A 10-year-old child, who has been placed in a foster home after being removed from parental
contact because of abuse, demonstrates a high level of apprehension and overreaction to
environmental stimuli.
The foster parents ask the nurse what measures they can use to help the child.
The nurse should recommend (more than one answer may be correct)
A. using a calm manner and low voice.
B. avoiding repetition in what is said to the child.
C. structuring and maintaining simplicity in the environment.
D. minimizing opportunities for exercise and play.
E. explaining and reinforcing reality to avoid distortions.
ANS:
A, C, E
Rationale: The child can be hypothesized to have moderate to severe trait (chronic) anxiety. A calm
manner will calm the child. A simple, structured, predictable environment is less anxiety provoking
and will reduce overreaction to stimuli. Calm, simple explanations that reinforce reality validate the
environment. Option B: Repetition is often needed when the individual is unable to concentrate
because of elevated levels of anxiety. Option D: Opportunities for play and exercise should be
provided as avenues to reduce anxiety. Physical movement helps channel and lower anxiety. Play
helps by allowing the child to act out concerns.
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