Comprehensive exams for Mental Health Q 169
Jennifer, an adolescent who is depressed and reported by her parents as having difficulty in school is brought to the community mental health center to be evaluated. Which of the following other health problems would the nurse suspect?
A. Anxiety disorder
B. Behavioral difficulties
C. Cognitive impairment
D. Labile moods
Correct Answer: B. Behavioral difficulties
Adolescents tend to demonstrate severe irritability and behavioral problems rather than simply a depressed mood. A failure to follow the expected trajectory of social-emotional development can lead to undetected mental and emotional health problems. Adverse childhood experiences can alter development significantly. Thus, alongside screening for child development, actively screening for family dysfunction and supporting families in establishing a healthy nurturing environment is vital.
Option A: Anxiety disorder is more commonly associated with small children rather than with adolescents. By having a thorough knowledge of developmental pathways and adverse childhood experiences, and having a close follow up established with families in the medical home, pediatricians and medical professionals are in a prime position to identify risk factors and developmental delays timely.
Option C: Cognitive impairment is typically associated with delirium or dementia. Medical professionals taking care of children should begin with identifying and addressing the family’s concerns, asking open-ended questions regarding social-emotional milestones and intentionally observing parent-child interaction and child’s interaction with the environment including themselves. While examining the patient, they should observe age-appropriate developmental interaction. They should give teenagers the opportunity to engage in health visits in a private and safe environment without a caregiver.
Option D: Labile mood is more characteristic of a client with cognitive impairment or bipolar disorder. The American Academy of Pediatrics (AAP) and Bright Futures Guidelines for Health Supervision of Infants, Children, and Adolescents emphasize active screening for developmental delays and environmental risk factors on top of clinical surveillance. This includes the use of standardized screening tools for social-emotional development and for environmental risks appropriate to the risk level of the population you serve.