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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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A group of nursing students is reviewing information about temperament and its effect on the child?s behavior. The students demonstrate understanding of the concept when they identify which of the following as characteristic of temperament. Select all that apply.
- A. Emotional bonding
- B. Sequential growth processes
- C. Activity level
- D. Adaptability
- E. Insecurity
Correct Answer: C,D
Rationale: Temperament includes activity level (C) and adaptability (D), innate traits influencing behavior. Emotional bonding (A) and growth processes (B) are developmental, and insecurity (E) is a state, not a temperament trait.
A nurse is preparing to interview a 4-year-old preschooler. Which of the following would be most effective to use for the assessment?
- A. Direct, simple questions
- B. Play materials such as blocks
- C. Pediatric anxiety rating scale
- D. Children?s Depression Inventory
Correct Answer: B
Rationale: Play materials like blocks (B) engage a 4-year-old, allowing expression through play, which is developmentally appropriate. Direct questions (A) may overwhelm, and rating scales (C, D) are less suitable for preschoolers.
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.
A nurse is interviewing a 12-year-old boy who has been diagnosed with depression. The client?s depression was triggered by the death of his father 2 years ago. The nurse interprets which comment made by the boy as reflecting egocentrism?
- A. If I hadn?t yelled at my dad and told him to go away, he never would have died.
- B. I?m still sad because my dad died a couple of years ago.
- C. I think I?m just experiencing normal grieving.
- D. My father was the best friend I ever had; I still can?t believe he?s gone for good.
Correct Answer: A
Rationale: Blaming himself for his father?s death (A) reflects egocentrism, a developmental trait where the child believes their actions directly cause external events. Sadness (B), normal grieving (C), and loss acknowledgment (D) are typical grief responses, not egocentrism.
A group of nursing students is reviewing information about stress and coping in children. The students demonstrate a need for additional study when they identify which of the following as a stressful experience for a child?
- A. Death of a pet
- B. Chronic illness
- C. Racial discrimination
- D. Social support
Correct Answer: D
Rationale: Social support (D) is a coping resource, not a stressor. Death of a pet (A), chronic illness (B), and racial discrimination (C) are recognized stressors for children.