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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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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 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 preparing to assess a 9-year-old child who has been sexually abused. Which of the following would be the priority for the nurse?
- A. Finding out when the abuse occurred
- B. Documenting the assessment for use in court
- C. Using anatomically correct dolls to elicit information
- D. Ensuring that the environment is safe and supportive
Correct Answer: D
Rationale: Ensuring a safe and supportive environment (D) is the priority to reduce trauma and build trust during assessment. Timing (A), documentation (B), and dolls (C) are secondary to creating a secure setting for the child.
A child and the child?s family visit a psychiatric outpatient setting because the parent is concerned about the child?s behavior at school. The child scores 65 on the Global Assessment of Functioning (GAF) scale. The nurse interprets this finding as which of the following?
- A. The child requires inpatient therapy.
- B. The child is experiencing homicidal thoughts.
- C. The child is functioning well in the area of school.
- D. The child can be treated effectively as an outpatient.
Correct Answer: D
Rationale: A GAF score of 65 indicates mild symptoms with generally good functioning, suggesting outpatient treatment (D) is appropriate. Inpatient therapy (A) is for lower scores, homicidal thoughts (B) are not indicated by this score, and school functioning (C) is not specifically supported.
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.