Ch 36: Mental Health Assessment of Children and Adolescents

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a) "It must be difficult to handle your child at home" Pg. 696 Parents find themselves chronically exhausted mentally and physically. Parents need support and reassurance, and making a statement about the difficulties of handling the child at home validates the mother's feelings. It is not appropriate to say, "Your son is a cute child, but he needs to calm down" because this suggests a simplistic solution to the child's problem.." It may make the parents defensive to say, "You need to take a firmer approach with your son." "Your son sure is active" is not a therapeutic response because it downplays the significance of the child's disorder and its effect on the family.

1. The parent of a 6-year-old child with attention deficit hyperactivity disorder asks to speak to the nurse about the child's disruptive behavior. The nurse would be most therapeutic by saying what? a) "It must be difficult to handle your child at home" b) "Your child sure is active" c) "Your child is cute but needs to calm down" d) "You need to take a firmer approach with your child"

c) Use the language and vocabulary of the child to describe the incident Pg. 711-712 If the child reports abuse, the nurse has the legal responsibly to report the abuse to child protection agencies. The nurse must use the same language and vocabulary that the child use to describe the abuse or anatomical terms and ask non-leading questions.

10. A nurse is talking with a school-age child who tells the nure about a time when a family member attacked the child. The child describes the events in detail. What is important for the nurse to consider when documenting and discussing the incident with other health care providers? a) Use leading questions to describe the incident b) Summarize the reported details in 4 or 5 sentences c) Use the language and vocabulary of the child to describe the incident d) Use professional language in the documentation

d) Fine motor functioning Pg. 707 Fine motor functioning is part of the developmental assessment and can be accomplished by asking the child to draw a picture or pick up sticks.

11. The nurse is performing a developmental assessment of a child who has just been admitted to the mental health unit. When asking the patient to pick up some sticks placed on a table, what part of the examination is the nurse performing? a) Intellectual functioning b) Cognition c) Gross motor functioning d) Fine motor functioning

a) ADHD is not the fault of the parents or the child and techniques and school programs are available to help d) It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem e) Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems Pg. The child with ADHD cannot accomplish complex tasks, such as homework, in a noisy or chaotic setting where there are a lot of distractions. Helping the child focus on one task at a time increases the chance of success. A predictable schedule helps provide the structure that the child needs. The child benefits from clear, unambiguous directions.

12. A nurse is providing education to a group of parents who have children with attention deficit hyperactivity disorder (ADHD). Which statement would be accurate and should be included in the education? Select all that apply. a) ADHD is not the fault of the parents or the child and techniques and school programs are available to help b) Medication alone will adequately treat children with ADHD c) Children with ADHD do not qualify for special school services under the Individuals With Disabilities Education Act d) It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem e) Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems

b) Often the parents or teacher notice positive outcomes of treatment Pg. Parents and teachers are likely to notice positive outcomes of treatment before the child does. Medications are often effective in decreasing hyperactivity as the school nurse would be involved in that process as well. Siblings are usually not the first to notice, since they usually distance themselves from the child with ADHD. Changes can be subtle but are noticed well before a follow-up visit is scheduled.

13. The parent of a child with attention deficit hyperactivity disorder (ADHD) tells the school nurse that the child's teacher has called a conference. Which statement is true regarding evaluation of treatments for the child with ADHD? a) Often the child notices the change in treatment before anyone else b) Often the parents or teacher notice positive outcomes of treatment c) Often the change is subtle and gets noticed at the follow-up visit d) Often it is the siblings that notice the change in behavior first

c) Provide a safe environment Pg. 711-712 Based on the provided information, this may be a display of disruptive attachment manifesting as a reactive attachment disorder. However, there is insufficient information at this time for clinical diagnosis and best practice is to maintain a safe environment. There is no indication of child abuse. Asking the child to explain their behavior would not be warranted because it would only serve to escalate the situation. Referring the family and the child for counseling may be warranted, but it is not the priority at this time.

14. A nurse observes a preschool-aged child refusing the efforts of the parents to provide comfort during a physical examination. The preschool-aged child displays aggressive behavior and begins to hit and flail. The parents just turn their back on the child, which only serves to make things worse. Based on this presentation, what is the best nursing response? a) Refer the family and child for counseling b) Ask the child to explain their behavior c) Provide a safe environment d) Assess for child abuse

c) Play a competitive board game Pg. 700 Nurses can establish rapport with school-aged children by using competitive board games such as checkers.

15. To establish rapport with a 10-year-old child who is hospitalized in a psychiatric setting, the nurse should... a) Use sports to bond with the child b) Analyze a fairy tale c) Play a competitive board game d) Use the DECA tool

b) Offer a transitional object for the child to hold Pg. 696 Young children may fear separating from their parents. The nurse can reassure children by showing them where the waiting room is and telling them that they can check on their parents when they wish. Other comfort measures include introducing a game or toy or allowing the child to hold a transitional object.

16. The nurse caring for a young child knows the importance of interviewing both child and parent. When it comes time to speak with the child alone, however, some children fear separation from their parents. What could the nurse do to ease this separation? a) Extend the time the child is away from the parents to promote desensitization b) Offer a transitional object for the child to hold c) Tell the child there is nothing to be afraid of d) Speak to the child as if he or she was an adult

a) Slow to warm up Pg. 707 The classic New York Longitudinal Study (Thomas, Chess, & Birch, 1968) identified three main patterns of temperament seen in infancy that often extend into childhood and later life. A difficult temperament is characterized by irregular sleep and eating patterns, negative response to new stimuli, slow adaptation, a negative mood, and high emotional intensity. An easy temperament is characterized by a positive mood, regular patterns of eating and sleeping, a positive approach to new situations, and low emotional intensity. A slow-to-warm-up temperament is characterized by a negative, mildly emotional response to new situations that is expressed with intensity and initially slow adaptation but evolves into a positive response. Challenging is not one of the three main patterns of temperament.

17. The nurse is assessing a child's temperament as part of the psychological assessment. Which type of temperament is characterized by a negative, mildly emotional response to new situations that is expressed with intensity and initially slow adaptation but evolves into a positive response? a) Slow to warm up b) Difficult c) Challenging d) Easy

a) Fine motor functioning Pg. 707 To test fine motor functioning, the nurse may ask the child to draw a picture or pick up sticks. Asking a child to hop on one foot, throw a ball, or run tests gross motor functioning. Intellectual functioning is tested by evaluating the child's creativity, academic performance, and memory. Tests of cognition involve the child's vocabulary, level of comprehension, drawing ability, and responsiveness to questions.

18. When a child is asked to draw a picture during a mental status examination, the nurse is testing which of the following? a) Fine motor functioning b) Gross motor functioning c) Intellectual functioning d) Cognition

d) Intellectual functioning Pg. 707 The nurse should observe the child's sentence structure and vocabulary for a general sense of the child's intellectual functioning.

19. During a mental status examination of a child, the nurse observes the child's sentence structure and vocabulary for a general sense of... a) Ability to respond accurately to questions asked b) Ability to focus on the conversation c) Listening skills without interrupting d) Intellectual functioning

a) Belief that they will be blamed for their problems Pg. 696 Adolescents may act indifferent when asked to speak with them alone. Teens tend to be skeptical that adults can really understand their experience and suspicious that they will be blamed for their problems.

2. Adolescents receiving treatment for psychiatric disorders can be suspicious and guarded. The nurse understands what as a major reason for this type of behavior? a) Belief that they will be blamed for their problems b) Belief that their feelings are normal c) Belief that everybody hates them d) Belief that adults will understand their problems better than they understand them

c) Contradictory behavior Pg. 710 Preschoolers with disorganized attachment manifest contradictory behavior.

20. Preschoolers with disorganized attachment will display... a) Self-serving behavior b) Cooperative behavior c) Contradictory behavior d) Appropriate behavior

c) "Tell me about your faith background" Pg. 711 Questioning about a client's spiritual life should include interviewing strategies that are unbiased and facilitate understanding of the client's spiritual values. Questions can include but not limited to child's and family's specific faith background, level of activity with that group, support received from spiritual practices, religious rituals of importance, and religious influences on lifestyle and health choices.

21. When asking about a client's spiritual life, which question is appropriate? a) "Do you go to church?" b) "Do you believe in God?" c) "Tell me about your faith background" d) "Can you share with me about your parents' religious preference?"

d) Slow-to-warm-up and appropriate Pg. 707 A slow-to-warm-up temperament is characterized by a negative response that changes to a positive response over time. Temperaments are categorized as easy, difficult, and slow-to-warm-up. They can be construed as being positive or negative. There is no provided information relative to age and/or developmental delay, so the nurse cannot make that judgment.

22. A nurse is working with a pediatric client who appears shy but then warms up to the interaction and becomes engaged. How would the nurse best describe the client's temperament? a) Consistent with age b) Difficult, yet expected c) Easy with a developmental lag d) Slow-to-warm-up and appropriate

a) Attention to developmental milestones Pg. 701 Attention to feelings, signs and symptoms, and family history is common to both age groups. Attention to developmental milestones and stages is prioritized in the child psychiatric assessment.

23. The child psychiatric assessment differs from that of adults in which of the following ways? a) Attention to developmental milestones b) Attention to signs and symptoms c) Attention to the family history d) Attention to feelings

c) Healthy functioning Pg. 711 A score of 70 to 100 usually indicates that the child is functioning well in relation to school, peers, family, and community. A GAF score of 51 to 69 indicates moderate impairment. A score of 30 may indicate that the child is severely homicidal or suicidal and has made previous attempts.

24. A Global Assessment of Functioning (GAF) score of 80 would indicate which of the following? a) Moderate impairment b) Severely homicidal tendencies c) Healthy functioning d) Suicidal tendencies

b) Erikson's Pg. 708 The most commonly used model is Erikson's to assess the psychosocial development of children.

25. The nurse caring for a child with a mental health disorder knows the importance of assessing for psychosocial development as well assessing the biologic and psychological domains. Which model is the most commonly used to assess the psychosocial development of a child? a) Piaget's b) Erikson's c) Baker Miller's d) Freud's

d) Thinking-feeling-doing game Pg. 700 A therapeutic game that is helpful in assessing a child's perception, cognition, and emotions and in establishing rapport is the thinking-feeling-doing game. Cards have hypothetical situations; after drawing one, the nurse asks the child what a person might think or feel in that particular situation.The nurse can establish rapport with school-aged children by using competitive board games, such as checkers and playing cards. Analyzing children's perceptions of fairy tales can provide clinicians with clues to culture, problems, solutions, and elements of mental functioning. Drawings are also used in child assessment to illuminate the child's intellect, creative talents, neuropsychological deficits, body image difficulties, and perceptions of family life.

26. A nurse working on a mental health unit with a newly admitted 8-year-old wants to better understand what this child is thinking as well as how the child is feeling. What is the best method for the nurse to use to accomplish these goals? a) Fairy tales b) Drawings c) Play therapy d) Thinking-feeling-doing game

b) Intellectual functioning c) Gross and fine motor movement d) Cognition Pg. 707 The nurse can assess for developmental delays by asking questions from specific sections of the mental status examination. Areas covered on the exam include intellectual functioning, gross and fine motor functioning, cognition, thinking and perception and social interactions and play.

27. A variety of areas are assessed during the mental status examination. Which are sections of the mental status examination? Select all that apply. a) Academic interests b) Intellectual functioning c) Gross and fine motor movement d) Cognition e) Religious background

c) "We'll be sure to record the child's weight on a weekly basis" Pg. Stimulant medications used to treat ADHD can suppress appetite, and the child may lose or fail to gain weight properly. The client is too young to manage medications independently. Ritalin should be given in divided doses, and taking it at bedtime can cause insomnia. Ritalin reduces hyperactivity, impulsivity, and mood lability and helps the child to pay attention more appropriately. However, it does not wholly eliminate the challenges of the disorder.

28. Which statement would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective? a) "We're so glad that methylphenidate will eliminate the problems of ADHD" b) "We'll teach the child the proper way to take the medication, so the child can manage it independently" c) "We'll be sure to record the child's weight on a weekly basis" d) "We'll be sure the child takes methylphenidate at the same time every day, just before bedtime"

b) Interviewing the client's teachers c) Directly observing the child d) Interviewing the client's parents e) Assessing the client in a group of peers Pg. 699 During assessment, the nurse gathers information through direct observation and from the child's parents, day care providers (if any), and teachers. Assessing the child in a group of peers is likely to yield useful information because the child's behavior may be subdued or different in a focused one-to-one interaction with the nurse. Reviewing the client's record will not yield much assessment data. Reviewing the client's record provides useful data about the child's history but this is not considered the nurse's own assessment data.

29. Which would be important circumstances to gather assessment data for a child with attention deficit hyperactivity disorder (ADHD)? Select all that apply. a) Reviewing the client's record b) Interviewing the client's teachers c) Directly observing the child d) Interviewing the client's parents e) Assessing the client in a group of peers

d) "We'll have the child do homework at the kitchen table with the child's siblings" Pg. 711 The child with ADHD cannot accomplish complex tasks, such as homework, in a noisy or chaotic setting where there are a lot of distractions. The other choices do not indicate the need for further teaching.

3. When teaching the parents of a child with attention deficit hyperactivity disorder (ADHD), which statement by the parents would indicate the need for further teaching? a) "We'll use simple, clear directions and instructions" b) "We'll set up rules with specific times for eating, sleeping, and playing" c) "We'll make sure the child completes one task before going on to another" d) "We'll have the child do homework at the kitchen table with the child's siblings"

d) Clinical interview with child Pg. 696 The clinical interview is the primary assessment tool used in child and adolescent psychiatry. Although use of the DSM-IV-TR and an interview with parents and siblings may be important, none of these is the primary assessment tool.

30. Which of the following is the primary assessment tool in child in adolescent psychiatry? a) DSM-V assessment b) Interview with parents c) Interview with siblings d) Clinical interview with child

b) "Your child will probably always have some autistic traits" Pg. Autistic traits persist into adulthood, and most people with autism remain dependent to some degree on others. Manifestations vary from little speech and poor daily living skills throughout life to adequate social skills that allow relatively independent functioning. Social skills rarely improve enough to permit marriage and child rearing. Stating, "You seem worried about your child's future" is empathic but does not address the parent's specific question.

31. The parents of an autistic child ask the nurse, "Will my child ever be normal?" Which would be the most appropriate response by the nurse? a) "Your child should outgrow autistic traits by adolescence" b) "Your child will probably always have some autistic traits" c) "You seem worried about your child's future" d) "Autistic children can fully recover with the right treatment and education"

b) "What do you want to do when you grow up?" Pg. 708 Other ways to assess a child's self-concept include asking the child what the child wants to do when they grow up, what their best subjects are in school, what things they are really good at, and how well liked they are at school.

32. Which question is an appropriate question that provides information regarding a child's self-concept? a) "Do you get along with your parents about food?" b) "What do you want to do when you grow up?" c) "Do you have friends at school?" d) "If you were stranded on an island, what three things would you want to have?"

a) Aggression towards peers c) Falling grades d) Withdrawal from peers e) Decreased concentration Pg. 710 Falling grades, loss of interest in normal activities, decreased concentration, or withdrawal from or aggression toward peers may indicate that the child is experiencing emotional problems.

33. Changes in behavior at school may be evidenced by which of the following? Select all that apply. a) Aggression towards peers b) Physical disability c) Falling grades d) Withdrawal from peers e) Decreased concentration

c) Gross motor functioning Pg. 707 When checking for gross motor functioning the nurse can ask the patient to hop on one foot, throw a ball, walk up and down the hall, or run.

34. The nurse is performing a developmental assessment with a school-aged child who has demonstrated limited school functioning due to emotional lability. The nurse asks the child to hop on one foot and then throw a ball. Which part of the developmental assessment is the nurse performing? a) Cognition b) Intellectual functioning c) Gross motor functioning d) Fine motor functioning

d) Behavior disturbances Pg. 705 Generally, parents provide better information about externalizing symptoms such as behavior disturbances or parent-child relationships.

35. When a nurse is interviewing a parent and a child in a psychiatric setting, the nurse recognizes that parents generally provide better information about the child's... a) Sleep patterns b) Moods c) Suicide ideation d) Behavior disturbances

a) The nurse should corroborate information offered by the child with other sources b) Children have a less specific sense of time than adults e) The nurse should use simple phrasing with children Pg. 695 Children have a less specific sense of time than adults. The nurse should use simple phrasing with children and corroborate information offered by them with other resources. Children cannot sequence events well and do not have more developed memories than adults.

36. Which of the following is accurate regarding the completion of a mental health assessment of a child? Select all that apply. a) The nurse should corroborate information offered by the child with other sources b) Children have a less specific sense of time than adults c) Children can sequence events well d) Children have a more developed memory than adults e) The nurse should use simple phrasing with children

c) Tourette's syndrome Pg. 703 Many childhood psychiatric disorders, such as autism, intellectual disability, developmental learning disorders, some language disorders (e.g., dyslexia), attention deficit hyperactivity disorder (ADHD), and Tourette's syndrome, appear to be genetically transmitted. Research increasingly shows that major psychiatric disorders (e.g., depression, anxiety disorder, schizophrenia, bipolar disorder, substance abuse) run in families but are not necessarily identified as being genetically transmitted.

37. A psychiatric-mental health nurse is reviewing an article about genetics and the role in the development of a childhood psychiatric disorder. The nurse demonstrates understanding of this information by identifying which disorder as being genetically transmitted? a) Anxiety disorder b) Depression c) Tourette's syndrome d) Bulimia

a) Showing acceptance d) Maintaining eye contact e) Speaking slowly Pg. 697-698 Establishing rapport can be facilitated by maintaining appropriate eye contact; speaking slowly, clearly, and calmly with friendliness and acceptance; using a warm and expressive tone; reacting to communications from interviewees objectively; showing interest in what the interviewees are saying; and making the interview a joint undertaking.

38. A nurse is conducting an assessment of a child. Which technique would be most effective for the nurse to use to establish rapport with family members? Select all that apply. a) Showing acceptance b) Reacting subjectively c) Making the interview nurse centered d) Maintaining eye contact e) Speaking slowly

a) Receptive language Pg. 705 The fact that the child can respond to the nurse to make the statement that "they cannot understand what the nurse is saying" identifies an issue with receptive language. There is no specific information to suggest a problem with authority and/or a defense mechanism or that the dominant language is a second language because communication has been established.

39. The nurse asks a child to have a seat on the examining table. The child responds to the nurse stating they cannot understand what the nurse is saying. The nurse has provided simple instructions to the child relative to having a seat on the examining table. What type of problem does the nurse identify? a) Receptive language b) Defense mechanism c) Problem with authority d) The dominant language is a second language

c) Joining in play Pg. 699 The nurse can achieve rapport with preschoolers by joining their world of play. Play is an activity by which children transform an experience from real life into a symbolic, non-literal representation.

4. When working with a hospitalized preschooler, the nurse knows that the best way to achieve rapport is by doing what? a) Talking to the child one-on-one b) Being friendly with the child when the parents are around c) Joining in play d) Providing multiple rewards for acceptable behavior

a) 5 Pg. 705 By age 5 years, children should be able to dress themselves with minimal assistance, color within the lines, and draw a three-part human. By age 6 years, children should be able to draw a six-part human. By age 7 years, children should print well and begin to write script. By age 8 years, children should demonstrate mature handwriting skills.

40. The nurse is assessing a child's fine motor skills. By which age should a child be able to dress himself with minimal assistance? a) 5 b) 6 c) 7 d) 8

a) Difficult Pg. 707 The classic New York Longitudinal Study (Thomas, Chess, & Birch, 1968) identified three main patterns of temperament seen in infancy that often extend into childhood and later life. A difficult temperament is characterized by irregular sleep and eating patterns, negative response to new stimuli, slow adaptation, a negative mood, and high emotional intensity. An easy temperament is characterized by a positive mood, regular patterns of eating and sleeping, a positive approach to new situations, and low emotional intensity. A slow-to-warm-up temperament is characterized by a negative, mildly emotional response to new situations that is expressed with intensity and initially slow adaptation but evolves into a positive response. Challenging is not one of the three main patterns of temperament.

41. In the biopsychosocial psychiatric nursing assessment of children, assessment of the psychological domain includes assessing the child's temperament. Which type of temperament is characterized by a negative response to new stimuli and high emotional intensity? a) Difficult b) Easy c) Challenging d) Slow to warm up

c) Egocentrism Pg. 700-702 Egocentrism includes the concepts of the imaginary audience and the personal fable. It is a preoccupation with one's own appearance, behavior, thoughts, and feelings. The other options are antonyms of egocentric.

42. A teenager with a personality disorder has been admitted to a mental health facility. During the admission interview, the teen tells the nurse that his parents recently separated and that he is to blame. What attitude is this client exhibiting? a) Altruism b) Submissiveness c) Egocentrism d) Humility

b) Developmental level Pg. 696 Developmental level of the child or adolescent frames the assessment and management of the plan of care. Educational level, GAF score, and social skills are important but do not frame the assessment and plan of care.

43. When interviewing children or adolescents, which of the following frames the assessment and management of the plan of care? a) Educational level b) Developmental level c) Assessment tools d) Social skills

a) Asking them what they would wish for d) Getting them to draw e) Asking them what they want to do when they grow up Pg. 708 Eliciting from young children their view of themselves is helpful. The best ways to do this is by getting them to draw, asking them what they would wish for, asking them what they want to do when they grow up, and discussing their best subjects in school. Filling out a survey and making comparisons are not good techniques with young children.

44. A nurse working on a unit for children with mental health issues understands the importance of assessing self-concept, even in young children. Some ways to do this when working with young children are which of the following? Select all that apply. a) Asking them what they would wish for b) Getting them to fill out a survey on self-esteem c) Comparing them to others of the same age d) Getting them to draw e) Asking them what they want to do when they grow up

c) Straightforward questions about suicide and violence Pg. 702 The nurse must ask the child about any suicidal or violent thoughts. The best way to assess these areas is to ask straightforward questions.

45. A nurse assessing for suicide and violent thoughts of children should ask... a) Indirect questions about how they feel b) Avoid assessing children at the age of 7 as it is not applicable c) Straightforward questions about suicide and violence d) Questions about suicide and telling them before asking that this information will be shared with others if anyone is in danger

d) "Mother-child separation for 1 week or more within the first 2 years of life has been related to self-reliance on the child's part in later years" Pg. All the statements are true except that mother-child separation for 1 week or longer within the first 2 years of life has been shown to be related to higher levels of child negativity (at age 3 years) and aggression (at ages 3 to 5 years).

46. A nursing student has learned about attachment and how this emotional bond between infant and parent helps create the groundwork for future relationships. What statement made by this student indicates a need for further clarification from the instructor? a) "The need for touch appears to be biologically driven" b) "Children who have developed a secure attachment will protest when their parents leave them, beginning at 6 to 8 months" c) "A secure attachment is based on the caretaker's consistent and appropriate response to the infant's attachment behaviors" d) "Mother-child separation for 1 week or more within the first 2 years of life has been related to self-reliance on the child's part in later years"

b) Easy temperament Pg. 707 An easy temperament can serve as a protective factor against the development of psychopathology. Children with easy temperaments can adapt to change without intense emotional reactions.

47. Which temperament can serve as a protective factor against the development of psychopathology? a) Difficult temperament b) Easy temperament c) Slow-to-warm-up temperament d) Attachment disorganization temperament

b) Assess interactions between child and caregiver c) Develop a treatment alliance Pg. 696 The assessment interview is the initial contact between the child and caregiver. The first step is to establish a treatment alliance and the second step is to assess the interactions between the child and parent.

5. There are two steps necessary in an assessment interview between a child and caregiver. Which are the steps? Select all that apply. a) Diagnosis problems and develop a plan of care b) Assess interactions between child and caregiver c) Develop a treatment alliance d) Determine school goals for the child

a) Asking about things that are important to the child Pg. 696-697 The nurse can establish a high degree of credibility by asking about things important to the child such as a sport the child participates in or an object he or she has brought.

6. When interviewing a 12-year-old child in an outpatient psychiatric setting, the nurse can establish a high degree of credibility by... a) Asking about things that are important to the child b) Providing advice to the child about his or her parents c) Asking the child to describe his or her parents d) Giving the child a transitional object to hold

c) It is much more difficult to diagnose psychiatric disorders in children and adolescents Pg. 702 It is much more difficult to diagnose psychiatric disorders in children and adolescents. Many of the same psychiatric disorders that affect adults also occur in children and adolescents, but because psychiatric disorders in children are difficult to diagnose, they do not manifest themselves very quickly. Children and adolescents share many of the same mental health problems as older clients, but this does not highlight a particular need for advocacy.

7. For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders? a) Psychiatric disorders in children manifest themselves very quickly b) It is not necessary because psychiatric disorders do not occur in children and adolescents c) It is much more difficult to diagnose psychiatric disorders in children and adolescents d) Children and adolescents experience some of the same mental health problems as adults

d) Use reflective comments e) Use appropriate vocabulary Pg. 699 During the comprehensive assessment, the nurse needs to be a good, active listener. Using appropriate vocabulary, tolerating a child's anxious, angry or sad behavior, and use of reflective comments are useful listening skills.

8. Which are nursing actions that support active listening? Select all that apply. a) Sit with arms and legs crossed b) Use a computer to write out observations c) Interrupt conversations to ask more questions d) Use reflective comments e) Use appropriate vocabulary

b) Language c) Psychosocial development e) Maturation Pg. 707 The key areas of developmental assessment include maturation, psychosocial development, and language. Family relationship and peer adjustment are part of the social domain.

9. A nurse is completing a developmental assessment of a child. On which area would the nurse focus? Select all that apply. a) Family relationship b) Language c) Psychosocial development d) Peer adjustment e) Maturation


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