Deck 21: Crisis: Theory and Intervention

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?

A) Arranging for his minister to meet with him
B) Suggesting he be admitted to a mental health facility
C) Providing him the opportunity to talk about the experience
D) Encouraging him to leave the area in order to forget the experience

Answer 1

Providing him the opportunity to talk about the experience

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?

A) Job loss
B) Marital breakup
C) Death of a friend
D) Loss of religious faith

Answer 2

Loss of religious faith

Question 3

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

A) Symptomology of acute stress disorder can occur within a month of experiencing the trauma.
B) The patient generally has had time to reflect on the trauma and is now ready to discuss its impact.
C) Medications prescribed to help manage the initial anxiety caused by the trauma will need to be re-evaluated.
D) Private insurance carriers require professional mental health follow-ups when initial counseling has occurred.

Answer 3

Symptomology of acute stress disorder can occur within a month of experiencing the trauma.

Question 4

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

A) Individuals unselfishly share the limited resources.
B) The community's shopping mall and theater reopen.
C) A community rally is held to show support for the rebuilding of the town.
D) Individuals protest the government's plan to distribute flood recovery funding.

Question 5

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

A) Suicide precautions
B) Introduction to a support group
C) Introducing new coping mechanisms
D) Assessment for obsessive-compulsive rituals

Question 6

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

A) Agreeing to see a grief counselor
B) Stating, "At least no one was hurt in the fire."
C) Addressing the details regarding the rebuilding of the house
D) Stating, "I knew things were going along too well to be true."

Question 7

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

A) "Will I ever be able to go back to my family and job?"
B) "I don't ever want to feel so out of control ever again."
C) "Will you please ask the doctor if I can have a pill for my nerves?"
D) "I will let you know if I start feeling the need to hurt myself again."

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?

A) "I don't know what I'll do to fill my days now."
B) "Life isn't worth living if I have to live alone."
C) "Prayer doesn't seem to give me the peace it has in the past."
D) "Maybe going and spending time with my daughter will help."

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?

A) Short-term therapy will be suggested.
B) Antianxiety medication will be prescribed.
C) The patient will be scheduled for a consult at the sleep patient.
D) The patient will be assessed for possible posttraumatic stress disorder (PTSD).

Question 10

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

A) The age of the patient
B) The years they were married
C) How the patient has handled other deaths
D) Availability of an effective support system

Question 11

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

A) Methods to establish rapport
B) Family counseling techniques
C) The meaning of the crisis event to the individual
D) Posttraumatic stress disorder treatment modalities

Question 12

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

A) Individuals opening their homes to those without shelter.
B) Nearby communities provide clothing and food for victims.
C) The community remembers the event with a rally in its newly rebuilt park.
D) State leaders attend a community meeting to discuss why funding is slow to arrive.

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?

A) Elation and hyperactivity
B) Denial of the incident and suspicion
C) Shock, numbness, confusion, and disorganization
D) Highly emotional displays, such as begging for help

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):

A) Threat to survival."
B) Threat to the familiar."
C) Opportunity to learn."
D) Psychiatric disorder."

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:

A) Evaluate the patient for recent substance use.
B) Ensure the patient's safety and develop rapport.
C) Screen for the level of psychiatric care needed.
D) Assist the patient to make sense of the experience.

Question 16

Which event has the potential for causing a situational crisis?

A) Losing one's faith in God
B) Losing a job after 10 years
C) Leaving home to attend college
D) Retirement from teaching school

Question 17

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

A) "I can't get evicted and live on the street; I'd kill myself first."
B) "I need to get drunk and forget about money problems for a little while"
C) "I need to figure out a way to get enough money to meet my rent this month."
D) "I've always been able to rely on my mother but she won't give it to me this time."

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:

A) Offer antianxiety medication.
B) Explore earlier life experiences.
C) Explain computer-based crisis therapy.
D) Arrange for an agency to provide shelter and food.

Question 19

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

A) The schizophrenic older adult living on the streets
B) The anorexic young adult hospitalized for treatment
C) The orphaned teenager who lives with grandparents
D) The teenager who has a problem with authority figures

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:

A) Waiting with the families and friends
B) Facilitating understanding and providing support
C) Determining the level of individual family coping
D) Assisting the medical team with the physical injuries

Question 21

Which situations would increase an individual's risk for ineffective coping related to stress? Select all that apply.

A) Being over 65 years of age
B) Being unmarried and female
C) Having been adopted as an infant
D) Having a history of chronic back pain
E) Being diagnosed with both depression and hypertension

Question 22

Which nursing interventions are implemented when using the ACT model to manage a patient who has experienced a physical assault while visiting a vacation resort? Select all that apply.

A) Assessing the patient's need for medical attention
B) Performing a cultural assessment
C) Arranging for a social service consult
D) Offering to notify the patient's family
E) Requesting a visit by the hospital clergy

Question 23

Which assessment observations will be most influential in determining whether a patient exhibiting signs of alcohol intoxication who was brought to the emergency room by friends will be involuntarily admitted for psychiatric evaluation? Select all that apply.

A) The patient's earlier contact with a crisis hotline
B) Expressing a desire, "to just drive myself home"
C) Patient's admission that, "I don't want to keep living like this."
D) Uncooperative and disrespectful behavior towards the hospital staff
E) Announcing that, "my girlfriend will pay for leaving me for my best friend."

Question 24

Which statement is the basis for the combination of both interactive therapy and antidepressant medication for a patient whose chronic depression resulted in a suicide attempt?

A) Therapy is seldom effective when not supported with appropriately prescribed medications.
B) The suicide attempt was the deciding factor in determining the need to prescribe an antidepressant.
C) Patients are more willing to attend therapy sessions when they are prescribed medications to manage acute symptoms.
D) Research has shown that a combination of therapy and medications achieve expected outcomes more effectively than single interventions.

Question 25

Which statements are the basis for making counseling available to grade-school children who have experienced the violent death of a classmate? Select all that apply.

A) It is vital to foster each child's sense of psychologically safety.
B) The fear of the unknown circumstances of the classmate's death will serve to increase their own anxieties.
C) Counseling will provide mental health professionals with the opportunity to address all the children's concerns.
D) The more appropriate information the children are given about their classmate's death, the better they will be able to understand why the death occurred.
E) Although the children may not be capable of understanding the information they are given, the interaction with mental health providers will minimize their anxieties.

Question 26

Which characteristic makes a stressful event a crisis situation? Select all that apply.

A) The event was not expected.
B) The patient felt emotional or physically threatened.
C) The event resulted in physical trauma to the patient.
D) The patient showed immediate signs of anxiety or panic.
E) The patient has little or no social support system to rely upon.

Question 27

Which patient behavior assures the nurse that the primary goal of crisis intervention has been achieved by a patient who experiencing extreme mania?

A) The patient has resumed a healthy sleep pattern.
B) The patient has asked that their family be allowed to visit.
C) The patient demonstrates an understanding of manic behaviors.
D) The patient is compliant with the medication therapy prescribed.