On the basis of the principles of crisis intervention, when is the best time for the nurse to offer assistance to those most affected by this incident?
- A. After the funeral
- B. Within 6 months
- C. Immediately
- D. Six weeks later
Correct Answer: C
Rationale: Immediate intervention addresses acute distress and prevents long-term issues.
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Which area of the adolescent's social history is most appropriate for the clinic nurse to assess?
- A. Peer relationships
- B. School performance
- C. Church attendance
- D. Employment records
Correct Answer: A
Rationale: Peer relationships strongly influence gang involvement and antisocial behavior.
Which nursing instruction is most appropriate when teaching a client who self-administers haloperidol (Haldol)?
- A. Take the pills on an empty stomach.
- B. Do not skip meals while taking the drug.
- C. Stop taking the drug if sedation occurs.
- D. Rise slowly from a sitting position.
Correct Answer: D
Rationale: Rising slowly prevents orthostatic hypotension, a common side effect.
If ruminations about suicide are present, which observation by the nurse is most significant?
- A. The teen is not attending school regularly.
- B. The teen is hoarding sharp objects in the bedroom.
- C. The teen is not completing homework assignments.
- D. The teen is not participating in extracurricular activities.
Correct Answer: B
Rationale: Hoarding sharp objects indicates a high risk for self-harm.
When the gym owner asks the teenager if he would like a drug to help increase muscle mass, which factor will most likely influence a desire to accept?
- A. Several teammates are taking this drug.
- B. The team is having a winning season.
- C. His parents support his interest in football.
- D. He can afford to pay for a substantial supply.
Correct Answer: A
Rationale: Peer influence is a strong motivator for adolescents.
Which of the following risk factors would the nurse expect to note when assessing the mother?
- A. The pregnancy was unplanned and unwanted.
- B. The baby's father abandoned the mother.
- C. The mother is an adolescent.
- D. The mother's socioeconomic status is low.
- E. The mother has a history of alcohol and drug abuse.
- F. The mother has dropped out of high school.
Correct Answer: A,C,D,E
Rationale: Unplanned pregnancy, adolescent motherhood, low socioeconomic status, and substance abuse are risk factors for failure to thrive.
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