The nurse assigned to implement a critical incident stress ...

[deesands]

The nurse assigned to implement a critical incident stress debriefing for a group who responded to a
  plane crash disaster scene must correctly
 
  organize the elements of the debriefing for maximal
  effectiveness. Put the following elements in the order in which they should occur after an
  explanation of the purpose and ground rules of the meeting have been given.
  A. Ask each person to tell of his or her involvement in the incident.
  B. Review the material discussed, then ask how closure should proceed.
  C. Ask participants to discuss their first thoughts of the incident.
  D. Ask participants to describe cognitive, physical, and emotional/behavioral symptoms
  experienced at the scene and symptoms experienced after the initial experience.
  E. Acknowledge and affirm the normality of expressed symptoms; offer anticipatory guidance.
  F. Encourage discussion of the worst thing about the incident, what is painful, and what
  participants would like to forget.

Question 2

A client has had a series of diagnostic tests, although he protests that nothing is wrong with him
  except a chest cold that he can't shake off. The diagnostic tests reveal a mass in the left upper lobe
  of the client's lung.
 
  He is scheduled to undergo a biopsy. When the nurse explains the procedure to
  him, he seems to have difficulty grasping what she is saying and asks questions such as What do
  you mean I'm going to have surgery? What are they going to do? His voice is tremulous. His
  respirations are noticeably rapid at 28 breaths/min, and his pulse is 110 beats/min. The nurse should
  assess the client's level of anxiety as
  a. mild.
  b. moderate.
  c. severe.
  d. panic.

[Ptupou85]

Answer to Question 1

A, C, F, D, E, B
Rationale: Option A: The fact phase allows the participants to introduce themselves and tell how
each was involved, including what happened from their perspective. Option C: The thought phase
follows, with all participants discussing their first thoughts of the incident. Option F: First thoughts
are followed by a discussion of reactions to the event: the worst thing about the incident, what
participants would like to forget, and what was most painful. Option D: Symptoms are described:
what cognitive, physical, emotional, or behavioral experience they encountered at the scene and after
the initial experience. Option E: The normalcy of the symptoms is affirmed and anticipatory
guidance is given regarding possible future symptoms. Option B: What has been discussed is
reviewed, how closure should proceed is determined, referrals are provided, and the debriefing
experience is summarized.

Answer to Question 2

ANS: B
Moderate anxiety causes the individual to grasp less information and reduces problem-solving
ability to a less-than-optimal level. Option A: Mild anxiety heightens attention and enhances
problem solving. Option C: Severe anxiety causes great reduction in the perceptual field. Option D:
Panic-level anxiety results in disorganized behavior.