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The nurse is assessing an 8-year-old child?s self-concept. Which of the following would be least appropriate for the nurse to ask?
- A. If you had three wishes, what would you wish for?
- B. What would you like to be when you grow up?
- C. What subjects do you like best in school?
- D. What did you have for breakfast this morning?
Correct Answer: D
Rationale: Asking about breakfast (D) is unrelated to self-concept, which involves self-perception and aspirations. Questions about wishes (A), future goals (B), and school preferences (C) elicit insights into the child?s self-view and identity.
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The nurse is preparing to interview a 6-year-old girl and her mother in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should:
- A. Tell the child she watches Sesame Street all the time.
- B. Talk to the child while standing up and looking down at her.
- C. Tell the child that this must be a bit scary for her.
- D. Ask the parent if the child can be interviewed alone.
Correct Answer: C
Rationale: Acknowledging the child?s potential fear (C) validates her emotions, fostering trust and a treatment alliance. Claiming to watch Sesame Street (A) may seem inauthentic, standing over the child (B) is intimidating, and interviewing alone (D) may be premature for a young child.
To establish rapport with a 10-year-old child who is hospitalized in a psychiatric setting, which statement by the nurse would be most appropriate?
- A. Let?s compare your situation to that of Cinderella?s in the fairy tale.
- B. I?m going to use the DECA tool to measure your self-control and initiative.
- C. Let?s have you draw a picture of yourself.
- D. Would you like to play a game of checkers with me?
Correct Answer: D
Rationale: Playing a game like checkers (D) is an engaging, non-threatening way to build rapport with a 10-year-old. Comparing to a fairy tale (A) may confuse, mentioning assessment tools (B) is too clinical, and drawing (C) may feel directive before trust is established.
A nurse in an outpatient clinic is assessing a child, and the nurse will interview the child and the child?s parents separately. Which of the following comments would the nurse anticipate the child making during the upcoming interview?
- A. I can?t get along with my parents.
- B. I yell at my parents a lot.
- C. I?m sad a lot, and I have trouble sleeping.
- D. I refuse to do what my parents tell me to.
Correct Answer: C
Rationale: Sadness and sleep issues (C) are common psychological symptoms in children that may be expressed in a clinical setting, especially given school behavior concerns. Parent conflict (A, B, D) may be reported, but sadness and sleep issues are more directly tied to internal distress.
A nurse is preparing an inservice presentation for a group of staff psychiatric nurses who will be providing care to children and adolescents in a new outpatient psychiatric clinic. When describing important issues related to interviewing children, which of the following would the nurse emphasize? Select all that apply.
- A. Use of simple terms such as sad or nervous instead of depressed or anxious.
- B. Need for individualization of questions based on judgment and discretion.
- C. Use of questions that lead the child to the desired response.
- D. Speaking in longer sentences that include a description of what is being asked.
- E. Need for the child?s statements and behaviors to guide the interview.
Correct Answer: A,B,E
Rationale: Using simple terms (A), individualizing questions (B), and following the child?s lead (E) are key to effective pediatric interviews. Leading questions (C) bias responses, and long sentences (D) may overwhelm young children.
A nurse is preparing to complete a mental status examination of an adolescent who is experiencing behavioral problems at school. When assessing the adolescent?s thought processes, which of the following would the nurse need to keep in mind about this age group? Select all that apply.
- A. View of things in a concrete manner
- B. Ability to look at things hypothetically
- C. Beginning ability to use logic
- D. Ability to use abstract thinking
- E. Difficulty in putting feelings into words
Correct Answer: B,C,D,E
Rationale: Adolescents develop hypothetical thinking (B), logical reasoning (C), abstract thinking (D), and often struggle to verbalize feelings (E). Concrete thinking (A) is more typical of younger children.