impulse control
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?
"He should have helped me cheat on a test when I asked him."
A patient has an impulse-control disorder. The nurse is teaching the patient's family how to prevent an aggressive response from the patient. What statements made by a family member indicate a need for further education?
"I should avoid using matter-of-fact sentences." "I should avoid setting limits consistently."
A nurse interviews the parents of a 19-year-old male diagnosed with intermittent explosive disorder. Which comments from these parents are most likely?
"We get scared that our son will hurt us." "There has always been chaos in our family." "All of our son's grandparents are alcoholics."
Which child is demonstrating behaviors that support a diagnosis of adolescent onset conduct disorder?
A 12-year-old male who steals a bicycle as a gang initiation
The nurse responsible for the safety of a 10-year-old patient diagnosed with impulse control disorder is most concerned about which of the following?
A notation in the child's medical history describing a previous suicide attempt.
The nurse provides parenting skills education to the parents of children diagnosed with oppositional defiant disorder with the primary expectation that they will then be prepared to provide the child with:
A nurturing home life with consistent limits and boundaries
A nurse is teaching a group of teachers about managing children with disruptive behaviors. What suggestion can help the teachers plan their activities to prevent these children from getting frustrated?
Alternate physical and mental activities
While using pharmacological therapy to treat a patient with intermittent explosive disorder, which therapy should be avoided?
Antianxiety medications
Which classification of medication may be prescribed in intermittent explosive disorder?
Anticonvulsants
The health care provider considers medication for a 14-year-old diagnosed with conduct disorder. This adolescent's behavior shows aggression, impulsivity, and hyperactivity. The nurse will prepare educational materials regarding which type of medication?
Antipsychotic
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?
Antisocial
As an adult, a client who has been diagnosed with childhood-onset conduct disorder is at high risk for developing what?
Antisocial personality disorder
A nurse is caring for a patient with hostile behavior. What strategies should the nurse adopt when communicating with this patient?
Apply consistent limits
Which factors are considered when determining a patient is at high risk for suicide?
Attempted suicide two years ago Father committed suicide at age 45 Reports excessive reliance upon alcohol
Which of the following would not be considered a predisposing factor for conduct disorder?
Being an only child
Which behavior consistently demonstrated by a child is a predictor of future antisocial personality disorder in adults?
Callousness
Which unit intervention is appropriate for a hospitalized child diagnosed with an impulse control disorder?
Care plans will include daily relationship strengthening activities with each child. There are posted consequences for specific unacceptable behaviors. Therapy will be goal-oriented in its focus. Orientation to unit will include detailed explanation of rules and boundaries.
After reviewing the following information, select the intervention that best addresses the evidence-based care identified as a need of the hospitalized child diagnosed with conduct disorder.
Care plans will include daily relationship-strengthening activities with each child.
The nurse prepares the plan of care for a 9-year-old diagnosed with childhood-onset conduct disorder. Which nursing diagnosis is most likely to apply to this child?
Chronic low self-esteem
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 the Diagnostic and Statistical Manual of Mental Disorders DSM-5 diagnosis of
Conduct disorder
The nurse is assessing an adult patient with a history of immature coping skills and poor problem-solving abilities. Which impulsive disorder do these features represent?
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?
Conduct disorder
When working with a patient demonstrating impulse control disorders, all of the following nursing interventions have priority except
Confronting the patient concerning the disruptive behavior
A nurse observes unlicensed assistive personnel (UAPs) in a residential treatment setting for adolescents diagnosed with impulse control disorders. The UAPs frequently are controlling, challenging, and demanding during interactions. The nurse plans staff development sessions focused on improving communication skills. Which finding regarding the adolescents shows that the desired learning occurred?
Decreased aggressive behavior
The nurse is interviewing the family of a patient with a history of oppositional defiant disorder and notes that the patient blames coworkers and family for his own behavior and states that he is better than the rest of them. What nursing diagnosis does this reflect?
Defensive coping
Which characteristic in a child serves to support the diagnosis of oppositional defiant disorder?
Deliberately agitating family members Vindictive responses to imagined personal wrongs Cannot assume responsibility when proven responsible for failures
Ariel Castro was convicted in 2013 of kidnapping, raping, and torturing three women for over 10 years. At his sentencing hearing he said, "We had a lot of harmony going on in that home." Which sentiment is most evident in his comment?
Denial
Which nursing interventions are appropriate for a care plan that focuses on intermittent explosive disorder?
Establishing a trusting relationship with the patient
A patient diagnosed with conduct disorder craves
Excitement without concern for possible negative outcomes
A nurse is assessing a patient with conduct disorder. Which assessment findings would indicate suicidal risk in the patient?
Feelings of despair Impulsive behavior Past suicide attempts
The nurse is teaching the family of a patient with intermittent explosive disorder. What conditions may be associated with intermittent explosive disorder?
Hypertension Diabetes Anxiety disorders
Which short-term outcomes would be appropriate for a teenager diagnosed with impulse control disorder who has been hospitalized for suicidal ideations?
Identify support persons to contact when ideations occur Express feelings that trigger ideations to staff as soon as they occur Agree not to harm self for the next 12 hours
When treating impulse control disorders, psychodynamic psychotherapy is directed toward
Identifying the triggers of the rage
The nurse is caring for a patient with an impulse disorder who is undergoing multisystemic therapy. How would the patient demonstrate improvement due to this therapy?
Improvement in functioning of the child within the family Improvement in school performance
While reviewing a patient's medical report, the nurse finds out that there is an increase in gray matter in left temporal area of the patient's brain. Which behavioral symptoms does the nurse correlate with this report?
Impulsivity Antisocial personality Aggression
A patient is diagnosed with oppositional defiant disorder. Which neurobiological changes in the brain are related to oppositional defiant disorder?
Increased gray matter in the left temporal area Decreased gray matter density in the orbitofrontal cortex Decreased gray matter density in the left prefrontal cortex
A nurse is assessing a patient known to have oppositional defiant disorder. Which diagnosis does the nurse formulate when the child shows hostile laughter?
Ineffective coping
A nurse is assessing a young man who has repeated outbursts of aggression. The family complains that the man seems to calm down initially but then explodes with rage and may even hit others. What does the nurse identify this condition as?
Intermittent explosive disorder
The primary characteristic that separates intermittent explosive disorder (IED) from oppositional defiance is that IED
Is diagnosed in individuals 18 years of age or older
Which statements are true regarding childhood-onset conduct disorder?
It is more commonly diagnosed in males. It is characterized by disregard for the rights of others. It allows patients to rationalize their aggressive behaviors.
A nurse is assessing an adolescent boy from an upper-class family. He has an irresistible desire to steal objects from others' bags. What does the nurse diagnose this condition as?
Kleptomania
A patient says, "When I go to the mall, I steal things. I don't know why I do it because I take things I don't need." Which term applies to this behavior?
Kleptomania
A nurse is caring for a child who has callousness as a type of conduct disorder. Which behaviors does the nurse identify as features of this disorder?
Lack of empathy Indifference to family commitments Unconcerned about other's emotions
Which technique for managing disruptive behaviors is most analogous to assertiveness?
Limit setting
Staff working on an inpatient adolescent mental health unit desire to maintain safety and a calm milieu. Which technique should staff use most for interactions with patients?
Low expressed emotion
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?
Low self-esteem Low intelligence Chaotic and negligent parenting Conflict in marriage
A nurse is assessing a child who exhibits disruptive behavior at home and school. Which intervention does the nurse advise to the parents when the child throws furniture at home?
Make the child replace the disturbed furniture
Which characteristic supports the diagnosis of intermittent explosive disorder?
Male who is 19 years old Has a history of damaging the property of others Frequently demonstrates anger by shouting
The nurse is providing information about dialectical behavioral therapy to the parents of a patient with conduct disorder. Which skills are taught in this therapy?
Mindfulness Emotional Regulation Distress tolerance Personal effectiveness
A mother tells the nurse that 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?
Oppositional defiant disorder
A nurse is assessing a group of children with oppositional defiant disorder. Which predisposing factors does the nurse identify with this disorder?
Parental rejection Harsh discipline at home Attention deficit hyperactivity disorder
The nurse is assessing a patient with impulse disorder for suicidal tendencies. What suicidal predictors does the nurse assess for in the patient?
Past suicidal attempts Family history of suicide attempt Feeling of hopelessness Drug or alcohol use
The nurse is preparing to set goals for a 10-year-old diagnosed with an impulse control disorder. To best ensure the expected therapeutic outcomes, the nurse includes goals that are:
Patient-centered and includes the patient's input
An adult patient is being treated for conduct disorder. The nurse observes that the patient becomes violent and starts to hurt himself and others. What management technique is used as a last resort?
Physical restraint
Which behaviors in an adolescent support the diagnosis of conduct disorder?
Physically and verbally bullies classmates regularly Juvenile arrest record for stealing on three separate occasions Sexually suggestive and aggressive Has a history of school truancy
A nurse is teaching a group of teachers about managing oppositional behaviors in children. Which technique should the nurse suggest when a child shows disruptive behavior to seek attention?
Planned ignoring
Which statement is true regarding the relationship between parenting and behavioral problems in a child?
Poor parenting does not necessarily result in behavioral problems.
The nurse is caring for a patient with conduct disorder. What psychosocial interventions may be needed for this patient?
Provide a climate of safety. Set limits and expectations. Provide structure and boundaries.
A nurse is teaching a group of parents in a child development class. What does the nurse suggest to the parents to avoid impulse disorders in children?
Provide support to the child
Which intervention is NOT therapeutic when attempting to reduce a patient's agitation?
Relaxing rules before they trigger aggression
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?
Risk for suicide
A nurse is caring for a patient with impulse control disorders. What nursing diagnosis is appropriate when the patient shows clenched fists and has a rigid body posture?
Risk of violence to others
Which nursing interventions are helpful when working with parents or caregivers of children and adolescents with impulse disorders?
Teach them role-playing techniques. Show them how to make home a safe environment. Refer parents and caregivers to local self-help groups.
Which statement concerning impulse control disorders is true?
The associated behaviors can lead to problems with the law. Common misconceptions are that the behaviors are a result of poor parenting. Oppositional defiant disorder is one such illness. Early diagnosis and treatment is vital to future behaviors.
A nurse is caring for a child with behavior issues and reads the diagnosis as oppositional disorder. Which behavior does the nurse observe in relation to this diagnosis?
The child is irritable and vindictive.
Which assessment is of importance for supporting a diagnosis of oppositional defiant disorder?
The issues that result in power struggles and triggers for outbursts
Which statement regarding associated environmental factors is true regarding oppositional defiant disorder?
The timing of traumatic effects has a great impact on a child's future development. The divorce of parents has a traumatic effect on a child. This disorder appears to run in families. These behaviors can be learned as well as resulting from genetics.
Which statement is true about the characteristics of the oppositional defiant child?
These behaviors are a predictor of future mental health disorders.
A nurse works in a psychiatric clinic and manages patients with impulsive disorders. Why should the nurse apply cognitive behavior therapy (CBT)?
To develop realistic and positive thoughts To focus on the patient's emotions and behavior To identify the triggers of maladaptive behaviors
When parents share that their 8-year-old child seems to "always try to be annoying and hateful," the nurse suspects the child is
Vindictive
Which question is focused on the assessment of a child with a possible diagnosis of oppositional defiant disorder?
What seems to trigger your outbursts?" "How do your outbursts make your parents feel?" "What would help you control your outbursts?" "What do your parents do when you won't do as they ask?"
Comorbid conditions commonly associated with oppositional defiant disorder do NOT include
conversion disorder.
Pyromania, a behavior associated with impulse control disorders, causes an individual to engage in which problematic behavior?
start fires.
A poorly developed sense of empathy is thought to be the result of having
unmet physical and emotional needs.
