Nokea
The nurse is assessing a 35-year-old woman who is seeking assistance at a local community counseling center. Which of the following statements made by the woman would indicate that she is experiencing a crisis?
- A. I?m so upset; my husband has never left me like this before.
- B. I?m confused and hurt; I have lost my best friend and my lover.
- C. I don?t understand; I can?t seem to function like I usually do.
- D. No matter what I do, I am still overcome by these sad feelings.
Correct Answer: C
Rationale: A crisis is characterized by an inability to function as usual due to overwhelming stress. The statement 'I can?t seem to function like I usually do' directly indicates impaired functioning, a hallmark of a crisis. The other statements reflect emotional distress but do not explicitly highlight functional impairment.
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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.
Assessment of a patient indicates complicated grief. Which statements would the nurse identify as supporting this reaction? Select all that apply.
- A. It?s been 2 months, and I still want my son back.
- B. I still wait for him to come right through the door every day.
- C. I?m really struggling with trusting anybody anymore.
- D. I wish I could go back to the days before he died.
- E. Life seems so empty now that he?s gone. What will I do?
Correct Answer: A,B,C,D,E
Rationale: Complicated grief involves persistent, intense symptoms such as longing (A), denial of the loss (B), trust issues (C), yearning for the past (D), and feelings of emptiness (E), indicating difficulty moving forward.
The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Assessment of which of the following would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?
- A. Tachycardia
- B. Profuse perspiration
- C. Unexplained gastrointestinal disturbance
- D. Tremors
Correct Answer: C
Rationale: Unexplained gastrointestinal disturbances can be a psychosomatic aftereffect of disaster-related stress, indicating lingering psychological impact. Tachycardia, perspiration, and tremors are more acute stress responses, less likely months later.
After teaching a group of nursing students about crisis, the instructor determines that the teaching was successful when the students state which of the following?
- A. Crisis triggers maladaptive responses.
- B. Crisis is a time-limited event.
- C. Chronic crisis is a real situation.
- D. Events causing a crisis are similar for everyone.
Correct Answer: B
Rationale: A crisis is a time-limited event, typically resolving within weeks as individuals adapt or receive support. Crises do not always trigger maladaptive responses (A), chronic crisis is not a standard term (C), and events vary by individual (D).
An individual is seeking employment as a nurse in a crisis center. The interviewer asks the person what he would ask someone who called the crisis hotline to determine whether the caller was experiencing a crisis. Which response would be most appropriate?
- A. To what extent are you involved in a crisis situation?
- B. Tell me about what you are experiencing and what it means to you.
- C. How would you rate your level of functioning on a scale from 1 to 10?
- D. Why do you think you are in a crisis situation?
Correct Answer: B
Rationale: Asking the caller to describe their experience and its meaning allows the nurse to assess the emotional and functional impact, key indicators of a crisis. This open-ended question encourages detailed responses. The other options are too vague (A), quantitative (C), or assume a crisis (D), which may limit the assessment.