A nurse is interviewing a mother of two children, ages 5 and 14. ...

[crobinson2013]

A nurse is interviewing a mother of two children, ages 5 and 14. They were in a hotel fire a year ago in which their father was killed. The mother is concerned because the younger child has nightmares.
 
  The older child does not seem to have any problems. What action by the nurse is the most appropriate?
  A.
  Ask the mother about physical injuries to the children.
  B.
  Determine if the mother sought counseling after the fire.
  C.
  Focus the appointment on the younger child only.
  D.
  Inquire if the older child avoids hotels, even on television.

Question 2

A nurse wishes to increase an at-risk child's resilience. What action by the nurse would be most helpful?
 
  A.
  Assist the child in recognizing internal resources.
  B.
  Help the child see that others are worse off.
  C.
  Instruct the child to toughen up.
  D.
  Teach the child therapeutic communication skills.

[Chelseyj.hasty]

Answer to Question 1

ANS: D
The younger child has risk factors for and symptoms of posttraumatic stress disorder (PTSD). Although the mother expresses concerns about only the younger child, the nurse should inquire about the health of the older child too, in order to provide holistic care to this family. There are developmental differences in presenting symptoms, and although nightmares in a younger child might be frequently seen in PTSD, an older child might avoid situations or places that remind him or her of the incident. Information about physical injuries is important to note, but is not the priority 1 year after the fire. PTSD does not appear immediately after an incident, so counseling after the fire may not have prevented the onset of PTSD and certainly would not have identified its presence.

Answer to Question 2

ANS: A
Resilience is the ability to recognize and use internal or external resources in dealing with adversity. Helping the child see his or her internal resources is a positive step in improving resiliency. Telling the child that others are worse off than he or she is or that he or she should toughen up is dismissive and not helpful. Teaching appropriate communication is important, but children do not need therapeutic communication skills.

[crobinson2013]

Excellent

[kusterl]

TYSM