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

Correct Answer: A

Rationale: The correct answer is A: Problem stimulating usual problem solving. In crisis intervention, the first phase is when the individual encounters a problem that triggers their usual problem-solving skills. This initial phase involves recognizing the crisis and attempting to assess and address the problem. This sets the stage for further crisis intervention strategies. Choices B, C, and D are incorrect: B: Trial and error attempts to alleviate problem - This typically occurs after the crisis has been recognized and initial problem-solving attempts have been made. C: Automatic relief behaviors take over - This is more likely to be a coping mechanism employed after the crisis has escalated and the individual is seeking immediate relief. D: Serious personality disorganization - This usually occurs in the later stages of a crisis when the individual's ability to cope is severely compromised.

Correct Answer: C

Rationale: The correct answer is C, a patient diagnosed with schizophrenia. CBT may not be suitable for individuals with severe cognitive impairments like those with schizophrenia. Schizophrenia can affect a person's ability to engage in cognitive processes necessary for CBT, such as reality testing and cognitive restructuring. Patients with schizophrenia may struggle with delusions, hallucinations, and disorganized thinking, making it challenging to benefit from traditional CBT techniques. Substance abuse (A), depression (B), and eating disorders (D) are conditions that have shown to respond well to CBT techniques, making them appropriate candidates for treatment.

Correct Answer: B

Rationale: The correct answer is B: Hildegarde Peplau. She is considered the mother of psychiatric nursing and played a major role in developing specialty training programs for psychiatric nurses. Peplau's interpersonal theory of nursing emphasized the importance of the nurse-patient relationship in mental health care, leading to the integration of psychological principles into nursing practice. Nutting (A) was a nursing education pioneer, Bailey (C) was known for her work in public health nursing, and Richards (D) was the first trained nurse in the US, but they did not have the same impact on psychiatric nursing training as Peplau.

Correct Answer: A

Rationale: The correct answer is A: To have the client choose the topic of the conversation. By asking the client to share what's on their mind, the nurse is allowing the client to lead the discussion and express their concerns or thoughts. This empowers the client to direct the conversation towards what is most important to them, promoting client-centered care and fostering a sense of autonomy. Choice B is incorrect because the purpose is not to present new ideas but to encourage the client to share their own thoughts. Choice C is incorrect as conveying interest is important in therapeutic communication but not the primary purpose of this specific technique. Choice D is incorrect as the purpose is not specifically to provide time for reflection but to allow the client to initiate the conversation.

Correct Answer: C

Rationale: The correct answer is C: Limiting use of electronic devices in the hour before bedtime. Exposure to blue light emitted by electronic devices can disrupt the production of melatonin, a hormone that regulates sleep. By limiting electronic device use before bedtime, the nurse can help the individual maintain a more natural sleep-wake cycle. Choice A is not directly related to the impact of light on sleep patterns. Choice B, exercising before bedtime, can actually stimulate the body and make it harder to fall asleep. Choice D, dimming screens, is a good practice but may not be as effective as completely avoiding electronic devices before bedtime to optimize sleep quality.