An adolescent was arrested for prostitution and assault on a parent. The adolescent says, 'I hate my parents. They focus all attention on my brother, who's perfect in their eyes.' Which nursing diagnosis is most applicable?

Correct Answer: C

Rationale: The correct answer is C: Defensive coping related to inappropriate methods of seeking parental attention as evidenced by acting out. This is the most applicable nursing diagnosis because the adolescent is using inappropriate methods (prostitution and assault) to seek attention due to feeling neglected by their parents. The adolescent's behavior is a manifestation of coping with their perceived lack of attention from their parents. A: Disturbed personal identity is incorrect because the primary issue is not related to personal identity but rather seeking attention. B: Hopelessness related to achievement of role identity is incorrect because the main issue is not feeling unloved but seeking attention through negative behaviors. D: Impaired parenting related to inequitable feelings toward children is incorrect as it focuses on the parents' behavior rather than the adolescent's coping mechanism.

Correct Answer: A

Rationale: The correct answer is A: Parent-child interaction therapy (PCIT). PCIT focuses on improving parent-child communication and interactions, teaching parents effective discipline strategies, and enhancing the parent-child relationship. This therapy is specifically designed to help parents manage disruptive behaviors in children, such as conduct disorder (CD). By participating in PCIT, parents can learn skills to respond to rule-breaking behavior in a positive and effective manner, ultimately improving the child's behavior and family dynamics. Incorrect choices: B: Behavior modification therapy focuses on changing specific behaviors through reinforcement and punishment, but may not address the underlying parent-child relationship issues. C: Multi-systemic therapy (MST) targets various systems influencing the adolescent's behavior, but may not directly address the parents' need for guidance on managing rule-breaking behavior at home. D: Pharmacotherapy involves medication treatment, which may be used in conjunction with therapy but does not directly address the parents' need for guidance on responding to rule-breaking behavior.

Correct Answer: C

Rationale: The correct answer is C because reduced gray matter in the cortex and dysfunction of the amygdala can lead to decreased feelings of empathy. The adolescent's lack of remorse for stealing and wrecking the neighbor's motorcycle suggests a deficit in empathy, which is controlled by the amygdala and the cortex. The amygdala is responsible for processing emotions, including empathy, while the cortex plays a role in higher cognitive functions like decision-making and understanding consequences. Dysfunction in these areas can result in a lack of emotional response or understanding of the impact of one's actions, leading to a lack of remorse. Choice A is incorrect because while serotonin dysregulation and increased testosterone activity can affect behavior, they are not directly linked to remorse. Choice B is incorrect as neuron destruction in the hippocampus is associated with memory and learning, not empathy. Choice D is incorrect because disturbances in the occipital lobe are related to visual processing, not empathy or remorse.

Correct Answer: C

Rationale: The correct answer is C: Remains free from injury. This is the first priority because during a manic episode, clients may engage in risky behaviors that can lead to harm. Ensuring the client's safety and preventing injury is crucial before addressing other needs. Choices A, B, and D are important but not as urgent as safety. Maintaining nutritional status, interacting appropriately with peers, and achieving proper sleep can be addressed once the client's safety is ensured.

Correct Answer: C

Rationale: The correct answer is C: Weight gain is a common but troubling side effect. Weight gain is a well-known side effect of lithium, commonly seen in individuals taking this medication for bipolar disorder. It is essential for the nurse to acknowledge the client's concern and provide accurate information about the medication's potential side effects. Choices A, B, and D are incorrect because weight gain is a known side effect of lithium, and denying or downplaying the client's experience could lead to misunderstanding and lack of trust in the healthcare provider.