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.

Answer and Explanation

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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Correct Answer is D

Explanation

Choice A reason: Offering information is supportive, but this does not address the spouse’s emotional needs or encourage discussion about the client’s values.

Choice B reason: Calling a chaplain might be supportive later, but it avoids addressing the spouse’s statement directly and risks shifting responsibility away from the nurse.

Choice C reason: Reassurance without exploring the client’s and family’s values minimizes the spouse’s need for deeper reflection and personal decision-making.

Choice D reason: Encouraging the spouse to reflect on the client’s beliefs and values promotes autonomy and supports decision-making that honors the client’s wishes, making it the most therapeutic response.

A. Encourage the client to explore childhood experiences that may have caused these fears. B. Reassure the client that everyone feels insecure sometimes and they are overthinking the situation. C. Advise the client to start attending large events to desensitize themselves to rejection. D. Assist the client in identifying and challenging negative self-beliefs through gradual social exposure.

Correct Answer is D

Explanation

Choice A reason: While exploring childhood experiences may provide insight into the origins of fear, this approach does not directly help the client build the confidence and skills needed to engage socially in the present. It may keep the focus on the past rather than promoting immediate coping strategies.

Choice B reason: Offering reassurance without addressing the underlying cognitive distortions minimizes the client’s distress and may come across as dismissive. This response fails to provide practical tools for overcoming fear of rejection.

Choice C reason: Encouraging participation in large social gatherings too quickly can overwhelm a client with avoidant traits. Such exposure without proper preparation and gradual buildup is more likely to increase anxiety and avoidance rather than reduce it.

Choice D reason: Supporting the client in recognizing and challenging self-defeating beliefs, while practicing gradual social exposure, is evidence-based and therapeutic. This method uses cognitive-behavioral strategies that are effective in reducing avoidance, building self-esteem, and encouraging healthier relationships.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A 28-year-old client with a diagnosis of Avoidant Personality Disorder tells the nurse, "I want to make friends. I'm too afraid they'll laugh at me or think I'm weak." Which nursing intervention is most appropriate to help this client begin developing healthier interpersonal relationships?

Correct Answer is D

Explanation

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?

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