Question 1

A nurse is caring for a client in crisis.While providing care it is imperative that the nurse communicate effectively with this client.Which is true when communicating with clients in crisis? Select all that apply.
A)Communication should be frequent.
B)Communication should be brief.
C)Communication should be simple.
D)Communication should be detailed.
E)Communication should be directive.

Accepted Answer

When communicating with clients in crisis, it is important to keep the communication frequent, brief, simple, and directive. Clients in crisis may have difficulty processing complex information and can become easily overwhelmed, so it is important to keep the communication as clear and concise as possible. Directives can also be helpful in providing structure and support to the client during this difficult time. Avoiding detailed communication can be important, as it may lead to additional stress and confusion for the client.

Question 2

A nurse is providing care to a woman who recently got married and would like to try to become pregnant.The woman has been on an antianxiety medication,paroxetine (Paxil),for the past year.The woman feels that she needs to continue receiving treatment for anxiety,especially if she gets pregnant.What information should the nurse provide regarding treatment options during pregnancy?
A)The woman should consider switching to a different SSRI such as fluoxetine (Prozac).
B)The woman should consider switching to cognitive-behavioral therapy (CBT)rather than medication.
C)The woman should consider stopping all medications immediately.
D)The woman should consider gradually decreasing medication until she finds out she is pregnant.

Accepted Answer

A)For women who are pregnant or trying to become pregnant, nonpharmacologic therapies such as CBT and relaxation techniques are the safest for reducing anxiety and preventing harm to the fetus. The woman should not stop all treatment immediately. When stopping medication, the medication should be tapered off, but this should continue even after she finds out she is pregnant, not until she finds out she is pregnant. If she changes to a different SSRI, she should change to sertraline (Zoloft), which does not have the same risk of birth defects as paroxetine or fluoxetine.
B)For women who are pregnant or trying to become pregnant, nonpharmacologic therapies such as CBT and relaxation techniques are the safest for reducing anxiety and preventing harm to the fetus. The woman should not stop all treatment immediately. When stopping medication, the medication should be tapered off, but this should continue even after she finds out she is pregnant, not until she finds out she is pregnant. If she changes to a different SSRI, she should change to sertraline (Zoloft), which does not have the same risk of birth defects as paroxetine or fluoxetine.
C)For women who are pregnant or trying to become pregnant, nonpharmacologic therapies such as CBT and relaxation techniques are the safest for reducing anxiety and preventing harm to the fetus. The woman should not stop all treatment immediately. When stopping medication, the medication should be tapered off, but this should continue even after she finds out she is pregnant, not until she finds out she is pregnant. If she changes to a different SSRI, she should change to sertraline (Zoloft), which does not have the same risk of birth defects as paroxetine or fluoxetine.
D)For women who are pregnant or trying to become pregnant, nonpharmacologic therapies such as CBT and relaxation techniques are the safest for reducing anxiety and preventing harm to the fetus. The woman should not stop all treatment immediately. When stopping medication, the medication should be tapered off, but this should continue even after she finds out she is pregnant, not until she finds out she is pregnant. If she changes to a different SSRI, she should change to sertraline (Zoloft), which does not have the same risk of birth defects as paroxetine or fluoxetine.

Question 3

Free-floating anxiety is often connected to what stimulus?
A)Elevators
B)Airplanes
C)No specific stimulus
D)Water

Accepted Answer

Free-floating anxiety is not tied to any specific stimulus or trigger. It is a general feeling of anxiety, worry, or unease that can occur without an identifiable cause.

Question 4

A client with what level of anxiety would be most receptive to learning tools that would help the client recognize triggers?
A)Mild
B)Moderate
C)Severe
D)Panic

Accepted Answer

Clients with mild anxiety are not completely overwhelmed by their symptoms and are more likely to be receptive to learning tools and coping strategies. By teaching the client to recognize triggers, they can learn to anticipate and manage their anxiety before it becomes more intense. Clients with moderate, severe, or panic-level anxiety may be too overwhelmed to focus on learning new techniques for recognizing triggers.

Question 5

Which nursing diagnosis would be a priority for a client who is experiencing a situational crisis?
A)Ineffective Coping
B)Ineffective Activity Planning
C)Readiness for Enhanced Communication
D)Chronic Low Self-Esteem

Accepted Answer

In a situational crisis, the client may be struggling with their ability to cope effectively. Therefore, addressing ineffective coping would be a priority nursing diagnosis to prevent the client from experiencing further distress or harm.

Question 6

A 72-year-old client presents to the clinic with complaints of restlessness,muscle tension,and increased perspiration.Her vital signs are P 112,R 23,BP 131/85,and T 97.8°F.The nurse recognizes these manifestations as signs and symptoms of moderate anxiety.However,the client reports that she does not feel anxious about anything and has never before been diagnosed with an anxiety disorder.What other factor must the nurse consider based on this client's age?
A)These manifestations could instead be related to a medical illness.
B)These manifestations could be related to an overdose of antianxiety medications.
C)These manifestations could indicate a change in the client's cognitive functioning.
D)These manifestations could be related to drug-drug interactions between selective serotonin reuptake inhibitors (SSRIs)and other medications.

Accepted Answer

In elderly patients, anxiety symptoms may be caused by underlying medical conditions such as thyroid disorders or cardiac conditions. Therefore, the nurse must consider a medical evaluation to rule out any possible physical causes for the anxiety symptoms before considering other factors such as medication side effects or cognitive changes.

Question 7

The nurse is discharging a client diagnosed with general anxiety disorder (GAD).The client is prescribed a selective serotonin reuptake inhibitor (SSRI).Which statement made by the client would indicate to the nurse a need for further education?
A)"This medicine could make me feel like I have the jitters."
B)"I may experience some nausea while on this medication."
C)"My doctor will start me off on a high dose and then decrease the dose."
D)"This medicine alters the levels of the neurotransmitter serotonin in the brain."

Accepted Answer

This statement is incorrect and indicates a need for further education. Starting with a high dose and decreasing it is not typical with SSRIs. Usually, the dose is gradually increased over time to reach the therapeutic level. The other statements are correct and do not require further clarification.

Question 8

The nurse is beginning crisis counseling with a client.What actions will the nurse use when counseling the client? Select all that apply.
A)Assist in coping with the problem.
B)Conduct follow-up assessments.
C)Boil down the problem.
D)Achieve rapport.
E)Assess physiologic status.

Accepted Answer

A)When conducting crisis counseling with a client, the nurse will achieve rapport, boil down the problem, and assist the client in coping with the problem. Assessing physiologic status and conducting follow-up assessments are not steps within crisis counseling.
B)When conducting crisis counseling with a client, the nurse will achieve rapport, boil down the problem, and assist the client in coping with the problem. Assessing physiologic status and conducting follow-up assessments are not steps within crisis counseling.
C)When conducting crisis counseling with a client, the nurse will achieve rapport, boil down the problem, and assist the client in coping with the problem. Assessing physiologic status and conducting follow-up assessments are not steps within crisis counseling.
D)When conducting crisis counseling with a client, the nurse will achieve rapport, boil down the problem, and assist the client in coping with the problem. Assessing physiologic status and conducting follow-up assessments are not steps within crisis counseling.
E)When conducting crisis counseling with a client, the nurse will achieve rapport, boil down the problem, and assist the client in coping with the problem. Assessing physiologic status and conducting follow-up assessments are not steps within crisis counseling.

Question 9

The nurse is providing care to a client who is "in crisis." The client recently lost a job,was served with divorce papers,and has been sick with back-to-back colds for 1 month.Which nursing statement demonstrates understanding of the care of a client in crisis?
A)"Experiencing a crisis is never positive,so we must work to relieve your anxiety as soon as possible."
B)"People generally find it easier to work through a crisis if someone is working with them."
C)"Men often handle crisis better individually,whereas women do better with a counselor."
D)"Once you reach the crisis state,you may remain there for several months until you recover."

Accepted Answer

This statement acknowledges the importance of support during a crisis and the role of the nurse in providing that support. Option A may be perceived as dismissive of the client's experience, option C perpetuates gender stereotypes, and option D is not accurate for all individuals experiencing crisis.

Question 10

A client tells a nurse that he believes he has an anxiety disorder because his mom and sister both have anxiety disorders.The nurse recognizes that the client believes in which theory related to the etiology of anxiety disorders?
A)Neurochemical theories
B)Neurobiological theories
C)Genetic theories
D)Humanistic theories

Accepted Answer

The client believes that anxiety disorders run in his family, suggesting he subscribes to the genetic theory of anxiety disorder etiology.

Question 11

What characteristic is essential for individuals to adapt to crisis in a positive way?
A)Security
B)Strength
C)Resilience
D)Independence

Accepted Answer

Resilience is the ability to recover and adapt to adversity, challenges, and crisis. It involves being flexible, having a positive attitude, and having the ability to problem-solve and cope with stress. Resilient individuals can better navigate unexpected changes and challenges, and are more likely to bounce back from difficult situations. Security, strength, and independence may be important, but resilience is essential for positive adaptation to crisis.

Question 12

After an assessment,the nurse determines that an older adolescent client is experiencing a maturational crisis because of which findings? Select all that apply.
A)Relationship with significant other ended
B)Inability to focus on school studies
C)Cannot sleep at night and skips classes
D)Recent death of a friend
E)Graduating from high school in 2 months

Accepted Answer

A) Senior year is a transition to work or college. This is a developmental progression to the next level of maturity, a predictable event experienced by nearly all individuals. The client is demonstrating stressors unique to progressing to the next level of maturity. The recent death of a friend and having a relationship with a significant other end are situational crises.
B) Senior year is a transition to work or college. This is a developmental progression to the next level of maturity, a predictable event experienced by nearly all individuals. The client is demonstrating stressors unique to progressing to the next level of maturity. The recent death of a friend and having a relationship with a significant other end are situational crises.
C) Senior year is a transition to work or college. This is a developmental progression to the next level of maturity, a predictable event experienced by nearly all individuals. The client is demonstrating stressors unique to progressing to the next level of maturity. The recent death of a friend and having a relationship with a significant other end are situational crises.
D) Senior year is a transition to work or college. This is a developmental progression to the next level of maturity, a predictable event experienced by nearly all individuals. The client is demonstrating stressors unique to progressing to the next level of maturity. The recent death of a friend and having a relationship with a significant other end are situational crises.
E) Senior year is a transition to work or college. This is a developmental progression to the next level of maturity, a predictable event experienced by nearly all individuals. The client is demonstrating stressors unique to progressing to the next level of maturity. The recent death of a friend and having a relationship with a significant other end are situational crises.

Question 13

The nurse is providing care to a client who is experiencing a crisis.Which statement by the client indicates that the goals of care have not been met?
A)"I came up with some ideas on how to cope when I am in this position."
B)"I feel like I am in control and can begin managing things now."
C)"I am not sure whom I am going to call when I start feeling like this again."
D)"I can deal with this,I am a strong person,and I have a lot of friends and family."

Accepted Answer

The statement "I am not sure whom I am going to call when I start feeling like this again" indicates that the client is unsure of how to access appropriate support and resources during future crises, suggesting that the goals of care have not been fully met. The other statements demonstrate progress towards coping and self-management.

Question 14

The nurse needs to plan interventions to address a client's crisis.Which action by the nurse is appropriate?
A)Develop the plan prior to meeting with the client.
B)Conduct a complete assessment.
C)Determine follow-up.
D)Focus on long-term problems.

Accepted Answer

Conducting a complete assessment is essential prior to planning interventions for a client in crisis. This will provide the nurse with a better understanding of the client's situation and help them tailor interventions to meet the client's specific needs. Developing a plan prior to meeting with the client or focusing on long-term problems may be premature or inappropriate without fully understanding the situation, while determining follow-up can be addressed as part of the overall plan.

Question 15

A client states to the nurse,"I experience shortness of breath and dizziness every time I get into an elevator." Which actions by the nurse are appropriate based on this data? Select all that apply.
A)Assist the client to rethink the degree of anxiety associated with elevators.
B)Ask the client how he has survived in life so far with elevators.
C)Instruct the client in deep breathing exercises.
D)Suggest that the client should avoid elevators.
E)Tell the client that elevators are completely safe.

Accepted Answer

A) Deep breathing exercises can help the client reduce the anxiety associated with a fearful situation, such as entering an elevator. Assisting the client to rethink the degree of anxiety associated with elevators helps the client learn to manage the anxiety. Suggesting that the client avoid elevators will not help the client. Asking the client how he has survived in life so far with elevators will not help the situation. Telling the client that elevators are completely safe might not be true and should not be said to the client.
B) Deep breathing exercises can help the client reduce the anxiety associated with a fearful situation, such as entering an elevator. Assisting the client to rethink the degree of anxiety associated with elevators helps the client learn to manage the anxiety. Suggesting that the client avoid elevators will not help the client. Asking the client how he has survived in life so far with elevators will not help the situation. Telling the client that elevators are completely safe might not be true and should not be said to the client.
C) Deep breathing exercises can help the client reduce the anxiety associated with a fearful situation, such as entering an elevator. Assisting the client to rethink the degree of anxiety associated with elevators helps the client learn to manage the anxiety. Suggesting that the client avoid elevators will not help the client. Asking the client how he has survived in life so far with elevators will not help the situation. Telling the client that elevators are completely safe might not be true and should not be said to the client.
D) Deep breathing exercises can help the client reduce the anxiety associated with a fearful situation, such as entering an elevator. Assisting the client to rethink the degree of anxiety associated with elevators helps the client learn to manage the anxiety. Suggesting that the client avoid elevators will not help the client. Asking the client how he has survived in life so far with elevators will not help the situation. Telling the client that elevators are completely safe might not be true and should not be said to the client.
E) Deep breathing exercises can help the client reduce the anxiety associated with a fearful situation, such as entering an elevator. Assisting the client to rethink the degree of anxiety associated with elevators helps the client learn to manage the anxiety. Suggesting that the client avoid elevators will not help the client. Asking the client how he has survived in life so far with elevators will not help the situation. Telling the client that elevators are completely safe might not be true and should not be said to the client.

Question 16

A client who has just experienced a crisis is likely to present to the emergency department with which clinical manifestation?
A)Depression
B)Disorientation
C)Fatigue
D)Sleeplessness

Accepted Answer

Disorientation is a common clinical manifestation in individuals who have just experienced a crisis. They may feel confused, overwhelmed, and unsure of their surroundings or what has happened. Other possible symptoms may include physical symptoms such as palpitations, difficulty breathing, or sweating. Depression, fatigue, and sleeplessness may all be experienced as a result of the crisis, but they may not be the presenting symptom in the emergency department.

Question 17

Which of these is an accurate description of a crisis?
A)An acute event that is detrimental
B)A chronic event that is intermittent
C)A chronic event that is consistent and ongoing
D)An acute event that will resolve

Accepted Answer

A)A crisis is an acute event, not a chronic event. Crises usually resolve within 4-6 weeks. A crisis can provide opportunities for growth or deterioration, so not all crises are detrimental.
B)A crisis is an acute event, not a chronic event. Crises usually resolve within 4-6 weeks. A crisis can provide opportunities for growth or deterioration, so not all crises are detrimental.
C)A crisis is an acute event, not a chronic event. Crises usually resolve within 4-6 weeks. A crisis can provide opportunities for growth or deterioration, so not all crises are detrimental.
D)A crisis is an acute event, not a chronic event. Crises usually resolve within 4-6 weeks. A crisis can provide opportunities for growth or deterioration, so not all crises are detrimental.

Question 18

A nurse on the behavioral health unit is leading a group regarding risk factors for anxiety.At the completion of group work,which comment made by a client would indicate the need for further teaching?
A)"A lack of social interaction places me at risk for anxiety."
B)"My personality could place me at risk for anxiety because I am shy."
C)"Chronic illness is not a risk factor unless I am also unemployed."
D)"I experienced a traumatic event that placed me at risk for having this anxiety disorder."

Accepted Answer

The comment that chronic illness is not a risk factor unless the person is also unemployed is incorrect. Chronic illness can be a risk factor for anxiety regardless of employment status. This indicates a need for further education on risk factors for anxiety. The other options demonstrate understanding of risk factors for anxiety.

Question 19

A client states,"I haven't left my house for 6 years." Based on this data,which diagnosis does the nurse anticipate for this client?
A)Hematophobia
B)Social anxiety disorder
C)Pathophobia
D)Agoraphobia

Accepted Answer

The client's statement indicates prolonged avoidance of leaving the house, which is a key feature of agoraphobia. Hematophobia is a fear of blood, pathophobia is a fear of disease, and social anxiety disorder is characterized by anxiety in social situations, but none of these accurately reflect the client's reported behavior.

Question 20

A clinic nurse is assessing a client who is experiencing crisis.The nurse needs to determine the client's immediate needs.Which is the priority action by the nurse?
A)Scan for physical distress.
B)Explore perceptions of the crisis.
C)Develop a follow-up plan.
D)Assess for immediate safety needs.

Accepted Answer

In a crisis situation, the immediate priority of the nurse should be to assess for any immediate safety needs of the client. This could include assessing for suicidal ideation, self-harm, or harm to others. The nurse must ensure that the client is safe before exploring their perceptions of the crisis or developing a follow-up plan. Scanning for physical distress is also important, but it is not the immediate priority in a crisis situation.

Quiz 31: Stress and Coping

A nurse is caring for a client in crisis.While providing care it is imperative that the nurse communicate effectively with this client.Which is true when communicating with clients in crisis? Select all that apply.

Free-floating anxiety is often connected to what stimulus?

A client with what level of anxiety would be most receptive to learning tools that would help the client recognize triggers?

Which nursing diagnosis would be a priority for a client who is experiencing a situational crisis?

The nurse is discharging a client diagnosed with general anxiety disorder (GAD) .The client is prescribed a selective serotonin reuptake inhibitor (SSRI) .Which statement made by the client would indicate to the nurse a need for further education?

The nurse is beginning crisis counseling with a client.What actions will the nurse use when counseling the client? Select all that apply.

The nurse is providing care to a client who is "in crisis." The client recently lost a job,was served with divorce papers,and has been sick with back-to-back colds for 1 month.Which nursing statement demonstrates understanding of the care of a client in crisis?

A client tells a nurse that he believes he has an anxiety disorder because his mom and sister both have anxiety disorders.The nurse recognizes that the client believes in which theory related to the etiology of anxiety disorders?

What characteristic is essential for individuals to adapt to crisis in a positive way?

After an assessment,the nurse determines that an older adolescent client is experiencing a maturational crisis because of which findings? Select all that apply.

The nurse is providing care to a client who is experiencing a crisis.Which statement by the client indicates that the goals of care have not been met?

The nurse needs to plan interventions to address a client's crisis.Which action by the nurse is appropriate?

A client states to the nurse,"I experience shortness of breath and dizziness every time I get into an elevator." Which actions by the nurse are appropriate based on this data? Select all that apply.

A client who has just experienced a crisis is likely to present to the emergency department with which clinical manifestation?

Which of these is an accurate description of a crisis?

A nurse on the behavioral health unit is leading a group regarding risk factors for anxiety.At the completion of group work,which comment made by a client would indicate the need for further teaching?

A client states,"I haven't left my house for 6 years." Based on this data,which diagnosis does the nurse anticipate for this client?

A clinic nurse is assessing a client who is experiencing crisis.The nurse needs to determine the client's immediate needs.Which is the priority action by the nurse?