Question 1

Which of the following are effective interventions that a nurse should utilize when caring for an inpatient client who expresses anger inappropriately? (Select all that apply.)

Accepted Answer

A)  Maintain a calm demeanor.
B)  Clearly delineate the consequences of the behavior.
C)  Use therapeutic touch to convey empathy.
D)  Set limits on the behavior.
E)  Teach the client to avoid "I" statements related to expression of feelings. A, B, D

Question 2

After threatening to jump off a bridge, a client is brought to an emergency department by police. To assess for suicide potential, which question should a nurse ask first?

Accepted Answer

A)  "Are you currently thinking about harming yourself?"
B)  "Why do you want to harm yourself?"
C)  "Have you thought about the consequences of your actions?"
D)  "Who is your emergency contact person?" A

Question 3

An inpatient client with a known history of violence suddenly begins to pace. Which client behavior should alert a nurse to escalating anger and aggression?

Accepted Answer

A)  The client requests prn medications.
B)  The client has a tense facial expression and body language.
C)  The client refuses to eat lunch.
D)  The client sits in group therapy with back to peers. B

Question 4

A mother is concerned about her ability to perform in her new role. She is quite anxious and refuses to leave the postpartum unit. To offer effective client care, a nurse should recognize which information about this type of crisis?

Accepted Answer

A)  This type of crisis is precipitated by unexpected external stressors.
B)  This type of crisis is precipitated by preexisting psychopathology.
C)  This type of crisis is precipitated by an acute response to an external situational stressor.
D)  This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.

Question 5

A college student who was nearly raped while jogging completes a series of appointments with a rape crisis nurse. At the final session, which client statement most clearly suggests that the goals of crisis intervention have been met?

Accepted Answer

A)  "You've really been helpful.Can I count on you for continued support?"
B)  "I work out in the college gym rather than jogging outdoors."
C)  "I'm really glad I didn't go home.It would have been hard to come back."
D)  "I carry mace when I jog.It makes me feel safe and secure."

Question 6

A high school student has learned that she cannot graduate. Her boyfriend will be attending a college out of state that she planned to also attend. She is admitted to a psychiatric unit after overdosing on Tylenol. Which is the correctly written priority nursing diagnosis for this client?

Accepted Answer

A)  Ineffective coping R/T situational crisis AEB powerlessness
B)  Anxiety R/T fear of failure
C)  Risk for self-directed violence R/T hopelessness
D)  Risk for low self-esteem R/T loss events AEB suicidal ideations

Question 7

A client comes to a psychiatric clinic experiencing sudden extreme fatigue and decreased sleep and appetite. The client works 12 hours a day and rates anxiety as 8/10 on a numeric scale. What correctly written long-term outcome is realistic in addressing this client's crisis?

Accepted Answer

A)  The client will change his or her type A personality traits to more adaptive ones by week 1.
B)  The client will list five positive self-attributes.
C)  The client will examine how childhood events led to an overachieving orientation.
D)  The client will return to previous adaptive levels of functioning by week 6.

Question 8

Which of the following nursing statements and/or questions represent appropriate communication to assess an individual in crisis? (Select all that apply.)

Accepted Answer

A)  "Tell me what happened."
B)  "What coping methods have you used, and did they work?"
C)  "Describe to me what your life was like before this happened."
D)  "Let's focus on the current problem."
E)  "I'll assist you in selecting functional coping strategies."

Question 9

A wife brings her husband to an emergency department after an attempt to hang himself. He is a full-time student and works 8 hours at night to support his family. He states, "I can't function any longer under all this stress." Which type of crisis is the client experiencing?

Accepted Answer

A)  Maturational/developmental crisis
B)  Psychiatric emergency crisis
C)  Anticipated life transition crisis
D)  Traumatic stress crisis

Question 10

What is the best nursing rationale for holding a debriefing session with clients and staff after clients have witnessed a peer being "taken-down" after a violent outburst?

Accepted Answer

A)  To reinforce unit rules with the client population
B)  To create protocols for the future release of tensions associated with anger
C)  To process feelings and concerns related to the witnessed intervention
D)  To discuss the client problems that led to inappropriate expressions of anger

Question 11

An involuntarily committed client, when offered a dinner tray, pushes it off the bedside table onto the floor. Which intervention should a nurse prioritize to address this behavior?

Accepted Answer

A)  Initiate forced medication protocol.
B)  Help the client to explore the source of anger.
C)  Ignore the act to avoid reinforcing the behavior.
D)  With staff support and a show of solidarity, set firm limits on the behavior.

Question 12

A despondent client who has recently lost her husband of 30 years tearfully states, "I'll feel a lot better if I sell my house and move away." Which nursing reply is most appropriate?

Accepted Answer

A)  "I'm confident you know what's best for you."
B)  "This may not be the best time for you to make such an important decision."
C)  "Your children will be terribly disappointed."
D)  "Tell me why you want to make this change."

Exam 13: Crisis Intervention