A distraught mother brings her ten-year-old-son to the pediatrician and explains that no matter how much she tries to encourage her son to read books, he shows no interest and gets really upset when she pushes him to have reading time. In school, he gets average grades and explains that he gets frustrated because the schoolwork makes no sense. What diagnosis would the nurse suspect?

Correct Answer: D

Rationale: The correct answer is D: dyslexia. Dyslexia is a specific learning disability that affects reading and related language-based processing skills. In this case, the child's lack of interest in reading, frustration with schoolwork, and difficulty understanding the material points towards dyslexia. Dysphagia (choice A) is difficulty swallowing, not related to reading. Dyscalculia (choice B) is a learning disability related to math, not reading. Dysgraphia (choice C) is a learning disability related to writing, not reading. Therefore, based on the symptoms described, dyslexia is the most likely diagnosis.

Correct Answer: B

Rationale: Step 1: Asking "What brings you into the hospital today?" is most helpful as it allows the patient to express their immediate concerns and reasons for admission. Step 2: This question helps establish rapport, gather important information, and set the tone for the assessment. Step 3: Understanding the patient's presenting issues is crucial for providing appropriate care and intervention. Step 4: The other options are not as relevant for the initial assessment as they focus on past psychiatric history, suicidal ideation, or unrelated personal relationships. Summary: Option B is the correct choice as it focuses on the current situation, which is crucial for the initial assessment, while the other options are less relevant for gathering immediate, pertinent information.

Correct Answer: A

Rationale: The correct answer is A: Establish trust and rapport. Patient-centered interview techniques focus on building a trusting relationship with the patient, which is crucial when discussing sensitive topics like abuse. Sitting near the patient helps create a sense of closeness and comfort, facilitating open communication. Trust and rapport are essential for the patient to feel safe enough to disclose abuse. Asking lots of questions (B) may feel intrusive and overwhelming for the patient. Interrupting the patient's story (C) can disrupt the flow and hinder the patient's ability to express themselves fully. Utilizing closed-ended questions (D) may limit the information shared and inhibit a deeper understanding of the patient's situation.

Correct Answer: A

Rationale: The correct answer is A: Oral. Suspicion and manipulation are traits associated with fixation at the oral stage, according to Freud's psychosexual development theory. At this stage, the primary focus is on oral activities such as sucking and biting. Fixation can lead to traits like suspicion and manipulation. The other choices are incorrect because they correspond to different stages: B) Anal relates to issues with control and orderliness, C) Phallic relates to Oedipus complex and gender identity, and D) Genital is the mature stage where healthy relationships are formed.

Correct Answer: C

Rationale: The correct answer is C: Nonfatal act with the intent to die. Parasuicide refers to self-harming behaviors that are not fatal but are carried out with the intention of causing harm or death to oneself. This differs from a voluntary act of killing oneself (Option A), as parasuicide does not result in death. It also differs from all suicide-related behaviors and thoughts (Option B), as parasuicide specifically involves nonfatal actions. Finally, it is distinct from a voluntary attempt without death as the aim (Option D), as parasuicide is characterized by the intent to die, even though death may not occur.