Approximately how many youths who complete suicide have a preexisting psychiatric illness?

Correct Answer: D

Rationale: In pediatric nursing, understanding the relationship between psychiatric illness and suicide risk is crucial for providing comprehensive care to children and adolescents. The correct answer to the question is D) 90%. This means that the vast majority of youths who complete suicide have a preexisting psychiatric illness. This statistic highlights the critical importance of mental health screening and intervention in this population. Children and adolescents with psychiatric illnesses are at significantly higher risk for suicidal ideation and behaviors, making early identification and treatment essential in preventing tragic outcomes. Option A) 10% is incorrect because research consistently shows a much higher correlation between psychiatric illness and youth suicide. Option B) 30% and option C) 50% also underestimate the prevalence of preexisting psychiatric conditions among youths who die by suicide. Educationally, this question emphasizes the need for pediatric nurses to be vigilant in assessing the mental health of their young patients, especially those with preexisting psychiatric illnesses. It underscores the necessity of integrated care that addresses both physical and mental health needs to promote overall well-being and prevent adverse outcomes like suicide.

Correct Answer: C

Rationale: The correct answer is C) separation anxiety. In this scenario, the child's fear of being injured during transport to school and expressing it to teachers and parents indicates separation anxiety. Separation anxiety is a developmentally normal fear experienced by children when separated from their primary caregivers or familiar surroundings. This fear often manifests as concerns about safety and well-being when apart from their attachment figures. Option A) nonpathological anxiety is incorrect because the child's fear is related to separation from his father and is developmentally appropriate. Option B) school phobia refers to an intense fear or refusal to attend school due to various reasons like social anxiety or specific phobias, which is not the case here. Option D) generalized anxiety disorder involves excessive worry and anxiety about various aspects of life, not just separation from caregivers. Understanding childhood anxiety disorders and their presentations is crucial for pediatric nurses as they play a vital role in early identification, intervention, and support for children and families dealing with such issues. Recognizing separation anxiety helps nurses provide appropriate education and support to both the child and the family to address the underlying concerns and promote healthy coping strategies.

Correct Answer: A

Rationale: The correct answer is A) hypomanic episode. In diagnosing a major depressive episode according to the DSM-5 criteria, the presence of a hypomanic episode would actually indicate a different mood disorder, such as bipolar disorder, rather than major depressive disorder. B) Depressed mood is a key diagnostic criterion for major depressive episode, characterized by feelings of sadness, emptiness, or irritability. C) Loss of interest or pleasure, known as anhedonia, is another hallmark symptom of major depressive episode, where individuals lose interest in activities they once enjoyed. D) Significant weight loss is also a common symptom seen in major depressive episodes, along with changes in appetite, either increase or decrease. In an educational context, understanding the diagnostic criteria for mood disorders is crucial for nurses working with pediatric patients. Recognizing these symptoms can help in early identification, appropriate referral, and intervention to support the mental health of children and adolescents. It is important for nurses to be able to differentiate between different mood disorders to provide optimal care and support to their pediatric patients.

Correct Answer: C

Rationale: The most important next action in this scenario is to conduct lead level testing (Option C). Lead exposure has been associated with developmental delays, behavioral problems, and cognitive impairments in children. Children with ASD may be at higher risk for lead exposure due to their behavior patterns, such as pica eating habits. Identifying and addressing lead exposure is crucial in managing the child's overall health and development. Physical examination for dysmorphic features (Option A) may be important in assessing for certain genetic disorders but is not the most pressing concern in this case. Hearing tests (Option B) are important but are not the priority given the child's specific symptoms and risk factors. Wood's lamp (Option D) is used to assess for certain skin conditions and is not relevant to the child's presentation of delayed speech and behavioral concerns. In an educational context, this question highlights the importance of considering environmental factors and potential comorbidities in children with developmental disorders like ASD. It underscores the need for a comprehensive approach to assessment and management that takes into account the specific needs and risks of each individual child. By understanding the rationale behind prioritizing lead level testing in this case, healthcare providers can improve their ability to provide holistic and effective care for children with ASD.

Correct Answer: A

Rationale: In pediatric nursing, it is crucial to understand the safety considerations when administering drugs to breastfeeding mothers. The correct answer, psychotropic drugs (Option A), can be given with caution to breastfeeding mothers due to their relatively low transfer into breast milk and established safety profiles in lactation. Psychotropic drugs such as selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed to nursing mothers with minimal adverse effects on the infant. Amphetamines (Option B) are not recommended during breastfeeding due to their potential for significant transfer into breast milk, leading to adverse effects on the infant's central nervous system and potential for stimulation. Bromocriptine (Option C) is contraindicated in breastfeeding mothers as it has been associated with severe adverse effects in infants, including respiratory distress and seizures. Methimazole (Option D) is also not recommended during breastfeeding as it can accumulate in the infant's thyroid gland, leading to potential hypothyroidism. Educationally, understanding the compatibility of medications with breastfeeding is essential for pediatric nurses to provide safe and effective care to both the mother and the infant. It is crucial to assess the risks and benefits of medications, consider alternative treatment options, and consult with healthcare providers to ensure the well-being of the breastfeeding dyad. This knowledge empowers nurses to advocate for evidence-based care and promote maternal and infant health during the breastfeeding period.