A nurse is caring for a child whose guardians report that the child is consistently unable to speak during class and other social situations. The nurse should identify that the child is experiencing which of the following anxiety disorders?
Separation anxiety disorder.
Agoraphobia.
Generalized anxiety disorder.
Selective mutism.
The Correct Answer is D
Choice A reason: Separation anxiety disorder involves excessive distress when separated from caregivers, but the key feature here is lack of speech in specific settings.
Choice B reason: Agoraphobia is the fear of being in situations where escape may be difficult, not selective inability to speak.
Choice C reason: Generalized anxiety disorder is characterized by excessive worry in many areas of life, not persistent mutism in social contexts.
Choice D reason: Selective mutism is an anxiety disorder where a child consistently fails to speak in certain settings, like school, despite being able to speak in others, making this the correct diagnosis.
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Related Questions
Correct Answer is C
Explanation
Choice A reason: Rationalization involves creating logical explanations to justify behavior or feelings. In this case, the client is not justifying but outright rejecting the diagnosis, so this does not apply.
Choice B reason: Regression occurs when an individual reverts to earlier developmental behaviors, such as childish actions, to cope with stress. The client is not reverting to earlier behaviors but refusing to accept reality.
Choice C reason: Denial is the refusal to accept reality or facts, blocking external events from conscious awareness. The client’s insistence that the diagnosis is a mistake demonstrates denial, making this the correct defense mechanism.
Choice D reason: Projection occurs when a person attributes their unacceptable thoughts or feelings to someone else. The client is not attributing their illness to others but rejecting its existence altogether.
Correct Answer is D
Explanation
Choice A reason: While it is true that untreated suicidal depression can be fatal, this response is confrontational and increases fear without addressing the spouse’s concern.
Choice B reason: Assuring the spouse that the client will not feel anything oversimplifies ECT. Though anesthesia prevents pain, this statement dismisses the spouse’s fears and does not encourage discussion.
Choice C reason: While medications do take weeks to be effective, simply giving this fact does not address the emotional concerns and fears about ECT being “cruel.”
Choice D reason: This response acknowledges the seriousness of the illness, explains why ECT may be necessary, and opens dialogue by inviting the spouse to share concerns. It is therapeutic, informative, and supportive, making it the best choice.
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