NSG 3450 Mental Health Nursing Exam 4 |
Questions and Correct Answers with Rationales |
New 2026-2027 Update | Galen
Psychiatric Nursing, Violence, Abuse, and Forensic Nursing Questions
Violence and Aggression
Question 1. Assessing for _________ is the single best predictor of future
violence.
Correct Answer: History of violence
Rationale: A history of previous violent behavior is the strongest predictor of
future violence. Past behavior is the best indicator of future behavior.
Question 2. Which individuals are most at risk for displaying aggressive
behavior? Select all that apply.
a. An adolescent embarrassed in front of friends
b. A young male who feels rejected by the social group
c. A young adult depressed after the death of a friend
d. A middle-aged adult who feels that concerns are going unheard
e. A patient who was discovered telling a lie
Correct Answer: a, b, d, e
Rationale: Risk factors for aggression include humiliation (a), rejection (b),
feeling unheard or disrespected (d), and being caught in a lie (e). Depression after a
death is not typically associated with aggression.
Question 3. A newly admitted male patient has a long history of aggressive
behavior toward staff. Which statement by the nurse demonstrates the need
for more information about the use of restraint?
,a. "If his behavior warrants restraints, someone will stay with him the entire time
he's restrained."
b. "I'll call the primary provider and get an as needed (PRN) seclusion/restraint
order."
c. "If he is restrained, be sure he is offered food and fluids regularly."
d. "Remember that physical restraints are our last resort."
Correct Answer: b. "I'll call the primary provider and get an as needed (PRN)
seclusion/restraint order."
Rationale: PRN orders for restraint/seclusion are not permitted. Restraint orders
must be time-limited and based on specific behaviors, not "as needed." The nurse
needs more education on this regulation.
Question 4. Which intervention(s) should the nurse implement when helping a
patient expresses anger in an inappropriate manner? Select all that apply.
a. Approach the patient in a calm, reassuring manner
b. Provide suggestions regarding acceptable ways of communicating anger
c. Warn the patient that being angry is not a healthy emotional state
d. Set limits on the angry behavior that will be tolerated
e. Allow any expression of anger as long as no one is hurt
Correct Answer: a, b, d
Rationale: Therapeutic interventions include approaching calmly, teaching
acceptable expression, and setting limits. Anger is a normal emotion; warning
against it is incorrect. Allowing any expression can be unsafe.
Question 5. Which guidelines should direct nursing care when deescalating an
angry patient? Select all that apply.
a. Intervene as quickly as possible
b. Identify the trigger for the anger
c. Behave calmly and respectfully
d. Recognize the patient's need for increased personal space
e. Demands are agreed to as long as they won't result in harm to anyone
,Correct Answer: a, b, c, d
Rationale: De-escalation includes early intervention, identifying triggers, calm
demeanor, and respecting personal space. Agreeing to demands reinforces
inappropriate behavior and is not therapeutic.
Question 6. Which comorbid condition would result in cautious use of a
selective serotonin reuptake inhibitor for a patient with chronic aggression?
a. Asthma
b. Anxiety disorder
c. Glaucoma
d. Bipolar disorder
Correct Answer: d. Bipolar disorder
Rationale: SSRIs can trigger manic episodes in patients with bipolar disorder.
Caution is required, and mood stabilizers are typically used first.
Question 7. John Patrick is a widower with four daughters. He has enjoyed a
healthy relationship with all of them until they reached puberty. As each girl
began to mature physically, he acted in an aggressive manner, beating her
without provocation. John Patrick is most likely acting on:
a. Self-protective measures
b. Stress of raising four daughters
c. Frustration on unhealthy desire
d. Motivating his daughters to be chaste
Correct Answer: c. Frustration on unhealthy desire
Rationale: This scenario describes incestuous dynamics where the father's
aggression is driven by inappropriate sexual feelings toward his maturing
daughters.
Question 8. A nurse named Darryl has been hired to work in a psychiatric
intensive care unit. He has undergone training on recognizing escalating
, anger. Which statement indicates that he understands danger signs in regard
to aggression?
a. "I need to be aware of patients who are withdrawn and sitting alone."
b. "An obvious change in behavior is a risk factor for aggression."
c. "Patients who seek constant attention are most likely to be violent."
d. "Patients who talk to themselves are the most dangerous."
Correct Answer: b. "An obvious change in behavior is a risk factor for
aggression."
Rationale: A sudden change in behavior is a key warning sign for impending
aggression. Withdrawal may be a sign of depression, not necessarily aggression.
Question 9. An effective method of preventing escalation in an environment
with violent offenders is to develop a level of trust through:
a. A casual authoritative demeanor
b. Keeping patients busy
c. Brief, frequent, nonthreatening encounters
d. Threats of seclusion or punishment
Correct Answer: c. Brief, frequent, nonthreatening encounters
Rationale: Brief, frequent, nonthreatening interactions build trust without
overwhelming the patient or triggering defensiveness.
Question 10. Twenty-four hour observation is a good choice for restraint in
which of the following patients?
a. An inmate with suicidal ideation on hospice care
b. A sex offender in the psychiatric intensive care unit
c. An aggressive female with antisocial personality disorder
d. An inmate diagnosed with paranoid schizophrenia
Correct Answer: a. An inmate with suicidal ideation on hospice care
Rationale: Continuous observation is appropriate for patients at high risk for self-
harm, especially those in hospice care with limited time and significant distress.
Questions and Correct Answers with Rationales |
New 2026-2027 Update | Galen
Psychiatric Nursing, Violence, Abuse, and Forensic Nursing Questions
Violence and Aggression
Question 1. Assessing for _________ is the single best predictor of future
violence.
Correct Answer: History of violence
Rationale: A history of previous violent behavior is the strongest predictor of
future violence. Past behavior is the best indicator of future behavior.
Question 2. Which individuals are most at risk for displaying aggressive
behavior? Select all that apply.
a. An adolescent embarrassed in front of friends
b. A young male who feels rejected by the social group
c. A young adult depressed after the death of a friend
d. A middle-aged adult who feels that concerns are going unheard
e. A patient who was discovered telling a lie
Correct Answer: a, b, d, e
Rationale: Risk factors for aggression include humiliation (a), rejection (b),
feeling unheard or disrespected (d), and being caught in a lie (e). Depression after a
death is not typically associated with aggression.
Question 3. A newly admitted male patient has a long history of aggressive
behavior toward staff. Which statement by the nurse demonstrates the need
for more information about the use of restraint?
,a. "If his behavior warrants restraints, someone will stay with him the entire time
he's restrained."
b. "I'll call the primary provider and get an as needed (PRN) seclusion/restraint
order."
c. "If he is restrained, be sure he is offered food and fluids regularly."
d. "Remember that physical restraints are our last resort."
Correct Answer: b. "I'll call the primary provider and get an as needed (PRN)
seclusion/restraint order."
Rationale: PRN orders for restraint/seclusion are not permitted. Restraint orders
must be time-limited and based on specific behaviors, not "as needed." The nurse
needs more education on this regulation.
Question 4. Which intervention(s) should the nurse implement when helping a
patient expresses anger in an inappropriate manner? Select all that apply.
a. Approach the patient in a calm, reassuring manner
b. Provide suggestions regarding acceptable ways of communicating anger
c. Warn the patient that being angry is not a healthy emotional state
d. Set limits on the angry behavior that will be tolerated
e. Allow any expression of anger as long as no one is hurt
Correct Answer: a, b, d
Rationale: Therapeutic interventions include approaching calmly, teaching
acceptable expression, and setting limits. Anger is a normal emotion; warning
against it is incorrect. Allowing any expression can be unsafe.
Question 5. Which guidelines should direct nursing care when deescalating an
angry patient? Select all that apply.
a. Intervene as quickly as possible
b. Identify the trigger for the anger
c. Behave calmly and respectfully
d. Recognize the patient's need for increased personal space
e. Demands are agreed to as long as they won't result in harm to anyone
,Correct Answer: a, b, c, d
Rationale: De-escalation includes early intervention, identifying triggers, calm
demeanor, and respecting personal space. Agreeing to demands reinforces
inappropriate behavior and is not therapeutic.
Question 6. Which comorbid condition would result in cautious use of a
selective serotonin reuptake inhibitor for a patient with chronic aggression?
a. Asthma
b. Anxiety disorder
c. Glaucoma
d. Bipolar disorder
Correct Answer: d. Bipolar disorder
Rationale: SSRIs can trigger manic episodes in patients with bipolar disorder.
Caution is required, and mood stabilizers are typically used first.
Question 7. John Patrick is a widower with four daughters. He has enjoyed a
healthy relationship with all of them until they reached puberty. As each girl
began to mature physically, he acted in an aggressive manner, beating her
without provocation. John Patrick is most likely acting on:
a. Self-protective measures
b. Stress of raising four daughters
c. Frustration on unhealthy desire
d. Motivating his daughters to be chaste
Correct Answer: c. Frustration on unhealthy desire
Rationale: This scenario describes incestuous dynamics where the father's
aggression is driven by inappropriate sexual feelings toward his maturing
daughters.
Question 8. A nurse named Darryl has been hired to work in a psychiatric
intensive care unit. He has undergone training on recognizing escalating
, anger. Which statement indicates that he understands danger signs in regard
to aggression?
a. "I need to be aware of patients who are withdrawn and sitting alone."
b. "An obvious change in behavior is a risk factor for aggression."
c. "Patients who seek constant attention are most likely to be violent."
d. "Patients who talk to themselves are the most dangerous."
Correct Answer: b. "An obvious change in behavior is a risk factor for
aggression."
Rationale: A sudden change in behavior is a key warning sign for impending
aggression. Withdrawal may be a sign of depression, not necessarily aggression.
Question 9. An effective method of preventing escalation in an environment
with violent offenders is to develop a level of trust through:
a. A casual authoritative demeanor
b. Keeping patients busy
c. Brief, frequent, nonthreatening encounters
d. Threats of seclusion or punishment
Correct Answer: c. Brief, frequent, nonthreatening encounters
Rationale: Brief, frequent, nonthreatening interactions build trust without
overwhelming the patient or triggering defensiveness.
Question 10. Twenty-four hour observation is a good choice for restraint in
which of the following patients?
a. An inmate with suicidal ideation on hospice care
b. A sex offender in the psychiatric intensive care unit
c. An aggressive female with antisocial personality disorder
d. An inmate diagnosed with paranoid schizophrenia
Correct Answer: a. An inmate with suicidal ideation on hospice care
Rationale: Continuous observation is appropriate for patients at high risk for self-
harm, especially those in hospice care with limited time and significant distress.
