Question 1

Which intervention by the nurse would be the most therapeutic when a student reports witnessing a depressed teenager put a gun into a locker?

Accepted Answer

The nurse must report any violent threats to the school's administration immediately.The best approach is to encourage the witness to tell school authorities exactly what was seen.

Question 2

A parent calls the school nurse to say,"My teenager got a forearm tattoo without my permission and won't be returning to school.We will educate our child at home,away from all the evil influences at your institution." Which is the most appropriate initial action for a school nurse to take?

Accepted Answer

The parent is upset because she equates the tattoo with negative aspects of growth and may not know that a tattoo is often considered no worse than piercing one's ears to many individuals.Although the parent may elect to educate the child at home,such an approach may fail if it lacks the proper purpose for its implementation.Persuading the parent to come in and see the nurse and counselor will help her to problem solve more effectively and view the tattoo in a healthier perspective.

Question 3

An adult states,"When I was young,I would never have even thought of being disrespectful or being disobedient to my parents." The nurse gains insight that supports the theory that this adult was probably raised in a home with which parenting style?

Accepted Answer

Authoritarian parents are oriented toward shaping,controlling,and restricting the adolescent to fixed standards.Obedience is seen as a virtue,and power and responsibility are not shared with the adolescent.Traditional parents value a sense of continuity and order.Democratic parents do not believe that their standards are always right.Permissive is not a parenting style identified in the textbook.

Question 4

An adolescent currently being treated for aggressive behavior says,"I need to tell you something very important,but first you have to promise not to tell anyone else." Which communication by the nurse would be most therapeutic?

Accepted Answer

The nurse has a duty to report any information that is provided that could present danger to the patients themselves or to others.

Question 5

Which response by an adolescent during the termination of outpatient substance abuse therapy indicates the need to reevaluate the treatment plan? The adolescent:

Accepted Answer

Expressing doubts about readiness is also within the range of answers,but the therapist will want to work with the adolescent before termination to build support and feelings of confidence.The remaining options reflect responses within the normal range of emotional readiness to terminate.

Question 6

A teacher shows a nurse an adolescent's textbook that has been defaced with sexually explicit drawings and asks,"Do you think that this student is being molested at home?" The nurse responds most therapeutically by:

Accepted Answer

The initial step is to determine what the adolescent says about the schoolbook defacement and then respond from there.The behavior may be a cry for help,but the teacher needs to view it correctly and not jump to premature conclusions.

Question 7

A father drags his adolescent to the nurse's office at school and says,"I caught him trying to run away from school again." The nurse should initially:

Accepted Answer

Although running away may be a cry for help,an attempt to escape from an unbearable living situation,or both,it also can be a solution that would be chosen by an unmotivated youth who may have a conduct disorder.The most therapeutic intervention is one that initiates communication regarding the root of the child's behavior.

Question 8

When a teacher reports that an adolescent has begun failing in class and is isolated from friends during laboratory sessions,the nurse responds most therapeutically by stating:

Accepted Answer

The symptoms the teacher is observing may well be adolescent depression,but the nurse would be most therapeutic to offer perspective discussion regarding how adolescents generally display depression.

Question 9

An adolescent refuses to go to gym class after classmates jokingly called two freckles under his nipples extra breasts.Which intervention would be most therapeutic for this adolescent?

Accepted Answer

It is important to acknowledge the patient's concern while still focusing on reality.Inadequately addressing and minimizing the patient's concerns and sending the child back to the gym set up a situation that may create a regressive struggle.Calling the principal is an overreaction at this point.Informing the parents and suggesting a follow-up discussion would be premature and could overwhelm an already traumatized and sensitive adolescent.

Question 10

A parent reports,"My adolescent sometimes acts like an adult and at other times like a child." The nurse reassures the parent,explaining that this represents an expected attempt to cope with changes in which developmental area?

Accepted Answer

In response to the changes of puberty that affect identity and the feelings that are associated with this,adolescents use defenses against these feelings that were helpful in childhood and also experiment with new,more adult-like attempts at mastery.Because of these attempts to cope,adolescents sometimes act like adults and at other times act like children.

Question 11

A parent shares with a nurse a concern that an adolescent "constantly reads about Hitler and watches history television programs that show concentration camp footage." Which statement would be the most therapeutic response?

Accepted Answer

Adolescence is a time for exploration before adulthood.Without any other behavioral changes,the adolescent may just be interested in history,so it would be most therapeutic for the nurse to obtain further information from the parent before seeing the adolescent or recommending help.

Question 12

Which intervention would be the most therapeutic for the school nurse on the 1-year anniversary of a shooting that killed three of the school's adolescent students?

Accepted Answer

The occurrence of school shootings has caused experts to look more closely at lethality among adolescents.Providing a forum that will allow everyone involved to express grief and will educate them on strategies they can take to prevent further outbreaks would help to reduce feelings of powerlessness.

Question 13

A nurse would be most concerned about the risk of suicide in which adolescent?

Accepted Answer

All the problems described are indicators of depression in adolescents.Although the incidence of depression is twice as great in girls as in boys,the male suicide rate for 15- to 19-year-olds is five times the female rate.

Question 14

Since the divorce of parents 6 months ago,an adolescent has been absent from school nearly every Friday and gives vague complaints of various illnesses.Which nursing intervention would be most therapeutic in this situation?

Accepted Answer

The most effective action by the nurse would be to arrange for a family meeting to determine what is happening to cause the student to feel sick on Fridays.Directly asking the student may be too threatening,because there seems to be an inability to articulate concerns,except somatically.The medical examination is premature and outside the nurse's authority.A telephone call is a superficial intervention for serious adolescent maladaptive behavior.

Question 15

Which behavior would indicate to the nurse that an adolescent has entered the third stage of substance abuse? The adolescent:

Accepted Answer

The third stage of substance abuse (regular use) is characterized by progression to midweek use of substances to get high; excitement followed by guilt over use; and regular use progressing from tobacco,alcohol,and marijuana to other substances such as hash oil,tranquilizers,sedatives,and amphetamines.

Question 16

Which nursing intervention would be most effective when assisting an adolescent whose best friend recently committed suicide?

Accepted Answer

The adolescent has experienced a deep loss.The nurse is responsible for identifying adolescents who may be at risk for depression and other problems and then determining the need,if any,for monitoring and treatment.

Question 17

Which statement would be the most therapeutic initially when interviewing an adolescent who attempted suicide in the school bathroom?

Accepted Answer

The most therapeutic communication is the one that facilitates discussion about feelings and thoughts as well as more adaptive problem solving and suggests that there are options other than suicide.

Question 18

Which nursing intervention would be most effective when assisting an adolescent who is in stage three of substance abuse?

Accepted Answer

Stage three of substance abuse (regular use) indicates that the adolescent has progressed to midweek use to get high and will benefit from participation in drug-free self-help groups and family therapy.Family intervention is also an important part of treatment,because the issues surrounding the problem of adolescent use must be addressed for the whole family affected.The remaining options are demonstrating interventions that the client has either progressed past or has yet arrived at the stage where they could be effective.

Question 19

An adolescent relates a mutual masturbatory experience to a nurse and says,"I think I'm a homosexual." Which statement by the nurse with respect to the patient's development stage is most appropriate?

Accepted Answer

The most therapeutic nursing intervention is the one that provides the information that adolescence is a time when sexual identity and sexual behavior vary.

Question 20

An adolescent says,"What am I supposed to do? My parents are so strict.They never let me do anything or go anywhere with my friends." Which nursing intervention would be most effective?

Accepted Answer

Adolescents can exaggerate situations and issues and often need time and perspective to view issues more objectively.By helping the adolescent view the issues more dispassionately,the nurse will assist him or her to problem solve more effectively and to begin to view issues from the parents' perspective as well.

Quiz 36: Adolescent Psychiatric Nursing