Ch42 Social and Environmental Influences on the Child Study Guide 2024

Which adolescent behavior, reported by a parent, would cause the nurse to suspect possible substance abuse? 1. Becoming very involved with friends and in activities related to basketball 2. Becoming moody, crying, and weeping one minute and then cheerful and excited the next 3. Receiving numerous detentions for sleeping in class 4. Wearing baggy, oversized clothing and dyeing hair black - ANSWERSAnswer: 3 Explanation: 1. Periodically distancing themselves from their parents and preferring involvement with their peers are normal adolescent behaviors. 2. Mood swings are normal adolescent behaviors. 3. Even though most teens do prefer staying up late, they are not usually so tired that they fall asleep during the day, especially while engaged in classroom activities. This behavior is abnormal and could indicate involvement with substance abuse or an underlying pathology. 4. Experimentation with different clothes and hair is a normal adolescent behavior. During a well-child examination, the parents of a 4-year-old client inform the nurse that they are thinking of buying a television for their child's bedroom and ask for advice as to whether this is appropriate. Which response by the nurse is most appropriate? 1. "It is okay for children to have a television in their room as long as you limit the amount of time they watch it to less than 2 hours per day." 2. "Research has shown that watching educational television shows improves a child's performance in school." 3. "Don't buy a television for your child's room; he is much too young for that." 4. "Research has shown that children with a television in their bedroom spend significantly less time playing outside than other children." - ANSWERSAnswer: 4 Explanation: 1. This information is correct in that limiting television viewing to less than 2 hours per day is appropriate, but the probability of this occurring with a television in the child's room is low; the child will most likely be watching much more than 2 hours per day. 2. This statement might encourage the parents to allow the child to watch more television, and the child's developmental need for physical activity is greater than the benefit that he might obtain by watching educational programs. 3. This statement does not give parents a rationale, and it might seem opinionated to them. 4. Young children need to be physically active at this age. Research has shown that children with a television in their bedroom spend significantly less time playing outside than do other children, and physical inactivity in children has been linked to many chronic diseases, such as obesity and type 2 diabetes. Telling parents this is the best response because it gives the parents an evidence-based reason for not placing a television in the child's room. A mother of two children, an 8-year-old and a 10-year-old, tells you that her husband has recently been deployed to the Middle East. The mother is concerned about the children's constant interest in watching TV news coverage of activities in the Middle East. Which suggestion by the nurse to the mother is most appropriate? 1. "Spend time with your children, and take cues from them about how much they want to discuss." 2. "Allow the children to watch as much television as they want. This is how they are coping with their father's absence." 3. "The less that you discuss this, the quicker the children will adjust to their father's absence. Try to keep them busy and use distractions to keep their mind off of it." 4. "It will just take some time to adjust to their father's absence and then everything will return to normal." - ANSWERSAnswer: 1 Explanation: 1. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase. 2. Constant viewing of the TV coverage of the war might increase the children's anxiety and fear for their father's safety. 3. Children need to be able to discuss their feelings and concerns with an adult; otherwise, their emotional distress could increase. 4. The mother should be aware that even though the children might appear to have adjusted, there could be delayed reactions or regressions in behavior. A 7-year-old child is seen in the pediatric clinic 3 times in the last 2 months for complaints of abdominal pain. On each occasion, the physical examination and all ordered laboratory work have been normal. Which is the priority nursing assessment at this time? 1. The child's normal eating habits 2. Recent viral illnesses or other infectious symptoms 3. Review of the child's immunization history 4. Changes in school or home life - ANSWERSAnswer: 4 Explanation: 1. Because of the abdominal complaints, the child's eating habits would have already been discussed. 2. With normal blood work and tests, the chance of any illness over the last few months is unlikely. 3. The immunization history would have been reviewed on the previous visits. 4. With a normal examination and laboratory work, there is a high probability that this child's abdominal pain is stress related, and it is most important to identify the possible stressors in this child's life to aid in diagnosis and treatment. Asking about changes in home or school life is most likely to get to information about recent stresses in the child's life. The nurse is providing care to homeless adolescents at an outreach clinic. Which concept is important for the nurse to consider when providing care to this population? 1. Teens who are homeless will get a job and somewhere to live. 2. Teens who are homeless will seek help when needed. 3. Teens who are homeless will not be fearful of authority figures. 4. Teens who are homeless are most likely to have unprotected sex. - ANSWERSAnswer: 4 Explanation: 1. Homeless teens are less likely to obtain employment and a place to live, as often these teens do not have the skills to be able to accomplish such tasks. 2. Homeless teens are less likely to seek help when needed, frequently because of mistrust of others. 3. Homeless teens are generally fearful and distrustful of authority figures. 4. Teens who are homeless are more likely to engage in risky behaviors, such as unprotected sex with multiple partners and substance abuse. They are more likely to need emergency care, to be depressed, and to become pregnant than are other teens. A parent is concerned about her 8-year-old child's recent behavior and calls the nurse for advice. According to the parent, her child is constantly crying, is not sleeping well, has withdrawn from activities, and does not want to attend school. Which should the nurse explore in more detail with the parent? 1. Bullying 2. Sexual abuse 3. Lead poisoning 4. Drug abuse - ANSWERSAnswer: 1 Explanation: 1. Physical complaints, suicidal thoughts, and other problems can result from bullying. 2. Sexual abuse should be suspected if the child is experiencing vaginal discharge or excessive sexual curiosity for age. 3. Lead poisoning can lead to physical symptoms, including neurologic deficits, but would not include the signs of emotional distress that the child is exhibiting. 4. Drug abuse is more likely to occur in an adolescent than a child of this age.