Deck 24: Crisis and Disaster

Question 1

A patient being seen in the clinic for superficial cuts on both wrists is pacing and sobbing. After a few minutes, the patient is calmer. The nurse attempts to determine the patient's perception of the precipitating event by saying which of the following?

A) "Tell me why you were crying."
B) "How did your wrists get injured?"
C) "How can I help you feel more comfortable?"
D) "What was happening just before you started to feel this way?"

Answer 1

"What was happening just before you started to feel this way?"

Question 2

Which situation demonstrates use of primary care related to crisis intervention?

A) Implementation of suicide precautions for a depressed patient
B) Teaching stress reduction techniques to a first-year college student
C) Assessing coping strategies used by a patient who attempted suicide
D) Referring a patient with schizophrenia to a partial hospitalization program

Answer 2

Teaching stress reduction techniques to a first-year college student

Question 3

While conducting the initial interview with a patient in crisis, the nurse should do which of the following?

A) Listen carefully and summarize often
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

Answer 3

Listen carefully and summarize often

Question 4

During the initial interview at the crisis centre, a patient says, "I've been served with divorce papers. I'm so upset and anxious that I can't think clearly." Which comment should the nurse use to assess personal coping skills?

A) "In the past, how have you handled difficult or stressful situations?"
B) "What would you like us to do to help you feel more relaxed?"
C) "Tell me more about how it feels to be anxious and upset."
D) "Can you describe your role in the marital relationship?"

Question 5

A woman says, "I can't take anymore. Last year my husband had an affair, and now we do not 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 the nurse focus on during crisis intervention?

A) The possible mastectomy
B) The disordered family communication
C) The effects of the husband's extramarital affair
D) Coping with the reaction to the daughter's events

Question 6

A woman said, "I can't take 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) Identify measures useful to help improve the couple's communication.
B) The patient's feelings about the possibility of having a mastectomy
C) Whether the husband is still engaged in an extramarital affair
D) Clarify what the patient means by "I can't take anymore."

Question 7

After celebrating the fortieth 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

Question 8

Which scenario is an example of an adventitious crisis?

A) The 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 person
D) A riot at a rock concert

Question 9

A patient comes to the crisis centre saying, "I'm in a terrible situation. I don't know what to do." The triage nurse can initially assume that the patient is which of the following?

A) Suicidal
B) Anxious and fearful
C) Misperceiving reality
D) Potentially homicidal

Question 10

A patient who is 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 how long?

A) 1 to 2 weeks
B) 3 to 4 weeks
C) 4 to 6 weeks
D) 6 to 8 weeks

Question 11

A student falsely accused a college professor of sexual intimidation. The professor tells the nurse, "I cannot teach nor do any research. My mind is totally preoccupied with these false accusations." What is the priority nursing diagnosis?

A) Ineffective denial related to threats to professional identity
B) Deficient knowledge related to sexual harassment protocols
C) Impaired social interaction related to loss of teaching abilities
D) Ineffective role performance related to distress from false accusations

Question 12

An adult seeks counselling after the spouse was 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?"

Question 13

Six months ago, a woman had a prophylactic double mastectomy because of a family history of breast cancer. One week ago, this woman learned her husband was involved in an extramarital affair. The woman tearfully says to the nurse, "What else can happen?" What type of crisis is this person experiencing?

A) Maturational
B) Adventitious
C) Situational
D) Recurring

Question 14

Six months ago, a woman had a prophylactic double mastectomy because of a family history of breast cancer. One week ago, this woman learned her husband was involved in an extramarital affair. The woman tearfully says, "What else can happen?" If the woman's immediate family is unable to provide sufficient support, which of the following should the nurse do?

A) Suggest hospitalization for a short period
B) Ask what other relatives or friends are available for support
C) Tell the patient, "You are a strong person. You can get through this crisis"
D) Foster insight by relating the present situation to earlier situations involving loss

Question 15

Which communication technique will the nurse use more in crisis intervention than in traditional counselling?

A) Role modeling
B) Giving direction
C) Information giving
D) Empathic listening

Question 16

Which agency plays a major role in mass disaster planning and prevention?

A) Health Canada
B) Provincial or territorial disaster management agencies
C) National Incident Management System
D) Federal Emergency Management Agency

Question 17

An adult has cared for a debilitated parent for 10 years. The parent's condition recently declined, and the health care provider recommended placement in a nursing home. 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 which of the following?

A) Resolving the feelings associated with the threat to the person's self-concept
B) Ability of the person to identify situational supports in the community
C) Reliance on assistance from role models within the person's culture
D) Mobilization of automatic relief behaviours by the person

Question 18

An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The adolescent told both parents about the uncle's behaviour, but the parents did not believe the adolescent. What type of crisis exists?

A) Maturational
B) Adventitious
C) Situational
D) Organic

Question 19

A patient comes to the crisis clinic after an unexpected job termination. The patient paces around the room sobbing, cringes when approached, and responds to questions with only shrugs or monosyllables. Choose the nurse's best initial comment 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 and pacing so we can talk about your problems."
D) "Let's set some guidelines and goals for your visit here."

Question 20

A victim of spousal violence comes to the crisis centre seeking help. Which of the following crisis intervention strategy will be the nurse's focus?

A) Supporting emotional security and reestablishing equilibrium
B) Long-term resolution of issues precipitating the crisis
C) Promoting growth of the individual
D) Providing legal assistance

Question 21

An adult comes to the crisis clinic after termination 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

Question 22

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 the nurse expect 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

Question 23

Which health care worker should be referred for critical incident stress debriefing?

A) A nurse who works at an oncology clinic where patients receive chemotherapy
B) A case manager whose patients have serious mental illness and are cared for at home
C) A health care employee who worked 12 hours at the information desk of a critical care unit
D) An emergency medical technician (EMT) who treated victims of a car bombing at a mall

Question 24

A nurse assesses a patient in crisis. Select the most appropriate question for the nurse to ask to assess this patient's situational support.

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?"

Question 25

A patient that has recently survived a plane crash has returned to work and reports being able to sleep well at night. The nurse meets with the patient once a month to provide ongoing support and encouragement. Which type of crisis intervention is the nurse performing?

A) Primary
B) Secondary
C) Tertiary
D) Critical incident stress debriefing

Question 26

The principle most useful to a nurse planning crisis intervention for any patient is which of the following?

A) That the patient is experiencing a state of disequilibrium
B) That the patient is experiencing a type of mental illness
C) That the patient poses a threat of violence to others
D) That the patient has high potential for self-injury

Question 27

At the last contracted visit in the crisis intervention clinic, an adult says, "I've emerged from this a stronger person. You helped me get my life back in balance." The nurse responds, "I think we should 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 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.

Question 28

Which are characteristics of a mental health emergency? Select all that apply.

A) Self-care limitations
B) Depression
C) Effective coping strategies
D) Behavioural disturbances
E) Collective self-efficacy