Mental Health Course Point Chapter 16

A couple that has struggled to maintain an income and housing for their young family asks their case manager how their struggles will affect their children's emotional development. Which of the following possible responses by the nurse is best?

"How you live certainly affects their developing sense of themselves and the world, but your love and nurturance are the most powerful influences on them."

An 11-year-old child talks to the school nurse about a single episode of disruptive behavior in class. The child states, "I had a stomach ache and felt like vomiting. I couldn't help it. I was just so mad at my dad." The most appropriate response by the nurse would be ...

"I can see that you're angry. Let's look at better ways to express it."

The nurse is caring for an adolescent with attention deficit hyperactivity disorder (ADHD). The nurse is teaching about the disorder and determines that the teaching has been most effective when the client makes which statement?

"I have been very impulsive with risk taking, and that is unsafe."

A male client with advanced heart failure was being cared for by his 15-year-old son and his family. The person recently died and the home health care nurse is making a home visit to the family to assess how the family is coping with the death. When interviewing the 15-year-old family member, which statement would the nurse most likely expect to hear?

"I've been getting support from my friends."

A nurse is assessing a child for possible child abuse and neglect. When reviewing the child's history, which factor would the nurse identify as increasing the child's risk? Select all that apply.

Family substance abuse Child history of medical problems Lack of social support for parents

A nurse is assessing a child for possible child abuse and neglect. When reviewing the child's history, which factor would the nurse identify as increasing the child's risk? Select all that apply.

Lack of social support for parents Child history of medical problems Family substance abuse

A nurse is interviewing a child who is suspected of being a victim of bullying. Which finding would the nurse interpret as supporting this suspicion? Select all that apply.

Low self-esteem Problems with relationships

The nurse assesses a child and his mother following numerous outbursts of anger the child has been experiencing. The nurse informs the mother that anger is a natural part of grieving; the mother will be less likely to view it as abnormal and more likely to accept and cope with it constructively. This describes ...

Normalization

A psychiatric-mental health nurse is conducting a program for a local community group about factors that help protect children from mental health problems. Which factor would the nurse most likely include? Select all that apply.

Presence of a caring adult or parent Feelings of being connected to school

A pediatric nurse realizes that even though some children have an experience that predisposes them to a disorder, they have characteristics that can reduce the probability of it developing. These characteristics are referred to as which of the following?

Protective factors

A nurse is reading a journal article about substance abuse, families, and the effect on children. After reading the article, the nurse demonstrates understanding of the topic by identifying that children of parents engaged in substance abuse are at greater risk for which condition? Select all that apply.

Substance abuse Behavior disorders

Which child has the greatest risk for exhibiting bullying behaviors?

a school-age male who has divorced parents and a history of physical abuse

The mother of a 5-year-old child asks the nurse if the child should attend their grandfather's funeral. Which question should the nurse ask first to assist the mother in making this decision?

"Does the child have a basic understanding about death?"

During group therapy with children, one child comes to the group late and makes another child give up their seat. Which statement by the child supports the diagnosis of conduct disorder?

"Hey kid, I'll let you pick which seat you get next time we have group."

At approximately what age do children understand the permanence of death?

7

The child's response to divorce is similar to which of the following?

Death

The nurse provides care for a school-age child who is hospitalized for the treatment of injuries sustained from a motor vehicle accident. Which topic is a priority when planning for the psychosocial care of this child?

loss of autonomous behavior

Which age group may express their grief as somatic symptoms?

school-age children

Social skills training is suggested for a child who has engaged in bullying. The parent asks the nurse, "What exactly is involved with this training?" Which information would the nurse mostlikely include in the response?

"It involves instruction, feedback, support and practice to help the child interact with others."

The nurse provides education to parents of a newborn who also have a young school-age child at home. The parents are concerned about sibling rivalry. Which statement does the nurse include in the teaching session to assist with the transition?

"It is important to include your older child in the care of your new baby."

A psychiatric-mental health nurse is interviewing an adolescent at the community mental health center. The adolescent was referred to the center because of behavioral problems. The adolescent is the older of two children. Which statement by the adolescent would the nurse interpret as a possible contributing factor?

"My brother can do no wrong in my parents' eyes, but me, that's another story."

A nurse is teaching a group of parents about how children respond to loss and death. Which statement by the nurse would be most appropriate when describing how to address the topic of death with preschoolers?

"Tell them honestly that the person has died and won't be coming back."

A psychiatric-mental health nurse is conducting a program for young and middle-aged adults who are providing care to their aging parents who are receiving hospice care. One of the participants asks the nurse, "When my dad dies, how should we handle it with our 4-year-old?" Which response by the nurse would be most appropriate? Select all that apply.

"When the child sees you're upset, reassure them that you will be okay." "Allow the child to express how they are feeling through their play." "Be honest in your statements about the death and repeat them as necessary."

A psychiatric nurse who works with children is giving a talk to a local community group and explains that chronic childhood illnesses present a unique set of challenges. The nurse adds that many families can adjust to the stressors, but some children will experience psychiatric symptoms more often than their healthy peers. What percentage does the nurse identify as the increased risk for children dealing with chronic illnesses?

3 to 4 times more likely

A nursing instructor is teaching about how death affects children at different ages. At what age does the teacher tell students that most children can understand the permanence of death?

7 years

A psychiatric-mental health nurse is conducting a teaching session about death and grieving for a group of parents. The parents have children ranging in age from 2 years to 18 years. When discussing the concept of death, the nurse would explain that children of which age would be capable of understanding about the permanence of death?

7 years old

A nurse is providing care to several children with chronic physical illnesses. Which child would the nurse most likely identify as being at greatest risk for mental health problems?

A child with spinal cord trauma

A nurse is reading a journal article about out-of-home placement. Which age group would the nurse most likely find as accounting for about half of this population of children?

Adolescents

A nursing instructor is teaching about death and how different age groups grieve. Which group would be most likely to ask for permission to grieve openly and then ask for acceptance of their sometimes extreme reactions?

Adolescents

A psychiatric-mental health nurse is presenting a program for a group of community leaders about mental health and children and adolescents. When describing the current status of out-of home placement, which group would the nurse most likely identify as accounting for the greatest percentage?

Adolescents

In which age group would a nursing student expect to see a person fascinated with death and enjoying morbid books and movies?

Adolescents

While assessing a four-year-old child about the reactions to his parents divorcing, the child states, "My mom and dad are getting a divorce."The nurse interprets this statement as reflecing the child's awareness of the reality. Which action would the nurse implement first to gain a clearer picture?

Ask questions to assess the child's level of understanding of the divorce.

A family of four children recently lost their father and require intervention because they are not handling the stress related to his death well. The nurse has instructed the children and mother to read several books about the death of a parent and how the family responded to the crisis. This is an example of which of the following?

Bibliotherapy

A nurse is working with a couple who is in the process of divorcing. After discussing the effect of divorce on children's mental health, the nurse determines that additional teaching is needed when the couple identify which factor as protecting the children's mental health?

Boundary-free home setting

A nurse is assessing a family in which a parent has a problem with alcohol abuse. When interviewing the family, one of the children demonstrates behavior that the nurse suspects as fulfilling the role of the family mascot. Which behavior would support the nurse's suspicion?

Child makes jokes and clowns around to relieve the tension.

A psychiatric-mental health nurse is conducting a teaching session for a group of families undergoing divorce. The nurse is explaining about the effects of divorce on children. Which factor would the nurse most likely include as influencing a child's response to the divorce? Select all that apply.

Child's temperament Parental interventions Level of stress, change, and conflict surrounding the divorce

The expression of grief through regression, or somatic complaints or withdrawal, describes the grief of ...

Children

Psychoeducational programs for children are designed to provide which of the following?

Coping skills

A psychiatric-nurse is conducting an assessment of a child who has a physical illness. Which reaction would the nurse be alert for as a common reaction? Select all that apply.

Depression Somatic complaints Regression

Studies of attachment show that the quality of the emotional bond between the child and parental figure is a ...

Determinant of the success of later relationships

The nurse working with pediatric clients knows the importance of checking for developmental delays, which not only slow the child's progress but also are often associated with what?

Development of poor self-esteem

A helpful approach used by nurses working with adolescents is ...

Discussion

A nurse is working at a community health center that serves a large adolescent population. When implementing activities to address the risk-taking behaviors of adolescents, which strategy would the nurse most likely employ? Select all that apply.

Discussion that encourages questions about risky behaviors Peer group social skills training Teens role modeling positive behaviors

A psychiatric-mental health nurse is making regular home visits to a family who is living in poverty. The family consists of a mother, father, and two children, ages 2 and 4. During the visits, the nurse is providing support and education to the family as well as connecting the family to the services they need. The nurse is engaged in which intervention?

Early intervention

A nurse is reviewing the history of a child who has experienced abuse. The nurse would be alert for the development of which problem? Select all that apply.

Eating disorder Substance abuse Self-destructive behavior

A psychiatric-mental health nurse is using bibliotherapy with a family. Which activity would the nurse most likely use?

Educational pamphlets

Adolescents can engage in impulsive and risky behaviors at times and believe they are invulnerable to consequences that others suffer. This type of thinking can be attributed to which characteristics consistent with this developmental stage?

Egocentric thinking

Children whose parents divorce often blame themselves and think that they are the root of the problem. Which type of thinking may cause these thoughts?

Egocentric thinking

When explaining the invincibility fable phenomenon to the parents of an adolescent, the nurse describes it as reflective of which concept of adolescent development?

Egocentric thinking

A psychiatric-mental health nurse is working with a couple who are divorcing. The couple has three children. Which aspect would the nurse likely emphasize to the couple as being most important to promote the children's adjustment to the divorce?

Encouraging positive statements about the other parent

Abuse can have lifelong effects on development. What have children who have been maltreated more prone to do? Select all that apply.

Enter aggressive relationships Abuse drugs Develop eating disorders Become depressed

A psychiatric-mental health nurse is engaged in supporting and educating a family to assist with the attachment between the children and parents. The nurse is most likely engaged in which activity?

Family preservation

A nurse is conducting an in-service education program for a group of nurses working in ambulatory care centers. The topic is child abuse. The nurse determines that the teaching was successful when the group identifies which finding as suggestive of possible physical abuse? Select all that apply.

Fear of adults, especially parents Clusters of lacerations on the torso Bald spots interspersed with normal hair

The nurse conducts wellness assessments for a child who is homeless and currently living in a shelter with a parent. Which issue(s) are a priority for the nurse to monitor for during the assessment process? Select all that apply.

Fine motor delays Has not developed appropriate language skills The presence of anxiety

Following the death of a parent, which of the following levels of the surviving parent is the best predictor of a child's adjustment to the loss?

Functional

Which of the following is the most restrictive type of mental health care for children and adolescents?

Group home

A nurse is conducting a program for community health leaders about out-of-home placement and factors contributing to this situation. The nurse determines that the program was successful when the group identifies which factor as contributing to out-of-home placement?

Growing population of families living in poverty

During an interview, a child whose parent abuses alcohol tells the nurse, "When I get home from school every day, I pick up my younger brother and sister from the bus stop and get them a snack before I start making dinner for everyone. I also make sure that my parents eat." The nurse interprets this behavior as the child fulfilling which role?

Hero

What is accurate about bullying?

It is a deliberate attempt to harm someone.

The mother of a 5-year-old girl who shows clinging behavior and gets anxious when not with either parent asks how to help the child relax enough to go to sleep without staying beside the child's bed. The nurse should recommend that the mother does which of the following?

Leave the door open so the child can hear the parents' voices while going to sleep.

The parents of a 12-year-old are hostile to each other, fight frequently, and plan to divorce. The child will move with the mother to another part of town. Which of the following factors will likely have the most negative effect on the child?

Observing the parental fights and wanting to be loyal to both parents

A nurse is conducting a program for a local school district on bullying. When describing the types of activities involved, the nurse describes relational aggression. The nurse determines that additional teaching is needed when the group identifies which behavior as an example?

Physical aggression

Girls who bully are more likely to use which of the following?

Relational aggression

Assessment of a client at risk for psychopathology is able to attain good mental health, maintain hope, and achieve healthy outcomes. The nurse interprets this as demonstrating which of the following?

Resilience

A nurse is reviewing the history of a family in which a parent has a history of alcoholism. One of the children has been exhibiting behavior problems requiring a focus on interventions to address the child's problems. The nurse identifies this child as assuming which role in the family?

Scapegoat

Which of the following describes a child of a parent diagnosed with alcoholism who diverts attention away from the parent with alcoholism?

Scapegoat

The nurse working with a child using instruction, feedback, support, and practice with learning behaviors that help children to interact more effectively with peers and adults refers to ...

Social skills training

Which type of intervention may be helpful for children who are bullies?

Social skills training

A nurse in the community is working to promote the health of homeless families who are living in local shelters. When working with these families, which information would be mostimportant for the nurse to keep in mind? Select all that apply.

The children of homeless families have a limited ability to speak for themselves. The living conditions can negatively affect the children's physical and mental health.

A psychiatric-mental health nurse assesses a group of adolescents and decides to implement social skills training. Which finding about the group members would support the nurse's decision? Select all that apply.

The group members are exhibiting low self-esteem. The group members demonstrate aggressive behaviors. The group members are have engaged in bullying behavior.

A psychiatric-mental health nurse is working with a couple who are getting a divorce. The couple has 2 children, ages 5 and 7 years. When discussing the effects of divorce on the children, which information would the nurse most likely include?

The most difficult time for the children is usually the first 2 to 3 years after the couple's breakup.

When viewing grief in various age groups, how do 5-year-old children view death?

They view death as reversible.

An only child who was hospitalized with a broken leg and arm after a fall when he was 5 years old is now 10 years old. While at the clinic for a yearly check-up, he tells the nurse that his parents will not let him play sports at all or outside with other children unless he is supervised by one of his parents. He says that he does not understand why his parents act this way. The nurse would suspect which situation?

Vulnerable child syndrome

Which individual would benefit from the inclusion of social skills training in the nursing plan of care? Select all that apply

a child with low self-esteem a child who exhibits bullying behaviors a child with poor coping skills a child who exhibits aggression

The nurse is counseling a couple who have just gotten divorced. The wife has custody of the two children, ages 7 and 9 years. The nurse should instruct the couple that divorce can affect the children and that ...

a structured home and school environment can lessen the emotional problems.

The nurse provides care for children who will be placed out of the home due to safety issues related to parental substance use disorder. Which role does the nurse assume with the interdisciplinary approach to care? Select all that apply.

advocate coordinator case manager

A 3-year-old child has been admitted to the hospital after an automobile accident. The nurse can anticipate that the child will exhibit ...

anxiety around strangers.

A parent brings their child to the clinic reporting that their child has started to wet the bed at night, refuses to go to school, and cries when it is time to go. The parent tells the nurse that up until recently the child loved to go to school. What should the nurse suspect is happening to this child?

bullying at school

A nurse is conducting the interview of a girl who has been accused of bullying by spreading rumors online about two other children in the class. The nurse interprets this action as:

cyberbullying.

A psychiatric-mental health nurse is preparing a presentation for a group of new parents in the local community about how to promote their children's mental health. After providing the parents with instruction, the nurse determines the need for additional teaching when the group identifies which factor as promoting mentally healthy children?

difficult temperament

A child's parents are getting a divorce. Which type of thinking may cause the child to believe that he or she is the root of the parents' problems?

egocentric

The parents of an adolescent are concerned that their child is engaging in activities that put the child in danger. "We're so worried. When we ask our child about these activities, it's as if our child thinks nothing will ever happen." When counseling the parents, the nurse integrates understanding that this behavior is reflective of which aspect of adolescence?

egocentric thinking

The nurse is counseling a family with a 4-year-old child. The child's grandfather died 3 weeks ago. The nurse should explain to the parents that preschoolers who are grieving often:

express themselves through fantasy play.

According to Piaget, adolescents who have reached the final stage of cognitive development are in a stage termed ...

formal operations.

A nurse is speaking to a community group and is describing the various etiologies and risk factors associated with ADHD. Which of the following would the nurse include? Select all that apply.

genetics family stress marital discord

A psychiatric-mental health nurse is providing counseling to parents who have just lost a child to cancer. They have a school-aged child at home. When explaining the concept of grief for the surviving child, which reaction would the nurse explain as being most commonly experienced by surviving siblings?

guilt

The nurse suspects the school-age child to have attention-deficit/hyperactivity disorder (ADHD). Which client finding(s) would the nurse likely use as a basis for this suspicion related to symptomatology? Select all that apply.

moving and fidgeting disruptive behavior unsafe activities

A psychiatric-mental health nurse is reading a journal article describing research about sibling relationships. The nurse demonstrates understanding of the article by identifying that sibling relationships significantly influence which type of development?

personality

Preschool programs that target children's social and emotional competencies are an example of ...

primary prevention.

The adjustment to an out-of-home placement can be viewed through the conceptual framework of Bowlby's stages of coping with parental separation. According to Bowlby (1960), the child initially responds to separation from parents with:

protest.

The literature on children of parents with alcoholism has described several typical roles that children assume. Which role is described as problem children who divert attention away from the parent with alcoholism?

scapegoat

When describing the treatment plan to the caregiver for a child with ADHD, which area would the nurse identify as important to address? Select all that apply.

school accommodations family treatment individual treatment medication

A nurse is providing care to the parents of a newborn and is working with them to promote attachment between themselves and their child. The nurse encourages actions that promote attachment to help achieve which outcome for their child?

to test the world without fear of rejection

When providing education to the caregiver of a child with attention deficit hyperactivity disorder (ADHD), the nurse explains that some stimulant medications can be effective for:

use in children over 6 years of age.