A nurse is caring for a client who is experiencing a crisis. Which of the following actions should the nurse take first?
Refer the client to crisis intervention services.
Determine the client's previous methods of coping with crisis.
Discuss with the client the cause of the crisis.
Assist the client to develop strategies to overcome the crisis.
The Correct Answer is B
Choice A rationale:
Referring the client to crisis intervention services might be necessary, but before doing so, the nurse should gather information to understand the client's current situation and coping mechanisms.
Choice B rationale:
Assessing the client's previous coping methods helps the nurse understand the client's strengths and provides insights into potential strategies for managing the crisis effectively.
Choice C rationale:
Discussing the cause of the crisis might be helpful, but it's important to first assess the client's current coping abilities and resources.
Choice D rationale:
Assisting the client in developing strategies to overcome the crisis is important, but it should come after a thorough assessment of the client's current coping mechanisms and situation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
Appointing the client as a leader may not be appropriate, as individuals with antisocial personality disorder may misuse their position of authority.
Choice B rationale:
Clients with antisocial personality disorder often struggle with interpersonal relationships, may be manipulative, and may engage in behaviors that violate the rights of others. Monitoring the client's interactions with other clients helps ensure a safe and therapeutic environment while preventing harm to others.
Choice C rationale:
Offering warnings before consequences might not be effective with clients who have antisocial personality disorder, as they may disregard rules and consequences.
Choice D rationale:
Assigning a room near the activity area does not necessarily address the need to monitor the client's interactions with others.
Correct Answer is A
Explanation
Choice A rationale:
Instructing the parent to remove their shirt allows for direct skin-to- skin contact between the parent's chest and the preterm newborn, which is commonly known as kangaroo care. This technique promotes bonding, warmth, and comfort for both the parent and the newborn.
Choice B rationale:
Placing the newborn and parent in a private room that is brightly lit might not be optimal for skin-to-skin care, as preterm newborns are sensitive to light and sound. A calm and dimly lit environment is preferred.
Choice C rationale:
Placing the newborn in a horizontal position in the parent's arms is appropriate, as it allows for skin-to-skin contact and facilitates bonding. The newborn's head is positioned near the parent's chest to listen to the heartbeat.
Choice D rationale:
Completely undressing the newborn is not necessary for skin-to-skin care and may cause discomfort to the newborn. Keeping the newborn dressed in a diaper is sufficient.
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