Question 1

The nurse is planning a presentation on crisis intervention to faculty and staff at a local high school. What information will the nurse want to include? Select all that apply.

Accepted Answer

3. When providing education to faculty and staff, the nurse will provide general education regarding crisis, including information related to the stages of the General Adaptation Syndrome, the importance of social connectivity, and basic coping skills. Individuals from different cultures may respond differently in times of crisis. Psychological debriefing should be conducted by a trained professional.

Question 2

The advanced practice nurse (APRN) is caring for a patient who recently relocated from another city. The patient is reporting depressive symptoms and no previous history of depression. Which therapy will the APRN be most likely to discuss with the patient?

Accepted Answer

3. Short-term cognitive-behavioral therapy is considered the first-line treatment for individuals experiencing mood symptoms secondary to crisis. Pharmacotherapy, psychological first aid, and critical incident stress debriefing are therapies that may be used in the collaborative care of a patient experiencing crisis; however, these are not considered to be the first-line treatments for the patient experiencing mood symptoms secondary to crisis.

Question 3

The nurse is caring for a school-age child who is experiencing crisis. The child's mother tells the nurse that the child has started wetting the bed at night. Which statements by the nurse are the most appropriate regarding the best therapies for the child? Select all that apply.

Accepted Answer

1. School-based interventions, as well as interventions aimed at parental involvement may be beneficial to the child who is experiencing crisis. Studies have shown that cognitive-behavior therapy (CBT) is most beneficial for children in crisis. However, it is not known what aspect of CBT makes this therapy effective, so attempting either cognitive therapy or behavioral therapy alone is not likely to be effective.
2. School-based interventions, as well as interventions aimed at parental involvement may be beneficial to the child who is experiencing crisis. Studies have shown that cognitive-behavior therapy (CBT) is most beneficial for children in crisis. However, it is not known what aspect of CBT makes this therapy effective, so attempting either cognitive therapy or behavioral therapy alone is not likely to be effective.
3. School-based interventions, as well as interventions aimed at parental involvement may be beneficial to the child who is experiencing crisis. Studies have shown that cognitive-behavior therapy (CBT) is most beneficial for children in crisis. However, it is not known what aspect of CBT makes this therapy effective, so attempting either cognitive therapy or behavioral therapy alone is not likely to be effective.

Question 4

A patient who is a senior in high school fails two classes and is unable to graduate. Which type of crisis is the patient likely experiencing?

Accepted Answer

4. A maturational crisis may occur when an individual has difficulty achieving a developmental task such as graduating from high school. Situational crises typically arise from sudden, unanticipated events or changes. The patient likely knew about the failing grades. Adventitious crises arise from traumatic events that are well beyond the expected scope of normal human experience, such as violent crime, natural disasters, war, and terrorism. Biological is a stage of wellness, not crisis.

Question 5

The nurse is caring for a patient who is experiencing a situational crisis. Which statement by the nurse best reflects the therapeutic communication necessary when caring for this patient?

Accepted Answer

4. Stating that the nurse is sorry for what the patient has experienced reflects empathy. Assessing the patient's current emotional state and coping mechanisms that have been effective in the past require open-ended questions and attentive listening. Stating that the nurse knows how the patient feels hinders this communication and takes the focus off the patient. Telling the patient to stay busy does not empower the patient to identify and adopt coping strategies. Telling the patient it could have been worse minimizes the patient's unique experience.

Question 6

The nurse is caring for patients in the aftermath of a tornado that has damaged several homes and the local elementary school. What will the nurse address during patient education sessions?

Accepted Answer

1. Following a community-wide crisis, the nurse will focus patient education on basic coping skills. Rather than providing education on long-term interventions, the nurse should focus education on short-term interventions. Taking a direct and instructional approach to crisis education is more important than patient-nurse collaboration. The nurse will not provide patient education on therapeutic communication during crisis; rather, the nurse will use therapeutic communication when providing patient education.

Question 7

The nurse is performing a crisis assessment on a patient who is experiencing crisis due to a recent divorce. Which statement made by the patient will alert the nurse that the patient is experiencing the exhaustion phase of crisis?

Accepted Answer

4. Classifying the stage of adaptation displayed by the individual is a component of the initial crisis assessment. The General Adaptation Syndrome describes three basic stages through which most individuals progress during attempts to cope with significant stressors: alarm, resistance, and exhaustion. The statement, "I just can't seem to cope anymore. I am not sure what I am going to do" is characteristic of the exhaustion phase of crisis. Exhaustion occurs when coping resources are low or depleted. The statement, "I can't believe this is happening to me" best describes the alarm stage of crisis, which occurs during the initial reaction to a crisis. The statements "I have called my mom to help me with the kids" and "I am tired from moving all of my belongings into a new house" best describe the resistance stage of crisis when the individual mobilizes resources in an effort to attempt to resolve the stressor.

Question 8

A nurse educator is providing a review course for staff nurses regarding the impact and risk factors for situational crisis among the psychiatric patient population. The educator asks one of the staff nurses to provide a clinical example of a patient at increased risk for situational crisis. Which statements made by the staff nurse indicates that teaching has been effective? Select all that apply.

Accepted Answer

2. Situational crises develop in response to sudden, unexpected traumatic life events. Situational crises often are beyond the established coping capabilities of the individuals experiencing them. Situational crises can arise from many kinds of precipitants, including immigration. Acute and chronic illness, such as depression and psychosis, may lead to situational crises. Legal problems, such as arrest and incarceration, may lead to a situational crisis. The teenager who is graduating high school is most at risk for a maturational crisis, not a situational crisis.
3. Situational crises develop in response to sudden, unexpected traumatic life events. Situational crises often are beyond the established coping capabilities of the individuals experiencing them. Situational crises can arise from many kinds of precipitants, including immigration. Acute and chronic illness, such as depression and psychosis, may lead to situational crises. Legal problems, such as arrest and incarceration, may lead to a situational crisis. The teenager who is graduating high school is most at risk for a maturational crisis, not a situational crisis.
4. Situational crises develop in response to sudden, unexpected traumatic life events. Situational crises often are beyond the established coping capabilities of the individuals experiencing them. Situational crises can arise from many kinds of precipitants, including immigration. Acute and chronic illness, such as depression and psychosis, may lead to situational crises. Legal problems, such as arrest and incarceration, may lead to a situational crisis. The teenager who is graduating high school is most at risk for a maturational crisis, not a situational crisis.
5. Situational crises develop in response to sudden, unexpected traumatic life events. Situational crises often are beyond the established coping capabilities of the individuals experiencing them. Situational crises can arise from many kinds of precipitants, including immigration. Acute and chronic illness, such as depression and psychosis, may lead to situational crises. Legal problems, such as arrest and incarceration, may lead to a situational crisis. The teenager who is graduating high school is most at risk for a maturational crisis, not a situational crisis.

Question 9

The nurse preceptor is giving a seminar about recognition and assessment of coping mechanisms found in older adult patients in crisis to a group of novice nurse. Which statement by the novice nurse indicates that the teaching has been effective?

Accepted Answer

3. Crisis coping mechanisms vary across the life span. Older adults are more likely to suffer from a lack of social supports due to a variety of factors such as relocation and outliving some close family members and friends. Older adults generally have well-established coping mechanisms based on a life of experiences. Older adults generally do not use physiological coping as much as younger adults due physiological changes associated with aging. The older adult is more likely to use belief-based coping during crisis.

Question 10

A nurse is planning care for a patient who is experiencing a situational crisis. What is the most effective way for the nurse to plan for the patient's crisis intervention?

Accepted Answer

2. Nursing care is based on complete assessments. Thus, a plan cannot be developed prior to meeting with the patient. The time frame, whether short-term or long-term, and the need for follow-up, will be determined by the findings of the assessment.

Question 11

The nurse is caring for a patient who is experiencing a crisis. What is the priority during the patient's initial crisis assessment?

Accepted Answer

1. The priority during an initial crisis assessment is to determine the safety of the individual. While the other answer choices are components of the initial crisis assessment, ensuring safety is the priority.

Question 12

The nurse is caring for a patient in crisis who has recently returned from military service in an active war zone. When initially assessing this patient, which concepts will the nurse apply regarding the type of crisis the patient is experiencing? Select all that apply.

Accepted Answer

1. The patient described in the scenario is likely experiencing a type II trauma. Type I trauma experiences are one-time, limited experiences that generally are less likely to cause PTSD, whereas type II trauma experiences are recurrent or chronic and are more likely to cause PTSD. Assessment of the type of trauma and how the individual is adapting to it helps determine an appropriate approach to crisis care and the risk of psychiatric sequelae. Providing the patient with education about type II, not type I traumas, will help the patient understand the condition and will provide the patient with resources and interventions to help with this crisis. Loss of trust in those whom an individual has trusted during the trauma period increases risk for posttraumatic stress disorder (PTSD), so it will be important for the nurse to assess how the patient views authorities associated with the period of military service.
2. The patient described in the scenario is likely experiencing a type II trauma. Type I trauma experiences are one-time, limited experiences that generally are less likely to cause PTSD, whereas type II trauma experiences are recurrent or chronic and are more likely to cause PTSD. Assessment of the type of trauma and how the individual is adapting to it helps determine an appropriate approach to crisis care and the risk of psychiatric sequelae. Providing the patient with education about type II, not type I traumas, will help the patient understand the condition and will provide the patient with resources and interventions to help with this crisis. Loss of trust in those whom an individual has trusted during the trauma period increases risk for posttraumatic stress disorder (PTSD), so it will be important for the nurse to assess how the patient views authorities associated with the period of military service.
4. The patient described in the scenario is likely experiencing a type II trauma. Type I trauma experiences are one-time, limited experiences that generally are less likely to cause PTSD, whereas type II trauma experiences are recurrent or chronic and are more likely to cause PTSD. Assessment of the type of trauma and how the individual is adapting to it helps determine an appropriate approach to crisis care and the risk of psychiatric sequelae. Providing the patient with education about type II, not type I traumas, will help the patient understand the condition and will provide the patient with resources and interventions to help with this crisis. Loss of trust in those whom an individual has trusted during the trauma period increases risk for posttraumatic stress disorder (PTSD), so it will be important for the nurse to assess how the patient views authorities associated with the period of military service.
5. The patient described in the scenario is likely experiencing a type II trauma. Type I trauma experiences are one-time, limited experiences that generally are less likely to cause PTSD, whereas type II trauma experiences are recurrent or chronic and are more likely to cause PTSD. Assessment of the type of trauma and how the individual is adapting to it helps determine an appropriate approach to crisis care and the risk of psychiatric sequelae. Providing the patient with education about type II, not type I traumas, will help the patient understand the condition and will provide the patient with resources and interventions to help with this crisis. Loss of trust in those whom an individual has trusted during the trauma period increases risk for posttraumatic stress disorder (PTSD), so it will be important for the nurse to assess how the patient views authorities associated with the period of military service.

Question 13

A nurse is researching the trends of maturational crisis for a graduate-level research course. When considering risk factors for this type of crisis, which patients will the nurse determine are at greatest risk for developing a maturational crisis? Select all that apply.

Accepted Answer

3. Maturational crises may occur when an individual has difficulty achieving developmental tasks using available resources and coping strategies. Maturational crises may occur during milestones or developmental tasks, such as early parenting situations, and transitioning from home to college. The young adult single parent and college students are most at risk for experiencing a maturational crisis. The young child whose parent is murdered, as well as the older adult whose spouse recently passed away, are most likely to experience a situational crisis. The exchange student whose family has been killed in a terrorist attack overseas is most at risk for adventitious crisis.
4. Maturational crises may occur when an individual has difficulty achieving developmental tasks using available resources and coping strategies. Maturational crises may occur during milestones or developmental tasks, such as early parenting situations, and transitioning from home to college. The young adult single parent and college students are most at risk for experiencing a maturational crisis. The young child whose parent is murdered, as well as the older adult whose spouse recently passed away, are most likely to experience a situational crisis. The exchange student whose family has been killed in a terrorist attack overseas is most at risk for adventitious crisis.

Question 14

The nurse is planning care for a patient who is experiencing a crisis. The patient tells the nurse, "I feel out of control, and I can't seem to make any decisions." Which nursing action will best promote effective interventions for this patient?

Accepted Answer

2. In order to promote effective interventions for a patient experiencing crisis, the most effective intervention is identifying the origin of the patient's crisis. Once the nurse can determine the cause of the patient's crisis, the nurse can then individualize care for the patient. While the other answer choices may be appropriate nursing interventions, these do not best promote effective interventions for the patient.

Question 15

A nurse has traveled overseas to provide relief for a community experiencing crisis after a natural disaster. Which concept will guide the nurse in planning care for these individuals?

Accepted Answer

2. In intercultural situations, the nurse must provide culturally competent care with interventions centered on the involvement of local community leadership. How individuals perceive crisis can vary among cultures, as can manifestations. Local community leadership will have the greatest information about resources available locally and can provide valuable information on what community members will perceive as their greatest needs. How individuals express pain or respond to trauma may also vary, and nurses should work with members of the community to ensure they provide culturally competent care and not assess individual patients based solely on Western norms.

Question 16

When providing staff education regarding basic safety monitoring and status reporting of a patient in crisis, what will the charge nurse include?

Accepted Answer

3. Basic safety monitoring and status reporting of a patient in crisis involves surveillance for common illness and suicide prevention. Stress reduction techniques are components of basic coping skills, and are a separate topic than from monitoring and status reporting. Common emotional responses would not be addressed in a session on basic safety monitoring and status reporting.

Question 17

The nurse is caring for a male patient who is experiencing a crisis. In considering the plan of care, which factor will the nurse take into account?

Accepted Answer

2. Men are far more likely to resist help during a time of crisis because help-seeking behaviors may challenge social norms of masculinity and induce a sense of vulnerability. Men usually access intervention only when in acute crisis; for this reason, it is critical to initiate crisis intervention within 24 to 48 hours of initial contact. The most successful interventions for men include the utilization of peer-led men's support groups, not individual psychotherapy.

Question 18

The nurse is providing education to a family who is experiencing crisis due to divorce. The nurse emphasizes the importance of self-care and treatment of crisis. Which statements will the nurse include in the family teaching? Select all that apply.

Accepted Answer

1. When providing education to individuals in crisis, it is important for the nurse to provide hope and discuss options available to help patients and families cope with the crisis. The nurse should emphasize the importance of monitoring for behavioral changes during the adaptation stage of the General Adaptation Syndrome. Writing in a journal may help by providing a way for individuals to monitor feelings of anxiety or to document stress exposures. While every crisis is different, there are common emotions that occur while coping with crisis. The nurse should emphasize the importance of social support, not social isolation, during times of crisis.
2. When providing education to individuals in crisis, it is important for the nurse to provide hope and discuss options available to help patients and families cope with the crisis. The nurse should emphasize the importance of monitoring for behavioral changes during the adaptation stage of the General Adaptation Syndrome. Writing in a journal may help by providing a way for individuals to monitor feelings of anxiety or to document stress exposures. While every crisis is different, there are common emotions that occur while coping with crisis. The nurse should emphasize the importance of social support, not social isolation, during times of crisis.
3. When providing education to individuals in crisis, it is important for the nurse to provide hope and discuss options available to help patients and families cope with the crisis. The nurse should emphasize the importance of monitoring for behavioral changes during the adaptation stage of the General Adaptation Syndrome. Writing in a journal may help by providing a way for individuals to monitor feelings of anxiety or to document stress exposures. While every crisis is different, there are common emotions that occur while coping with crisis. The nurse should emphasize the importance of social support, not social isolation, during times of crisis.
4. When providing education to individuals in crisis, it is important for the nurse to provide hope and discuss options available to help patients and families cope with the crisis. The nurse should emphasize the importance of monitoring for behavioral changes during the adaptation stage of the General Adaptation Syndrome. Writing in a journal may help by providing a way for individuals to monitor feelings of anxiety or to document stress exposures. While every crisis is different, there are common emotions that occur while coping with crisis. The nurse should emphasize the importance of social support, not social isolation, during times of crisis.

Question 19

The community health nurse is teaching a group of adults about crisis experienced by various populations. Which statement by one of the group members indicates that the nurse's teaching has been effective?

Accepted Answer

3. Situational crises develop in response to sudden, unexpected traumatic life events. Situational crises often are beyond the established coping capabilities of the individuals experiencing them. Situational crises can arise from many kinds of precipitants, including medical (acute onset injury or new chronic illness diagnosis), psychosocial (divorce, legal problems, financial problems), and cultural (immigration). Patients with chronic illness are at greater risk for situational crisis than individuals without chronic illness. A complicated divorce is more likely to be a situational crisis than an adventitious crisis. Adventitious crises arise from traumatic events that are well beyond the expected scope of normal human experience, such as violent crime, natural disasters, war, and terrorism. Maturational crisis occurs more frequently in adolescents and young adults than in the older adult population. Patients who have miscarried during pregnancy or have delivered a preterm infant are at greater risk for a maturational crisis or situational crisis, not an adventitious crisis.

Question 20

The nurse is participating in psychological debriefing of a patient who is experiencing a crisis. Which statements will the nurse include when providing education to the patient or family of the patient who is experiencing crisis? Select all that apply.

Accepted Answer

1. Debriefing interventions aim to provide information regarding the crisis, elicit feelings and perceptions related to the crisis, provide education regarding normal responses to trauma, and provide resources for treatment and support. Debriefing interventions include those that address patients' need for resources such as transportation and spiritual support; strategies to recognize and respond appropriately to stress, such as maintaining a calendar or journal to document stress and anxiety; and teaching and reinforcing behavioral modifications such as relaxation techniques. Pharmacological therapy is not a common treatment for crisis; furthermore, sedatives are not commonly prescribed for the patient in crisis.
2. Debriefing interventions aim to provide information regarding the crisis, elicit feelings and perceptions related to the crisis, provide education regarding normal responses to trauma, and provide resources for treatment and support. Debriefing interventions include those that address patients' need for resources such as transportation and spiritual support; strategies to recognize and respond appropriately to stress, such as maintaining a calendar or journal to document stress and anxiety; and teaching and reinforcing behavioral modifications such as relaxation techniques. Pharmacological therapy is not a common treatment for crisis; furthermore, sedatives are not commonly prescribed for the patient in crisis.
3. Debriefing interventions aim to provide information regarding the crisis, elicit feelings and perceptions related to the crisis, provide education regarding normal responses to trauma, and provide resources for treatment and support. Debriefing interventions include those that address patients' need for resources such as transportation and spiritual support; strategies to recognize and respond appropriately to stress, such as maintaining a calendar or journal to document stress and anxiety; and teaching and reinforcing behavioral modifications such as relaxation techniques. Pharmacological therapy is not a common treatment for crisis; furthermore, sedatives are not commonly prescribed for the patient in crisis.
5. Debriefing interventions aim to provide information regarding the crisis, elicit feelings and perceptions related to the crisis, provide education regarding normal responses to trauma, and provide resources for treatment and support. Debriefing interventions include those that address patients' need for resources such as transportation and spiritual support; strategies to recognize and respond appropriately to stress, such as maintaining a calendar or journal to document stress and anxiety; and teaching and reinforcing behavioral modifications such as relaxation techniques. Pharmacological therapy is not a common treatment for crisis; furthermore, sedatives are not commonly prescribed for the patient in crisis.

Quiz 26: Crisis Intervention