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 A

Explanation

Choice A rationale:

The statement "You are feeling very depressed. I felt the same way when I decided to leave my husband." is a non-therapeutic statement that demonstrates sympathy. The nurse is sharing personal experiences, which can shift the focus from the client's feelings to the nurse's own experiences.

Choice B rationale:

The statement "I can understand you are feeling depressed. It was a difficult decision. I'll sit with you." is a therapeutic response that offers support and empathy without diverting the focus to the nurse's experiences. The nurse's willingness to sit with the client is a positive aspect of this response.

Choice C rationale:

The statement "You seem depressed. It was a difficult decision to make. Would you like to talk about it?" is a therapeutic response that acknowledges the client's feelings, offers support, and invites further conversation. This response encourages the client to express themselves.

Choice D rationale:

The statement "I know this is a difficult time for you. Would you like medication for anxiety?" acknowledges the client's difficulties but immediately offers medication as a solution. While medication can be a valid option, it's important to prioritize open communication and emotional support before suggesting medication.

A. "You should try to see your partner's point of view before your own.” B. "Relationship difficulties are stressful and require effort to resolve.” C. "We could develop a plan for how to talk about this with your partner.” D. "Tell me more about the concerns that you have regarding your marriage.”

Correct Answer is A

Explanation

Choice A rationale:

Similar to the explanation in , this statement requires intervention. It reflects a judgmental and prescriptive approach, which is not conducive to a therapeutic conversation. It implies that the nurse knows what the client should do, undermining the client's autonomy and self-discovery process.

Choice B rationale:

Recognizing that relationship difficulties are stressful and require effort to resolve is a valid and supportive statement. It acknowledges the challenges the client is facing and does not impose a specific solution.

Choice C rationale:

Suggesting the development of a communication plan is a proactive and therapeutic response. It empowers the client to work collaboratively toward improving their marital situation.

Choice D rationale:

Encouraging the client to share more about their concerns promotes open communication and allows the nurse to better understand the client's perspective. This response is client-centered and supportive.

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Naxlex Comprehensive Predictor Exams

A client has made the decision to leave her alcoholic husband and reports feeling very depressed. Which of the following is a non-therapeutic statement by the nurse that demonstrates sympathy?

Correct Answer is A

Explanation

A nurse is assessing a client who is sharing information regarding concerns about their marriage. The client states "My spouse and I argue most times." Which of the following statements by the nurse requires intervention by the charge nurse?

Correct Answer is A

Explanation

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A nurse in the Emergency Department is caring for a client with symptoms of depression and admits to thoughts of self-harm with a plan. The client has a history of borderline personality disorder, depression, and substance abuse. Which of the following is the priority action by the nurse?

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