Which situation demonstrates the use of primary care related to crisis intervention?
- A. Implementing suicide precautions for a patient with depression
- B. Teaching stress-reduction techniques to a beginning student nurse
- C. Assessing coping strategies used by a patient who has attempted suicide
- D. Referring a patient with schizophrenia to a partial hospitalization program
Correct Answer: B
Rationale: Primary crisis intervention promotes mental health and reduces mental illness, such as teaching stress-reduction techniques. Other options are secondary or tertiary interventions.
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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 troubled adolescent opened fire in a high school cafeteria, fatally shooting three people and injuring many others. Hundreds of parents come to the high school after hearing the news reports. After the police arrest the shooter, which action should occur next?
- A. Ask the police to encircle the school campus with yellow tape to prevent parents from entering.
- B. Announce over the loudspeakers, 'The campus is now secure. Please return to your classrooms.'
- C. Require parents to pass through metal detectors and then allow them to look for their children in the school.
- D. Designate zones according to the alphabet, and direct students to the zones based on their surnames to facilitate reuniting them with their parents.
Correct Answer: D
Rationale: Organizing reunification by alphabetized zones is a practical solution to manage chaos and reunite families efficiently.
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.
A patient comes to the clinic with superficial cuts on the left wrist. The patient is pacing and sobbing. After a few minutes with the nurse, the patient is calmer. What should the nurse ask to determine the patient's perception of the precipitating event?
- A. Tell me why you were crying.
- B. How did your wrist get injured?
- C. How can I help you feel more comfortable?
- D. What was happening just before you started feeling this way?
Correct Answer: D
Rationale: A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits the assessment of the precipitating event. Asking 'why' questions are a nontherapeutic communication technique.
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.
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