Test 3 MH CH11rename
wipimebe's version from 2015-10-06 21:25
Section1. A crisis results in psychiatric problems when:
a. adversity occurs
b. coping mechanisms fail
c. unpredictable events occur
d. stress is experienced
A crisis can turn into psychiatric problems when an individualÕs normal coping mechanisms fail. Because of the challenge that the crisis presents, the person is called to adjust to the unexpected and to adapt to a situation or event that is unpredictable. When the person is unable to meet the challenge through normal coping mechanisms, a crisis ensues.
2. A crisis is BEST defined as which of the following?
a. unexpected life demand
b. turning point
c. negative or positive event
d. a time of bad luck
The Oxford English Dictionary (1989) defines crisis as the turning point in a disease, the decisive stage in the progress of anything, a state of affairs in which change for the better or worse is imminent. The original use of the term was for a turning point in an illness. The other options could be true of a crisis, but turning point is the best definition.
3. A family is staying overnight in a resort area. In the morning, they discover that their automobile has been stolen. Most of their luggage and money was left in the car, so they have little clothing or money. This family is experiencing which of the following types of crisis?
a. community crisis
b. maturational crisis
c. cultural crisis
d. situational crisis
The loss of their automobile, luggage, and clothing can be seen as a situational crisis. This type of crisis is any event that poses a threat or challenge to an individual or family. A community crisis is a crisis of a proportion to affect an entire community of people. A maturational crisis is a stage in a personÕs life where adjustment and adaptation to new responsibilities and life patterns are necessary. A cultural crisis is a situation where a person experiences culture shock in the process of adapting or adjusting to a new culture or returning to oneÕs own culture after being assimilated into another.
4. A young adult woman who was born in Central America and spoke only Spanish emigrated to the United States and lived with Spanish-speaking cousins. This young woman enrolled in a local college. After graduation, she married and later gave birth to a child. Which of the following would MOST likely have been a cultural crisis for this young woman?
a. attending college and speaking English
b. getting married and the relationship
c. living with her cousins
d. having her first child
Attending college and speaking English would most likely cause the woman to experience a cultural crisis because she was originally from Central America and spoke only Spanish. By definition a cultural crisis is a situation where a person experiences culture shock in the process of adapting or adjusting to a new culture.
5. Which of the following events has the potential for creating a maturational crisis?
a. an earthquake in Los Angeles
b. becoming an adolescent
c. winning the lottery
d. getting a divorce
Becoming an adolescent has the potential for creating a maturational crisis. Adolescence is a period in the individualÕs life where adjustments and adaptation to new responsibilities and life patterns are necessary. Making the transition from adolescence to adulthood can be very stressful. An earthquake is an example of a community crisis; winning the lottery or getting a divorce are examples of a situational crises.
6. When the river flooded several small towns, leaving people homeless and making travel difficult, this type of crisis would MOST likely be described as which of the following types of crisis?
When the river flooded, it affected the entire community: therefore it would be considered a community crisis. A situational crisis is any event that poses a threat or challenge to an individual or family. A maturational crisis is a stage in a personÕs life where adjustment and adaptation to new responsibilities and life patterns are necessary. A cultural crisis is a situation where a person experiences culture shock in the process of adapting or adjusting to a new culture or returning to oneÕs own culture after being assimilated into another.
7. A maturational crisis can occur at any time during the life cycle. The key task for the nurse providing intervention to a client who is experiencing a maturational crisis is to:
a. discuss the current crisis with the family members
b. support the clientÕs adaptive defense mechanisms
c. challenge the clientÕs defense mechanisms
d. explore the clientÕs past psychological history
A priority intervention for the nurse when caring for an individual experiencing a maturational crisis is to support the clientÕs adaptive defense mechanisms. This support will facilitate the individualÕs return to a precrisis level of functioning.
8. Older adolescents typically become more distressed in a crisis situation when:
a. their access to mother is limited
b. siblings are upset with them
c. interactions with their peer group are disrupted
d. contact with their church group is limited
Older adolescents are particularly distressed when their interactions with their peer group are disrupted. For the adolescent, the peer group serves as the major form of a support system.
9. The three stages of Hans SelyeÕs General Adaptation Syndrome are:
a. fight, flight, norming
b. shock, resistance, fatigue
c. alarm, resistance, exhaustion
d. shock, countershock, homeostasis
SelyeÕs General Adaptation Syndrome includes three major stages. The individualÕs initial response involves an alarm reaction, then a stage of resistance, and a final stage of exhaustion. The first and third stages are broken down further to include shock and countershock.
10. In Callista RoyÕs Adaptation Model (1980), the person is seen as having component parts that are:
a. internal and external
c. physical and cognitive
According to Roy, the person is seen as having component parts. These parts are biopsychosocial components. Health is defined in terms of an equilibrium or balance between the parts that promotes harmony or adjustment.
11. Erickson and colleagues introduced the Adaptive Potential Assessment Model that described three states of coping potential as:
a. stress, adaptation, maladaptation
b. impoverishment, nourishment, starvation
c. imbalance, homeostasis, balance
d. arousal, equilibrium, and impoverishment
The Adaptive Potential Assessment Model described three stages of coping potential. These states are arousal, equilibrium, and impoverishment. In arousal the person has coping resources, whereas in impoverishent the resources are depleted.
12. A client voices that he feels Òanxious, but excitedÓ about an upcoming job interview. The psychiatric nurse correctly assesses the client as being in the stress state of:
c. adaptive equilibrium
d. maladaptive equilibrium
The psychiatric nurse would correctly assess a client as being in the arousal state of stress if the client states he feels anxious but excited. In the arousal state the person has coping resources. The person will react, attempting to reestablish balance or equilibrium.
13. A client voices that she feels ÒoverwhelmedÓ because her husband moved out of the home and filed for divorce. The psychiatric nurse correctly assesses the client as being in the stress state of:
c. adaptive equilibrium
d. maladaptive equilibrium
A client who voices feeling overwhelmed is most likely experiencing the impoverishment state. In a state of impoverishment the individualÕs resources are depleted.
14. You are working with a client who reveals in the assessment that she was raped while returning to her parked car one night. After the rape, she broke up with her boyfriend and went through counseling for 6 months. Two years later, she is unable to have a relationship with any man. Based on EricksonÕs Adaptive Potential Assessment Model, which state of coping best describes the clientÕs current state?
c. adaptive equilibrium
d. maladaptive equilibrium
Based on EricksonÕs Adaptive Potential Assessment Model, a woman unable to have a relationship with a man after being the victim of rape is most likely in a state of maladaptive equilibrium. The woman is unable to reestablish her precrisis level of equilibrium and balance.
15. Madeleine LeiningerÕs theory directs the nurse to understand the meaning of crisis events for the client from:
a. within the clientÕs cultural perspective
b. a comparison with American culture
c. the nurseÕs perspective of the event
d. whatever cultural rules are known
LeiningerÕs theory directs the nurse to understand the meaning of crisis events for the client from within a clientÕs cultural perspective. Nurses skilled in cultural care understand that there are important cultural perspectives in all lifeÕs events. Related to crisis, cultural care theory guides the nurse in two matters: recognizing that crises are culturally determined and understanding that insensitive cross-cultural experiences can produce crisis and culture conflict for the nurse and client.
16. Critical incident stress management (CISM) is provided to help emergency personnel successfully manage the stress produced by the crises and disasters that they are called upon to respond to. As a result of meta-analysis of existing data about the effectiveness of CISM, Bledsoe recommends that CISM:
a. is universally helpful to emergency personnel even if they initially resist the intervention
b. is most effective when offered in a peer group counseling format
c. should never be mandatory, because it may lead to a worsening of stress symptoms
d. should be provided as one-on-one individual counseling over six or more sessions
Bledsoe recommends that CISM should never be mandatory, because it may lead to a worsening of stress symptoms. It is believed that debriefing may not always be effective and for some individuals it may actually lead to a worsening of the stress symptoms.
17. A Vietnamese family comes to the emergency room after the death of one of their family members. The nurse informs them that only one member of the family is able to see the person who died. The family members begin to chant and cry out loud. The BEST action for the nurse at this time is to:
a. inform the family that the rules are the same for everyone
b. ask the family members what behaviors they need to perform after a death
c. realize that this is probably a culturally related habit and show sympathy for the family
d. look up information on the Internet that describes the needs of the Vietnamese after a death
The best action for the nurse to take at this time is to ask the family members what behaviors they need to perform after a death. This would demonstrate that the nurse is sensitive to the familyÕs cultural practices and rituals.
18. In research involving a study of persons who were experiencing the crisis of losing their home and possessions because of fire, victims reacted to the statement, ÒYou are lucky no one was hurt,Ó in which of the following ways?
a. appreciation for the insight of the person making the statement
b. relief after being reminded that their loss was small
c. confusion and a state of amnesia
d. feeling misunderstood and their situation trivialized
Victims felt misunderstood and their situation trivialized. The comment that they were lucky was viewed as uncaring and left the victims feeling neglected. In general, loss of possessions was trivialized leaving the victims without permission to display grief.
19. A client comes into the emergency room and is in a state of panic. Which of the following nursing actions is a priority in assisting this client?
a. Talk with the family about the client.
b. Determine the precipitating event for the panic.
c. Construct a care plan for the client.
d. Assess the clientÕs psychiatric history.
A priority for the nurse intervening with a client in a state of panic is to determine the precipitating event for the panic. The nurseÕs initial assessment would not focus on the clientÕs psychiatric history or involve talking with the family. In addition, a care plan is not developed until the assessment is complete and a nursing diagnosis is made.
20. A client in the community is experiencing an emotional crisis after her family was killed in a house fire. The client states, ÒI canÕt take it anymore.Ó To provide safe care, which of the following actions would the nurse take first?
a. Recommend hospitalization.
b. Provide emotional support.
c. Conduct a suicide assessment.
d. Provide reassurance of access to care.
The clientÕs comment should alert the nurse to conduct a suicide assessment. The nurse must determine if the client is experiencing feelings of severe despair that could lead to self-destructive or suicidal behavior. This assessment would begin with questioning the client about thoughts of self-harm.