Nokea
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.
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An adult tells the nurse, 'I can't take anymore! My mother passed away, my husband lost his job and yesterday my daughter told me she's quitting college and moving in with her boyfriend.' What is the priority nursing diagnosis?
- A. Fear, related to impending breast surgery
- B. Deficient knowledge, related to breast lesion
- C. Ine efectiva coping, related to perceived loss of daughter
- D. Impaired verbal communication, related to spousal estrangement
Correct Answer: C
Rationale: This nursing diagnosis reflects the precipitating event (daughter's actions) causing the crisis. Other options are not supported by the data provided.
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 and moving in with her boyfriend.' Which issue should be the focus for crisis intervention?
- A. Possible mastectomy
- B. Disordered family communication
- C. Effects of the divorce
- D. Coping with the reaction to the daughter's events
Correct Answer: D
Rationale: The focus of crisis intervention is on the most recent problem?'the straw that broke the camel's back.' The daughter's decision is the immediate precipitating event causing disequilibrium.
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 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.
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.