A nurse on a mental health unit is preparing to document an incident involving a client. Which considerations by the nurse will ensure competency in the documentation?

This scenario requires applying knowledge of mental health resilience and protective factors. To answer, one must distinguish between risk factors, such as maternal age or family instability, and positive childhood experiences, like supportive adult relationships, which mitigate the impact of anxiety disorders.

Choice A rationale: Maternal age at birth is often considered a social determinant of health rather than a protective factor. Adolescents born to teenage parents may face higher socio-economic challenges, which are generally categorized as potential risk factors for stress.

Choice B rationale: Having parents in the military is a demographic characteristic that often involves unique stressors. While military families can be supportive, the career itself is not inherently a protective childhood experience without further context regarding family dynamics.

Choice C rationale: Moving frequently, or high residential mobility, is typically viewed as a risk factor for adolescent anxiety. Frequent moves can disrupt social support networks, peer relationships, and educational consistency, potentially exacerbating symptoms of an anxiety disorder.

Choice D rationale: A supportive relationship with a non-parental adult, such as a teacher, is a significant protective factor. Positive childhood experiences involving being heard and supported build resilience and provide an emotional buffer against the effects of anxiety.

Choice A rationale
Agoraphobia is characterized by a fear of being in situations where escape might be difficult or embarrassing, or help might not be available in the event of panic symptoms. This does not align with the child’s symptoms of not being able to speak in class or other social situations.
Choice B rationale
Generalized anxiety disorder is characterized by excessive, uncontrollable worry about a variety of topics and is not specific to social situations. The child’s symptoms are more specific to social situations, which does not align with generalized anxiety disorder.

Choice C rationale
Selective mutism is an anxiety disorder characterized by a consistent failure to speak in specific social situations in which there is an expectation for speaking, despite speaking in other situations. This aligns with the child’s symptoms of not being able to speak during class and other social situations.
Choice D rationale
Separation anxiety disorder is characterized by excessive fear or anxiety about separation from those to whom the individual is attached. The child’s symptoms do not indicate a fear of separation, but rather a fear of speaking in social situations.