The nurse is assessing an inpatient client with a known history of violence. The client suddenly displays clenched fists. What additional behavior by the client would suggest that the aggression is escalating? The client:

refuses to eat lunch.

requests prn medications.

is pacing around the milieu.

sits in a group with their peers.

Answer and Explanation

The Correct Answer is C

a. refuses to eat lunch. Refusal to eat lunch might indicate displeasure or upset but does not directly suggest escalating aggression.
b. requests prn medications. Requesting prn (as needed) medications typically indicates the client is aware of their distress and is seeking help, not escalating aggression.
c. is pacing around the milieu. Pacing can be a sign of increasing agitation and is often observed in clients who are escalating towards aggressive behavior. This physical activity can indicate restlessness and an inability to calm down.
d. sits in a group with their peers. Sitting in a group with peers suggests a level of social engagement and does not indicate escalating aggression.

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Correct Answer is A

Explanation

a. experience no loss of contact with reality. The key difference is reality testing. Clients with neurosis (anxiety disorders, OCD) generally maintain contact with reality, even though their thoughts or behaviours might be distressing. Clients with psychosis (schizophrenia) experience a break with reality, such as hallucinations or delusions.
b. Never have mood or personality changes. Not true. Mood and personality changes can occur in both neurosis and psychosis.
c. Have conflict but only use adaptive defence mechanisms to cope. Défense mechanisms are used by everyone to cope with anxiety, but in neurosis, they might be less healthy or maladaptive.
d. Are always aware that their behaviours are maladaptive. Not necessarily. Clients with neurosis might have limited insight into how their behaviours affect themselves or others.

A. Clinically significant distress in occupational functioning. B. Sudden unexpected travel or confused wandering. C. An inability to recall their parent's contact information. D. Occasional periods of forgetfulness

Correct Answer is B

Explanation

a. Clinically significant distress in occupational functioning. While distress in occupational functioning may occur, it is not specific to dissociative fugue and is more broadly associated with various mental health disorders.
b. Sudden unexpected travel or confused wandering. This choice is correct because dissociative fugue is characterized by sudden, unexpected travel away from one's home or usual place of work, with an inability to recall some or all of one's past.
c. An inability to recall their parent's contact information. While memory loss is part of dissociative fugue, the focus is on broader, more significant amnesia than just inability to recall specific information like contact details.
d. Occasional periods of forgetfulness. This does not capture the severity or the specific nature of the amnesia involved in dissociative fugue.

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The nurse is assessing an inpatient client with a known history of violence. The client suddenly displays clenched fists. What additional behavior by the client would suggest that the aggression is escalating? The client:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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