Chapter 26: Crisis and Disaster

Chapter 26: Crisis and Disaster

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient comes to the crisis clinic after an unexpected job termination. The patient paces around the room sobbing, cringes when approached, and responds to questions with only shrugs or monosyllables. Choose the nurse’s best initial comment 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 and pacing so we can talk about your problems.”
d.	“Let’s set some guidelines and goals for your visit here.”

 

 

ANS:  B

A crisis exists for this patient.  The two primary thrusts of crisis intervention are to provide for the safety of the individual and use anxiety-reduction techniques to facilitate use of inner resources. The nurse offers therapeutic presence, which provides caring, ongoing observation relative to the patient’s safety, and interpersonal reassurance.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 505-507 (Table 26-4) and (Box 26-2) | Page 510-512 (Nursing Care Plan 26-1)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Psychosocial Integrity

 

2. A patient being seen in the clinic for superficial cuts on both wrists is pacing and sobbing.  After a few minutes, the patient is calmer. The nurse attempts to determine the patient’s perception of the precipitating event by asking:

a.	“Tell me why you were crying.”
b.	“How did your wrists get injured?”
c.	“How can I help you feel more comfortable?”
d.	“What was happening just before you started to feel this way?”

 

 

ANS:  D

A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits assessment of the precipitating event.  “Why” questions are non-therapeutic.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 501-502                                  TOP:   Nursing Process: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

3. 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.	c.	misperceiving reality.
b.	anxious and fearful.	d.	potentially homicidal.

 

 

ANS:  B

Individuals in crisis are universally anxious. They are often frightened and may be mildly confused. Perceptions are often narrowed with anxiety.

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 499 | Page 502 | Page 505-506 (Table 26-2)

TOP:   Nursing Process: Diagnosis/Analysis

MSC:  Client Needs: Psychosocial Integrity

 

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

a.	Maturational	c.	Situational
b.	Adventitious	d.	Organic

 

 

ANS:  B

An adventitious crisis is a crisis of disaster that is not a part of everyday life. It is unplanned or accidental. Adventitious crises include natural disasters, national disasters, and crimes of violence. Sexual molestation falls within this classification. Maturational crisis occurs as an individual arrives at a new stage of development, when old coping styles may be ineffective. Situational crisis arises from an external source such as a job loss, divorce, or other loss affecting self-concept or self-esteem. “Organic” is not a type of crisis.

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 500-502                                  TOP:   Nursing Process: Assessment

MSC:  Client Needs: Psychosocial Integrity

 

5. 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.

 

 

ANS:  A

Severe anxiety narrows perceptions and concentration.  By speaking in short concise sentences, the nurse enables the patient to grasp what is being said. Conveying urgency will increase the patient’s anxiety. Letting the patient know who controls the interview or stating that time is limited is non-therapeutic.

 

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 506 (Table 26-3) | Page 507 (Box 26-2) | Page 510-512 (Nursing Care Plan 26-1)

TOP:   Nursing Process: Implementation     MSC:  Client Needs: Psychosocial Integrity