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A 25-year-old legal secretary is seeking counseling because she recently lost her job unexpectedly. Which question would be most appropriate for the nurse to use in assessing the patient?s response to losing her job?
- A. What happened to cause you to lose your job?
- B. How did you feel immediately after being told you no longer had a job?
- C. How do you expect yourself to be able to handle this situation?
- D. How have you responded to previous stressful situations?
Correct Answer: B
Rationale: Assessing the patient?s emotional response immediately after the job loss provides insight into the impact of the event and her coping mechanisms. Understanding her feelings helps evaluate the crisis?s severity. The other questions focus on causes, expectations, or past behavior, which are less directly tied to her current response.
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A Red Cross nurse is interviewing a woman whose house was totally destroyed during the night by a tornado; the woman?s pet poodle died as a result of the tornado. Which of following would the nurse most likely expect to hear from the woman?
- A. I don?t know. I can?t feel anything right now. Nothing seems real.
- B. Devastated. . . . I just feel totally devastated. I don?t know how I can go on living.
- C. I just want my insurance man to get here so I can file a claim. Everything I had is gone.
- D. I always thought my dog would die peacefully in my arms. Now I?ll never be able to hold her again.
Correct Answer: A
Rationale: After a traumatic event like a tornado, shock and dissociation are common, as reflected in the statement 'I can?t feel anything right now. Nothing seems real.' This indicates a crisis response. The other statements reflect grief (B, D) or practical concerns (C), which may occur later but are less immediate.
A nursing instructor who is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals?
- A. You should ask them to give you a brief medical history so their physical needs can be met.
- B. Focus on safety needs and provide simple, clear instructions to help them function effectively.
- C. Help them determine what their long-term goals will be so they can maintain a sense of hope.
- D. Try to redirect their attention away from the problems at hand so you can decrease their anxiety.
Correct Answer: B
Rationale: In a disaster, initial interventions prioritize safety and clear communication to help individuals function despite stress. Medical history (A), long-term goals (C), or redirection (D) are less immediate and may not address acute needs effectively.
A nursing instructor is describing uncomplicated grief to a class. Which of the following would the instructor most likely include in the discussion?
- A. Uncomplicated grief differs from normal grief because it lasts longer.
- B. Most bereaved persons experience uncomplicated grief.
- C. Uncomplicated grief is primarily loss associated with death.
- D. This type of grief is less painful and disruptive than normal grief.
Correct Answer: B
Rationale: Uncomplicated grief is the typical, adaptive response to loss experienced by most bereaved individuals, resolving naturally over time. It is not longer (A), not limited to death (C), and not less painful (D) than normal grief, as they are synonymous.
The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Assessment of which of the following would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?
- A. Tachycardia
- B. Profuse perspiration
- C. Unexplained gastrointestinal disturbance
- D. Tremors
Correct Answer: C
Rationale: Unexplained gastrointestinal disturbances can be a psychosomatic aftereffect of disaster-related stress, indicating lingering psychological impact. Tachycardia, perspiration, and tremors are more acute stress responses, less likely months later.
The nurse is assessing a 35-year-old woman who is seeking assistance at a local community counseling center. Which of the following statements made by the woman would indicate that she is experiencing a crisis?
- A. I?m so upset; my husband has never left me like this before.
- B. I?m confused and hurt; I have lost my best friend and my lover.
- C. I don?t understand; I can?t seem to function like I usually do.
- D. No matter what I do, I am still overcome by these sad feelings.
Correct Answer: C
Rationale: A crisis is characterized by an inability to function as usual due to overwhelming stress. The statement 'I can?t seem to function like I usually do' directly indicates impaired functioning, a hallmark of a crisis. The other statements reflect emotional distress but do not explicitly highlight functional impairment.