Nokea
A school nurse is meeting with the parent of a child who stated the child's other parent has been given a lengthy prison sentence. Which action by the nurse would be most helpful to mitigate an adverse child experience?
- A. Assessing the student's grades and ability to complete class work
- B. Suggesting a mentoring program for children of incarcerated parents
- C. Asking the parent to tell you what happened
- D. Suggesting the parent help the child identify their strengths
Correct Answer: B
Rationale: Factors that can mitigate adverse child experiences include strengthening economic support to families; promoting social norms that protect against violence and adversity; and ensuring a strong start for children including support groups, mentoring, and teaching needed skills.
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A nurse is conducting a parent workshop on how to build self-esteem in children. Which teaching points would the nurse include to help parents achieve this goal? Select all that apply.
- A. Reinforce their child's positive qualities.
- B. Overlook occasional negative behavior.
- C. Ignore neutral behavior that is a matter of personal preference.
- D. Listen and "fix things" for their children.
- E. Describe the child's behavior and judge it.
- F. Let their children practice skills and make it safe to fail.
Correct Answer: A,C,F
Rationale: The nurse should include the following teaching points for parents: (1) reinforce their child's positive qualities; (2) address negative qualities constructively; (3) ignore neutral behavior that is a matter of taste, preference, or personal style. Parents should allow children to be challenged or fail, rather than "fix things" for their children; avoid judgmental observations and let their child know what to expect, practice the necessary skills, be patient, and make it safe to fail.
A patient is admitted through the emergency department with severe facial burns and cuts to the face after a car accident in which their fianc?© was the driver. Three weeks later, their fianc?© has not yet contacted them. The patient states that they are too tired to have visitors anyway and frequently lies with their eyes closed and head turned away. Based on this information, what action would the nurse take first?
- A. Identify a disturbance in self-concept.
- B. Question the patient about disturbances of body image.
- C. Ask the patient how the accident has affected her.
- D. Explain that the wounds are healing well, but she can consult a plastic surgeon after discharge if needed.
Correct Answer: C
Rationale: The nurse first assesses the patient's response to the accident before documenting a health problem and etiology. The nurse takes cues from the patient regarding their traumatic injuries, their fianc?©'s failure to contact them, and their withdrawal, which point to potential problems with both body image and self-esteem.
A patient who has been in the United States only 3 months has recently suffered the loss of partner and job. They state that nothing feels familiar-"I don't know who I am supposed to be here"-and says "I miss home terribly." For what alteration in self-concept is this patient most at risk?
- A. Disturbed (or Risk for Disturbed) Personal Identity
- B. Disturbed Body Image
- C. Chronic (or Risk for Chronic) Low Self-Esteem or Situational (or Risk for Situational) Low Self-Esteem
- D. Impaired Role Performance
Correct Answer: A
Rationale: An unfamiliar culture, coupled with traumatic life events such as loss of husband and job, result in this patient's total loss of their sense of self, supported by the statement: "I don't know who I am supposed to be here."
A young adult businessperson attends counseling, attempting to deal with a history of sexual abuse by their father. "I should feel satisfied with what I've achieved, but nothing I accomplish makes me feel good about myself.... I hate my father for making me feel like I'm no good. This is an awful way to live." What statement by the nurse would be most helpful?
- A. "You've managed to overcome a lot since your childhood."
- B. "Can you identify some positive attributes about yourself."
- C. "Perhaps it's time to accept you're an adult and the abuse is in the past."
- D. "What might make you feel more content? Go after it!"
Correct Answer: B
Rationale: This patient's self-concept disturbance is mainly one of devaluing themselves and thinking that they are no good. The nurse assists the patient in reframing their negative thoughts into positive thoughts by identifying positive attributes.
A mother of an outspoken school-aged child tells the nurse: "I feel incompetent as a parent and have difficulty disciplining my child." What should be the nurse's first action when counseling this patient?
- A. Recommending that she discipline her child more strictly and consistently
- B. Making a "to-do" list for the child's father to allow her more time to focus on improving her parenting skills
- C. Assisting the mother to identify both what she thinks is successful and what she can do to improve
- D. Exploring how the child can improve their behavior and make the mother's role as a parent easier
Correct Answer: C
Rationale: The nurse assesses the issue first, helping the mother identify what they believe is working and what is preventing them from being an effective parent. Next the nurse can explore solutions aimed at improving their parenting skills. Without assessment, there is no indication the child needs more strict discipline or assistance of the father. The child is not responsible for making the mother's parental role easier.