A nurse is caring for a client who has a new diagnosis of human immunodeficiency virus (HIV). He states, "I don't care what the doctors say, there is no way I can have HIV, and I don't need treatment for something I don't have." The nurse identifies that the client is experiencing which of the following types of crisis?

Maturational.

Adventitious.

Internal.

Situational.

Answer and Explanation

The Correct Answer is D

Answer is d. Situational.

a. Maturational crisis: This type of crisis occurs in response to life transitions or developmental stages, such as marriage, parenthood, retirement, or aging. It involves challenges related to adjusting to new roles, responsibilities, or expectations. However, the client's denial of a new HIV diagnosis and refusal of treatment do not align with the characteristics of a maturational crisis, as it pertains to planned life events rather than unexpected health crises.

b. Adventitious crisis: Adventitious crises are caused by events that are unplanned, unexpected, and often traumatic, such as natural disasters, accidents, or crimes. These crises can affect individuals, families, or communities and may result in significant psychological distress and disruption. However, the client's denial of an HIV diagnosis does not fit the criteria for an adventitious crisis, as it is a personal health issue rather than an external event affecting a broader population.

c. Internal crisis: While internal struggles and conflicts can contribute to a person's overall crisis experience, "internal crisis" is not a recognized category within the context of nursing crises. Internal factors such as psychological distress, unresolved trauma, or maladaptive coping mechanisms may exacerbate crisis situations, but they are typically addressed within the framework of other crisis categories such as situational, maturational, or existential crises.

d. Situational crisis: Correct. A situational crisis arises from an external event or situation that the individual finds overwhelming, threatening, or challenging to cope with. In this scenario, the client's denial of their HIV diagnosis and refusal of treatment represent a situational crisis as it stems from the unexpected news of their health condition. The client's perception of the diagnosis as threatening or inconceivable leads to emotional distress and maladaptive coping mechanisms, which can hinder their ability to accept and manage their medical condition effectively.

In summary, the correct answer is d because the client's denial of their HIV diagnosis and refusal of treatment align with the characteristics of a situational crisis, which arises from an external event that the individual perceives as overwhelming or threatening. Understanding the nature of the crisis can guide the nurse in providing appropriate support, education, and intervention to help the client navigate through this challenging time and make informed decisions regarding their healthcare.

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Correct Answer is C

Explanation

Choice A rationale:

Approaching the client frequently throughout the day for brief interactions might exacerbate the client's suspiciousness and discomfort. Individuals who are extremely suspicious may interpret frequent approaches as intrusive or manipulative, leading to increased agitation or withdrawal.

Choice B rationale:

Disclosing personal information to the client in an attempt to demonstrate approachability is not recommended. Sharing personal information can blur professional boundaries and may not necessarily address the client's suspicion. It's important to build trust gradually through consistent, respectful, and professional interactions.

Choice C rationale:

Adopting a neutral attitude when providing care is appropriate because it helps create a non-threatening environment. Individuals who are suspicious may interpret overly friendly or emotionally charged behavior as insincere or manipulative. A neutral and respectful approach allows the client to feel more comfortable and safe in the nurse's presence.

Choice D rationale:

Waiting for the client to initiate interaction may not be effective in establishing a therapeutic relationship. Extremely suspicious clients might be hesitant to initiate interactions due to their mistrust. Nurses should take the initiative to approach clients with suspicion in a respectful and neutral manner to gradually build rapport and trust.

A. Decreases or eliminates a behavior by introducing a more adaptive behavior that is incompatible with the unacceptable behavior. B. Is an aversion therapy that produces unpleasant consequences for undesirable behavior. C. An aversive stimulus or punishment during which the client is removed from the environment where the unacceptable behavior is being exhibited. D. Relies on individual's imagination rather than medication for unpleasant symptoms.

Correct Answer is B

Explanation

The correct answer is choice B: Is an aversion therapy that produces unpleasant consequences for undesirable behavior.

Choice A rationale:

Decreases or eliminates a behavior by introducing a more adaptive behavior that is incompatible with the unacceptable behavior. Choice A refers to the technique of "differential reinforcement," where an undesirable behavior is replaced by a more appropriate behavior. This technique involves reinforcing positive behaviors while ignoring or providing minimal attention to negative behaviors. It is not the same as covert sensitization.

Choice B rationale:

Is an aversion therapy that produces unpleasant consequences for undesirable behavior. Covert sensitization is a form of aversion therapy used to eliminate unwanted behaviors by associating them with unpleasant imagery or thoughts. It's based on the principle that if a person can associate a negative response with a certain behavior, they will be less likely to engage in that behavior. This technique is used for behaviors like addiction or certain compulsive behaviors.

Choice C rationale:

An aversive stimulus or punishment during which the client is removed from the environment where the unacceptable behavior is being exhibited. Choice C refers to "time-out," a technique used to decrease undesirable behaviors by removing the individual from the environment where the behavior is occurring. This is often used with children and involves giving them a brief break from a situation to help them calm down. It's not the same as covert sensitization.

Choice D rationale:

Relies on an individual's imagination rather than medication for unpleasant symptoms. Choice D is not directly related to covert sensitization. Covert sensitization involves creating a negative association with a behavior using mental imagery. It's not about relying on imagination instead of medication.

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is extremely suspicious of the nursing staff and other clients. Which of the following nursing approaches is appropriate when establishing a therapeutic relationship with this client?

Correct Answer is C

Explanation

The nurse is assessing a client in group therapy on which type of techniques for modifying behaviors would be most appropriate. The nurse has decided to use covert sensitization. Which of the following statementbest describes this type of therapy?

Correct Answer is B

Explanation

A nurse is planning care for a client newly admitted with major depressive disorder. After ensuring safety, which of the following actions should the nurse plan to take?

A nurse is planning care for a client who has dependent personality disorder. Which of the following actions should the nurse plan to take?

A nurse is caring for a client who has paranoid personality disorder. Which of the following findings should the nurse expect? (Select all that apply.).

A nurse is providing teaching to a client diagnosed with schizophrenia and is prescribed haloperidol (Haldol). Which of the following information should the nurse include in the teaching?

A nurse is caring for a school-age child who has a history of conduct disorder. Which of the following actions should the nurse take while caring for the child? (Select all that apply.).

The community health nurse recognizes that which of the following mental health issues is most prevalent in the homeless population?

A nurse is teaching a newly licensed nurse about reporting suspected child abuse. Which of the following statements indicates that the newly licensed nurse has the correct information about child abuse?