Chapter 53 Psychosocial Problems in Children and Families

Chapter 53  Psychosocial Problems in Children and Families

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. Which sign or symptom is likely to be manifested by an adolescent with a depressive

disorder?
a. Abuse of alcohol
b. Impulsivity and distractibility
c. Carelessness and inattention to details
d. Refusal to leave the house

ANS: A
Depression often manifests in conjunction with substance abuse, so children who abuse
substances should be evaluated for depression as well. Impulsivity and distractibility are
manifestations of attention-deficit/hyperactivity disorder (ADHD). A diminished ability to
think or concentrate, carelessness, and inattention to details is a clinical manifestation of
ADHD. A refusal to leave the house, even to play with friends, is characteristic of separation
anxiety disorder.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1325 | Table 53.1 OBJ: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

2. Which statement about suicide is correct?

a. Children younger than 10 years of age are least likely to attempt suicide.
b. Suicide risk decreases with age.
c. Suicide is usually an isolated event in a school community.
d. The prevalence of suicide attempts is higher among males.

ANS: A
Suicide by children under the age of 10 is uncommon although it is the third leading cause of
death in children ages 5 to 10. The risk of suicide increases with age. It is common for suicide
to occur in a cluster within a community (e.g., schools). Males have a 4% rate of suicide
attempts compared to 8% in females; however, males are more likely to die after a suicide
attempt.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 1318 OBJ: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

3. An adolescent states “I am very sad. I wish I was not alive.” What is the best response by the

nurse?
a. “Everyone feels sad once in a while.”
b. “You are just trying to escape your problems.”
c. “Have you told your parents how you feel?”
d. “Have you thought about hurting yourself?”

ANS: D

This response acknowledges the adolescent’s suicide gesture and further assesses the
adolescent’s condition. It is judgmental and belittles the teen’s feelings to tell the teen that
everyone is sad once in a while or to accuse the teen of trying to escape problems. The parents
should be made aware of an adolescent’s precarious mental state; however, this response does
not address the adolescent’s statement. It also does not begin to provide safety for the teen.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 1319 | Box 53.1 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

4. The long-term treatment plan for an adolescent with an eating disorder focuses on which of

the following?
a. Managing the effects of malnutrition
b. Establishing sufficient caloric intake
c. Improving family dynamics
d. Restructuring perception of body image

ANS: A
The treatment of eating disorders is initially focused on reestablishing physiologic
homeostasis. Once body systems are stabilized, the next goal of treatment for eating disorders
is maintaining adequate caloric intake. Although family therapy is indicated when
dysfunctional family relationships exist, the primary focus of therapy for eating disorders is to
help the adolescent cope with complex issues. The focus of treatment in individual therapy for
an eating disorder involves restructuring cognitive perceptions about the individual’s body
image.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 1324 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity

5. A parent of a child with an anxiety disorder states, “I don’t know how my child developed this

problem.” On what information should the nurse base a response?
a. Genetic factors, hormonal imbalances, and societal influences all contribute to the

development of anxiety disorders in children.
b. Like many conditions affecting children, the etiology of anxiety disorders is

unknown.
c. The majority of anxiety disorders has a clear pattern of genetic inheritance.
d. Dysfunctional family patterns are usually identified as the cause of an anxiety

disorder.

ANS: A
Anxiety disorders are responses to stress and may be manifested as disturbances in feeling,
body functions, behavior, or performance. Children with a history of verbal, physical, or
sexual abuse; frequent separation from or loss of loved ones; drug use, incarceration, or lower
socioeconomic status; homosexuality; chronic illness; behavioral disorders; and dysfunctional
families are more likely than peers with healthy family patterns to have anxiety disorders. The
etiology of many anxiety disorders in children can be identified. Some anxiety disorders are
inheritable disorders. Others have been identified as having other origins. Research
consistently shows that psychosocial disorders are caused by a combination of predisposing or
inherent factors and environmental or interactional factors.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 1314 OBJ: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity