Chapter 20: Crisis and Mass Disaster

Essentials of Psychiatric Mental Health Nursing ,2nd Edition by Elizabeth M. Varcarolis

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Chapter 20: Crisis and Mass Disaster

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. A patient comes to the clinic with superficial cuts on the left wrist. The patient paces around the room sobbing but cringes when approached and responds to questions with only shrugs or monosyllables. Select the nurse’s best initial statement 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 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 the use of inner resources. The nurse offers therapeutic presence, which provides caring, ongoing observation relative to the patient’s safety, and interpersonal reassurance.

 

DIF:    Cognitive Level: Application           REF:   Page: 391|Page: 394

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

  1. A patient comes to the clinic with superficial cuts on the left wrist. The patient is pacing and sobbing. After a few minutes with the nurse, the patient is calmer. What should the nurse ask to determine the patient’s perception of the precipitating event?
a. “Tell me why you were crying.”
b. “How did your wrist 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 the assessment of the precipitating event. Asking “why” questions is a poor communication technique.

 

DIF:    Cognitive Level: Application           REF:   Page: 391|Page: 394

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

  1. 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.
b. anxious and fearful.
c. misperceiving reality.
d. potentially homicidal.

 

 

ANS:  B

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

 

DIF:    Cognitive Level: Analysis                REF:   Pages: 390-393

TOP:   Nursing Process: Diagnosis| Nursing Process: Analysis

MSC:  NCLEX: Psychosocial Integrity

 

  1. An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The patient told the parents about the uncle’s behavior, but the parents did not believe the adolescent. What type of crisis exists?
a. Maturational
b. Adventitious
c. Situational
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.

 

DIF:    Cognitive Level: Application           REF:   Pages: 389-390

TOP:   Nursing Process: Diagnosis| Nursing Process: Analysis

MSC:  NCLEX: Psychosocial Integrity

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