Chapter 22: Caring for the Child With a Psychosocial or Cognitive Condition

Chapter 22: Caring for the Child With a Psychosocial or Cognitive Condition

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse wishes to increase an at-risk child’s resilience. What action by the nurse would be most helpful?

ANS:  A

Resilience is the ability to recognize and use internal or external resources in dealing with adversity. Helping the child see his or her internal resources is a positive step in improving resiliency. Telling the child that others are worse off than he or she is or that he or she should “toughen up” is dismissive and not helpful. Teaching appropriate communication is important, but children do not need therapeutic communication skills.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Psychosocial Integrity

Integrated Process: Nursing Process: Implementation

Difficulty: Easy

PTS:   1

2. A faculty member is explaining the impact of immigration on mental health to a group of nursing students. What information should the faculty member provide?

ANS:  B

New immigrants to this country are often consumed with learning English, getting jobs, and adapting to an entirely different way of life in a new world. Often meeting these basic human needs consumes family energy, leaving family members no resources to identify and seek treatment for psychosocial or cognitive disorders. Immigrants suffer from disparities in health care, and often their health-care needs are unmet. Immigrants and refugees do have mental health problems, especially if they have come from war-torn or violent societies. Not all immigrants are non-English-speaking individuals.

Cognitive Level: Comprehension/Understanding

Content Area: Pediatrics/Maternity

Patient Needs: Psychosocial Integrity

Integrated Process: Teaching/Learning

Difficulty: Easy

PTS:   1

3. When working with immigrant and refugee families, what strategy by the nurse is likely to have the most positive impact?

ANS:  B

Nurses who work with immigrant/refugee families should praise the families for what they are doing well and keep resilience-promoting strategies in mind. Anticipatory guidance can prepare families for handling future problems. Referrals are always an important aspect of care when appropriate, but the nurse needs to provide effective strategies. Newcomers to this country do need to understand laws surrounding discipline if they come from a country in which typical disciplinary measures might be seen as problematic in the United States.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Psychosocial Integrity

Integrated Process: Nursing Process: Implementation

Difficulty: Moderate

PTS:   1

4. The pediatric nurse is assessing a child who complains of a stomach ache. This is the child’s fourth visit to the clinic for the same problem, and there has not been a diagnosis yet. What action by the nurse is best?

ANS:  A

Children with anxiety often present with somatic complaints that do not have a physical cause. The nurse should inquire about the symptoms characteristic of all anxiety disorders, including impaired function or development related to anxiety. The nurse should not just instruct the mother to send the child to school, as this is not a helpful strategy in alleviating the problem. A thorough history is important, but most likely would have already been done in prior visits. Performing and documenting an abdominal exam are both important, but again will not provide specific assistance in this situation.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Psychosocial Integrity

Integrated Process: Nursing Process: Assessment

Difficulty: Moderate

PTS:   1

5. A nurse is interviewing a mother of two children, ages 5 and 14. They were in a hotel fire a year ago in which their father was killed. The mother is concerned because the younger child has nightmares. The older child does not seem to have any problems. What action by the nurse is the most appropriate?

ANS:  D

The younger child has risk factors for and symptoms of posttraumatic stress disorder (PTSD). Although the mother expresses concerns about only the younger child, the nurse should inquire about the health of the older child too, in order to provide holistic care to this family. There are developmental differences in presenting symptoms, and although nightmares in a younger child might be frequently seen in PTSD, an older child might avoid situations or places that remind him or her of the incident. Information about physical injuries is important to note, but is not the priority 1 year after the fire. PTSD does not appear immediately after an incident, so counseling after the fire may not have prevented the onset of PTSD and certainly would not have identified its presence.

Cognitive Level: Application/Applying

Content Area: Pediatrics/Maternity

Patient Needs: Psychosocial Integrity

Integrated Process: Nursing Process: Assessment

Difficulty: Moderate

PTS: