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 D

Explanation

Answer is d. Maintain eye contact with the client and summarize the client’s feelings.

a. Identify other housing options and sources of transportation: While it is essential to address practical needs such as housing and transportation for clients who have experienced a crisis like a house fire, it is not the immediate priority when the client is in acute emotional distress. In this scenario, the client is expressing emotional distress and may not be ready to focus on practical solutions. Therefore, addressing the client's emotional needs should take precedence over addressing practical concerns.

b. Notify the facility chaplain to request scheduling an appointment: While spiritual support can be beneficial for individuals coping with trauma or loss, it should not be the immediate response when a client is in acute emotional distress. While the chaplain's support may be sought later as part of the client's holistic care, it should not precede addressing the client's immediate emotional needs.

c. Confirm that everything will be all right because belongings can be replaced: This option is incorrect because it offers false reassurance and dismisses the client's feelings about their loss. While it is true that belongings can be replaced, the emotional impact of losing possessions, especially in a traumatic event like a house fire, should not be trivialized. The client's feelings of distress and uncertainty are valid and should be acknowledged and addressed by the nurse.

d. Maintain eye contact with the client and summarize the client’s feelings: Correct. This action demonstrates therapeutic communication, which is crucial in providing an atmosphere of support and safety for the client. Maintaining eye contact shows empathy, support, and advocacy, indicating to the client that their feelings are being heard and validated. Summarizing the client's feelings allows the nurse to demonstrate active listening and understanding, fostering trust and rapport between the nurse and client. By prioritizing the client's emotional needs, the nurse can help the client begin to process their feelings and move towards coping and problem-solving.

In summary, the correct answer is d because maintaining eye contact with the client and summarizing their feelings demonstrates therapeutic communication, which is essential in providing support and validation for the client's emotional distress. This approach allows the nurse to establish rapport and trust with the client, facilitating further therapeutic interventions and support.

A. Democratic. B. Surrogate. C. Laissez-faire. D. Autocratic.

Correct Answer is A

Explanation

Choice A rationale:

In a democratic leadership style, the leader involves the group in decision-making and encourages open discussion. By asking the group for their input on resolving the bathroom issue, the nurse is demonstrating democratic leadership.

Choice B rationale:

A surrogate leadership style involves a designated individual acting as a substitute for the leader. It's not applicable in this scenario where the nurse is involving the group in decision-making.

Choice C rationale:

Laissez-faire leadership involves minimal interference and decision-making by the leader. In this scenario, the nurse is actively seeking group input, which contradicts the laissez-faire approach.

Choice D rationale:

An autocratic leadership style involves the leader making decisions without group input. Since the nurse is soliciting ideas from the group, this style doesn't apply here.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who lost all his possessions in a house fire and states, "I have no idea what I am going to do. I cannot think right now." Which of the following actions should the nurse take?

Correct Answer is D

Explanation

During a group therapy meeting, a client brings up a concern about the cleanliness of the bathroom. The nurse asks the group what should be done about the issue and how to resolve it. The nurse is demonstrating which type of leadership style?

Correct Answer is A

Explanation

A nurse is caring for a client who is experiencing a manic episode. Other clients begin to complain about her disruptive behavior on the unit. Which of the following actions should the nurse take?

A nurse notices that a client who has moderate anxiety is pacing the corridor and rambling. As the nurse approaches, the client states, "I am at the end of my rope. I don't think I can take any more bad news." Which of the following responses should the nurse make?

A nurse is caring for a client who has been diagnosed with end-stage liver cancer. The nurse recognizes that which of the following responses is an indication the client is in the denial phase of the grief process?

A nurse at a walk-in mental health clinic is assessing a client experiencing severe anxiety. The nurse should recognize the client might exhibit which of the following manifestations?

A nurse is assessing a client who has illness anxiety disorder. Which of the following findings should the nurse expect?

A nurse in a mental health clinic is attempting to develop a therapeutic relationship with a client. Which of the following should be the appropriate action by the nurse?

A nurse is caring for an adolescent client who has a new diagnosis of schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following is an appropriate statement by the nurse?

A nurse in a mental health facility is caring for a client who is upset about the loss of privileges due to repetitive negative behavior. Which of the following statements by the nurse demonstrates the effective use of assertive communication?