Nokea
A patient visiting the crisis clinic for the first time asks, 'How long will I be coming here?' The nurse's reply should consider that the usual duration of crisis intervention is how long in weeks?
- A. 1 to 2
- B. 3 to 4
- C. 4 to 6
- D. 6 to 12
Correct Answer: C
Rationale: The disorganization associated with crisis is so distressing that it usually cannot be tolerated for more than 4 to 6 weeks.
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After celebrating a 40th birthday, an individual becomes concerned with the loss of youthful appearance. What type of crisis has occurred?
- A. Reactive
- B. Situational
- C. Maturational
- D. Adventitious
Correct Answer: C
Rationale: Maturational crises occur at new developmental stages when old coping styles become ineffective. This scenario reflects such a crisis.
At the last contracted visit in the crisis intervention clinic, an adult says, 'I've emerged from this a stronger person. You helped me feel like my life is back in balance.' The nurse responds, 'I think it would be worthwhile to have two more sessions to explore why your reactions were so intense.' Which analysis applies?
- A. The patient is experiencing transference.
- B. The patient demonstrates a need for continuing support.
- C. The nurse is having difficulty terminating the relationship.
- D. The nurse is empathizing with the patient's feelings of dependency.
Correct Answer: C
Rationale: The nurse's suggestion to continue sessions beyond the crisis focus indicates difficulty terminating the relationship.
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 feeling this way?
Correct Answer: D
Rationale: 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 are a nontherapeutic communication technique.
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. What is 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 am 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.
Correct Answer: B
Rationale: 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. The incorrect responses use nontherapeutic techniques, including false reassurance and giving advice.
Which scenario is an example of an adventitious crisis?
- A. Death of a child from sudden infant death syndrome
- B. Being fired from a job because of company downsizing
- C. Retirement of a 55 year old
- D. A riot at a rock concert
Correct Answer: D
Rationale: An adventitious crisis is unplanned and violent, like a riot. Other options represent situational or maturational crises.