Nokea
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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A home-health nurse is working with a poverty-stricken family that has two small children, ages 2 and 3 years. The family lives in an isolated rural area. The family?s home has a dirt floor, and there are chickens living in the house with the family. Because of a recent wind storm, there is a sizeable hole in the roof that lets rain and snow into the house. Which nursing intervention would be the highest priority in this situation?
- A. Make immunization appointments for the children in a nearby town?s public health clinic.
- B. Help the family find funding and manpower to patch and repair the roof of their home.
- C. Determine the educational readiness of the two children.
- D. Report the family for child abuse because of neglect.
Correct Answer: B
Rationale: Repairing the roof is the highest priority to ensure a safe, habitable environment, protecting the children from health risks due to exposure. Immunizations are important but less urgent, educational readiness is secondary, and reporting neglect is premature without assessing intent or resources.
A nurse is working with a family in which the parents have just gotten divorced. After teaching the parents about measures to reduce the risk of emotional problems for the children, which statement by the parents indicates a need for additional teaching?
- A. We will try to alter their routines so they don?t think about the past.
- B. We will make sure that they understand that they did not cause the divorce.
- C. We will develop a regular and consistent schedule for visitation.
- D. We will make sure that we are consistent in the limit that we set.
Correct Answer: A
Rationale: Altering routines to avoid the past may disrupt stability and hinder processing the divorce, indicating a need for further teaching. Ensuring children don?t feel responsible, consistent visitation, and consistent limits are appropriate strategies to reduce emotional problems.
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.
The nurse is working with a child who has engaged in bullying. Which of the following would be most effective for the nurse to implement?
- A. Psychoeducation
- B. Bibliotherapy
- C. Early intervention program
- D. Social skills training
Correct Answer: D
Rationale: Social skills training is most effective for addressing bullying, as it teaches empathy, communication, and conflict resolution, targeting the root behaviors. Psychoeducation provides knowledge, bibliotherapy uses reading, and early intervention is broader, not specific to bullying.
A nurse is working with a child for which an out-of-home placement has occurred. Which of the following would the nurse anticipate as the child?s initial response?
- A. Despair
- B. Withdrawal
- C. Protest
- D. Detachment
Correct Answer: C
Rationale: Protest is the initial response in children experiencing out-of-home placement, often manifesting as anger or resistance due to separation. Withdrawal, despair, or detachment may follow later as part of the grief process, per Bowlby?s attachment theory.