A. Maturational Show Each developmental stage represents a maturational crisis. Situational crisis arises from events that are extraordinary, external rather than internal, and unanticipated. An adventitious crisis results from events not part of everyday life, such as a natural disaster (e.g., flood, fire, earthquake) or a national disaster (e.g., acts of terrorism, war, riots, airplane crashes). Biological is not a crisis type. Sets found in the same folderRecommended textbook solutions
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Terms in this set (20)Considering client function, what is the expected outcome at the conclusion of crisis intervention therapy? Function is higher level than before the crisis. Function is at the precrisis level. Function is only marginally below the precrisis level. Function is occurring without aid from identified support systems. Function is at the precrisis level. The intent of crisis intervention is to return the individual to the precrisis level of functioning. While this goal is not always attainable, it remains the expected outcome of crisis intervention therapy. What type of crises occur as an individual moves from one developmental level to another? Reactive Recurring Situational Maturational Maturational Maturational crises are normal states in growth and development in which specific new maturational tasks must be learned when old coping mechanisms are no longer effective. This challenge is not specifically associated with any of the other options. Which nursing action directed toward a client in crisis demonstrates signs of a problematic nurse-client relationship? Offering to change the time of the counseling session for the second time in 3 weeks Experiencing frustration about the decisions the client is making Giving the client a personal number to call when they "need to talk" Suggesting that the client attend an extra counseling session each month Giving the client a personal number to call when they "need to talk" Giving a client one's personal telephone number is a reaction to the nurse's need to be needed and undermines the client's sense of self-reliance. None of the other behaviors demonstrate a breakdown in the nurse-client behavior but rather reactions to commonly experienced issues within that relationship What type of crisis is a newly unemployed person most likely to experience? Reactive Situational Maturational Unexpected Situational Situational crises arise from external sources. Examples are death of a loved one, divorce, marriage, or a change in health status. Unemployment is not generally associated with any of the other options. What is the typical response when a stressful event occurs and the individual is unable to resolve the situation by using their usual coping strategies? A state of emotional disorder results in trial-and-error problem solving. They will withdraw and act as though the problem does not exist. They develop severe personality disorganization. Their distress often causes them to resort to planning suicide. A state of emotional disorder results in trial-and-error problem solving. The description is that of the second stage of crisis, according to accepted crisis theory. In this stage the individual will adopt the trial-and-error method of problem solving since their usual strategies are no longer effective Which statement would suggest to the crisis intervention nurse the need to arrange for hospitalization of a client? "I'm feeling overwhelmed by all that has happened, and I need help sorting it out." "I see no solution for this situation if nothing changes by tomorrow." "There are three possibilities that might help, but I can't decide what to do." "I feel a little calmer than yesterday at this time, but things are still very difficult." "I see no solution for this situation if nothing changes by tomorrow." Whenever the client presents a danger to himself or herself or others, hospitalization must be considered. Such a danger may exist if the client expresses hopelessness as in the correct option. None of the other options express hopelessness. A crisis is so acutely uncomfortable to the individual that it is likely to self-resolve in what time frame? 1 to 10 days. 1 to 3 weeks. 4 to 6 weeks. 3 to 4 months. 4 to 6 weeks. At 4 to 6 weeks, the individual is making accommodations and adjustments to relieve anxiety, and the crisis is no longer a crisis Which assumption serves as a foundation for the use of crisis intervention? The individual is mentally healthy but in a state of disequilibrium. Long-term dysfunctional adjustment can be addressed by crisis intervention. An anxious person is unlikely to be willing to try new problem-solving strategies. Crisis intervention nurses need to remain passive as the client deals with the crisis. The individual is mentally healthy but in a state of disequilibrium. The patient in a crisis situation is assumed to be mentally healthy, to have functioned well in the past, and to be presently in a state of disequilibrium. None of the other options present correction foundational statements for crisis intervention. A 12-year-old finds herself feeling anxious and overwhelmed and seeks out the school nurse to report that "Everything is changing; my body, the way the boys who were my friends are treating me, everything is so different." What term is used to describe what this child is experiencing? A personal identity disorder A maturational crisis Suicidal ideations Mild neurosis A maturational crisis The maturational crisis of moving from childhood into adolescence may be difficult because many new coping skills are necessary. The child's statements provide no support for any of the other options. To assess the client's perception of the event precipitating a crisis, the nurse would initially ask which question? "How does this situation affect your life?" "During difficult times in the past, what has helped you?" "Can you give me the name of someone you trust?" "Who is available to help you?" "How does this situation affect your life?" Individuals process information differently. An event may be minor to some while being extremely serious to others. The correct option is the only query that is directed at the client's perception of the precipitating event. The other options ask important questions but are not related to perception of the precipitating event. A client is treated in the emergency department for injuries sustained while vacationing hundreds of miles away from home. How should the nurse best meet the client's emotional needs in order to minimize the risk of crisis? Arranging to hospitalize the client so all needs will be met. Referring the client for traditional psychotherapy for the expected development of posttraumatic stress disorder. Providing temporary support by arranging shelter for the client and contacting family or traveling companions. Suggesting that contacting a victim support group would be more appropriate than crisis intervention. Providing temporary support by arranging shelter for the client and contacting family or traveling companions. When a client has no support system, the nurse may assume that role for a short time. In this situation, temporary shelter and contact with family/friends would be supportive. The other options are appropriate when a crisis occurs. A woman comes to the crisis intervention clinic and reports that her 16-year-old son uses drugs in the home and often assaults her. The nurse tells the client: "This is not an uncommon problem. Don't worry." "Together we will be able to work on this problem." "Now that you are asking for help, everything will be all right." "I have friends in law enforcement who can help us choose a solution." "Together we will be able to work on this problem." The nurse takes an active collaborative role in problem resolution beginning with telling the client that a solution will be found. None of the other options offers support but rather unrealistic reassurance or minimization of the problem. A client comes to the crisis intervention clinic and tearfully tells the nurse, "It is so painful! I have thought about it, and I cannot see how I can go on without my partner." The nurse states, "You have resilience and will look back on this as a crisis you were able to manage." What is the evaluation of the nurse's response after analysis of this nurse-client interaction? demonstrates a good understanding of the effect of time on perception of a crisis. is offering a statement of positive outcome based on client coping ability. has failed to follow up on the client's verbal clues to suicidal thoughts. has introduced a concept associated with traditional psychotherapy. has failed to follow up on the client's verbal clues to suicidal thoughts. Nurses who are uncomfortable with the idea of suicide may fail to pick up on a client's clues. This client clearly was open to discussing her suicidal thoughts, or she would not have said, "I cannot see how I can go on." The nurse's statement is not associated with the evaluation presented by any of the other options. Which situation has the potential for early crisis intervention to occur? Mrs. R tells the nurse in the well-baby clinic that she's feeling uptight and has arranged to see a primary care therapist. Ms. T is hospitalized after an unsuccessful suicide attempt that she states, "was a mistake." Mr. W asks for reassurance that he will be welcome at the day hospital after his hospital discharge. Ms. G enters the emergency department with a strong smell of alcohol on his person, stating he is anxious and depressed. Mrs. R tells the nurse in the well-baby clinic that she's feeling uptight and has arranged to see a primary care therapist. Phase I intervention is when a person confronted by a conflict or problem that threatens the self-concept responds with increased feelings of anxiety. The increase in anxiety stimulates the use of problem-solving techniques and defense mechanisms in an effort to solve the problem and lower anxiety. Alcohol represents an ineffective coping mechanism while the other options demonstrate the existence of a crisis What is the priority concern of the crisis intervention nurse regarding the client? The client's physical safety Setting up support contacts Helping the client brainstorm possible solutions Assisting the client to work through termination issues associated with therapy The client's physical safety Client safety is always the priority concern in crisis intervention therapy. The disequilibrium of crisis predisposes the client to suicidal thinking. None of the other options have priority over client safety. A 36 year old comes to the crisis clinic with reports of not sleeping, anxiety, and excessive crying. After a tornado devastated his hometown, the client was suddenly unemployed and homeless. Which of the following statements regarding crisis accurately describes the client's situation? He is experiencing low self-esteem from the job loss, as well as anger because of the loss of his home. He is experiencing a situational crisis that is associated with both a natural disaster and a personal event. He is experiencing ineffective coping and should be hospitalized for intensive therapy. He is experiencing a situational crisis with the added stress of financial burden. He is experiencing a situational crisis that is associated with both a natural disaster and a personal event. It is possible to experience more than one type of crisis situation simultaneously, and as expected, the presence of more than one crisis further taxes individual coping skills. The client lost his job (personal event) and also experienced the devastating effects of a tornado (natural disaster). The first option may be true but doesn't accurately describe the crisis criteria. There is nothing in the scenario suggesting he needs acute hospitalization at this time. He is experiencing not only a personal situational crisis but a natural disaster as well, which makes coping more difficult. DIF: Cognitive Level: Analyze (Analysis)REF: page 7TOP: Nursing Process: DiagnosisMSC: NCLEX: Psychosocial Integrity Two 16-year-old students were both involved in serious car accident. Both students have spoken with a counselor about the incident. One student has been able to move forward with little dysfunction as a result of the accident while the other has been experiencing anxiety and an inability to concentrate in school even after numerous counseling sessions. The difference in the way the accident affected both boys may be explained primarily by what factor? Personal perception of the event. Individual personality. Existence of previous, unresolved emotion trauma. One student received ineffective counseling. Personal perception of the event. People vary in the way they absorb, process, and use information from the environment. Some people may respond to a minor event as if it were life threatening. Conversely, others may experience a major event and look at it in a calmer fashion. The other options may be true but are not the primary reason for two people responding differently to the same event. DIF: Cognitive Level: Analyze (Analysis)REF: pages 2, 3TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity What is the highest nursing priority for a client experiencing a situational crisis? Reduction of expressed anxiety. Development of new coping skills. Prevention of boundary blurring. Promoting client safety. Promoting client safety. The nurse's initial task is to promote safety by assessing the patient's potential for suicide or homicide. The other options are all important components of the care plan, but safety of the patient takes the highest priority. DIF: Cognitive Level: Analyze (Analysis)REF: page 10TOP: Nursing Process: PlanningMSC: NCLEX: Physiological Integrity Which assessment data describes a client in phase IV of Caplan's phases of crisis? The client reports experiencing increased anxiety and feelings of extreme discomfort the day after the tornado. The client comes to the crisis clinic reporting depression and expresses that he does not want to go on living. The client reports experiencing a panic attack. The client reports experiencing anxiety symptoms the day after being fired. The client comes to the crisis clinic reporting depression and expresses that he does not want to go on living. This describes that phase IV, which, if coping is ineffective, may lead to depression, confusion, violence, or suicidality. The other options describe phase II, phase III, and phase I in Caplan's phases of crisis. DIF: Cognitive Level: Analyze (Analysis)REF: page 9TOP: Nursing Process: AssessmentMSC: NCLEX: Psychosocial Integrity What is the expected outcome for an individual who has successful resolved all the maturational crises they have been presented with? The development of basic human qualities The development of basic human qualities The development of new, effective coping mechanisms The ability to pass through subsequent developmental stages Sets with similar termscrisis55 terms penguinpastapotato Nurs 343 Ch. 2355 terms brittanyblair147 Mental Health: Crisis and Disaster41 terms beckyjoy1985 Mental Health: Crisis and Disaster41 terms CourtneyLeann Sets found in the same folderChapter 16, PTSD, Halter, Questions18 terms cmillage Varcarolis Chp 318 terms Nikita_Patel51 Psych Ch. 320 terms A_A_Coleman Varcarolis Chapter 118 terms awiswell_MU Other sets by this creatorCH 31- Elders16 terms anna_loew9 Ch 30- Dying, death, grieving15 terms anna_loew9 CH 7- The nursing process/standards of care14 terms anna_loew9 CH 27- Anger, aggression, violence17 terms anna_loew9 Verified questions
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What are the two priority goals when someone is in crisis quizlet?What are the two initial goals for crisis interventions? The focus of crisis intervention is on the present problem. The two initial goals are to ensure patient safety and take measures to reduce patient anxiety. Anxiety reduction and coping is important; however, safety is a priority need.
What is the priority during the initial interview with a client in crisis?1 Correct: The essential component of the initial interview is to assess how the crisis may affect the client's safety. Assessment of self-harm can give the nurse the information needed to intervene appropriately and keep the client safe.
What are the four domains of crisis?The four commonly agreed upon categories of crises are: developmental, existential, situational, and ecosystemic (James & Gilliland). Developmental crises are those events that are related to the normal maturation process and occur with transitions in life.
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Which area is the priority focus when a nurse is working with a patient in crisis quizlet?
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