Chapter 21: Crisis, Loss, Grief, Bereavement, and Disaster Management

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Analyze

Integrated Process: Nursing Process

Objective: 3

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1. A nurse is assessing a 35-year-old client who is seeking assistance at a local community counseling center. Which statement would indicate that the client is experiencing a crisis?

A) “I’m so upset; my spouse has never left me like this before.”

B) “I’m confused and hurt; I have lost my best friend and my lover.”

C) “I don’t understand; I can’t seem to function like I usually do.”

D) “No matter what I do, I am still overcome by these sad feelings.”

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2. A client’s poodle ran in front of a car and was killed. The client continues to be upset by the pet’s death, and explains to a community counseling center nurse, “I can’t stop crying because my Precious meant the world to me, and now my world will never be the same!” If the nurse were to determine that the client was experiencing a crisis, which type of crisis would it most likely be?

A) Maturational

B) Situational

C) Traumatic

D) Developmental

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3. A 62-year-old client experienced the loss of an 87-year-old parent a week ago. A hospice nurse is making a follow-up visit to determine how the client is handling the death. Which statement indicates to the hospice nurse that the client is in the acute mourning stage of bereavement?

A) “I keep thinking about my father; I have trouble believing he’s dead. I feel guilty because I didn’t go to the nursing home to visit him last week!”

B) “I’ve been grieving my father; losing him is a tremendous loss, but I have to get on with my life.”

C) “My father was a saint. I am so angry at God for taking him away! I’m crying all the time; I haven’t been able to work for days.”

D) “I’m going to spend the weekend with my children; they understand what I’ve been going through, and I can relax around them.”

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4. A 25-year-old client is seeking counseling for recently and unexpectedly losing a job. Which question would be most appropriate for a nurse to use in assessing the client’s response to losing the job?

A) “What happened to cause you to lose your job?”

B) “How did you feel immediately after being told you no longer had a job?”

C) “How do you expect yourself to be able to handle this situation?”

D) “How have you responded to previous stressful situations?”

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5. An individual is seeking employment as a nurse in a crisis center. The interviewer asks the job candidate what the candidate would ask to determine whether the caller was experiencing a crisis. Which response would be most appropriate?

A) “To what extent are you involved in a crisis situation?”

B) “Tell me about what you are experiencing and what it means to you.”

C) “How would you rate your level of functioning on a scale from 1 to 10?”

D) “Why do you think you are in a crisis situation?”

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6. A Red Cross nurse is working with tornado victims. The nurse is interviewing a client whose house was totally destroyed and pet poodle died as a result of the tornado. Which statement would the nurse most likely expect to hear from this client?

A) “I don’t know. I can’t feel anything right now. Nothing seems real.”

B) “I just feel totally devastated. I don’t know how I can go on living.”

C) “I just want my insurance man to get here so I can file a claim. Everything I had is gone.”

D) “I always thought my dog would die peacefully in my arms. Now I’ll never be able to hold her again.”

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7. A nurse is part of team working with hurricane victims. One of the hurricane victims is staying in a temporary shelter provided by the Red Cross. To determine the extent to which this victim can cognitively cope with the situation and how much support is needed, which question would be most appropriate for the nurse to ask?

A) “What kind of help do you need from us?”

B) “What are your thoughts about what you will do during the next few days?”

C) “How are you feeling about all that you have gone through?”

D) “Are you feeling guilty because you survived and some of your neighbors did not?”

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8. A family has just lost their home in a fire. An on-call nurse from a community counseling center has been called in to the emergency department to help them with this traumatic event. Which priority would the nurse identify for this family?

A) Arranging for follow-up therapy to deal with the crisis

B) Completing a family genogram to determine family patterns

C) Assessing the impact of the loss on their lifestyle

D) Arranging for emergency shelter and food supplies

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9. A nursing instructor is lecturing to students about how to respond to individuals who are in the midst of a disaster. Which statement would be most appropriate to include about initial nursing interventions for such individuals?

A) “You should ask them to give you a brief medical history so their physical needs can be met.”

B) “Focus on safety needs and provide simple, clear instructions to help them function effectively.”

C) “Help them determine what their long-term goals will be so they can maintain a sense of hope.”

D) “Try to redirect their attention away from the problems at hand so you can decrease their anxiety.”

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10. A nurse is working as part of a community disaster response team. When responding to a community disaster, the nurse integrates understanding of individuals’ reactions by anticipating which response?

A) People can become aggressive and violent when their basic needs are threatened.

B) People involved in the disaster will always put the welfare of others before their own.

C) Losses incurred during the disaster have little, if any, long-term effect on victims.

D) The psychological distress associated with disasters is felt immediately.

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11. A group of nursing students is reviewing information about the types of crisis. The students demonstrate understanding of the information when they identify which happening as a developmental crisis?

A) Going away to college

B) Obtaining a job promotion

C) Loss of a pet

D) Earthquake

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12. As part of a community program on crisis prevention, a nurse is describing the phases of crisis. Which phase would the nurse identify as occurring first?

A) Person has a problem that doesn’t “fit” with the usual problem-solving methods.

B) Trial and error attempts are made to alleviate the problem.

C) Automatic relief behaviors take over as the “fight-or-flight” hormones dissipate.

D) Person has serious personality disorganization.

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13. A nurse is assessing the parents of a 6-year-old child who has died from leukemia. The nurse is integrating the Dual Process model (DPM) for the assessment. Which action would the nurse identify as reflecting the parents’ loss-oriented coping?

A) Engaging in new activities

B) Denying the grief

C) Developing new relationships

D) Thinking about the lost child

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14. A psychiatric–mental health nurse is describing uncomplicated bereavement to a group of nurses working with terminally ill clients. Which information would the nurse most likely include in the discussion?

A) Uncomplicated bereavement differs from normal bereavement because it lasts longer.

B) Most bereaved persons experience uncomplicated bereavement.

C) Uncomplicated bereavement is primarily loss associated with death.

D) This type of bereavement is less painful and disruptive than normal bereavement.

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15. After teaching a group of nurses about crisis, the group leader determines that the education was successful based on which statement by the group?

A) “Crisis usually results in negative outcomes.”

B) “Crisis is a time-limited event.”

C) “Chronic crisis is a real situation.”

D) “Events causing a crisis are similar for everyone.”

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16. The nurse is providing follow-up care to victims of a disaster that occurred several months ago. Which finding would lead the nurse to suspect that the victims are experiencing possible aftereffects of the disaster?

A) Tachycardia

B) Profuse perspiration

C) Unexplained gastrointestinal disturbance

D) Tremors

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17. A nurse is working with a client who is in crisis. Which action would be least appropriate for the nurse to take?

A) Support the client’s cultural beliefs about expressing feelings.

B) Encourage the client to focus on one aspect at a time.

C) Provide the client with an understanding that everything will be okay.

D) Explain information clearly to clarify any misconceptions or myths.

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18. A group of nursing students is reviewing information about grief and bereavement. The students demonstrate understanding of the information when making which statement?

A) Grief and bereavement are used interchangeably as responses to loss.

B) Bereavement is the process of mourning and grief is the emotional reaction.

C) Grief involves confronting the stressor, but bereavement helps to avoid the stressor.

D) Bereavement is influenced by culture, but grief is not.

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19. Assessment of a client indicates complicated grief. Which statement would the nurse identify as supporting this reaction? Select all that apply.

A) “It’s been 2 months, and I still want my son back.”

B) “I still wait for him to come right through the door every day.”

C) “I’m really struggling with trusting anybody anymore.”

D) “I wish I could go back to the days before he died.”

E) “Life seems so empty now that he’s gone. What will I do?”