Chapter 10: Intervening in Crises

Chapter 10: Intervening in Crises

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A new mother is concerned about her ability to perform her parental role. She is quite anxious and ambivalent about leaving the postpartum unit. To offer effective client care, a nurse should be familiar with what information about this type of crisis?

1.	This type of crisis is precipitated by unexpected external stressors.
2.	This type of crisis is precipitated by preexisting psychopathology.
3.	This type of crisis is precipitated by an acute response to an external situational stressor.
4.	This type of crisis is precipitated by normal life-cycle transitions that overwhelm the client.

 

 

____     2.   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?

1.	Maturational/developmental crisis
2.	Psychiatric emergency crisis
3.	Anticipated life transition crisis
4.	Traumatic stress crisis

 

 

____     3.   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 long-term outcome is realistic in addressing this client’s crisis?

1.	The client will change his type-A personality traits to more adaptive ones by one week.
2.	The client will list five positive self-attributes.
3.	The client will examine how childhood events led to his overachieving orientation.
4.	The client will return to previous adaptive levels of functioning by week six.

 

 

____     4.   A high school student has learned that she cannot graduate. Her boyfriend will be attending a college out of state that she planned to attend. She is admitted to a psychiatric unit after overdosing on Tylenol. Which is the priority nursing diagnosis for this client?

1.	Ineffective coping R/T situational crisis AEB powerlessness
2.	Anxiety R/T fear of failure
3.	Risk for self-directed violence R/T hopelessness
4.	Risk for low self-esteem R/T loss events AEB suicidal ideations

 

 

____     5.   After threatening to jump off of a bridge, a client is brought to an emergency department by police. To assess for suicide potential, which question should a nurse ask first?

1.	“Are you currently thinking about harming yourself?”
2.	“Why do you want to harm yourself?”
3.	“Have you thought about the consequences of your actions?”
4.	“Who is your emergency contact person?”

 

MULTIPLE CHOICE

 

1. ANS:  4

Chapter: Chapter 10, Crisis Intervention

Objective: Identify types of crisis that occur in people’s lives.

Page: 196

Heading: Types of Crises > Class 2: Crises of Anticipated Life Transitions

Integrated Processes: Teaching and Learning

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	This type of stress is not caused by unexpected external stressors.
2	This type of stress is not caused by preexisting psychopathology.
3	This type of stress is not caused by an acute response to an external situational stressor.
4	The nurse should understand that this type of crisis is precipitated by normal life-cycle transitions that overwhelm the client. Reassurance and guidance should be provided as needed, and the client should be referred to services that can provide assistance.

 

 

PTS:   1                    CON:  Health Promotion

 

2. ANS:  2

Chapter: Chapter 10, Crisis Intervention

Objective: Identify types of crisis that occur in people’s lives.

Page: 197

Heading: Types of Crises > Class 6: Psychiatric Emergencies

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	The client is not experiencing a maturational/developmental crisis.
2	The nurse should determine that the client is experiencing a psychiatric emergency crisis. Psychiatric emergencies occur when crisis situations result in severe impairment, incompetence, or an inability to assume personal responsibility.
3	The client is not experiencing an anticipated life transition crisis.
4	The client is not experiencing a traumatic stress crisis.

 

 

PTS:   1                    CON:  Health Promotion

 

3. ANS:  4

Chapter: Chapter 10, Crisis Intervention

Objective: Describe the steps in crisis intervention.

Page: 197

Heading: Types of Crises > Class 5: Crisis Reflecting Psychopathology

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	Changing his type-A personality traits to more adaptive ones by one week may be unrealistic for this client.
2	Listing five positive self-attributes may not be realistic for this client.
3	Examining childhood events may not be realistic for this client.
4	The nurse should identify that a realistic long-term outcome for this client is to return to previous adaptive levels of functioning. The nurse should work with the client to develop attainable outcomes that reflect immediacy of the situation.

 

 

PTS:   1                    CON:  Health Promotion

 

4. ANS:  3

Chapter: Chapter 10, Crisis Intervention

Objective: Describe the steps in crisis intervention.

Page: 201–202

Heading: Table 10-1. Nursing Diagnosis: Risk for Self-directed or Other Directed Violence

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	Ineffective coping R/T situational crisis AEB powerlessness is inappropriate because safety is a priority.
2	Anxiety R/T fear of failure is inappropriate because safety is a priority.
3	The priority nursing diagnosis for this client is risk for self-directed violence R/T hopelessness. Nurses should prioritize diagnoses and outcomes based on potential safety risk to the client or others.
4	Risk for low self-esteem R/T loss events AEB suicidal ideations is inappropriate because safety is a priority.

 

 

PTS:   1                    CON:  Health Promotion

 

5. ANS:  1

Chapter: Chapter 10, Crisis Intervention

Objective: Identify the role of the nurse in crisis intervention.

Page: 203

Heading: Phases of Crises Intervention: The Role of the Nurse > Phase 1: Assessment

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Health Promotion

Difficulty: Moderate

 

	Feedback
1	The nurse should first assess the client for current harmful or suicidal thoughts to minimize risk of harm to the client and provide appropriate interventions. A suicidal client is experiencing a psychiatric emergency. The crisis team’s priority is to assess client safety.
2	This question is important after the immediate risk of harm has been ruled out.
3	This question should be addressed after the client is safe.
4	The client’s safety should be assessed prior to asking this question.

 

 

PTS:     1          CON:   Health Promotion