Deck 20: Crisis and Mass Disaster

Question 1

A patient visiting the crisis clinic for the first time asks,"How long will I be coming here?" The nurse's reply should consider that the usual duration of crisis intervention is _____________ weeks.

A)1 to 2
B)3 to 4
C)4 to 6
D)6 to 12

Answer 1

4 to 6

Question 2

Which communication technique is used more in crisis intervention than traditional counseling?

A)Role modeling
B)Giving direction
C)Information giving
D)Empathic listening

Answer 2

Giving direction

Question 3

A woman says,"I can't take it 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 and moving in with her boyfriend." Which issue should be the focus for crisis intervention?

A)Possible mastectomy
B)Disordered family communication
C)Effects of the husband's infidelity
D)Coping with the reaction to the daughter's events

Answer 3

Coping with the reaction to the daughter's events

Question 4

Which scenario is an example of an adventitious crisis?

A)Death of a child from sudden infant death syndrome
B)Being fired from a job because of company downsizing
C)Retirement of a 55-year-old
D)Riot at a rock concert

Question 5

A patient comes to the crisis center saying,"I'm in a terrible situation.I don't know what to do." The triage nurse can initially assume that the patient is:

A)suicidal.
B)anxious and fearful.
C)misperceiving reality.
D)potentially homicidal.

Question 6

After celebrating a 40th birthday,an individual becomes concerned with the loss of youthful appearance.What type of crisis has occurred?

A)Reactive
B)Situational
C)Maturational
D)Adventitious

Question 7

Which situation demonstrates the use of primary care related to crisis intervention?

A)Implementing suicide precautions for a patient with depression.
B)Teaching stress reduction techniques to a beginning student nurse.
C)Assessing coping strategies used by a patient who has attempted suicide.
D)Referring a patient with schizophrenia to a partial hospitalization program.

Question 8

A victim of spousal violence comes to the crisis center seeking help.The nurse uses crisis intervention strategies that focus on:

A)supporting emotional security and reestablishing equilibrium
B)offering a long-term resolution of issues precipitating the crisis
C)promoting growth of the individual
D)providing legal assistance

Question 9

A patient comes to the clinic with superficial cuts on the left wrist.The patient paces around the room sobbing but cringes when approached and responds to questions with only shrugs or monosyllables.Select the nurse's best initial statement 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 so we can talk about your problems."
D)"Let's set some guidelines and goals for your visit here."

Question 10

A woman says,"I can't take it 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." If this person's immediate family is unable to provide sufficient situational support,the nurse should:

A)suggest hospitalization for a short period.
B)ask what other relatives or friends are available for support.
C)tell the patient,"You must be strong.Don't let this crisis overwhelm you."
D)foster insight by relating the present situation to earlier situations involving loss.

Question 11

While conducting the initial interview with a patient in crisis,the nurse should:

A)speak in short,concise sentences.
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.

Question 12

A patient comes to the clinic with superficial cuts on the left wrist.The patient is pacing and sobbing.After a few minutes with the nurse,the patient is calmer.What should the nurse ask to determine the patient's perception of the precipitating event?

A)"Tell me why you were crying."
B)"How did your wrist get injured?"
C)"How can I help you feel more comfortable?"
D)"What was happening just before you started to feel this way?"

Question 13

During the initial interview at the crisis center,a patient says,"I've been served with divorce papers.I'm so upset and anxious that I can't think clearly." What could the nurse say to assess personal coping skills?

A)"What would you like us to do to help you feel more relaxed?"
B)"In the past,how did you handle difficult or stressful situations?"
C)"Do you think you deserve to have things like this happen to you?"
D)"I can see you are upset.You can rely on us to help you feel better."

Question 14

An adult seeks counseling after the spouse is 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?"

Question 15

A woman says,"I can't take it 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)Identifying measures useful to help improve the couple's communication
B)Discussing the patient's feelings about the possibility of having a mastectomy
C)Determining whether the husband is still engaged in an extramarital affair
D)Clarifying what the patient means by,"I can't take it anymore!"

Question 16

Which agency provides coordination in the event of a terrorist attack?

A)U.S.Food and Drug Administration (FDA)
B)Environmental Protection Agency (EPA)
C)National Incident Management System (NIMS)
D)Federal Emergency Management Agency (FEMA)

Question 17

An adult tells the nurse,"I can't take it 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 told me she's quitting college and moving in with her boyfriend." What is the priority nursing diagnosis?

A)Fear,related to impending surgery
B)Deficient knowledge,related to breast lesion
C)Ineffective coping,related to perceived loss of daughter
D)Impaired verbal communication,related to spousal estrangement

Question 18

A woman says,"I can't take it 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 type of crisis is this person experiencing?

A)Maturational
B)Adventitious
C)Situational
D)Recurring

Question 19

An adult has cared for a debilitated parent for 10 years.The parent's condition has recently declined,and the health care provider has recommended placement in a skilled care facility.The adult says,"I've always been able to care for my parents.Nursing home placement goes against everything I believe." Successful resolution of this person's crisis will most closely relate to:

A)resolving the feelings associated with the threat to the person's self-concept
B)maintaining the ability to identify situational supports in the community
C)relying on the assistance from role models within the person's culture
D)mobilizing automatic relief behaviors by the person

Question 20

An adolescent comes to the crisis clinic and reports sexual abuse by an uncle.The patient told the parents about the uncle's behavior,but the parents did not believe the adolescent.What type of crisis exists?

A)Maturational
B)Adventitious
C)Situational
D)Organic

Question 21

A nurse driving home after work comes upon a serious automobile accident.The driver gets out of the car with no apparent physical injuries.Which assessment findings would be expected from the driver immediately after this event? Select all that apply.

A)Difficulty using a cell phone
B)Long-term memory losses
C)Fecal incontinence
D)Rapid speech
E)Trembling

Question 22

An adult comes to the crisis clinic after being terminated from a job of 15 years.The patient says,"I don't know what to do.How can I get another job? Who will pay the bills? How will I feed my family?" Which nursing diagnosis applies?

A)Hopelessness
B)Powerlessness
C)Chronic low self-esteem
D)Disturbed thought processes

Question 23

The assumption most useful to a nurse planning crisis intervention for any patient is that the patient:

A)is experiencing a state of disequilibrium.
B)is experiencing a type of mental illness.
C)poses a threat of violence to others.
D)has a high potential for self-injury.

Question 24

After completing the contracted number of visits to the crisis clinic,an adult says,"I've emerged from this as a stronger person.You supported me while I worked through my feelings of loss and helped me find community resources.I'm benefiting from a support group." The nurse can evaluate the patient's feelings about the care received as:

A)not at all satisfied
B)somewhat satisfied
C)moderately satisfied
D)very satisfied

Question 25

A troubled adolescent opened fire in a high school cafeteria,fatally shooting three people and injuring many others.Hundreds of parents come to the high school after hearing the news reports.After the police arrest the shooter,which action should occur next?

A)Ask the police to encircle the school campus with yellow tape to prevent parents from entering.
B)Announce over the loudspeakers,"The campus is now secure.Please return to your classrooms."
C)Require parents to pass through metal detectors and then allow them to look for their children in the school.
D)Designate zones according to the alphabet,and direct students to the zones based on their surnames to facilitate reuniting them with their parents.

Question 26

At the last contracted visit in the crisis intervention clinic,an adult says,"I've emerged from this a stronger person.You helped me feel like my life is back in balance." The nurse responds,"I think it would be worthwhile to have two more sessions to explore why your reactions were so intense." Which analysis applies?

A)The patient is experiencing transference.
B)The patient demonstrates a need for continuing support.
C)The nurse is having difficulty terminating the relationship.
D)The nurse is empathizing with the patient's feelings of dependency.

Question 27

An appropriate question for the nurse to ask to assess situational support is:

A)"Has anything upsetting occurred in the past few days?"
B)"Who can be helpful to you during this time?"
C)"How does this problem affect your life?"
D)"What led you to seek help at this time?"

Question 28

Which health care worker should be referred to critical incident stress debriefing?

A)Nurse who works at an oncology clinic where patients receive chemotherapy
B)Case manager whose patients are seriously mentally ill and are being cared for at home
C)Health care employee who worked 8 hours at the information desk of an intensive care unit
D)Emergency medical technician (EMT)who treated victims of a car bombing at a department store