CH 35 Mental Health

When addressing general intelligence during the mental status exam, which of the following components may be tested? Select all that apply. Organization Memory Concentration Vocabulary Apgar score

Memory Vocabulary Concentration Organization

A nurse asks an assigned client diagnosed with a tic disorder, "How are you doing today?" The client responds with "doing today, doing today, doing today." Which speech pattern disturbance is this an example of? Selective mutism Stereotypic movement disorder Echolalia Reactive attachment disorder

Echolalia

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? Submissiveness Altruism Humility Egocentrism

Egocentrism

An 11-year-old has been diagnosed with depression. When interviewing the child for the first time, which question would be most appropriate to ask? "Do you ever feel anxious?" "Have you ever heard of thorazine?" "Have you ever had delusions?" "Are you feeling sad?"

"Are you feeling sad?"

A nurse tells the child and caregiver that the nurse will interview each of them separately. The caregiver questions why this needs to occur. What is the nurse's best response? "Both interviews provide unique and meaningful information." "By interviewing separately I can validate all the information." "Research shows that information validates the child's feeling." "Parents know best and I will determine this during the interview."

"Both interviews provide unique and meaningful information."

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? "It must be difficult to handle your child at home." "Your child sure is active." "You need to take a firmer approach with your child." "Your child is cute but needs to calm down."

"It must be difficult to handle your child at home."

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? "The need for touch appears to be biologically driven." "A secure attachment is based on the caretaker's consistent and appropriate response to the infant's attachment behaviors." "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." "Children who have developed a secure attachment will protest when their parents leave them, beginning at 6 to 8 months."

"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."

When interviewing children or adolescents, which of the following frames the assessment and management of the plan of care? Educational level Assessment tools Developmental level Social skills

Developmental level

In a preschool child assessment to clarify the child's body image difficulties, the nurse will use ... Direct questions Drawings Playing checkers Playing cards

Drawings

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

"Tell me about your faith background."

A nurse is assessing language development of a 2-year-old. What is a normal language pattern for a 2-year-old? "Mama" "Go" "Want eat" "Apple pie"

"Want eat"

A nurse is teaching a family how to best help their child who has been recently diagnosed with a neurodevelopmental disorder. Which statement indicates to the nurse that teaching has been effective? "We will be able to go on the bus tour with our church group." "We will be able to do more things with our family." "We will be able to enjoy more structure in our home." "We will be able to go to the races every weekend like we used to."

"We will be able to enjoy more structure in our home."

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? "We'll teach the child the proper way to take the medication, so the child can manage it independently." "We'll be sure to record the child's weight on a weekly basis." "We'll be sure the child takes methylphenidate at the same time every day, just before bedtime." "We're so glad that methylphenidate will eliminate the problems of ADHD."

"We'll be sure to record the child's weight on a weekly basis."

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? "We'll use simple, clear directions and instructions." "We'll have the child do homework at the kitchen table with the child's siblings." "We'll set up rules with specific times for eating, sleeping, and playing." "We'll make sure the child completes one task before going on to another."

"We'll have the child do homework at the kitchen table with the child's siblings."

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

"What do you want to do when you grow up?"

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? "Your child should outgrow autistic traits by adolescence." "Autistic children can fully recover with the right treatment and education." "Your child will probably always have some autistic traits." "You seem worried about your child's future."

"Your child will probably always have some autistic traits."

Which of the following is a normal Global Assessment of Functioning (GAF) score? 68 52 60 80

80

A nurse completes a Global Assessment of Functioning (GAF) scale on an adolescent during an assessment. The nurse calculates a 55. What is the analysis of the score? A high level of impairment A moderate level of impairment No impairment A low level of impairment

A moderate level of impairment Explanation: The GAF scale ranges from 0 to 100; the lower the score, the higher level of impairment, with a greater likelihood of psychiatric symptoms and serious impairment in communication or judgement. Moderate scores are 51 to 69. Children in this category are not homicidal or suicidal and usually respond well to outpatient interventions. Low is 70 to 100; in this case the child is functioning well in relation to school, peers, family, and community

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

Joining in play

When is the Global Assessment of Functioning (GAF) score always measured initially? During rehabilitation During crisis stabilization At intake Upon discharge

At intake

The child psychiatric assessment differs from that of adults in which of the following ways? Attention to signs and symptoms Attention to feelings Attention to developmental milestones Attention to the family history

Attention to developmental milestones

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

Belief that they will be blamed for their problems

The nurse is assisting a child with attention deficit hyperactivity disorder (ADHD) to complete the child's activities of daily living. Which is the best approach for nurse to use with this child? Offer rewards when all tasks are completed. Let the child complete tasks at the child's own pace. Break tasks into small steps. Set a time limit to complete all tasks.

Break tasks into small steps.

Which of the following is the primary assessment tool in child in adolescent psychiatry? Interview with siblings Clinical interview with child Interview with parents DSM-V assessment

Clinical interview with child

Preschoolers with disorganized attachment will display ... Self-serving behavior Cooperative behavior Contradictory behavior Appropriate behavior

Contradictory behavior

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? Piaget's Freud's Erikson's Baker Miller's

Erikson's

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

Falling grades Decreased concentration Aggression towards peers Withdrawal from peers

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?

Fine motor functioning

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? Cognition Fine motor functioning Intellectual functioning Gross motor functioning

Fine motor functioning

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

Fine motor functioning

Which intervention assists the nurse to gain rapport with the child and parent? Discuss the history with the caregiver. Greet the child in friendly, personal way. Introduce child and caregiver to staff. Give paperwork to caregiver to complete.

Greet the child in friendly, personal way.

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? Cognition Fine motor functioning Gross motor functioning Intellectual functioning

Gross motor functioning

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

Healthy functioning

During a nurse's assessment, the nurse should assess the child's gross motor coordination. To do this, the nurse can ask the child to ... Pick up sticks Display mannerisms Tie his or her shoes Hop on one foot

Hop on one foot

The parents of a child are concerned about their child's behavior now that the child has started school. The nurse assesses and evaluates the child. Which symptoms are characteristic of attention deficit hyperactivity disorder (ADHD)? Select all that apply. Impulsiveness Overactivity Enuresis Inattentiveness Encopresis

Inattentiveness Overactivity Impulsiveness

A nurse assessing a child for developmental delays focuses on the child's memory, attention, and organization. The nurse is evaluating which area? Intellectual functioning Cognition Social interaction Thinking and perception

Intellectual functioning

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

Intellectual functioning

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. ADHD is not the fault of the parents or the child and techniques and school programs are available to help. It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem. 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. Medication alone will adequately treat children with ADHD. Children with ADHD do not qualify for special school services under the Individuals With Disabilities Education Act.

It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem. 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. ADHD is not the fault of the parents or the child and techniques and school programs are available to help.

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

It is much more difficult to diagnose psychiatric disorders in children and adolescents.

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? Extend the time the child is away from the parents to promote desensitization Speak to the child as if he or she was an adult. Tell the child there is nothing to be afraid of. Offer a transitional object for the child to hold.

Offer a transitional object for the child to hold.

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? Often the change is subtle and gets noticed at the follow-up visit Often the parents or teacher notice positive outcomes of treatment Often it is the siblings that notice the change in behavior first Often the child notices the change in treatment before anyone else

Often the parents or teacher notice positive outcomes of treatment

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? Often the parents or teacher notice positive outcomes of treatment Often the change is subtle and gets noticed at the follow-up visit Often the child notices the change in treatment before anyone else Often it is the siblings that notice the change in behavior first

Often the parents or teacher notice positive outcomes of treatmentc

What materials would assist the preschool age child to develop rapport with the nurse? Select all that apply. Dress up clothes Video games Puzzles Puppets Paint and an easel

Paint and an easel Puppets Dress up clothes

Which statement about educating parents of a child with attention deficit hyperactivity disorder (ADHD) is true? It is unimportant to educate the family members about ADHD as they already know the problem too well. It is important for the nurse to spend the majority of his or her time with parents of children with ADHD in talking to the parents. If the child receives special school services under the Individuals with Disabilities Education Act, there is no need for further services. Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful.

Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful.

A nurse working in a psychiatric facility for children understands the importance of meeting with parents alone after meeting with the child. Which of the following is the main reason for doing this? Parents need to be able to vent to a professional. Parents need some time away from the child. Parents need to be able to speak freely without preoccupation with the child's feelings. Parents need to have adults to talk to without children around.

Parents need to be able to speak freely without preoccupation with the child's feelings.

The nurse understands the importance of developing rapport with family members before the evaluation when caring for children with psychiatric disorders. The main reason for doing this is what? Reducing cost of stay Reducing anxiety Reducing fear of rejection Reducing length of stay

Reducing anxiety

The nurse is working with a child with a mental health problem and the family must be included in the care. Which is one of the best ways the nurse can advocate for the child? Support transferring the child to a healthy living environment. Reinforce the parents' expectations of the child's behavior. Interpret the child's thoughts and feelings to the parent. Teach the parents age-appropriate expectations of the child.

Teach the parents age-appropriate expectations of the child.

The nurse asking to speak to the child alone can provide reassurance to the child by ... Speaking to the child in an assertive voice and telling the child that you will not hurt him or her Telling the child that we will only be together for a short time Allowing the parent to stay if the child requests Showing the child that the waiting area is close by, where the parents will wait for the child

Showing the child that the waiting area is close by, where the parents will wait for the child

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? Easy Difficult Challenging Slow to warm up

Slow to warm up

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition? Falls Substance abuse disorders Motor vehicle accidents Mood disorders

Substance abuse disorders

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition? Motor vehicle accidents Falls Mood disorders Substance abuse disorders

Substance abuse disorders

Additional assessments should be performed on preteens and adolescents related to high-risk behaviors. What other areas should be discussed during the exam? Diet Sexual activity Obsessions or compulsions Exercise Substance use

Substance use Sexual activity Obsessions or compulsions

A young client has been brought to a clinic for evaluation. The client has developed several motor tics and shouts throughout the day. The mother states this has been going on for over a year. Which disorder does the nurse suspect this to be? Tourette's disorder communication disorder autism spectrum disorder attention deficit hyperactivity disorder

Tourette's disorder

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

Use appropriate vocabulary Use reflective comments

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

Use appropriate vocabulary Use reflective comments

During a comprehensive assessment of a child, which person does the nurse interview first? grandparents child parent caregiver

child

A nurse is discussing a client's condition with the client's family. A family member states that the client has a long history of mental retardation. The nurse corrects the family member by explaining that which is the correct term for this condition? mental delay intellectual retardation intellectual disability mental incapacity

intellectual disability

A variety of areas are assessed during the mental status examination. Which are sections of the mental status examination? Select all that apply.

intellectual functioning gross and fine motor movement cognition

A variety of areas are assessed during the mental status examination. Which are sections of the mental status examination? Select all that apply. academic interests cognition intellectual functioning gross and fine motor movement religious background

intellectual functioning gross and fine motor movement cognition

Which are included in the mental health comprehensive evaluation of children and adolescents? Select all that apply. school records laboratory values medical history mental status examination a full set of vital signs

medical history mental status examination school records

LGBTQ children and adolescents are highly stimatized and feel isolated from their peers. How else may they feel because they do not adhere to conventional gender expectations? inclusion protected respect victimized

victimized