Nokea
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.
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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.
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.
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.
The nurse is counseling a family with a 10-year-old child after the death of a favorite uncle. The nurse provides guidance to the parents, informing them that the child may exhibit which of the following as a response?
- A. Talk about scary, morbid novels all the time.
- B. Complain of aches and pains, stomachaches, that sort of thing.
- C. Suddenly become afraid of leaving home to go to school.
- D. Become obsessed with religious rituals, Bible verses, and prayer.
Correct Answer: B
Rationale: Children aged 10 often express grief somatically, such as through aches or stomachaches, as a way to process loss. Talking about morbid novels, fear of leaving home, or religious obsession are less typical grief responses and may indicate other issues.
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.