A nurse is discussing the diathesis-stress model with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the model?

Conduct Disorder

Choice A Reason: Childhood Depression

Childhood depression is a mood disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. Symptoms can include changes in appetite, sleep disturbances, and difficulty concentrating. While depression can lead to behavioral issues, it is less likely to be associated with the specific behaviors described in the scenario, such as running away and being abusive towards parents. These behaviors are more indicative of a disruptive behavior disorder rather than a mood disorder.

Choice B Reason: Oppositional Defiant Disorder

Oppositional Defiant Disorder (ODD) is characterized by a pattern of angry, irritable mood, argumentative/defiant behavior, or vindictiveness. Children with ODD often lose their temper, argue with adults, and refuse to comply with rules. While ODD can involve some of the behaviors described, such as being abusive towards parents, it typically does not include the more severe behaviors like running away or engaging in illegal activities such as prostitution. Therefore, ODD is not the most fitting diagnosis in this case.

Choice C Reason: Conduct Disorder

Conduct Disorder is a more severe behavioral disorder characterized by a repetitive and persistent pattern of behavior that violates the rights of others or major age-appropriate societal norms or rules. Symptoms include aggression towards people and animals, destruction of property, deceitfulness or theft, and serious violations of rules, such as running away from home and engaging in illegal activities like prostitution. Given the behaviors described in the scenario, Conduct Disorder is the most appropriate diagnosis. Adolescents with Conduct Disorder often exhibit a lack of remorse or guilt and may have a history of problematic behaviors that escalate over time.

Choice D Reason: Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) is a developmental disorder characterized by difficulties with social interaction, communication, and repetitive behaviors. While individuals with ASD may exhibit challenging behaviors, these are typically related to difficulties in understanding social norms and communication rather than intentional defiance or rule-breaking. The behaviors described in the scenario, such as running away and engaging in prostitution, are not characteristic of ASD, making it an unlikely diagnosis in this context.

The correct answer is b. Administer oxygen via 100% nonrebreather and place an IV catheter to give naloxone.

Choice A Reason: Get the defibrillator to the patient’s bedside and open the crash cart

While having the defibrillator and crash cart ready is important in emergency situations, it is not the immediate priority in this scenario. The patient’s symptoms suggest opioid overdose, which requires immediate intervention to support breathing and reverse the effects of the opioid. The primary focus should be on ensuring adequate oxygenation and administering naloxone.

Choice B Reason: Administer oxygen via 100% nonrebreather and place an IV catheter to give naloxone

This is the correct answer. The patient’s blue-tinged lips, slowed respirations, and pinpoint pupils are indicative of opioid overdose. Administering oxygen via a 100% nonrebreather mask helps to ensure adequate oxygenation, while placing an IV catheter allows for the administration of naloxone, an opioid antagonist that can reverse the effects of the overdose. This intervention addresses the immediate life-threatening condition.

Choice C Reason: Administer naloxone intranasally if there is not an IV catheter in place

While administering naloxone intranasally is an appropriate alternative if IV access is not available, it is not the first priority. The initial focus should be on ensuring adequate oxygenation and establishing IV access for more effective administration of naloxone. If IV access cannot be quickly established, then intranasal naloxone can be used.

Choice D Reason: Contact the patient’s parents or legal guardian for consent to treat

Obtaining consent is important, but it is not the immediate priority in a life-threatening situation. The nurse’s primary responsibility is to stabilize the patient and address the acute medical emergency. Once the patient is stabilized, the nurse can then contact the parents or legal guardian for further consent and information.