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During the initial interview at the crisis center, a patient says, 'I've been served with divorce papers. I'm so upset and anxious that I can't think clearly.' What could the nurse say to assess personal coping skills?
- A. What would you like us to do to help you feel more relaxed?
- B. In the past, how did you handle difficult or stressful situations?
- C. Do you think you deserve to have things like this happen to you?
- D. I can see you are upset. You can rely on us to help you feel better.
Correct Answer: B
Rationale: This question directly assesses the patient's past coping strategies, which is key to understanding their ability to manage the current crisis.
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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 driving home after work comes upon a serious automobile accident. The driver gets out of the car with no apparent physical injuries. Which assessment findings would be expected from the driver immediately after this event? (Select all that apply.)
- A. Difficulty using a cell phone
- B. Long-term memory losses
- C. Fecal incontinence
- D. Rapid speech
- E. Trembling
Correct Answer: A,D,E
Rationale: Immediate responses to a crisis include shock, confusion, difficulty with decision-making, and physical symptoms like trembling and rapid speech. Incontinence and long-term memory loss are not typical immediate responses.
An adolescent comes to the crisis clinic and reports sexual abuse by an uncle. The patient told the parents about the uncle's behavior, but the parents did not believe the adolescent. What type of crisis exists?
- A. Maturational
- B. Adventitious
- C. Situational
- D. Organic
Correct Answer: B
Rationale: An adventitious crisis is a crisis of disaster that is not a part of everyday life; it is unplanned or accidental. Adventitious crises include natural disasters, national disasters, and crimes of violence. Sexual molestation falls within this classification.
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.
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.