Chapter 11: Childhood and Neurodevelopmental Disorders
The child prescribed an antipsychotic medication to manage violent behavior is one most likely diagnosed with A. ADHD. B. post-traumatic stress disorder (PTSD). C. communication disorder. D. an anxiety disorder.
ANS: A
Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness? A. The child has been raised by a parent with recurring major depressive disorder. B. The child's best friend was absent from the child's birthday party. C. The child was not promoted to the next grade one year. D. The child moved to three new homes over a 2-year period.
ANS: A
Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders? A. Impaired social interaction related to difficulty maintaining relationships B. Chronic low self-esteem related to excessive negative feedback C. Deficient fluid volume related to abnormal eating habits D. Anxiety related to nightmares and repetitive activities
ANS: A
A child diagnosed with ADHD will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications? A. CNS stimulants B. Tricyclic antidepressants C. Antipsychotics D. Anxiolytics
ANS: A
A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child: A. displays resiliency. B. has a passive temperament. C. is at risk for PTSD. D. uses intellectualization to deal with problems.
ANS: A
Soon after parents announced they were divorcing, a child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, "If my parents loved me, they would work out their problems." Which nursing diagnosis has the highest priority? A. Social isolation B. Decisional conflict C. Chronic low self-esteem D. Disturbed personal identity
ANS: A
Which assessment findings present familial risks for a child to develop a psychiatric disorder? (Select all that apply.) A. Having a mother diagnosed with schizophrenia B. Being the oldest child in a family C. Living with an alcoholic parent D. Being an only child E. Living in an urban community
ANS: A, C
A child reports to the school nurse of being verbally bullied by an aggressive classmate. What is the nurse's best first action? A. Give notice to the chief administrator at the school regarding the events. B. Encourage the victimized child to share feelings about the experience. C, Encourage the victimized child to ignore the bullying behavior. D. Discuss the events with the aggressive classmate.
ANS: B
At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate? (Select all that apply.) A. Report the finding to the official child protection social services agency. B. Educate all members of the family about potential safety risks in online environments. C. Talk with the parents about parental controls on the children's communication devices. D. Encourage the family to schedule daily time together without communication devices. E. Obtain the family's network password and examine online sites family members have visited.
ANS: B, C, D
A nurse prepares to lead a discussion at a community health center regarding children's health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use? (Select all that apply.) A. Autism B. Bullying C. Mental retardation D. Autism spectrum disorder E. Intellectual development disorder
ANS: B, D, E
A child diagnosed with ADHD shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine salts (Adderall). The nurse should monitor for which desired behavior? A. Increased expressiveness in communication with others B. Abilities to identify anxiety and implement self-control strategies C. Improved abilities to participate in cooperative play with other children D. Tolerates social interactions for short periods without disruption or frustration
ANS: C
A desired outcome for a 12-year-old diagnosed with ADHD is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? A. Reality therapy B. Simple restitution C. Social skills group D. Insight-oriented group therapy
ANS: C
A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to: A. promote integration of self-concept. B. provide inpatient treatment for the child. C. reduce loneliness and increase self-esteem. D. improve language and communication skills.
ANS: C
A nurse will prepare teaching materials for the parents of a child newly diagnosed with ADHD. Information will focus on which medication likely to be prescribed? A. Paroxetine B. Imipramine C. Methylphenidate D. Carbamazepine
ANS: C
A nurse works with a child who is sad and irritable because the child's parents are divorcing. Why is establishing a therapeutic alliance with this child a priority? A. Therapeutic relationships provide an outlet for tension. B. Focusing on the strengths increases a person's self-esteem. C. Acceptance and trust convey feelings of security to the child. D. The child should express feelings rather than internalize them.
ANS: C
Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others' conversations. How should the nurse document these behaviors? A. Disobedience B. Hyperactivity C. Impulsivity D. Anxiety
ANS: C
The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate? A. "Perhaps your child was misdiagnosed." B. "Your observation indicates the medication is effective." C. "Tics often change frequency or severity. That doesn't mean they aren't real." D. "This finding is unexpected. How have you been administering your child's medication?"
ANS: C
What is the nurse's priority focused assessment for side effects in a child taking methylphenidate for ADHD? A. Dystonia, akinesia, and extrapyramidal symptoms B. Bradycardia and hypotensive episodes C. Sleep disturbances and weight loss D. Neuroleptic malignant syndrome
ANS: C
When a 5-year-old is disruptive, the nurse says, "You must take a time-out." The expectation is that the child will: A. go to a quiet room until called for the next activity. B. slowly count to 20 before returning to the group activity. C. sit on the edge of the activity until able to regain self-control. D. sit quietly on the lap of a staff member until able to apologize for the behavior.
ANS: C
When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses: A. guided imagery. B. talk focused on a specific issue. C. play and talk about a play activity. D. group discussion about selected topics.
ANS: C
Which behavior indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective? The child: A. plays with one toy for 30 minutes. B. repeats words spoken by a parent. C. holds the parent's hand while walking. D. spins around and claps hands while walking.
ANS: C
Which child demonstrates behaviors indicative of a neurodevelopmental disorder? A. A 4-year-old who stuttered for 3 weeks after the birth of a sibling B. A 9-month-old who does not eat vegetables and likes to be rocked C. A 3-month-old who cries after feeding until burped and sucks a thumb D. A 3-year-old who is mute, passive toward adults, and twirls while walking
ANS: D
A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will (Select all that apply) A. graduate from high school. B. live independently in an apartment. C. independently perform own personal hygiene. D. obtain employment in a local sheltered workshop. E. correctly use public buses to travel in the community.
ANS: C, D, E
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, "What should we do?" Select the nurse's best response. A. "Ask the teacher to let the child call you at play time." B. "Withdraw the child from preschool until maturity increases." C. "Remain with your child for the first hour of preschool time." D. "Give your child a kiss before you leave the preschool program."
ANS: D
A child diagnosed with ADHD had this nursing diagnosis: impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behavior with others. Which finding indicates the plan of care was effective? The child: A. has an improved ability to identify anxiety and use self-control strategies. B. has increased expressiveness in communication with others. C. shows increased responsiveness to authority figures. D. engages in cooperative play with other children.
ANS: D
A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder? The child: A. has occasional toileting accidents. B. interrupts or intrudes on others. C. cries when separated from a parent. D. continuously rocks in place for 30 minutes.
ANS: D
The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behavior is most consistent with diagnostic criteria for A. communication disorder. B. stereotypic movement disorder. C. intellectual development disorder. D. ADHD.
ANS: D
When a 5-year-old diagnosed with ADHD bounces out of a chair and runs over and slaps another child, what is the nurse's best action? A. Instruct the parents to take the aggressive child home. B. Direct the aggressive child to stop immediately. C. Call for emergency assistance from other staff. D. Take the aggressive child to another room.
ANS: D