Psych Exam 2: Chapter 35

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. Peer adjustment c. Maturation d. Psychosocial development e. Language

c. Maturation d. Psychosocial development e. Language

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? a. victimized b. inclusion c. respect d. protected

a. victimized

The nurse is caring for an adolescent in the outpatient psychiatric setting. To help the adolescent feel more in control of the initial therapy sessions, which statement by the nurse would be most appropriate? a. "If something is uncomfortable for you, you don't have to talk about it." b. "I won't share anything with your parents that you don't want me to share." c. "Adolescents often feel a distrust of authority figures. Is that true with you?" d. "Your parents care a great deal about you. That's why you are here."

a. "If something is uncomfortable for you, you don't have to talk about it."

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

a. "Tell me about your faith background."

The nurse is interviewing the parents of a child being treated for Tourette syndrome. Which assessment question(s) is relevant when evaluating this child? Select all that apply. a. "Would you describe your child as a worrier?" b. "Are ritual behaviors important to your child?" c. "Does your child have difficult concentrating on tasks or problems?" d. "Have teachers ever mentioned your child having difficulty in class?" e. "Is your child easily angered?"

a. "Would you describe your child as a worrier?" c. "Does your child have difficult concentrating on tasks or problems?" d. "Have teachers ever mentioned your child having difficulty in class?" b. "Are ritual behaviors important to your child?"

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

a. 80

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. Ability to look at things hypothetically b. Ability to use abstract thinking c. Beginning ability to use logic d. Difficulty in putting feelings into words e. Their view of things in a concrete manner

a. Ability to look at things hypothetically b. Ability to use abstract thinking

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

a. Aggression towards peers b. Withdrawal from peers c. Falling grades e. Decreased concentration

Which action provides first-hand information about the issue and reinforces interest in the child's viewpoint during the assessment? a. Ask about the history of the current problem. b. Inquire about the school report card. c. Solicit information regarding after school activities the child is involved in. d. Request that the child interpret the parent's concerns.

a. Ask about the history of the current problem.

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. Asking them what they want to do when they grow up d. Comparing them to others of the same age e. Getting them to draw

a. Asking them what they would wish for c. Asking them what they want to do when they grow up e. Getting them to draw

For which reasons is it more difficult to diagnose psychiatric disorders in children than in adults? Select all that apply. a. Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level. b. Sometimes, children "outgrow" psychiatric disorders. c. Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria as for adults. d. Because they are constantly changing and developing, children are unable to discriminate unusual or unwanted symptoms from normal feelings and sensations. e. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening.

a. Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level. d. Because they are constantly changing and developing, children are unable to discriminate unusual or unwanted symptoms from normal feelings and sensations. e. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening.

Which of the following pieces of data obtained during an assessment would cause the nurse to consider a child at risk for a psychiatric disorder? a. Being raised by a mother with depression b. Regular prenatal care for the mother c. Developmental milestones achieved on schedule d. Harmonious parental relationships in the household

a. Being raised by a mother with depression

During the mental status examination, the nurse could assess self-concept by asking the child about which of the following? Select all that apply. a. Best-liked qualities b. Basic math calculations c. Three wishes d. Favorite stories e. Play

a. Best-liked qualities c. Three wishes d. favorite stories e. Play

A nurse is conducting a developmental assessment of a child. When conducting the neurologic screening, which information would be important to gather? a. Child's Apgar score b. Excitability c. Concentration d. Responses to discipline

a. Child's Apgar score

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

a. Cognition

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

a. Contradictory behavior

A school-aged child tells that nurse that the child does not like school anymore and their parent is upset about their poor grades. Which is main concern about this client? a. Emotional problems focusing on peer adjustment and school b. Mental issues to perform the tasks necessary for performance in the classroom c. Social issues regarding participating in school activities d. Religious issues and ability to conform to them while in the school setting

a. Emotional problems focusing on peer adjustment and school c. Social issues regarding participating in school activities

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. Intellectual functioning c. Cognition d. Gross motor functioning

a. Fine motor functioning

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

a. Joining in play

After completing the mental status assessment of a boy age 9 years, the nurse documents the findings. Which of the following would the nurse document as reflecting the child's motor activity? Select all that apply. a. Nail biting b. Favorite story, Huckleberry Finn c. History of temper tantrums d. "Went to the park last weekend" e. Hyperalertness f. Short attention span

a. Nail biting e. Hyperalertness

Ground rules for nurses to follow when establishing rapport with children include what? a. Showing acceptance and giving clear directions about unacceptable behavior b. Tailoring your speech to fit the child by using child-like language c. Imitating the child's nonverbal behavior to establish rapport d. Letting the child know that you are in charge by setting the rules quickly

a. Showing acceptance and giving clear directions about unacceptable behavior

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

a. 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? a. Substance use b. Obsessions or compulsions c. Exercise d. Sexual activity e. Diet

a. Substance use b. Obsessions or compulsions d. Sexual activity

Which activity would asist a school-aged child to develop rapport with the nurse during an assessment? a. playing checkers b. use of colored pencils and paper c. playing video games d. using blocks

a. playing checkers

A nurse identifies that a child's temperament is happy when the parents are present but more withdrawn when they are not. Which is a likely explanation of this phenomenon about temperament? a. Temperament is influenced by parental control. b. Temperament is determined by social influence of peers. c. Temperament does not have the ability to change during one's life. d. Temperament is controlled by the child's emotions.

a. Temperament is influenced by parental control.

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 can sequence events well c. Children have a less specific sense of time than adults d. The nurse should use simple phrasing with children e. Children have a more developed memory than adults

a. The nurse should corroborate information offered by the child with other sources c. Children have a less specific sense of time than adults d. The nurse should use simple phrasing with children

Which section of the mental health examination focuses on level of consciousness and judgment? a. Thinking and perception b. Intellectual functioning c. Fine motor functioning d. Cognition

a. Thinking and perception

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. Tourette's syndrome b. anxiety disorder c. depression d. bulimia

a. Tourette's syndrome

The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time? a. Try to remember that the parents are trying to the best of their ability to carry out the suggestions. b. Review effective disciplinary practices with the parents again. c. Explore alternative living arrangements for the child. d. Refer the parents to a family therapist.

a. Try to remember that the parents are trying to the best of their ability to carry out the suggestions.

A nurse is talking with a school-age child who tells the nurse 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 the language and vocabulary of the child to describe the incident. b. Summarize the reported details in 4 or 5 sentences. c. Use leading questions to describe the incident. d. Use professional language in the documentation.

a. Use the language and vocabulary of the child to describe the incident.

Why should a mental status examination be used during an assessement of a child? Select all that apply. a. Uses observations and direct questioning b. Is part of the DSM III requirements for treatment c. Can be performed during subsequent visits d. Aids in the diagnosis of a psychiatric condition c. Alerts clinicians about need for additional testing

a. Uses observations and direct questioning c. Can be performed during subsequent visits d. Aids in the diagnosis of a psychiatric condition c. Alerts clinicians about need for additional testing

The nurse is assessing a child being evaluated for a diagnosis of an autism spectrum disorder. Which example of dysfunctional communication is the nurse likely to observe? a. When the nurse uses the phase, "tell me about," the child repeats the phrase rather than responding appropriately, mimicking the words and phrases spoken by others b. Regularly responds to questions using a jumble of words that lack true meaning c. The child clearly prefers using sign language rather than the spoken word to communicate d. Communicates using a vocabulary that centers on shrieks and clicking sounds

a. When the nurse uses the phase, "tell me about," the child repeats the phrase rather than responding appropriately, mimicking the words and phrases spoken by others

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. giving the child a transitional object to hold. c. asking the child to describe his or her parents. d. providing advice to the child about his or her parents.

a. asking about things that are important to the child.

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. behavior disturbances. b. moods. c. suicide ideation. d. sleep patterns.

a. behavior disturbances.

As a child with ADHD moves into adolescence, problematic behaviors continue. A nurse is aware of these behaviors when teaching families regarding their teenagers with ADHD. Which are typical behaviors that the nurse would discuss with families that have children with ADHD? Select all that apply. a. cutting class b. failed relationships c. drug usage d. getting speeding tickets e. attending study groups

a. cutting class b. failed relationships c. drug usage d. getting speeding tickets

Which is an example of egocentrism by an adolescent? a. does not talk much because they think they are being watched by others b. only eats food from a particular store c. is willing to assist with any social event d. shares stories about parents and siblings

a. does not talk much because they think they are being watched by others

A nurse completes a Global Assessment of Functioning (GAF) scale on an adolescent during an assessment. The nurse calculates a 25. What level of impairment does this score indicate? a. high b. low c. medium d. none

a. high

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

a. intellectual functioning c. cognition d. gross and fine motor movement

An assessment of a child is different from an assessment of adults. Which are included in the assessment of children and adolescents? Select all that apply. a. language b. social abilities c. medical history d. emotional skills e. school grades

a. language b. social abilities d. emotional skills

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

a. play a competitive board game.

A nurse is interviewing a boy age 12 years who has been diagnosed with depression. The client's depression was triggered by the death of his father two years ago. The nurse interprets which comment made by the boy as reflecting egocentrism? a. "My father was the best friend I ever had; I still can't believe he's gone for good." b. "If I hadn't yelled at my dad and told him to go away, he never would have died." c. "I think I'm just experiencing normal grieving." d. "I'm still sad because my dad died a couple of years ago."

b. "If I hadn't yelled at my dad and told him to go away, he never would have died."

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? a. "We will be able to do more things with our family." b. "We will be able to enjoy more structure in our home." c. "We will be able to go on the bus tour with our church group." d. "We will be able to go to the races every weekend like we used to."

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

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

b. "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? 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?"

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

Which is a question that helps to identify a teen's misconception about the nurse working with the teen? a. "How do you feel right now?" b. "Why do you think you are here?" c. "What is the best way to describe what is happening to you?" d. "Do you think you want to hurt yourself?"

b. "Why do you think you are here?"

The nurse is providing care to a 10-year-old child who is hospitalized in a psychiatric setting. To establish rapport with the child, which statement by the nurse would be most appropriate? a. "I'm going to use the DECA tool to measure your self-control and initiative." b. "Would you like to play a game of checkers with me?" c. "Let's compare your situation to that of Cinderella's in the fairy tale." d. "Let's have you draw a picture of yourself."

b. "Would you like to play a game of checkers with me?"

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. No impairment b. A moderate level of impairment c. A high level of impairment d. A low level of impairment

b. A moderate level of impairment

Which age group is dependent on the rapport established by the nurse? a. Pre-school age client b. Adolescent c. Young adult d. School-age client

b. Adolescent

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

b. Attention to developmental milestones

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

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

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? a. Let the child complete tasks at the child's own pace. b. Break tasks into small steps. c. Set a time limit to complete all tasks. d. Offer rewards when all tasks are completed.

b. Break tasks into small steps.

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

b. Clinical interview with child

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. Develop a treatment alliance. c. Determine school goals for the child. d. Assess interactions between child and caregiver.

b. Develop a treatment alliance. d. Assess interactions between child and caregiver.

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

b. Easy temperament

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. a. Enuresis b. Inattentiveness c. Encopresis d. Impulsiveness e. Overactivity

b. Inattentiveness d. Impulsiveness e. Overactivity

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. Interviewing the client's parents d. Assessing the client in a group of peers e. Directly observing the child

b. Interviewing the client's teachers c. Interviewing the client's parents d. Assessing the client in a group of peers e. Directly observing the child

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

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

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? a. Reducing cost of stay b. Reducing anxiety c. Reducing length of stay d. Reducing fear of rejection

b. Reducing anxiety

Which is an example of assortative mating? a. Second cousin diagnosed with type 1 diabetes mellitus b. Sibling with schizophrenia. c. Parent with multiple sclerosis d. Close family friend with an addition to prescriptive medications

b. Sibling with schizophrenia.

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. Making the interview nurse centered. b. Speaking slowly. c. Showing acceptance. d. Reacting subjectively. e. Maintaining eye contact.

b. Speaking slowly. c. Showing acceptance. e. Maintaining eye contact.

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? a. Reinforce the parents' expectations of the child's behavior. b. Teach the parents age-appropriate expectations of the child. c. Support transferring the child to a healthy living environment. d. Interpret the child's thoughts and feelings to the parent.

b. Teach the parents age-appropriate expectations of the child.

A nurse working with an adolescent understands the importance of using a straightforward approach and making the teenager feel in control. The nurse can best do this by which of the following? a. Stopping any hostile behavior from the very beginning b. Telling the teenager that he or she does not have to talk about anything that he or she is not ready to reveal c. Sugarcoating everything so that the client does not feel bad d. Not mentioning what information the nurse will share with others

b. Telling the teenager that he or she does not have to talk about anything that he or she is not ready to reveal

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 can be treated effectively as an outpatient. c. The child is functioning well in the area of school. d. The child is experiencing homicidal thoughts.

b. The child can be treated effectively as an outpatient.

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? a. attention deficit hyperactivity disorder b. Tourette's disorder c. communication disorder d. autism spectrum disorder

b. Tourette's disorder

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

b. Vocabulary c. Concentration d. Memory e. Organization

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

b. developmental level

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

b. paint and an easel. c. dress up clothes d. puppets

The nurse is preparing to interview a 6-year-old child and her mother in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should ... a. act in a professional manner. b. recognize the child's individuality. c. sit in a chair next to the child. d. ask the parent if the child can be interviewed alone.

b. recognize the child's individuality.

A nurse asks a child "what do they want to do when they grow up." With this question, the nurse is assessing the child's: a. ambitions. b. self-concept. c. thought process. d. caregiver influence.

b. self-concept.

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. Challenging b. Slow to warm up c. Difficult d. Easy

b. slow to warm up

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? a. "Do you ever feel anxious?" b. "Have you ever had delusions?" c. "Are you feeling sad?" d. "Have you ever heard of thorazine?"

c. "Are you feeling sad?"

The nurse is beginning an assessment interview with a girl age 8 years who has been brought in for counseling by her parents. When beginning the interview, which question would be most appropriate for the nurse to ask first? a. "How old are you?" b. "How are you feeling?" c. "Has anyone told you about why you are here today?" d. "Why do you think I'm talking to you alone without your parents here?

c. "Has anyone told you about why you are here today?"

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

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

c. "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."

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

c. "Want eat"

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."

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

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

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

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. 8 b. 7 c. 5 d. 6

c. 5

A group of nurses is reviewing information about temperament and its effect on the child's behavior. The nurses demonstrate understanding of the concept when they identify which of the following as characteristic of temperament. Select all that apply. a. Emotional bonding b. Insecurity c. Activity level d. Sequential growth processes e. Adaptability

c. Activity level e. Adaptability

Which phenomenon may contribute to the genetic transmission of psychiatric disorders? a. Attachment b. Maturation c. Assortative mating d. Egocentricism

c. Assortative mating

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 adults will understand their problems better than they understand them b. Belief that everybody hates them c. Belief that they will be blamed for their problems d. Belief that their feelings are normal

c. Belief that they will be blamed for their problems

A child is brought to the clinic for an evaluation. This is the child's first visit. When preparing to interview the child, which action would be most important for the nurse to do first? a. Assess the interactions between child and parent b. Initiate a discussion with the parents. c. Develop a treatment alliance d. Involve the child in the discussion

c. Develop a treatment alliance

An adolescent female is being interviewed during a mental health assessment. She constantly looks in her purse mirror and applies make-up. This is an example of which of the following? a. Temperament b. Attachment c. Egocentrism d. Maturation

c. Egocentrism

A nurse is preparing to assess a child age 9 years who has been sexually abused. Which of the following would be the priority for the nurse? a. Finding out when the abuse occurred b. Using anatomically correct dolls to elicit information c. Ensuring that the environment is safe and supportive d. Documenting the assessment for use in court

c. Ensuring that the environment is safe and supportive

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. Cognition b. Intellectual functioning c. Fine motor functioning d. Gross motor functioning

c. Fine motor functioning

A nurse is talking to a 7-year-old. The child describes in detail a family pet who recently died. Which response by the nurse is appropriate? a. When are you going to get another dog? b. I need to interview another client. c. I am sad for your loss. d. How long did you have the dog?

c. I am sad for your loss.

A nurse is preparing an in-service 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. Speak in longer sentences that include a description of what is being asked. b. Use questions that lead the child to the response desired. c. Need to individualize the questions based on judgment and discretion. d. The need for the child's statements and behaviors to guide the interview. e. Use simple terms such as sad or nervous instead of depressed or anxious.

c. Need to individualize the questions based on judgment and discretion. d. The need for the child's statements and behaviors to guide the interview. e. Use simple terms such as sad or nervous instead of depressed or anxious.

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

c. Offer a transitional object for the child to hold.

A nurse is preparing to interview a child who is 4 years old. Which technique would be most effective for the nurse to use for the assessment? a. Pediatric anxiety rating scale b. Children's Depression Inventory c. Play materials such as blocks d. Direct, simple questions

c. Play materials such as blocks

A group of nursing students is reviewing information about stress and coping in children. The students demonstrate a need for additional study when they identify which of the following as a stressful experience for a child? a. Death of a pet b. Racial discrimination c. Social support d. Chronic illness

c. Social support

The parent of a 15-year-old tells the nurse that the child is becoming more assertive in conflict situations and wants to get a job. The parent asks if it is healthy for a 15-year-old to be so independent. Which is valid information for the nurse to offer the parent? a. The parent should observe for signs of substance abuse. b. The child is overly independent. c. The behaviors reflect normal growth and development. d. It sounds like the child is trying to avoid the parent.

c. The behaviors reflect normal growth and development.

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. Play therapy b. Fairy tales c. Thinking-feeling-doing game d. Drawings

c. Thinking-feeling-doing game

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

c. drawings

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. Fine motor functioning b. Cognition c. Gross motor functioning d. Intellectual functioning

c. gross motor functioning

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? a. intellectual retardation b. mental incapacity c. intellectual disability d. mental delay

c. intellectual disability

Which activity would assist the adolescent to establish rapport with the nurse? a. board games b. dress up clothes c. interview d. video games

c. interview

A nurse completes a Global Assessment of Functioning (GAF) scale on an adolescent during an assessment. The nurse calculates a 75. What level of impairment does this score indicate? a. high b. moderate c. low d. none

c. low

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

c. school records d. medical history e. mental status examination

When performing a spiritual assessment on a child, the nurse and child discuss church attendance and practices that are most important to the child. Which domain is the nurse addressing when doing this assessment? a. All of the above b. Psychological c. Social d. Biologic

c. social

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? a. "Research shows that information validates the child's feeling." b. "By interviewing separately I can validate all the information." c. "Parents know best and I will determine this during the interview." d. "Both interviews provide unique and meaningful information."

d. "Both interviews provide unique and meaningful information."

The nurse is preparing to meet with the parents after interviewing the child. Which is the nurse's best opening question to the parents? a. "Describe the current problem and what are the leading causes of the problem." b. "Tell me about the school issues of your child." c. "Can you describe a situation where your child has had problems with peer socialization?" d. "How have things been in your family?"

d. "How have things been in your family?"

A nurse in an outpatient clinic is assessing a child, and the nurse will interview the child and the child's parents separately. Which of the following comments would the nurse anticipate the child making during the upcoming interview? a. "I yell at my parents a lot." b. "I refuse to do what my parents tell me to." c. "I can't get along with my parents." d. "I'm sad a lot, and I have trouble sleeping."

d. "I'm sad a lot, and I have trouble sleeping."

A nurse is interviewing a child age 12 years 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. "You'd get along better with your parents if you'd follow their advice." c. "I have several teddy bears; would you like one to hold?" d. "Tell me about your best friend."

d. "Tell me about your best friend."

The nurse is assessing the self-concept of a child age 8 years. Which of the following would be least appropriate for the nurse to ask? a. "If you had three wishes, what would you wish for?" b. "What would you like to be when you grow up?" c. "What subjects do you like best in school?" d. "What did you have for breakfast this morning?"

d. "What did you have for breakfast this morning?"

A nurse is performing an assessment interview of a boy age 14 years who is being admitted to an adolescent substance abuse unit. His parents are concerned about their son's repeated problems at school that they associate with his drug use. The boy stalks into the office, abruptly sits down, crosses his arms, and says, "Okay, ask your stupid questions, but don't expect me to cooperate!" Which response by the nurse would be most appropriate? a. "Why are you so angry?" b. "Why don't we wait until you've calmed down a bit to start the interview?" c. "Your attitude is offensive; I can see why your parents brought you here." d. "You seem pretty upset. Tell me about what is upsetting you."

d. "You seem pretty upset. Tell me about what is upsetting you."

A nurse is assessing a child's gross motor skills. The nurse would expect the child to be able to skip and play hopscotch by which age? a. 4 b. 5 c. 6 d. 7

d. 7

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

d. At intake

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. Challenging b. Slow to warm up c. Easy d. Difficult

d. Difficult

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. Humility b. Altruism c. Submissiveness d. Egocentrism

d. Egocentrism

A nurse is assessing a preschooler and uses play to develop rapport with the child. The nurse uses play based on the understanding that it helps in which area? a. Serves as a reminder of their abilities. b. Measures the level of attachment. c. Helps assess the child's cognition. d. Encourages verbalizations.

d. Encourages verbalizations.

Which nursing intervention should take priority for a child with attention deficit hyperactivity disorder (ADHD)? a. Improved role performance b. Structured daily routine c. Simplifying instructions and directions d. Ensuring the child's safety and that of others

d. Ensuring the child's safety and that of others

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. Freud's b. Piaget's c. Baker Miller's d. Erikson's

d. Erikson's

Functional status is evaluated in children and adolescents using which of the following? a. DSM-IV-TR Axis II b. SAD Person Scale c. Beck Depression Inventory d. GAF scale

d. GAF scale

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

d. Greet the child in friendly, personal way.

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

d. 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 ... a. Pick up sticks b. Tie his or her shoes c. Display mannerisms d. Hop on one foot

d. Hop on one foot

Which is considered a hyperactive/impulsive behavior seen in attention deficit hyperactivity disorder (ADHD)? a. Frequent forgetfulness in daily activities b. Making careless mistakes c. Avoiding tasks requiring mental effort d. Inability to play quietly

d. Inability to play quietly

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 focus on the conversation b. Ability to respond accurately to questions asked c. Listening skills without interrupting d. Intellectual functioning

d. Intellectual functioning

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 it is the siblings that notice the change in behavior first c. Often the change is subtle and gets noticed at the follow-up visit d. Often the parents or teacher notice positive outcomes of treatment

d. Often the parents or teacher notice positive outcomes of treatment

A nurse is preparing to assess a school-aged child. Which method would be most effective for the nurse to use to establish rapport with this child? a. Wearing dress-up clothes b. Playing cards c. Playing with dolls d. Painting a picture

d. Painting a picture

Given that the child's primary environment is most often with the parent, the assessment of the child and parent interaction commences when ... a. Child and parent get each other's attention b. Both child and parent are interviewed c. Parent is asked to leave the room, noting attachment issues and then commence interview of child d. Parent and child are in the waiting area, noting behaviors expressed toward each other

d. Parent and child are in the waiting area, noting behaviors expressed toward each other

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

d. 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? a. Parents need to be able to vent to a professional. b. Parents need some time away from the child. c. Parents need to have adults to talk to without children around. d. Parents need to be able to speak freely without preoccupation with the child's feelings.

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

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

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

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

d. Straightforward questions about suicide and violence

The nurse is preparing to interview a girl 6 years of age and her mother in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should do what? a. Talk to the child while standing up and looking down at her. b. Tell the child she watches Sesame Street all the time. c. Ask the parent if the child can be interviewed alone. d. Tell the child that this must be a bit scary for her.

d. Tell the child that this must be a bit scary for her.

A parent is concerned that the parent's child might suffer from attention deficit hyperactivity disorder (ADHD). The parent brings the child in to be evaluated. Which behavior reported by the parent would be consistent with this diagnosis? a. The child has been hoarding objects. b. The child is excelling academically in school. c. The child has lots of friends. d. The child interrupts others.

d. The child interrupts others.

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

d. Use appropriate vocabulary e. Use reflective comments

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

d. child

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? a. Reactive attachment disorder b. Stereotypic movement disorder c. Selective mutism d. Echolalia

d. echolalia