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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.
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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.
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.
The nurse is counseling a family with a child who has been abused by adult family friend in the past. When explaining about the child?s needs, which of the following would be most important for the nurse to stress?
- A. A supportive relationship with an adult
- B. Long-term psychotherapy
- C. Antidepressant medications
- D. Short-term separation from the parents
Correct Answer: A
Rationale: A supportive relationship with a trusted adult is critical for an abused child?s recovery, providing safety and emotional stability. Long-term psychotherapy or medications may be needed but are secondary, and separation from parents is not indicated unless they are the abusers.
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.
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.