A 10-year-old child hospitalized for anxiety and worry after witnessing intimate partner violence is most likely to benefit from which nursing intervention?
Teaching the child to focus on positive memories.
Encouraging the child to write about their experiences in a journal.
Teaching the child deep breathing exercises.
Establishing a therapeutic rapport and offering anticipatory guidance.
The Correct Answer is D
Choice A reason: While focusing on positive memories can be a component of resilience-building, it may inadvertently encourage the suppression of trauma in a child who has witnessed violence. Nursing care must first address the child's current psychological distress and safety rather than merely redirecting thoughts away from the traumatic event.
Choice B reason: Journaling can be an effective therapeutic tool for adolescents or adults, but for a 10-year-old child experiencing acute anxiety post-trauma, it may be overwhelming. Without a stable therapeutic foundation, asking a child to revisit traumatic experiences independently through writing could potentially trigger further emotional dysregulation or secondary traumatization.
Choice C reason: Deep breathing exercises are valuable somatic interventions for managing the physiological symptoms of anxiety. However, for a child who has witnessed intimate partner violence, the priority is establishing a sense of safety and trust. Relaxation techniques are secondary to the primary need for a secure therapeutic relationship.
Choice D reason: Establishing therapeutic rapport is the foundational step in trauma-informed care for children. Providing anticipatory guidance helps the child and guardians understand that their reactions are normal responses to abnormal events. This builds a safe environment, allowing the child to feel supported while navigating the complexities of their emotional recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: A toxicology test, typically performed via urine or blood sampling, is the definitive objective screening tool for identifying the presence of specific chemical metabolites in the body. In an emergency setting, this provides immediate physiological data regarding recent substance ingestion that subjective self-reporting might lack.
Choice B reason: The Eysenick Personality Inventory is a psychological instrument designed to measure specific personality traits, such as extraversion and neuroticism, based on a biopsychosocial model. It is a diagnostic tool for temperament and character assessment and has no utility in detecting the physiological presence of illicit drugs.
Choice C reason: The Personality Diagnostic Questionnaire is a self-report tool used specifically to screen for the presence of personality disorders as defined by the DSM. While the client in the prompt has a personality disorder, this tool assesses long-term behavioral patterns rather than acute substance use or intoxication.
Choice D reason: The Minnesota Multiphasic Personality Inventory (MMPI) is an extensive standardized psychometric test of adult personality and psychopathology. It is used for clinical diagnosis and chronic mental health assessment; however, it is not designed to provide real-time information regarding recent chemical exposure or drug use.
Correct Answer is B
Explanation
Choice A reason: Anhedonia, or the lack of interest in daily activities, is a core diagnostic criterion for major depressive disorder. While it reflects the severity of the depression, it is a common finding and does not necessarily indicate an imminent transition to suicidal action as clearly as a sudden mood shift.
Choice B reason: A sudden, unexplained improvement in mood or a transition from agitation to calm is a classic "red flag" for imminent suicide. This often occurs because the client has finally made a definitive decision to end their life, resulting in a sense of relief and the energy necessary to carry out a plan.
Choice C reason: Feelings of worthlessness and excessive guilt are standard symptoms of the cognitive triad of depression. While they contribute to the overall risk profile, they are chronic features of the illness and are less predictive of an immediate suicide attempt than a sudden behavioral change.
Choice D reason: Increased appetite and weight gain (atypical depression features) or decreased appetite are common somatic variations in depression. These changes in vegetative signs are clinically significant for diagnosis and treatment planning but do not serve as acute indicators of immediate self-harm risk.
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