The psychiatric nurse practitioner is evaluating a 6-year-old girl who acts inappropriately with her peers, asking to see their "bathing suit parts." She reports playing a "secret game" with her mom's boyfriend in which he touched her under her panties. Which of the following is the most appropriate immediate action?
Call the grandmother to come get the child.
Tell the mother to cease contact with the boyfriend.
Call the local child protection agency.
Call the child's school and have them call child protective services.
The Correct Answer is C
Choice A reason: While involving a trusted family member may be helpful later, it does not fulfill the legal and ethical obligation to report suspected abuse. It delays appropriate intervention.
Choice B reason: Telling the mother to cease contact with the boyfriend may be necessary, but it is not the PMHNP’s role to enforce protective measures without proper reporting. This action alone does not initiate an investigation or ensure the child’s safety.
Choice C reason: Mandatory reporting laws require healthcare professionals to report suspected child abuse immediately to the appropriate child protection agency. This ensures that trained professionals can investigate and intervene to protect the child.
Choice D reason: Delegating the responsibility to the school is inappropriate. The PMHNP is the mandated reporter and must act directly to notify child protective services.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Creutzfeldt-Jacob disease is a rare neurodegenerative disorder caused by prion proteins. It presents with rapidly progressive dementia, myoclonus, and motor dysfunction, but does not typically include the classic triad of Wernicke’s encephalopathy.
Choice B reason: Lewy body dementia is characterized by fluctuating cognition, visual hallucinations, and parkinsonian features. While it may include motor and cognitive symptoms, it does not typically present with the acute ocular and vestibular signs seen in Wernicke’s encephalopathy.
Choice C reason: Wernicke’s encephalopathy is a neurologic emergency caused by thiamine deficiency, often due to chronic alcohol abuse. The classic triad includes ophthalmoplegia (e.g., nystagmus), ataxia, and confusion. The patient’s history and symptoms strongly support this diagnosis.
Choice D reason: Delirium is an acute disturbance in attention and cognition, often reversible and multifactorial. While it may coexist with Wernicke’s encephalopathy, it does not explain the specific ocular and vestibular findings.
Correct Answer is A
Explanation
Choice A reason: The ventral tegmental area (VTA) and nucleus accumbens are central components of the mesolimbic dopamine pathway, which is the primary reward circuit in the brain. Dopamine release in this pathway reinforces behaviors and is heavily involved in addiction and substance use disorders.
Choice B reason: The mesocortical pathway connects the VTA to the prefrontal cortex and is involved in cognition, emotion, and executive function. While it plays a role in psychiatric conditions, it is not the primary reward center.
Choice C reason: The locus coeruleus is involved in arousal and stress responses via norepinephrine, not dopamine. It is not part of the reward system central to substance use disorders.
Choice D reason: The raphe nucleus is the primary source of serotonin in the brain and is involved in mood regulation. It does not mediate dopamine-driven reward processes.
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