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NCLEX · Crisis and Grief

A nurse is caring for a client who survived a violent assault. The client is experiencing acute stress and says, 'I keep seeing it happen over and over.' Which intervention is most appropriate during the acute phase?

Correct answer

Provide a safe, calm environment, allow the client to express feelings at their own pace, validate their experience, and ensure basic needs and safety — avoid forcing the client to recount details or pushing for emotional processing prematurely

  1. A Encourage the client to forget about the event
  2. B Provide a safe, calm environment, allow the client to express feelings at their own pace, validate their experience, and ensure basic needs and safety — avoid forcing the client to recount details or pushing for emotional processing prematurely
  3. C Immediately confront the trauma in detail
  4. D Tell the client they are lucky to be alive

Why this is the answer

ACUTE STRESS / TRAUMA RESPONSE — CRISIS INTERVENTION: In the acute phase after trauma, the priorities are SAFETY, STABILIZATION, and SUPPORT — not deep emotional processing. APPROPRIATE INTERVENTIONS: Ensure physical safety and basic needs; provide a calm, safe environment; allow the client to express feelings AT THEIR OWN PACE; validate their experience and normalize their reactions ('what you're feeling is a normal response to an abnormal event'); offer presence and support; AVOID: Forcing the client to recount details (re-traumatizing); pushing premature emotional processing; minimizing ('you're lucky'); telling them to 'forget it' (invalidating); ACUTE STRESS reactions (intrusive memories, hypervigilance, dissociation) are normal in the immediate aftermath; if symptoms persist beyond a month, it may develop into PTSD; PSYCHOLOGICAL FIRST AID principles: safety, calm, connectedness, self-efficacy, hope; REFERRAL: Trauma-informed counseling for ongoing support; nursing role: provide safety and support, validate, avoid re-traumatization, connect to resources.
Source: NCLEX-RN Psychosocial — Crisis Intervention, Acute Trauma Response

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