Question 1

An adolescent client who was diagnosed with conduct disorder at the age of 8 is sentenced to juvenile detention after bringing a gun to school. How should the nurse apply knowledge of conduct disorder to this client's situation?

Accepted Answer

A)  Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.
B)  Childhood-onset conduct disorder is caused by a difficult temperament, and the child is likely to outgrow these behaviors by adulthood.
C)  Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5, and therefore improvement is likely.
D)  Childhood-onset conduct disorder has no treatment or cure, and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder. A

Question 2

In planning care for a child diagnosed with autistic disorder, which would be a realistic client outcome?

Accepted Answer

A)  The client will communicate all needs verbally by discharge.
B)  The client will participate with peers in a team sport by day 4.
C)  The client will establish trust with at least one caregiver by day 5.
D)  The client will perform most self-care tasks independently. C

Question 3

An 8-year-old client diagnosed with attention deficit-hyperactivity disorder (ADHD) was admitted 5 days ago for management of temper tantrums. What would be a priority nursing intervention during the termination phase of the nurse-client relationship?

Accepted Answer

A)  Set a contract with the client to limit acting-out behaviors while hospitalized.
B)  Teach the importance of taking fluoxetine (Prozac)  consistently, even when feeling better.
C)  Discuss behaviors that are and are not acceptable on the unit.
D)  Ask the client to demonstrate learned coping skills without direction from the nurse. D

Question 4

A child diagnosed with severe autistic disorder has the nursing diagnosis of disturbed personal identity. Which outcome would best address this client's diagnosis?

Accepted Answer

A)  The client will name own body parts as separate from others by day 5.
B)  The client will establish a means of communicating personal needs by discharge.
C)  The client will initiate social interactions with caregivers by day 4.
D)  The client will not harm self or others by discharge.

Question 5

A preschool child is admitted to a psychiatric unit with a diagnosis of autistic disorder. To help the child feel more secure on the unit, which intervention should a nurse include in this client's plan of care?

Accepted Answer

A)  Encourage and reward peer contact.
B)  Provide consistent caregivers.
C)  Provide a variety of safe daily activities.
D)  Maintain close physical contact throughout the day.

Question 6

Which of the following risk factors noted during a family history assessment should a nurse associate with the potential development of mental retardation? (Select all that apply.)

Accepted Answer

A)  A family history of Tay-Sachs disease
B)  Childhood meningococcal infection
C)  Deprivation of nurturance and social contact
D)  History of maternal multiple motor and verbal tics
E)  A diagnosis of maternal major depressive disorder

Question 7

Which should be the priority nursing intervention when caring for a child diagnosed with conduct disorder?

Accepted Answer

A)  Modify the environment to decrease stimulation and provide opportunities for quiet reflection.
B)  Convey unconditional acceptance and positive regard.
C)  Recognize escalating aggressive behaviors and intervene before violence occurs.
D)  Provide immediate positive feedback for appropriate behaviors.

Question 8

After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss?

Accepted Answer

A)  The pharmacological action of Ritalin causes a decrease in appetite.
B)  Hyperactivity seen in ADHD causes increased caloric expenditure.
C)  Side effects of Ritalin cause nausea; therefore, caloric intake is decreased.
D)  Increased ability to concentrate allows the client to focus on activities rather than food.

Question 9

A nursing instructor presents a case study in which a 3-year-old child is in constant motion and is unable to sit still during story time. The instructor asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation?

Accepted Answer

A)  "This child's behavior must be evaluated according to developmental norms."
B)  "This child has symptoms of attention deficit hyperactivity disorder."
C)  "This child has symptoms of the early stages of autistic disorder."
D)  "This child's behavior indicates possible symptoms of oppositional defiant disorder."

Question 10

Which behavioral approach should a nurse utilize when caring for children diagnosed with disruptive behavior disorders?

Accepted Answer

A)  Involving parents in designing and implementing the treatment process
B)  Reinforcing positive actions to encourage repetition of desired behaviors
C)  Providing opportunities to learn appropriate peer interactions
D)  Administering psychotropic medications to improve quality of life

Question 11

A 6-year-old client is prescribed methylphenidate (Ritalin) for a diagnosis of attention deficit-hyperactivity disorder (ADHD). When teaching the parents about this medication, which nursing statement explains how Ritalin works?

Accepted Answer

A)  "Ritalin's sedation side effect assists children by decreasing their energy level."
B)  "How Ritalin works is unknown.It is a stimulant; however, it does combat the symptoms of ADHD."
C)  "Ritalin helps the child focus by decreasing the amount of dopamine in the basal ganglia and neuron synapse."
D)  "Ritalin decreases hyperactivity by increasing serotonin levels."

Question 12

A preschool child diagnosed with autistic disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate?

Accepted Answer

A)  Place client in restraints until the aggression subsides.
B)  Sedate the client with neuroleptic medications.
C)  Hold client's head steady and apply a helmet.
D)  Distract the client with a variety of games and puzzles.

Question 13

A nursing instructor is teaching about pharmacological treatments for attention deficit-hyperactivity disorder (ADHD). Which information about atomoxetine (Strattera) should be included in the lesson plan?

Accepted Answer

A)  Strattera, unlike methylphenidate (Ritalin) , is a central nervous system depressant.
B)  When taking Strattera, a client should eliminate all red food coloring from the diet.
C)  Strattera will be a life-long intervention for clients diagnosed with this disorder.
D)  Strattera, unlike methylphenidate (Ritalin) , is a selective norepinephrine reuptake inhibitor.

Question 14

When planning care for a client, which medication classification should a nurse recognize as effective in the treatment of Tourette's syndrome?

Accepted Answer

A)  Neuroleptic medications
B)  Antimanic medications
C)  Tricyclic antidepressant medications
D)  Monoamine oxidase inhibitor medications

Question 15

A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first?

Accepted Answer

A)  A client diagnosed with oppositional defiant disorder being sexually inappropriate with staff
B)  A client diagnosed with conduct disorder who is verbally abusing a peer in the milieu
C)  A client diagnosed with conduct disorder who is demanding special attention from staff
D)  A client diagnosed with attention deficit disorder who has a history of self-mutilation

Question 16

The nurse should recognize which of the following findings contribute to a client's development of attention deficit-hyperactivity disorder (ADHD)? (Select all that apply.)

Accepted Answer

A)  The client's father was a smoker.
B)  The client was born 7 weeks premature.
C)  The client is lactose intolerant.
D)  The client has a sibling diagnosed with ADHD.
E)  The client has been diagnosed with dyslexia.

Question 17

Which nursing intervention should be prioritized when caring for a child diagnosed with mild mental retardation?

Accepted Answer

A)  Encourage the parents to always prioritize the needs of the child.
B)  Modify the child's environment to promote independence and encourage impulse control.
C)  Delay extensive diagnostic studies until the child is developmentally mature.
D)  Provide one-on-one tutorial education in a private setting to decrease overstimulation.

Question 18

A client has an IQ of 47. Which nursing diagnosis best addresses a client problem associated with this degree of mental retardation?

Accepted Answer

A)  Risk for injury R/T self-mutilation
B)  Altered social interaction R/T nonadherence to social convention
C)  Altered verbal communication R/T delusional thinking
D)  Social isolation R/T severely decreased gross motor skills

Question 19

Which finding should a nurse expect when assessing a child diagnosed with separation anxiety disorder?

Accepted Answer

A)  The child has a history of antisocial behaviors.
B)  The child's mother is diagnosed with an anxiety disorder.
C)  The child previously had an extroverted temperament.
D)  The child's mother and father have an inconsistent parenting style.

Question 20

A child diagnosed with attention deficit-hyperactivity disorder (ADHD) is having difficulty completing homework assignments. What information should the nurse include when teaching the parents about task performance improvement?

Accepted Answer

A)  The parents should isolate the child when completing homework to improve focus.
B)  The parents should withhold privileges if homework is not completed within a 2-hour period.
C)  The parents should divide the homework task into smaller steps and provide an activity break.
D)  The parents should administer an extra dose of methylphenidate (Ritalin)  prior to homework.

Exam 23: Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence