Ch. 20 - Psychotherapy for Children - TB

A nurse generalist and advanced practice nurse both work on the staff of an inpatient unit. The advanced practice nurse has a comprehensive role as a primary caregiver in child psychiatry.
Which of the following will be performed by the advanced practice nurse but not by the nurse generalist?

1. Explaining the treatment plan to a family
2. Performing admission assessments
3. Participating in discharge planning
4. Providing one-to-one counseling
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A nurse generalist and advanced practice nurse both work on the staff of an inpatient unit. The advanced practice nurse has a comprehensive role as a primary caregiver in child psychiatry.
Which of the following will be performed by the advanced practice nurse but not by the nurse generalist?

1. Explaining the treatment plan to a family
2. Performing admission assessments
3. Participating in discharge planning
4. Providing one-to-one counseling
4. Providing one-to-one counseling
A growing role of the child psychiatric mental health nurse is:

1. Scrutinizing the public.
2. Promoting infant mental health.
3. Monitoring adult inpatient psychiatric clients.
4. Preventing mental health problems.
2. Promoting infant mental health.
When discussing indicators of emotionally disturbed children or children with disruptive behavior disorders with a group of student nurses, the psychiatric nurse states that one of the best
indicators of emotionally disturbed children is that they have difficulty:

1. Seeking out peers.
2. Digesting a balanced diet.
3. Interpreting internal stimuli or external cues.
4. Following rules and norms of behavior.
4. Following rules and norms of behavior.
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
2. Providing consistency and continuity of caregivers
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
2. Facilitate stroking and touching their infant
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.
2. Life experiences.
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.
2. Complete a comprehensive evaluation.
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 influence mental health outcomes.
4. Early psychological trauma may create deficits or abnormalities in brain structure.
2. The feedback mechanism appears dysfunctional, creating neurotoxic effects on brain development and function.
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.
3. Mental retardation.
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 best response? 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.
2. Assess for a family history of the disorder.
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.4. Separation anxiety disorder.A mother questions why it is important to list when her child sat up, began crawling, started walking, and was potty trained as she is bringing the toddler in because the child screams at night. The nurse explains to the mother that: 1. It is not normal for a young child to scream at night. 2. Children who scream at night have more difficulty with problem solving. 3. Children with mental disorders have difficulty with elimination at night. 4. A developmental history is part of assessing well-being of a child.4. A developmental history is part of assessing well-being of a child.Which of the following behaviors observed by the nurse will be important to disclose to the teacher of a child with a stereotypic movement disorder? 1. An episode of self-mutilation 2. Depression that results from feelings of inadequacy 3. Tendency to be hypoactive 4. Flexibility and ability to contribute to learning1. An episode of self-mutilationThe school nurse is observing a young child who has episodes of rage toward peers during recess and at lunchtime. The advantage of conducting an assessment in this environment is: 1. This will assist in identifying the bullies who trigger the explosive episodes. 2. This provides an opportunity to collect data in the event that other children are injured and legal documentation is needed. 3. To provide data for the parents who are in denial about the problem. 4. This provides a picture of problems and strengths in a realistic context.4. This provides a picture of problems and strengths in a realistic context.The nurse is assessing a depressed child who was referred by the elementary school nurse. What is the best approach to use when assessing the childs socialization? 1. Tell me about the friends you enjoy being with. 2. So you spend a lot of time with your friends? 3. You seem like a person who would have a lot of friends. 4. How many friends do you have at school?1. Tell me about the friends you enjoy being with.The nurse is assessing a child diagnosed with conduct disorder. Which would be the most appropriate question to ask the parents? 1. Does your child have a history of cruelty to other people and animals? 2. Does your child unconsciously direct feelings and desires from other relationships toward others? 3. Does your child seem to be reassured by your presence? 4. Does your child readily seek out caregivers in times of stress?1. Does your child have a history of cruelty to other people and animals?When planning a new childrens mental health clinic, the nurse understands the importance of including a play area. Play and toys are used to assess children with suspected mental disorders because: 1. Children do not usually relate to adults. 2. Children express themselves through play. 3. Only toys that are developmentally appropriate and specific to the childs biological age are used. 4. Play enables the nurse to assess cognitive ability.2. Children express themselves through play.The parents of a child with a spectrum disorder are asking the nurse about what kind of social expectations are realistic for their child. Which of the following is the overall outcome for a child diagnosed with a spectrum disorder? 1. To acknowledge the effects of ones own behavior on others 2. To function more effectively in social and emotional interactions 3. To stay on task 4. To acknowledge personal strengths2. To function more effectively in social and emotional interactionsThe school nurse recommends that the parents of a student seek help because the student is constantly in trouble and recently has set several small fires on school grounds. The nurse is concerned because the child is manifesting signs of: 1. Conduct disorder. 2. Depression. 3. Oppositional defiant disorder. 4. Attention deficit hyperactivity disorder.1. Conduct disorder.In working with a preschool-age child, which intervention would be considered as part of an effective plan for time-outs? 1. Identify in advance, situations that lead to anger 2. Explanations are not important to the child who is out of control 3. Length of time depends upon how long it takes the child to calm down 4. Incorporate a token economy3. Length of time depends upon how long it takes the child to calm downThe nurse works with both the child and parents to help the child develop interpersonal skills. Which of the following general outcomes facilitates engaging the parents in the process? 1. Increasing knowledge of the childs psychopathology 2. Understanding the childs unique temperament and needs 3. Responding to separation anxiety 4. Administering PRN medications effectively2. Understanding the childs unique temperament and needsThe new stepfather of a child diagnosed with a conduct disorder wants to know the reason for including him in family therapy sessions. The nurse explains that the goal of family therapy is to: 1. Increase the probability that the childs mental health will improve. 2. Help the child relive past events and related feelings. 3. Provide an opportunity for the parents to interact with their child in a safe environment. 4. Speak for the child so the parents can become more aware of the childs potential.1. Increase the probability that the childs mental health will improve.A client, age 8, has just been prescribed pemoline (Cylert). The childs parents ask about the long-term effects of this medication. The nurse conducting patient teaching for the parents about this medication will include which of the following statements? 1. Photosensitivity is a problem with long-term use. 2. This is one of the drugs found to be safe for long-term use. 3. At the present time, there is limited information about this. 4. There seems to be a better outcome when the higher dose is given at bedtime.3. At the present time, there is limited information about this.The nurse administering a lithium carbonate (Lithobid) to a child with mental retardation monitors the child for which of the following therapeutic effects? 1. Weight loss 2. Decreased agitation 3. Weight gain 4. Elevated mood2. Decreased agitationWhen caring for children in the mental health setting, nurses may become aware of unresolved issues about their own family. If left unaddressed, care for the child may be affected because: 1. This experience should not affect nurses. 2. There is an increased potential for regression. 3. This opportunity will help the nurses heal. 4. Nurses feelings may become activated.4. Nurses feelings may become activated.A nurse caring for a child is concerned about remaining therapeutic when working with a child with anger management issues. Which of the following must the nurse avoid in order to remain therapeutic? 1. Examining personal feelings about the child 2. Reflecting back on a situation 3. Projecting his/her feelings onto the child 4. Sharing his/her concerns with peers and colleagues3. Projecting his/her feelings onto the child