Author Question: The nurse is communicating with a client who is experiencing a crisis related to marital ... (Read 78 times)

kodithompson · **on:** Jul 8, 2018

The nurse is communicating with a client who is experiencing a crisis related to marital difficulties. Which of the following statements made by the nurse is the best example of therapeutic communication when working with this client?

a. I think we should work toward fixing your marital difficulties immediately.
b. I'm going to call the counselor and make an appointment for you.
c. What would happen if you chose to go for counseling compared to seeking a divorce?
d. I think you and your spouse need to go for counseling as soon as possible.

Question 2

The nurse is caring for an older adult client who has recently lost his job, is experiencing a major physical illness, and lives alone. The client states, I sometimes wish I wasn't here. When working with this client, the nurse recognizes that

a. an increase in the client's energy level indicates the client is coping better.
b. older adult clients have a lower rate of suicide.
c. the client should be assessed for imminent danger of doing harm to self.
d. when the client begins giving away possessions, it is a positive sign.

CAPTAINAMERICA · **Reply #1 on:** Jul 8, 2018

Answer to Question 1

ANS: C
Clients in crisis generally feel powerless. Nurses can introduce alternative methods that the client may not have considered. Helping a client examine the consequences of proposed solutions and breaking tasks down into small, achievable parts empowers clients. Proposed solutions should accommodate both the problem and client resources. It's helpful to assist clients in discussing the consequences, costs, and benefits of choosing of one action versus another (e.g., What would happen if you chose this course of action as compared to? or What is the worst that could happen if you decided to?). The locus of control for decision making should always remain with the client to whatever extent is possible. Making autonomous choices encourages clients to become invested in the solution-finding process and hopeful about finding a resolution to a crisis situation.

Answer to Question 2

ANS: C
Verbal indicators of potential suicide include statements such as I don't think I can go on without . . .; I sometimes wish I wasn't here; or People would be better off without me. Risk factors for suicide include a major physical illness, social isolation, and a recent major loss. A major goal in evaluating suicidal risk is to assess whether the client is in imminent danger of doing harm to self. Irrational behaviors, drug and alcohol abuse, previous suicide attempts, and verbal threats are matters of concern, as is a sudden mood changeespecially if the client demonstrates much more energy. Suicide rates are higher for older adults, especially for white males. Behavioral indicators of escalating suicidal ideation include giving away possessions.