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A woman says, 'I can't take anymore, and I have no children or husband to turn to! This last year has been one crisis after another.' If this person's immediate family is unable to provide sufficient situational support, what should the nurse do?
- A. Suggest hospitalization for a short period.
- B. Ask what other relatives or friends are available for support.
- C. Tell the patient, 'You must be strong. Don't let this crisis overwhelm you.'
- D. Foster insight by relating the present situation to earlier situations involving loss.
Correct Answer: B
Rationale: The assessment of situational supports should continue. Exploring other potential supports is appropriate before considering hospitalization. Advice and psychotherapy are not suitable for crisis intervention.
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Which agency provides coordination in the event of a terrorist attack?
- A. U.S. Food and Drug Administration (FDA)
- B. Environmental Protection Agency (EPA)
- C. National Incident Management System (NIMS)
- D. Federal Emergency Management Agency (FEMA)
Correct Answer: C
Rationale: NIMS provides a systematic approach to coordinate disaster response across various agencies and organizations.
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.
An adult comes to the crisis clinic after being terminated from a job of 15 years. The patient says, 'I don't know what to do. How can I get another job? Who will pay the bills? How will I feed my family?' Which nursing diagnosis applies?
- A. Hopelessness
- B. Powerlessness
- C. Chronic low self-esteem
- D. Disturbed thought processes
Correct Answer: B
Rationale: The patient's statements reflect a lack of control over life events, indicating powerlessness. Other diagnoses are not supported by the data.
A nurse assesses an adult experiencing a crisis. What question asked by the nurse will best determine situational support?
- A. Has anything upsetting occurred in the past few days?
- B. Who can be helpful to you during this time?
- C. How does this problem affect your life?
- D. What led you to seek help at this time?
Correct Answer: B
Rationale: This question directly assesses available situational support, critical for crisis intervention planning.
Which health care worker should be referred to critical incident stress debriefing?
- A. Nurse who works at an oncology clinic where patients receive chemotherapy.
- B. Case manager whose patients are seriously mentally ill and are being cared for at home.
- C. Health care employee who worked 8 hours at the information desk of intensive care unit.
- D. Emergency medical technician who treated victims of a car bombing at a department store.
Correct Answer: D
Rationale: The EMT experienced an adventitious crisis (bombing), warranting critical incident stress debriefing due to the traumatic nature of the event.