F.b) Trauma and Stressor-Related Disorders, Crisis and Response to Disaster

__________________________ refers to the cumulative negative effects on the body of continually having to adapt to changing environmental conditions and psychosocial challenge. It is more than chronic stress rather it is the sum total of the war and tear on the body that accumulates from the constant effort required to maintain normally body rhythms with changing environmental conditions

Allostatic Road

A client is treated in the emergency department for injuries sustained while vacationing hundreds of miles away from home. To best meet the client's emotional needs, the nurse should: A. arrange to hospitalize the client. B. refer the client for traditional psychotherapy for posttraumatic stress disorder. C. provide temporary support by arranging shelter and contacting the client's friends. D. suggest that contacting a victim support group would be more appropriate than crisis intervention. When a client has no support system, the nurse may assume that role for a short time.

C

A crisis is so acutely uncomfortable to the individual that it is likely to self-resolve in: A. 1 to 10 days. B. 1 to 3 weeks. C. 4 to 6 weeks. D. 3 to 4 months. At 4 to 6 weeks, the individual is making accommodations and adjustments to relieve anxiety, and the crisis is no longer a crisis.

C

A cruel and abusive person often uses rationalization to explain the behavior. Which comment demonstrates use of this defense mechanism? a. "I don't know why I do mean things." b. "I have always had poor impulse control." c. "That person should not have provoked me." d. "I'm really a coward who is afraid of being hurt."

C

A patient diagnosed with emphysema has severe shortness of breath and needs portable oxygen when leaving home. Recently the patient has reduced activity because of fear that breathing difficulty will occur. A nurse suggests using guided imagery. Which image should the patient be encouraged to visualize? a. Engaging in activity without using any supplemental oxygen b. Sleeping comfortably and soundly, without respiratory distress c. Feeling relaxed and taking regular deep breaths when leaving home d. Having a younger, healthier body that knows no exercise limitations

C

A patient diagnosed with obsessive-compulsive disorder has this nursing diagnosis: Anxiety related to __________ as evidenced by inability to control compulsive cleaning. Which phrase correctly completes the etiological portion of the diagnosis? a. feelings of responsibility for the health of family members b. approval-seeking behavior from friends and family c. persistent thoughts about bacteria, germs, and dirt d. needs to avoid interactions with others

C

A patient experiencing moderate anxiety says, "I feel undone." An appropriate response for the nurse would be: a. "What would you like me to do to help you?" b. "Why do you suppose you are feeling anxious?" c. "I'm not sure I understand. Give me an example." d. "You must get your feelings under control before we can continue."

C

A patient experiencing panic suddenly began running and shouting, "I'm going to explode!" Select the nurse's best action. a. Ask, "I'm not sure what you mean. Give me an example." b. Capture the patient in a basket-hold to increase feelings of control. c. Tell the patient, "Stop running and take a deep breath. I will help you." d. Assemble several staff members and say, "We will take you to seclusion to help you regain control."

C

A patient newly diagnosed as HIV-positive seeks the nurse's advice on how to reduce the risk of infections. The patient says, "I used to go to church and I was in my best health then. Maybe I should start going to church again." Which response will the nurse offer? a. "Religion does not usually affect health, but you were younger and stronger then." b. "Contact with supportive people at church might help, but religion itself is not especially helpful." c. "Studies show that spiritual practices can enhance immune system function and coping abilities." d. "Going to church would expose you to many potential infections. Let's think about some other options."

C

A patient reports, "I am overwhelmed by stress." Which question by the nurse would be most important to use in the initial assessment of this the patient? a. "Tell me about your family history. Do you have any relatives who have problems with stress?" b. "Tell me about your exercise. How much activity do you typically get in a day?" c. "Tell me about the kinds of things you do to reduce or cope with your stress." d. "Stress can interfere with sleep. How much did you sleep last night?"

C

A patient tells a nurse, "My new friend is the most perfect person one could imagine: kind, considerate, and good-looking. I can't find a single flaw." This patient is demonstrating: a. denial. b. projection. c. idealization. d. compensation.

C

A patient tells the nurse, "My doctor thinks my problems with stress relate to the negative way I think about things and suggested I learn new ways of thinking." Which response by the nurse would support the recommendation? a. Encourage the patient to imagine being in calm circumstances. b. Provide the patient with a blank journal and guidance about journaling. c. Teach the patient to recognize, reconsider, and reframe irrational thoughts. d. Teach the patient to use instruments that give feedback about bodily functions.

C

A patient visiting the crisis clinic for the first time asks, "How long will I be coming here?" The nurse's reply should consider that the usual duration of crisis intervention is _____________ weeks. a. 1 to 2 b. 3 to 4 c. 4 to 6 d. 6 to 12 The disorganization associated with crisis is so distressing that it usually cannot be tolerated for more than 4 to 6 weeks. If the crisis is not resolved by that time, the individual usually adopts dysfunctional behaviors that reduce anxiety without solving the problem. Crisis intervention can shorten the duration.

C

A person has minor physical injuries after an auto accident. The person is unable to focus and says, "I feel like something awful is going to happen." This person has nausea, dizziness, tachycardia, and hyperventilation. What is the person's level of anxiety? a. Mild b. Moderate c. Severe d. Panic

C

A person with a fear of heights drives across a high bridge. Which division of the autonomic nervous system will be stimulated in response to this experience? a. Limbic system b. Peripheral nervous system c. Sympathetic nervous system d. Parasympathetic nervous system

C

A person with a fear of heights drives across a high bridge. Which structure will stimulate a response from the autonomic nervous system? a. Thalamus b. Parietal lobe c. Hypothalamus d. Pituitary gland

C

A woman comes to the crisis intervention clinic expressing concern that her 16-year-old is using illegal drugs in their home.The nurse will: A. encourage the mother to call the police when her son brings drugs home. B. inform her of the obligation to report this information to the police. C. work with the client to set goals that are mutually acceptable. D. refer the client to the police for consultation. Goal setting is a collaborative task. Goals must be acceptable to the client and seen by the nurse as safe and appropriate.

C

A woman says, "I can't take it anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." What type of crisis is this person experiencing? a. Maturational b. Adventitious c. Situational d. Recurring A situational crisis arises from an external source and involves a loss of self-concept or self-esteem. An adventitious crisis is a crisis of disaster, such as a natural disaster or crime of violence. Maturational crisis occurs as an individual arrives at a new stage of development, when old coping styles may be ineffective. No classification of recurring crisis exists.

C

According to the Recent Life Changes Questionnaire, which situation would most necessitate a complete assessment of a person's stress status and coping abilities? a. A person who has been assigned more responsibility at work b. A parent whose job required relocation to a different city c. A person returning to college after an employer ceased operations d. A man who recently separated from his wife because of marital problems

C

After celebrating a 40th birthday, an individual becomes concerned with the loss of youthful appearance. What type of crisis has occurred? a. Reactive b. Situational c. Maturational d. Adventitious Maturational crises occur when a person arrives at a new stage of development and finds that old coping styles are ineffective but has not yet developed new strategies. Situational crises arise from sources external to the individual, such as divorce and job loss. No classification called reactive crisis exists. Adventitious crises occur when disasters such as natural disasters (e.g., floods, hurricanes), war, or violent crimes disrupt coping styles.

C

An adult tells the nurse, "I can't take it anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter told me she's quitting college and moving in with her boyfriend." What is the priority nursing diagnosis? a. Fear, related to impending surgery b. Deficient knowledge, related to breast lesion c. Ineffective coping, related to perceived loss of daughter d. Impaired verbal communication, related to spousal estrangement This nursing diagnosis is the priority because it reflects the precipitating event associated with the patient's crisis. Data are not present to make the other diagnoses of Deficient knowledge, Fear, or Impaired verbal communication.

C

Eye Movement Desensitization and Reprocessing (EMDR)

EMDR is a unique, nontraditional form of psychotherapy designed to diminish negative feelings associated with memories of traumatic events. Unlike most forms of talk therapy, EMDR focuses less on the traumatic event itself and more on the disturbing emotions and symptoms that result from the event. Treatment includes a hand motion technique used by the therapist to guide the client's eye movements from side to side, similar to watching a pendulum swing. EMDR is a controversial intervention, because it is unclear exactly how it works, with some psychologists claiming it does not work.

A nurse assesses a patient with a tentative diagnosis of generalized anxiety disorder. Which question would be most appropriate for the nurse to ask? a. "Have you been a victim of a crime or seen someone badly injured or killed?" b. "Do you feel especially uncomfortable in social situations involving people?" c. "Do you repeatedly do certain things over and over again?" d. "Do you find it difficult to control your worrying?"

D

A patient checks and rechecks electrical cords related to an obsessive thought that the house may burn down. The nurse and patient explore the likelihood of an actual fire. The patient states this event is not likely. This counseling demonstrates principles of: a. flooding. b. desensitization. c. relaxation technique. d. cognitive restructuring.

D

A patient comes to the clinic with superficial cuts on the left wrist. The patient is pacing and sobbing. After a few minutes with the nurse, the patient is calmer. What should the nurse ask to determine the patient's perception of the precipitating event? a. "Tell me why you were crying." b. "How did your wrist get injured?" c. "How can I help you feel more comfortable?" d. "What was happening just before you started to feel this way?" A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits the assessment of the precipitating event. Asking "why" questions is a poor communication technique.

D

A patient is brought to the Emergency Department after a motorcycle accident. The patient is alert, responsive, and diagnosed with a broken leg. The patient's vital signs are pulse (P) 72 and respiration (R) 16. After being informed surgery is required for the broken leg, which vital sign readings would be expected? a. P 64, R 14 b. P 68, R 12 c. P 72, R 16 d. P 80, R 20

D

A patient tells the nurse, "I know that I should reduce the stress in my life, but I have no idea where to start." What would be the best initial nursing response? a. "Physical exercise works to elevate mood and reduce anxiety." b. "Reading about stress and how to manage it might be a good place to start." c. "Why not start by learning to meditate? That technique will cover everything." d. "Let's talk about what is going on in your life and then look at possible options."

D

A patient undergoing diagnostic tests says, "Nothing is wrong with me except a stubborn chest cold." The spouse reports the patient smokes, coughs daily, lost 15 pounds, and is easily fatigued. Which defense mechanism is the patient using? a. Displacement b. Regression c. Projection d. Denial

D

A person who feels unattractive repeatedly says, "Although I'm not beautiful, I am smart." This is an example of: a. repression. b. devaluation. c. identification. d. compensation.

D

A person who has been unable to leave home for more than a week because of severe anxiety says, "I know it does not make sense, but I just can't bring myself to leave my apartment alone." Which nursing intervention is appropriate? a. Help the person use online video calls to provide interaction with others. b. Advise the person to accept the situation and use a companion. c. Ask the person to explain why the fear is so disabling. d. Teach the person to use positive self-talk techniques.

D

A student says, "Before taking a test, I feel very alert and a little restless." The nurse can correctly assess the student's experience as: a. culturally influenced. b. displacement. c. trait anxiety. d. mild anxiety.

D

Tend and Befriend

Tending = nurturant activities designed to protect self and offsrping befriend: creating and maintaining of social networks that aid in the process

Factors that predict the development of ____________include: Being female Type and severity of the trauma Past trauma (including childhood physical, sexual, and emotional abuse Availability of support at the time of the stressful event

PTSD

Types of Crises Stressful experience for which coping mechanisms fail. _____________________ _____________: Three stages: shock and disbelief, acute mourning, resolution Mourning It is acute and time limited and may be developmental, or situational. 1.______________________ - Any event that overwhelms an individual's coping resources and upsets his or her equilibrium 2. _________________________ - Assumes that psychosocial development progresses in an orderly, easily identifiable process.

bereavement, grief situation, developmental

Allostasis

how the cardio system adjusts to resting and active states of the body (from a stress and stress response perspective, this refers to how the body adaptsot changing external environments)

Cognitive Appraisal

process where people examine demands and constraints of a situation to their own personal resources (Primary: am i in danger? If yes - go into secondary where they consider options for dealing with stressor. There must be a balance between demnds and personal resources. )

The Freeze-hide response

tendency to produce passive response to stress

What word comes from the greek word for wound?

trauma

Effects of disaster are greatest when _______ of the following are present Extreme and widespread property damage Serious and ongoing finance problems for the community Human intent was the cause High prevalence of trauma: injuries, loss of life

two

The Evolution of the Concept of Stress Stress as a Physiologic Response The perception of a stressor triggers an automatic, total-body response (alarm reaction) If the stressor is not mediated (and the body does not return to homeostasis) and the stressor remains present for hours or days, the stage of resistance occurs and efforts to adapt continue If continued, the body moves into the stage of ______________________:where individual resources deplete, exhaustion ensues Keeping in mind that stressors are Abstract, what may be a stressor for one individual may not be for another What may be a stressor for many individuals may be managed differently individually

- exhaustion

Acute Stress Disorder The individual will experience personally, or witness _____________________ a severe threat in which life or injury is or appears to be at stake. This experience must then continue to affect the individual's mental health status in such areas as arousal, _________________ memories, and changes in behavior and functioning

- others experience - intrusive

There are many types of Traumas: Define the names of the following: 1. related to an unexpected and overwhelming event such as an accident, natural disaster, a single episode of abuse or assault, sudden loss, or witnessing violence 2. ongoing abuse, domestic violence, war, ongoing betrayal, often involving being trapped emotionally and/or physically 3. results from exposure to early ongoing or repetitive trauma (as infants, children and youth) involving neglect, abandonment, physical abuse or assault, sexual abuse or assault, emotional abuse, witnessing violence or death, and/or coercion or betrayal. *interferes with healthy attachement and development* 4. The effects of stress and trauma experienced in one generation can be transmitted to subsequent generations / Adverse experiences in childhood and adulthood may influence the risk for various health and social outcomes in offspring of those who encountered the stressor or trauma directly 5. A social group is affected by the consequences of multiple, collectively experienced adversities across time that outweigh group resiliency factors, become cumulative, and are carried forward to subsequent generations such that the trauma may be considered as part of a singe trajectory 6. Occurs when a traumatic event is experienced by a significant proportion of a given social group / It can have long-term consequences for the social group beyond its additive effect on individuals such that social norms, dynamics, functioning, and structure of the group may be modified (ex. ww2, hirshima, vietnam, etc)

1. Single Incident 2. Complex or repetitive 3. Development 4. Intergenerational 5. Historical 6. Collective

Trauma-informed Practice Project includes what focuses?

1. trauma awareness 2. emphasis on safety and trust 3. Opportunity for choice, collaboration and connection 4. strengths based and skill building

A nurse assesses an individual who commonly experiences anxiety. Which comment by this person indicates the possibility of obsessive-compulsive disorder? a. "I check where my car keys are eight times." b. "My legs often feel weak and spastic." c. "I'm embarrassed to go out in public." d. "I keep reliving a car accident."

A

A nurse leads a psychoeducational group for depressed patients. The nurse plans to implement an exercise regime for each patient. The rationale to use when presenting this plan to the treatment team is that exercise: a. has an antidepressant effect comparable to selective serotonin reuptake inhibitors. b. prevents damage from overstimulation of the sympathetic nervous system. c. detoxifies the body by removing metabolic wastes and other toxins. d. improves mood stability for patients with bipolar disorders.

A

A patient fearfully runs from chair to chair crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. The initial nursing intervention of highest priority is to: a. provide for the patient's safety. b. encourage clarification of feelings. c. respect the patient's personal space. d. offer an outlet for the patient's energy.

A

A patient in the emergency department shows disorganized behavior and incoherence after a friend suggested a homosexual encounter. In which room should the nurse place the patient? a. An interview room furnished with a desk and two chairs b. A small, empty storage room with no windows or furniture c. A room with an examining table, instrument cabinets, desk, and chair d. The nurse's office, furnished with chairs, files, magazines, and bookcases

A

A patient who had been experiencing significant stress learned to use progressive muscle relaxation and deep breathing exercises. When the patient returns to the clinic 2 weeks later, which finding most clearly shows the patient is coping more effectively with stress? a. The patient's systolic blood pressure has changed from the 140s to the 120s mm Hg. b. The patient reports, "I feel better, and that things are not bothering me as much." c. The patient reports, "I spend more time napping or sitting quietly at home." d. The patient's weight decreased by 3 pounds.

A

A person speaking about a rival for a significant other's affection says in an emotional, syrupy voice, "What a lovely person. That's someone I simply adore." The individual is demonstrating: a. reaction formation. b. repression. c. projection. d. denial.

A

A student says, "Before taking a test, I feel very alert and a little restless." Which nursing intervention is most appropriate to assist the student? a. Explain that the symptoms result from mild anxiety and discuss the helpful aspects. b. Advise the student to discuss this experience with a health care provider. c. Encourage the student to begin antioxidant vitamin supplements. d. Listen attentively, using silence in a therapeutic way.

A

A victim of spousal violence comes to the crisis center seeking help. The nurse uses crisis intervention strategies that focus on: a. supporting emotional security and reestablishing equilibrium b. offering a long-term resolution of issues precipitating the crisis c. promoting growth of the individual d. providing legal assistance Strategies of crisis intervention are directed toward the immediate cause of the crisis and are aimed at bolstering the emotional security and reestablishing equilibrium, rather than focusing on underlying issues and long-term resolutions. The goal is to return the individual to the pre-crisis level of function. Crisis intervention is, by definition, short term. Promoting growth is a focus of long-term therapy. Providing legal assistance might be applicable.

A

An adult has cared for a debilitated parent for 10 years. The parent's condition has recently declined, and the health care provider has recommended placement in a skilled care facility. The adult says, "I've always been able to care for my parents. Nursing home placement goes against everything I believe." Successful resolution of this person's crisis will most closely relate to: a. resolving the feelings associated with the threat to the person's self-concept b. maintaining the ability to identify situational supports in the community c. relying on the assistance from role models within the person's culture d. mobilizing automatic relief behaviors by the person The patient's crisis clearly relates to a loss of (or threatened change in) self-concept. Her capacity to care for her parents, regardless of the deteriorating condition, has been challenged. Crisis resolution involves coming to terms with the feelings associated with this loss. Identifying situational supports is relevant but less so than coming to terms with the threat to self-concept. Reliance on lessons from role models can be helpful but is not the primary factor associated with resolution in this case. Automatic relief behaviors are not helpful and are part of the fourth phase of crisis.

A

An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic. Which defense mechanism is evident? a. Rationalization b. Compensation c. Introjection d. Regression

A

Mason and Charlie, both 16 years old, were involved in a bad car accident in which they were both passengers. Mason spoke with a counselor about the incident once and has been able to move forward with little dysfunction. Charlie has been experiencing anxiety and an inability to concentrate in school even after numerous counseling sessions. The difference in the way the accident affected both boys may be explained by: A. perception of the event. B. Mason's more laid-back personality. C. the possibility that Charlie may have experienced previous trauma from which he did not fully recover. D. the possibility that counseling Charlie received may have been inadequate. People vary in the way they absorb, process, and use information from the environment. Some people may respond to a minor event as if it were life-threatening. Conversely, others may experience a major event and look at it in a calmer fashion. The other options may be true but are not the primary reason two people respond differently to the same event.

A

The assumption most useful to a nurse planning crisis intervention for any patient is that the patient: a. is experiencing a state of disequilibrium. b. is experiencing a type of mental illness. c. poses a threat of violence to others. d. has a high potential for self-injury. Disequilibrium is the only answer universally true for all patients in crisis. A crisis represents a struggle for equilibrium when problems seem unsolvable. Crisis does not reflect mental illness. The potential for self-violence or other-directed violence may or may not be a factor in crisis.

A

The priority concern of the crisis intervention nurse is: A. client safety. B. setting up future contacts. C. brainstorming possible solutions. D. working through termination issues. Client safety is always the priority concern in crisis intervention therapy. The disequilibrium of crisis predisposes the client to suicidal thinking.

A

To assess the client's perception of the event precipitating a crisis, the nurse would initially ask: A. "What was happening just before you began feeling this way?" B. "During difficult times in the past, what has helped you?" C. "Can you give me the name of someone you trust?" D. "Who is available to help you?" Option A is the only query that is directed at the client's perception of the precipitating event. The other options ask important questions but are not related to perception of the precipitating event.

A

Two staff nurses applied for promotion to nurse manager. The nurse not promoted initially had feelings of loss but then became supportive of the new manager by helping make the transition smooth and encouraging others. Which term best describes the nurse's response? a. Altruism b. Suppression c. Intellectualization d. Reaction formation

A

When a stressful event occurs and the individual is unable to resolve the situation by using his or her usual coping strategies, the individual: A. becomes disorganized and uses trial-and-error problem solving. B. withdraws and acts as though the problem does not exist. C. develops severe personality disorganization. D. resorts to planning suicide. This is the second stage of crisis, according to accepted crisis theory.

A

Which assumption serves as a foundation for the use of crisis intervention? A. The individual is mentally healthy but in a state of disequilibrium. B. Long-term dysfunctional adjustment can be addressed by crisis intervention. C. An anxious person is unlikely to be willing to try new problem-solving strategies. D. Crisis intervention nurses need to remain passive as the client deals with the crisis.

A

Which situation has the potential for early crisis intervention to occur? A. Mrs. R tells the nurse in the well-baby clinic that she's feeling uptight and has arranged to see a primary care therapist. B. Ms. T is hospitalized after an unsuccessful suicide attempt that she states, "was a mistake." C. Mr. W asks for reassurance that he will be welcome at the day hospital after his hospital discharge. D. Ms. G enters the emergency department with a strong smell of alcohol on his person, stating he is anxious and depressed. Phase I intervention is when a person confronted by a conflict or problem that threatens the self-concept responds with increased feelings of anxiety. The increase in anxiety stimulates the use of problem-solving techniques and defense mechanisms in an effort to solve the problem and lower anxiety. Option B indicates a phase 4 response to a crisis; option C would be a phase 3 response. In option D the client is using inappropriate coping mechanisms, which are not effective to treat depression and anxiety.

A

While conducting the initial interview with a patient in crisis, the nurse should: a. speak in short, concise sentences. b. convey a sense of urgency to the patient. c. be forthright about time limits of the interview. d. let the patient know the nurse controls the interview. Severe anxiety narrows perceptions and concentration. By speaking in short, concise sentences, the nurse enables the patient to grasp what is being said. Conveying urgency will increase the patient's anxiety. Letting the patient know who controls the interview or stating that time is limited is nontherapeutic.

A

An individual says to the nurse, "I feel so stressed out lately. I think the stress is affecting my body also." Which somatic complaints are most likely to accompany this feeling? Select all that apply. a. Headache b. Neck pain c. Insomnia d. Anorexia e. Myopia

A,B,C,D

Which changes reflect short-term physiological responses to stress? Select all that apply. a. Muscular tension, blood pressure, and triglycerides increase. b. Epinephrine is released, increasing heart and respiratory rates. c. Corticosteroid release increases stamina and impedes digestion. d. Cortisol is released, increasing glucogenesis and reducing fluid loss. e. Immune system functioning decreases, and risk of cancer increases. f. Risk of depression, autoimmune disorders, and heart disease increases.

A,B,C,D

Which nursing comments are likely to help a patient to cope by addressing the mediators of stress? Select all that apply. a. "A divorce, while stressful, can be the beginning of a new, better phase of life." b. "You said you used to jog; getting back to aerobic exercise could be helpful." c. "Journaling often promotes awareness of how experiences have affected people." d. "Slowing your breathing by counting to three between breaths will calm you." e. "Would a short-term loan make your finances less stressful?" f. "There is a support group for newly divorced persons in your neighborhood."

A,C,E,F

A nurse driving home after work comes upon a serious automobile accident. The driver gets out of the car with no apparent physical injuries. Which assessment findings would be expected from the driver immediately after this event? Select all that apply. a. Difficulty using a cell phone b. Long-term memory losses c. Fecal incontinence d. Rapid speech e. Trembling Immediate responses to crisis commonly include shock, numbness, denial, confusion, disorganization, difficulty with decision making, and physical symptoms such as nausea, vomiting, tremors, profuse sweating, and dizziness associated with anxiety. Incontinence and long-term memory losses would not be expected.

A,D,E

A patient comes to the crisis center saying, "I'm in a terrible situation. I don't know what to do." The triage nurse can initially assume that the patient is: a. suicidal. b. anxious and fearful. c. misperceiving reality. d. potentially homicidal. Individuals in crisis are universally anxious. They are often frightened and may be mildly confused. Perceptions are often narrowed.

B

A patient experiences a sudden episode of severe anxiety. Of these medications in the patient's medical record, which is most appropriate to give as a prn anxiolytic? a. buspirone (BuSpar) b. lorazepam (Ativan) c. amitriptyline (Elavil) d. desipramine (Norpramin)

B

A patient experiencing significant stress associated with a disturbing new medical diagnosis asks the nurse, "Do you think saying a prayer would help?" Select the nurse's best answer. a. "It could be that prayer is your only hope." b. "You may find prayer gives comfort and lowers your stress." c. "I can help you feel calmer by teaching you meditation exercises." d. "We do not have evidence that prayer helps, but it wouldn't hurt."

B

A patient fearfully runs from chair to chair crying, "They're coming! They're coming!" The patient does not follow the staff's directions or respond to verbal interventions. Which nursing diagnosis has the highest priority? a. Fear b. Risk for injury c. Self-care deficit d. Disturbed thought processes

B

A patient is experiencing moderate anxiety. The nurse encourages the patient to talk about feelings and concerns. What is the rationale for this intervention? a. Offering hope allays and defuses the patient's anxiety. b. Concerns stated aloud become less overwhelming and help problem solving begin. c. Anxiety is reduced by focusing on and validating what is occurring in the environment. d. Encouraging patients to explore alternatives increases the sense of control and lessens anxiety.

B

A 12-year-old finds herself feeling anxious and overwhelmed and seeks out the school nurse to report that "Everything is changing . . . my body, the way the boys who were my friends are treating me, everything is so different." It is likely the child is: A. describing personal identity disorder. B. experiencing a maturational crisis. C. potentially suicidal. D. mildly neurotic. The maturational crisis of moving from childhood into adolescence may be difficult because many new coping skills are necessary.

B

A nurse wants to teach alternative coping strategies to a patient experiencing severe anxiety. Which action should the nurse perform first? a. Verify the patient's learning style. b. Lower the patient's current anxiety. c. Create outcomes and a teaching plan. d. Assess how the patient uses defense mechanisms.

B

A patient comes to the clinic with superficial cuts on the left wrist. The patient paces around the room sobbing but cringes when approached and responds to questions with only shrugs or monosyllables. Select the nurse's best initial statement to this patient. a. "Everything is going to be all right. You are here at the clinic, and the staff will keep you safe." b. "I see you are feeling upset. I'm going to stay and talk with you to help you feel better." c. "You need to try to stop crying so we can talk about your problems." d. "Let's set some guidelines and goals for your visit here." A crisis exists for this patient. The two primary thrusts of crisis intervention are to provide for the safety of the individual and use anxiety-reduction techniques to facilitate the use of inner resources. The nurse offers therapeutic presence, which provides caring, ongoing observation relative to the patient's safety, and interpersonal reassurance.

B

A patient nervously says, "Financial problems are stressing my marriage. I've heard rumors about cutbacks at work; I am afraid I might get laid off." The patient's pulse is 112/minute; respirations are 26/minute; and blood pressure is 166/88. Which nursing intervention will the nurse implement? a. Advise the patient, "Go to sleep 30 to 60 minutes earlier each night to increase rest." b. Direct the patient in slow and deep breathing via use of a positive, repeated word. c. Suggest the patient consider that a new job might be better than the present one. d. Tell the patient, "Relax by spending more time playing with your pet."

B

A patient performs ritualistic hand washing. Which action should the nurse implement to help the patient develop more effective coping? a. Allow the patient to set a hand-washing schedule. b. Encourage the patient to participate in social activities. c. Encourage the patient to discuss hand-washing routines. d. Focus on the patient's symptoms rather than on the patient.

B

A patient preparing for surgery has moderate anxiety and is unable to understand preoperative information. Which nursing intervention is most appropriate? a. Reassure the patient that all nurses are skilled in providing postoperative care. b. Present the information again in a calm manner using simple language. c. Tell the patient that staff is prepared to promote recovery. d. Encourage the patient to express feelings to family.

B

A patient says, "One result of my chronic stress is that I feel so tired. I usually sleep from 11:00 PM to 6:30 AM. I started setting my alarm to give me an extra 30 minutes of sleep each morning, but I don't feel any better and I'm rushed for work." Which nursing response would best address the patient's concerns? a. "You may need to speak to your doctor about taking a sedative to help you sleep." b. "Perhaps going to bed a half-hour earlier would work better than sleeping later." c. "A glass of wine in the evening might take the edge off and help you to rest." d. "Exercising just before retiring for the night may help you to sleep better."

B

A patient tells the nurse, "I will never be happy until I'm as successful as my older sister." The nurse asks the patient to reassess this statement and reframe it. Which reframed statement by the patient is most likely to promote coping? a. "People should treat me as well as they treat my sister." b. "I can find contentment in succeeding at my own job level." c. "I won't be happy until I make as much money as my sister." d. "Being as smart or clever as my sister isn't really important."

B

A patient with an abdominal mass is scheduled for a biopsy. The patient has difficulty understanding the nurse's comments and asks, "What do you mean? What are they going to do?" Assessment findings include tremulous voice, respirations 28, and pulse 110. What is the patient's level of anxiety? a. Mild b. Moderate c. Severe d. Panic

B

A recent immigrant from Honduras comes to the clinic with a family member who has been a U.S. resident for 10 years. The family member says, "The immigration to America has been very difficult." Considering cultural background, which expression of stress by this patient would the nurse expect? a. Motor restlessness b. Somatic complaints c. Memory deficiencies d. Sensory perceptual alterations

B

A woman comes to the crisis intervention clinic and reports that her 16-year-old son uses drugs in the home and often assaults her. The nurse tells the client,: A. "This is not an uncommon problem. Don't worry." B. "Together we will be able to work on this problem." C. "Now that you are asking for help, everything will be all right." D. "I have friends in law enforcement who can help us choose a solution." The nurse takes an active collaborative role in problem resolution beginning with telling the client that a solution will be found.

B

A woman is 5'7", 160 lbs, and wears a size 8 shoe. She says, "My feet are huge. I've asked three orthopedists to surgically reduce my feet." This person tries to buy shoes to make her feet look smaller and, in social settings, conceals both feet under a table or chair. Which health problem is likely? a. Social anxiety disorder b. Body dysmorphic disorder c. Separation anxiety disorder d. Obsessive-compulsive disorder due to a medical condition

B

A woman says, "I can't take it anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." If this person's immediate family is unable to provide sufficient situational support, the nurse should: a. suggest hospitalization for a short period. b. ask what other relatives or friends are available for support. c. tell the patient, "You must be strong. Don't let this crisis overwhelm you." d. foster insight by relating the present situation to earlier situations involving loss. The assessment of situational supports should continue. Although the patient's nuclear family may not be supportive, other situational supports may be available. If they are adequate, admission to an inpatient unit will be unnecessary. Psychotherapy is not appropriate for crisis intervention. Advice is usually nontherapeutic.

B

An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The patient told the parents about the uncle's behavior, but the parents did not believe the adolescent. What type of crisis exists? a. Maturational b. Adventitious c. Situational d. Organic An adventitious crisis is a crisis of disaster that is not a part of everyday life; it is unplanned or accidental. Adventitious crises include natural disasters, national disasters, and crimes of violence. Sexual molestation falls within this classification. Maturational crisis occurs as an individual arrives at a new stage of development, when old coping styles may be ineffective. Situational crisis arises from an external source such as a job loss, divorce, or other loss affecting self-concept or self-esteem. Organic is not a type of crisis.

B

An adult comes to the crisis clinic after being terminated from a job of 15 years. The patient says, "I don't know what to do. How can I get another job? Who will pay the bills? How will I feed my family?" Which nursing diagnosis applies? a. Hopelessness b. Powerlessness c. Chronic low self-esteem d. Disturbed thought processes The patient describes feelings of the lack of control over life events. No direct mention is made of hopelessness or chronic low self-esteem. The patient's thought processes are not shown to be altered at this point.

B

An appropriate question for the nurse to ask to assess situational support is: a. "Has anything upsetting occurred in the past few days?" b. "Who can be helpful to you during this time?" c. "How does this problem affect your life?" d. "What led you to seek help at this time?" Only the correct answer focuses on situational support. The incorrect options focus on the patient's perception of the precipitating event.

B

Carter experiences each of the following during his crisis. Which of the following describes phase IV of Caplan's phases of crisis? A. Carter experiences increased anxiety and feelings of extreme discomfort the day after the tornado. B. Carter comes to the crisis clinic complaining of depression and expresses that he does not want to go on living. C. Carter experiences a panic attack at his mother's home in a nearby town where he is staying after the tornado. D. Carter experiences anxiety symptoms the day after he was fired. This describes phase IV, which, if coping is ineffective, may lead to depression, confusion, violence, or suicidality. The other options describe phase II, phase III, and phase I in Caplan's phases of crisis.

B

Carter, aged 36 years, comes to the crisis clinic for his first visit with complaints of not sleeping, anxiety, and excessive crying. He recently was fired suddenly from his job and 3 days later lost his home to a tornado that devastated the town he lives in. Which of the following statements regarding crisis accurately describes Carter's situation? A. He is experiencing low self-esteem from the job loss, as well as anger because of the loss of his home. B. He is experiencing both a situational and an adventitious crisis. C. He is experiencing ineffective coping and should be hospitalized for intensive therapy. D. He is experiencing a situational crisis with the added stress of financial burden. It is possible to experience more than one type of crisis situation simultaneously, and as expected, the presence of more than one crisis further taxes individual coping skills. Carter lost his job (situational crisis) and also experienced the devastating effects of a tornado (adventitious crisis). The first option may be true but doesn't accurately describe the crisis criteria. There is nothing in the scenario suggesting he needs acute hospitalization at this time. He is experiencing not only a situational crisis, but an adventitious one as well, which makes coping more difficult.

B

During the initial interview at the crisis center, a patient says, "I've been served with divorce papers. I'm so upset and anxious that I can't think clearly." What could the nurse say to assess personal coping skills? a. "What would you like us to do to help you feel more relaxed?" b. "In the past, how did you handle difficult or stressful situations?" c. "Do you think you deserve to have things like this happen to you?" d. "I can see you are upset. You can rely on us to help you feel better." The correct answer is the only option that assesses coping skills. The incorrect options offer unrealistic reassurance, are concerned with self-esteem, and ask the patient to decide on treatment at a time when he or she "cannot think clearly."

B

The expected outcome at the conclusion of crisis intervention therapy is that the client will function: A. at a higher level than before the crisis. B. at the precrisis level. C. only marginally below the precrisis level. D. without aid from identified support systems. The intent of crisis intervention is to return the individual to the precrisis level of functioning.

B

The nurse assesses a patient who complains of loneliness and episodes of anxiety. Which statement by the patient is mostly likely if this patient also has agoraphobia? a. "I'm sure I will get over not wanting to leave home soon. It takes time." b. "Being afraid to go out seems ridiculous, but I can't go out the door." c. "My family says they like it now that I stay home most of the time." d. "When I have a good incentive to go out, I can do it."

B

The nurse working with a client in crisis must initially assess for the client's: A. self-report of feeling depressed. B. unrealistic report of a crisis-precipitating event. C. report of a high level of anxiety. D. admission that he or she is abusing drugs. A person's equilibrium may be adversely affected by one or more of the following: an unrealistic perception of the precipitating event, inadequate situational supports, and inadequate coping mechanisms. These factors must be assessed when a crisis situation is evaluated because data gained from the assessment are used as guides for both the nurse and the client to set realistic and meaningful goals as well as to plan possible solutions to the problem situation.

B

When a person becomes unemployed, he is likely to experience a(n): A. reactive crisis. B. situational crisis. C. adventitious crisis. D. substance abuse crisis. Situational crises arise from external sources. Examples are death of a loved one, divorce, marriage, or a change in health status.

B

Which communication technique is used more in crisis intervention than traditional counseling? a. Role modeling b. Giving direction c. Information giving d. Empathic listening The nurse working in crisis intervention must be creative and flexible in looking at the patient's situation and suggesting possible solutions to the patient. Giving direction is part of the active role a crisis intervention therapist takes. The other options are used equally in crisis intervention and traditional counseling roles.

B

Which scenario best demonstrates an example of eustress? An individual: a. loses a beloved family pet. b. prepares to take a one-week vacation to a tropical island with a group of close friends. c. receives a bank notice there were insufficient funds in their account for a recent rent payment. d. receives notification their current employer is experiencing financial problems and some workers will be terminated.

B

Which situation demonstrates the use of primary care related to crisis intervention? a. Implementing suicide precautions for a patient with depression. b. Teaching stress reduction techniques to a beginning student nurse. c. Assessing coping strategies used by a patient who has attempted suicide. d. Referring a patient with schizophrenia to a partial hospitalization program. Primary crisis intervention promotes mental health and reduces mental illness. The incorrect options are examples of secondary or tertiary intervention.

B

Which statement would suggest to the crisis intervention nurse the need to arrange for hospitalization of a client? A. "I'm feeling overwhelmed by all that has happened, and I need help sorting it out." B. "I see no solution for this situation if nothing changes by tomorrow." C. "There are three possibilities that might help, but I can't decide what to do." D. "I feel a little calmer than yesterday at this time, but things are still very difficult." Whenever the client presents a danger to himself or herself or others, hospitalization must be considered.

B

The nurse wishes to use guided imagery to help a patient relax. Which comments would be appropriate to include in the guided imagery script? Select all that apply. a. "Imagine others treating you the way they should, the way you want to be treated..." b. "With each breath, you feel calmer, more relaxed, almost as if you are floating ..." c. "You are alone on a beach, the sun is warm, and you hear only the sound of the surf ..." d. "You have taken control, nothing can hurt you now. Everything is going your way..." e. "You have grown calm, your mind is still, there is nothing to disturb your wellbeing ..." f. "You will feel better as work calms down, as your boss becomes more understanding ..."

B,C,E

A client comes to the crisis intervention clinic and tearfully tells the nurse, "It is so painful! I have thought about it, and I cannot see how I can go on without my partner." The nurse states, "You have resilience and will look back on this as a crisis you were able to manage." Analysis of this interaction reveals that the nurse: A. has a good understanding of the effect of time on perception of a crisis. B. is offering a statement of positive outcome based on client coping ability. C. has not followed up on the client's verbal clues to suicidal thoughts. D. has stepped into the territory of traditional psychotherapy. Nurses who are uncomfortable with the idea of suicide may fail to pick up on a client's clues. This client clearly was open to discussing her suicidal thoughts, or she would not have said, "I cannot see how I can go on."

C

At the last contracted visit in the crisis intervention clinic, an adult says, "I've emerged from this a stronger person. You helped me feel like my life is back in balance." The nurse responds, "I think it would be worthwhile to have two more sessions to explore why your reactions were so intense." Which analysis applies? a. The patient is experiencing transference. b. The patient demonstrates a need for continuing support. c. The nurse is having difficulty terminating the relationship. d. The nurse is empathizing with the patient's feelings of dependency. The nurse's remark is clearly an invitation to work on other problems and prolong contact with the patient. The focus of crisis intervention is on the problem that precipitated the crisis, not other issues. The scenario does not describe transference. The patient's need for continuing support is not demonstrated in the scenario. The scenario does not describe dependency needs.

C

The nurse caring for a client in crisis shows signs of a problematic nurse-client relationship by: A. offering to change the time of the counseling session for the second time in 3 weeks. B. experiencing frustration about the decisions the client is making. C. giving the client permission to call him or her at home when the client "needs to talk." D. suggesting that the client attend an extra counseling session each month. The behavior in option C is a reaction to the nurse's need to be needed and undermines the client's sense of self-reliance.

C

Tori is the nurse working with Carter and other members of the community after the tornado. As the weeks go by, she begins to feel anxious and distressed. She speaks to her nurse mentor about her feelings. Which of the following may Tori be experiencing? A. Reactionary grief B. Maturational crisis C. Vicarious traumatization D. Transference Even experienced nurses working in disaster situations can become overwhelmed when witnessing catastrophes such as loss of human life or mass destruction of people's homes and belongings (e.g., floods, fires, tornadoes). Researchers have found that mental health care providers may experience psychological distress from working with traumatized populations, a phenomenon of secondary traumatic stress or "vicarious traumatization." Reactionary grief does not describe secondary stress from working with such populations. A maturational crisis arises from disruption of a developmental stage. Transference describes feelings displaced onto the nurse or therapist by the patient.

C

Two staff nurses applied for a charge nurse position. After the promotion was announced, the nurse who was not promoted said, "The nurse manager had a headache the day I was interviewed." Which defense mechanism is evident? a. Introjection b. Conversion c. Projection d. Splitting

C

When a tornado results in the loss of homes, businesses, and life, the town residents are likely to experience a(n): A. maturational crisis. B. situational crisis. C. adventitious crisis. D. endogenous crisis. An adventitious crisis is unplanned, accidental, and not part of everyday life. Examples are disasters and crimes of violence.

C

When alprazolam (Xanax) is prescribed for a patient who experiences acute anxiety, health teaching should include instructions to: a. report drowsiness. b. eat a tyramine-free diet. c. avoid alcoholic beverages. d. adjust dose and frequency based on anxiety level.

C

When the client begins to sob uncontrollably and her speech becomes so incoherent that she is unable to give the nurse any information, the immediate interventions will focus on: A. securing hospital admission. B. contacting a family member or close friend. C. lowering her anxiety level from severe to moderate. D. assisting the client to identify new effective coping strategies. Individuals with severe anxiety are not able to collaborate in problem solving. The nurse must assist the client to lower anxiety from severe to moderate or lower.

C

Which agency provides coordination in the event of a terrorist attack? a. U.S. Food and Drug Administration (FDA) b. Environmental Protection Agency (EPA) c. National Incident Management System (NIMS) d. Federal Emergency Management Agency (FEMA) The NIMS provides a systematic approach to guide departments and agencies at all levels of government, nongovernmental organizations, and the private sector during disaster situations.

C

How a stressful even develops into a crisis depends on three balancing factors: Perception of the event - does the person have a realistic view of the situation? Available situational supports - adequate supports? Coping mechanisms - effective coping mechanisms? ________________________ is the provision of emergency psychological care to assist victims in returning to an adaptive level of functioning and to prevent or moderate the potentially negative effects of a psychological trauma. _________________________ - access Stabilization - prevent the situation from getting worse Facilitate understanding - help individuals develop an accurate understanding of the situation and its consequences Focus on problem solving - ID and prioritize immediate problems Encourage self-reliance

Crisis intervention early intervention

A troubled adolescent opened fire in a high school cafeteria, fatally shooting three people and injuring many others. Hundreds of parents come to the high school after hearing the news reports. After the police arrest the shooter, which action should occur next? a. Ask the police to encircle the school campus with yellow tape to prevent parents from entering. b. Announce over the loudspeakers, "The campus is now secure. Please return to your classrooms." c. Require parents to pass through metal detectors and then allow them to look for their children in the school. d. Designate zones according to the alphabet, and direct students to the zones based on their surnames to facilitate reuniting them with their parents. 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 helps anxious parents and their children to unite. Preventing parents from uniting with their children would further incite the situation.

D

A woman says, "I can't take it anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college and moving in with her boyfriend." Which issue should be the focus for crisis intervention? a. Possible mastectomy b. Disordered family communication c. Effects of the husband's infidelity d. Coping with the reaction to the daughter's events The focus of crisis intervention is on the most recent problem—"the straw that broke the camel's back." The patient has coped with the breast lesion, the husband's infidelity, and the disordered communication. Disequilibrium occurs only with the introduction of the daughter leaving college and moving.

D

A woman says, "I can't take it anymore! Last year my husband had an affair and now we don't communicate. Three months ago, I found a lump in my breast. Yesterday my daughter said she's quitting college." What is the nurse's priority assessment? a. Identifying measures useful to help improve the couple's communication b. Discussing the patient's feelings about the possibility of having a mastectomy c. Determining whether the husband is still engaged in an extramarital affair d. Clarifying what the patient means by, "I can't take it anymore!" During crisis intervention, the priority concern is patient safety. This question helps assess personal coping skills. The other options are incorrect because the focus of crisis intervention is on the event that occurred immediately before the patient sought help.

D

After completing the contracted number of visits to the crisis clinic, an adult says, "I've emerged from this as a stronger person. You supported me while I worked through my feelings of loss and helped me find community resources. I'm benefiting from a support group." The nurse can evaluate the patient's feelings about the care received as: a. not at all satisfied b. somewhat satisfied c. moderately satisfied d. very satisfied The patient mentions a number of indicators that suggest a high degree of satisfaction with the Nursing Outcomes Classification of patient satisfaction: psychologic care. No indicators express low-to-moderate satisfaction.

D

An adult seeks counseling after the spouse is murdered. The adult angrily says, "I hate the beast that did this. It has ruined my life. During the trial, I don't know what I'll do if the jury doesn't return a guilty verdict." What is the nurse's highest priority response? a. "Would you like to talk to a psychiatrist about some medication to help you cope during the trial?" b. "What resources do you need to help you cope with this situation?" c. "Do you have enough support from your family and friends?" d. "Are you having thoughts of hurting yourself or others?" The highest nursing priority is safety. The nurse should assess suicidal and homicidal potentials. The incorrect options are important but not the highest priority.

D

Crises that occur as an individual moves from one developmental level to another are called: A. reactive crises. B. recurring crises. C. situational crises. D. maturational crises. Maturational crises are normal states in growth and development in which specific new maturational tasks must be learned when old coping mechanisms are no longer effective.

D

For a patient experiencing panic, which nursing intervention should be implemented first? a. Teach relaxation techniques. b. Administer an anxiolytic medication. c. Prepare to implement physical controls. d. Provide calm, brief, directive communication.

D

In the event of an adventitious crisis, which age group would be least in need of crisis intervention? A. Children B. Such crises seldom require intervention C. The elderly D. A distinction cannot be made The need for psychological first aid (crisis intervention) and debriefing after any crisis situation cannot be overstressed for all age groups (children, adolescents, adults, and the elderly).

D

The adult child of a patient diagnosed with major depression asks, "Do you think depression and physical illness are connected? Since my father's death, my mother has had shingles and the flu, but she's usually not one who gets sick." Which answer by the nurse best reflects current knowledge about psychoneuroimmunology? a. "It is probably a coincidence. Emotions and physical responses travel on different tracts of the nervous system." b. "You may be paying more attention to your mother since your father died and noticing more things such as minor illnesses." c. "So far, research on emotions or stress and becoming ill more easily is unclear. We do not know for sure if there is a link." d. "Negative emotions and stress may interfere with the body's ability to protect itself and can increase the likelihood of infection."

D

Tori knows that Carter needs assistance with many aspects of getting through the crisis. Tori's highest priority in Carter's care is: A. reduction of Carter's anxiety. B. development of new coping skills. C. prevention of boundary blurring. D. keeping Carter safe. The nurse's initial task is to promote safety by assessing the patient's potential for suicide or homicide. The other options are all important components of the care plan, but safety of the patient takes the highest priority.

D

When a nurse asks a newly admitted patient to describe social supports, the patient says, "My parents died last year and I have no family. I am newly divorced, and my former inlaws blame me. I don't have many friends because most people my age just want to go out drinking." Which action will the nurse apply? a. Advise the patient that being so particular about potential friends reduces social contact. b. Suggest using the Internet as a way to find supportive others with similar values. c. Encourage the patient to begin dating again, perhaps with members of the church. d. Discuss how divorce support groups could increase coping and social support.

D

Which health care worker should be referred to critical incident stress debriefing? a. Nurse who works at an oncology clinic where patients receive chemotherapy b. Case manager whose patients are seriously mentally ill and are being cared for at home c. Health care employee who worked 8 hours at the information desk of an intensive care unit d. Emergency medical technician (EMT) who treated victims of a car bombing at a department store Although each of the individuals mentioned experiences job-related stress on a daily basis, the person most in need of critical incident stress debriefing is the EMT, who experienced an adventitious crisis event by responding to a bombing and provided care to victims of trauma.

D

Which scenario is an example of an adventitious crisis? a. Death of a child from sudden infant death syndrome b. Being fired from a job because of company downsizing c. Retirement of a 55-year-old d. Riot at a rock concert The rock concert riot is unplanned, accidental, violent, and not a part of everyday life. The incorrect options are examples of situational or maturational crises.

D

Stringere + stresse =

Stress

__________________________ : Proposes that preexisting genetic, biologic, and psychological vulnerabilities interact with negative or stressful life events to cause illness Predicts an inverse relationship between vulnerability and stress (the more vulnerable, the smaller the stressor required to cause illness)

Stress Diathesis model

The problem with this conceptualization of stress is that stress can only be looked at once it is provoked or in retrospect (after it has occurred) and individual meaning or coping abilities are not taken into consideration with this view. What conceptualization?

Stress as a stimulus

Which is a phase of Disaster? a. Preparation b. Mitigation c. Recovery d. Response e. Burial

a,b,c,d

What did Eli suffer after he witnessed Cam's Suicide outcome in the greenhouse?

acute stress disorder (Acute Stress Disorder The individual will experience personally, or witness other's experience(s) a severe threat in which life or injury is or appears to be at stake. This experience must then continue to affect the individual's mental health status in such areas as arousal, intrusive memories, and changes in behavior and functioning_