Question 1

A nurse is assessing a 35-year-old client who is seeking assistance at a local community counseling center. Which statement would indicate that the client is experiencing a crisis?&#10;A) &#34;I'm so upset; my spouse has never left me like this before.&#34;&#10;B) &#34;I'm confused and hurt; I have lost my best friend and my lover.&#34;&#10;C) &#34;I don't understand; I can't seem to function like I usually do.&#34;&#10;D) &#34;No matter what I do, I am still overcome by these sad feelings.&#34;

Accepted Answer

Crisis occurs when there is a perceived challenge or threat that overwhelms the capacity of the individual to cope effectively with the event. Life is disrupted, and unexpected emotional (e.g., depression) and biologic (e.g., nausea, vomiting, diarrhea, and headache) responses occur. Functioning is severely impaired. Although feelings of upset, confusion, hurt, and sadness may occur with a crisis, the key component is impaired functioning.

Question 2

A client's poodle ran in front of a car and was killed. The client continues to be upset by the pet's death, and explains to a community counseling center nurse, "I can't stop crying because my Precious meant the world to me, and now my world will never be the same!" If the nurse were to determine that the client was experiencing a crisis, which type of crisis would it most likely be?

A) Maturational
B) Situational
C) Traumatic
D) Developmental

Situational

Accepted Answer

A situational crisis occurs whenever a specific stressful event threatens a person's biopsychosocial integrity and results in some degree of psychological disequilibrium. The pet's death caused the client to experience a degree of psychological disequilibrium. A developmental or maturational crisis is one involving normal growth and development. A traumatic crisis is initiated by unexpected, unusual events that affect an individual or multitude of people.

Question 3

A 62-year-old client experienced the loss of an 87-year-old parent a week ago. A hospice nurse is making a follow-up visit to determine how the client is handling the death. Which statement indicates to the hospice nurse that the client is in the acute mourning stage of bereavement?

A) "I keep thinking about my father; I have trouble believing he's dead. I feel guilty because I didn't go to the nursing home to visit him last week!"
B) "I've been grieving my father; losing him is a tremendous loss, but I have to get on with my life."
C) "My father was a saint. I am so angry at God for taking him away! I'm crying all the time; I haven't been able to work for days."
D) "I'm going to spend the weekend with my children; they understand what I've been going through, and I can relax around them."

"My father was a saint. I am so angry at God for taking him away! I'm crying all the time; I haven't been able to work for days."

Accepted Answer

The fact that the client is crying all the time, feeling angry for much of the time, missing work, and idealizing the father are all indicators of the acute mourning stage of bereavement. This stage is characterized by intense feeling states, social withdrawal, and identification with the deceased person. The statement about having trouble believing he is dead suggests the shock stage. The statement about grieving the father but having to get on with life suggests the beginning of the resolution stage, as does the statement about spending the weekend with children to relax.

Question 4

A 25-year-old client is seeking counseling for recently and unexpectedly losing a job. Which question would be most appropriate for a nurse to use in assessing the client's response to losing the job?&#10;A) &#34;What happened to cause you to lose your job?&#34;&#10;B) &#34;How did you feel immediately after being told you no longer had a job?&#34;&#10;C) &#34;How do you expect yourself to be able to handle this situation?&#34;&#10;D) &#34;How have you responded to previous stressful situations?&#34;

Accepted Answer

Individual responses to a crisis can be best understood by assessing the usual responses of the person to stressful events. The response to the crisis also depends on the meaning of the event to the person. Asking about the cause of job loss, immediate feelings, and how the person expects to handle the situation do not address the client's response to the job loss.

Question 5

An individual is seeking employment as a nurse in a crisis center. The interviewer asks the job candidate what the candidate would ask to determine whether the caller was experiencing a crisis. Which response would be most appropriate?

A) "To what extent are you involved in a crisis situation?"
B) "Tell me about what you are experiencing and what it means to you."
C) "How would you rate your level of functioning on a scale from 1 to 10?"
D) "Why do you think you are in a crisis situation?"

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Accepted Answer

A response to the crisis depends on the meaning of the event to the victim. Telling someone to describe what they are experiencing and what that experience means to them elicits more information than asking a person to quantify the extent of the crisis. Asking someone "why" tends to put an individual on the defensive because the question implies that the individual needs to "justify" his or her perception. Asking about the extent of the crisis would be difficult for the person to answer. In addition, it already assumes that the client is in crisis. Rating the level of functioning would be important information to ask later, after establishing what the client is experiencing.

Question 6

A Red Cross nurse is working with tornado victims. The nurse is interviewing a client whose house was totally destroyed and pet poodle died as a result of the tornado. Which statement would the nurse most likely expect to hear from this client?

A) "I don't know. I can't feel anything right now. Nothing seems real."
B) "I just feel totally devastated. I don't know how I can go on living."
C) "I just want my insurance man to get here so I can file a claim. Everything I had is gone."
D) "I always thought my dog would die peacefully in my arms. Now I'll never be able to hold her again."

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Accepted Answer

In the beginning of a crisis, a victim may report the feeling of numbness and shock. The reality of the client's loss has not had sufficient time to "sink in." When it does, the client will experience intense emotions regarding loss.

Question 7

A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with the situation and how much support is needed, which question would be most appropriate for the nurse to ask?

A) "What kind of help do you need from us?"
B) "What are your thoughts about what you will do during the next few days?"
C) "How are you feeling about all that you have gone through?"
D) "Are you feeling guilty because you survived and some of your neighbors did not?"

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Accepted Answer

By assessing the victim's ability to solve problems, the nurse can evaluate whether the victim can cognitively cope with the crisis situation and determine the kind and amount of support needed. At this point in time, the client may not be able to identify the type of help he needs or what will occur the next few days. Asking about feeling guilty is inappropriate. Additionally, this is a closed-ended question that does not allow the victim to explore current feelings.

Question 8

A family has just lost their home in a fire. An on-call nurse from a community counseling center has been called in to the emergency department to help them with this traumatic event. Which priority would the nurse identify for this family?

A) Arranging for follow-up therapy to deal with the crisis
B) Completing a family genogram to determine family patterns
C) Assessing the impact of the loss on their lifestyle
D) Arranging for emergency shelter and food supplies

Accepted Answer

Safety interventions to protect people in crisis from harm should include preventing the individuals from committing suicide or homicide, arranging for food and shelter (if needed), and mobilizing social support. Additionally, the priorities of physical needs surpass those of psychosocial needs. After the individual's safety needs are met, the nurse can address the psychosocial aspects of the crisis.

Question 9

A nursing instructor is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals?

A) "You should ask them to give you a brief medical history so their physical needs can be met."
B) "Focus on safety needs and provide simple, clear instructions to help them function effectively."
C) "Help them determine what their long-term goals will be so they can maintain a sense of hope."
D) "Try to redirect their attention away from the problems at hand so you can decrease their anxiety."

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Accepted Answer

When responding to a disaster, the nurse would follow the ABCs of psychological first aid: arousal, behavior, and cognition. Thus, the first area to address is arousal. When arousal is present, the intervention goal is to decrease excitement by providing safety, comfort, and consolation. When abnormal or irrational behavior is present, survivors should be assisted to function more effectively in the disaster. If cognitive disorientation occurs, reality testing and clear information should be provided. In the initial phases, the nurse should assist the victim in focusing on the reality of problems that are immediate, with specific goals that are consistent with available resources and with the culture/lifestyle of the victim.

Question 10

A nurse is working as part of a community disaster response team. When responding to a community disaster, the nurse integrates understanding of individuals' reactions by anticipating which response?&#10;A) People can become aggressive and violent when their basic needs are threatened.&#10;B) People involved in the disaster will always put the welfare of others before their own.&#10;C) Losses incurred during the disaster have little, if any, long-term effect on victims.&#10;D) The psychological distress associated with disasters is felt immediately.

Accepted Answer

In a disaster, shelter, money, and food may not be available. The absence of basic human needs, such as food, a place to live, or immediate transportation quickly becomes a priority that may precipitate acts of violence. Additionally, the victims may experience economic distress because of job loss and loss of other resources. This may ultimately lead to psychological distress, potential acts of aggression, and other mental health problems. Long-term mental health consequences are evident in most disasters.

Question 11

A group of nursing students is reviewing information about the types of crisis. The students demonstrate understanding of the information when they identify which happening as a developmental crisis?&#10;A) Going away to college&#10;B) Obtaining a job promotion&#10;C) Loss of a pet&#10;D) Earthquake

Accepted Answer

The answer of A group of nursing students is reviewing...

Question 12

As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which phase would the nurse identify as occurring first?&#10;A) Person has a problem that doesn't &#34;fit&#34; with the usual problem-solving methods.&#10;B) Trial and error attempts are made to alleviate the problem.&#10;C) Automatic relief behaviors take over as the &#34;fight-or-flight&#34; hormones dissipate.&#10;D) Person has serious personality disorganization.

Accepted Answer

The answer of As part of a community program on...

Question 13

A nurse is assessing the parents of a 6-year-old child who has died from leukemia. The nurse is integrating the Dual Process model (DPM) for the assessment. Which action would the nurse identify as reflecting the parents' loss-oriented coping?

A) Engaging in new activities
B) Denying the grief
C) Developing new relationships
D) Thinking about the lost child

Accepted Answer

The answer of A nurse is assessing the parents of...

Question 14

A psychiatric-mental health nurse is describing uncomplicated bereavement to a group of nurses working with terminally ill clients. Which information would the nurse most likely include in the discussion?

A) Uncomplicated bereavement differs from normal bereavement because it lasts longer.
B) Most bereaved persons experience uncomplicated bereavement.
C) Uncomplicated bereavement is primarily loss associated with death.
D) This type of bereavement is less painful and disruptive than normal bereavement.

Accepted Answer

The answer of A psychiatric-mental health nurse is describing uncomplicated...

Question 15

After teaching a group of nurses about crisis, the group leader determines that the education was successful based on which statement by the group?&#10;A) &#34;Crisis usually results in negative outcomes.&#34;&#10;B) &#34;Crisis is a time-limited event.&#34;&#10;C) &#34;Chronic crisis is a real situation.&#34;&#10;D) &#34;Events causing a crisis are similar for everyone.&#34;

Accepted Answer

The answer of After teaching a group of nurses about...

Question 16

The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Which finding would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?

A) Tachycardia
B) Profuse perspiration
C) Unexplained gastrointestinal disturbance
D) Tremors

Accepted Answer

The answer of The nurse is providing follow-up care to...

Question 17

A nurse is working with a client who is in crisis. Which action would be least appropriate for the nurse to take?&#10;A) Support the client's cultural beliefs about expressing feelings.&#10;B) Encourage the client to focus on one aspect at a time.&#10;C) Provide the client with an understanding that everything will be okay.&#10;D) Explain information clearly to clarify any misconceptions or myths.

Accepted Answer

The answer of A nurse is working with a client...

Question 18

A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when making which statement?&#10;A) Grief and bereavement are used interchangeably as responses to loss.&#10;B) Bereavement is the process of mourning and grief is the emotional reaction.&#10;C) Grief involves confronting the stressor, but bereavement helps to avoid the stressor.&#10;D) Bereavement is influenced by culture, but grief is not.

Accepted Answer

The answer of A group of nursing students is reviewing...

Question 19

Assessment of a client indicates complicated grief. Which statement would the nurse identify as supporting this reaction? Select all that apply.&#10;A) &#34;It's been 2 months, and I still want my son back.&#34;&#10;B) &#34;I still wait for him to come right through the door every day.&#34;&#10;C) &#34;I'm really struggling with trusting anybody anymore.&#34;&#10;D) &#34;I wish I could go back to the days before he died.&#34;&#10;E) &#34;Life seems so empty now that he's gone. What will I do?&#34;

Accepted Answer

The answer of Assessment of a client indicates complicated grief....

Deck 21: Crisis, Loss, Grief, Bereavement, and Disaster Management