During a family session, it is revealed that an older child has sexually assaulted a younger child. Both children live in the same home with their parents. What is the PMHNP's next step?
Call the police to have the older child arrested.
Maintain a calm demeanor, step out of the room, and call 911.
Sign an order of involuntary consent for the older child and have him sent to an inpatient psychiatric hospital for treatment.
Ensure the older child is not left alone with the younger child and call child protective services.
The Correct Answer is D
Choice A reason: While law enforcement may eventually be involved, the immediate priority is child safety and mandated reporting. Arresting the older child without a full assessment may not be developmentally appropriate or trauma-informed.
Choice B reason: Calling 911 may be necessary in cases of acute danger, but in this scenario, the PMHNP should first ensure safety and follow mandated reporting protocols. Emergency services are not the first-line response unless there is imminent risk.
Choice C reason: Involuntary psychiatric hospitalization requires specific criteria, including danger to self or others and inability to care for oneself. While the older child may need evaluation, this step is premature without a full assessment and proper reporting.
Choice D reason: This is the correct and legally mandated response. The PMHNP must ensure the younger child is protected and report the incident to child protective services. This initiates a formal investigation and ensures both children receive appropriate care and intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This response reflects a core principle of motivational interviewing—expressing empathy and highlighting ambivalence. It validates the client’s conflicting feelings and opens the door for deeper exploration of values and goals, which can enhance motivation for change.
Choice B reason: This response is confrontational and may provoke defensiveness. Motivational interviewing avoids judgment and instead fosters collaboration and self-reflection.
Choice C reason: This statement is shaming and accusatory. It undermines the supportive tone of motivational interviewing and may damage rapport, reducing the likelihood of behavior change.
Choice D reason: While honesty is important, this directive approach lacks the client-centered spirit of motivational interviewing. It imposes a solution rather than guiding the client to discover their own motivation.
Correct Answer is B
Explanation
Choice A reason: Projection involves attributing one’s own unacceptable thoughts or feelings to another person. For example, someone who is angry may accuse others of being hostile. This does not apply to the woman’s behavior, as she is not externalizing her own feelings.
Choice B reason: Denial is the refusal to accept reality or facts, often to avoid emotional pain. In this case, the woman is denying the seriousness and danger of her abusive relationship. She minimizes the abuse and reframes her husband’s behavior as a result of his own trauma, thereby avoiding the painful truth of her situation.
Choice C reason: Rationalization involves creating logical explanations to justify unacceptable behavior or feelings. While the woman’s statements may contain elements of rationalization, the dominant mechanism is denial—she is refusing to acknowledge the abuse as a threat to her safety.
Choice D reason: Displacement involves redirecting emotions from a threatening target to a safer one. For example, someone angry at their boss might yell at their spouse. This mechanism is not evident in the woman’s response.
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