A nurse in an outpatient mental health clinic is discussing the development of anxiety-related disorders in children to a group of parents. The nurse should include that which of the following is an adverse childhood experience (ACE) that can contribute to the development of an anxiety disorder?

Correct Answer: C

Rationale: The correct answer is C) Having a physical disability. Adverse Childhood Experiences (ACEs) are traumatic events occurring before the age of 18, which can have lasting negative effects on health and well-being. Children with physical disabilities may experience higher levels of stress, social isolation, and challenges in coping with their condition, leading to an increased risk of developing anxiety disorders. Option A, having a family with a strong social support system, is incorrect because while social support can be protective against the negative effects of stress, it is not considered an adverse childhood experience. Option B, having caregivers who have steady employment, is incorrect as well. While stable employment can contribute to a more secure and supportive environment for a child, it is not an adverse experience in itself. Option D, performing well in school, is also incorrect. Academic achievement is a positive factor and not considered an adverse experience. In fact, it can be a protective factor against developing anxiety disorders. In an educational context, it is crucial for nurses and healthcare professionals to understand the impact of adverse childhood experiences on mental health outcomes. By recognizing and addressing these experiences, healthcare providers can better support children and families in managing and preventing the development of anxiety disorders.

Correct Answer: C

Rationale: In this scenario, the nurse's priority should be option C: Awareness of potential for self-harm. Borderline personality disorder is characterized by impulsivity, emotional instability, and a high risk of self-harm or suicide. By educating the family about the potential for self-harm, the nurse is addressing a critical safety concern and helping the family understand the seriousness of the diagnosis. This information empowers the family to provide a safe environment and intervene effectively in case of a crisis. Option A, providing resources for group therapy, is important for long-term management of borderline personality disorder, but safety concerns must be addressed first. Option B, medication compliance, is relevant but not as immediate as addressing the risk of self-harm. Option D, information about insurance coverage, is important but is not as urgent or critical as ensuring the safety of the client. In an educational context, understanding the priority of addressing immediate safety concerns in clients with borderline personality disorder is crucial for nurses providing care in behavioral health settings. Emphasizing the importance of assessing and managing the risk of self-harm is fundamental to ensuring the well-being of clients with this condition.

Correct Answer: A

Rationale: In clients with dependent personality disorder, the correct finding is that they are fearful of making decisions (Option A). This is because individuals with this disorder typically have an excessive need to be taken care of, which leads to a lack of confidence in their abilities to make decisions independently. This fear of making decisions can manifest in various aspects of their lives, from daily choices to significant life decisions. Options B, C, and D are incorrect for clients with dependent personality disorder. Option B, erratic behaviors, is more commonly associated with conditions like borderline personality disorder or certain mood disorders. Option C, dramatic behaviors, are characteristic of histrionic personality disorder. Option D, easily expressing disagreement with others, is not typical for individuals with dependent personality disorder, as they often avoid conflict and seek approval from others to maintain their sense of security and reliance. Educationally, understanding the specific characteristics and common findings associated with different personality disorders is crucial for nurses in planning effective care. By recognizing these distinctions, nurses can tailor interventions and support strategies to meet the unique needs of clients with various personality disorders, promoting better outcomes and enhancing the therapeutic relationship.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Alzheimer's disease. Cortical thinning is a characteristic feature of Alzheimer's disease, a type of dementia that primarily affects areas of the brain responsible for memory, thinking, and language. This thinning is due to the degeneration and loss of nerve cells in the cerebral cortex over time. Option A) Prion disease is characterized by the accumulation of abnormal prion proteins in the brain, leading to rapid neurological deterioration, but it does not typically present with cortical thinning as seen in Alzheimer's disease. Option C) Substance use disorder primarily affects brain function through the effects of substances on neurotransmitter systems and neural pathways, rather than cortical thinning. Option D) HIV infection can lead to neurocognitive disorders, but cortical thinning is not a typical feature of HIV-related brain changes. Educationally, understanding the specific brain changes associated with different types of dementia is crucial for nurses caring for patients with cognitive impairments. Recognizing cortical thinning as a hallmark of Alzheimer's disease can aid in early detection, appropriate care planning, and effective communication with the healthcare team and family members.

Correct Answer: D

Rationale: The correct answer is D) The fear of abandonment associated with progress toward autonomy and independence. This is the likely trigger for the self-inflicted wrist lacerations in a patient with borderline personality disorder. Individuals with this disorder often have intense fears of abandonment and struggle with feelings of insecurity and instability in relationships. As the patient gains new privileges and moves towards autonomy, the fear of being abandoned or rejected can trigger self-destructive behaviors as a way to cope with overwhelming emotions. Option A) An inherited disorder that manifests itself as an incapacity to tolerate stress, while stress intolerance can be a component of borderline personality disorder, it does not directly address the trigger of abandonment fears. Option B) The use of projective identification and splitting to bring anxiety to manageable levels refers to defense mechanisms that individuals with borderline personality disorder may use, but this does not directly explain the trigger for the self-mutilation. Option C) A constitutional inability to regulate affect, predisposing to psychic disorganization addresses a characteristic of borderline personality disorder but does not specifically link it to the trigger of fear of abandonment. Educationally, understanding the triggers for self-destructive behaviors in individuals with borderline personality disorder is crucial for nurses to provide effective care and support. By recognizing the underlying fears and insecurities, nurses can implement strategies to help patients cope with their emotions and develop healthier ways of managing distress.