Author Question: A client with marked cognitive impairment is combative and difficult to manage. He has pulled out ... (Read 42 times)

jake · **on:** Jul 19, 2018

A client with marked cognitive impairment is combative and difficult to manage. He has pulled out
his nasogastric tube, his intravenous line, and his indwelling urinary catheter.

He had climbed out of
bed over the side rails while the nurse tried to calm and restrain him. The nurse notifies the doctor on
call and can anticipate that the physician will order a
a. small dose of a selective serotonin reuptake inhibitor.
b. large dose of a benzodiazepine.
c. maintenance dose of buspirone.
d. small dose of a high-potency antipsychotic.

Question 2

A mother of one, who is the victim of partner abuse, describes her partner as someone who is easily
frustrated and more likely to abuse her after a experiencing an event in which self-esteem is
challenged.

The most recent episodes of violence were related to feeling upset over job loss. The
type of therapy that would provide the greatest help to the client's partner is
a. individual therapy focusing on decision making.
b. group therapy focusing on anger management.
c. couples therapy focusing on assertiveness.
d. family therapy focusing on parenting.

6ana001 · **Reply #1 on:** Jul 19, 2018

Answer to Question 1

D
Aggressive behavior can be safely managed by antipsychotic medication. Initial dosing should be
small and raised cautiously until behavior is controlled. Option A: Selective serotonin reuptake
inhibitors are not indicated for aggressive behavior. Option B: If a benzodiazepine is used, the initial
dose should be low. Option C: Buspirone is not effective if given on an as-needed basis. It is
administered in small divided doses daily to control agitation.

Answer to Question 2

B
Group therapy provides assurance that the abuser is not alone and that positive change is possible.
By learning to recognize signs of escalating anger and ways to channel anger nonviolently, the cycle
of abuse may be broken. Option A is inappropriate because decision making is not an identified
problem. Option C: Therapy focusing on assertiveness might be premature. The partner needs to
work with the problem of anger first, or the abuse may intensify as the client becomes more
assertive. Option D: Family therapy focusing on parenting would not focus on the priority problem.