Questions and Answers
What is the principle most useful to a nurse planning crisis intervention for any patient?
The patient is experiencing a state of disequilibrium.
Select the most appropriate question for a nurse to assess a patient's situational support.
Which nursing diagnosis applies to a patient who lost a job and expresses uncertainty about the future?
What should occur after police arrest the shooter in a school shooting incident?
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Which analysis applies when a patient expresses gratitude and the nurse suggests two more sessions?
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Which health care worker should be referred for critical incident stress debriefing?
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Which assessment findings would be expected from a driver involved in a serious automobile accident?
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Which aspects of disaster management have nurses fulfilled after a category 5 hurricane?
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Choose the nurse's best initial comment to a patient sobbing and cringing after an unexpected job termination.
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What should the nurse ask to determine the patient's perception of the precipitating event after superficial cuts on both wrists?
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If a patient states, 'I'm in a terrible situation. I don't know what to do,' what can the triage nurse initially assume?
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What type of crisis exists when an adolescent reports sexual abuse by an uncle and is not believed by their parents?
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While conducting an initial interview with a patient in crisis, the nurse should:
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What is the nurse's highest priority response to an adult who expresses anger about a spouse's murder?
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Which type of crisis is a woman experiencing after a prophylactic double mastectomy and discovering her husband’s affair?
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What is the nurse's priority assessment regarding a woman troubled by multiple personal issues?
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If a woman's family cannot provide sufficient support, what should the nurse do?
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Which issue should the nurse focus on during crisis intervention for a woman facing multiple stressful events?
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What is the usual duration of crisis intervention?
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What is the priority nursing diagnosis for a professor falsely accused of sexual intimidation?
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Which communication technique is used more in crisis intervention than traditional counseling?
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Which scenario demonstrates the use of primary care related to crisis intervention?
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What is the focus of crisis intervention strategies for a victim of spousal violence?
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After celebrating her fortieth birthday, an individual is concerned about her appearance. What type of crisis has occurred?
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Which situation is an example of an adventitious crisis?
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Which agency provides coordination in the event of a terrorist attack?
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During the initial interview, what comment should the nurse use to assess personal coping skills for a patient upset over divorce papers?
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What will the successful resolution of an individual's crisis most closely relate to regarding the placement of a parent in a nursing facility?
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Study Notes
Crisis Intervention Basics
- Crisis intervention aims to provide immediate support and strategies to reestablish equilibrium and safety.
- Two key components: ensuring individual safety and employing anxiety-reduction techniques.
- Therapeutic presence from the nurse is crucial for reassurance and safety.
Patient Assessment
- Assessing recent events is vital to understand the precipitating factors for a patient's crisis.
- "What was happening just before you started to feel this way?" effectively identifies recent stressors.
- Nurses should communicate using concise sentences to aid understanding during high anxiety.
Types of Crises
- Adventitious Crisis: Unplanned events like natural disasters or violence. Example: sexual abuse cases.
- Situational Crisis: Arises from external circumstances affecting self-image, such as job loss or divorce.
- Maturational Crisis: Occurs at transitional life stages (e.g., aging).
- Adventitious crises are distinct from situational as they arise unexpectedly outside daily life.
Prioritizing Nursing Interventions
- Focus on immediate threats to safety, such as assessing suicidal thoughts in distressed individuals.
- Understanding the patient’s historical coping strategies can inform intervention approaches.
- Short-term strategies are prioritized to restore balance rather than long-term resolutions.
Duration of Crisis Intervention
- Typical duration for crisis interventions ranges from 4 to 8 weeks for effective resolution.
- If symptoms persist beyond this, the individual may develop maladaptive coping strategies.
Communication in Crisis
- Use active listening and support; the phrase “How can I help you feel more comfortable?” may not probe deeply enough.
- Prioritize questions that assess coping skills, like asking about past experiences with stress.
Accessing Support Systems
- Evaluate the presence of situational supports; absence of support from the immediate family may not indicate a lack of available alternatives.
- Nurses should encourage exploration of available community resources.
Special Considerations
- In suspected cases of violence or abuse, fostering emotional security is paramount for recovery.
- Crisis resolutions often require addressing self-concept concerns, particularly for caregivers faced with role changes.
Example of Scenario Planning
- For individuals facing life-altering stress (e.g., illness or family issues), the nurse’s focus should typically be on the most recent crisis trigger as it may be the tipping point in their distress.
Summary of Nursing Roles
- Nurses in crisis settings often take on active roles to guide patients rather than adopting a passive, traditional counseling approach.
- Primary care interventions aim to foster mental health through education and proactive support.
Agencies and Systems
- National Incident Management System (NIMS) coordinates responses to widespread crises like terrorist attacks or natural disasters.### Hopelessness and Powerlessness
- Powerlessness is characterized by a lack of control over life events, distinct from hopelessness and low self-esteem.
- Thought processes of the patient are currently unaffected.
School Shooting Incident
- A school cafeteria shooting resulted in three fatalities and numerous injuries.
- Parent anxiety necessitated organization for student reunification after police secured the scene.
- Designating alphabetized zones for student-parent reunification is critical for efficient management and reducing chaos.
Crisis Intervention and Patient Support
- A patient's statement of emerging stronger indicates progress, yet the nurse's suggestion for additional sessions may reflect reluctance to conclude support.
- Crisis intervention focuses primarily on the precipitating issue, not extended therapy.
Critical Incident Stress Debriefing
- A health care worker at a critical care unit information desk is most suitable for referral due to extended exposure to traumatic contexts.
- Emergency Medical Technicians (EMTs) involved in severe incidents, such as vehicle bombings, are also at heightened risk and require immediate attention post-crisis.
Post-Accident Assessment
- Immediate post-accident assessments should include signs of shock or anxiety, identified by rapid speech, trembling, and difficulty with simple tasks like using a cell phone.
- Long-term memory loss and fecal incontinence are not expected acute responses.
Disaster Management Phases
- Activities carried out by nurses after a catastrophic event, such as a hurricane, relate to mitigation (limiting disaster impact) and response (execution of emergency plans).
- Preparedness refers to pre-disaster planning, while recovery and evaluation phases pertain to post-disaster stability and future planning improvements.
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Description
This quiz covers the essentials of crisis intervention, emphasizing immediate support and safety strategies. It highlights the importance of patient assessment and the various types of crises that individuals may encounter. Improve your understanding of how to effectively manage crises in a nursing context.
