Child & Adolescent
A child with autism spectrum disorder benefits most from which classroom strategies? Name two.
Structured routines and visual schedules; also predictable transitions and reduced sensory overload.
Two common symptoms of uncomplicated alcohol withdrawal.
Tremor, anxiety, insomnia, diaphoresis, tachycardia, GI upset.
Acute stress response—name two common physical symptoms.
Tachycardia, rapid breathing, sweating, GI upset, insomnia.
Medication adherence—two tactics to improve follow-through.
Simplify regimen (once-daily if possible), pill organizers/reminders, involve supports, address side effects openly.
Confidentiality limit when a patient discloses a credible threat.
Duty to warn/protect—notify identifiable potential victim/authorities per policy/state law and document actions.
Patient: “Nothing will ever get better.” Provide a therapeutic response.
Reflect and explore: “It sounds like you’re feeling hopeless. Can you share what’s been hardest this week?”
Oppositional defiant disorder—two characteristic behaviors and one effective nursing intervention.
Angry/irritable mood and argumentative/defiant behavior; intervention: consistent limit-setting with clear, calm consequences and parent training.
Opioid withdrawal—two hallmark symptoms and first-line comfort measures.
Myalgias, lacrimation/rhinorrhea, piloerection; measures: clonidine/lofexidine for autonomic symptoms, antiemetics, fluids, symptomatic care.
List two hallmark PTSD symptoms across clusters.
Intrusions (nightmares/flashbacks), avoidance, negative mood/cognition changes, hyperarousal (hypervigilance, startle).
New antidepressant—expected onset and initial counseling point.
New antidepressant—expected onset and initial counseling point.
Mandatory reporting—what level of certainty is required?
Report reasonable suspicion (not proof) for children, elders, and vulnerable adults per jurisdiction.
Patient repeatedly asks “Why?” about limits. Name a more therapeutic approach.
Use simple, concrete explanations and set clear, consistent limits; invite feelings: “Let’s talk about how this feels for you.”
Illness anxiety disorder—core feature and one teaching point.
Preoccupation with having/acquiring serious illness despite minimal symptoms; teach: limit reassurance, use scheduled check-ins, CBT.
Disulfiram—one key safety warning for patients.
Avoid all alcohol-containing products (e.g., mouthwash, sauces, hand sanitizers); reaction risk can persist up to ~14 days after last dose.
Why is assessing trauma history clinically significant in mental health?
Informs risk, triggers, and treatment planning; trauma can underlie dissociation, mood/anxiety, and substance use disorders.
Rationale for behavioral contracts in anorexia nervosa or OCD.
Provide structure, externalize rules, set measurable goals, and reduce power struggles/symptom rituals.
Least restrictive alternative—give one example in practice.
De-escalation and PRN meds before restraints; voluntary admission before involuntary when appropriate.
De-escalation—two techniques when a patient is escalating but not violent.
Maintain calm tone and nonthreatening posture, give space, offer choices, validate feelings, set clear expectations.
For ADHD or disruptive behaviors, name two milieu strategies to improve success.
Break tasks into small steps, provide immediate feedback/rewards, seat away from distractions, use timers/cues.
Brief intervention steps for risky alcohol use (name two).
Use motivational interviewing: ask permission, explore pros/cons, reflect ambivalence, set a small change goal.
Acute stress disorder—two early interventions.
Ensure safety and stabilization, psychoeducation on common reactions, normalize sleep/meal routines, connect supports.
Lithium—three critical patient teachings.
Maintain fluids/salt, consistent lab monitoring (levels, renal, thyroid), recognize toxicity signs (coarse tremor, confusion, vomiting/diarrhea).
Mechanical restraints—two in-hospital requirements.
Time-limited provider order, continuous monitoring and frequent circulation/skin checks with documentation.
Respond to a request for advice on leaving an IPV relationship.
Avoid direct advice; prioritize safety planning, offer resources/hotlines, respect autonomy, and assess immediate danger.
For adolescents with self-harm risk, list two priority safety steps in the milieu.
Remove sharps/ligatures, increase observation level, collaborative safety planning, and engage caregivers as appropriate.
Medication options for alcohol use disorder aside from disulfiram (name two) and a teaching point.
Naltrexone (oral/LAI) and acamprosate; teaching: check for opioid use before naltrexone, acamprosate requires TID dosing and renal dosing.
Two strategies to build resilience/coping post-trauma.
Strengthen social support, teach grounding/mindfulness, problem-solving skills, and gradual exposure with therapy support.
Valproic acid—two labs and one safety counseling point.
Monitor LFTs and platelets; counsel on hepatic symptoms (abdominal pain, jaundice), pregnancy risks, and drug interactions.
Cultural humility—two practical steps in care.
Ask about preferred language and decision-making customs; use qualified interpreters; avoid assumptions about beliefs.
A patient makes a sexualized comment to the nurse. Therapeutic boundary response?
Set limit respectfully and redirect: “I want to help with your care. That comment is not appropriate. Let’s focus on your treatment plan.”