EXAM 2 -- Ch 9-14 Flashcards
Which of the following is a correct assumption regarding the concept of crisis?
a. Crises occur only in individuals with psychopathology
b. The stressful event that precipitates crisis is seldom identifiable
c. A crisis situation contains the potential for psychological growth or deterioration.
d. Crises are chronic situations that recur many times during an individual’s life.
C
Crises occur when an individual:
a. Is exposed to a precipitating stressor.
b. Perceives a stressor to be threatening.
c. Has no support systems.
d. Experiences a stressor and perceives coping strategies to be ineffective.
D
Amanda’s mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. What is this type of crisis called?
a. Crisis resulting from traumatic stress
b. Maturational or developmental crisis
c. Dispositional crisis
d. Crisis of anticipated life transitions
A
Amanda’s mobile home was destroyed by a tornado. Amanda received only minor injuries but is experiencing disabling anxiety in the aftermath of the event. The most appropriate crisis intervention with Amanda would be to:
a. Encourage her to recognize how lucky she is to be alive.
b. Discuss stages of grief and feelings associated with each.
c. Identify community resources that can help Amanda.
d. Suggest that she find a place to live that provides a storm shelter.
B
Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother’s behaviour. What is this type of crisis called?
a. Crisis resulting from traumatic stress
b. Maturational or developmental crisis
c. Dispositional crisis
d. Crisis reflecting psychopathology
C
Jenny reported to the high school nurse that her mother drinks too much. She is drunk every afternoon when Jenny gets home from school. Jenny is afraid to invite friends over because of her mother’s behaviour. The most appropriate nursing intervention would be to:
a. Make arrangements for her to start attending Alateen meetings.
b. Help her identify the positive things in her life and recognize that her situation could be a lot worse than it is
c. Teach her about the effects of alcohol on the body and that it can be hereditary.
d. Refer her to a psychiatrist for private therapy to learn to deal with her home situation.
A
Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger’s first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. What is this type of crisis called?
a. Crisis resulting from traumatic stress
b. Dispositional crisis
c. Psychiatric emergency
d. maturational or developmental crisis
D
Ginger, age 19 and an only child, left 3 months ago to attend a college of her choice 500 miles away from her parents. It is Ginger’s first time away from home. She has difficulty making decisions and will not undertake anything new without first consulting her mother. They talk on the phone almost every day. Ginger has recently started having anxiety attacks. She consults the nurse practitioner in the student health center. The most appropriate nursing intervention with Ginger would be to:
a. Suggest she move to a college closer to home.
b. Work with Ginger on unresolved dependency issues.
c. Help her find someone in the college town from whom she could seek assistance rather than calling her mother regularly.
d. Recommend that the college physician prescribe an antianxiety medication for Ginger.
B
Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become increasingly despondent. Her husband is very concerned and takes her to the local mental health center. What is this type of crisis called?
a. Dispositional crisis
b. Crisis of anticipated life transitions
c. Psychiatric emergency
d. Crisis resulting from traumatic stress
B
Marie, age 56, is the mother of five children. Her youngest child, who had been living at home and attending the local college, recently graduated and accepted a job in another state. Marie has never worked outside the home and has devoted her life to satisfying the needs of her husband and children. Since the departure of her last child from home, Marie has become increasingly despondent. Her husband is very concerned and takes her to the local mental health center. The most appropriate nursing intervention with Marie would be to:
a. Refer her to her family physician for a complete physical examination.
b. Suggest she seek outside employment now that her children have left home.
c. Identify convenient support systems for times when she is feeling particularly despondent,
d. begin grief work and assist her to recognize areas of self-worth separate and apart from her children.
D
Which of the following is the desired outcome of working with an individual who has witnessed a traumatic event and is now experiencing panic anxiety?
a. The individual will experience no anxiety.
b. The individual will demonstrate hope for the future.
c. The individual will identify that anxiety is at a manageable level.
d. The individual will verbalize acceptance of self as worthy.
C
Andrew, a firefighter, and his entire unit responded to the aftermath of an earthquake. Working as a team, he and his best friend Carlo entered a building together to search for survivors. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, “I don’t know why Carlo had to die and I didn’t!” This statement by Andrew suggests that he is experiencing:
a. Spiritual distress
b. Night terrors
c. Survivor’s guilt
d. suicidal ideation
C
Andrew, a firefighter, and his entire unit responded to the aftermath of an earthquake. Working as a team, he and his best friend Carlo entered a building together to search for survivors. Carlo was killed when the building collapsed. Andrew was injured but survived. Since that time, Andrew has had frequent nightmares and anxiety attacks. He says to the mental health worker, “I don’t know why Carlo had to die and I didn’t!” Intervention with Andrew would include:
a. Encouraging expression of feelings.
b. Antianxiety medications
c. Participation in a support group.
d. a and c
e. All of the above
E
Which of the following is a true statement about mental health recovery? (Select all that apply)
a. Mental health recovery applies only to severe and persistent mental illnesses
b. Mental health recovery serves to provide empowerment to the consumer
c. Mental health recovery is based on the medical model
d. Mental health recovery is a collaborative process
B, D
Which of the following individuals demonstrates the highest number of risk factors for suicide?
a. John, who reports that he is in deep emotional pain, feels hopeless, and says “No one is there for me.”
b. Kelly, who has been seeing a doctor for chronic, intractable pain, verbalizes a deep commitment to her religious faith and is taking pain medication.
c. Jim, an American Indian, who graduated from high school with honors but does not yet have a job.
d. Mike, a physician, who reports feeling “burnt out” and is considering retirement.
A
The nurse in the emergency department encounters a patient, Niko, who is expressing suicide ideation. The nurse recognizes that which of the following considerations are important to good suicide risk assessment? (Select all that apply)
a. Collaborating with the patient
b. Asking specific questions about leisure activities.
c. Establishing trust and open communication with the patient
d. Asking the patient specific questions about the strength of his intention to die
e. Identifying whether the patient has thought about a plan for trying to kill himself
A, C, D, E
Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, “My boyfriend broke up with me. We had been together for 6 years. I love him so much, I know I’ll never get over him.” Which is the best response by the nurse?
a. “You’ll get over him in time, Theresa.”
b. “Forget him. There are other fish in the sea.”
c. “You must be feeling very sad about your loss.”
d. “Why do you think he broke up with you, Theresa?”
C
Theresa, age 27, was admitted to the psychiatric unit from the medical intensive care unit where she was treated for taking a deliberate overdose of her antidepressant medication, trazodone (Desyrel). She says to the nurse, “My boyfriend broke up with me. We had been together for 6 years. I love him so much, I know I’ll never get over him.” The nurse identifies the primary nursing diagnosis for Theresa as “Risk for Suicide related to feelings of hopelessness from loss of relationship.” Which is the outcome that would be most appropriate for this diagnosis?
a. the patient has experienced no physical harm to herself.
b. the patient sets realistic goals for herself.
c. The patient expresses some optimism and hope for the future.
d. The patient has reached a stage of acceptance in the loss of the relationship with her boyfriend.
A
Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Klonsky and May’s “Three-Step Theory” suggests that the nurse should assess which three issues to evaluate Theresa’s active risk for suicide attempt?
a. Level of education, ethnic background, and current employment
b. Relationships with previous boyfriends, coping mechanisms, and intent to have future boyfriends
c. Self-esteem, GPA, and physical attractiveness
d. Degree of psychological pain, connectedness with others, and suicide ideation in combination with capacity to make attempt
D
Theresa is hospitalized following a suicide attempt after breaking up with her boyfriend. Theresa says to the nurse, “When I get out of here, I’m going to try this again, and next time I’ll choose a no-fail method.” Which is the best response by the nurse?
a. “You are safe here. We will make sure nothing happens to you.”
b. “You’re just lucky your roommate came home when she did.”
c. “What exactly do you plan to do?”
d. “I don’t understand. You have so much to live for.”
C
