Age Specific Nursing Care

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A community mental health nurse is assigned to investigate the frequent school absences of an 11-year-old child. The nurse finds the child home alone, caring for his 1- and 3-year-old siblings. The house is cluttered and dirty, and both parents are at work. The child tells the nurse that whenever his mother is called to work at her part-time job, he must watch the kids because the family cannot afford a babysitter. Based on the information obtained thus far, what preliminary assessment can be made?

  • A. The child is coping well with a difficult situation.
  • B. The child and his siblings are experiencing neglect.
  • C. The children are at high risk for sexual abuse.
  • D. The children are experiencing physical abuse.
Correct Answer: B

Rationale: The correct answer is B: The child and his siblings are experiencing neglect. Neglect is defined as failure to provide for a child's basic needs, such as supervision, food, shelter, and medical care. In this scenario, the child is left alone to care for his younger siblings, indicating a lack of appropriate supervision and care from the parents. The house being cluttered and dirty further suggests neglect in terms of living conditions.

Choice A is incorrect because the child is not coping well; rather, he is forced into a caretaker role beyond his developmental capacity. Choice C is incorrect as there is no information provided to suggest sexual abuse. Choice D is incorrect as there is no evidence of physical abuse in the scenario.

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Which nursing strategy leads patients to respond more positively to limit setting?

  • A. Confront the patient with the inappropriateness of the behavior.
  • B. Explore with the patient the underlying dynamics of the behavior.
  • C. Reflect back to the patient an understanding of the patient's distress.
  • D. State clear disapproval of the behavior, and support its consequences.
Correct Answer: C

Rationale: The correct answer is C because reflecting back to the patient an understanding of their distress shows empathy and validation, which can help build a therapeutic relationship and lead to a more positive response to limit setting. This approach acknowledges the patient's feelings without judgment, fostering trust and cooperation.

Choice A is incorrect as confrontation may lead to defensiveness and resistance. Choice B is incorrect as exploring underlying dynamics may not address the immediate need for setting limits. Choice D is incorrect as clear disapproval and consequences may create a negative, punitive atmosphere rather than promoting understanding and collaboration.

Which characteristics are most likely in a sexual perpetrator? Select all that apply.

  • A. Male.
  • B. Female.
  • C. Stranger.
  • D. Age 30 or younger.
Correct Answer: A

Rationale: Step 1: Research shows that the majority of sexual perpetrators are male.
Step 2: Societal norms and power dynamics often contribute to male perpetration.
Step 3: Males are more likely to have societal privilege and opportunity to commit sexual offenses.
Step 4: Gender stereotypes and toxic masculinity can influence male behavior towards sexual violence.
Summary: Choice A is correct because statistical data and societal factors support the likelihood of male sexual perpetrators. Choices B, C, and D are incorrect as they do not align with the established patterns and research on sexual perpetration.

A 28-year-old female client was admitted 3 days ago after she ran nude through the streets shouting that she was the 'Queen of Hearts.' Since admission, the client remains delusional, shouts obscenities, and demonstrates loosely associated thoughts. Based on these data, the nurse should develop a nursing diagnosis of:

  • A. Risk for violence
  • B. Defensive coping
  • C. Disturbed thought processes
  • D. Impaired memory
Correct Answer: C

Rationale: The correct nursing diagnosis is "Disturbed thought processes" (C) because the client's behavior of being delusional, shouting obscenities, and demonstrating loosely associated thoughts indicates a disruption in their ability to think clearly and logically. This diagnosis reflects the client's cognitive dysfunction and disorganized thinking patterns.

Choice A (Risk for violence) is incorrect because the client's behavior does not directly suggest a risk for violence towards others or themselves.

Choice B (Defensive coping) is incorrect as the client's behavior is not indicative of using defensive mechanisms to cope with stress or anxiety.

Choice D (Impaired memory) is incorrect as the client's symptoms are more indicative of thought processing issues rather than memory deficits.

In summary, the client's presentation aligns closely with symptoms of disturbed thought processes, making it the most appropriate nursing diagnosis in this case.

The main focus of medical management for anorexia is to:

  • A. Encourage rapid weight gain.
  • B. Encourage the client to eat voluntarily.
  • C. Teach more appropriate food choices.
  • D. None of the above.
Correct Answer: D

Rationale: The correct answer is D because the main focus of medical management for anorexia is not to encourage rapid weight gain, as it can lead to serious health complications. Encouraging the client to eat voluntarily is also not the main focus, as anorexia involves psychological factors that go beyond simple lack of appetite. Teaching more appropriate food choices is not the main focus either, as anorexia requires comprehensive treatment that addresses underlying emotional issues. Overall, the main focus is on a multidisciplinary approach that includes therapy, nutritional counseling, and medical monitoring to address the physical and psychological aspects of the disorder.

A client with schizophrenia tells the nurse as they sit in the day room, 'I hear voices telling me bad things.' The most therapeutic response the nurse can make is:

  • A. Tell me what the voices are saying.'
  • B. I understand you hear these so-called voices, but I hear only the people in the room talking.'
  • C. The voices are not real. They're only your imagination.'
  • D. Do you think the voices would go away if we went into your room to talk?'
Correct Answer: B

Rationale: The correct answer is B because it demonstrates empathy and validation of the client's experience. By acknowledging the client's reality of hearing voices and emphasizing that the nurse does not hear them, the nurse establishes trust and rapport. This response shows active listening and validates the client's feelings without judgment.

Incorrect responses:
A: Asking the client to describe the voices may increase distress and is not as supportive as acknowledging their experience.
C: Dismissing the voices as not real can invalidate the client's experience and may lead to mistrust.
D: Suggesting a change of location does not address the client's immediate concerns and may not be therapeutic in this situation.

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