Chapter 22 Crisis

Chapter 22  Crisis

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1) A client, aged 16 years, comes to the crisis clinic with several superficial cuts on her left wrist. She paces around the room and cries with convulsive sobs. She cowers when approached and responds to the nurse’s questions with shrugs or monosyllables. The nurse assigned to assess the client should first say
A.
“I can see you are feeling anxious. I am going to stay and talk with you to help you feel better.”
B.
“Everything is going to be all right. You are here at the clinic and the staff will keep you safe.”
C.
“You need to try to stop crying so I can ask you some very important questions.”
D.
“Let’s set some guidelines and goals for your visit here.”

ANS: A
The two primary thrusts of crisis intervention are to provide for the safety of the individual and use anxiety-reduction techniques so that inner resources can be used. The nurse offers her presence, which provides caring, ongoing observation relative to the client’s safety, and gives interpersonal reassurance.

DIF: Cognitive Level: Application REF: Text Page: 463, Text Page: 464
TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

2) A client, aged 16 years, comes to the crisis clinic with several superficial cuts on her left wrist. She paces around the room and cries with convulsive sobs. She cowers when approached and responds to the nurse’s questions with shrugs or monosyllables. After a few minutes spent with the nurse, the client is slightly calmer. To assess the client’s perception of the precipitating event, the nurse should ask
A.
“Why are you crying?”
B.
“Why did you injure your wrist?”
C.
“How can I help you feel more comfortable?”
D.
“What was happening just before you started to feel this way?”

ANS: D
A clear definition of the immediate problem provides the best opportunity to find a solution. Asking about recent upsetting events permits assessment of the precipitating event. Options A and B use a poor communication technique, asking a “why” question. Option C asks the client to make a decision that should be made by the nurse after assessment is completed.

DIF: Cognitive Level: Application REF: Text Page: 460
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

3) A client, aged 16 years, comes to the crisis clinic with several superficial cuts on her left wrist. She paces around the room and cries with convulsive sobs. She cowers when approached and responds to the nurse’s questions with shrugs or monosyllables. The nurse states “You are behaving like a very sick person. I wonder why.” The client begins to cry and replies “I am at the end of my rope. I need help. My uncle keeps trying to molest me. My mother says I am lying about it. I read about mental illness in a book, and thought I could get help if I behaved that way.” The best rationale for identifying this situation as a crisis for the client is that the client
A.
has identified it as a stressful event.
B.
is attempting to cope with an event having a pathological outcome.
C.
is manifesting a state of disequilibrium related to failure of usual coping mechanisms.
D.
is demonstrating a permanent change in coping ability, resulting in a lower level of adaptation.

ANS: C
A crisis occurs when a stressful event overtaxes the individual’s usual ability to cope and the individual enters a state of disequilibrium. Option A is too simplistic. Not all stressful events result in crises. Option B assumes that the outcome will be pathological. Option D assumes that the outcome will result in a lower level of adaptation. In fact, an individual in crisis may emerge at a higher level of functioning, the same level of functioning, or a lower level of functioning.

DIF: Cognitive Level: Application REF: Text Page: 459
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

4) A client, aged 16 years, comes to the crisis clinic. The nurse learns she is being molested by her uncle. The client told her mother of the uncle’s behavior, but the mother accused the daughter of lying. The client’s crisis would be classified as
A.
maturational.
B.
situational.
C.
adventitious.
D.
organic.

ANS: C
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. Option A: Maturational crisis occurs as an individual arrives at a new stage of development, when old coping styles may be ineffective. Option B: Situational crisis arises from an external source such as a job loss, divorce, or other loss affecting self-concept or self-esteem. Option D is not a type of crisis.

DIF: Cognitive Level: Analysis REF: Text Page: 459
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

5) A client, aged 16 years, comes to the crisis clinic. The nurse learns the client is being molested by her uncle. The client told her mother, who accused her of lying. To proceed with crisis intervention, the nurse must assume that
A.
the client has a demonstrated previous ability to cope.
B.
the client will not be open to a therapist’s intervention.
C.
the therapist must help the client resolve past and current issues.
D.
the therapist must assume a passive, nondirective role as the client problem solves.

ANS: A
Crisis intervention is aimed at maintaining, at a minimum, the precrisis level of functioning. Crisis intervention is therefore appropriate only for someone who functioned adequately before the crisis. Option B: This assumption would obstruct crisis intervention. Option C: The focus of crisis intervention is on only the present problem. Option D: The therapist must be prepared to assume an active, direct role if necessary.

DIF: Cognitive Level: Application REF: Text Page: 459
TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity