Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Synthesize the key ideas in the biopsychosocial theories that help you understand the development of childhood psychiatric disorders.

Question 5

Type: MCSA

The nurse observes an 8-year-old child regressing to behavior that is characteristic of a toddler when faced with new situations. The child has been in several foster care families over the past three years. Which of the following interventions is appropriate for this child?

1. Providing for unmet needs

2. Providing consistency and continuity of caregivers

3. Ignoring the regressive behavior

4. Ignoring the negative behavior and reinforcing the positive behavior

Correct Answer: 2

Rationale 1: Defense mechanisms commonly employed by children are repression, reaction formation, and projection. The child comes to deal with the world through these distorted views in an attempt to defend against painful unconscious issues. Providing the child with consistency and continuity of caregivers will minimize situations that stimulate regression. The nurse will be able to evaluate the clients response to having consistency and continuity of caregivers. The nurse must recognize this behavior as a defense mechanism, and plan care that will strengthen the childs coping mechanisms. Providing for unmet needs is not specific or individualized and will be difficult to measure.

Rationale 2: Defense mechanisms commonly employed by children are repression, reaction formation, and projection. The child comes to deal with the world through these distorted views in an attempt to defend against painful unconscious issues. Providing the child with consistency and continuity of caregivers will minimize situations that stimulate regression. The nurse will be able to evaluate the clients response to having consistency and continuity of caregivers. The nurse must recognize this behavior as a defense mechanism, and plan care that will strengthen the childs coping mechanisms. Providing for unmet needs is not specific or individualized and will be difficult to measure.

Rationale 3: Defense mechanisms commonly employed by children are repression, reaction formation, and projection. The child comes to deal with the world through these distorted views in an attempt to defend against painful unconscious issues. Providing the child with consistency and continuity of caregivers will minimize situations that stimulate regression. The nurse will be able to evaluate the clients response to having consistency and continuity of caregivers. The nurse must recognize this behavior as a defense mechanism, and plan care that will strengthen the childs coping mechanisms. Providing for unmet needs is not specific or individualized and will be difficult to measure.

Rationale 4: Defense mechanisms commonly employed by children are repression, reaction formation, and projection. The child comes to deal with the world through these distorted views in an attempt to defend against painful unconscious issues. Providing the child with consistency and continuity of caregivers will minimize situations that stimulate regression. The nurse willbe able to evaluate the clients response to having consistency and continuity of caregivers. The nurse must recognize this behavior as a defense mechanism, and plan care that will strengthen the childs coping mechanisms. Providing for unmet needs is not specific or individualized and will be difficult to measure.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Synthesize the key ideas in the biopsychosocial theories that help you understand the development of childhood psychiatric disorders.

Question 6

Type: MCSA

The parents of a premature infant are visiting their baby in the neonatal intensive care unit for the first time. The nurse observes the couple standing beside the incubator. Which of the following interventions will help facilitate the infants immediate mental health needs?

1. Notify the infants physician to come and talk with the parents

2. Facilitate stroking and touching their infant

3. Continue to observe their interactions to rule out a problem with bonding

4. Have them meet with other parents of premature infants

Correct Answer: 2

Rationale 1: Helping the parents stroke and touch their infant is the first step in facilitating the attachment process, which is essential to developing a socioemotional bond. Having the parents meet with the physician or other parents of premature infants will be beneficial but will not help meet the infants immediate mental health needs. The nurse will need to observe the newfamilys interactions, but intervening to help the parents interact with their infant would be the priority action.

Rationale 2: Helping the parents stroke and touch their infant is the first step in facilitating the attachment process, which is essential to developing a socioemotional bond. Having the parents meet with the physician or other parents of premature infants will be beneficial but will not help meet the infants immediate mental health needs. The nurse will need to observe the newfamilys interactions, but intervening to help the parents interact with their infant would be the priority action.

Rationale 3: Helping the parents stroke and touch their infant is the first step in facilitating the attachment process, which is essential to developing a socioemotional bond. Having the parents meet with the physician or other parents of premature infants will be beneficial but will not help meet the infants immediate mental health needs. The nurse will need to observe the newfamilys interactions, but intervening to help the parents interact with their infant would be the priority action.

Rationale 4: Helping the parents stroke and touch their infant is the first step in facilitating the attachment process, which is essential to developing a socioemotional bond. Having the parents meet with the physician or other parents of premature infants will be beneficial but will not help meet the infants immediate mental health needs. The nurse will need to observe the newfamilys interactions, but intervening to help the parents interact with their infant would be the priority action.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Synthesize the key ideas in the biopsychosocial theories that help you understand the development of childhood psychiatric disorders.

Question 7

Type: MCSA

The nurse is meeting for the first time with a child who was brought to the clinic with a mental health concern. When planning care for a child with a mental health problem, the nurse must understand both the childs mental health problems and the childs:

1. Previous hospitalizations.

2. Life experiences.

3. Physiological health problems.

4. Artistic ability.

Correct Answer: 2

Rationale 1: The nurse must understand the pathology involved in the childs mental health problems and the childs life experiences, as they may contribute to the childs problems as wellas strengths. Physiological health problems, artistic abilities, and previous hospitalizations are components of the childs life experiences. These must be considered in order to develop interventions that are appropriate to the child.

Rationale 2: The nurse must understand the pathology involved in the childs mental health problems and the childs life experiences, as they may contribute to the childs problems as well as strengths. Physiological health problems, artistic abilities, and previous hospitalizations are components of the childs life experiences. These must be considered in order to develop interventions that are appropriate to the child.

Rationale 3: The nurse must understand the pathology involved in the childs mental health problems and the childs life experiences, as they may contribute to the childs problems as well as strengths. Physiological health problems, artistic abilities, and previous hospitalizations are components of the childs life experiences. These must be considered in order to develop interventions that are appropriate to the child.

Rationale 4: The nurse must understand the pathology involved in the childs mental health problems and the childs life experiences, as they may contribute to the childs problems as well as strengths. Physiological health problems, artistic abilities, and previous hospitalizations are components of the childs life experiences. These must be considered in order to develop interventions that are appropriate to the child.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: Differentiate between the multicausal and interactive models of child mental illness.

Question 8

Type: MCSA

The nurse providing case management to a child with a mental illness will collect data from the childs parents, teachers, and other health care providers in order to:

1. Complete a mental status exam.

2. Complete a comprehensive evaluation.

3. Collaborate with individuals that are significant to the child.

4. Complete a personality profile.

Correct Answer: 2

Rationale 1: A comprehensive evaluation includes collecting data from the various individuals, including the childs parents, teachers, and other health care providers. The comprehensive assessment is important in order to gain understanding into the variables that impact the childs mental health. Data for the mental status exam and personality profile is not gathered from parents, teachers, and other health care providers. The purpose for gathering the data is to complete the comprehensive assessment; collaboration may be a result of the process.

Rationale 2: A comprehensive evaluation includes collecting data from the various individuals, including the childs parents, teachers, and other health care providers. The comprehensive assessment is important in order to gain understanding into the variables that impact the childs mental health. Data for the mental status exam and personality profile is not gathered from parents, teachers, and other health care providers. The purpose for gathering the data is to complete the comprehensive assessment; collaboration may be a result of the process.

Rationale 3: A comprehensive evaluation includes collecting data from the various individuals, including the childs parents, teachers, and other health care providers. The comprehensive assessment is important in order to gain understanding into the variables that impact the childs mental health. Data for the mental status exam and personality profile is not gathered from parents, teachers, and other health care providers. The purpose for gathering the data is to complete the comprehensive assessment; collaboration may be a result of the process.

Rationale 4: A comprehensive evaluation includes collecting data from the variousindividuals, including the childs parents, teachers, and other health care providers. The comprehensive assessment is important in order to gain understanding into the variables that impact the childs mental health. Data for the mental status exam and personality profile is not gathered from parents, teachers, and other health care providers. The purpose for gathering the data is to complete the comprehensive assessment; collaboration may be a result of the process.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Differentiate between the multicausal and interactive models of child mental illness.

Question 9

Type: MCSA

A nurse is describing the multicausal perspective of mental health and illness to the parents of a child recently diagnosed with a spectrum disorder. Which statement would the nurse utilize when describing this approach?

1. Exposure to drugs and alcohol has been associated with psychiatric disorders.

2. The feedback mechanism appears dysfunctional, creating neurotoxic effects on brain development and function.

3. The childs genetically determined attributes and life experiences interact to influencemental health outcomes.

4. Early psychological trauma may create deficits or abnormalities in brain structure.

Correct Answer: 3

Rationale 1: The childs genetically determined attributes and life experiences interacting to influence mental health outcomes explains the perspective of the multicausal model of mental health and illness. Discussing feedback mechanism dysfunction would provide a partial explanation of neuroendocrine reactivity. Discussing the effects of early psychological trauma on brain structure partially explains nervous system responsiveness. Discussing the association of exposure to drugs and alcohol to psychiatric disorders partially explains complications occurring during the perinatal period as a cause of some mental illnesses.

Rationale 2: The childs genetically determined attributes and life experiences interacting to influence mental health outcomes explains the perspective of the multicausal model of mental health and illness. Discussing feedback mechanism dysfunction would provide a partial explanation of neuroendocrine reactivity. Discussing the effects of early psychological trauma on brain structure partially explains nervous system responsiveness. Discussing the association of exposure to drugs and alcohol to psychiatric disorders partially explains complications occurring during the perinatal period as a cause of some mental illnesses.

Rationale 3: The childs genetically determined attributes and life experiences interacting to influence mental health outcomes explains the perspective of the multicausal model of mental health and illness. Discussing feedback mechanism dysfunction would provide a partial explanation of neuroendocrine reactivity. Discussing the effects of early psychological trauma on brain structure partially explains nervous system responsiveness. Discussing the association of exposure to drugs and alcohol to psychiatric disorders partially explains complications occurring during the perinatal period as a cause of some mental illnesses.

Rationale 4: The childs genetically determined attributes and life experiences interacting to influence mental health outcomes explains the perspective of the multicausal model of mental health and illness. Discussing feedback mechanism dysfunction would provide a partial explanation of neuroendocrine reactivity. Discussing the effects of early psychological trauma on brain structure partially explains nervous system responsiveness. Discussing the association of exposure to drugs and alcohol to psychiatric disorders partially explains complications occurring during the perinatal period as a cause of some mental illnesses.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Differentiate between the multicausal and interactive models of child mental illness.

Question 10

Type: MCSA

A mother told the nurse she was appalled that the nurse would dare to ask if she took any drugs during her pregnancy. The nurse explains that the information is important in understanding the childs health because embryonic exposure to toxins during pregnancy is the major risk factor for:

1. Depression in preschoolers.

2. Lactose intolerance.

3. Mental retardation.

4. Mental illness.

Correct Answer: 3

Rationale 1: The major risk factor for retardation is the early alteration of embryonic development because of exposure to toxins in utero (maternal drug use, for example) or chromosomal changes (such as Down syndrome). Depression in preschoolers, mental illness, and lactose intolerance are not associated with maternal drug use.

Rationale 2: The major risk factor for retardation is the early alteration of embryonic development because of exposure to toxins in utero (maternal drug use, for example) or chromosomal changes (such as Down syndrome). Depression in preschoolers, mental illness, and lactose intolerance are not associated with maternal drug use.

Rationale 3: The major risk factor for retardation is the early alteration of embryonic development because of exposure to toxins in utero (maternal drug use, for example) or chromosomal changes (such as Down syndrome). Depression in preschoolers, mental illness, and lactose intolerance are not associated with maternal drug use.

Rationale 4: The major risk factor for retardation is the early alteration of embryonic development because of exposure to toxins in utero (maternal drug use, for example) or chromosomal changes (such as Down syndrome). Depression in preschoolers, mental illness, and lactose intolerance are not associated with maternal drug use.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: Incorporate an understanding of the potential risk factors for childhood mental illness into working with children in community settings

Question 11

Type: MCSA

A mother is concerned because her 6-year-old son stutters. She wants to know if she did anything during her pregnancy to cause this. Which of the following would be the bestresponse? The nurse should:

1. Assess for impaired thermoregulation during the postnatal period.

2. Assess for a family history of the disorder.

3. Verbalize the implied by asking, Are you saying you feel responsible for his problem?

4. Ask if the mother had preeclampsia during labor.

Correct Answer: 2

Rationale 1: The only known predisposing factor for the development of a communication disorder is a family history of the disorder. For stuttering, especially, family and twin studies provide strong evidence of a genetic factor in its etiology. Since family history is the only known predisposing factor, asking about impaired thermoregulation or preeclampsia is not relevant.

Questioning the mothers feelings does not address the cause of the stuttering.

Rationale 2: The only known predisposing factor for the development of a communication disorder is a family history of the disorder. For stuttering, especially, family and twin studies provide strong evidence of a genetic factor in its etiology. Since family history is the only known predisposing factor, asking about impaired thermoregulation or preeclampsia is not relevant.

Questioning the mothers feelings does not address the cause of the stuttering.

Rationale 3: The only known predisposing factor for the development of a communication disorder is a family history of the disorder. For stuttering, especially, family and twin studies provide strong evidence of a genetic factor in its etiology. Since family history is the only known predisposing factor, asking about impaired thermoregulation or preeclampsia is not relevant.

Questioning the mothers feelings does not address the cause of the stuttering.

Rationale 4: The only known predisposing factor for the development of a communication disorder is a family history of the disorder. For stuttering, especially, family and twin studies provide strong evidence of a genetic factor in its etiology. Since family history is the only known predisposing factor, asking about impaired thermoregulation or preeclampsia is not relevant.

Questioning the mothers feelings does not address the cause of the stuttering.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: Incorporate an understanding of the potential risk factors for childhood mental illness into working with children in community settings.

Question 12

Type: MCSA

A 7-year-old child recently experienced the death of the familys pet dog, which was the childs constant companion. The child is at risk for:

1. A conduct disorder.

2. Elimination disorder.

3. Angoraphobia.

4. Separation anxiety disorder.