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A child and the child?s family visit a psychiatric outpatient setting because the parent is concerned about the child?s behavior at school. The child scores 65 on the Global Assessment of Functioning (GAF) scale. The nurse interprets this finding as which of the following?
- A. The child requires inpatient therapy.
- B. The child is experiencing homicidal thoughts.
- C. The child is functioning well in the area of school.
- D. The child can be treated effectively as an outpatient.
Correct Answer: D
Rationale: A GAF score of 65 indicates mild symptoms with generally good functioning, suggesting outpatient treatment (D) is appropriate. Inpatient therapy (A) is for lower scores, homicidal thoughts (B) are not indicated by this score, and school functioning (C) is not specifically supported.
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The nurse is assessing an 8-year-old child?s self-concept. Which of the following would be least appropriate for the nurse to ask?
- A. If you had three wishes, what would you wish for?
- B. What would you like to be when you grow up?
- C. What subjects do you like best in school?
- D. What did you have for breakfast this morning?
Correct Answer: D
Rationale: Asking about breakfast (D) is unrelated to self-concept, which involves self-perception and aspirations. Questions about wishes (A), future goals (B), and school preferences (C) elicit insights into the child?s self-view and identity.
A nurse in an outpatient clinic is assessing a child, and the nurse will interview the child and the child?s parents separately. Which of the following comments would the nurse anticipate the child making during the upcoming interview?
- A. I can?t get along with my parents.
- B. I yell at my parents a lot.
- C. I?m sad a lot, and I have trouble sleeping.
- D. I refuse to do what my parents tell me to.
Correct Answer: C
Rationale: Sadness and sleep issues (C) are common psychological symptoms in children that may be expressed in a clinical setting, especially given school behavior concerns. Parent conflict (A, B, D) may be reported, but sadness and sleep issues are more directly tied to internal distress.
The nurse is caring for an adolescent in the outpatient psychiatric setting. To help the adolescent feel more in control of the initial therapy sessions, which statement by the nurse would be most appropriate?
- A. I won?t share anything that you don?t want me to with your parents.
- B. Adolescents often feel a distrust of authority figures. Is that true with you?
- C. Your parents care a great deal about you. That?s why you are here.
- D. If something is uncomfortable for you, you don?t have to talk about it.
Correct Answer: D
Rationale: Allowing the adolescent to opt out of uncomfortable topics (D) empowers them and enhances control. Promising confidentiality (A) may conflict with legal obligations, questioning distrust (B) may alienate, and focusing on parental care (C) shifts attention from the adolescent?s autonomy.
To establish rapport with a 10-year-old child who is hospitalized in a psychiatric setting, which statement by the nurse would be most appropriate?
- A. Let?s compare your situation to that of Cinderella?s in the fairy tale.
- B. I?m going to use the DECA tool to measure your self-control and initiative.
- C. Let?s have you draw a picture of yourself.
- D. Would you like to play a game of checkers with me?
Correct Answer: D
Rationale: Playing a game like checkers (D) is an engaging, non-threatening way to build rapport with a 10-year-old. Comparing to a fairy tale (A) may confuse, mentioning assessment tools (B) is too clinical, and drawing (C) may feel directive before trust is established.
A nurse is performing an assessment interview of a 14-year-old boy who is being admitted to an adolescent substance abuse unit. His parents are concerned about their son?s repeated problems at school that they associate with his drug use. The boy stalks into the office, abruptly sits down, crosses his arms, and says, Okay, ask your stupid questions, but don?t expect me to cooperate! Which response by the nurse would be most appropriate?
- A. Your attitude is offensive; I can see why your parents brought you here.
- B. Why don?t we wait until you?ve calmed down a bit to start the interview?
- C. Why are you so angry?
- D. You seem pretty upset. Tell me about what is upsetting you.
Correct Answer: D
Rationale: Acknowledging the adolescent?s upset feelings and inviting discussion (D) validates emotions and encourages engagement. Criticizing attitude (A) alienates, delaying the interview (B) dismisses the moment, and questioning anger (C) may feel confrontational.