A nurse is obtaining a health history from an adolescent who they suspect is experiencing physical maltreatment. Which of the following actions should the nurse take?

Make an audio recording of the adolescent's responses

Promise not to disclose information shared during the interview

Obtain a history from both the adolescent and their caregiver.

Use leading questions during the interview.

Answer and Explanation

The Correct Answer is C

Rationale:

A. Make an audio recording of the adolescent's responses: Audio recordings require consent and may not be legally or ethically appropriate in suspected abuse cases. Documentation should be written, factual, and follow institutional policies and mandatory reporting laws.

B. Promise not to disclose information shared during the interview: Nurses must never promise confidentiality in suspected abuse cases, as they are mandated reporters. All disclosures of abuse must be reported to child protective services or appropriate authorities.

C. Obtain a history from both the adolescent and their caregiver: Gathering information from both parties helps identify inconsistencies and assess the situation fully. However, this should be done separately to allow the adolescent to speak freely and without coercion.

D. Use leading questions during the interview: Leading questions can influence the adolescent’s responses and compromise the integrity of the assessment. Open-ended, nonjudgmental questions are essential to support accurate and unbiased information gathering.

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Correct Answer is C

Explanation

Rationale:

A. "Opioids should not be given to older adults.": Opioids can be given to older adults when necessary, but with caution. The dose may need adjustment due to age-related changes in metabolism and increased sensitivity, not outright avoidance.

B. "Pain perception is decreased in older adult clients.": Pain perception does not decrease with age. Older adults may have conditions that affect communication or cognition, but their ability to feel pain remains intact, and they can still experience significant discomfort.

C. "Older adults report pain less frequently than younger clients.": Older adults often underreport pain due to beliefs that pain is a normal part of aging or fear of treatment consequences. This makes active assessment and trust-building essential in managing their pain effectively.

D. "Older adults require higher doses of pain medication.": Older adults typically require lower or more carefully titrated doses due to slower metabolism, decreased renal clearance, and heightened drug sensitivity, especially to central nervous system effects.

A. Client reports spending most of their time alone in their apartment. B. Client has initiated a daily exercise routine and utilizes deep breathing techniques as needed. C. Client has joined a local support group and has been reading books about their illness. D. Client participates in cognitive-behavioral therapy sessions with their mental health provider. E. Client reports drinking 4 to 5 cups of coffee each morning

Correct Answer is ["B","C","D"]

Explanation

Rationale:

Client has initiated a daily exercise routine: This indicates self-motivation, structured routine, and engagement in positive coping behaviors, all of which are therapeutic goals in managing schizophrenia.
Client utilizes deep breathing techniques as needed: Use of self-regulation techniques like deep breathing suggests the client is managing anxiety and stress proactively.
Client has joined a local support group: Participation in social support groups improves social functioning and decreases isolation, a common issue in schizophrenia.
Client has been reading books about their illness: Demonstrates insight, knowledge-seeking behavior, and a willingness to understand and manage the condition, which aligns with psychoeducation goals.
Client participates in cognitive-behavioral therapy sessions with their mental health provider: Engagement in CBT is a strong indicator of therapeutic alliance and compliance with structured treatment plans aimed at cognitive restructuring and behavioral management.

Rationale for Incorrect Finding:

Client reports spending most of their time alone in their apartment: Although some solitude is not unusual, spending most of the time alone may indicate ongoing social withdrawal, a negative symptom of schizophrenia, and a barrier to full community reintegration.
Client reports drinking 4 to 5 cups of coffee each morning: Excessive caffeine can worsen anxiety, interfere with sleep, and interact with psychiatric medications, so this behavior does not align with optimal treatment outcomes.

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A nurse is obtaining a health history from an adolescent who they suspect is experiencing physical maltreatment. Which of the following actions should the nurse take?

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Explanation

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Explanation

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