Peds Quiz 4 Review

A nurse in a community clinic is speaking to a parent who expresses concern for her adolescent son. Which of the following statements by the mother should indicate to the nurse that the adolescent is at risk for suicide?

"His basketball coach committed suicide last month."

A nurse is collecting data from an adolescent client who has anorexia nervosa. Which of the following statements by the client is a sign of cognitive distortion?

"If I eat one piece of candy, I may as well eat ten."

The nurse answering phone calls at a local suicide prevention hotline would recognize the statement indicating the greatest risk of suicide is:

"My parents aren't home and won't be back for 4 hours. That should be enough time for the pills to work. I've got a hundred of them.

failure to thrive characterisitics

- no fear towards strangers - potential for developmental delays due to decreased nutritional intake - can form close relationships w siblings

A nurse is caring for a client who has anorexia nervosa and insists on exercising three times each day. Which of the following actions should the nurse take?

-Allow the client to exercise once per day for a set amount of time. (roughly 30 min per day)

A nurse is collecting data from an adolescent client who anorexia nervosa. Which of the following findings should nurse expect?

-Amenorrhea -Altered body image -Hypokalemia

ADHD risk factors

-Born prematurely/low birth weight -Prenatal exposure to alcohol & or nicotine -hx of chronic head trauma, otitis media or meningitis

A nurse is assisting with a psychosocial assessment of an adolescent client. Which of the following factors indicate to the nurse a potential risk for suicide?

-Death of a parent at a young age -Recent or impending move -Low parental expectations -Sudden decline in school performance

A nurse is collecting data from a child who has autism spectrum disorder. Which of the following findings should the nurse expect?

-Delayed language development -Spins a toy repetitively -Ritualistic behavior

A nurse is reviewing the medical record of a client who attempted suicide. Which of the following findings should the nurse identify as risk factors for suicide?

-Diagnosis of major depressive disorder -Unemployment -Access to firearms

A nurse is reinforcing teaching with a group of adolescents regarding identifying behavioral indicators of depression. Which of the following manifestations should the nurse include?

-Irritability -Decreased energy -Isolation from peers

Identify which characteristic is typical of patients with anorexia

-Weight is below normal -Perfectionist, has unrealistic expectations -Sees self as fat even when emaciated

classroom strategies for children with ADHD

-allowing extra time for testing -allow for regular breaks in class -combine verbal & visual instructions -provide consistent classroom rules -decrease stimuli in the environment

patient teaching for a child with PTSD

-children can benefit from psychotherapy -can be linked to phobia's -develops after a traumatic event - 3 stages: initial, second & third response

What are the different types and settings of psychiatric treatment for

-inpatient hospital settings -residential treatment settings -outpatient locations -partial hospitalization treatment settings

signs and symptoms of depressive disorder in children

-sad facial expressions -tendency to remain alone -withdrawn from family, friends or activities -fatigue -tearful/crying -ill feeling -feelings of worthlessness -weight loss or weight gain -alterations in sleep -lack of interest -low self esteem -hopelessness -suicidal ideation -constipation

Intellectual Disability (ID)

A disorder marked by intellectual functioning and adaptive behavior that are well below average. Previously called mental retardation. -will need supportive schools, day programs, psych support or even inpatient setting if suicidal -can be difficult to perform routine ADL's

A nurse is caring for a client three days after admission to an acute care mental health facility for treatment of major depression. The client leaves her current activity, approaches the nurse and states, "There's no reason to go on living. I just want to end it all". Which of the following nursing interventions is appropriate?

Ask the client if she has a PLAN to commit suicide.

A nurse is caring for a client who has obsessive compulsive disorder (OCD) and is constantly picking up after others and cleaning in the day room. The nurse should recognize the client's actions as which of the following?

Decreasing anxiety to a tolerable level

A nurse in an addiction rehabilitation center is contributing to the plan of care for a newly admitted client who has alcohol use disorder. Which of the following interventions is the nurse's priority?

Determine the client's level of disorientation

A nurse is collecting data on an adolescent client who has attention deficit hyperactivity disorder (ADHD). Which of the following manifestations should the nurse expect to find?

Difficulty maintaining sustained attention

The school nurse suggests to the classroom teacher that the most appropriate classroom intervention for a child with attention deficit hyperactivity disorder (ADHD) would be to:

Divide work assignments into shorter periods with breaks in between.

Abusers of which drug place the user at risk for HIV or hepatitis infection?

Heroin

A nurse is collecting data from a client following a recent suicide attempt. Which of the following findings in the client's history places him at the greatest risk for another suicide attempt?

Impulsivity

A nurse is assisting with the admission of a client to an acute mental health unit following a suicide attempt. The client has a history of depression, substance abuse, and anorexia nervosa. Which of the following actions should the nurse take first?

Initiate one-to-one nursing observation.

The nurse decides to hold a seminar for the faculty. The nurse explains how to identify students at risk. Which of the following is a factor that increases the risk of suicide?

Lack of coping skills

A nurse is assisting with the admission of an adolescent female client who has anorexia nervosa. Which of the following findings should the nurse expect?

Muscle weakness.

A nurse is contributing to the plan of care for a client who is newly admitted with severe depression. Which of the following actions should be added to the plan of care?

Offer the client frequent small snacks during waking hours.

A nurse is making a home visit for a 16-year-old adolescent who attempted suicide. Which of the following behaviors should alert the nurse that the adolescent still has suicidal intent?

Planning to give his CD collection to his girlfriend.

A nurse is reviewing the admission laboratory values for a client who has a history of bulimia nervosa. Which of the following findings is the nurse's priority?

Potassium 2.8 mEq/L

A nurse is reviewing the plan of care for a client who has depression. Which of the following actions should the nurse plan to take?

Reinforce how to use assertive communication techniques

A mother is concerned because her adolescent son is always in trouble for fighting at school and always seem to be angry. She mentions that her husband drinks a bit. The understanding guiding the nurse's response is:

The boy is only one member of the family affected by alcoholism, and all members should receive immediate intervention.

A client who is depressed and has attempted suicide tells the nurse, "l should have died because I am totally worthless. Which of the following responses should the nurse make?

You've been feeling that your life has no meaning.'

Autism Spectrum Disorder (ASD)

a disorder that appears in childhood and is marked by significant deficiencies in communication and social interaction, and by rigidly fixated interests and repetitive behaviors -well structured home, school and caregivers -keep a consistent routine, avoid inconsistency

attention-deficit/hyperactivity disorder (ADHD)

a psychological disorder marked by the appearance by age 7 of one or more of three key symptoms: extreme inattention, hyperactivity, and impulsivity

depressive disorder in children/adolescents

can be overlooked since school-aged children have trouble expressing their feelings

A nurse is assisting with a conflict-resolution group for adolescent clients in a community clinic facility. Which of the following clients should the nurse identify as being the highest risk for a suicide attempt?

client who attempted suicide the previous year

dyslexia

impairment of the ability to read