Deck 20: Communicating With Patients in Crisis

Question 1

An older adult patient who is mourning the death of her spouse comes to the health clinic for follow-up care for an irregular heartbeat. During the examination the patient tells the nurse, "I don't care about my irregular heartbeat; I will be with my husband soon." The best response by the nurse is,

A) "It sounds as if you would like to see your husband again."
B) "Your husband is dead and you have so much to live for."
C) "Your heartbeat was good today. The medication seems to be working."
D) "Have you talked to your children recently about how you're doing?"

Answer 1

"It sounds as if you would like to see your husband again."

Question 2

The nurse is caring for a patient who is experiencing a crisis situation. The nurse recognizes that after feeling a sense of shock, the patient will go through a period of recoil in which the patient

A) behaviors can appear normal to outsiders.
B) takes constructive actions to face and resolve the reality issues present.
C) achieves at least precrisis functioning.
D) experiences variations in emotions.

Answer 2

behaviors can appear normal to outsiders.

Question 3

A patient states, "I feel like I have no control over my life." The nurse determines the patient is experiencing a sense of powerlessness. Which strategy most likely assisted the nurse in the identification of powerlessness?

A) Looking for central emotional themes in the patient's story
B) Keeping the focus on the future
C) Providing lengthy responses when interacting with the patient
D) Ignoring vocal inflections as the patient speaks

Answer 3

Looking for central emotional themes in the patient's story

Question 4

The nurse is performing an initial assessment on a mental health patient in the emergency department. The patient is uncooperative, and the nurse recognizes the patient's behavior is escalating. The most appropriate response by the nurse is to

A) use a vulnerable stance.
B) maintain constant eye contact.
C) move quickly with hands hidden behind back.
D) ignore provocative statements.

Question 5

A patient is admitted to a psychiatric unit with severe depression and thoughts of suicide. The patient is placed on suicide precautions. When caring for this patient, the nurse recognizes that

A) people who talk about harming themselves are at less risk.
B) patients who verbalize or behaviorally demonstrate "a weight being lifted off the shoulders" are no longer at risk.
C) once the acute crisis has subsided, the patient is no longer at risk.
D) a major goal in evaluating suicidal risk is to assess for imminent danger of doing harm to self.

Question 6

When collecting assessment data, the nurse recognizes that a client might be more prone to violent behavior when having a history of which of the following?

A) Psychosis
B) Childhood abuse
C) Lack of impulsivity
D) Mental retardation
E) Delirium

Question 7

The nurse is caring for an older adult patient who has recently lost his job, is experiencing a major physical illness, and lives alone. The patient states, "I sometimes wish I wasn't here." When working with this patient, the nurse recognizes that

A) an increase in the patient's energy level indicates the patient is coping better.
B) older adult patients have a lower rate of suicide.
C) the patient should be assessed for imminent danger of doing harm to self.
D) when the patient begins giving away possessions, it is a positive sign.

Question 8

The nurse is caring for a family that is experiencing a crisis. The nurse recognizes that interventions for initial family responses to crisis include

A) minimizing the family's sense of control within the hospital environment.
B) prohibiting extreme expression of feelings.
C) providing the family with information that is lengthy and abstract.
D) repeating and frequently reinforcing information.

Question 9

A model of psychosocial development in which each stage is associated with a psychosocial crisis to be resolved was developed by which theorist?

A) Caplan
B) Erikson
C) Aguilera
D) Roberts

Question 10

When educating a student nurse about the definition of a crisis state, the nurse recognizes that additional instruction is needed when the student nurse states,

A) "A crisis state is an acute normal human response."
B) "A crisis state is a mental illness."
C) "A crisis state represents a personal response."
D) "A crisis state creates a temporary disconnect from attachment to others."

Question 11

A patient is admitted to a psychiatric unit for crisis intervention. When caring for this patient, the nurse recognizes that crisis intervention is

A) a long-term treatment to improve coping skills.
B) a system for focusing on future problem-solving skills.
C) a method of intervention with a goal of returning the patient to a level of functioning higher than their precrisis level.
D) a time-limited treatment focused on the immediate problem and its resolution.

Question 12

A patient with a history of violence is admitted to a psychiatric unit. The nurse observes the patient pacing the halls and speaking to other patients in a menacing way. The nurse is concerned that the patient will become physically violent. The nurse should initially

A) encourage the patient to stop pacing and sit down.
B) increase environmental stimuli by promoting more sensory input.
C) call the patient by name using a low, calm tone of voice.
D) refrain from medicating the patient.

Question 13

A patient experiences an unusually stressful life event that exceeds their resources and coping skills. The nurse recognizes the patient is experiencing which type of crisis?

A) Developmental
B) Private
C) Adventitious
D) Situational

Question 14

A patient enters the emergency department. When performing the initial admission assessment, the nurse recognizes which patient behavior as an indicator that the patient may become violent?

A) Coherent speech
B) Flat affect
C) A relaxed posture
D) Confusion

Question 15

The nurse is communicating with a patient who is experiencing a crisis related to marital difficulties. Which of the following statements made by the nurse is the best example of therapeutic communication when working with this patient?

A) "I think we should work toward fixing your marital difficulties immediately."
B) "I'm going to call the counselor and make an appointment for you."
C) "What would happen if you chose to go for counseling compared to seeking a divorce?"
D) "I think you and your spouse need to go for counseling as soon as possible."

Question 16

When working on a psychiatric unit, the nurse recognizes that indicators of potential violence include which of the following?

A) Confusion
B) Orientation
C) Coherent speech
D) Exaggerated gestures
E) Prolonged eye contact

Question 17

A patient who is experiencing a crisis is admitted to a nursing unit. When entering the patient's room, the nurse should attempt to establish rapport and engage the patient by

A) offering a brief introductory statement to quickly orient the patient to the purpose of crisis questions.
B) demonstrating an inflexible approach when caring for the patient.
C) placing the patient in a dimly lit room close to the nursing unit.
D) delegating to several nurses the role as primary contact for information.