Chapter 50 - practice questions

what would lead the nurse to suspect that an adolescent has bulimia? a. body mass index less than 17 b. calluses on the back of knuckles c. nail pitting d. bradycardia

b. calluses on back of knuckles feedback: the adolescent with bulimia would exhibit calluses on the back of the knuckles and split fingernail and would be of normal weight or slightly overweight. a body mass index of 17, nail pitting, and bradycardia would suggest anorexia.

a school nurse is working with the parents of an 8-year-old who has tourette syndrome on how best to accommodate the child. what adivce would be the most helpful? select all that apply. a. allowing for breaks when tics occur b. providing for "time-outs" during the day c. using a tape recorder to take notes d. ensuring a specified amount of time for test taking e. implementing a reward system for behavior

a. allowing for breaks when tics occur c. using a tape recorder to take notes feedback: together the school nurse and parents should arrange for classroom accommodations such as allowing for "tic breaks," taking untimed tests or tests in another room, or using note takers or tape recorders. time-outs and reward systems are more appropriate for the child with ADHD.

a child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. the nurse interprets this as which type of therapy? a. cognitive therapy b. behavioral therapy c. milieu therapy d. individual therapy

a. cognitive therapy feedback: cognitive therapy teaches children to change reactions so that automatic negative thought patterns are replaced with alternative ones. behavioral therapy uses stimulus and response conditioning to manage or alter behavior, reinforcing desired behaviors and replacing the inappropriate ones. milieu therapy involves a specially structured setting designed to promote the child's adaptive and social skills. with individual therapy, the child and therapist work together to resolve the conflicts, emotions, or behavior problems.

a nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. what would the nurse be least likely to include? a. focus the child's attention on the negative behavior b. set limits with the child for responsible behavior c. ignore inappropriate behaviors d. provide positive feedback for self-control efforts

a. focus the child's attention on the negative behavior feedback: behavior management techniques include redirecting the child's attention when needed, setting limits for responsible behavior, ignoring inappropriate behaviors, and providing praise and positive feedback for the child's self-control efforts.

a nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). when explaining this disorder to the parents, what would the nurse include as being involved? select all that apply. a. impulsivity b. inattention c. distractibility d. hyperactivity e. defiance f. anxiety

a. impulsivity b. inattention c. distractibility d. hyperactivity feedback: ADHD is characterized by inattention, impulsivity, distractibility, and hyperactivity. anxiety disorder and oppositional defiant disorder may be comorbidities associated with ADHD.

a school-age child diagnosed with depression is receiving antidepressant therapy. what behavior would the nurse instruct the parents to watch for and to notify the healthcare provider immediately if the child demonstrates it? a. loss of interest b. gastric upset c. sedation d. urinary retention

a. loss of interest feedback: children taking antidepressants are at risk for the development of presuicidal behavior, which may be indicated by a loss of interest or pleasure. gastric upset, sedation, and urinary retention may or may not occur, but none of these would be as important to report as the potential for self-harm.

the nurse is caring for a child with bipolar disorder. the child is taking lithium as ordered. the parents inquire about the potential side effects. which response by the nurse would be the most appropriate? a. you might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea b. he might experience a significant decrease in his appetite and difficulty sleeping c. you need to watch for dry mouth, urinary retention, and constipation d. this medication can cause seizures, agitation, headache, and nausea

a. you might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea feedback: the nurse needs to explain that the potential side effects of lithium include polyuria, polydipsia, tremors, nausea, weight gain, and diarrhea.

the nurse is caring for an adolescent girl with anorexia nervosa. what findings would indicate to the nurse that the girl requires hospitalization? a. weight gain of one-half pound per week b. food refusal c. body mass index of 18 d. soft, sparse body hair and dry, sallow skin

b. food refusal feedback: food refusal, severe weight loss, unstable vital signs, arrested pubertal development, and the need for enteral nutrition warrant hospitalization. soft, sparse body hair and dry, sallow skin are signs of anorexia, but do not warrant hospitalization. a weight gain of one-half pound per week indicates progress toward therapeutic goals. a body mass index of 18 is on the low end of the normal range of body mass.

a nurse is conducting a screening program for autism in infants and children. what would the nurse identify as a warning sign? a. lack of babbling by 6 months b. inability to say a single word by 16 months c. lack of gestures by 8 months d. inability to use two words by 18 months

b. inability to say a single word by 16 months feedback: warning signs of autism include no babbling by 12 months, no pointing or using gestures by 12 months, no single words by 16 months, no two-word utterances by 24 months, and loss of language or social skills at any age.

a nurse is caring for a 5-year-old girl with depression. the girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. the girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. the nurse anticipates a referral to a therapist that specializes in: a. individual therapy b. play therapy c. behavioral therapy d. hypnosis

b. play therapy feedback: play therapy is designed to change emotional status and encourages the child to act out the feelings of sadness, fear, hostility, or anger. it is particularly beneficial for the younger child.

the nurse working in a pediatric mental health clinic is assessing a 4-year-old child who has suffered from physical abuse. which type of therapy does the nurse anticipate will be most helpful in developing a trusting relationship as well as assisting in determining the client's current emotional state? a. behavioral therapy b. play therapy c. cognitive behavioral therapy d. family therapy

b. play therapy feedback: play therapy will be the most helpful, espeically in the initial phase of assessment, because it encourages the child the act out feelings of sadness, fear, hostility, or anger.

the nurse is caring for a 7-year-old with tourette syndrome. the nurse would be alert for which comorbid condition? a. depression b. anxiety disorder c. attention deficit/hyperactivity disorder d. asperger syndrome

c. attention deficit/hyperactivity disorder feedback: attention deficit/hyperactivity disorder and obessive-compulsive disorders occur in 50% of children with tourette syndrome. depression, anxiety disorder, and asperger syndrome are not typical comorbid conditions associated with tourette syndrome.

the nurse is caring for a 3-year-old boy. the parents are concerned that he is exhibiting signs of cognitive delays. which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability? a. he is not speaking in complete sentences b. we can understand a lot of what he says, but no one else can c. he seems to be speaking words less and less frequently d. he is unable to sit still for a short story

c. he seems to be speaking words less and less frequently feedback: reports of regression or the loss of previously acquired skills points to autism rather than intellectual disability. not speaking in complete sentences, others not being able to understand what the child is saying, and an inability to sit still for a short story suggest a learning disability.

the nure is reviewing the medical record of a child who has dyspraxia. this child will experience difficulty with: a. reading and writing b. mathematics and computation c. manual dexterity and coordination d. composition and spellling

c. manual dexterity and coordination feedback: dyspraxia refers to problems with manual dexterity and coordination. dyslexia involves difficulty with reading, writing, and spelling. dyscalculia involves problems with mathematics and computations. dysgraphia involves difficulty producing the written word in composition, spelling, and writing.

when reviewing the medical record of a child, what would the nurse interpret as the most sensitive indicator of intellectual disability? a. history of seizures b. preterm birth c. vision deficit d. language delay

d. language delay feedback: due to the extent of cognition required to understand and produce speech, the most sensitive early indicator of intellectual disability is delayed language development. a history of seizures, preterm birth, and vision deficit may be associated with intellectual disability but are not the most sensitive indicators.

when assessing the adolescent with anorexia, what would the nurse expect to find? a. tachycardia b. hypertension c. fever d. sparse body hair

d. sparse body hair feedback: an adolescent with anorexia often exhibits a low body temperature; bradycardia; and hypotension; as well as soft, sparse body hair and thinning scalp hair.

a child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. what information would the nurse include when teaching the child and his parents about this drug? a. give the drug three times a day: morning, midday, and after school b. this drug may cause drowsiness, so be careful when doing things c. some increase in appetite may occur, so watch how much you eat d. take this drug every day in the morning when you wake up

d. take this drug every day in the morning when you wake up feedback: long-acting methylphenidate is administered once daily in the morning, whereas the other forms are given three times a day. the drug typically causes difficulty sleeping and decreased appetite.