Final Exam - Chapter 23

Which observation demonstrates the effective use of cognitive behavioral therapy with a client diagnosed with intermittent explosive disorder?

"Do you usually have an explosive episode after a work day?"

A nurse is assessing a client with oppositional defiant disorder (ODD). What questions related to the disorder should the nurse ask the parents while taking the history of the client? Select all that apply.

"Does your child get confused much of the time?" "Does your child have difficulty paying attention?" "Does your child get extremely upset for getting poor grades in school?

The parents of a 15-year-old adolescent report that their child is behaving abnormally. After obtaining the history of the client, the nurse responds by telling the parents that their child's behavior is normal for his age. What would the parents have told the nurse regarding their child? Select all that apply.

"Our child spends more time playing than studying." "Our child doesn't listen to us, preferring to listen to friends."

After completing a series of parent training sessions with parents of an 8-year-old client with oppositional defiant disorder, the child's mother calls the nurse with concerns. The mother states, "What you taught us isn't working. Can you please talk to my child about his behavior?" Which is the nurse's most effective response?

"Please tell me more about what you are having difficulty with."

Which statement by the nurse demonstrates an understanding of the importance of keeping negative emotions from interfering with care provided to aggressive clients?

"Talking with other staff helps."

In a discussion with a group of high school teachers about oppositional defiant disorder (ODD), the nurse says that behavior modification of the parents and teachers toward such children forms the basis of therapy. What is the most appropriate rationale that the nurse gives when asked about this strategy?

Adolescents with ODD learn maladaptive behavior at home and it can be perpetuated at school.

A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply.

Antidepressant drugs Mood-stabilizing drugs

A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply.

Antidepressants Mood-stabilizing agents

A 16-year-old client is highly disruptive in class and has been in trouble at home. The client's parent recently found the client torturing a cat. When the parent questioned the client about how the client could hurt an animal, the client laughed. Which condition will the client most likely be diagnosed with?

Conduct disorder

Which childhood disorder is characterized by serious violations of social norms, such as destruction of property?

Conduct disorder

Which disorder of childhood is characterized by aggression to people and animals, destruction of property, deceitfulness and theft, and serious violation of rules?

Conduct disorder

A nurse is caring for an adolescent with conduct disorder. The nurse tries to involve the client in discussions on age-related topics such as books, current trends, and movies. What is the nurse trying to accomplish by doing this?

Help the client develop peer relationships.

A nurse is assessing an adolescent with oppositional defiant disorder (ODD). Other than disruptive behavior, what other findings might the nurse expect to see during the assessment? Select all that apply.

Impaired decision making Impaired attention Impaired problem-solving abilities

A nurse is assessing an adolescent with oppositional defiant disorder (ODD). Other than disruptive behavior, what other findings might the nurse expect to see during the assessment? Select all that apply.

Impaired decision making Impaired attention Impaired problem-solving abilities

Which would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors?

Limit setting

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply.

Peer group of the adolescent Temperament of the adolescent Behavior of parents

A nurse is planning to educate a client who is diagnosed with intermittent explosive disorder about self-management strategies for the condition. What topics should the nurse address while teaching this client? Select all that apply.

Strategies for anger management Relaxation techniques Strategies to avoid alcohol and substance use

A nurse is caring for a client with conduct disorder. The nurse needs to help the client understand the relationship between aberrant behavior and the consequences when the behavior is problematic. Which nursing intervention is most appropriate to help this client?

Teach the client about limit setting and the need for limits.

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply.

Temperament of the adolescent Peer group of the adolescent Behavior of parents

A nurse is assessing a 15-year-old adolescent with conduct disorder. Which appearance might the nurse see in the adolescent?

The adolescent has lots of tattoos and body piercings.

A nurse is assessing an adolescent with conduct disorder. Which should the nurse expect to find in this adolescent? Select all that apply.

The adolescent may be unwilling to speak to the nurse. The adolescent may behave disrespectfully to the nurse. The adolescent may make derogatory comments about parents and teachers.

A nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent has been prescribed risperidone by the primary health care provider. What would be the most likely reason for the health care provider to prescribe this drug to the client?

The adolescent's behavior poses a danger to others.

A nurse is counseling the parents of a 5-year-old child with oppositional defiant disorder (ODD). What type of management does the nurse suggest to help the parents deal with the disorder?

The child can be managed if the parents modify their own behavior.

The nurse is documenting clinical observations after a therapeutic session with an adolescent client with a disruptive behavior disorder. What should the nurse identify is an internalizing behavior?

The client only stares at the nurse when asked how the client is doing today.

The nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent is not interested in seeking summer employment. What is the most likely reason for the client's disinterest in getting a job?

The client prefers stealing money over working for it.

A nurse is caring for a client with conduct disorder. The nurse tells the client, "It is not appropriate for you to break things in this center every time you get angry. You should inform me when you get angry. If you break anything else in the facility, you will not be allowed to play video games for a week." What is the statement indicative of?

The nurse is trying to teach limit setting.

A nurse is studying the medical records of a client with conduct disorder. The nurse finds that the client was prescribed lithium. What would be the most likely reason for prescribing this drug for this client?

The presence of aggression

The nurse uses the technique of time-out for a client with conduct disorder. Which problem demonstrated by the client would have led the nurse to use this intervention?

Threatening the nurse

For which reason would a nurse ask an adolescent client with conduct disorder to maintain a diary?

To help identify feelings.

When providing education to the parents of a client with conduct disorder, which is a valid teaching point?

Use 'I' language and express an emotion when setting limits.

The nurse is assessing a child diagnosed with conduct disorder. Based on which behavior would this client be described as exhibiting the disorder at moderate intensity?

Verbal bullying

A high school teacher has referred an adolescent to the school health nurse for repeated episodes of aggressive behavior and verbalizing profanities loudly at other students in the class. The adolescent can sometimes be apologetic. The nurse should suspect which disruptive behavior disorder?

intermittent explosive disorder

A nurse is assessing a 2-year-old child in a child and family outpatient mental health clinic. The parents tell the nurse that the child can be combative when the child's wants are not met. The parents describe the child as "defiant." What is the most appropriate response of the nurse to the parents?

"It sounds like very challenging behavior, testing is quite normal at this age."

A nurse is assessing an adolescent with conduct disorder. Which statement by the nurse about the adolescent is most likely to be true?

The sibling of the client has conduct disorder.

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply.

Behavior of parents Temperament of the adolescent Peer group of the adolescent

After teaching a group of nursing students about kleptomania, the instructor determines that the education was successful when the students state what?

The disorder is difficult to detect and treat.

A nurse is providing community education regarding adolescents with oppositional defiance disorder (ODD). Which point should the nurse include in the educational session?

Behavior problems can develop when parental figures pay attention to a child's maladaptive behaviors.

A nurse is speaking to the parents of a 15-year-old client who has been suspended from school for physically abusing classmates. The client has had many warnings from school staff; however, the client's behavior persists. What other statements by the parents would lead the nurse to suspect this client has conduct disorder? Select all that apply.

"My child is consistently performing poorly academically." "My child does not have any friends."

A nurse is speaking to the parents of a 15-year-old client who has been suspended from school for physically abusing classmates. The client has had many warnings from school staff; however, the client's behavior persists. What other statements by the parents would lead the nurse to suspect this client has conduct disorder? Select all that apply.

"My child is consistently performing poorly academically." "My child does not have any friends."

The parents of a 15-year-old adolescent report that their child is behaving abnormally. After obtaining the history of the client, the nurse responds by telling the parents that their child's behavior is normal for his age. What would the parents have told the nurse regarding their child? Select all that apply.

"Our child spends more time playing than studying." "Our child doesn't listen to us, preferring to listen to friends."

The nurse is teaching the parents of a child with conduct disorder about methods to deal with their child's detention from school for breaking science equipment. What advice should the nurse give the parents to deal with the situation?

"You should be supportive of the school for taking this step regarding your child's inappropriate behavior."

Which statement, made by the parent of a teen diagnosed with conduct disorder, demonstrates effective parenting?

"You will lose your driving privileges for a week if you don't clean your room today."

A nurse is assessing a 9-year-old child diagnosed with conduct disorder. Which advice should the nurse give the child's parents regarding treatment of the disorder?

"You will need to be involved in the therapeutic process for your child."

A nurse is performing a general assessment of adolescents in a school to identify students with conduct disorder. Which students are likely to be identified with the condition, based on the nurse's assessment? Select all that apply.

A student who repeatedly bullies younger students A student who is constantly involved in activities resulting in damage to school property A student who always uses abusive language while speaking to teachers

A 13-year-old child is constantly involved in breaking tables and chairs at school. On further assessment, the nurse finds that the child has conduct disorder. Which condition is the child most likely to develop in the future if not treated effectively for this condition?

Antisocial personality disorder

Children with conduct disorder may be diagnosed with which disorder as adults?

Antisocial personality disorder

A nurse suspects that an adolescent has oppositional defiant disorder (ODD). In which situation will the client most likely display behavior consistent with ODD?

At home while confronting parents

During dinner time on an inpatient unit, an adolescent client throws a tray across the table. What would be an effective use of limit setting with this client?

Remind the client about the behavior contract.

A nurse is educating a group of parents about conduct disorder. According to the nurse, which children are most at risk for developing conduct disorder? Select all that apply.

Children with low self-esteem Children with poor peer relationships Children neglected by their parents

A 14-year-old client's behavior meets the criteria for a conduct disorder when the nursing assessment documents that the child has what? Select all that apply.

Confessed to hurting the neighbor's dog Served after-school detention for repeatedly disobeying the teaching staff Been regularly accused by family members of "stealing their stuff" Been caught lying on a regular basis

A nurse is speaking to parents of a child at school. The parents tell the nurse that their child has a calm temperament. However, the child experiences bed wetting at night when exposed to new situations. If emotionally upset, the child is unable to articulate feelings and prefers to cry alone. What psychiatric disorder is this child likely to develop in the future?

Depression

A 12-year-old child is brought to the mental health clinic by the child's parents because of a court-ordered evaluation. When assessing the child, which would lead the nurse to suspect that the child has a conduct disorder? Select all that apply.

Destruction of neighbor's car on two separate occasions Arrests for petty larceny several times Evidence of overt lying

A nurse is counseling the parents of a client with conduct disorder. The nurse tells them that they should be vigilant in watching for certain behaviors that their child is prone to exhibit. Which behaviors would the nurse want the parents to watch for? Select all that apply.

Early onset of sexual behavior Alcohol and substance abuse Smoking

A nurse is counseling the parents of a client with conduct disorder. The nurse tells them that they should be vigilant in watching for certain behaviors that their child is prone to exhibit. Which behaviors would the nurse want the parents to watch for? Select all that apply.

Early onset of sexual behavior Alcohol and substance abuse Smoking

A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session? Select all that apply.

Effective parenting skills Skills to improve peer relationships Skills to improve academic performance

A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session? Select all that apply.

Effective parenting skills Skills to improve peer relationships Skills to improve academic performance

A nurse is meeting the parents of an 8-year-old child with oppositional defiant disorder. Which strategies can the nurse offer the parents to promote the use of positive reinforcement? (Select all that apply.)

Give high-fives for following through on a request the first time. Offer the child a toy or a game after a week of good behavior at school. Take the child out for ice cream after a weekend free of arguing or questioning.

Which would be an appropriate intervention for a child diagnosed with conduct disorder?

Have the child accept responsibility for individual behavior

A 15-year-old client with intermittent explosive disorder (IED) gives no history of childhood abuse, neglect, or maltreatment. What could be the cause of the disorder in this client?

Imbalance in the production of serotonin

The nurse who provides care under the auspices of a group home is planning the care of a 12-year-old client who has been referred to the home by the court system. Knowing that the client has a documented history of conduct disorder, which nursing diagnosis should the nurse prioritize during the client's transition into the group home?

Impaired social interaction due to aggressive behavior

An adolescent client demonstrates callous and unemotional behavior in the absence of extreme aggressive behavior and mood disturbances. The client has a diagnosis of conduct disorder. Which treatment would be most effective for this client?

Individualized behavior therapy

A nurse is meeting the parents of an 8-year-old child with oppositional defiant disorder. Which strategies can the nurse offer the parents to promote the use of positive reinforcement? (Select all that apply.)

Offer the child a toy or a game after a week of good behavior at school. Take the child out for ice cream after a weekend free of arguing or questioning. Give high-fives for following through on a request the first time.

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications?

Presence of comorbid psychiatric disorders

A nurse is planning to educate a client who is diagnosed with intermittent explosive disorder about self-management strategies for the condition. What topics should the nurse address while teaching this client? Select all that apply.

Relaxation techniques Strategies for anger management Strategies to avoid alcohol and substance use

A nurse is planning to educate a client who is diagnosed with intermittent explosive disorder about self-management strategies for the condition. What topics should the nurse address while teaching this client? Select all that apply.

Relaxation techniques Strategies to avoid alcohol and substance use Strategies for anger management

A nurse is counseling the parents of a client with conduct disorder. The nurse tells them that they should be vigilant in watching for certain behaviors that their child is prone to exhibit. Which behaviors would the nurse want the parents to watch for? Select all that apply.

Smoking Alcohol and substance abuse Early onset of sexual behavior

A nurse is counseling the parents of an adolescent client with oppositional defiant disorder (ODD). The parents state, "We've tried everything, what else are we supposed to do?" What is the most likely reason for the parents' voiced loss of hope?

The adolescent may have limited sensitivity to reward and punishment.

A nurse is developing a plan of care for a client with conduct disorder. Which would be treatment outcomes for this client? Select all that apply.

The client will engage in socially acceptable behavior. The client will learn effective problem-solving skills. The client will not hurt others or damage property

A nurse is developing a plan of care for a client with conduct disorder. Which would be treatment outcomes for this client? Select all that apply.

The client will not hurt others or damage property. The client will engage in socially acceptable behavior. The client will learn effective problem-solving skills.

A nurse observes a middle school student having an angry outburst in the hallway. The nurse is aware that the student has these outbursts frequently. The nurse suspects that the student has intermittent explosive disorder (IED). What other assessment findings would support this conclusion? Select all that apply.

The student has caused extensive damage to school property. The student has experienced anger episodes over very minor events. The student has had outbursts of anger without any warning.

A nurse is assessing a 10-year-old child who is displaying behaviors that are consistent with oppositional defiance disorder. When conducting the assessment, the nurse should also assess for which co-morbidity?

attention deficit hyperactivity disorder

A nurse is working with an adolescent client with a diagnosis of conduct disorder. The nurse is helping the client reflect on a situation in which the client became aggressive and asks how the client could have handled it differently. The nurse is employing which intervention?

improving coping skills and self-esteem

A school counselor has made a referral to the school health nurse for a 14-year-old client who has been bringing alcohol to school in a water bottle. The client was overheard talking about having multiple sexual partners over the past week. This client can be accurately identified as having which intensity level of conduct disorder?

moderate conduct disorder

When providing education to a client with intermittent explosive disorder, the nurse explains that antidepressant medications can be effective in the treatment of the condition because they:

promote balancing of serotonin.