Chapter 42

A caregiver of a 10-year-old girl who has a pattern of school success, solid peer relationships and a healthy family life tells the nurse that for the past three weeks the child has complained of abdominal pain and has even vomited and had diarrhea when it has been just about time for her to go to school. The girl says she doesn't feel good, and yet after her mother keeps her home from school, by midmorning the girl is fine. She is also fine on weekends. Which of the following questions would be important for the nurse to first ask the caregiver?

"Have you explored with your child if something is causing her to be afraid to go to school?"

The nurse is discussing health concerns and issues with with a group of caregivers of adolescents. Which of the following statements made by the caregivers would indicate a need for follow-up by the nurse?

"Our daughter has never had any health problems, and now she has developed so many cavities."

The nurse is working with a group of caregivers of school-age children diagnosed with attention deficit hyperactivity disorder. Which of the following statements would be most appropriate for the nurse to make to this group of caregivers?

"The medications your child is on may cause a decreased appetite."

The nurse is working with a group caregivers of children who are diagnosed with autism. Which of the following statements made by the parents shows an example of echolalia?

"When she watches TV and hears a commercial, she repeats one word from the commercial but doesn't seem to understand what she is saying."

The nurse is discussing the use of alcohol with a group of adolescents. One of the teens says that she heard your fine motor control could be affected at low levels of alcohol. Another teen was correct in saying that most states consider a person under the influence of alcohol if the blood alcohol level is which of the following?

0.8%

Infantile autism is usually present at birth, but frequently not diagnosed until which of the following ages?

1 year of age

When weighing and measuring an adolescent whose ideal body weight is 105 pounds, the nurse would identify the child as obese if the child weighs which of the following?

126 pounds

The nurse has gathered the following data on four different children. Which of the following children will likely be further assessed and tested for autism?

A 14-month-old whose reaction to his caregiver leaving him is to calmly repeat the statement, "Bye bye, Will. Bye bye, Will."

The nurse recognizes that which of the following children would be the most likely to fall into the category in which most children attempt or commit suicide?

A 16-year-old boy who has had 12 girlfriends over the past year.

The drug most commonly abused used by children and adolescents is which of the following?

Alcohol

Adolescent athletes sometimes take megadoses of which of the following substances because they believe it will increase their athletic abilities?

Anabolic Steroids

The nurse is working with a group of caregivers of adolescents who have abused substances. One of the caregivers states, "I have heard that some drugs have the effect of causing an excited feeling and it makes the person more social." Which of the following would most likely have the effect this caregiver is describing?

Cocaine

The nurse recognizes in working with children that the child who has polyphagia will likely exhibit which of the following?

Compulsive overeating

The nurse is caring for a child with an eating disorder. Which of the following is the highest priority in treatment of the disorder?

Correct fluid and electrolyte imbalances

Which of the following disorders is a concern in adulthood as well as in childhood for the person who is overweight or obese during childhood?

Diabetes Mellitus

The nurse is collecting data on an adolescent who is brought to the emergency center by the caregivers, who suspect that she has been using substances. The adolescent states that she has not had anything to eat nor any sleep in several days, but that she is nauseated. The nurse observes that she is diaphoretic, clenching her teeth, and complaining of blurred vision. Which of the following substances would this adolescent most likely have been using?

Ecstasy

The nurse is collecting data from the caregiver of an 8-year-old child who recently started soiling his underwear each day rather than using the toilet to defecate. This behavior indicates a symptom of which of the following?

Encopresis

During a routine well-child check the caregiver of a 10-year-old tells the nurse that her child has recently starting passing stool into his underwear. This behavior indicates a symptom of which of the following?

Enuresis

The nurse is doing a presentation on the diagnosis of bulimia to a group of pediatric nurses. Which of the following clinical manifestations would the nurse teach this group to observe for in the adolescent with bulimia?

Hypokalemia

Sixteen-year-old Candace is being seen for a long overdue checkup. Her caregiver has come with her. Candace is calm, pleasant, and in good spirits. The caregiver reports to the nurse that she is relieved because for the past six months Candace has been lethargic, angry, and sad. The mother reports that since she got her driver's license two days earlier, her child's mood has changed dramatically. Rather than resist this appointment, Candace had simply smiled and said, "It won't matter much, but okay, I'll be ready in a minute." The nurse recognizes that the child's seeming well-being and drastic change in behavior should be further investigated to determine which of the following?

If the child is planning to commit suicide.

The nurse is working with a group of caregivers of adolescents who have abused substances. One of the caregivers states, "My son used to do great in school. However, since he started using drugs he has no motivation, he is never on time, and he makes the worst decisions, especially when he is driving." These behaviors indicate that this adolescent was likely using which of the following substances?

Marijuana

The nurse is collecting data for a child diagnosed with nonorganic failure to thrive, and notes that the child voluntarily vomits after eating. This is referred to as which of the following?

Rumination

The nurse is doing a presentation on the diagnosis of anorexia nervosa to a group of pediatric nurses. Which of the following clinical manifestations would the nurse teach this group to observe for in the adolescent with anorexia nervosa?

Soft hairs on their back and arms

Contract agreements are often recommended for patients with eating disorders. In forming a contract with a hospitalized adolescent diagnosed with anorexia nervosa, the nurse should make a point to do which of the following?

Stress to the patient that she is in control of the outcome of her care

The nurse is doing an in-service training with nurses who will be working with children who have concerns with drugs and alcohol. In discussing this topic, one of the nurses says that sometimes a person has a compulsive need to use a substance for its satisfying or pleasurable effects. Which of the following best describes what the nurse is referring to?

Substance abuse

The nurse is collecting data on an 18-month-old old child with a diagnosis of autism. Which of the following clinical manifestations would likely have been noted in the child with this diagnosis?

The child does not respond or talk to the nurse when asked simple questions.

The nurse in the well-child clinic observes that a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, "Oh, yeah," and happily climbs back up. The nurse suspects that which of the following applies to this child?

The child has attention deficit hyperactive disorder.

Which of the following characteristics are commonly noted in the child with anorexia nervosa?

The child has rigid study skills and ritualistic behavior.

The nurse is collecting data on a 16-year-old adolescent girl with the diagnosis of bulimia. Which of the following would the nurse most likely note in this child?

The child is of normal weight for her height according to the growth charts.

The nurse is caring for a 6-month-old infant diagnosed with nonorganic failure to thrive. Which of the following would the nurse most likely have noted with this child?

The child plays and sleeps quietly for long periods of time without fussing.

The nurse is working with school-age children who are having enuresis or encopresis. Which of the following will most likely be the first step in this child's treatment?

The child will have a complete physical exam.

The nurse is developing a plan of care for the child hospitalized with nonorganic failure to thrive. The following nursing interventions would be included in this plan. Which nursing intervention would be the highest priority for this child?

The nurse should teach and support the caregiver

The ability of body tissues to endure and adapt to continued or increased use of a substance, so that the drug user requires larger doses of the drug to produce the desired effect is called which of the following?

Tolerance

The nurse is observing a group of two and three year olds in a play group setting. Which of the following behaviors noted in one of the children indicates to the nurse that the child may be autistic?

While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack.

The nurse is doing an in-service training with nurses who will be working with children who have concerns with drugs and alcohol. In discussing this topic, one of the nurses says she has heard that there may be physical and psychological signs that occur when a drug is no longer being used. Which of the following best describes what the nurse is referring to?

Withdrawal symptoms