Mental Health Ch 26- Crisis

A parent seeks counseling after the rape and murder of a child. The parent tearfully says, "I hate the person who did this. At the trial, I don't know what I will do if he's not found guilty." What is the nurse's highest priority response?

"Are you thinking of killing yourself or others like the person who killed your child?"

Which question best assesses an individual's ability to cope with the potential emotional crisis resulting from the death of a parent?

"Have you ever lost a loved one before?"

Which statement indicates that the nurse is experiencing difficulty in effectively implementing crisis interventions? Select all that apply.

"I really don't know how the patient will get along without our daily talks." "The patient would certainly tell me if he or she was suicidal; so I don't have to ask directly." "The patient needs to move on with his life; he's mourned his wife's death long enough." "I'll give the patient my personal telephone number so he or she can call whenever he or she needs to."

A nurse manager instructed the nurse to conduct crisis intervention for a patient who is depressed due to the death of a partner. The nurse manager gives instructions to the nurse for conducting effective crisis intervention. Which statement made by the nurse manager is appropriate?

"Remember that crisis counseling is the relationship between the nurse and patient."

A major hurricane destroyed a community. Afterward, which comment best predicts that a victim will be able to maintain or promptly return to a state of equilibrium?

"We had had big storms before. If we pull together, we can help each other and rebuild our community."

To assess the patient's perception of the event precipitating a crisis, the nurse would initially ask

"What was happening just before you began feeling this way?"

In the event of an adventitious crisis, which age group would be least in need of crisis intervention?

A distinction cannot be made

A family's home and possessions are lost when a massive forest fire burns out of control. What type of crisis has occurred?

Adventitious

When a tornado results in the loss of homes, businesses, and life, the town residents are likely to experience a(n)

Adventitious crisis

Whose model does a nurse follow while conducting crisis intervention for a patient with acute stress disorder?

Albert R. Roberts's

The nurse is caring for a depressed patient who was rescued from an earthquake. As part of the counselling and treatment, the nurse wants to assess the patient's family and the patient's stressors. What appropriate action will the nurse take?

Ask the patient to describe his or her feelings.

The nurse is performing crisis intervention for a patient who has been sexually assaulted. What appropriate action does the nurse take first?

Assess the patient for any suicidal intentions

The expected outcome at the conclusion of crisis intervention therapy is that the patient will function

At the precrisis level

When a stressful event occurs and the individual in the second stage of crisis is unable to resolve the situation by using his or her usual coping strategies, the individual

Becomes disorganized and uses trial-and-error problem solving

A 12-year-old female 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

Experiencing a maturational crisis

Following an assessment, the nurse concludes that the patient is in phase 2 crisis. What signs and symptoms does the nurse find in the patient?

Feelings of extreme discomfort

A nurse manager instructs a nurse to perform crisis intervention for an acute crisis. Which step should be the priority while conducting a secondary care for the patient?

Focus on the safety of the patient.

A crisis is so acutely uncomfortable to the individual that it is likely to self-resolve in

Four to six weeks

The nurse is performing crisis intervention for a sexually assaulted patient. What appropriate action should the nurse take to help the patient cope with the crisis? Select all that apply

Frequently restate the statements made by the patient during interview. Encourage the patient to express feelings in a nondestructive manner. Guide the patient about maintaining support systems.

Which outcome indicates the individual is demonstrating a commonly observed but negative coping strategy after a crisis event? Select all that apply.

Gaining 10 pounds over a six-week period of time Losing one's driver's license for driving drunk Offering numerous excuses for not socializing

The nurse caring for a patient in crisis shows signs of a problematic nurse-patient relationship by

Giving the patient permission to call him or her at home when the patient "needs to talk"

A patient 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

Has not followed up on the patient's verbal clues to suicidal thoughts

The patient experiences each of the following during his or her crisis. Which scenario describes a patient in phase IV of a crisis response?

Individual comes to the crisis clinic complaining of depression and expresses that he or she does not want to go on living.

The nurse interacts with a patient at a crisis center. The patient speaks of distressing events and makes dismissive comments. What diagnosis should the nurse make from the patient's symptoms?

Ineffective denial

The primary factor that makes an event a crisis is the:

Ineffectiveness of one's usual coping strategies.

On the way home from work a nurse comes upon a severe automobile accident. The driver emerges from the car without apparent physical injuries but is unable to recall the spouse's phone number, has difficulty finding a driver's license, and has diaphoresis and trembling. How will the nurse assess this reaction? The driver:

Is experiencing disequilibrium.

Which event leads to the development of a situational crisis in patients?

Loss of a job

When the patient begins to sob uncontrollably and speech becomes so incoherent that the patient is unable to give the nurse any information, the immediate interventions will focus on

Lowering the patient's anxiety level from severe to moderate

A man is having difficulty adjusting to becoming a father. He has not bonded with his newborn and frequently stays out at night drinking with friends. Which type of crisis is evident?

Maturational

Crises that occur as an individual moves from one developmental level to another are called

Maturational crises

Which situation has the potential for early crisis intervention to occur?

Mrs. R tells the nurse in the well-baby clinic that she's feeling uptight and has arranged to see a primary care therapist.

The priority concern of the crisis intervention nurse is

Patient safety

Which criteria are considered when planning relevant outcomes for patients in crisis? Select all that apply.

Patient-centered focus Outcomes are culturally sensitive Family has input when appropriate Patient's personal values are considered

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. What is the most likely reason that accounts for the difference in the way individuals who experience the same event are affected emotionally by that event?

Perception of the event

During which crisis phase does a patient exhibit serious personality disorganization, depression, and confusion?

Phase 4

The nurse is assessing a patient with anxiety who is a victim of intimate partner abuse. Which nursing intervention will help in reducing the anxiety levels of the patient?

Provide knowledge of problem-solving techniques.

The nurse is giving crisis intervention to a depressed patient who lost her child in an accident. The patient is blaming herself and has suicidal ideation. What is the primary nursing intervention for the patient?

Recommend hospitalization of the patient.

After the bomb explosions at the Boston Marathon in 2013, members of the community donned t-shirts that said, "Boston Strong." Which phase of the disaster management continuum is evident by this behavior?

Recovery

In which phase of a disaster management program does the health care professional implement the actual disaster plan?

Response

The nurse is caring for a patient who recently escaped a relationship marked by repeated domestic violence. The nurse observes that the patient is unable to make decisions and is dependent on the nurse. What appropriate action should the nurse take?

Set realistic goals for the patient

A nurse working in a trauma center has been accused of getting overly attached to some patients. The nurse has even called some patients after they are discharged and tries to give advice about general health issues. What is the best course of action for this nurse?

Share personal feelings with trained professionals.

An adult has a family history of colon cancer, so this adult has screening colonoscopies every five years. At age 55, the colonoscopy reveals a malignant tumor in the ascending colon. The nurse should assess this adult for which type of crisis?

Situational

When a person becomes unemployed, he or she is likely to experience a(n)

Situational crisis

After a disaster, a nurse leads a discussion designed to assist rescuers to talk about their feelings and reactions as well as to support their coping skills. What level of crisis intervention is represented by this action?

Tertiary

Which assumption serves as a foundation for the use of crisis intervention?

The individual is mentally healthy but in a state of disequilibrium.

The nurse is assessing a patient rescued from a terrorist attack and finds that the patient has impaired thinking and severe anxiety. Which strategy does the nurse use while conducting crisis intervention for the patient? Select all that apply.

The nurse focuses on the present situation of the patient. The nurse encourages the patient to express feelings in a nondestructive manner. The nurse assists the patient to identify past coping skills.

A nurse is conducting crisis intervention for a patient who is a victim of physical assault and learns that the patient is confused and overwhelmed. Which strategy does the nurse implement while interacting with the patient to make the patient feel comfortable?

The nurse summarizes the information given by the patient.

A nurse is planning crisis intervention for a patient who has acute stress and panic episodes. Which nursing intervention does the nurse implement while giving primary care to the patient?

The nurse teaches relaxation techniques to the patient.

The nurse is caring for a patient with rape-trauma syndrome. What outcome shown by the patient after eight weeks indicates effective crisis intervention?

The patient concentrates on the given task.

A nurse is conducting crisis intervention for a patient, and has identified that the patient has impaired social interaction. Which sign and symptom does the nurse find in the patient?

The patient has difficulty with interpersonal relationships.

An individual comes to the crisis clinic for a first visit and reports not sleeping well, anxiety, and excessive crying. These symptoms occurred shortly after a sudden job loss and losing his or her home to a tornado that devastated the town in which the patient lives. Which of the following statements regarding crisis accurately describes the individual's situation?

The patient is experiencing both a situational and an adventitious crisis.

A nurse is caring for a group of patients in a rehabilitation center that were rescued from a tornado. The nurse identifies a patient with disturbed identity who is isolated from the other patients. What does the nurse interpret from the patient's behavior?

The patient is in a depressed state.

An adult recently diagnosed with multiple sclerosis says, "I'm worried I won't be able to support my family or send my children to college." This person begins drinking alcohol heavily and omitting prescribed medications. What is the likely cause of the patient's behavior?

The patient is in a state of situational crisis.

A nurse is conducting crisis intervention for a patient in a rehabilitation center with extreme levels of depression. The patient has low self-esteem and impaired social interaction. Which outcome in the patient indicates effective crisis intervention?

The patient starts setting goals.

When does a patient have symptoms of self-hatred and depression?

When the patient has chronic low self-esteem

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

Work with the patient to set goals that are mutually acceptable