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The nurse is caring for an adolescent in the outpatient psychiatric setting. To help the adolescent feel more in control of the initial therapy sessions, which statement by the nurse would be most appropriate?
- A. I won?t share anything that you don?t want me to with your parents.
- B. Adolescents often feel a distrust of authority figures. Is that true with you?
- C. Your parents care a great deal about you. That?s why you are here.
- D. If something is uncomfortable for you, you don?t have to talk about it.
Correct Answer: D
Rationale: Allowing the adolescent to opt out of uncomfortable topics (D) empowers them and enhances control. Promising confidentiality (A) may conflict with legal obligations, questioning distrust (B) may alienate, and focusing on parental care (C) shifts attention from the adolescent?s autonomy.
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A group of nursing students is reviewing information about stress and coping in children. The students demonstrate a need for additional study when they identify which of the following as a stressful experience for a child?
- A. Death of a pet
- B. Chronic illness
- C. Racial discrimination
- D. Social support
Correct Answer: D
Rationale: Social support (D) is a coping resource, not a stressor. Death of a pet (A), chronic illness (B), and racial discrimination (C) are recognized stressors for children.
A nurse is preparing to interview a 4-year-old preschooler. Which of the following would be most effective to use for the assessment?
- A. Direct, simple questions
- B. Play materials such as blocks
- C. Pediatric anxiety rating scale
- D. Children?s Depression Inventory
Correct Answer: B
Rationale: Play materials like blocks (B) engage a 4-year-old, allowing expression through play, which is developmentally appropriate. Direct questions (A) may overwhelm, and rating scales (C, D) are less suitable for preschoolers.
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.
A nurse is interviewing a 12-year-old child in an outpatient psychiatric setting. Which of the following would be most appropriate for the nurse to say to establish a high degree of credibility?
- A. How would you describe your parents?
- B. Tell me about your best friend.
- C. I have several teddy bears; would you like one to hold?
- D. You?d get along better with your parents if you?d follow their advice.
Correct Answer: B
Rationale: Asking about the child?s best friend (B) is age-appropriate and non-threatening, building rapport and credibility. Asking about parents (A) may feel confrontational, offering a teddy bear (C) is too juvenile for a 12-year-old, and giving advice (D) is judgmental and undermines trust.
A nurse is interviewing a 12-year-old boy who has been diagnosed with depression. The client?s depression was triggered by the death of his father 2 years ago. The nurse interprets which comment made by the boy as reflecting egocentrism?
- A. If I hadn?t yelled at my dad and told him to go away, he never would have died.
- B. I?m still sad because my dad died a couple of years ago.
- C. I think I?m just experiencing normal grieving.
- D. My father was the best friend I ever had; I still can?t believe he?s gone for good.
Correct Answer: A
Rationale: Blaming himself for his father?s death (A) reflects egocentrism, a developmental trait where the child believes their actions directly cause external events. Sadness (B), normal grieving (C), and loss acknowledgment (D) are typical grief responses, not egocentrism.