The Point: Chapter 22 Neurodevelopmental Disorders

A nurse is assessing a 7-year-old child in a school. The nurse suspects that the child has an insecure relationship with the parents. Which statement said by the child would have led the nurse to this conclusion?

"Please don't tell my mom anything we've talked about."

A nurse is using limit setting with a child hospitalized for a psychiatric disorder. Which statement made by the nurse would reflect appropriate limit setting? Select all that apply.

"Swearing is not allowed here on the unit." "You will lose television privileges for 24 hours if you ignore a unit rule." "When you feel like swearing come and talk to me."

A nurse is speaking to the parents of a child with attention deficit hyperactivity disorder (ADHD). The parents ask the nurse about the reason for the child's underachievement in academics. What explanation given by the nurse is most appropriate?

"Your child has trouble following the teacher's directions."

Approximately what percentage of children diagnosed with attention deficit hyperactivity disorder (ADHD) will continue to experience symptoms into adulthood?

60%

Assessment of an 8-year-old client reveals communication difficulties and an inability to manage age-appropriate tasks. The child undergoes standardized testing. An intelligent quotient (IQ) of which would support a diagnosis of intellectual disability?

65

Below average intellectual functioning is initially diagnosed when an intelligence quotient (IQ) is below which level?

70

When describing intellectual disability to a group of parents, a nurse would identify which intelligent quotient (or less) as the usual threshold?

70

When working with children with neurodevelopmental disorders, which would be appropriate?

Building on the child's strength

Nurses who work in a pediatric psychiatric-mental health facility should do what?

Develop self-awareness of issues that remind them of their own childhood and adolescence.

A nurse is assessing an 8-year-old child. The child is unable to dress the self and is not able to manipulate toys, such as building blocks. The child stutters while talking. The child does not have impaired motor coordination. What is the most likely diagnosis of the child?

Developmental coordination disorder

The nurse is developing a care plan for a client diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse teaches the client to take the last dose of dextroamphetamine when?

Early in the afternoon

Which aspect of managing a child with attention deficit hyperactivity disorder (ADHD) may often be overlooked in the treatment plan?

Effects on siblings

A nurse is studying the brain images of children with attention deficit hyperactivity disorder (ADHD). In these images, the nurse would find abnormalities related to which area of the brain?

Frontal lobe

The parents of a toddler are distraught that the toddler has been diagnosed with autism spectrum disorder. When providing care for the child and the parents, the nurse understands that autism spectrum disorder is thought to be caused by what?

Genetic factors

A child is taking methylphenidate for treatment of attention deficit hyperactivity disorder (ADHD). Which side effect must be monitored in this child?

Growth delays

The nurse is assessing an adolescent client who was diagnosed with autism spectrum disorder as a child. On current assessment the nurse finds that the client's behavior has deteriorated. What may be the possible causes of this change? Select all that apply.

Hormonal changes Increased parental and peer pressure Inability to perform well in school

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed dextroamphetamine. For what effects should the nurse tell the parents to monitor the child? Select all that apply.

Insomnia Weight loss Appetite suppression

After educating a group of students on attention deficit hyperactivity disorder (ADHD), the instructor determines that additional education is required when the group identifies which as a typical characteristic?

Language difficulty

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)?

Methylphenidate

Which is an inattentive behavior seen in attention deficit hyperactivity disorder (ADHD)?

Missing details

Which is the drug of choice for a tic disorder?

Risperidone

When providing care for children with psychiatric disorders, which are the priorities for care? Select all that apply.

Safety Self-esteem

A child with an existing diagnosis of attention deficit hyperactivity disorder shows signs and symptoms of depression. Which would most likely be prescribed?

Selective serotonin and norepinephrine reuptake inhibitor (SSNRI)

When performing a spiritual assessment on a child, the nurse and child discuss church attendance and practices that are most important to the child. Which domain is the nurse addressing when doing this assessment?

Social

Which type of intervention may be helpful for children who are bullies?

Social skills training

The parents of a child with attention deficit hyperactivity disorder (ADHD) bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives the first dose of methylphenidate at about 7:30 a.m. every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 p.m. Which might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Switch to a longer-acting preparation.

A nurse is working with a child undergoing behavioral modification therapy for attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation?

The child cannot sit through meals.

The nurse expects the child with expressive language disorder is likely to present with which nursing assessment finding?

The child has difficulty forming complete sentences.

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder (ADHD). The nurse finds that these children do not like the child and do not want to include the child during play. What are the likely reasons for the children feeling this way? Select all that apply.

The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

The client is 6-year-old who has been diagnosed with autism spectrum disorder. Which symptom would the client display?

The client spends time alone with little interest in making friends.

A nurse is caring for a child with attention deficit hyperactivity disorder. The nurse asks the child to draw pictures of the child and family members. What is the most likely rationale for this intervention?

To help the child self-express

Which condition is characterized by multiple motor tics and one or more vocal tics many times throughout the day for 1 year or more?

Tourette syndrome

A psychiatric-mental health nurse is reviewing an article about genetics and the role in the development of a childhood psychiatric disorder. The nurse demonstrates understanding of this information by identifying which disorder as being genetically transmitted?

Tourette's syndrome

Which are nursing actions that support active listening? Select all that apply.

Use appropriate vocabulary Use reflective comments

Assessment of a child with autism spectrum disorder reveals stereotypic behavior. Which behavior would the nurse most likely document being demonstrated by the child?

Rocking Hand flapping Head banging

Which is a disturbance of the normal fluency and time patterning of speech?

Stuttering

The parents of a 2-year-old child complain to the nurse that their child is always dismantling toys, scribbling on the walls, and running all around the place and that it is very difficult to control the child's behavior. What is the most appropriate response from the nurse?

"At this child's age, these behaviors are expected."

A nurse tells the child and caregiver that the nurse will interview each of them separately. The caregiver questions why this needs to occur. What is the nurse's best response?

"Both interviews provide unique and meaningful information."

A nurse has been asked to identify children with attention deficit hyperactivity disorder (ADHD) in a school. Which children should the nurse identify as having ADHD? Select all that apply.

A child who makes excessive noise by tapping the desk A child who does not follow instructions in class

Which medication classification is used in the treatment of tic disorders?

Antipsychotics

Which term describes the use of socially unacceptable words, which are frequently obscene?

Coprolalia

A nurse is caring for a child with enuresis. The child does not have any abnormalities associated with development or behavior. Which drug would the child be prescribed to treat the condition?

Imipramine

An adolescent client says the client has become bored with the video game that has been used as a reward for positive behavior. Which is the most effective intervention for this client?

Let the client choose another reward that would be more fun.

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Substance abuse disorders

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The child is given medication and behavioral modification therapy to treat the condition. Which outcome achieved within 3 days would indicate successful therapy?

The child is able to complete assignments or tasks with assistance.

A nurse is assessing a child with attention deficit hyperactivity disorder (ADHD). For every question asked by the nurse, the child answers, "I don't know." What is the most likely reason for the child to respond in this way?

The child is not paying attention to the nurse's questions.

A nurse is assessing a child with attention deficit hyperactivity disorder. Which assessment finding is the nurse likely to see in this child? Select all that apply.

Overactivity Impulsiveness

The nurse is teaching the parents of a child with involuntary enuresis about methods to manage the condition. Which intervention does the nurse recommend to the parents?

The child should use pads with a warning bell.

The mental health nurse assesses for the most common mental health disorder found in children when asking which question?

"Do you ever get scolded at school for not sitting still?

A 9-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the client's parents state what?

"The client may have some side effects, like insomnia, loss of appetite, or weight loss, but they are rare."

After teaching a group of nursing students about pharmacotherapy and attention deficit hyperactivity disorder (ADHD), the instructor determines that the education was successful when they identify which agent as the first line choice?

Atomoxetine

Which is an antidepressant used to treat attention deficit hyperactivity disorder (ADHD)?

Atomoxetine

A nurse is assessing a child who had an episode of passing feces in the classroom. The child has no other disabilities. The nurse concludes that the child had intentional encopresis. Which other condition is the child likely to have?

Conduct disorder

After teaching a group of nursing students about intellectual disability, the instructor determines that the teaching was successful when the students identify which as the most common etiology?

Genetic syndromes

The nurse working with pediatric clients knows the importance of checking for developmental delays, which not only slow the child's progress but also are often associated with what?

Development of poor self-esteem

The nurse is assessing a child with autism spectrum disorder. After reading the medical history, the nurse finds that the child engages in stereotypical motor behavior. Which observation of the child made by the nurse might be indicative of stereotypical motor behavior?

Flapping hands repeatedly

Which is considered a hyperactive/impulsive behavior seen in attention deficit hyperactivity disorder (ADHD)?

Inability to play quietly

The nurse is counseling a family whose child has autism. When describing this condition, which would the nurse most likely include?

Onset before child is 2.5 years old

The nurse is teaching a client's parents about managing the child's tic disorder. The nurse explains that it is extremely important for the child to get plenty of rest. What is the primary reason for the nurse to provide this education? Choose the best answer.

Physical stress and fatigue can increase symptoms in tic disorder.

A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder. Which would the nurse identify as reflecting impulsiveness in the child?

Risk-taking behavior

A 7-year-old client experiences tics, which have become increasingly frequent in recent months. How should the nurse educate the client's teacher to respond to the tics?

Teach the client's classmates that the tics are not something that the client can control.

A nurse is assessing a 2-year-old child diagnosed with autism spectrum disorder. Which findings does the nurse expect to find on assessment? Select all that apply.

The child avoids eye contact. The child does not relate to parents. The child becomes upset with minor changes in routine.

The nurse is assessing a child with tic disorder. The nurse documents in the assessment sheet that the child exhibits coprolalia. What might be be interpreted from this?

The child continuously repeats socially unacceptable words.

A nurse is preparing a treatment plan for a child with attention deficit hyperactivity disorder (ADHD). What should be the treatment goals for the child? Select all that apply.

The child should remain free of injury. The child should follow directions. The child should be able to complete tasks.

When a client repeatedly vocalizes an obscene phrase and imitates the motions of a staff member, the nurse documents that the client is most likely exhibiting symptoms of what disorder?

Tourette's syndrome