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.”
ANS: B This patient is experiencing a crisis. The two primary thrusts of crisis intervention are to provide for the safety of the individual and to...
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?”
ANS: D A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits a...
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
ANS: B Individuals in crisis are universally anxious. They are often frightened and may be mildly confused. Perceptions are often narrowed with anx...
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
ANS: B An adventitious crisis is a crisis of disaster that is not a part of everyday life. It is unplanned or accidental. Adventitious crises inclu...
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
ANS: A Severe anxiety narrows perceptions and concentration. The nurse should listen carefully and summarize what the patient is saying to ensure c...
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?”
ANS: D The highest nursing priority is safety. The nurse should assess suicidal and homicidal potential. The distracters are options, but the highe...
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
ANS: C A situational crisis arises from an external source and involves a loss of self-concept or self-esteem. An adventitious crisis is a crisis o...
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.”
ANS: D During crisis intervention, the priority concern is patient safety. This question helps assess personal coping skills. The other options are...
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
ANS: B The assessment of situational supports should continue. Even though the patient’s nuclear family may not be supportive, other situational su...