Chapter 23

A 14-year-old girl is being treated for conduct disorder. She refuses to attend class today, stating that yesterday the other nurse told her she did not have to go to class if she did not want to. Which would be the best response by the nurse?

"Missing class is against the rules."

Which are most likely included in the history of a child with conduct disorder? Select all that apply.

Disturbed relationships with peers Aggression toward people or animals Destruction of property Serious violation of rules

Which is likely to be most effective for adolescents with conduct disorder?

Early intervention

The nurse is using limit setting with a child diagnosed with conduct disorder. Which statement reflects the most effective way for the nurse to set limits with the child?

'That is not allowed here. You will lose a privilege. You need to stop."

The nurse understands that when working with a child with a disruptive behavior disorder, the family must be included in the care. Which is one of the best ways the nurse can advocate for the child?

Teach the parents age-appropriate expectations of the child.

A child is expelled from school for repeated fighting and vandalizing school property. The school nurse and counselor meet with the parents to explain that the child may benefit from counseling and are formulating a collaborative plan. The child is experiencing signs of which of the following disorder?

Conduct disorder

Which is an effective way for parents to deal with problem behaviors in children and to prevent later development of conduct disorders?

Group-based parenting classes

The client was brought to the clinic after breaking out several windows. The nurse questions the client regarding this action. The nurse knows which disorder is exemplified by vandalism, conning others, running away from home, verbal bullying and intimidation, drinking alcohol, and sexual promiscuity?

Moderate conduct disorder

A child has been displaying behaviors associated with conduct disorder. As the nurse evaluates these behaviors she will further assess for which common risk factors seen in children with conduct disorder? Select all that apply.

Poor family functioning Family history of substance abuse Possible child abuse Poverty conditions

The nurse is meeting with a family of a client with conduct disorder. The nurse discusses changes the parents can make to help their child change problematic behaviors. Which parenting technique would the nurse encourage the parents to use?

Provide consistent consequences for behaviors.

Which are important points for the nurse to consider when working with clients with disruptive behavior disorders and their families? Select all that apply.

Remember to focus on the client's strengths and assets, as well as their problems. Avoid a "blaming" attitude toward clients and/or families. Focus on positive actions to improve situations and/or behaviors.

When presenting information about conduct disorders to a community group, the nurse is asked, "Which is the best setting for care of a client with conduct disorders when parents cannot provide safe, structured environments and adequate supervision for the client?" Which would be the most appropriate reply by the nurse?

Residential treatment settings

Which steps are involved in limit setting? Select all that apply.

State expected behavior. Inform clients or the rule or limit. Explain the consequences if clients exceed the limit.

The nurse is assessing an adolescent client. The father is in the room and answers most of the questions, even though the questions are directed at the client. Which of the following actions from the parents of a child with conduct disorders may contribute to the problems of the child? Select all that apply.

The parents may not behave appropriately themselves because of a lack of knowledge. The parents blame the school when the child causes a disturbance in school and receives detention. The parents engage in yelling at, hitting, or simply ignoring the behavior of their child.

The adolescent client is exhibiting "bullying behaviors". Which of the following may be concerns that a nurse has when caring for clients who have conduct disorders? Select all that apply.

Thinking that the client should be able to refrain from hostility and aggression through use of will power. Having conflicted feelings regarding holding clients accountable for their behaviors without having a punitive attitude. Having anxiety and fears for the nurse's personal safety.

Which is true of the time-out strategy that may be used for persons with conduct disorder?

Time-out is retreat to a neutral place, so clients can regain self-control.

Which is the most important reason for the nurse who cares for children with conduct disorders to discuss feelings, fears, or frustrations with colleagues?

To keep negative emotions from interfering with the ability to provide care to clients with problems with aggression.

The nurse has been working with the family of a small child with oppositional defiant disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best nursing action at this time?

Try to remember that the parents are trying to the best of their ability to carry out the suggestions.

A pre-teen client has been considered a neighborhood bully for several years. Peers avoid him, and the mother says she cannot believe a thing he tells her. Recently, the client was observed shooting at several dogs with a pellet gun and setting fire to a vacant lot for the first time. A nurse would assess these behaviors as being most consistent with which disorder?

conduct disorder

After being arrested for prostitution, an adolescent client has been referred to a mental health clinic by a juvenile officer. The client has a history of truancy and being physically abusive to siblings. From the history gathered during assessment, the nurse might anticipate which diagnosis?

conduct disorder

A client has been referred to a mental health center by a juvenile court after being arrested for vandalism. At the mental health center, the client refuses to participate in scheduled activities. The client was seen pushing another client, causing the person to fall. Which approach by nursing staff would be most therapeutic?

establishing firm limits

A young client, diagnosed with oppositional defiant disorder, becomes angry and defiant over the rules of the day treatment program. The client is shouting at the nurse. Which action by the nurse can help defuse the situation?

suggesting that the client go to the gym and shoot baskets

When a young client is disruptive, the nurse responds, "You must take a time-out." What is the expectation of a client during a time-out?

to sit in a designated place until able to regain self-control and review the episode