Chapter 50 exam 3

Parents of a 36-month-old child confide in the clinic nurse that their child does not speak and spends hours staring at their ceiling fan. They are worried that their child may have autism spectrum disorder. Which question would be important for the nurse to ask the parents?

"Does your child come and hug you or seek comfort from you?" Children with autism spectrum disorder lack communication and social skills. These children often will not seek comfort, make eye contact, or develop peer relationships. It is important during the health history for the nurse to focus on the findings the parents are presenting and not on extra information that may or may not be helpful.

A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement?

"I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already." Clients with anorexia view themselves as fat even though they are emaciated and have a skeleton-like appearance. Stating that she is tired, another symptom of anorexia, along with the feeling that she is already fat both are warning signs for anorexia nervosa.

While interviewing an adolescent client with depression, the client reveals to the nurse that he has considered hurting himself. Which response by the nurse would be most appropriate?

"Tell me exactly how you would hurt yourself." It is important to find out exactly how the adolescent is envisioning harming himself and to take measures to prevent an attempted suicide

The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which finding will the nurse expect to assess?

Indifferent attachment to a parent A child with autism spectrum disorder can show a lack of or no attachment to parents.

Which behavior typical of children with autism spectrum disorder (ASD) requires the nurse to maintain special care to keep them safe?

Insensitivity to pain A number of children with autism spectrum disorder may have a hyposensitivity to pain. Thus, if they hurt themselves, they may not feel the associated pain.

What is an example of impaired adaptive functioning in an 8-year-old girl with a developmental disorder?

The child cannot properly dress herself. A child with impaired adaptive functioning would not be able to dress herself properly, if at all. The inability to copy a phone number or sentence, or to read well, reflects learning disorders.

A school nurse is developing a plan of care for a child with suspected violence between the child's parents. The nurse monitors for which behaviors in the child?

aggressive behavior in school Children who have a parent who is violent may be identified because of behavior problems, noncompliance, and aggression in school. Developmental delays occur in children with other disorders. Development of tics or twitches occurs with Tourette syndrome. Compensating by overachieving is not typically related to violence in the home.

The most common use disorder among children and adolescents is:

alcohol. Alcohol misuse occurs when a person ingests a quantity sufficient to cause intoxication. It is also the most common substance use disorder among children and adolescents.

A parent brings a child to the clinic because the parent suspects a cognitive impairment. What tests should the nurse anticipate the health care provider will order for the child? Select all that apply.

blood lead levels genetic and chromosome tests neuroendocrine tests Tests to rule out infections hearing and vision screening

Which factors are possible causes of cognitive disorders?

head trauma chromosomal disorders anoxia at birth very low birth weight fetal alcohol spectrum disorder Causes of cognitive disorders include chromosomal and metabolic disorders, anoxia at birth, head trauma, very low birth weight, and fetal alcohol spectrum disorder, among other causes.

A parent brings a child to the pediatric clinic, stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptoms does the nurse anticipate finding with this child?

inattention, impulsive, and hyperactivity Attention deficit hyperactivity disorder (ADHD) is characterized by three major behaviors: inattention, impulsiveness, and hyperactivity.

The nurse is examining a child with fetal alcohol spectrum disorder. Which assessment finding should the nurse expect?

low nasal bridge with short upturned nose Typical facial features in an infant with fetal alcohol spectrum disorder include a low nasal bridge with short upturned nose, flattened midface, and a long philtrum with narrow upper lip. Microcephaly

The nurse is recording vital signs in the client diagnosed with complications of anorexia nervosa. Which findings are consistent with the condition? Select all that apply.

orthostatic hypotension weak pulse hypothermia Anorexia nervosa is a condition most commonly seen in adolescents. In this condition, the individual is obsessed with body weight. There is a noted loss of weight. The vital signs frequently display orthostatic hypotension, irregular and decreased pulse, or hypothermia.

An adolescent client has been diagnosed with bulimia nervosa. What does the nurse explain as the goal of treatment for this client?

restoring nutritional balance and a healthy self-image Treatment focused on restoring nutritional balance and keeping a structured nutritional intake is key for bulimia nervosa.

A 7-year-old child being treated for depression will most likely be given which first-line pharmacologic treatment?

selective serotonin reuptake inhibitors (SSRIs) The most commonly used antidepressant medications for children and adolescents are SSRIs. Side effects, especially nausea, headache, and stomachache, are minimal, especially when the starting dose is low with a gradual increase to a therapeutic level.

A child is brought to the emergency department for evaluation. The caregiver states, "The child was running and tripped over the scooter on the sidewalk and landed on the left arm." The nurse assesses and records the findings (above). The nurse suspects child abuse (child mistreatment) and notifies the proper authorities. Which finding(s) will the nurse use to support this suspicion?

spiral fracture bruises on the thighs bruise on the upper back Bruises that occur accidentally to a child usually appear over bony areas such as the knees, elbows, shin, and forehead. Those that have been inflicted in an abusive manner may be found in soft tissue such as the buttocks, genitalia, thighs, back of the knees, upper back, and nose and eyes. In this case, findings suggesting child abuse (child mistreatment) include the spiral fracture and bruises on the thighs and upper back. The bruises on the knee and hand abrasion are likely accidenta

A 16-year-old girl is being seen for a long-overdue checkup. Her caregiver has come with her. She is calm, pleasant, and in good spirits. The caregiver reports to the nurse that she is relieved because for the past 6 months the teenager has been lethargic, angry, and sad. The mother reports that since she got her driver's license two days earlier, her child's mood has changed dramatically. Rather than resist this appointment, the girl had simply smiled and said, "It won't matter much, but okay, I'll be ready in a minute." The nurse recognizes that the child's seeming well-being and drastic change in behavior should be further investigated to determine if the child:

is planning to commit suicide. Attempted suicide rarely occurs without warning and usually is preceded by a long history of emotional problems, difficulty forming relationships, feelings of rejection, and low self-esteem. Suicidal adolescents may appear suddenly elated after a long period of acting dejected, and might verbalize their hopelessness with statements such as "I won't be around much longer," or "After Monday, it won't matter anyhow." Some deaths reported as accidents, particularly one-car accidents, are thought to be suicides.

During adolescence, alcohol is connected to what problem frequently seen in this age group?

automobile accidents Adolescents who drink and drive do not realize the impact of the alcohol in their reflexes and judgment.

The nurse in the well-child clinic observes that a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, "Oh, yeah," and happily climbs back up. The nurse suspects that the child has:

attention deficit hyperactive disorder (ADHD). The child with ADHD may have these characteristics: Impulsiveness, easy distractibility, frequent fidgeting or squirming, difficulty sitting still, problems following through on instructions despite being able to understand them, inattentiveness when being spoken to, frequent losing of things, going from one uncompleted activity to another, difficulty taking turns, frequent excessive talking, and engaging in dangerous activities without considering the consequences.