NUR 162 EXAM 2 CONTENT QUESTIONS AND ANSWERS
ELABORATIONS//
Hostility
Answers:verbal aggression, including threatening behavior intended for harm or
forcing compliance
physical aggression
Answers:actual injury or physical harm with the intent to force compliance
assertive communication
Answers:using "I" statements to properly express feelings of anger w/o
suppression
catharsis
Answers:expressing anger through releasing them through safe activities
(ex: hitting a punching bag, yelling, rage rooms)
-contraindicated in angry or aggressive clients
risk factors of high hostility and anger
Answers:CAD, HTN
seen in: paranoia, delirium, dementia, substance abuse, antisocial/BPD, depression
anger suppression
Answers:holding in feelings of anger, trying to ignore them
-common in women (via denying power + respect)
phases of hostility and aggression
,Answers:-triggering: incident that initiates aggressive response (s/sx: restlessness,
anxiety, pacing, loud voice/anger/irritability)
-escalation: client responses represent behaviors indicating towards losing control
(s/sx: flushed face, yelling, swearing, demanding, threatening gestures)
-crisis: client loses control (s/sx: loss of emotional/physical control, throwing
things, kicking, hitting, inability to communicate clearly)
-recovery: client regains physical and emotional control (lowering voice, more
rational and clearer communication, physical relaxation)
-post-crisis: client attempts to reconcile + returns to level of functioning before
aggressive incident (remorse, apologies, crying, withdrawn behavior)
intermittent explosive disorder
Answers:-discrete episodes of aggressive impulses that result in assaults or
destruction
-only dx if client does not have cormorbid psych disorders
acting out
Answers:defense mechanism used when clients deal with emotional stressors or
conflicts than reflection
(ex: verbal/physical aggression to feel less powerless)
-seen in children/adolescents
neurobiologic theories for anger
Answers:-serotonin plays inhibitory role in aggressive behavior (low serotonin
may indicate aggression, ex: depression)
-increased dopamine + norepi can be associated with increased violent impulse
behaviors
, psychosocial theories for anger
Answers:-children develop impulse control (ability to delay gratification)
-children with a poor family and social dynamic (receiving inconsistent responses
for behaviors, social determinant struggles) are at risk for socially inappropriate
behaviors
cultural considerations for aggression
Answers:-Hwa-Byung: cultural syndrome attributed to anger suppression in
Korean women (s/sx: ab pain, insomnia, depression, sighing)
-Bouffee delirante: West African and Haitian, seen in sudden outbursts in
agitated/aggressive behavior including hallucinations and paranoia that can
resemble psychotic episodes
-Amok: dissociation followed with aggressive/violent outbursts seen in men
tx for aggressive clients
Answers:Dx: schizophrenia or bipolar disorder
-Lithium
-Carbamazepine/Depakote: tx aggression in dementia and psychosis
-Clozapine/atypicals
-benzodiazepines tx aggression in older adults but can result in loss of social
inhibition
-atypicals are more effective for aggressive client tx (b/c of EPS symptoms,
benztropine)
actions best to handle hostile interactions
Answers:-engage with client in dialogue most effective to prevent escalation to
physical aggression
ELABORATIONS//
Hostility
Answers:verbal aggression, including threatening behavior intended for harm or
forcing compliance
physical aggression
Answers:actual injury or physical harm with the intent to force compliance
assertive communication
Answers:using "I" statements to properly express feelings of anger w/o
suppression
catharsis
Answers:expressing anger through releasing them through safe activities
(ex: hitting a punching bag, yelling, rage rooms)
-contraindicated in angry or aggressive clients
risk factors of high hostility and anger
Answers:CAD, HTN
seen in: paranoia, delirium, dementia, substance abuse, antisocial/BPD, depression
anger suppression
Answers:holding in feelings of anger, trying to ignore them
-common in women (via denying power + respect)
phases of hostility and aggression
,Answers:-triggering: incident that initiates aggressive response (s/sx: restlessness,
anxiety, pacing, loud voice/anger/irritability)
-escalation: client responses represent behaviors indicating towards losing control
(s/sx: flushed face, yelling, swearing, demanding, threatening gestures)
-crisis: client loses control (s/sx: loss of emotional/physical control, throwing
things, kicking, hitting, inability to communicate clearly)
-recovery: client regains physical and emotional control (lowering voice, more
rational and clearer communication, physical relaxation)
-post-crisis: client attempts to reconcile + returns to level of functioning before
aggressive incident (remorse, apologies, crying, withdrawn behavior)
intermittent explosive disorder
Answers:-discrete episodes of aggressive impulses that result in assaults or
destruction
-only dx if client does not have cormorbid psych disorders
acting out
Answers:defense mechanism used when clients deal with emotional stressors or
conflicts than reflection
(ex: verbal/physical aggression to feel less powerless)
-seen in children/adolescents
neurobiologic theories for anger
Answers:-serotonin plays inhibitory role in aggressive behavior (low serotonin
may indicate aggression, ex: depression)
-increased dopamine + norepi can be associated with increased violent impulse
behaviors
, psychosocial theories for anger
Answers:-children develop impulse control (ability to delay gratification)
-children with a poor family and social dynamic (receiving inconsistent responses
for behaviors, social determinant struggles) are at risk for socially inappropriate
behaviors
cultural considerations for aggression
Answers:-Hwa-Byung: cultural syndrome attributed to anger suppression in
Korean women (s/sx: ab pain, insomnia, depression, sighing)
-Bouffee delirante: West African and Haitian, seen in sudden outbursts in
agitated/aggressive behavior including hallucinations and paranoia that can
resemble psychotic episodes
-Amok: dissociation followed with aggressive/violent outbursts seen in men
tx for aggressive clients
Answers:Dx: schizophrenia or bipolar disorder
-Lithium
-Carbamazepine/Depakote: tx aggression in dementia and psychosis
-Clozapine/atypicals
-benzodiazepines tx aggression in older adults but can result in loss of social
inhibition
-atypicals are more effective for aggressive client tx (b/c of EPS symptoms,
benztropine)
actions best to handle hostile interactions
Answers:-engage with client in dialogue most effective to prevent escalation to
physical aggression
