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A nurse is preparing an inservice presentation for a group of staff psychiatric nurses who will be providing care to children and adolescents in a new outpatient psychiatric clinic. When describing important issues related to interviewing children, which of the following would the nurse emphasize? Select all that apply.
- A. Use of simple terms such as sad or nervous instead of depressed or anxious.
- B. Need for individualization of questions based on judgment and discretion.
- C. Use of questions that lead the child to the desired response.
- D. Speaking in longer sentences that include a description of what is being asked.
- E. Need for the child?s statements and behaviors to guide the interview.
Correct Answer: A,B,E
Rationale: Using simple terms (A), individualizing questions (B), and following the child?s lead (E) are key to effective pediatric interviews. Leading questions (C) bias responses, and long sentences (D) may overwhelm young children.
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The nurse is preparing to interview a 6-year-old girl and her mother in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should:
- A. Tell the child she watches Sesame Street all the time.
- B. Talk to the child while standing up and looking down at her.
- C. Tell the child that this must be a bit scary for her.
- D. Ask the parent if the child can be interviewed alone.
Correct Answer: C
Rationale: Acknowledging the child?s potential fear (C) validates her emotions, fostering trust and a treatment alliance. Claiming to watch Sesame Street (A) may seem inauthentic, standing over the child (B) is intimidating, and interviewing alone (D) may be premature for a young child.
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.
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.
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 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.