Nokea
A patient?s 5-year-old poodle ran in front of a car and was killed. The patient continues to be upset by her pet?s death, and she explains to a community counseling center nurse that she can?t stop crying because, 'My Precious meant the world to me, and now my world will never be the same!' If the nurse were to determine that the patient was experiencing a crisis, which of the following types of crisis would it most likely be?
- A. Maturational
- B. Situational
- C. Traumatic
- D. Developmental
Correct Answer: B
Rationale: A situational crisis arises from an external event, such as the sudden loss of a pet. The patient?s intense grief and sense of a changed world suggest a situational crisis triggered by the pet?s death. Maturational and developmental crises relate to life transitions, and traumatic crises involve life-threatening events, which do not apply here.
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As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first?
- A. Problem stimulating usual problem solving
- B. Trial and error attempts to alleviate problem
- C. Automatic relief behaviors take over
- D. Serious personality disorganization
Correct Answer: A
Rationale: The first phase of a crisis involves the individual attempting to use usual problem-solving methods to address the stressor. If ineffective, it progresses to trial-and-error (B), relief behaviors (C), and potentially disorganization (D).
A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with his situation and how much support he needs, which question would be most appropriate for the nurse to ask?
- A. What kind of help do you need from us?
- B. What are your thoughts about what you will do during the next few days?
- C. How are you feeling about all that you have gone through?
- D. Are you feeling guilty because you survived and some of your neighbors did not?
Correct Answer: B
Rationale: Asking about the victim?s thoughts on next steps assesses their cognitive coping and planning ability, indicating their level of functioning and support needs. The other questions focus on practical needs (A), emotions (C), or specific guilt (D), which are less directly tied to cognitive coping.
A nurse is working as part of a community disaster response team. When responding to a community disaster, the nurse integrates understanding of individuals? responses, anticipating which of the following?
- A. People can become aggressive and violent when their basic needs are threatened.
- B. People involved in the disaster will always put the welfare of others before their own.
- C. Losses incurred during the disaster have little, if any, long-term effect on victims.
- D. The psychological distress associated with disasters is felt immediately.
Correct Answer: A
Rationale: Disasters can threaten basic needs, leading to stress responses like aggression or violence. Altruism (B) is not universal, long-term effects are common (C), and psychological distress may be delayed (D), making A the most accurate anticipation.
A 62-year-old man experienced the loss of his 87-year-old father a week ago. The hospice nurse is making a follow-up visit to determine how he is handling his father?s death. Which of the following statements made indicates to the hospice nurse that patient is in the acute mourning stage of bereavement?
- A. I keep thinking about my father; I have trouble believing he?s dead. I feel guilty because I didn?t go to the nursing home to visit him last week!
- B. I?ve been grieving my father; losing him is a tremendous loss, but I have to get on with my life.
- C. My father was a saint. I am so angry at God for taking him away! I?m crying all the time; I haven?t been able to work for days.
- D. I?m going to spend the weekend with my children; they understand what I?ve been going through, and I can relax around them.
Correct Answer: C
Rationale: The acute mourning stage involves intense emotional reactions such as anger, crying, and inability to work, as seen in the statement about anger at God and persistent crying. The other statements reflect denial/guilt (A), acceptance (B), or coping (D), which align with different stages of grief.
A nurse is working with a patient who is in crisis. Which of the following would be least appropriate for the nurse to do?
- A. Support the patient?s cultural beliefs about expressing feelings.
- B. Encourage the patient to focus on one aspect at a time.
- C. Provide the patient with an understanding that everything will be okay.
- D. Explain information clearly to clarify any misconceptions or myths.
Correct Answer: C
Rationale: Promising that 'everything will be okay' is inappropriate as it may dismiss the patient?s reality and undermine trust. Supporting cultural beliefs (A), focusing on one aspect (B), and clarifying information (D) are therapeutic interventions.