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 B
Explanation
Choice A reason: Beneficence refers to the ethical obligation to do good and promote the well-being of patients. It emphasizes positive actions but does not specifically address fairness in care delivery.
Choice B reason: Justice is the ethical principle that emphasizes fairness, equity, and impartiality in healthcare. It requires that nurses treat all patients equally, distribute resources fairly, and avoid discrimination. Justice ensures that care is provided based on need and not influenced by bias or favoritism.
Choice C reason: Respect is a foundational value in nursing ethics, involving honoring the dignity, autonomy, and rights of individuals. While it supports fair treatment, it does not directly define fairness in the distribution of care.
Choice D reason: Fidelity refers to faithfulness and loyalty in professional relationships. It involves keeping promises and maintaining trust but does not specifically address fairness in care.
Correct Answer is A
Explanation
Choice A reason: Carbamazepine is a potent inducer of cytochrome P450 enzymes, particularly CYP3A4, which metabolizes buprenorphine. This induction accelerates buprenorphine clearance, reducing its plasma concentration and therapeutic effect. Clinical evidence supports that co-administration can lead to subtherapeutic levels and relapse risk.
Choice B reason: Amitriptyline is a tricyclic antidepressant that does not significantly affect buprenorphine metabolism. While it may contribute to sedation or other side effects, it does not reduce buprenorphine efficacy.
Choice C reason: Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) and a CYP2D6 inhibitor. It does not significantly impact buprenorphine metabolism via CYP3A4 and is unlikely to reduce its efficacy.
Choice D reason: Erythromycin is a CYP3A4 inhibitor, which could potentially increase buprenorphine levels rather than decrease them. It is not associated with reduced efficacy of buprenorphine.
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