Exam 3

Question 1

Mental Health in Children/Adolescents

Answer 1

• Correct perception of the environment
• Appropriate interpretation of reality
• Positive self-concept
• Age-appropriate coping with stress & anxiety
• Mastery of developmental tasks
• Spontaneous and creative expression
• Satisfying relationships

Question 2

Resilience

Answer 2

• Adaptability to changes in environment
• Ability to form nurturing relationships with older adults when parent is not available
• Ability to distance self from emotional chaos
• Good social intelligence (understanding and adapting to social cues)
• Good problem-solving skills
• Ability to perceive a long-term future

Question 3

Common issues

Answer 3

• Adolescent risk-taking
• Chronic physical illness
• Separation & divorce
• Sibling relationships
• Physical illness
• Death & grief
• Bullying

Question 4

Communication techniques

Answer 4

• Speak about the present
• Be kind
• Brief, simple language, clear expectations
• Ask direct questions when seeking specific information
• Reinforce conversation with body language
• Be quiet and firm when reinforcing limits

Question 5

Mental health promotion

Answer 5

• Build self-esteem
• Set positive examples
• Involve in community activities
• Provide training as needed
  o Values clarification
  o Problem-solving
  o Social skills
  o Assertiveness
• Include peer role models, teachers, parents, community leaders, etc.

Question 6

Etiology of peds MH disorders

Answer 6

•	Genetic
•	Biochemical
•	Social & environmental:
-	Abuse & neglect; poverty & homelessness; substance abuse; foster care placement; witnessing violence; victim to bullying
•	Traumatic event
•	Cultural
•	Familial risk factors:
-	Severe marital discord; low SES; large families & overcrowding; parental criminality; maternal psychiatric disorders; foster-care

Question 7

Oppositional Defiance Disorder

Answer 7

• Risk Factors:
- Family history of mental illness
- Family dysfunction
- Neurobiological causes
• Nursing Assessment:
- Angry, irritable, argumentative, angry outbursts
- Defiant, vindictive, blames others
- Social/emotional difficulties
• Nursing Interventions:
- Separate unacceptable behavior from personal worth; ensure that patient knows this!
- Be non-judgmental & establish trust
- Identify triggers, explore feelings, decrease stimuli
- Develop rewards for appropriate behavior; reinforce what they do well
- Ignore bad behavior if not harmful (may be attention seeking)
- Develop consequences for non-adherence together
- Teach taking responsibility for behavior
- Teach how to address and cope with negative feelings
- Teach problem solving skills
• Desired Outcome:
- Realization that there are rules & others have rights