Crisis intervention NCLEX-RN Practice Questions

Crisis intervention NCLEX-RN Practice Questions equip aspiring nurses with the clinical reasoning and communication skills needed to keep clients safe and restore stability during acute psychological distress. In this topic-wise set, you will navigate real-world scenarios involving suicidal ideation, violent behavior, sexual assault, intimate partner violence, disaster response, and acute anxiety. Each question focuses on Psychosocial Integrity, emphasizing priority actions, therapeutic communication, least restrictive measures, legal-ethical duties, and interprofessional collaboration. Designed to mirror NCLEX-RN complexity, these items challenge you to identify immediate safety needs, select evidence-based interventions, and apply short-term, goal-directed strategies. Use these MCQs to sharpen rapid assessment, de-escalation techniques, and crisis-specific nursing interventions that foster safety, trust, and recovery.

Q1. A client in the emergency department is pacing, clenching fists, and shouting after losing a job. What is the nurse’s priority initial action?

• Encourage the client to ventilate feelings with open-ended questions
• Provide detailed coping strategies for unemployment
• Reduce environmental stimuli and speak in short, simple sentences
• Offer a written crisis plan to review at home

Correct Answer: Reduce environmental stimuli and speak in short, simple sentences

Q2. A client states, “I have a plan to kill myself tonight when my partner leaves. I have the pills in my bag.” Which action should the nurse take first?

• Ask the client to sign a no-suicide contract
• Remove access to means and initiate one-to-one observation
• Explore long-term psychotherapy options
• Call the client’s partner to stay with them

Correct Answer: Remove access to means and initiate one-to-one observation

Q3. A sexual assault survivor arrives within two hours of the attack. What is the nurse’s best initial intervention?

• Begin detailed questioning about the assault chronology
• Provide privacy, ensure safety, and obtain informed consent for evidence collection
• Encourage a shower to increase comfort
• Ask why the client did not fight back

Correct Answer: Provide privacy, ensure safety, and obtain informed consent for evidence collection

Q4. During a disaster response, a nurse provides Psychological First Aid (PFA). Which action aligns with PFA principles?

• Mandate group debriefing to process emotions immediately
• Provide practical assistance, accurate information, and link to supports
• Encourage detailed recounting of traumatic events
• Advise clients to postpone sleep to avoid nightmares

Correct Answer: Provide practical assistance, accurate information, and link to supports

Q5. A client with escalating aggression says, “Back off or I’ll hurt someone.” Which intervention is most appropriate initially?

• Stand at an angle, maintain two-arm’s length distance, and set clear limits
• Place the client in seclusion immediately without an order
• Attempt to touch the client’s shoulder to show support
• Ignore the threat and continue the assessment

Correct Answer: Stand at an angle, maintain two-arm’s length distance, and set clear limits

Q6. An adolescent presents after cyberbullying, expressing hopelessness and access to a family firearm. What is the nurse’s priority?

• Teach digital resilience strategies
• Advise the parent to monitor social media use
• Assess suicide risk and secure the firearm immediately
• Schedule a follow-up in two weeks

Correct Answer: Assess suicide risk and secure the firearm immediately

Q7. A client in acute panic-level anxiety following a home invasion is hyperventilating and unable to focus. Which nursing action is most effective initially?

• Explore childhood trauma history
• Use calm, brief statements and coach slow, diaphragmatic breathing
• Encourage group therapy participation today
• Provide printed educational materials about PTSD

Correct Answer: Use calm, brief statements and coach slow, diaphragmatic breathing

Q8. A nurse suspects intimate partner violence (IPV). What is the best nursing action?

• Ask the partner to provide collateral history
• Conduct a private screening using validated tools and offer a safety plan
• Advise the client to leave immediately regardless of readiness
• Document only objective injuries, avoiding client quotes

Correct Answer: Conduct a private screening using validated tools and offer a safety plan

Q9. A client tells the nurse, “I’m going to kill my ex who ruined my life. I know where she is tonight.” What is the nurse’s legal-ethical obligation?

• Maintain confidentiality and continue therapy
• Warn the intended victim and notify the provider/authorities per policy and law
• Offer relaxation techniques to reduce anger
• Suggest journaling to express feelings

Correct Answer: Warn the intended victim and notify the provider/authorities per policy and law

Q10. Which statement reflects therapeutic communication with a grieving parent in crisis?

• “You need to be strong for your other children.”
• “Why didn’t you call sooner?”
• “I’m here with you. What feels most overwhelming right now?”
• “Let’s focus on moving on quickly.”

Correct Answer: “I’m here with you. What feels most overwhelming right now?”

Q11. A severely agitated client with acute psychosis poses imminent harm despite de-escalation attempts. Which is the least restrictive appropriate next step?

• Seclusion with four-point restraints immediately
• Offer prescribed oral PRN antipsychotic/benzodiazepine if willing
• Apply restraints and medicate without explanation
• Discharge the client to reduce unit disruption

Correct Answer: Offer prescribed oral PRN antipsychotic/benzodiazepine if willing

Q12. A client on a 72-hour hold for suicidal ideation asks to leave after admitting intent and plan. Which response is appropriate?

• Allow discharge because admission is voluntary
• Explain legal criteria and that leaving is unsafe given current risk
• Ignore the request and change the subject
• Ask a family member to supervise discharge

Correct Answer: Explain legal criteria and that leaving is unsafe given current risk

Q13. Following a fatal motor vehicle collision, a survivor repeatedly says, “It should have been me.” What immediate nursing action is best?

• Challenge the irrational thought with logic
• Normalize acute guilt reactions and assess for self-harm risk
• Focus on long-term cognitive therapy
• Provide written pamphlets and leave the room

Correct Answer: Normalize acute guilt reactions and assess for self-harm risk

Q14. The nurse prepares to use restraints for violent behavior. Which action is required?

• Apply restraints if staff feel uncomfortable
• Obtain a time-limited provider order and perform ongoing circulation and safety checks
• Use restraints indefinitely until behavior improves
• Delegate restraint assessment to unlicensed staff

Correct Answer: Obtain a time-limited provider order and perform ongoing circulation and safety checks

Q15. A client in crisis after a disaster says, “I can’t think straight.” Which goal is most appropriate for crisis intervention?

• Resolve all past traumas
• Develop long-term personality change
• Restore functional stability and problem-solving in the here-and-now
• Achieve complete symptom remission before discharge

Correct Answer: Restore functional stability and problem-solving in the here-and-now

Q16. A client with alcohol intoxication is loud and threatening. What is the priority nursing action?

• Begin motivational interviewing about alcohol use
• Ensure safety by removing bystanders and using de-escalation techniques
• Confront the client about consequences
• Collect a detailed drinking history immediately

Correct Answer: Ensure safety by removing bystanders and using de-escalation techniques

Q17. The nurse answers a crisis hotline: “I have a gun and I’m done.” What should the nurse do first?

• Offer general coping strategies
• Keep the caller on the line, determine location, and activate emergency response
• Tell the caller to put the gun away and call tomorrow
• Explore childhood experiences with loss

Correct Answer: Keep the caller on the line, determine location, and activate emergency response

Q18. A client with borderline personality disorder in crisis demands a specific nurse and threatens self-harm if refused. What is the best response?

• Agree to the demand to prevent escalation
• Set clear, consistent limits and ensure safety monitoring
• Ignore the threat and continue routine care
• Confront the client about manipulation

Correct Answer: Set clear, consistent limits and ensure safety monitoring

Q19. For a rape survivor who declines police involvement, which nursing action is appropriate?

• Insist on reporting regardless of consent
• Respect the decision, provide medical care, resources, and document objectively
• Delay treatment until the client agrees to report
• Contact the perpetrator for mediation

Correct Answer: Respect the decision, provide medical care, resources, and document objectively

Q20. An older adult living alone after a spouse’s death presents with weight loss, poor hygiene, and confusion. What is the priority?

• Educate on grief stages
• Assess for delirium and self-neglect; initiate safety measures and referrals
• Schedule group therapy next month
• Encourage exercise goals

Correct Answer: Assess for delirium and self-neglect; initiate safety measures and referrals

Q21. A client says, “I don’t want to live,” but denies plan or means and agrees to tell staff if feelings worsen. Which intervention is essential?

• Rely on a no-suicide contract as sufficient safety
• Perform ongoing suicide risk assessments and implement close observation
• Discharge with a hotline number
• Assign a roommate for conversation

Correct Answer: Perform ongoing suicide risk assessments and implement close observation

Q22. During a crisis assessment, which question is most critical to determine immediate risk?

• “When did your symptoms first start?”
• “Do you have thoughts of harming yourself or others right now?”
• “What is your support network like?”
• “Have you tried meditation before?”

Correct Answer: “Do you have thoughts of harming yourself or others right now?”

Q23. A client with severe agitation refuses oral medication. What is the next least restrictive intervention?

• Offer IM medication if clinically indicated and explain purpose and effects
• Apply restraints before offering alternatives
• Threaten discharge
• Leave the client alone to calm without monitoring

Correct Answer: Offer IM medication if clinically indicated and explain purpose and effects

Q24. After a workplace shooting, staff are tearful and fearful. What is the nurse’s immediate priority in crisis support?

• Arrange mandatory psychological debriefing for all staff
• Ensure safety, provide factual updates, and facilitate access to practical supports
• Encourage recounting graphic details to process trauma
• Assess long-term career goals

Correct Answer: Ensure safety, provide factual updates, and facilitate access to practical supports

Q25. A client with acute mania threatens peers. Despite de-escalation, danger persists. What is the safest action?

• Encourage a debate group to channel energy
• Implement seclusion/restraints per protocol with continuous monitoring
• Allow pacing without limits
• Use group therapy for impulse control

Correct Answer: Implement seclusion/restraints per protocol with continuous monitoring

Q26. The nurse documents care for suspected IPV. Which documentation is best?

• “Client claims abuse.”
• Paraphrased summary to save time
• Objective findings, body map of injuries, and verbatim quotes in quotation marks
• Minimal detail to protect privacy

Correct Answer: Objective findings, body map of injuries, and verbatim quotes in quotation marks

Q27. A client experiencing acute stress after a fire repeatedly asks the same questions. Which response is most therapeutic?

• “I already told you that.”
• Provide simple, repeated information calmly and patiently
• Ignore the repetition to avoid reinforcing it
• Request neurology consult immediately

Correct Answer: Provide simple, repeated information calmly and patiently

Q28. A child presents with unexplained bruises and fearful behavior. What is the nurse’s priority action?

• Confront the caregiver in public
• Report suspected abuse per mandatory reporting laws and ensure the child’s safety
• Wait for more evidence before acting
• Ask the child to avoid upsetting the caregiver

Correct Answer: Report suspected abuse per mandatory reporting laws and ensure the child’s safety

Q29. In crisis counseling, which nursing approach is most appropriate?

• Insight-oriented, past-focused exploration
• Directive, problem-focused, time-limited interventions
• Long-term psychodynamic therapy
• Unstructured supportive silence

Correct Answer: Directive, problem-focused, time-limited interventions

Q30. A client expresses cultural beliefs about grieving that include specific rituals. Which action supports culturally sensitive crisis care?

• Apply standard protocols without adaptation
• Explore and accommodate rituals when safe, and integrate spiritual supports
• Discourage rituals to avoid dependency
• Require written proof of beliefs

Correct Answer: Explore and accommodate rituals when safe, and integrate spiritual supports

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