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A woman says, 'I can't take anymore! Last year my husband was diagnosed with cancer. Three months ago, I lost my job. Yesterday my daughter said she's quitting college.' What is the nurse's priority assessment?
- A. Identifying measures useful to help improve the couple's communication
- B. Discussing the patient's feelings about the possibility of having a mastectomy
- C. Determining whether the husband is still engaged in an extramarital affair
- D. Clarifying what the patient means by 'I can't take it anymore!'
Correct Answer: D
Rationale: During crisis intervention, the priority concern is patient safety. This question helps assess personal coping skills, focusing on the most immediate stressor causing disequilibrium.
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An adult seeks counseling after the spouse is murdered. The adult angrily says, 'I hate the monster that did this. It has ruined my life. During the trial, I don't know what I'll do if the jury doesn't return a guilty verdict.' What is the nurse's highest priority question?
- A. What do you mean when you say 'monster'?
- B. What resources do you need to help you cope with this situation?
- C. Would you consider hurting yourself or the person on trial?
- D. Are you having thoughts of hurting yourself or others?
Correct Answer: D
Rationale: The highest nursing priority is safety. The nurse should assess suicidal and homicidal potentials. The incorrect options may be important but not the highest priority.
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.
After completing the contracted number of visits to the crisis clinic, an adult says, 'I've emerged from this as a stronger person. You supported me while I worked through my feelings of loss and helped me find community resources. I'm benefiting from a support group.' The nurse can evaluate the patient's feelings about the care received as what?
- A. Marginally satisfied
- B. Somewhat satisfied
- C. Moderately satisfied
- D. Very satisfied
Correct Answer: D
Rationale: The patient's positive statements about strength, support, and resources indicate a high level of satisfaction.
Which patient statement best suggests they have returned to a pre-crisis level of functioning?
- A. My boss told me I am doing well and up for a promotion.
- B. I understand that bad things can happen to really good people.
- C. Going to my support group regularly has made a big difference.
- D. I'm much more comfortable asking for help than before my divorce.
Correct Answer: A
Rationale: Resolution of a crisis can result in a return to pre-crisis functioning, or a higher or lower level of functioning. The goal of crisis intervention is a return to at least pre-crisis functioning level. A good job performance evaluation is suggestive of pre-crisis functioning.
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.