Chapter 21 NCLEX Questions (Impulse Control Disorders)

Which of the following classifications of medication may be prescribed in intermittent explosive disorder? a. Anticonvulsants b. Psychostimulants c. Antianxiety agents such as benzodiazepines d. Monoamine oxidase (MAO) inhibitors

a (Although considered off-label use, anticonvulsants may reduce outbursts and contribute to mood stabilization. The other options are incorrect for use in intermittent explosive disorder.)

Which of the following statements are true regarding childhood-onset conduct disorder? (Select all that apply.) a. It is more commonly diagnosed in males. b. It is characterized by feelings of remorse and regret. c. It is usually diagnosed in late teen years. d. It is characterized by disregard for the rights of others. e. Those with conduct disorder rationalize their aggressive behaviors. f. It is usually outgrown by early adulthood.

a, d, e (Childhood-onset conduct disorder is more common in male patients and is seen before the age of 10 years. Hallmarks include disregard for the rights of others, physical aggression, poor peer relationships, and lack of feelings of guilt or remorse. The other options are the opposite of what is correct.)

Which nursing intervention is appropriate for the management of intermittent explosive disorder? a. Providing intensive family therapy b. Establishing a trusting relationship with the patient c. Setting up loose boundaries so the patient will feel relaxed d. Limiting decision-making opportunities to avoid frustration

b (Establishing rapport with the patient is essential in working to set goals, boundaries, and consequences, and providing opportunities for goal achievement. Intensive family therapy would not be a basic level RN intervention. Boundaries and structure are essential. Opportunities for patients to make good decisions and reach goals should be given, not limited.)

A 17-year-old patient is admitted to the psychiatric unit after threatening his mother during an argument and is diagnosed with conduct disorder. Which of the following would be an appropriate short-term outcome for this patient? a. Engages in appropriate coping skills to manage stressors b. Expresses feelings c. Maintains self-control during hospitalization d. Mother will improve communication skills to interact with Eli.

b (Expressing feelings is an appropriate short-term outcome and would be a good start to working with the patient to establish rapport, develop coping skills, and set goals. Engaging in appropriate coping skills and maintaining self-control are desired outcomes. Outcomes for the patient are being discussed, not outcomes for the patient's mother.)

Assessment for oppositional defiant disorder should include which interventions? a. Assessing the history, frequency, and triggers for violent outbursts b. Assessing moral development, belief system, and spirituality for the ability to understand the impact of hurtful behavior on others, to empathize with others, and to feel remorse c. Assessing issues that result in power struggles and triggers for outbursts d. Assessing sibling birth order to understand the dynamics of family interaction

c (Oppositional defiant disorder is characterized by defiant behavior, power struggles, outbursts, and arguing with adults, so assessment of these factors would be important. Assessing for violent outbursts refers to assessment for intermittent explosive disorder. Oppositional defiant disorder is not characterized by violent behaviors. Assessing for the ability to understand the impact of hurtful behaviors on others refers to assessment for conduct disorder. Birth order is not known to play a part in oppositional defiant disorder.)