Nokea
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.
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A nurse is performing an assessment interview of a 14-year-old boy who is being admitted to an adolescent substance abuse unit. His parents are concerned about their son?s repeated problems at school that they associate with his drug use. The boy stalks into the office, abruptly sits down, crosses his arms, and says, Okay, ask your stupid questions, but don?t expect me to cooperate! Which response by the nurse would be most appropriate?
- A. Your attitude is offensive; I can see why your parents brought you here.
- B. Why don?t we wait until you?ve calmed down a bit to start the interview?
- C. Why are you so angry?
- D. You seem pretty upset. Tell me about what is upsetting you.
Correct Answer: D
Rationale: Acknowledging the adolescent?s upset feelings and inviting discussion (D) validates emotions and encourages engagement. Criticizing attitude (A) alienates, delaying the interview (B) dismisses the moment, and questioning anger (C) may feel confrontational.
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 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 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.
After completing the mental status assessment of a 9-year-old boy, the nurse documents the findings. Which of the following would the nurse document as reflecting the child?s motor activity? Select all that apply.
- A. Favorite story, Huckleberry Finn
- B. Short attention span
- C. Hyperalertness
- D. Went to the park last weekend
- E. Nail biting
- F. History of temper tantrums
Correct Answer: B,C,E,F
Rationale: Motor activity includes short attention span (B), hyperalertness (C), nail biting (E), and temper tantrums (F), as they reflect observable behaviors. Favorite story (A) and park visits (D) are not motor-related.