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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.
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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 group of nursing students is reviewing information about temperament and its effect on the child?s behavior. The students demonstrate understanding of the concept when they identify which of the following as characteristic of temperament. Select all that apply.
- A. Emotional bonding
- B. Sequential growth processes
- C. Activity level
- D. Adaptability
- E. Insecurity
Correct Answer: C,D
Rationale: Temperament includes activity level (C) and adaptability (D), innate traits influencing behavior. Emotional bonding (A) and growth processes (B) are developmental, and insecurity (E) is a state, not a temperament trait.
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 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.