A PMHNP uses the Autism Diagnostic Observation Schedule (ADOS) to aid in the diagnosis of an 8-year-old boy. She asks the parents to leave the room while she conducts the exam. The parents are hesitant to leave their child and want to know why it is important to leave him alone during the exam. What is the PMHNP's most appropriate response?
"We need to ensure there is no cheating by you helping him."
"As parents, you will naturally want to provide assistance for your child, but the goal of the test is to see how the child does without your assistance."
"The test can be hard to watch, since it is likely your child won't be able to complete many of the behavior tests."
"Kids don't do as well when their parents are in the room, because they get too upset when they make a mistake."
The Correct Answer is B
Choice A reason: This response is overly simplistic and uses the word "cheating," which may sound accusatory and does not accurately explain the clinical rationale. The ADOS aims to assess a child's independent social, communicative, and behavioral functioning, not to catch parents assisting. Using such terminology may increase parental anxiety and reduce cooperation.
Choice B reason: This is the correct response because it clearly explains that the assessment's purpose is to observe the child’s behavior without parental influence. Parental presence can inadvertently alter a child's responses or behavior, potentially masking deficits in social communication or repetitive behaviors that are critical for the diagnosis of autism spectrum disorder. The phrasing reassures parents while providing a clear professional rationale.
Choice C reason: While the test may indeed be challenging, emphasizing the child’s potential inability to complete tasks is not the appropriate rationale for asking parents to leave. This approach may unnecessarily alarm parents and distract from the primary reason for their absence, which is to ensure accurate and unbiased assessment of the child.
Choice D reason: This answer incorrectly assumes that children’s distress is solely due to parental presence. While some children may behave differently with parents around, the main rationale for asking parents to leave is to obtain an independent assessment of the child's skills and behaviors, not simply to prevent emotional upset.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Atrial fibrillation typically presents with a rapid, irregularly irregular pulse, often exceeding 100 bpm. A rate of 157 indicates tachyarrhythmia consistent with AF.
Choice B reason: Hypotension may result from AF complications but is not diagnostic by itself.
Choice C reason: Bradycardia (pulse 43) is inconsistent with typical AF, which is usually tachyarrhythmic unless on rate-controlling medications.
Choice D reason: Hypertension alone does not confirm AF; the irregular tachycardic pulse is the key finding.
Correct Answer is C
Explanation
Choice A reason: OCD is characterized by obsessions and compulsions. While this patient reports persistent worry, she does not describe intrusive thoughts or ritualistic behaviors typical of OCD.
Choice B reason: Social anxiety disorder is marked by fear and avoidance of social situations. This patient’s worry is pervasive and not limited to social performance.
Choice C reason: This is correct. Generalized anxiety disorder involves chronic, excessive worry across multiple domains for at least six months, accompanied by physical symptoms such as muscle tension, restlessness, and difficulty concentrating, which matches this patient’s presentation.
Choice D reason: Panic disorder is defined by recurrent, unexpected panic attacks with somatic symptoms. This patient’s anxiety is ongoing and generalized, rather than episodic panic attacks.
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