Ch. 13 Study Questions

The outcome of crisis intervention therapy that should be identified for a patient who has been apathetic, fatigued, and feeling helpless since the recent birth of her baby is that she will: a. experience reduced anxiety. b. undergo personality change. c. identify the need for a support system. d. return to the precrisis level of functioning.

ANS: D A return to the precrisis level of functioning is the expected outcome for crisis intervention. DIF: Cognitive Level: Comprehension REF: Text Page: 187 TOP: Nursing Process: Outcome Identification MSC: NCLEX: Psychosocial Integrity

To understand the effects of a precipitating event such as the loss of one's job, a nurse must assess the: a. patient's appraisal of the event. b. perception of the support group. c. patient's awareness or lack of awareness of options. d. patient's own feelings about his or her response to the situation.

ANS: D The patient's perception is a key factor. What may be trivial to one may seem overwhelming to another and vice versa. If the patient does not perceive the event as problematical, a crisis may be averted. DIF: Cognitive Level: Application REF: Text Page: 187 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

Survivors of a hurricane are grieving the loss of loved ones and homes. Which level of crisis intervention would be most appropriate for a nurse to use? a. General support b. Generic approach c. Individual approach d. Environmental manipulation

ANS: B The generic approach is designed to reach high-risk individuals and large groups as quickly as possible. DIF: Cognitive Level: Application REF: Text Page: 188 TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

A jet plane carrying 140 passengers crashes in a nearby community. One can reliably predict that the survivors, families, and community will initially experience: a. a situational crisis. b. problem resolution. c. adjustment disorders. d. psychological equilibrium.

ANS: A A situational crisis occurs when an accidental, uncommon, or unexpected event upsets psychological equilibrium. DIF: Cognitive Level: Application REF: Text Page: 183 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A patient comes to the mental health center after being held hostage during a bank robbery 2 days ago. The patient relates a number of symptoms, including intrusive thoughts, nightmares, and feelings of helplessness. The nurse should consider the possibility that the patient is experiencing a _____ crisis. a. situational b. maturational c. developmental d. pseudopsychological

ANS: A A situational crisis occurs when an accidental, uncommon, or unexpected event upsets psychological equilibrium. DIF: Cognitive Level: Application REF: Text Page: 183 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

When a crisis clinic nurse asks a patient, "Who takes care of you when you are sick?" the nurse is exploring the balancing factors of: a. situational support. b. problem resolution. c. coping mechanisms. d. perception of the event.

ANS: A Balancing factors are important in the development and resolution of a crisis and include the precipitating stressor, the patient's perception of the stressor, the nature and strength of a patient's support systems and coping resources, and previous strengths and coping mechanisms. Family, friends, religious leaders, and co-workers are considered part of the patient's support system. DIF: Cognitive Level: Application REF: Text Page: 187 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A teenaged new mother reports she has felt apathetic, fatigued, and helpless since giving birth. She states, "I don't know what's expected of me." The nurse believes the patient will benefit from: a. crisis intervention. b. short hospitalization. c. neuroleptic medication. d. antidepressant medication.

ANS: A The patient is probably experiencing a maturational crisis related to the role changes required by the birth of the baby. Crisis intervention is appropriate. DIF: Cognitive Level: Application REF: Text Page: 184 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A patient comes to the mental health clinic with insomnia, irritability, increased tension, and headaches. The symptoms began 1 week ago after the patient was laid off from work. The patient expresses concern that this will result in a relocation that will be hard on the entire family. The patient is most likely experiencing: a. an anxiety reaction. b. a situational crisis. c. a maturational crisis. d. an adjustment disorder.

ANS: B A situational crisis occurs when a life event upsets an individual's psychological equilibrium. Loss of a job can give rise to a situational crisis. DIF: Cognitive Level: Application REF: Text Page: 183 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A patient comes to the mental health center and relates feeling very anxious since graduating from high school 1 week ago. The patient is having difficulty concentrating and feels shaky. This typifies: a. a situational crisis. b. a maturational crisis. c. psychological equilibrium. d. a pseudopsychological crisis.

ANS: B Maturational crises are developmental events requiring role change. DIF: Cognitive Level: Application REF: Text Page: 183 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A patient is being seen for crisis intervention as a result of receiving a poor job evaluation. The self-esteem need that nursing assessment will most likely reveal a problem with: a. dependency. b. role mastery. c. biological functioning. d. unmet financial responsibility.

ANS: B Self-esteem is threatened when role mastery is not attained. Role mastery is achieved when the person attains work, sexual, and family role successes. DIF: Cognitive Level: Application REF: Text Page: 186 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

A patient who undergoes a hostage experience begins crisis intervention therapy. The patient asks, "How long before I will feel like myself again?" The reply that shows the best understanding of the parameters of crisis intervention therapy would be: a. "No one can really say." b. "It usually takes about 6 weeks." c. "My best guess would be 6 months." d. "The experience usually results in permanent changes."

ANS: B Successful crisis intervention therapy is usually limited to 6 weeks' duration. DIF: Cognitive Level: Application REF: Text Page: 184 TOP: Nursing Process: Implementation MSC: NCLEX: Safe, Effective Care Environment: Management of Care