One liter of normal saline is to infuse over 8 hours. At what rate will the nurse set the infusion pump?

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.

a. You are safe now.

Explanation of Choices

Choice A Reason: You Are Safe Now

This statement is the most appropriate because it immediately addresses the client’s need for safety and reassurance. Victims of sexual assault often experience intense fear and anxiety. By reassuring the client that they are now in a safe environment, the nurse helps to stabilize the client’s emotional state and begins to build trust. This statement is crucial in creating a sense of security, which is the first step in providing effective care and support.

Choice B Reason: I’ll Call Your Spouse

While involving a support person can be beneficial, this statement does not address the client’s immediate emotional needs. The priority at this moment is to ensure the client feels safe and supported. Once the client is reassured and stabilized, the nurse can then discuss involving family members or other support persons. Immediate focus should be on the client’s safety and emotional well-being.

Choice C Reason: We’ll Have to Take Photographs of These Wounds

Taking photographs for forensic evidence is an important part of the medical and legal process following a sexual assault. However, this statement is not therapeutic and does not address the client’s immediate emotional needs. Discussing forensic procedures should come after the client feels safe and supported. The nurse should first focus on providing emotional reassurance before moving on to procedural details.

Choice D Reason: The Police Will Want to Interview You

Informing the client about the need for a police interview is necessary, but it is not the priority therapeutic statement at this moment. The client is likely already overwhelmed and distressed. The nurse should first provide reassurance and emotional support before discussing legal procedures. Ensuring the client feels safe and supported is essential before introducing additional stressors.