Nokea
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.
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A nursing instructor who is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals?
- A. You should ask them to give you a brief medical history so their physical needs can be met.
- B. Focus on safety needs and provide simple, clear instructions to help them function effectively.
- C. Help them determine what their long-term goals will be so they can maintain a sense of hope.
- D. Try to redirect their attention away from the problems at hand so you can decrease their anxiety.
Correct Answer: B
Rationale: In a disaster, initial interventions prioritize safety and clear communication to help individuals function despite stress. Medical history (A), long-term goals (C), or redirection (D) are less immediate and may not address acute needs effectively.
A patient?s 5-year-old poodle ran in front of a car and was killed. The patient continues to be upset by her pet?s death, and she explains to a community counseling center nurse that she can?t stop crying because, 'My Precious meant the world to me, and now my world will never be the same!' If the nurse were to determine that the patient was experiencing a crisis, which of the following types of crisis would it most likely be?
- A. Maturational
- B. Situational
- C. Traumatic
- D. Developmental
Correct Answer: B
Rationale: A situational crisis arises from an external event, such as the sudden loss of a pet. The patient?s intense grief and sense of a changed world suggest a situational crisis triggered by the pet?s death. Maturational and developmental crises relate to life transitions, and traumatic crises involve life-threatening events, which do not apply here.
A family has just lost their home in a fire. An on-call nurse from a community counseling center has been called in to the emergency department to help them with this traumatic event. Which of the following would the nurse identify as the priority for this family?
- A. Arranging for follow-up therapy to deal with the crisis
- B. Completing a family genogram to determine family patterns
- C. Assessing the impact of the loss on their lifestyle
- D. Arranging for emergency shelter and food supplies
Correct Answer: D
Rationale: The priority in a crisis is addressing immediate safety needs, such as shelter and food, per Maslow?s hierarchy. These basic needs must be met before addressing therapy (A), family patterns (B), or lifestyle impact (C), which are secondary concerns.
As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which of the following would the nurse identify as occurring first?
- A. Problem stimulating usual problem solving
- B. Trial and error attempts to alleviate problem
- C. Automatic relief behaviors take over
- D. Serious personality disorganization
Correct Answer: A
Rationale: The first phase of a crisis involves the individual attempting to use usual problem-solving methods to address the stressor. If ineffective, it progresses to trial-and-error (B), relief behaviors (C), and potentially disorganization (D).
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.