Navigating Pediatric Psychiatry: Essential Knowledge Assessment for Nursing
Professionals
1. A 9-year old child is admitted to a psychiatric treatment unit
accompanied by both parents. To establish trust and a position of
neutrality, which action should the nurse take?
A. Encourage the parents to leave while interviewing the child alone.
B. Interview the child and parents together, observing their interaction.
C. Provide diversion for the child, and interview the parents alone.
D. Review the clinical record prior to interviewing the parents.
Answer: B
RATIONALE: It is important for the nurse to be seen as a neutral person
who is interested in the family as an adaptive functioning unit. B
conducting the admission interview with the parents and child together,
the nurse establishes this neutral role from the beginning.
2. A community nurse is practicing primary prevention for psychiatric
disorders in children. On which of the following risk factors would the
nurse focus?
A. Being raised in a single parent home
B. Family history of mental illness
C. Lack of peer friendships
D. Family culture
Answer: B
RATIONALE: Abnormal genes and family history of mental illness have
been implicated in many psychiatric disorders occurring in children and
adolescents. Option A, there is no evidence that being raised in a single-
parent home will increase a child’s risk of developing a psychiatric
disorder.
3. The school nurse is meeting with the school and health treatment team
about a child who has been receiving methylphenidate (Ritalin) for 2
months. The meeting is to evaluate the results of the child’s medication
use. Which behaviour change noted by the teacher will help determine the
medication’s effectiveness?
A. Decreased repetitive behaviour
B. Decreased signs of anxiety
C. Increased depressed mood
, D. Increased ability to concentrate on tasks
Answer: D
RATIONALE: Methylphenidate (Ritalin) is used as a method of
treatment of ADHD. Evidence of increased ability to concentrate on tasks
while taking this medication would establish the drug’s effectiveness.
4. Which behavioural assessment in a child is most consistent with a
diagnosis of conduct disorder?
A. Arguing with adult
B. Gross impairment of communication
C. Physical aggression towards others
D. Refusal to separate caretaker
Answer: C
RATIONALE: Physical aggression toward others is a significant criterion
consistent with the diagnoses of conduct disorder.
5. A child with separation anxiety disorder has not attended school for three
weeks, and she cries and exhibits clinging behaviors when her mother
encourages her attendance. The priority nursing action by the home care
psychiatric nurse would be to:
A. Assist the child to return to school immediately with family support.
B. Arrange for a home-school teacher to visit for 2-weeks.
C. Encourage family discussion of various problem areas.
D. Use play therapy to help the child express their feelings.
Answer: A
RATIONALE: When a child refuses to attend to school as part of
separation anxiety disorder, it is important to avoid reinforcing this
behaviour. The nurse’s priority would be to assist the child in returning to
school immediately with support from the family.
6. The community nurse visits the home of a child recently diagnosed with
autism. The parents express feelings of shame and guilt about having
somehow caused this problem. Which statement by the nurse would best
help alleviate parental guilt?
A. “Autism is a rare disorder. Your other children should not be
affected.”
B. “The specific cause of autism is unknown. However, it is known to be
associated with problems in the structure of and chemicals in the
brain.”
C. “Sometimes a lack of prenatal care can be the cause of autism.”
, D. “Although autism is genetically inherited, if you did not have testing
you could not have known this would happen.”
Answer: B
RATIONALE: The statement id factual and does not cast blame on
anything the parents did or did not do.
7. The nurse questions the parents of a child with oppositional defiant
disorder about the roles of each parent in setting rules of behaviour. The
purpose for this type of questioning is to assess which element of the
family system?
A. Anxiety levels
B. Generational boundaries
C. Knowledge of growth and development
D. Quality of communication
Answer: B
RATIONALE: An important element in assessing the family system is
determining if the parents establish and maintain appropriate generational
boundaries, establishing clear rules and expectations as part of the
parental role.
8. The school nurse assesses a child newly diagnosed with attention deficit
hyperactivity disorder (ADHD). Which of the following symptoms are
characteristics of this disorder? Select all that apply.
A. Constant fidgeting and squirming
B. Excessive fatigue and somatic complaints
C. Difficulty paying attention to details
D. Easily distracted
E. Running away
F. Talking constantly even when inappropriate
Answer: A, C, D, and F
RATIONALE: These behaviors are all characteristics of ADHD and
indicate that the child is inattentive, hyperactive and impulsive.
9. The nurse enters the room of a client with a cognitive impairment
disorder and asks what day of the week it is; what the date, month, and
year are; and where the client is. The nurse is attempting to assess:
A. Confabulation
B. Delirium
C. Orientation
D. Perseveration