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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.
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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.
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.
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 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 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.