Exam 23: Crisis and Disaster

A patient who sought help in a crisis agrees after the first interview to return to the clinic for daily sessions.The nurse offers many suggestions for lifestyle changes the patient should make as crisis intervention progresses and provides after-hours phone support as well.After several sessions,which response on the nurse's part should most alert the nurse to a need for clinical supervision?

A patient presents in crisis.She tells the nurse,"I cannot take it anymore! It has to stop.Last year my husband had an affair,and we do not communicate anymore.Three months ago I found a lump in my breast,and yesterday my 20-year-old daughter told me she is quitting college and moving to another state with her boyfriend." After making the assessment that the patient's nuclear family is unable to provide the patient with sufficient support,which intervention would be most appropriate?

The priority assessment the nurse must make during the initial crisis intervention interview is the:

A factory abruptly closes;workers receive no warning and no explanation.An office worker tries to take it in stride and begins the job search,updating his resume,submitting applications,and offering support to his peers.Which assessment question would be most important to ask at this time?

The nurse is asked by the spouse of a patient seeking crisis intervention to give an example of an adventitious crisis.The nurse should mention:

During the initial interview at the crisis center,a patient reveals that his wife asked him for a divorce.He is so anxious that he "cannot think straight." Which response would best assess the patient's coping skills?

A nurse in the emergency room is responsible for responding to crises involving school children and has spent many days in local schools helping grieving students who have lost peers or teachers unexpectedly.She is also exposed daily to the victims of horrible accidents and other physical and emotional traumas.Which of the following would be most important for her to address in periodic clinical supervision?

A patient presents in crisis.She tells the nurse,"I cannot take it anymore! It has to stop.Last year my husband had an affair,and we do not communicate anymore.Three months ago I found a lump in my breast,and yesterday my 20-year-old daughter told me she is quitting college and moving to another state with her boyfriend." The nurse can make the assessment that crisis intervention is successful when the patient:

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

A 40-year-old man has just helped his youngest child move away to college.On returning home,he feels empty and restless and has difficulty sleeping in the nights that follow.This is an example of a ______________ crisis.

A factory abruptly closes during hard economic times.Six weeks later,an office worker has not received a single call-back from a prospective employer.He cannot sleep,is irritable,does not want to interact with his family or peers,paces frequently,and spends several hours most days alone in a local bar.Bills are piling up.He has given up applying for jobs.Which nursing intervention would be most important at this time?

A factory abruptly closes.An office worker initially tries to take it in stride,begins the job search,and networks with peers.Five weeks later,he has not received a single call-back from a prospective employer.He cannot sleep,is irritable,does not want to interact with his family or peers,paces,and spends several hours most days alone in a local bar.He has given up applying for jobs.Which three nursing diagnoses would be the highest priority at this time? Select all that apply.

A patient being interviewed on his first visit to the crisis center says he is there because he needs help,but then he falters and cannot continue his explanation.Which question would be of value in helping him relate his perception of the precipitating event?

The nursing diagnosis of Powerlessness related to impaired problem solving has been established for a patient seeking crisis counseling.An appropriate outcome for this nursing diagnosis would be that the patient will:

A factory abruptly closes.An office worker tries to take it in stride and begins the job search.Three weeks later,he has not received a single call-back from a prospective employer despite submitting over 30 applications.He is having trouble sleeping,is irritable,does not want to interact with his family,paces,and spends several hours most days in a local bar.He is now applying for minimum-wage service jobs.Which phase of the crisis is he experiencing?

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

The nurse assigned to implement a critical incident stress debriefing for a group who responded to a plane crash disaster scene must correctly organize the elements of the debriefing for maximal effectiveness.Put the following elements in the order in which they should occur during CISD: A) Provide resources,summarize the meeting,and convey support and appreciation to all. B) Affirm members' responses as normal and teach other responses that can occur later. C) Ask participants to introduce themselves,then discuss the facts of the event. D) Have members talk about what was worse about the accident,what they'd like to forget. E) Have participants first share what they were thinking at the scene of the accident. F) Discus members' physical,emotional and behavioral responses to the accident.

A patient presents in crisis.She tells the nurse,"I cannot take it anymore! It has to stop.Last year my husband had an affair,and we do not communicate anymore.Three months ago I found a lump in my breast,and yesterday my 20-year-old daughter told me she is quitting college and moving to another state with her boyfriend." The problem that should be the focus for crisis intervention is:

A patient,aged 16 years,comes to the crisis clinic and tells the nurse that an uncle tried to rape her yesterday.The patient had told her mother of the uncle's behavior,but the mother accused the daughter of lying and,contrary to the patient's hopes,indicated she would still allow the uncle to visit the family.The patient describes feeling "all confused" and shows minor lacerations on her forearms to the nurse,which she indicates she did out of desperation rather than a wish to die.Which nursing diagnosis would be most appropriate as her primary diagnosis?

Which of the following indicators best demonstrates that crisis intervention has been successful?