CPEN Psychosocial Emergencies 5 — Questions and Answers
Question 1: A nurse is caring for a 10-year-old brought in after witnessing his sibling's drowning death. Which intervention BEST supports the child's immediate psychological needs?
- Encourage the child to suppress emotions to stay strong for the family
- Provide a calm presence, validate feelings, and allow the child to express emotions at his own pace (Correct answer)
- Immediately refer the child for formal grief counseling before discharge
- Avoid discussing the event to prevent re-traumatization
Correct answer: Provide a calm presence, validate feelings, and allow the child to express emotions at his own pace
Providing a calm, validating presence and allowing the child to set the emotional pace supports healthy acute grief and reduces trauma responses.
Question 2: An 8-year-old with selective mutism is brought to the ED for an unrelated injury. Which approach BEST facilitates communication during assessment?
- Insist the child speak verbally so the assessment can proceed
- Allow the child to communicate through writing, drawing, or pointing (Correct answer)
- Speak only to the parent and exclude the child from all interactions
- Document the child as uncooperative and proceed without assessment
Correct answer: Allow the child to communicate through writing, drawing, or pointing
Offering alternative communication methods such as writing, drawing, or pointing respects the child's condition and enables effective assessment.
Question 3: A 15-year-old presents after being cyberbullied and expresses passive suicidal ideation ('I wish I were dead'). The nurse's PRIORITY action is:
- Dismiss the statement as typical adolescent drama
- Conduct a structured suicide risk assessment and determine safety plan needs (Correct answer)
- Immediately initiate a 72-hour psychiatric hold
- Contact school officials about the bullying before assessing risk
Correct answer: Conduct a structured suicide risk assessment and determine safety plan needs
Any expression of suicidal ideation requires a structured risk assessment to determine intent, plan, means, and appropriate level of care.
Question 4: Which of the following is a PROTECTIVE factor against suicide completion in adolescents?
- Social isolation
- Strong family connectedness and support (Correct answer)
- Access to firearms in the home
- History of previous self-harm
Correct answer: Strong family connectedness and support
Strong family connectedness is one of the most robust protective factors against adolescent suicide, buffering the impact of stressors.
Question 5: A 5-year-old is brought to the ED after disclosing abuse. The caregiver who may be the abuser is in the waiting room. According to mandated reporter obligations, the nurse should:
- Wait for the physician to make the report to child protective services
- Immediately report suspicion of abuse to child protective services as required by law (Correct answer)
- Confront the suspected abuser before making a report
- Consult the hospital attorney before taking action
Correct answer: Immediately report suspicion of abuse to child protective services as required by law
Nurses are mandated reporters and are legally required to immediately report suspected child abuse to child protective services regardless of physician involvement.
Question 6: A 12-year-old with generalized anxiety disorder presents to the ED with palpitations, shortness of breath, and trembling. After cardiac and respiratory causes are ruled out, the nurse explains that her symptoms are most likely caused by:
- Hypoglycemia triggered by stress
- Physiological arousal from the anxiety response activating the sympathetic nervous system (Correct answer)
- A conversion disorder
- Malingering to avoid school
Correct answer: Physiological arousal from the anxiety response activating the sympathetic nervous system
Anxiety activates the sympathetic nervous system, producing somatic symptoms including palpitations, dyspnea, and trembling through the fight-or-flight response.
Question 7: Which of the following is the MOST appropriate way to involve parents in the care of a suicidal adolescent in the ED?
- Exclude parents from all discussions to protect the adolescent's confidentiality completely
- Include parents in safety planning while balancing the adolescent's need for appropriate confidentiality (Correct answer)
- Allow parents to manage all care decisions without adolescent input
- Instruct parents to monitor the adolescent 24/7 without professional guidance
Correct answer: Include parents in safety planning while balancing the adolescent's need for appropriate confidentiality
Collaborative safety planning that includes parents while respecting developmentally appropriate confidentiality improves adherence and outcomes.
CPEN Psychosocial Emergencies 5
A nurse is caring for a 10-year-old brought in after witnessing his sibling's drowning death.
Which intervention BEST supports the child's immediate psychological needs?