While conducting the initial interview with a patient in crisis, the nurse should do which of the following?
Listen carefully and summarize often
Convey a sense of urgency to the patient
Let the patient know the nurse controls the interview
Be forthright about time limits of the interview
The Correct Answer is A
Choice A reason: In a crisis, the patient is often disorganized and overwhelmed. Active listening and frequent summarization help the nurse ensure accuracy, show the patient they are being heard, and help the patient organize their thoughts. This technique facilitates the identification of the precipitating event and current coping skills.
Choice B reason: While a crisis is an acute event, the nurse should remain calm and steady. Conveying a sense of urgency can escalate the patient's anxiety and further disorganize their thinking. The nurse's role is to provide a "holding environment" that feels safe and grounded.
Choice C reason: A therapeutic interview should be collaborative rather than authoritarian. While the nurse provides structure, claiming "control" can damage the rapport and make the patient feel disempowered. Empowerment is a key goal of crisis intervention to help the patient regain their sense of autonomy.
Choice D reason: While time limits exist in clinical settings, making them a primary focus of the initial interview can make the patient feel rushed or unimportant. The priority in the first meeting is establishing rapport and assessing safety and the nature of the crisis.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Viewing a patient’s expression of despair as a "call for sympathy" is non-therapeutic and dismissive. In a clinical setting, such statements must be taken seriously as expressions of psychological pain. Dismissing the patient’s feelings can lead to a failure to identify a potentially lethal underlying psychiatric crisis or clinical depression.
Choice B reason: There is no such thing as "normal pessimism" in the elderly that includes a lack of desire to live. This is a common ageist myth. While older adults face many losses, expressing that they have "nothing to live for" is a red flag for clinical depression and must be assessed with urgency.
Choice C reason: While the patient is clearly experiencing multiple losses, "normal grieving" generally allows for periods of hope and the ability to find meaning in some aspects of life. The patient’s statement goes beyond grief into the realm of hopelessness and worthlessness, which are hallmarks of a major depressive episode and suicide risk.
Choice D reason: Elderly males, particularly those who are socially isolated and facing chronic illness, have some of the highest suicide completion rates. The patient’s expression of hopelessness ("nothing to live for") is a primary indicator of suicidal ideation and requires an immediate, direct assessment of their intent and access to lethal means.
Correct Answer is C
Explanation
Choice A reason: While the 15 to 19 age range is a period of increased risk for suicide attempts, being in this age group is a demographic fact rather than an individual clinical characteristic that "alerts" a nurse to an imminent or specific possibility of suicide without other accompanying symptoms.
Choice B reason: Threatening to cause harm to peers is an indicator of potential violence toward others (homicidal ideation or conduct disorder) rather than self-directed violence. While all threats of harm must be taken seriously, this specifically points toward an externalized aggression rather than an internalized suicidal intent.
Choice C reason: Research consistently shows that LGBTQ+ youth face significantly higher rates of suicidal ideation and attempts due to societal stigma, bullying, and lack of support. When combined with a history of depression, this creates a high-risk clinical profile that requires proactive screening and targeted suicide prevention interventions.
Choice D reason: A history of torturing or abusing animals is a hallmark of conduct disorder and is often associated with the development of antisocial personality disorder. While it indicates significant psychological pathology and a risk for future interpersonal violence, it is not a classic or specific predictor of suicidal behavior.
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