The school nurse is caring for a 7-year-old child who has demonstrated a significantly lower-than-average score for mental age on standardized tests in reading. However, the child's IQ scores were within the average range. The nurse interprets this information as suggesting which of the following?

Correct Answer: D

Rationale: The correct answer is D: Dyslexia. Dyslexia is a learning disorder that affects reading ability despite average intelligence. In this case, the child's significantly lower-than-average mental age in reading but average IQ scores indicate a specific difficulty with reading and language processing, which aligns with dyslexia. A: Communication disorder does not specifically address the reading difficulties. B: Attention deficit hyperactivity disorder does not directly relate to the child's reading challenges. C: Asperger syndrome is a developmental disorder primarily affecting social interaction and communication, not reading skills.

Correct Answer: B

Rationale: The correct answer is B. Peplau's interpersonal theory emphasizes the importance of nurse-patient relationships and therapeutic communication. Using assertive communication helps build trust, address the patient's needs, and promote a therapeutic relationship. Rewarding desired behaviors (A) is behaviorist in nature and does not address the underlying emotional issues. Changing the patient's self-concept (C) is a long-term process that may not be appropriate for immediate care. Administering medications (D) may provide temporary relief but does not address the underlying emotional issues or promote therapeutic communication.

Correct Answer: D

Rationale: The correct answer is D: Social Isolation related to fear of recurrence of anxiety symptoms. This is the priority nursing diagnosis for the client because her inability to leave the house due to fear of another panic attack has led to significant social isolation. This isolation can exacerbate her anxiety and impact her overall well-being. By addressing social isolation, the nurse can help the client reconnect with the community and support systems, which is crucial for managing panic disorder. Choice A (Powerlessness related to symptoms of anxiety) is incorrect because while the client may feel powerless, the immediate concern is the social isolation impacting her daily functioning. Choice B (Decisional Conflict related to fear of leaving the house) is incorrect as the client's issue is more about the consequences of not leaving the house rather than a decisional conflict. Choice C (Ineffective Family Coping related to symptoms of anxiety) is also incorrect as the focus should be on the client's own coping mechanisms and isolation rather than the family's coping strategies.

Correct Answer: C

Rationale: The correct answer is C: Antisocial personality disorder. Individuals with antisocial personality disorder have a higher risk for substance abuse due to impulsivity, sensation-seeking behavior, and disregard for societal norms. This disorder is characterized by a lack of empathy and concern for others, leading to risky behaviors such as substance abuse. Mania, panic disorder, and phobias are not typically associated with as high a risk for substance abuse as antisocial personality disorder due to different underlying mechanisms. Mania is associated with impulsive behavior but may not always involve substance abuse. Panic disorder and phobias are anxiety disorders that are more focused on specific fears and avoidance behaviors rather than substance abuse tendencies.

Correct Answer: A

Rationale: The correct answer is A: One effective type of behavioral therapy used for tics is CBIT. This is correct because Comprehensive Behavioral Intervention for Tics (CBIT) is a well-established and evidence-based therapy for managing tics in individuals with tic disorders, including Tourette syndrome. CBIT focuses on teaching individuals techniques to monitor and control their tics through behavioral strategies. Choice B is incorrect because there are treatments available for Tourette syndrome, including medications and behavioral therapies like CBIT. Choice C is incorrect because not all people with tic disorders will have them for their entire lives; some may see improvement over time. Choice D is incorrect because Tourette syndrome typically starts in childhood, usually between the ages of 2 and 12 years old, not after age eighteen.

Correct Answer: B

Rationale: The correct answer is B: The nurse expresses a sense of discomfort and limits behaviors. This is the appropriate intervention because it establishes clear boundaries and communicates the nurse's discomfort while maintaining a therapeutic relationship. By expressing discomfort and setting limits, the nurse asserts their personal space and ensures a safe environment for both parties. Choice A is incorrect because ignoring the behavior doesn't address the issue and may compromise the nurse's well-being. Choice C is incorrect as it passively accepts the invasion of personal space without addressing the discomfort. Choice D is incorrect as it immediately escalates the situation to a confrontational level, which may not be necessary at this stage and could harm the therapeutic relationship.

Correct Answer: C

Rationale: The correct answer is C: Risk for Suicide. Given the patient's presentation of being tearful, previous suicide attempt, inability to concentrate, sleep disturbances, poor appetite, unkempt appearance, low monotone speech, and lack of eye contact, these are all indicative of suicidal ideation and risk. The nurse should prioritize this nursing diagnosis to ensure the patient's safety. A: Ineffective Role Performance does not address the immediate risk of suicide. B: Risk for Infection is not indicated by the patient's symptoms. D: Risk for Self-Mutilation is not the priority as the patient's immediate risk is suicidal behavior.

Correct Answer: B

Rationale: The correct answer is B because asking about hallucinations is crucial for assessing the individual's mental state. Hearing voices that no one else can hear may indicate a psychotic disorder, which could be relevant for an insanity defense. Choice A is irrelevant to legal insanity defense as intellectual deficiency is not the same as legal insanity. Choice C focuses on the crime but does not directly address the individual's mental state. Choice D is also irrelevant to the legal insanity defense as knowing the victim does not determine legal sanity.

Correct Answer: D

Rationale: The correct answer is D because a large group is more effective for dealing with a specific issue due to the diversity of perspectives and experiences that can be shared. In a large group, there are more opportunities for brainstorming, problem-solving, and support. This leads to a richer discussion and more comprehensive exploration of the issue at hand. Choice A is incorrect because transference and countertransference issues can still arise in a large group setting. Choice B is incorrect as group cohesiveness may actually be harder to achieve in a larger group. Choice C is incorrect as a large group offers more potential interactions and relationships, not limited ones.