Question 1

A worker has recently been involved in assisting with the cleanup from a flood that washed away many homes in his area and caused loss of life.Which crisis intervention would assist the worker in dealing with the traumatic experience?

Accepted Answer

The worker needs to be able to express his feelings and deal with the pain associated with the crisis event.Nurses can help facilitate understanding of the event by listening and teaching.The remaining interventions are not considered crisis interventions.

Question 2

At the crisis center a staff nurse tells the nurse clinician,"The patient is dealing with an internal crisis situation." Which situation would qualify as a trigger for that designation?

Accepted Answer

Internal (subjective)crises are threats to a person's well-being that are not so obvious to the outside observer.Some are associated with phase-of-life events.Loss of faith in a supreme being would exemplify an internal crisis.The other options are considered external (situational)crises.

Question 3

What is the basis for a 1-month crisis intervention follow-up for individuals who have survived a major hurricane?

Accepted Answer

An acute stress disorder (ASD)may manifest when a person is in crisis.ASD is an anxiety disorder that is characterized by a cluster of dissociative and anxiety symptoms that occur within 1 month of a major traumatic stressor.Although the patient may now be receptive to counseling,there is no reason to believe this will happen within a month.The remaining options are not necessarily true.

Question 4

Which behavior is observed in the honeymoon stage of a community's adjustment to a severe flood?

Accepted Answer

The honeymoon phase occurs 1 week to 3 to 6 months after the event,when feelings of community sharing and high social attachment exist demonstrated by a community rally.The heroic phase occurs immediately after the event,and it is a time of altruism and heroic behavior in the community such as selfless sharing.The disillusionment phase occurs 2 months to 1 to 2 years after the event,and it is characterized by feelings of disappointment,anger,resentment,and bitterness regarding the expectations of support that were not met and often demonstrated through examples of community protest.The reconstruction phase occurs 2 months to 1 to 2 years after the event,when physical and emotional reinvestment take place as community resources are re-established.

Question 5

Which nursing intervention is vital to the effective management of a psychiatric emergency resulting from a patient's experience of extreme despair?

Accepted Answer

A psychiatric emergency involves a sudden and serious psychological disturbance that results in a behavioral state that requires intervention to prevent a life-threatening or psychologically damaging consequence.Despair is often associated with the patient's attempt at self-harm and so suicide precautions are vital to emergency management in the situation.Obsessive-compulsive behavior is not generally seen as a response to despair.The remaining interventions would not be considered during emergency management.

Question 6

Which patient response demonstrates that the patient whose home was destroyed by a fire is coping with the disaster?

Accepted Answer

Coping does not imply mastery over the crisis; rather,it is the process that is used to respond to the crisis and find resolution.Working on rebuilding the home is an example of this process.The remaining option show varying degrees of attempting to justify or minimize the crisis.

Question 7

Which patient statement assures the nurse that the patient's immediate psychiatric emergency has been resolved?

Accepted Answer

The primary factor that distinguishes a psychiatric emergency from other types of crises and medical emergencies is the presence or threat of danger to the self or others.When the patient expresses the willingness to alert the staff when such feelings are occurring there is reason to believe the immediate emergency has past.The other options do not exhibit such a sense of willingness on the patient's part.

Question 8

Which patient statement made by a spouse is representative of those seen in Phase 3 of the crisis response regarding the death of a loved one?

Accepted Answer

Phase 3: Resources from within and outside of the individual are mobilized to resolve the problem and to alleviate the discomfort caused by the stressor.Phase 1: The individual is exposed to a stressor.Phase 2: Previous coping and problem-solving strategies fail to relieve the stressor.Phase 4: The absence of crisis resolution leads to major disorganization such as self-injurious behavior.

Question 9

What intervention has highest priority when a patient diagnosed with acute stress disorder (ASD)reports difficulty sleeping and is observed to have an exaggerated startled response 6 weeks after the trauma occurred?

Accepted Answer

If symptoms of ASD persist for more than 1 month,an assessment for other diagnoses may also be considered,such as posttraumatic stress disorder (PTSD).The remaining options do not address the issue of a more complex diagnosis and would be treating only isolated symptoms.

Question 10

Which factor will have the greatest impact on a patient's ability to effectively respond to the loss of a spouse?

Accepted Answer

An individual's interpretation of the crisis is based to a large degree on previous outcomes to similar situations such as experiencing another death crisis.The remaining options do not have the same degree of influence as does the correct option since they are not an example of previous experience.

Question 11

To plan effectively for an individual who is in crisis,the nurse must have an understanding of:

Accepted Answer

Knowing the meaning to the individual is crucial,since the mitigating circumstances and support a patient has may reduce the impact of the crisis event.For example,a property loss is likely to be of greater concern to someone with few financial resources than to someone who is wealthy or fully insured.Establishing rapport should occur prior to the planning stage.An understanding of family counseling techniques is not necessary.Crisis intervention may not depend on information about posttraumatic stress disorder.

Question 12

Which behavior is observed in the disillusionment stage of a community's adjustment to a devastating hurricane?

Accepted Answer

The disillusionment phase occurs 2 months to 1 to 2 years after the event,and it is characterized by feelings of disappointment,anger,resentment,and bitterness regarding the expectations of support that were not met and often demonstrated through examples of community protest meetings.The heroic phase occurs immediately after the event,and it is a time of altruism and heroic behavior in the community such as selfless sharing.The reconstruction phase occurs 2 months to 1 to 2 years after the event,when physical and emotional reinvestment take place as community resources are re-established.

Question 13

Which clinical picture can the nurse expect to see most frequently among patients who have been in a bus-train collision and derailment?

Accepted Answer

Common immediate responses to a traumatic event include shock,numbness,denial,dissociative behavior,confusion,disorganization,indecisiveness,and suggestibility.The other options contain behaviors that may be observed,but they are far less common than the behaviors given in the correct option.

Question 14

A new nurse mentions,"I can understand a situational crisis upsetting a person's equilibrium,but I don't understand how something positive,like getting married or having a baby,can precipitate a crisis." To explain,the mentor should answer,"You need to think of a crisis as a(n):

Accepted Answer

By viewing a crisis as a threat to the norm,it is possible to understand why even positive events,such as winning the lottery,may provoke a crisis.Crises are not considered discrete psychiatric disorders nor are they opportunities to learn.Crises are not always threats to one's physical survival.

Question 15

The crisis nurse working with law enforcement is called to assist at a scene where an overtly psychotic individual is threatening officers with a handgun.He shouts that aliens dressed like police are pursuing him and he has to get away.The priority intervention is:

Accepted Answer

Patients who feel threatened should be assured of their safety so that rapport building can take place.When rapport has been developed,the nurse may be able to convince the individual to give up any weapons.The patient is not capable of understanding the experience at this point in the scenario.Although relevant,the remaining options do not have the priority of the correct option since they depend upon a therapeutic nurse-patient rapport.

Question 16

Which event has the potential for causing a situational crisis?

Accepted Answer

A situational crisis occurs when a specific,external event,such as job loss,disturbs one's psychologic equilibrium.The other options would be considered internal (subjective)crises.

Question 17

Which patient statement is representative of those seen in Phase 2 of the crisis response regarding financial problems?

Accepted Answer

Phase 2: Previous coping and problem-solving strategies fail to relieve the stressor.Phase 1: The individual is exposed to a stressor.Phase 3: Resources from within and outside of the individual are mobilized to resolve the problem and to alleviate the discomfort caused by the stressor.Note that people may drop out of situations in numerous ways,including self-medication with alcohol.Phase 4: The absence of crisis resolution leads to major disorganization such as self-injurious behavior.

Question 18

A patient who survived a tornado is without shelter and food,has lost his car,and has learned that several friends sustained injuries.To tailor intervention to the patient's needs,the nurse would make it a priority to:

Accepted Answer

Maslow's hierarchy of need theory suggests that survival needs should be met first.Thus arranging for food and shelter takes precedence over other concerns.

Question 19

Which patient has the greatest risk for the development of a psychiatric emergency?

Accepted Answer

Populations at high risk for psychiatric emergencies include those with chronic mental pathologies,such as chronic schizophrenia,because their emotional stability can be easily disrupted.The other patients lack that element of emotional and cognitive fragility and have a responsible support system.

Question 20

Several school-age children injured in a school bus accident were brought to the ED.Family members and friends paced back and forth in the waiting room.Members of the crisis team were called in for the primary purpose of:

Accepted Answer

A crisis team is able to provide immediate emotional support to friends and families who are distressed over the event and the state of victims,and they are able to facilitate understanding of the event by teaching.The remaining options do not reflect the function of crisis intervention teams.

Quiz 21: Crisis: Theory and Intervention