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A nurse is preparing to complete a mental status examination of an adolescent who is experiencing behavioral problems at school. When assessing the adolescent?s thought processes, which of the following would the nurse need to keep in mind about this age group? Select all that apply.
- A. View of things in a concrete manner
- B. Ability to look at things hypothetically
- C. Beginning ability to use logic
- D. Ability to use abstract thinking
- E. Difficulty in putting feelings into words
Correct Answer: B,C,D,E
Rationale: Adolescents develop hypothetical thinking (B), logical reasoning (C), abstract thinking (D), and often struggle to verbalize feelings (E). Concrete thinking (A) is more typical of younger children.
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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.
After completing the mental status assessment of a 9-year-old boy, the nurse documents the findings. Which of the following would the nurse document as reflecting the child?s motor activity? Select all that apply.
- A. Favorite story, Huckleberry Finn
- B. Short attention span
- C. Hyperalertness
- D. Went to the park last weekend
- E. Nail biting
- F. History of temper tantrums
Correct Answer: B,C,E,F
Rationale: Motor activity includes short attention span (B), hyperalertness (C), nail biting (E), and temper tantrums (F), as they reflect observable behaviors. Favorite story (A) and park visits (D) are not motor-related.
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 preparing to assess a 9-year-old child who has been sexually abused. Which of the following would be the priority for the nurse?
- A. Finding out when the abuse occurred
- B. Documenting the assessment for use in court
- C. Using anatomically correct dolls to elicit information
- D. Ensuring that the environment is safe and supportive
Correct Answer: D
Rationale: Ensuring a safe and supportive environment (D) is the priority to reduce trauma and build trust during assessment. Timing (A), documentation (B), and dolls (C) are secondary to creating a secure setting for the child.
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.