Question 1

A community nurse approaches the organization's manager wanting to set up screening for risk factors for Tourette's syndrome in children.Which response by the manager is the most appropriate?

Accepted Answer

A)  Allocate funding for a family psychosocial or condition screening. 
B)  Deny the request because Tourette's syndrome has very little impact. 
C)  Explain that Tourette's syndrome is most likely inherited. 
D)  Facilitate cooperative agreements with a community laboratory facility.

Question 2

A child has the possible diagnosis of autism spectrum.While awaiting the results of further testing,which action by the nurse is the most appropriate?

Accepted Answer

A)  Continue to monitor the child for late signs of autism. 
B)  Reassure the parents that concerns are probably not valid. 
C)  Refer the child to audiology to rule out a hearing impairment. 
D)  Wait for results before referring the child to early intervention or a local school program.

Question 3

A father brings his child to the clinic with complaints that the child jumps around,gestures continuously with the hands,and makes grunting noises.He wants to know if the child has attention deficit-hyperactivity disorder (ADHD).What response by the nurse is the most appropriate?

Accepted Answer

A)  "Does your child have risks for obsessive-compulsive disorder?" 
B)  "I don't think so; that sounds more like a tic disorder." 
C)  "Possibly; those are some classic symptoms of ADHD." 
D)  "Yes, that definitely sounds like ADHD to me."

Question 4

A student nurse wants to know what substances adolescents are at highest risk for abusing.Which information is the most appropriate for the pediatric nurse to share with the student?

Accepted Answer

A)  It depends on what is popular at the time in their schools. 
B)  Alcohol and prescription drugs, because they are in most homes. 
C)  Substance abuse varies greatly between age groups and level of school. 
D)  There are no reliable data on substances abused most by adolescents.

Question 5

A pediatric nurse is explaining child abuse and neglect to a class of nursing students.Which information does this nurse provide the students during the presentation?

Accepted Answer

A)  Children with disabilities are at higher risk. 
B)  Diagnosing physical child abuse is easy and quick. 
C)  Each week, about 5 children die from abuse. 
D)  Neglect is most common, but is difficult to identify. 
E)  Unexplained, recurrent conditions may be caused by abuse.

Question 6

The mental health nurse is preparing a presentation for nurses who work with pediatric patients.Which barriers to mental health screening should the nurse include in the presentation?

Accepted Answer

A)  Belief that children do not have psychosocial or conditions 
B)  Family shame related to psychosocial or conditions 
C)  High level of health literacy regarding psychosocial or conditions 
D)  Minimizing of psychosocial or conditions symptoms by health-care providers 
E)  Stigma of psychosocial or conditions in society

Question 7

A pregnant woman asks the nurse how much alcohol must be consumed to put her fetus at risk of fetal alcohol spectrum disorder.What answer by the nurse is the most appropriate?

Accepted Answer

A)  Any alcohol during the third trimester 
B)  Any amount at any time during the pregnancy 
C)  More than 2 drinks/day in the first trimester 
D)  Three or more drinks/day throughout pregnancy

Question 8

A nurse is teaching a class to new mothers who are also high school students.What action by the nurse is the most appropriate in order to decrease the risk of child maltreatment?

Accepted Answer

A)  Explain the laws regarding child abuse and neglect. 
B)  Provide education on normal childhood development. 
C)  Refer all the young mothers to a social service agency. 
D)  Teach the mothers signs and symptoms of abuse.

Question 9

A child has been diagnosed with oppositional defiant disorder (ODD).The parents ask the nurse what risk factors the child has for this disorder.Which response by the nurse is the most appropriate?

Accepted Answer

A)  "I am not sure; you can ask the doctor during your appointment." 
B)  "It seems to be an inherited problem from a recessive gene." 
C)  "The etiology seems to be complex, with multiple causes." 
D)  "Unfortunately, nobody knows what causes this condition."

Question 10

A child with attention deficit-hyperactivity disorder (ADHD)is in the clinic with parents,who complain that even though they are following the treatment plan,the child is not improving.What action can the nurse suggest to improve the effectiveness of the plan?

Accepted Answer

A)  Consult with the school nurse to follow through with behavior logs. 
B)  Ensure the entire family is continuing to keep counseling appointments. 
C)  Reassure the parents that it takes a long time to see changes in behavior. 
D)  Teach the parents about herbal and diet therapies they can try at home.

Question 11

A nurse is working with a family whose child has bipolar disorder.Which item is the most appropriate for the nurse to including in the teaching session for this child and family?

Accepted Answer

A)  Ensure the child follows all house rules; do not give in. 
B)  Instruct family that if mania is uncontrollable, hospitalization is required. 
C)  Protect younger children from sexually aggressive behaviors. 
D)  Provide routine and structure and appropriate freedom.

Question 12

A mother requests information on caring for her child just adopted from a foreign orphanage.The mother has heard of reactive attachment disorder (RAD)and wants to provide an environment that is appropriate for this child.What suggestion by the nurse is the most appropriate?

Accepted Answer

A)  Ignore temper tantrums and crying fits. 
B)  Post a schedule of daily activities such as meals. 
C)  Put the child in psychotherapy. 
D)  Teach the child "stranger danger."

Question 13

A nurse is assessing a child who has a large head,an elongated face,and prominent ears.Which discharge instruction is most important?

Accepted Answer

A)  "Create a family pedigree so I can assess for Down syndrome." 
B)  "Please make an appointment with a pediatric cardiologist." 
C)  "We will call you regarding a referral for genetic testing." 
D)  "You will need to abstain from alcohol in your next pregnancy."

Question 14

When working with immigrant and refugee families,what strategy by the nurse is likely to have the most positive impact?

Accepted Answer

A)  Avoid anticipatory guidance and focus on immediate problems. 
B)  Praise the families often for what they are doing well. 
C)  Refer them to social services agencies that work with immigrants. 
D)  Teach them the laws and customs regarding discipline in the United States.

Question 15

A parent calls the clinic to clarify discharge instructions for his child,who was just diagnosed with major depression.The parent states "I was told to watch for anhedonia.What does that mean?" Which explanation by the nurse is the most appropriate?

Accepted Answer

A)  Flat affect and absence of emotions 
B)  Lack of personal hygiene and grooming 
C)  Loss of interest in activities once enjoyed 
D)  Self-mutilation or engaging in self-harm

Question 16

A nurse is caring for a child with attention deficit-hyperactivity disorder (ADHD).Which medications does the nurse anticipate may be prescribed for this child?

Accepted Answer

A)  Adderall (amphetamine salts) 
B)  Haldol (haloperidol) 
C)  Prozac (fluoxetine hydrochloride) 
D)  Ritalin (methylphenidate hydrochloride) 
E)  Strattera (atomoxetine)

Question 17

A nurse is interviewing a mother of two children,ages 5 and 14.They were in a hotel fire a year ago in which their father was killed.The mother is concerned because the younger child has nightmares.The older child does not seem to have any problems.What action by the nurse is the most appropriate?

Accepted Answer

A)  Ask the mother about physical injuries to the children. 
B)  Determine if the mother sought counseling after the fire. 
C)  Focus the appointment on the younger child only. 
D)  Inquire if the older child avoids hotels, even on television.

Question 18

The nurse is assessing a child for an anxiety disorder.What manifestations noted by the nurse are common to all anxiety disorders?

Accepted Answer

A)  Distress or avoidance of feared situations 
B)  Does not go away or gets worse over time 
C)  Impaired functioning or development 
D)  Leads to avoiding social situations 
E)  Physical symptoms such as palpitations and sweating

Question 19

A mother brings a child to the clinic with concerns about attention deficit-hyperactivity disorder (ADHD).Which behavioral assessment findings support this diagnosis?

Accepted Answer

A)  Compulsive "collecting" 
B)  Inability to stay in chair for a meal 
C)  Nonstop talking 
D)  Refusal to complete homework 
E)  Sleeping whenever possible

Question 20

Parents of a teen diagnosed with schizophrenia report being exhausted and overly stressed.Which action by the nurse is most appropriate?

Accepted Answer

A)  Ask if the parents are getting enough sleep. 
B)  Assess if the family is still in counseling. 
C)  Refer the family to a support organization. 
D)  Request medication to calm the parents.

Exam 22: Caring for the Child With a Psychosocial or Condition