Children and Adolescents

c. Reactive attachment disorder

A nurse observes that a child is withdrawn from her parents and does not interact much with them. On inquiry, the nurse finds that the child has been a victim of domestic violence and does not interact with anybody. Which clinical condition is the child likely to have? a. Separation anxiety b. Developmental delays c. Reactive attachment disorder d. Disinhibited social engagement behavior

b. Reading a story about a child who feels sad

A nurse plans to lead a group in a residential facility for kindergarten-aged, abused children. What therapeutic activity would be most appropriate for the nurse to incorporate? a. Building a house with blocks b. Reading a story about a child who feels sad c. Drawing pictures of fun activities at a park d. Discussing examples of child abuse and neglect

b

A nurse prepares the plan of care for a school-age child diagnosed with reactive attachment disorder. Which initial outcome should be the focus of the nurse's intervention? a. The child will decrease impulsive behavior. b. The child will express feelings through journaling. c. The child will verbally recount traumatic experiences. d. The child will correctly identify the date, time, and place.

Denver II Developmental Screening test

assessment designed for infants and children up to 6 years of age

mental status assessment

assessment similar to that of adults

"TCA toxicity" seizures agitation irregular pulse

A nurse is teaching the parents of a child who has autism spectrum disorder and a new prescription for imipramine about indications of toxicity. What should the nurse include in the teaching?

tourette's disorder

presents with motor and vocal tics with early childhood onset, ranging from mild to severe spasms; can be embarrassing

Attention Deficit Hyperactivity Disorder (ADHD)

problem with concentration and focus, easily distracted, appearing not to listen, lack of followthrough, organizational and time-management challenges, forgetfulness

developmental assessment

provides information about the child's current maturational level that, when compared with the child's chronological age, identifies developmental lags and deficits

1. counseling 2. appropriate schooling 3. IEP

what is implemented for a child with an ID

DSM-5 Domains: 1. Conceptual 2. Social 3. Practical

what is used to determine the severity of an ID

Vanderbilt Assessment Scale, including a parent or teacher form

what is used to diagnose ADHD

"hepatoxicity" yellow skin fever malaise

A nurse is providing teaching to an adolescent client who is to begin taking atomoxetine for ADHD. The nurse should instruct the client to monitor for what adverse effects?

1. administer in the morning 2. monitor for weight loss 3. this med blocks the blocking the synaptic reuptake of serotonin in the brain

A nurse is teaching a client who has intermittent explosive disorder about a new prescription for *fluoxetine*. What information should the nurse provide?

b.

A nurse is teaching a group of parents in a child development class. What does the nurse suggest to the parents to improve impulse disorders in children? a. Encourage angry outbursts b. Provide support to the child c. Follow flexible rules of parenting d. Encourage oppositional behavior

"TCA use = constipation" eat a diet high in fiber

A nurse is providing teaching to an adolescent client who has a new prescription for clomipramine for OCD. What info should the nurse include?

d

A 10-year-old diagnosed with childhood-onset conduct disorder gave a snack with a hidden peanut ingredient to a classmate with a known allergy to peanuts. The classmate suffered a severe allergic reaction. When the nurse counsels the child about this harmful behavior, which comment is most likely? a. "I am sorry I did it. I didn't mean to hurt him." b. "I did not know there were peanuts in that snack." c. "Why are you blaming me? I did not give snacks to anyone." d. "He should have helped me cheat on a test when I asked him."

c

A 12-year-old client expresses anger at his parents' divorce. He listens to music with violent themes, and his performance at school has declined dramatically. The nurse finds him crying in a chair. When the nurse approaches him, he begins screaming and banging his head against the wall. What is the nurse's most appropriate action? a. Arrange for the client to be placed in seclusion. b. Immediately place the client in physical restraints. c. Engage in therapeutic holding with the client. d. Direct the client to free-form movement therapy.

c

A 4-year-old child has poor eye contact and dislikes cuddling. Her language and speech are normal. What does this child's behavior indicate? a. Mild intellectual disability b. Moderate intellectual disability c. Level 1 autism spectrum disorder d. Level 2 autism spectrum disorder

c. Risperidone Risperidone is a second-generation antipsychotic medication that reduces irritability in persons diagnosed with autism spectrum disorder. Propranolol may be used for tremor in motor disorders. Haloperidol is a first generation antipsychotic medication that may be effective for tics. Methylphenidate is a stimulant used for attention deficit-hyperactivity disorder.

A child diagnosed with autism spectrum disorder consistently demonstrates irritability and is easily frustrated. Which medication is most likely to manage these symptoms effectively? a. Propranolol b. Haloperidol c. Risperidone d. Methylphenidate

c

A client is diagnosed as a child with attention deficit-hyperactivity Disorder (ADHA). Achieving which long-term goal will best indicate personal effective condition management as an adult? a. Absence of classic fidgety physical activity b. Mental focus that allows for completion of tasks c. Medication therapy discontinued by health care provider d. Demonstrates effective time management and organizational skills

c. Reactions to trauma

A mental health nurse plans care for four clients, each diagnosed with a different condition: reactive attachment disorder, disinhibited social engagement disorder, adjustment disorder, and acute stress disorder. What commonly shared feature will the nurse's interventions target in clients with these disorders? a. Feelings of guilt b. Self-care deficits c. Reactions to trauma d. Impaired social skills

a. Risk for suicide

A nurse assesses a 15-year-old who stole and wrecked a neighbor's classic antique car. Two years ago, this adolescent self-inflicted stab wounds. Which nursing diagnosis has priority? a. Risk for suicide b. Ineffective coping c. Impaired adjustment d. Impaired social interaction

d. Assembling and disassembling a simple toy alone

A nurse counsels parents of a child diagnosed with severe autism spectrum disorder (ASD). Which suggested activity is most likely to engage this child? a. Singing with a choir of young children b. Playing video games with an older child c. Riding bicycles with a small group of children d. Assembling and disassembling a simple toy alone

B

A nurse is assessing a 4-year-old child for indications of autism spectrum disorder. For which of the following indications should the nurse assess? A. Impulsive behavior B. Repetitive counting C. Destructiveness D. Somatic problems

a, d, e

A nurse is assessing a group of children with oppositional defiant disorder. Which predisposing factors does the nurse identify with this disorder? Select all that apply. a. Parental rejection b. Good family support c. Sociable child behaviors d. Harsh discipline at home e. Attention deficit-hyperactivity disorder

c, d, e

A nurse is assisting the parents of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following is an appropriate strategy for the nurse to recommend? (Select all that apply.) A. Allow the child to choose consequences for negative behavior. B. Use role playing to act out unacceptable behavior. C. Develop a reward system for acceptable behavior. D. Encourage the child to participate in school sports. E. Be consistent when addressing unacceptable behavior.

b. Allow the child to draw and play.

A nurse is caring for a child diagnosed with posttraumatic stress disorder as a result of violence at home. What trauma interventions should the nurse plan for this child? a. Involve the family in caring for the child. b. Allow the child to draw and play. c. Encourage the child to conceal emotions. d. Limit the child's activities.

remove the patch each day after 9 hrs

A nurse is caring for a school age child who has conduct disorder and a new prescription for methylphenidate transdermal patches. What information should the nurse provide about this medication?

a. Apply consistent limits

A nurse is caring for an adolescent client with hostile behavior. What strategies should the nurse adopt when communicating with this client? a. Apply consistent limits b. Use an angry tone when talking c. Maintain a threatening body posture d. Use negotiations to correct behavior

a

A nurse is managing the care of a 19-year-old adult diagnosed with Level 1 autism spectrum disorder. Which intervention will the nurse include in the client's plan of care? a. Organization and planning strategies b. Group therapy that focuses on social skills c. Boundary setting to manage aggressive behavior d. Techniques to help manage repetitive ritualistic behaviors

a, b, c

A nurse is obtaining a health history from the parents of a 12-year-old client who has conduct disorder. Which of the following are expected findings? (Select all that apply.) A. Bullying of others B. Threats of suicide C. Law-breaking activities D. Narcissistic behavior E. Flat affect

b, d, e

A nurse is performing an admission assessment on an adolescent client who has depression. Which of the following is an expected finding? (Select all that apply.) A. Fear of being alone B. Substance use C. Weight gain D. Irritability E. Aggressiveness

D

A nurse working in a pediatric clinic is caring for a preschool-age child who has a new diagnosis of ADHD. When teaching the parent about this disorder, which of the following statements should the nurse include in the teaching? A. "Behaviors associated with ADHD must be present prior to age 3." B. "This disorder is characterized by argumentativeness." C. "Below-average intellectual functioning is associated with ADHD." D. "Because of this disorder, your child is at an increased risk for injury."

b

A parent tells the nurse that his or her child often deliberately annoys others and blames others for misbehavior by saying, "They made me do it." What disorder is the child likely to have? a. Intermittent explosive disorder b. Oppositional defiant disorder c. Pyromania d. Kleptomania

Levels 1, 2, and 3 based on: 1. functional ability 2. social deficits 3. communication

ASD severity is based on what?

b. Conceptual ability c. Social skills d. Practical applications

According to the DSM-5, what factors are used to identify the severity of intellectual disability? Select all that apply. a. IQ range b. Conceptual ability c. Social skills d. Practical applications e. DNA testing

a. Presence of distorted perceptions of invincibility This age group does not have full development of the frontal lobe affecting judgement and impulse control, and often feels invincible.

An emergency department nurse is assessing a 16-year-old adolescent who has been inhaling aerosol paint. In this assessment, which topic must be explored that is different from such an assessment in the adult? a. Presence of distorted perceptions of invincibility b. Presence of possible ideas about hurting self or risking death c. Circumstances that contribute to the individual's instance of substance abuse d. Investigation of precursor feelings such as depression, anger, guilt, and rejection

Oppositional Defiant Disorder (ODD)

Angry mood. Defiant and headstrong behaviors.

a

As an adult, a client who has been diagnosed with childhood-onset conduct disorder is at highest risk for developing what? a. Antisocial personality disorder b. Obsessive-compulsive disorder c. Kleptomania d. Depression

b, c, d, e

Because depression may present differently in children than it does in adults, what is a possible indicator of depression in a child? Select all that apply. a. Hyperactivity and inattention b. Anger and isolation c. Changes in clothing style d. Changes in friendships e. Changes in music tastes f. Selective mutism

Childhood-onset conduct disorder

Can be seen as early as 2 years of age. More severe than ODD. Is physically aggressive, has poor peer relationships, shows little concern for others, and lacks guilt and remorse

1. more available recourses 2. good parenting/mentoring figure 3. neurologically less vulnerable to stress

Children with a high degree of resilience often have these 3 things in common...

Selective Mutism

Consistent failure to speak in situations where speaking is an expectation, although the child is able to speak at other times.

a, b, c, e

Which question is focused on the assessment of a child with a possible diagnosis of oppositional defiant disorder? Select all that apply. a. "What seems to trigger your outbursts?" b. "How do your outbursts make your parents feel?" c. "What would help you control your outbursts?" d. "Do you like going to school and learning?" e. "What do your parents do when you won't do as they ask?"

Reactive Attachment Disorder

Consistent pattern of inhibited, emotionally withdrawn behavior. Child rarely seeks comfort or responds to comforting. s/s: Limited positive affect irritability sadness fearfulness minimal social responsiveness d/t: Inconsistent care frequent changes in caregivers. May resemble autism spectrum disorder, depression, or disruptive mood disregulation disorder tx: Individual and family therapy, and medication for any underlying depression or anxiety, bibliotherapy

Separation Anxiety Disorder

Developmentally inappropriate fear of separation from the person to whom the child is most attached.

Specific learning disorders

Difficulty in learning and academic skills, often in a specific area (reading, written expression, math) ex. dyslexia, dyscalculia

Gender Dysphoria

Feeling of being in wrong gender body

b

For what condition does the Vanderbilt Assessment Scale screen? a. Intellectual disability b. Attention deficit-hyperactivity disorder (ADHD) c. Selective mutism d. Obsessive-compulsive disorder

1. Hereditary (Tay-Sach's Disease, fragile X syndrome) 2. Alterations in early embryo development (downs, fetal alcohol syndrome) 3. pregnancy/perinatal problems (fetal mutation, prematurity, hypoxia, infections) 4. other (trauma, poisoning)

IDs may be the result of...

Specific Phobias, in Childhood

Include fear of the dark, monsters, costumed characters, injections, water, and certain animals. Occur in 5% of children and 16% of adolescents.

c

Insecure attachment is related to trauma associated with whom? a. Strangers b. Siblings c. Caregivers d. Peers

dissociative disorders

May present in childhood or adolescence as the result of abuse or trauma, or modelling of behavior in the family. If a child appears spaced out or withdrawn, abuse or trauma should be considered watch for symptoms of abuse

sleep-wake disorders

Most common are sleep walking, night terror, and nightmares

1. stereotyped/repetitive speech, motor movements, echolalia (repetition of another persons spoken words), and the repetitive use of objects 2. excessive adherence to routines, rituals, or excessive resistance to change 3. fixated interest that are abnormal in intensity 4. hyporactive or hyprreactive to the sense of joy or unusual interest in sensory aspects of the environment (indifference to pain, heat, cold)

Must demonstrate 2 or more of these to be diagnosed with ASDs

IQs

No longer used to define the level of ID impairment

a, e

The nurse is caring for a child who is demonstrating posttraumatic stress behaviors related to possibly being sexually abused. Which intervention will the nurse include in the child's plan of care? Select all that apply. a. Providing the child with puppets to facilitate communication about the possible abuse b. Avoiding the use of sexually oriented terms that could trigger anxiety in the child c. Assuring the child that everything discussed will be kept confidential d. Directing the discussion to focus only on the issue of the possible abuse e. Introducing and practicing relaxation techniques with the child

pica

Persistent eating of non-food substances, not part of a culturally accepted ritual or practice.

Avoidant-Restrictive Food Intake Disorder

Persistent failure to meet nutritional or energy needs.

b

Playing a game of "Simon Says" is an example of which type of therapy appropriate for children? a. Psychodrama b. Movement therapy c. Therapeutic drawing d. Bibliotherapy

Autism Spectrum Disorders (ASDs)

Present with deficits in social and communication interactions, as well as repetitive patterns of behavior, interests, or activities

sexual dysfunctions

Problems with pain and arousal

Excoriation disorder

Recurrent skin picking resulting in skin lesions, infection, and scarring

Trichotillomania

Recurrent twisting or pulling out one's hair resulting in hair loss and sometimes damage

a, b, c, d, e

The nurse is educating a community of parents about psychological and environmental factors that may lead to conduct disorder. What psychological and environmental factors that can lead to conduct disorder should the nurse include in the teaching? Select all that apply. a. Low self-esteem b. Low intelligence c. Violence in the family d. Chaotic and negligent parenting e. Conflict in marriage f. Remorseful nature

Encopresis

Repeated passage of feces into inappropriate places such as clothing or the floor; may be involuntary or intentional. Considered normal until age 4 Gastroenterologist my be needed. Dietary changes (increase fiber and fluids); *positive approach*; bathroom schedule. Cognitive-behavioral therapy to reduce anxiety. Stool softeners, etc., may be needed.

Rumination Disorder

Repeated regurgitation of food, which is then re-chewed, re-swallowed, or spit out.

Enuresis (Nocturnal, Diurnal, or Both)

Repeated voiding of urine into bed or clothes; may be involuntary or intentional. Considered normal until age 5. Bladder training, voiding schedule, limiting night fluids, positive reinforcement; *avoiding shaming*. Bell and pad method has a 70% to 80% success rate.

a. Conduct disorder

Research has found that what childhood disorder is most associated with later substance abuse and elevated rates of mood disorders? a. Conduct disorder b. Attention deficit-hyperactivity disorder c. Autism spectrum disorder d. Tourette's syndrome

1. maternal age 2. exposure to substances 3. poor fetal muscle tone dx: blood/DNA tests, brain scans, IQ, FTT

Risk factors rt IDs

Spence Children's Anxiety Scale; or Hamilton Anxiety Scale

Scales used to assess phobias

d. Level 3 autism spectrum disorder

The nurse observes a 7-year-old child repeatedly removing a coin from his pocket and putting it back. When the nurse addresses the child, he starts banging his wrist against the table. The child's mother speaks to the child, and he begins making odd clicking noises with his tongue. What does this child's behavior indicate? a. Mild intellectual disability b. Moderate intellectual disability c. Level 2 autism spectrum disorder d. Level 3 autism spectrum disorder

d. A nurturing home life with consistent limits and boundaries

The nurse provides parenting skills education to the parents of children diagnosed with oppositional defiant disorder. What should this prepare the parents to provide to the child? a. Prescribed medications and group therapies b. Appropriate socializing activities and academic support c. Adequate food, clothing, shelter, and medical care d. A nurturing home life with consistent limits and boundaries

Paraphilic Disorders

Symptoms include recurrent, intense sexual fantasies, urges or behaviors involving sexual activity with a pre-pubescent child or children; individual is at least 16 years old and at least 5 years older than the child.

b. Antisocial

The health history for an adolescent diagnosed with conduct disorder indicates frequent callous behavior toward others. When this adolescent reaches adulthood, which personality disorder is most likely to emerge? a. Histrionic b. Antisocial c. Dependent d. Schizotypal

b.

The mother of a 6-year-old child expresses concern over the child's frequent temper outbursts. The child deals with any frustration by bullying and hitting and seldom shows any remorse for his or her actions. The nurse who gathers this data will note that the child's behaviors are most consistent with which DSM-5 diagnosis? a. Social phobia b. Conduct disorder c. Oppositional defiant disorder d. Attention deficit-hyperactivity disorder

c

The nurse interviews the parent of a 7-year-old child diagnosed with level 2 autism spectrum disorder. Which remark from the parent describes behavior that is most typical of children diagnosed with autism spectrum disorder? a. "My child occasionally has temper tantrums." b. "Sometimes my child wakes up with nightmares." c. "My child swings for hours on our backyard swing set." d. "Toilet training was more difficult for this child than my other children."

c. Beta blockers may be used in children with obsessive or anxious symptoms. Stimulants and nonstimulants are used in children with attention deficit-hyperactivity disorder. Antipsychotics may help children presenting with aggression and self-harm.

Which medication may be helpful in school-age children suffering from obsessive or anxious symptoms? a. Stimulants b. Antipsychotics c. Beta blockers d. Nonstimulants

c. Conduct disorder

The parents and teachers of a young adult have reported that the person does not obey school rules, destroys school property, and is involved in physical fights. What could be the possible diagnosis for this condition? a. Intermittent explosive disorder b. Oppositional defiant disorder c. Conduct disorder d. Kleptomania

a

What genetically determined constitutional factor is defined as the style of behavior habitually used to cope with demands of the environment? a. Temperament b. Creativity c. Conscience d. Attachment

Resiliency

What is developed through successful transition through a previous crisis, often with guidance and support? how well you recover from difficulties

a, b, d

Which of the following would be considered a predisposing factor for conduct disorder? Select all that apply. a. Chaotic home life b. Attention deficit-hyperactivity disorder (ADHD) c. Being an only child d. Exposure to drug abuse among family members e. Being the first-born

a, b, e

What is true about biochemical factors in attention deficit-hyperactivity disorder (ADHD)? Select all that apply. a. Inattentive-type ADHD is associated with alterations in the norepinephrine transporter gene. b. Hyperactive-impulse-type ADHD is associated with alterations in the dopamine transporter gene. c. Combined-type ADHD is associated with alterations in the serotonin transporter gene. d. Stimulant medications may be most effective in inattentive-type ADHD. e. Serotonin levels play a role in impulsivity and aggression.

a, d

What is true about suicide risk in children and adolescents? Select all that apply. a. HEADSSS is an appropriate scale to measure suicide risk in children and adolescents. b. Suicide is the number one leading cause of death among 15- to 24-year-olds. c. In children and adolescents, suicide is associated with excessive levels of norepinephrine. d. SAD PERSONS is an appropriate scale to measure suicide risk in children and adolescents. e. In children and adolescents, suicide is associated with excessive levels of serotonin.

b. Methylphenidate c. Dextroaphetamine/levoamphetamine e. Lisdexamfetaine

What medication would be most likely to be effective for clients with hyperactive-impulsive-type attention deficit-hyperactivity disorder (ADHD)? Select all that apply. a. Atomoxetine b. Methylphenidate c. Dextroaphetamine/levoamphetamine d. Guanfacine e. Lisdexamfetaine

c

What quality may explain why some individuals tend to survive traumas and stressors more successfully than others? a. Intimacy b. Adversity c. Resiliency d. Impulsivity

1. social/emotional reciprocity 2. verbal/nonverbal communication behavior 3. developing/maintaining relationships appropriate to their developmental level

What to children/adolescents have deficits in with an ASD (Spectrum Disorder)?

a. Comprehensive behavioral intervention for tics (CBIT)

What treatment specific for motor disorders uses habit reversal and relaxation techniques? a. Comprehensive behavioral intervention for tics (CBIT) b. Cognitive behavioral therapy (CBT) c. Positive reinforcement d. Therapeutic holding

a

When considering oppositional defiance disorder (ODD), which behavior will be viewed as mandatory diagnostic criteria? a. Hid the backpack of a classmate who refused to give up answers to a test b. Repeatedly refuses to follow family rules about completing chores c. Was discovered attempting to drown the neighbor's cat d. Ran away from home twice in the last six weeks

c. The issues that result in power struggles and triggers for outbursts

Which assessment is of importance for supporting a diagnosis of oppositional defiant disorder? a. The history, frequency, and triggers for violent outbursts b. The moral development, belief system, and spirituality for the ability to understand the impact of hurtful behavior on others c. The issues that result in power struggles and triggers for outbursts d. Sibling birth order to understand the dynamics of family interaction

a, b, d, e

Which behaviors in an adolescent support the diagnosis of conduct disorder? Select all that apply. a. Physically and verbally bullying classmates b. Juvenile arrest record for stealing on three separate occasions c. Signs of depression with suicidal tendencies d. Sexually suggestive and aggressive e. History of school truancy

a. Deliberately agitating family members b. Vindictive responses to imagined personal wrongs c. Unwillingness to assume responsibility when proven responsible for failures

Which characteristic in a child serves to support the diagnosis of oppositional defiant disorder? Select all that apply. a. Deliberately agitating family members b. Vindictive responses to imagined personal wrongs c. Unwillingness to assume responsibility when proven responsible for failures d. Manipulation regularly used to achieve personal goals e. Passive-aggressive when frustrated rather than outwardly angry

c. A 12-year-old boy with Tourette's Comprehensive Behavioral Intervention for Tics (CBIT) is a new treatment that includes habit reversal, insight, education, and relaxation techniques and has been shown to reduce tics.

Which child is most likely to benefit from CBIT? a. An 8-year-old boy with enuresis b. A 14-year-old girl with pica c. A 12-year-old boy with Tourette's d. A 17-year-old boy with obsessive-compulsive disorder

b. An 8-year-old child who has a medical history that includes several broken bones and a dislocated shoulder. c. A 4-year-old who was hospitalized for 2 months after being injured in an automobile accident. d. A 12-year-old who has been in cancer remission for 3 years since finishing both chemotherapy and radiation treatments.

Which child should be assessed for possible posttraumatic stress disorder (PTSD) as a result of exposure to major trauma in his or her life? Select all that apply. a. A 5-year-old child who lives with grandparents since his or her single parent was deployed by the military 10 months ago. b. An 8-year-old child who has a medical history that includes several broken bones and a dislocated shoulder. c. A 4-year-old who was hospitalized for 2 months after being injured in an automobile accident. d. A 12-year-old who has been in cancer remission for 3 years since finishing both chemotherapy and radiation treatments. e. A 3-year-old whose older sibling was born with both physical and cognitive impairments.

d. "My child's teacher thinks he may have a learning disorder because he doesn't speak in school."

Which comment by the parent of an 8-year-old child best describes behavior related to an anxiety disorder? a. "My child has a terrible temper. He lashes out at me and has trouble making friends." b. "My child never stops squirming and fidgeting. He can't even sit still long enough to eat a meal." c. "My child wets the bed several times a week. He's too embarrassed to wear a diaper at his age." d. "My child's teacher thinks he may have a learning disorder because he doesn't speak in school."

d. Conduct disorder

Which disorder in childhood is recognized as a precursor to future antisocial personality disorder in adults? a. Reactive attachment disorder b. Rumination disorder c. Oppositional defiant disorder d. Conduct disorder

c

Which intervention will the nurse identify for the care plan of a client diagnosed with a moderate form of intellectual disability? a. Discussing options for vocational training b. Providing choices for independent living c. Reinforcing the concepts of money management d. Discussing the choices related with buying a home

a, b, e

Which statement concerning developmental assessment of a 5-year-old child is true? Select all that apply. a. A concern is whether the child is functioning at his or her current chronological age. b. The Denver II Developmental Screening Test is appropriate for this age group. c. A specifically tailored tool should be used to evaluate this child's neuropsychological development. d. Generally, noted abnormal findings are considered to be permanent. e. Stress-related behaviors that are identified may be managed by the nurse.

a, b, c, e

Which statement concerning impulse control disorders is true? Select all that apply. a. The associated behaviors can lead to problems with the law. b. Common misconceptions are that the behaviors are a result of poor parenting. c. Oppositional defiant disorder is one such illness. d. Obsessive-compulsive disorder is one such illness. e. Early diagnosis and treatment is vital to future behaviors.

a, b, c, d

Which statement regarding associated environmental factors is true regarding oppositional defiant disorder? Select all that apply. a. The timing of traumatic effects has a great impact on a child's future development. b. The divorce of parents has a traumatic effect on a child. c. This disorder appears to run in families. d. These behaviors can be learned as well as result from genetics. e. The child's worldview is a result of internalized events, not parental example.

d. "Mom, Dad, and I talk about how much fun we had with Sammy."

Which statement, by a child who recently lost "Sammy," a beloved pet, best demonstrates the parent's role in nurturing the child's resiliency? a. "It's sad but Dad said that pets die every day." b. "Mom promised that I can get another pet really soon." c. "I am glad our cat is still alive." d. "Mom, Dad, and I talk about how much fun we had with Sammy."

a, b, c, e

Which statements regarding the implementation of play therapy are correct? Select all that apply. a. A child learns coping mechanisms through playing with toys. b. Limits are set only to promote security and provide a sense of reality. c. The expression of feelings is supported through the use of a variety of toys. d. Therapists direct the focus of a child's play toward identified problem areas. e. Acting out situations with dolls and puppets substitutes for verbal discussions.

a, b, d, e

Which unit intervention is appropriate for a hospitalized child diagnosed with an impulse control disorder? Select all that apply. a. Care plans will include daily relationship strengthening activities with each child. b. There are posted consequences for specific unacceptable behaviors. c. Flexibility is encouraged regarding rule interruption among unit staff members. d. Therapy will be goal oriented in its focus. e. Orientation to unit will include detailed explanation of rules and boundaries.

b. The child feels a lack of support in his or her life. Children's drawings may be interpreted for clues about their emotions that they may be unable to fully express verbally. Omission of legs from drawings of people suggests the child feels a lack of support in his or her life.

While engaged in therapeutic drawing, a 6-year-old child draws people without legs. What does this omission most likely suggest? a. The child has poor impulse control. b. The child feels a lack of support in his or her life. c. The child is shy and insecure. d. The child has difficulty expressing him- or herself.

bibliotherapy (Reactive Attachment Disorder)

books relating to the individual child's situation

developmental coordination disorder

delayed coordinated motor skills: clumsiness, slowness, difficulty with handwriting or riding bike

practical

domain that has to do with ability for self-care and life management

conceptual

domain that has to do with academic learning/speech

social

domain that has to do with interaction with other

disruptive mood dysregulation disorder

must be diagnosed in childhood, onset before age 10, severe recurrent outbursts, persistent irritability, uneven development look for signs of depression seen in adults

antisocial personality disorder

neurocognative disorder that cannot be diagnosed before age 18

personality disorders

neurocognitive disorder that must be present for more than one year if diagnosed prior to age 18

Intellectual Disability (ID)

neurodeveopmental disorder formerly called mental retardation

Adolescent-onset conduct disorder

results in less aggression Acts out misconduct with peer group (e.g., truancy, early-onset sexual behaviors, drinking, substance abuse, risk-taking behaviors)

Age group: incomplete frontal lobe development, affecting judgment, impulse control, and feeling of invincibility

risk factors for substance-related and addictive disorders

Somatic Symptom Disorder

symptoms due to anxiety, stress, or modelling behavior. Headaches, tummy aches, fatigue, frequent visits to school nurse

schizophrenia and psychotic disorders

symptoms late teens to mid 30s, hallucinations, paranoia, delusional or bizarre thinking, diminished emotional expression, and social impairment during acute stages hospitalization may be necessary although rare in childhood, may be misdiagnosed as autism

bipolar and related disorders

symptoms usually in late teens, mood labile, vacillating from depression to elevated states called mania or the less severe hypomania look for mood changes, and assess for suicidal thoughts, plans, and attempts using instruments such as the SAD PERSONS scale