Ch.22:

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

Stuttering

An adolescent client diagnosed with attention-deficit/hyperactivity disorder (ADHD) is being counseled in the clinic for daily stressors. For which common comorbidity should the nurse assess regularly to identify and treat early within the client?

substance use

A pediatric client diagnosed with attention-deficit/hyperactivity disorder (ADHD) is participating in behavioral strategies to assist with daily functioning. In the session, the nurse is utilizing play techniques to understand the child's thoughts and feelings and to promote communication. Which type of play is the nurse utilizing with the client?

therapeutic play

Which statement would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective?

"We'll be sure to record the child's weight on a weekly basis."

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.

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 provides care to a child whose parents recently separated and are planning to divorce. The child's parents ask the nurse how they can help their child deal with the situation. Which response by the nurse is appropriate?

"It is important that you help your child by not speaking negatively about the other."

The nurse is caring for a child taking clonidine for the treatment of attention deficit hyperactivity disorder (ADHD). The child informs the nurse that their mouth is dry all of the time. Which is the best response by the nurse?

"You can use calorie-free beverages to help relieve the dry mouth."

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."

A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder (ADHD). The parents ask about what actions the child may display. What statement(s) would the nurse provide? Select all that apply.

- "The child is restless and can't sit still." - "There is difficulty completing a task regardless of how simple." - "The child has risk-taking behavior."

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

The nurse is developing a plan of care for a school-age child with a psychiatric disorder. Which intervention(s) will the nurse initiate that will address the child's immediate needs? Select all that apply.

- Monitor the child for safety - promote self-esteem - provide emotional support to the child and parents

A psychiatric-mental health nurse is caring for a client diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which nursing action(s) are appropriate when caring for a client diagnosed with ADHD? Select all that apply.

- Provide close supervision - Provide clear directions about acceptable and unacceptable behavior - Get the client's full attention before speaking - Minimize changes to the daily routine

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 nurse conducts wellness assessments for a child who is homeless and currently living in a shelter with a parent. Which issue(s) are a priority for the nurse to monitor for during the assessment process? Select all that apply.

- The presence of anxiety - Fine motor delays - Has not developed appropriate language skills

Which individual would benefit from the inclusion of social skills training in the nursing plan of care? Select all that apply.

- a child with low self-esteem - a child with poor coping skills - a child who exhibits aggression - a child who exhibits bullying behaviors

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

70

The parent of a child with attention deficit hyperactivity disorder (ADHD) is prescribed pemoline for treatment. When evaluating the laboratory studies of the child, which result will the nurse report to the health care provider?

AST 65 U/L (1.1 μkat/L)

The parent of an 8-year-old client was concerned that the child may have an intellectual disability. The parent reports that the child has difficulty communicating. Which finding would confirm a diagnosis of intellectual disability?

An intelligence quotient (IQ) of 70 or below

A nurse is evaluating a child's attention span. Which finding indicates that the child's attention span is decreased?

Child is rocking in the chair continuously.

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

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

Coprolalia

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.

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

A nurse is assessing an 8-year-old child. The child is unable to dress without assistance and is not able to manipulate toys, such as building blocks. The child stutters while talking. The difficulty with motor coordination was first noted after the child started to attend school, and it is not an aspect of a general underlying medical condition. What is the most likely diagnosis of the child?

Developmental coordination disorder

When assessing a child with encopresis, impairments will depend upon all of the following conditions except for what?

Intolerance to sedentary activity

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

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?

Noon

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 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

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 pediatric client diagnosed with attention-deficit/hyperactivity disorder (ADHD) is in the immediate phase of care. Which client outcome would be identified in the immediate phase of care?

Successfully complete tasks or assignments with assistance within 24 to 36 hours.

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 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.

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.

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 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 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

A 2-year-old client is being assessed by the nurse during the annual well-visit check-up. Which assessment finding of the child would alert the nurse to follow-up with the parent to obtain more information?

becomes upset with minor changes in the routine

A psychiatric-mental health nurse is assessing a pediatric client. Upon assessment, the client repeats the last-heard sound from other people. Which observation would the nurse document in the client's medical record?

echolalia

A child with attention deficit hyperactivity disorder is taking methylphenidate in divided doses. If the child takes the first dose at 0800. Which behavior might the school nurse expect to see at noon?

increased impulsivity or hyperactive behavior

A pediatric client diagnosed with developmental coordination disorder is being assessed for speech difficulties. Upon further assessment, the parent of the client reveals that the client has difficulty with producing intelligible speech. Which communication disorder should the client be assessed for?

speech sound disorder

A pediatric client is being assessed in the clinic for a diagnosis of autism spectrum disorder (ASD). The client's parent describes that the client bangs their head repeatedly at times. Which assessment finding should be documented by the nurse?

stereotyped motor behavior