A nurse is caring for an adolescent client who has oppositional defiant disorder (ODD).

A nurse is reviewing the medical record of an adolescent client who has oppositional defiant disorder (ODD). Which of the following factors in the client's history are risk factors for ODD? Select all that apply.

Client's ethnicity

Housing transition

Client's comorbidities

Treatment of animals

Answer and Explanation

Correct Answer : B,C,E

A. Client's ethnicity is not a risk factor for oppositional defiant disorder (ODD). While cultural factors may influence behavior or presentation, ethnicity alone does not increase the likelihood of developing ODD.

B. Housing transition is a risk factor. Frequent moves, homelessness, or unstable living conditions create stress and instability in a child’s environment, which can contribute to the development of defiant and oppositional behaviors.

C. Client's comorbidities are risk factors. Conditions such as ADHD, depression, and anxiety increase the likelihood of ODD. ADHD, in particular, is strongly associated with impulsivity and defiant behavior.

D. Treatment of animals is not relevant to risk for ODD. The client’s reaction to giving up a family pet reflects stress or grief but is not a documented risk factor for developing ODD.

E. Family's socioeconomic status is a risk factor. Financial hardship and low socioeconomic status can increase environmental stress, reduce access to mental health resources, and exacerbate behavioral problems, all of which contribute to the risk for ODD.

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Correct Answer is A

Explanation

A. This demonstrates correct understanding. Environmental stressors, life changes, and psychosocial pressures are well-recognized contributors to depressive symptoms. Stress can trigger or exacerbate depression by affecting mood, sleep, appetite, and motivation.

B. While chronic illness can influence mood indirectly, renal dysfunction is not a direct cause of depression. Depression may co-occur in clients with chronic medical conditions but is typically mediated through psychosocial stress, fatigue, or illness burden.

C. Hypertension is generally not a direct cause of depression. However, some antihypertensive medications can contribute to mood changes, but the disease itself is not a primary causative factor.

D. An elevated heart rate is a physiological sign that may accompany anxiety or stress, but it is not a direct cause of depression.

A. I am newly divorced and a single parent." B. "I recently was promoted at work but now I'm unable to work with the same coworkers I was used to working with." C. "My ex-partner tells me that I can't do anything right." D. "My ex-partner constantly makes fun of my weight." E. "I suppose I really do need to be on medication, like my ex-partner said." F. "My friend recently passed away."

Correct Answer is ["C","D","E"]

Explanation

A. "I am newly divorced and a single parent" describes situational stress. While these circumstances can contribute to emotional strain, they do not indicate abuse by another person. Emotional abuse requires deliberate behaviors aimed at controlling, belittling, or harming the client psychologically. Simply being a single parent or divorced does not meet this criterion.

B. "I recently was promoted at work but now I'm unable to work with the same coworkers I was used to working with" reflects workplace adjustment challenges or difficulty with social interactions. Although stress from these changes may affect the client’s mood or anxiety levels, there is no indication of intentional manipulation, humiliation, or coercion by another person. This statement is related to environmental or situational stress rather than abuse.

C. "My ex-partner tells me that I can't do anything right" is a direct example of emotional abuse. The ex-partner’s consistent verbal belittlement undermines the client’s confidence and self-esteem. This type of criticism is designed to create feelings of incompetence and self-doubt. Over time, such behavior can contribute to depression, anxiety, and learned helplessness, which may manifest as the client feeling “like they are going crazy.”

D. "My ex-partner constantly makes fun of my weight" also represents emotional abuse. Mocking or shaming someone about personal characteristics, such as appearance or body size, targets their self-worth and can lead to shame, poor self-image, and increased vulnerability to depression or anxiety. This behavior is intentional and repetitive, fulfilling the criteria for emotional abuse.

E. "I suppose I really do need to be on medication, like my ex-partner said" demonstrates coercion and manipulation, a form of emotional abuse. Here, the ex-partner is attempting to control how the client perceives their mental health and influence their decisions regarding treatment. This undermines the client’s autonomy, self-confidence, and ability to trust their own judgment, which can exacerbate depressive symptoms or feelings of helplessness.

F. "My friend recently passed away" expresses grief, which is a normal emotional reaction to loss. There is no evidence of another person exerting control, manipulation, or psychological harm, so this statement does not indicate emotional abuse.

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Naxlex Comprehensive Predictor Exams

A nurse is reinforcing education to a client about the possible causes of their depressed mood. Which of the following client statements indicates an understanding of the teaching?

Correct Answer is A

Explanation

A nurse is caring for a client who is crying and states they are depressed and feel like they are "going crazy." Which of the following client statements indicates the client is experiencing emotional abuse? (Select All that Apply.)

Correct Answer is ["C","D","E"]

Explanation

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