A client who is a construction supervisor has a history of ...

[Kikoku]

A client who is a construction supervisor has a history of becoming violent when the client's workers do not complete their work within the established deadline.
 
  Police have been called to the worksite multiple times for behaviors including loud shouting and destruction of property. The most appropriate expected outcome related to resolving this problem would be for the client to: 1. Identify personal needs.
  2. Refrain from impulsive behavior.
  3. Refrain from self-injury and from injuring others.
  4. Identify alternative methods for expressing anger.

Question 2

A psychiatric hospital was recently purchased by a large healthcare system.
 
  The new administration's business motto is leaner and meaner, consequently, the staff mix has been adjusted by replacing some of the highly experienced nurses with robust male mental health technicians who cost less and are able to provide physical interventions. The change that is likely to increase the risk for violence in this hospital is the: 1. Change in hospital ownership.
  2. Advanced age of nursing staff.
  3. Adjustment in staff mix.
  4. Motto that implies staff will be mean.

[ergserg]

Answer to Question 1

4
Rationale: The client appears unable to respond to disappointment or anger toward employees in an appropriate manner. The other options are appropriate outcomes for a person with violent behavior but do not directly address the situation.

Answer to Question 2

3
Rationale: One factor that has contributed to increased violence is the substitution of high-skilled staff with paraprofessionals (lower skill level). Ownership change could be positive or negative, thus is not a risk factor. A business motto is not necessarily indicative of the care provided. Younger and less experienced nursing staff are at increased risk for violence.