A troubled adolescent pulled out a gun in a school cafeteria, fatally shot three people and injured many others. Hundreds of parents come to the school after hearing news reports. After police arrest the shooter, which action should occur next?

Correct Answer: D

Rationale: Chaos is likely among students and desperate parents. A directive approach is best. Once the scene is secure, creative solutions are needed. Creating zones by letters of the alphabet will assist anxious parents and their children to unite. Preventing parents from uniting with their children will further incite the situation.

Correct Answer: C

Rationale: Meeting privately with the member can convey interest and help defuse the anger so that it is less disruptive to the group. Removing the member would be a last resort and used only when the behavior is intolerably disruptive to the group process and all other interventions have failed. Decreasing the focus on the hostile member and focusing more on positive members can help soften the anger. Angry members often hide considerable vulnerability by using anger to keep others at a distance and intimidated. Changing the subject fails to respond to the behavior.

Correct Answer: A

Rationale: The correct answer is A) Anger is a subjective emotional state, while aggression is the behavior resulting from anger. This key difference is crucial in understanding and effectively managing behavioral health issues. Anger is a normal human emotion triggered by a perceived threat, injustice, or frustration. It is a subjective feeling that varies in intensity and duration. Aggression, on the other hand, refers to the outward expression of anger through behavior that is intended to cause harm or damage. Option B is incorrect because anger and aggression are not synonymous. While anger can lead to aggression, they are distinct concepts with different manifestations. Option C is incorrect as anger is not necessarily a behavior aimed at harming others, but rather a feeling or emotion. Option D is incorrect because while anger can be a reaction to a perceived threat, it is not solely limited to that, and aggression can stem from various factors beyond just frustration. In a behavioral health nursing context, understanding the distinction between anger and aggression is essential for assessing, planning, and implementing care plans for individuals experiencing these emotions. By recognizing the subjective nature of anger and the behavioral outcomes of aggression, nurses can tailor interventions to address both the emotional and behavioral aspects of client care effectively.

Correct Answer: D

Rationale: The DSM provides standard nomenclature, presents defining characteristics, and identifies underlying causes of mental disorders. It does not provide care plans or prognostic outcomes of treatment. Diagnosis of mental illness is not within the generalist RN's scope of practice, so documenting the code in the medical record would be inappropriate.

Correct Answer: C

Rationale: Only one in four (25%) adults needing mental health care receives the needed services. Substance abuse issues cannot be dealt with in the 3 to 5 days typical for admissions in the current managed care environment. Money saved by states when state hospitals were closed has not been transferred to community programs and support. Although people with severe and persistent mental illness have shorter hospital stays, they are admitted to hospitals more frequently. In some cities, emergency department visits for acutely disturbed persons have increased by 400% to 500%.