Chapter 36: Mental Health Assessment of Children and Adolescents

Format: Multiple Choice

Client Needs: Psychosocial Integrity

Cognitive Level: Apply

Integrated Process: Nursing Process

Objective: 2

Page and Header: 696, Establishment of a Therapeutic Alliance

1. The nurse is preparing to interview a 6-year-old client and parent in an outpatient psychiatric setting. To establish a treatment alliance with the child, the nurse should do what?

A) Tell the child, “I watch Sesame Street all the time.”

B) Talk to the child while standing up and looking down.

C) Tell the child that this must be a bit scary.

D) Ask the parent if the child can be interviewed alone.

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2. A nurse is interviewing a 12-year-old child in an outpatient psychiatric setting. Which statement would be most appropriate for the nurse to say to establish a high degree of credibility?

A) “How would you describe your parents?”

B) “Tell me about your best friend.”

C) “I have several teddy bears; would you like one to hold?”

D) “You’d get along better with your parents if you’d follow their advice.”

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3. 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) “Let’s compare your situation to that of Cinderella’s in the fairy tale.”

B) “I’m going to use the DECA tool to measure your self-control and initiative.”

C) “Let’s have you draw a picture of yourself.”

D) “Would you like to play a game of checkers with me?”

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4. 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) “I won’t share anything with your parents that you don’t want me to share.”

B) “Adolescents often feel a distrust of authority figures. Is that true with you?”

C) “Your parents care a great deal about you. That’s why you are here.”

D) “If something is uncomfortable for you, you don’t have to talk about it.”

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5. 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 is experiencing homicidal thoughts.

C) The child is functioning well in the area of school.

D) The child can be treated effectively as an outpatient.

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6. The nurse is assessing the self-concept of an 8-year-old child. Which question 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?”

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7. A nurse in an outpatient clinic is assessing a child, and 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 can’t get along with my parents.”

B) “I yell at my parents a lot.”

C) “I’m sad a lot, and I have trouble sleeping.”

D) “I refuse to do what my parents tell me to.”

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8. A nurse is performing an assessment interview of a 14-year-old client who is being admitted to an adolescent substance abuse unit. The parents are concerned about repeated problems at school that they associate with drug use. The client stalks into the office, abruptly sits down, and says, “Okay, ask your stupid questions, but don’t expect me to cooperate!” Which response by the nurse would be most appropriate?

A) “Your attitude is offensive; I can see why your parents brought you here.”

B) “Why don’t we wait until you’ve calmed down a bit to start the interview?”

C) “Why are you so angry?”

D) “You seem pretty upset. Tell me about what is upsetting you.”

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9. The nurse is beginning an assessment interview with an 8-year-old child who has been brought in for counseling by parents. When beginning the interview, which question would be most appropriate for the nurse to ask first?

A) “How are you feeling?”

B) “How old are you?”

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?

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10. A nurse is interviewing a 12-year-old client who has been diagnosed with depression. The client’s depression was triggered by the father’s death 2 years ago. The nurse interprets which comment made by the client as reflecting egocentrism?

A) “If I hadn’t yelled at my dad and told him to go away, he never would have died.”

B) “I’m still sad because my dad died a couple of years ago.”

C) “I think I’m just experiencing normal grieving.”

D) “My father was the best friend I ever had; I still can’t believe he’s gone for good.”

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11. A nurse is preparing to assess a 9-year-old child who has been sexually abused. Which action would be the priority for the nurse?

A) Find out when the abuse occurred.

B) Document the assessment for use in court.

C) Use anatomically correct dolls to elicit information.

D) Ensure that the environment is safe and supportive.

Page and Header: 709, Stress and Coping Behaviors

12. 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 experience as a stressful for a child?

A) Loss

B) Chronic illness

C) Racial discrimination

D) Social support

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13. A nurse is preparing to interview a 4-year-old child. Which technique would be most effective for the nurse to use for the assessment?

A) Direct, simple questions

B) Play materials such as blocks

C) Pediatric anxiety rating scale

D) Children’s Depression Inventory

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14. 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 does not have the ability to change during one’s life.

C) Temperament is determined by social influence of peers.

D) Temperament is controlled by the child’s emotions.

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15. A nurse asks a child, “What do you want to do when you grow up?” With this question, what is the nurse assessing?

A) Self-concept

B) Caregiver influence

C) Ambitions

D) Thought process

Page and Header: 696, Discussion with the Child; 697, Box 36.1

16. 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 instruction would the nurse emphasize? Select all that apply.

A) Use simple terms such as sad or nervous instead of depressed or anxious.

B) Individualize the questions based on judgment and discretion.

C) Use questions that lead the child to the response desired.

D) Speak in longer sentences that include a description of what is being asked.

E) Let the child’s statements and behaviors guide the interview.

Page and Header: 707, Temperament and Behavior

17. 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 characteristic of temperament. Select all that apply.

A) Emotional bonding

B) Sequential growth processes

C) Activity level

D) Adaptability

E) Insecurity

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18. 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 characteristic would the nurse need to keep in mind about this age group? Select all that apply.

A) Their view of things in a concrete manner

B) Ability to look at things hypothetically

C) Beginning ability to use logic

D) Ability to use abstract thinking

E) Difficulty in putting feelings into words

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19. After completing the mental status assessment of a 9-year-old boy, which finding would the nurse document as reflecting the child’s motor activity? Select all that apply.

A) Favorite story, Huckleberry Finn

B) Short attention span

C) Hyper-alertness

D) “Went to the park last weekend”

E) Nail biting

F) History of temper tantrums

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20. An assessment of a child is different from an assessment of adults. Which components are included in the assessment of children and adolescents? Select all that apply.

A) Language

B) Medical history

C) School grades

D) Emotional skills

E) Social abilities