A nurse is providing care to several chronically ill children. Which of the following would the nurse identify as having the greatest risk for developing a psychiatric problem?
- A. 12 year-old with diabetes mellitus
- B. 5 year-old with cerebral palsy
- C. 8 year-old who has chronic renal disease
- D. 10 year-old with a heart murmur
Correct Answer: C
Rationale: Chronic renal disease in an 8-year-old poses significant physical and emotional stress, including frequent medical interventions and lifestyle restrictions, increasing psychiatric risk. Diabetes and cerebral palsy also carry risks, but renal disease is more invasive, and a heart murmur is typically less severe.
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After teaching a class about childhood and adolescent mental health, the instructor determines that additional teaching is needed when the class identifies which of the following as promoting mental health in children?
- A. Difficult temperament
- B. Age-appropriate physical development
- C. Secure attachment
- D. Normal psychosocial development
Correct Answer: A
Rationale: Difficult temperament is a risk factor for mental health issues, not a promoter, indicating a need for further teaching. Age-appropriate physical development, secure attachment, and normal psychosocial development are protective factors that support mental health.
While caring for a family who lost a 10-year-old son in a car accident, the nurse should instruct the parents to tell the 4-year-old sister which of the following about her brother?
- A. He died and is not coming back.
- B. He passed on to the other side.
- C. He departed on a long journey.
- D. He has gone to see the Lord above.
Correct Answer: A
Rationale: For a 4-year-old, clear, simple language like 'He died and is not coming back' is appropriate to help them understand death without confusion. Euphemisms like 'passed on,' 'long journey,' or 'seeing the Lord' may confuse young children who think concretely and may expect the person to return.
A 3-year-old child has been admitted to the hospital after an automobile accident. Which statement by the nurse would be most appropriate when discussing the type of behavior the parents can expect their child to display while hospitalized?
- A. Your child may not be able to accept how the injury has changed your child?s appearance.
- B. Your child may seem unduly anxious in the presence of strangers.
- C. Your child may experience some guilt feelings associated with the accident.
- D. Your child will exhibit intermittent periodic mood swings, but these should be brief.
Correct Answer: B
Rationale: A 3-year-old is likely to exhibit stranger anxiety, especially in a stressful hospital setting, as they are developmentally prone to fear of unfamiliar people. Appearance concerns, guilt, or mood swings are more typical in older children with greater cognitive awareness.
The nurse is counseling a family with two parents and two children, ages 8 and 10 years. The mother complains that the children are constantly fighting and have intense sibling rivalry. When statement would be most appropriate when advising the parents about how to respond to the sibling rivalry?
- A. Try reacting to each as unique individuals with talents and interests distinctly their own.
- B. Be firm about telling the children they have to cooperate with one another.
- C. Slowly decrease the amount of attention and control shown to the older child.
- D. Make sure they have a quiet, subdued home environment to avoid stimulating conflict.
Correct Answer: A
Rationale: Treating children as unique individuals with distinct talents reduces sibling rivalry by fostering individual identity and reducing competition. Forcing cooperation, reducing attention to one child, or enforcing a quiet environment may not address the root cause and could escalate tension.
While engaging in a discussion with a group of teens about risk behaviors, one of the teens says, 'That will never happen to me.' The nurse interprets this as which of the following?
- A. Invincibility fable
- B. Formal operations
- C. Egocentric thinking
- D. Relational aggression
Correct Answer: A
Rationale: The statement reflects the invincibility fable, a common adolescent belief that they are immune to negative consequences. Formal operations refer to cognitive development, egocentric thinking is self-focused but not specific to risk, and relational aggression involves social harm, not denial of risk.
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