NUR 448 Chapter 21 fully solved
& verified for accuracy 2025-2026
1. What can reduce the risk of aggression in patients?
2. What interactions can lead to violence?
3. How can the nurse-patient relationship be enhanced? - answer 1. staff
attitude
2. interactions between patients, nursing personnel, and culture of the
unit
3. improve communication skills, advocate for clients, be available
What are some strategies to reduce the potential for violence? - answer 1.
continually assess the patients and milieu
2. provide patient education
3. collaborate with patients in treatment planning
4. provide meaningful patient activities and levels of stimulation
5. maintain safe unit staffing
6. the nurse must be aware of their own anger and methods to channel it
1. What are assaultive behavior patterns?
2. What can increased aggression lead to? - answer 1. assaultive behavior
patterns: ritualistic, stereotypical, automatic
2. increased aggression leads to reduced problem solving, creativity,
spontaneity, and behavioral options
What are the 5 phases of the assault cycle? - answer 1. triggering phase:
stress producing event
2. escalation phase: escalating behaviors indicating movement toward
loss of control
3. crisis phase: emotional and physical crisis, loss of control
4. recovery phase: cooling down, returning to normal responses
, 5. post-crisis depression phase: person attempting to reconcile with
others
How should the triggering phase of the assault cycle be managed? -
answer 1. assist patient to behave appropriately to their emotions
2. facilitate ventilation of negative emotions with empathy and concern
3. use relaxation techniques (journal writing, exercising, pounding clay,
walking up and down hall)
4. provide patient with a "time out" if needed
5. compliment for use of positive solutions
6. offer antianxiety or antipsychotic medications
How should the escalation phase of the assault cycle be managed? -
answer 1. allow the patient time to reduce their anxiety, fear, or anger
2. reframe the situation to a collaborative encounter
3. offer PRN antianxiety or antipsychotic medications early (lorazepam or
alprazolam for antianxiety; quetiapine, haloperidol, or ziprasidone for
antipsychotics)
4. offer "time out"
5. if behavior endangers others, use more restrictive measures
6. staff assistance for "show of concern" at greater distance than the
nurse
How should the crisis phase of the assault cycle be managed? - answer 1.
staff should utilize external control (verbal limits are ineffective)
2. immediate seclusion, restraint, or the administration of stat
medications (patients can still refuse unless there's an immediate threat)
3. emergency protocols preapproved by the physician
1. What is seclusion?
2. What behaviors are reasons for seclusion? - answer 1. placing a patient
alone in a specially designed, lockable room equipped with a security
window or a camera for observation
2. agitation and disruptive or inappropriate sexual behaviors
& verified for accuracy 2025-2026
1. What can reduce the risk of aggression in patients?
2. What interactions can lead to violence?
3. How can the nurse-patient relationship be enhanced? - answer 1. staff
attitude
2. interactions between patients, nursing personnel, and culture of the
unit
3. improve communication skills, advocate for clients, be available
What are some strategies to reduce the potential for violence? - answer 1.
continually assess the patients and milieu
2. provide patient education
3. collaborate with patients in treatment planning
4. provide meaningful patient activities and levels of stimulation
5. maintain safe unit staffing
6. the nurse must be aware of their own anger and methods to channel it
1. What are assaultive behavior patterns?
2. What can increased aggression lead to? - answer 1. assaultive behavior
patterns: ritualistic, stereotypical, automatic
2. increased aggression leads to reduced problem solving, creativity,
spontaneity, and behavioral options
What are the 5 phases of the assault cycle? - answer 1. triggering phase:
stress producing event
2. escalation phase: escalating behaviors indicating movement toward
loss of control
3. crisis phase: emotional and physical crisis, loss of control
4. recovery phase: cooling down, returning to normal responses
, 5. post-crisis depression phase: person attempting to reconcile with
others
How should the triggering phase of the assault cycle be managed? -
answer 1. assist patient to behave appropriately to their emotions
2. facilitate ventilation of negative emotions with empathy and concern
3. use relaxation techniques (journal writing, exercising, pounding clay,
walking up and down hall)
4. provide patient with a "time out" if needed
5. compliment for use of positive solutions
6. offer antianxiety or antipsychotic medications
How should the escalation phase of the assault cycle be managed? -
answer 1. allow the patient time to reduce their anxiety, fear, or anger
2. reframe the situation to a collaborative encounter
3. offer PRN antianxiety or antipsychotic medications early (lorazepam or
alprazolam for antianxiety; quetiapine, haloperidol, or ziprasidone for
antipsychotics)
4. offer "time out"
5. if behavior endangers others, use more restrictive measures
6. staff assistance for "show of concern" at greater distance than the
nurse
How should the crisis phase of the assault cycle be managed? - answer 1.
staff should utilize external control (verbal limits are ineffective)
2. immediate seclusion, restraint, or the administration of stat
medications (patients can still refuse unless there's an immediate threat)
3. emergency protocols preapproved by the physician
1. What is seclusion?
2. What behaviors are reasons for seclusion? - answer 1. placing a patient
alone in a specially designed, lockable room equipped with a security
window or a camera for observation
2. agitation and disruptive or inappropriate sexual behaviors
