A client is being admitted to the inpatient psychiatric unit. Which actions would be appropriate for the nurse to assess the client's risk of violence? Standard Text: Select all that apply
1. Wait to assess the client's risk of violence once the psychiatric symptoms have stabilized.
2. Assess history of psychotic illness as this is the most important predictor of violence potential.
3. Ask the client, "What is the most violent thing you have ever done?"
4. Review the client's past records and get information from the client's family.
5. Avoid discussing the client's past history of violence as this could provoke the client.
3,4
Rationale: Wait to assess the client's risk of violence once the psychiatric symptoms have stabilized. Do not wait to assess the client's risk of violence, this should be done as soon as possible so that a plan can be implemented to reduce the client's risk of violent behavior.
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