Chapter 17: Health Problems of School-Age Children and Adolescents

The nurse is teaching the parents of a child recently diagnosed with ADHD who has been prescribed methylphenidate (Ritalin). Which of the following should the nurse include in teaching about the side effects of methylphenidate? a. "Your child may experience a sense of nervousness." b. "You may see an increase in your child's appetite." c. "Your child may experience daytime sleepiness." d. "You may see a decrease in your child's blood pressure."

a. "Your child may experience a sense of nervousness." Nervousness is one of the common side effects of Ritalin.

A 9-year-old child has just been diagnosed with recurrent abdominal pain (RAP). Which of the following should the nurse include in preparing the family for discharge? (Select all that apply.) a. "Your child should be on a high-fiber diet." b. "You may give your child a stimulant laxative once a week." c. "You should help your child with bowel training to establish regular bowel habits." d. "Your child may place ice packs on the abdomen when pain occurs."

ANS: A, C A high-fiber diet with possible addition of bulk laxatives is beneficial in children with RAP. Bowel training is recommended to assist the child in establishing regular bowel habits.

An adolescent girl tells the nurse that she is very suicidal. The nurse asks her if she has a specific plan. Asking this should be considered which of the following? a. An appropriate part of the assessment b. Not a critical part of the assessment c. Suggesting that the adolescent needs a plan d. Encouraging the adolescent to devise a plan

a. An appropriate part of the assessment Routine health assessments of adolescents should include questions that assess the presence of suicidal ideation or intent. Questions such as "Have you ever developed a plan to hurt yourself or kill yourself" should be part of that assessment.

Which of the following is the most commonly used method in completed suicides? a. Firearms b. Drug overdose c. Self-inflected laceration d. Carbon monoxide poisoning

a. Firearms Firearms are the most commonly used instruments in completed suicides among both males and females. For adolescent boys, firearms are followed by hanging and overdose. For adolescent females, overdose and strangulation are the next most common means of completed suicide.

A mother calls the school nurse saying that her daughter has developed a school phobia. She has been out of school 3 days. The nurse's recommendations should include which of the following? a. Immediately return child to school. b. Explain to child that this is the last day she can stay home. c. Determine cause of phobia before returning child to school. d. Seek professional counseling before forcing child to return to school.

a. Immediately return child to school. The primary goal is to return the child to school. Parents must be convinced gently, but firmly, that immediate return is essential and that it is their responsibility to insist on school attendance.

What is the most significant factor in distinguishing those who commit suicide from those who make suicidal attempts or threats? a. Social isolation b. Level of stress c. Degree of depression d. Desire to punish others

a. Social isolation Social isolation is a significant factor in distinguishing adolescents who will kill themselves from those who will not. It is also more characteristic of those who complete suicide than of those who make attempts or threats.

Which of the following statements is true concerning adolescent suicide? a. A sense of hopelessness and despair are a normal part of adolescence. b. Gay and lesbian adolescents are at a particularly high risk for suicide. c. Problem-solving skills are of limited value to the suicidal adolescent. d. Previous suicide attempts are not an indication of risk for completed suicides.

b. Gay and lesbian adolescents are at a particularly high risk for suicide. A significant number of teenage suicides occur among homosexual youths. Gay and lesbian adolescents who live in families or communities that do not accept homosexuality are likely to suffer low self-esteem, self-loathing, depression, and hopelessness as a result of a lack of acceptance from their family or community.

Correct terminology is necessary in understanding substance abuse. Physical dependence is which of the following? a. Problem that occurs in conjunction with addiction b. Involuntary physiologic response to drug c. Culturally defined use of drugs for purposes other than accepted medical purposes d. Voluntary behavior based on psychosocial needs

b. Involuntary physiologic response to drug Physical dependence is an involuntary response to the pharmacologic characteristics of drugs such as opioids or alcohol.

Which of the following is descriptive of attention deficit hyperactivity disorder (ADHD)? a. Manifestations exhibited are so bizarre that the diagnosis is fairly easy. b. Manifestations affect every aspect of the child's life but are most obvious in the classroom. c. Learning disabilities associated with ADHD eventually disappear when adulthood is reached. d. Diagnosis of ADHD requires that all manifestations of the disorder be present.

b. Manifestations affect every aspect of the child's life but are most obvious in the classroom. ADHD affects every aspect of the child's life, but the disruption is most obvious in the classroom.

The psychologic effects of being obese during adolescence include which of the following? a. Sexual promiscuity b. Poor body image c. Feelings of contempt for thin peers d. Accurate body image but self-deprecating attitude

b. Poor body image Common emotional consequences of obesity include poor body image, low self-esteem, social isolation, and feelings of depression and isolation.

Which of the following is a characteristic of children with depression? a. Increased range of affective response b. Preoccupation with need to perform well in school c. Change in appetite, resulting in weight loss or gain d. Tendency to prefer play instead of schoolwork

c. Change in appetite, resulting in weight loss or gain Physiologic characteristics of children with depression include change in appetite resulting in weight loss or gain, nonspecific complaints of not feeling well, alterations in sleeping pattern, insomnia or hypersomnia, and constipation.

Which of the following is an important consideration when the nurse is discussing enuresis with the parents of a young child? a. Enuresis is more common in girls than in boys. b. Enuresis is neither inherited nor has a familial tendency. c. Organic causes that may be related to enuresis should be considered first. d. Psychogenic factors that cause enuresis persist into adulthood.

c. Organic causes that may be related to enuresis should be considered first. Organic causes that may be related to enuresis should be ruled out before psychogenic factors are considered.

Anorexia nervosa may best be described as which of the following? a. Occurs most frequently in adolescent males b. Occurs most frequently in adolescents from lower socioeconomic groups c. Results from a posterior pituitary disorder d. Results in severe weight loss in the absence of obvious physical causes

d. Results in severe weight loss in the absence of obvious physical causes The etiology of anorexia remains unclear, but a distinct psychologic component is present. The diagnosis is based primarily on psychologic and behavioral criteria.