Lilly, a single mother of four, comes to the crisis center 24 hours after a fire in which all the houses within a one-block area were wiped out. All of Lilly's household goods and clothing were lost. Lilly has no other family in the area. Her efforts to mobilize assistance have been disorganized, and she is still without shelter. She is distraught and confused. You assess the situation as:

Correct Answer: B

Rationale: The correct answer is B: An adventitious crisis. This type of crisis is caused by external events beyond a person's control, such as a natural disaster. In this scenario, Lilly's loss of her home and belongings due to the fire is an external event that led to her current state of distress. This crisis is not a result of her personal development or internal conflicts, ruling out options A, C, and D. Lilly's lack of support system and disorganization in seeking assistance further align with the characteristics of an adventitious crisis.

Correct Answer: D

Rationale: The correct answer is D because communication disorders labeled as unspecified can have various causes, including genetic predisposition, environmental factors, and physical conditions. Genetic factors play a role in some communication disorders, but they are not the sole cause. Traumatic brain injury, as mentioned in choice B, is a specific cause and not applicable to unspecified disorders. Choice C is incorrect as all disorders have underlying causes, even if they are not fully understood. Choice A is also incorrect as it oversimplifies the causes of unspecified communication disorders. In summary, choice D is the most comprehensive and accurate explanation as it considers the multifactorial nature of communication disorders.

Correct Answer: D

Rationale: The correct answer is D because it reflects the negative outcome of despair in Erikson's stage of "old age." In this stage, individuals reflect on their lives and may feel satisfied or dissatisfied. Option D shows the woman feeling anger and dissatisfaction, indicating despair. Choice A involves a woman struggling with caregiving, which could be a challenge but doesn't necessarily reflect despair. Choice B describes someone reflecting on their life, which is a positive aspect of this stage. Choice C shows a man openly discussing his accomplishments and failures, which is a healthy way of coping and doesn't indicate despair.

Correct Answer: C

Rationale: The correct answer is C because showing respect that is not based on the client's behavior is essential in establishing a therapeutic relationship. This approach conveys unconditional positive regard, helping the client feel valued and accepted regardless of their current emotional state. Choice A of establishing a friendship may blur boundaries and hinder the professional therapeutic relationship. Choice B of using humor may not be appropriate for a client experiencing anger and depression. Choice D of sympathizing with the client's sad feelings may be seen as pity rather than genuine understanding, which can be counterproductive. Overall, choice C demonstrates empathy, understanding, and a non-judgmental attitude, which are crucial in building trust and rapport with the client.

Correct Answer: D

Rationale: The correct answer is D: Psychotherapy. Advanced practice psychiatric/mental health nurses have specialized training to provide psychotherapy, which involves conducting therapy sessions to address mental health issues. This intervention requires advanced knowledge and skills in assessing, diagnosing, and treating complex psychiatric conditions. Basic level registered nurses typically do not have the expertise or training to conduct psychotherapy. A: Coordination of care - Both basic level and advanced practice nurses can coordinate care for patients, although advanced practice nurses may take on a more comprehensive role in care coordination. B: Health teaching - Both basic level and advanced practice nurses can provide health teaching to patients about mental health conditions and treatment options. Advanced practice nurses may have a deeper understanding of mental health concepts. C: Milieu therapy - Both basic level and advanced practice nurses can participate in creating a therapeutic environment for patients. Advanced practice nurses may have a more significant role in developing and implementing milieu therapy strategies.