagnoses for Anger, Aggression, and Violence - ANSWER -Risk for other-
directed violence, Risk for self-directed violence, Ineffective coping, Stress overload.
Outcomes for aggression - ANSWER -Identifies when angry, identifies alternatives to
aggression, refrains from verbal outbursts, avoids violating others personal space, maintains
self-control. Expresses feelings, verbalizes suicidal ideas, refrains from suicide attempts, plans
for the future. Identifies ineffective and effective coping, uses support system, uses new
coping strategies, engages in personal actions to manage stressors effectively.
Deescalation Techniques - ANSWER -Maintain the patients self-esteem and dignity.
Maintain calmness (you and pt). Assess the pt and the situation. Identify stressors and stress
indicators. Respond as early as possible. Use a calm clear tone of voice. Invest time, remain
honest. Determine what the patient considers to be needed, identify goals. Avoid invading
personal space, in time of high anxiety, personal space increases. Avoid arguing, use several
clear options, use genuineness and empathy, be assertive (NOT AGGRESSIVE) do not take
chances maintain personal safety.
Drug used for acute management of violent behavior. - ANSWER -Antianxiety Agents
(Benzodiazepines): Lorazepam (Ativan), Alprazolam (Xanax), Diazepam (Valium)
First Generation Antipsychotics: Haloperidol (Haldol), Perphenazine, Chlorpromazine
(Thorazine), Loxapine (Adasuve).
Second Generation Antipsychotics: Risperidone (Risperdal), Olanzapine (Zyprexa, Zydis),
Ziprasidone (Geodon)
Combinations: Haloperidol (Haldol)
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.
Drugs used for long-term management of chronic aggression - ANSWER -SSIR's: for the
population that is depressed, anxiety, personality disorder, dementia, and intellectual disability
Lithium: for the population that is intellectual disability, conduct disorder, antisocial
personality, bipolar disorder, and prison inmates.
Anticonvulsants : Schizophrenia, prison inmates, antisocial/ borderline personality, conduct
disorders, and bipolar disorders
Gabapentin: patients with co-existing anxiety disorder and personality disorder.
Benzodiazepines: should have underlying component of anxiety.
Second-generation antipsychotics: Schizophrenia, psychosis, and mania.
Beta-blockers: organic brain disease, brain injury, dementia, intellectual disability.
Psychostimulants: ADD/ADHD in children and adults.
Guidelines for Use of Mechanical Restraint: Indications for Use - ANSWER -To protect
the patient from self-harm.
To prevent the patient from assaulting others.
Seclusion - ANSWER -Involuntary confinement alone in a room that the patient is
physically prevented from leaving.
Restraints - ANSWER -Any manual method, physical or mechanical advice, material, or
equipment that restricts freedom of movement.
Guidelines for Use of Mechanical Restraint: Legal Requirements - ANSWER -
Multidisciplinary involvement, appropriate healthcare provider's signature according to state
law, patient advocate or relative notification, seclusion/restraint discontinued as soon as
possible.
questions and well verified
answers actual exam!!!
2026
Anger - ANSWER -An emotional response to frustration of desires, threat to one's needs
(emotional or physical), or a challenge.
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.
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.
Nursing Diagnoses for Anger, Aggression, and Violence - ANSWER -Risk for other-
directed violence, Risk for self-directed violence, Ineffective coping, Stress overload.
Outcomes for aggression - ANSWER -Identifies when angry, identifies alternatives to
aggression, refrains from verbal outbursts, avoids violating others personal space, maintains
self-control. Expresses feelings, verbalizes suicidal ideas, refrains from suicide attempts, plans
for the future. Identifies ineffective and effective coping, uses support system, uses new
coping strategies, engages in personal actions to manage stressors effectively.
Deescalation Techniques - ANSWER -Maintain the patients self-esteem and dignity.
Maintain calmness (you and pt). Assess the pt and the situation. Identify stressors and stress
indicators. Respond as early as possible. Use a calm clear tone of voice. Invest time, remain
honest. Determine what the patient considers to be needed, identify goals. Avoid invading
personal space, in time of high anxiety, personal space increases. Avoid arguing, use several
clear options, use genuineness and empathy, be assertive (NOT AGGRESSIVE) do not take
chances maintain personal safety.
Drug used for acute management of violent behavior. - ANSWER -Antianxiety Agents
(Benzodiazepines): Lorazepam (Ativan), Alprazolam (Xanax), Diazepam (Valium)
First Generation Antipsychotics: Haloperidol (Haldol), Perphenazine, Chlorpromazine
(Thorazine), Loxapine (Adasuve).
Second Generation Antipsychotics: Risperidone (Risperdal), Olanzapine (Zyprexa, Zydis),
Ziprasidone (Geodon)
Combinations: Haloperidol (Haldol)
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.
Drugs used for long-term management of chronic aggression - ANSWER -SSIR's: for the
population that is depressed, anxiety, personality disorder, dementia, and intellectual disability
Lithium: for the population that is intellectual disability, conduct disorder, antisocial
personality, bipolar disorder, and prison inmates.
Anticonvulsants : Schizophrenia, prison inmates, antisocial/ borderline personality, conduct
disorders, and bipolar disorders
Gabapentin: patients with co-existing anxiety disorder and personality disorder.
Benzodiazepines: should have underlying component of anxiety.
Second-generation antipsychotics: Schizophrenia, psychosis, and mania.
Beta-blockers: organic brain disease, brain injury, dementia, intellectual disability.
Psychostimulants: ADD/ADHD in children and adults.
Guidelines for Use of Mechanical Restraint: Indications for Use - ANSWER -To protect
the patient from self-harm.
To prevent the patient from assaulting others.
Seclusion - ANSWER -Involuntary confinement alone in a room that the patient is
physically prevented from leaving.
Restraints - ANSWER -Any manual method, physical or mechanical advice, material, or
equipment that restricts freedom of movement.
Guidelines for Use of Mechanical Restraint: Legal Requirements - ANSWER -
Multidisciplinary involvement, appropriate healthcare provider's signature according to state
law, patient advocate or relative notification, seclusion/restraint discontinued as soon as
possible.
