Deck 20: Communicating With Clients in Crisis

Question 1

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

A) people who talk about harming themselves are at less risk.
B) clients 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 client is no longer at risk.
D) a major goal in evaluating suicidal risk is to assess for imminent danger of doing harm to self.

Answer 1

a major goal in evaluating suicidal risk is to assess for imminent danger of doing harm to self.

Question 2

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

Answer 2

Erikson

Question 3

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.

Answer 3

repeating and frequently reinforcing information.

Question 4

An older adult client 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 client 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?"

Question 5

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

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.

Question 6

A client states,"I feel like I have no control over my life." The nurse determines the client 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 client's story
B) Keeping the focus on the future
C) Providing lengthy responses when interacting with the client
D) Ignoring vocal inflections as the client speaks

Question 7

A client is admitted to a psychiatric unit for crisis intervention.When caring for this client,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 client to a level of functioning higher than their precrisis level.
D) a time-limited treatment focused on the immediate problem and its resolution.

Question 8

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 9

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

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

Question 10

The nurse is performing an initial assessment on a mental health client in the emergency department.The client is uncooperative,and the nurse recognizes the client'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 11

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

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

Question 12

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

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

Question 13

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

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

Question 14

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 15

When a disaster strikes within a community,the shock of the disaster pulls people together and outside resources are brought in.This is known as which phase of the community response to disaster?

A) Reconstruction
B) Honeymoon
C) Heroic
D) Disillusionment

Question 16

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

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

Question 17

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 18

The nurse is communicating with a client 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 client?

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."