Ch. 10 Intervening in crises part 2 (Test 2)

Question 1

What is Phase 2 of crisis intervention?

Answer 1

Planning of therapeutic intervention. From the assessment data, the nurse selects appropriate nursing diagnoses that reflect the immediacy of the crisis situation.

Question 2

In what stage are desired outcome criteria established?

Answer 2

Phase 2

Question 3

When appropriate nursing actions are selected, what is taken into consideration?

Answer 3

The type of crisis as well as the individual’s strength and available resources for support

Question 4

What is phase 3 of crisis intervention?

Answer 4

Intervention. The actions identified in the planning phase are implemented.

Question 5

What approach is used in phase 3?

Answer 5

Reality oriented

Question 6

How is a rapid working relationship established? In what phase does this occur?

Answer 6

By showing unconditional acceptance, by active listening, and by attending to immediate needs. Phase 3.

Question 7

What is the basis for change in phase 3?

Answer 7

A problem solving model becomes the basis for change

Question 8

What is phase 4 of crisis intervention?

Answer 8

Evaluation of crisis resolution and anticipatory planning. A reassessment is conducted to determine whether the stated objectives were achieved.

Question 9

What is developed in phase 4?

Answer 9

A plan of action is developed for the individual to deal with the stressor should it recur

Question 10

Anger can be identified by a cluster of characteristics that include:

Answer 10

Frowning, clenched fists, low pitched voice, yelling and shouting, intense (or no) eye contact, easily offended, defensive response to criticism, passive aggressive behavior, flushed face, emotional over control, intense discomfort

Question 11

Aggression can be identified by a cluster of characteristics that include:

Answer 11

Pacing, restlessness, verbal or physical threats, threats of homicide or suicide, loud voice, argumentative, tense facial expression and body language, increased agitation with overreaction to environmental stimuli, panic anxiety leading to misinterpretation of the environment, disturbed thought processes, suspiciousness, angry mood often disproportionate to the situation

Question 12

A major difference between anger and aggression is what?

Answer 12

Intent. Aggression refers to behavior that is intended to inflict harm or destruction.

Question 13

What is the key issue in management of aggressive or violent behaviors?

Answer 13

Prevention

Question 14

What three factors are important considerations in identifying extent of risks?

Answer 14

Past history of violence, client diagnosis, current behaviors

Question 15

What is the most widely recognized risk factor for violence in a treatment setting?

Answer 15

Past history of violence

Question 16

The most common client diagnosis associated with violence are?

Answer 16

Substance abuse/intoxication, schizophrenia, mood disorders, dementia, antisocial/borderline/and intermittent explosive personality disorders

Question 17

Certain (what?) are predictive of impending violence and have been called a (what?); they include…?

Answer 17

Current behaviors. Prodromal syndrome. They include anxiety and tension, verbal abuse and profanity, and increasing hyperactivity

Question 18

Specific behaviors associated with the prodromal syndrome include:

Answer 18

Rigid posture, clenched fists and jaws, grim and defiant affect, talking in a rapid raised voice, arguing and demanding, using profanity and threatening verbalizations, agitation and pacing, and pounding and slamming

Question 19

Nursing diagnoses for inappropriate expression of anger or for aggressive behavior include:

Answer 19

Ineffective coping, risk for self directed or other directed violence

Question 20

What are identified as criteria for evaluation regarding anger and aggression management?

Answer 20

Outcome behaviors

Question 21

Anger and aggression management interventions:

Answer 21

Remain calm, set verbal limits on behavior, keep diary of anger, avoid touching the client, help determine source of anger, ignore derogatory remarks, help find alternative ways of releasing tension, role-model, observe for escalation of anger, when behaviors are observed first ensure that sufficient staff are available

Question 22

Techniques for dealing with aggression include:

Answer 22

Talking down, physical outlets, medications, call for assistance, restraints, observation and documentation, ongoing assessment, staff debriefing

Question 23

Evaluation of anger and aggression management

Answer 23

Evaluation consists of reassessment to determine if the nursing interventions have been successful in achieving the objectives of care

Question 24

What is a common feature of disasters?

Answer 24

They overwhelm local resources and threaten the function and safety of the community

Question 25

Disasters leave victims with…?

Answer 25

A damaged sense of safety and well being and varying amounts of emotional trauma

Question 26

Disaster nursing assessment- grieving is a (what?) response:

Answer 26

Natural response

Question 27

Common behavioral responses to disaster include:

Answer 27

Anger, disbelief, sadness, anxiety, fear, sleep disturbances, and increase in alcohol, caffeine, and tobacco use

Question 28

Children after disaster may experience:

Answer 28

Separation anxiety, nightmares, and problems with concentrating

Question 29

Disaster nursing diagnoses

Answer 29

Risk for injury, risk for infection, anxiety (panic), fear, spiritual distress, risk for Post-Trauma Syndrome, ineffective community coping.

Question 30

Disaster nursing outcome identification

Answer 30

Outcome behaviors are identified as criteria for evaluation

Question 31

Disaster nursing interventions are aimed at?

Answer 31

1. Maintaining anxiety at a manageable level. 2. Encouraging free expression of beliefs and values about spiritual issues. 3. Assistance to deal with emotional reactions in an individually appropriately manner. 4. Promotion of activities to improve community functioning.

Question 32

Evaluation of disaster nursing

Answer 32

Evaluation consists of reassessment to determine if the nursing interventions have been successful in achieving the objectives of care