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An adolescent diagnosed with generalized anxiety disorder says, 'My parents focus all their attention on my brother instead of me. He's perfect in their eyes.' Which type of therapy might promote the greatest change in this adolescent's behavior?
- A. Bibliotherapy
- B. Play therapy
- C. Family therapy
- D. Behavior modification therapy
Correct Answer: C
Rationale: Family therapy focuses on problematic family relationships and interactions. The patient has identified problems within the family. Bibliotherapy and play therapy are appropriate for children rather than adolescents. The adolescent's problem is interpersonal and relates to relationships and self-perception; therefore, behavior modification therapy would not help.
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A nurse assesses the four children below. Which assessment findings should prompt the nurse to refer the child for further evaluation?
- A. A 4-year-old who stuttered for 3 weeks after the birth of a sibling.
- B. A 9-month-old who does not eat vegetables and likes to be rocked.
- C. A 3-month-old who cries after feeding until burped and sucks a thumb.
- D. A 3-year-old who is mute, passive toward adults, and twirls while walking.
Correct Answer: D
Rationale: Symptoms consistent with an autistic spectrum disorder (ASD) are evident in the correct answer. The behaviors of the other children are expected and within normal ranges.
Which finding would prompt the nurse to carefully assess an 8-year-old child for development of a psychiatric disorder?
- A. Being raised by a parent with chronic major depressive disorder
- B. Moving to three new homes over a 2-year period
- C. Not being promoted to the next grade
- D. Having an imaginary friend
Correct Answer: A
Rationale: If the caregiver is unable to respond positively to the child, there is an increased risk of insecure attachment, developmental problems, and mental disorders. The chronicity of the parent's depression means it has been a consistent stressor. The other factors do not create ongoing stress.
A 5-year-old child diagnosed with attention-deficit/hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse's best action?
- A. Call for emergency assistance from another staff member.
- B. Instruct the parents to take the child home immediately.
- C. Direct this child to stop, and then comfort the other child.
- D. Take the child into another room with toys to act out feelings.
Correct Answer: D
Rationale: The use of play to express feelings is appropriate; the cognitive and language abilities of the child may require the acting out of feelings if verbal expression is limited. The incorrect options provide no outlet for feelings or opportunity to develop coping skills.
The child most likely to receive propranolol to manage tremors is one diagnosed with which disorder?
- A. Attention-deficit/hyperactivity disorder (ADHD)
- B. Posttraumatic stress disorder (PTSD)
- C. A motor disorder
- D. Separation anxiety
Correct Answer: C
Rationale: Propranolol is useful for managing tremors associated with various motor disorders. This medication is not indicated in any of the other disorders.
A parent diagnosed with schizophrenia and her 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a shelter volunteer. The child says, 'My three friends and I got an A on our school science project.' The nurse can assess that the child is demonstrating what characteristic?
- A. Resiliency
- B. Shy temperament
- C. Early posttraumatic stress disorder
- D. Uses intellectualization to deal with problems
Correct Answer: A
Rationale: Resiliency enables a child to handle the stresses of a difficult childhood. Resilient children can adapt to changes in the environment, take advantage of nurturing relationships with adults other than parents, distance themselves from emotional chaos occurring within the family, learn, and use problem-solving skills. None of the distractors demonstrate a means of handling stress.