1. Keep a safe distance from the visitor.
2. Yell for another nurse to assist with the visitor.
3. Leave the room.
4. Threaten the visitor with assault charges.
Correct Answer: 1
Rationale 1: The nurse should recognize threatening behavior and keep a safe distance from the visitor exhibiting
the behavior.
Rationale 2: The nurse should obtain assistance but yelling may increase the visitor’s aggression.
Rationale 3: The nurse should not leave the client unless it is absolutely necessary to obtain assistance.
Rationale 4: Threatening the visitor with assault charges may further escalate the situation.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-3: Describe how to recognize escalating violence.
Question 24
Type: MCSA
The emergency department (ED) has seen an increase in violent behavior over the past year. The manager has
voiced concerns to the chief nurse officer (CNO) regarding the safety of the ED staff. What should be done as a
first step in addressing this issue?
1. The manager should consult with local law enforcement.
2. The CNO should review the management of violent incidents procedure policy.
3. The CNO should discuss the matter with hospital security.
4. The CNO should have the manager discuss the matter with the ED staff.
Rationale 2: The first step should be to review and revise policies and procedures so they are reflective of
effectively managing the types of incidents seen in the department.
Rationale 3: The CNO should certainly discuss the request with hospital security, but this is not the first step.
Rationale 4: The CNO should not delegate this concern, but should personally manage the issue.
Global Rationale:
Cognitive Level: Applying
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 25
Type: MCSA
An emergency department (ED) has doubled its client visits within the past year. This has led to increased wait
times and overcrowding in the ED waiting room. Which recommendation by the ED nurse manager to the chief
nurse officer (CNO) would be most effective?
1. Increase the size of the waiting room and add more beds to the ED unit.
2. Hire more ED nursing staff to manage the increased volume of clients.
3. Hire another ED physician.
4. Hire another registration employee to improve the intake process and reduce the volume in the waiting areas.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-1: Discuss what health care organizations can do to prevent violence.
Question 26
Type: MCMA
A geriatric client in a long-term-care facility becomes increasingly confused and verbally aggressive as evening
approaches. Which actions would the nurse interpret as potentially signaling a violent episode?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The client is moving slowly toward the room door.
2. The client is staring blankly at the nurse.
3. The client suddenly becomes alert and oriented.
4. The client raises his fist.
5. The client says, “I know where there is a gun.”
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Assessment
Learning Outcome: 23-3: Describe how to recognize escalating violence.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Question 27
Type: MCMA
Two nurses are in the day room when a visitor approaches and starts yelling about the care his mother is receiving.
One nurse says, “I’m sorry you are upset. What can I do for you?” The visitor continues to complain more loudly.
What should the other nurse do?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Quietly direct other people out of the room.
2. Leave the room and call security.
3. Say, “Who are you?”
4. Move toward the visitor and say, “Keep your voice down.”
5. Stay next to the other nurse.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Implementation
Learning Outcome: 23-3: Describe how to recognize escalating violence.
Sullivan, Effective Leadership and Management, 8/e Test Bank
Copyright 2013 by Pearson Education, Inc.
Question 28
Type: MCMA
A highly intoxicated client is brought to the emergency department. Paramedics report that the client was violent
during transport and tried to kick the door out of the ambulance. How should the nurse prepare before seeing this
client?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Remove any hemostats from the pocket.
2. Take off the stethoscope and place it in the pocket.
3. Ask the paramedics to place the client in leather restraints.
4. Enter the room calmly, with a smile.
5. Give the client 20 minutes or so to calm down before the assessment begins.
Client Need: Safe Effective Care Environment
Client Need Sub: Management of Care
Nursing/Integrated Concepts: Nursing Process: Planning
Learning Outcome: 23-2: Identify threats and threatening behaviors.
Question 29
Type: MCMA
Sullivan, Effective Leadership and Management, 8/e Test Bank
As part of a presentation on health care workplace violence, the speaker says, “Injuries to nurses from violent acts
in the workplace are probably underreported.” What rationale should the speaker offer for this statement?
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. Nurses may not clearly understand what constitutes workplace violence.
2. Nurses may be unaware of how to report violent actions.
3. Nurses may feel that dealing with violence is an expected part of the job.
4. Nurses may believe that reporting a violent act will mark them as a weak employee.
5. Most violence against nurses is initiated by physicians, and nurses are afraid to report them.
Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Standard Text: Select all that apply.
1. The nurse should be removed from the unit.
2. A critical incident report should be written about the behavior.
3. The manager should explain that this is a good nurse who has difficulty tolerating stress.
4. Security should be notified of the behaviors.
5. The manager should warn other staff to stay clear of this nurse for the rest of the shift.