The nurse is providing care to a client who has become emotionally labile with paranoia after losing their career and home due to a motor vehicle accident. The nurse recognizes that the client is at what phase of crisis development?

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1.This incorrect. In phase 1, the individual is exposed to a precipitating crisis. Symptoms include increased anxiety and the use of previously employed problem-solving techniques.
2.This is incorrect. In phase 2, previous problem-solving techniques do not relieve the stressor, which further increases anxiety. Coping techniques that have worked in the past are attempted, only to create feelings of helplessness when they are not successful.
3.This is incorrect. In phase 3, all possible resources, both internal and external, are called on to resolve the problem and relieve the discomfort. New problem-solving techniques may be used, and, if effectual, resolutions may occur at this phase, with the client returning to a higher level, lower level, or the previous level of precrisis functioning.
4.This is correct. In phase 4, if the resolution does not occur in previous phases, Caplan states that the "tension mounts beyond a further threshold or its burden increases over time to a breaking point. Major disorganization of the individual with drastic results often occurs" (p. 41). Anxiety may reach panic levels. Cognitive functions are disordered, emotions are labile, and behavior may reflect the presence of psychotic thinking.

The Nurse Is Providing Care to a Client Who Has