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Walkthrough: Psychosocial Integrity Q4

by Rhonda Lawes

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    00:01 The school nurse identifies a school-age client who is experiencing adverse childhood events in the home.

    00:09 After an extensive assessment of the client's home, which situation does the nurse identify as an associated protective factor? Whoo. Okay, lots of words here. So what's our strategy? One sentence at a time.

    00:24 So let's dig in. Deal with the first sentence.

    00:27 The school nurse, this tells me what type of nurse I am, identifies a school-aged client that tells me, "I have a six to 12 year old ish child," who was experiencing an adverse childhood event.

    00:43 Okay, so things are not going well in the home.

    00:46 This is something that is adverse, right? Okay, so, school nurse, school-aged kid having an adverse childhood event in their home? After an extensive assessment of the client's home, which situation does the nurse identify as an associated protective factor? Okay, so this means I'm a school nurse, school-aged child, they have an adverse childhood event.

    01:12 Now I do an extensive assessment after that assessment, this question is going to give me options that I need to identify as what? Those last three words of the sentence.

    01:25 Even if you've never heard this terminology before, relax, I always tell people, "Don't panic. It's going to be okay." You know, a lot of stuff you have worked hard in nursing school, just look at the words together, and kind of put together what you think this could be.

    01:41 This says associated, that means to be with protective, you know that word, keep you safe. Factor.

    01:50 So that's what I'm looking for.

    01:52 I'm actually looking for which one of these events or situations will be an associated protective factor.

    02:00 So when you see the four options come up in just a minute, you're going to ask yourself: Number one.

    02:06 Is this unassociated protective factor? Yes or no? Number two.

    02:11 Is this an associated protective factor? Yes or no? Number three.

    02:17 Is this an associated protective factor? Yes or no? And remember, on every answer choice you want to say, "Why you have that opinion?" Number four.

    02:28 Is this an associated protective factor? Yes or no? And say why you've made that decision.

    02:36 Okay, press pause.

    02:37 I know that you have just the numbers, number one, number two, number three, and number four, on your practice sheet.

    02:43 I want you to eliminate those answer choices and say, why? Then restart the video, and we'll walk through the question.

    02:58 Welcome back. Let's take a look at this.

    03:01 Now, if you've not heard of adverse childhood events before, usually you'll see in the literature ACE, they're called ACEs.

    03:09 What we know about adverse childhood events is it's a scoring system.

    03:12 There's a tool associated with adverse childhood events.

    03:16 The higher the score, the bigger the risk the child has for having chronic health issues and problems throughout their life.

    03:25 So if you haven't studied that yet, in your program, man, take a minute, write in your notebook, look up ACEs, because it is fascinating research.

    03:34 But we're looking for something as an associated protective factor.

    03:39 Am I looking for an ACE? An adverse childhood event? No. The topic says that last sentence, "I'm looking for an associated protective factor." Now looking at number one.

    03:51 The child takes care of two younger siblings.

    03:54 Is that an associated protective factor? No. The child should not be expected to be like the caregiver for two younger siblings.

    04:05 This isn't something that protects the school aged child.

    04:08 This makes it more difficult for them and could be considered an adverse childhood event, depending on the situation.

    04:15 Number two.

    04:17 Is this an associated protective factor? The child attends a youth group meeting each week.

    04:24 Okay, let's look at that. Does that sound like a bad thing? Well, well, no. Because protective factors are positive influence for the kids, right? It helps their mental well being.

    04:36 Now this means it might be a sense of faith, whatever their faith is.

    04:40 Support, a stable family, a trusted adult they can talk to friendships they can count on, and just feeling like they can take care of themselves.

    04:52 Otherwise, it may also be including clubs or sports.

    04:55 So when we're thinking about protective factors, what are these types of things that help children do well and be successful? So if you don't know these, you haven't heard of these before, jot yourself some quick notes.

    05:10 Let's run through them together.

    05:11 They're things that positively influence mental well being.

    05:17 So, would this experience positively influence mental well being? Now think of these in a positive aspect, right.

    05:26 So having a sense of faith.

    05:28 Meaning there's something bigger than themselves.

    05:30 Their family is stable, and they feel supported.

    05:33 They have a trusted adult to confide in.

    05:36 They have reliable friendships.

    05:38 They have a strong sense of being able to do things themselves or self sufficiency.

    05:42 And they might even participate in clubs or sports, feeling like they belong.

    05:47 All of those are examples of protective factors that positively influence mental well being.

    05:54 So with that long definition, I wanted to make sure you had that concept in mind.

    05:59 Number two.

    06:00 Attending a youth group meeting each week.

    06:03 Now, we have no reason to believe that this is not a positive experience.

    06:07 It could be a sign of belonging there.

    06:09 So I'm going to leave number two in.

    06:12 Number three.

    06:13 Is this an associated protective factor? The child's parents divorced when the client was a toddler.

    06:20 No, we know, associated protective factors are things like a stable family.

    06:24 So comparing number two to number three, number two, seems like more of an associated protective factor.

    06:31 The number three, that's why I'm getting rid of number three.

    06:35 Number four.

    06:37 The child reads alone in the library during lunchtime.

    06:42 Then you think like, "Hey, I like to read and I'm fine." No, no, think of it this way. Compare number two to number four.

    06:49 Remember, we're looking for specifically an associated protective factor.

    06:54 And when you find yourself spiring, like, "Well, that's not weird. That shouldn't be a problem." No, stop.

    07:00 Go back to the topic of the question and say, which one of these two answers is more of an associated protective factor than the other one? Because remember, we're looking for something that will positively influence mental well being.

    07:16 So would that be more likely number two? Or number four? It's number two.

    07:23 That's right. So be careful.

    07:25 Don't be Spielberg.

    07:26 Don't make a whole movie that isn't there.

    07:29 And remember, the correct answer in this question was number two.

    07:35 That doesn't mean there's any one answer that is universally correct.

    07:39 Because it always depends on what the other answers are.

    07:42 That's what NCLEX is doing.

    07:44 They're trying to see if you have critical thinking skills, that you can look at options and determine which one is the best option that specifically addresses the topic of the question? All right, keep going.

    07:58 You're getting better at this.

    07:59 Reflect on your process through this question.

    08:02 Did you follow the recommended steps? Did you ask yourself on every one of the answer choices? Is this an associated protective factor? Is this an associated protective factor? Did you eliminate answer choices and say why? Those are the habits I want you to keep practicing.

    08:19 That's what's going to help you really make a difference in your performance.


    About the Lecture

    The lecture Walkthrough: Psychosocial Integrity Q4 by Rhonda Lawes is from the course NCLEX-RN® Question Walkthrough: Psychosocial Integrity.


    Included Quiz Questions

    1. The higher the score on the ACE tool, the higher chance of being at risk for future problems.
    2. The higher the score on the ACE tool, the lower chance of being at risk for future problems.
    3. The lower the score on the ACE tool, the higher chance of being at risk for future problems.
    4. ACE is a diagnosis.
    1. The child's mother died by suicide when the child was aged five.
    2. The child's parents were divorced when the child was 12.
    3. The child is not included in activities by peers at school.
    4. The child fell while riding a bike at age five and developed a concussion.
    1. A child who does well in school.
    2. A child with a mentor.
    3. A child who has strong friendships with peers.
    4. A child whose parents have unsteady unemployment.
    5. A child whose parents cannot provide three meals every day.
    1. A child whose parents are drug addicts and can't support the child's basic needs.
    2. A child whose parents are poor but the child's basic needs are met.
    3. A child supported by a mentor, involved in activities, and has their basic needs met.
    4. A child whose parents work full-time and child has strong friendships at school.

    Author of lecture Walkthrough: Psychosocial Integrity Q4

     Rhonda Lawes

    Rhonda Lawes


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