WEEK 9 [ADN 220] "DEVELOPMENT, AUTISM, CP, FTT"
The nurse is observing a 17-year-old client with attention-deficit/hyperactivity disorder (ADHD) at home. Which observation indicates to the nurse that client outcomes have been met? The client folds half a basket of laundry and leaves the rest to read a magazine. The client receives several text messages from friends and does not respond until after asking permission to do so. The client receives poor grades on homework for not completing assignments as requested. The client talks incessantly, jumping from one topic to another.
client receives several text messages from friends and does not respond until after asking permission to do so
A community health nurse is educating pregnant clients about the prenatal causes and risk factors associated with the development of attention-deficit/hyperactivity disorder (ADHD). Which statement will the nurse include? "ADHD has been linked to childhood exposure to folate." "ADHD has not been linked to prenatal exposure or disease." "ADHD has been linked to prenatal exposure to cigarette smoke." "ADHD has been linked to a specific gene, and genetic testing may help to diagnose this."
"ADHD has been linked to prenatal exposure to cigarette smoke."
The nurse is discussing a 13-year-old female client's recent diagnosis of attention-deficit/hyperactivity disorder (ADHD) with her parents. The client's mother states, "Our daughter has a male cousin who also has ADHD, but he doesn't act anything like her." How would the nurse best explain this difference to the client's parents? "Girls are usually younger than boys at the time of diagnosis." "Girls with ADHD tend to show less impulsiveness than boys with ADHD." "Girls with ADHD tend to show fewer language problems than boys with ADHD." "Girls with ADHD tend to show more aggression than boys with ADHD."
"Girls with ADHD tend to show less impulsiveness than boys with ADHD."
The nurse is caring for a family with four children whose third child has been diagnosed with ADHD. After completing an assessment, which statement made by the mother leads the nurse to a diagnosis of compromised family coping? "I don't know how to tell the rest of the family or how we will manage the other children." "Will he have to be put in an institution?" "We need to alert the teachers at school so they will know how to give the medication." "I'm not sure if we should let my child act in the school play."
"I don't know how to tell the rest of the family or how we will manage the other children."
The nurse is caring for a 6-year-old child who was recently diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which statement by the child's mother indicates to the nurse that teaching goals have not been achieved? "I will give him his ADHD medication with his meals." "I will take my child to the physician every 3 months for a weight and height check." "I will let him do his homework while he is watching his favorite television show." "I will stick to the same routine each day after school."
"I will let him do his homework while he is watching his favorite television show."
The parents of a toddler are concerned that their daughter sits quietly to play, but does not actively interact with her playmates who are sitting nearby. What should the nurse explain to the parents? "It is typical for toddlers to engage in solitary play." "It is typical for toddlers to engage in parallel play." "It is typical for toddlers to engage in cooperative play." "It is typical for toddlers to engage in dramatic play."
"It is typical for toddlers to engage in parallel play."
Kara arrives for her follow-up visit, and you call her back to the examination room. You begin the client history and interview. What information provided by Kara's father might indicate that Kara's condition has worsened? "When Kara wears a t-shirt, one side hangs lower than the other side." "Kara needs to have the hem on all her dresses adjusted." "Kara only wears her shirts tucked in now." "Kara has to roll up her jeans as they all appear too long."
"When Kara wears a t-shirt, one side hangs lower than the other side
A nurse is caring for a child who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client's healthcare provider has prescribed amphetamine-dextroamphetamine (Adderall) to treat the child's disorder. What statement will the nurse make to the child's parent regarding this medication? "This medication may increase the risk of psychosis." "Your child's liver function should be monitored with this medication." "Your child's growth may be delayed with this medication." "This medication has less abuse tendency because it is not a stimulant."
"Your child's growth may be delayed with this medication."
Thirteen-year-old Kara Justice arrives at the health care provider's office after being screened for scoliosis by the school nurse. You call Kara back to the exam room for a complete assessment. Kara is accompanied by her father. You carefully assess Kara's back and extremities. While she stands with her back to you, you notice that her hips and shoulders are uneven. You have her perform the Adams test (forward-bending test), which reveals a curve requiring further evaluation. Upon further question, Kara admits to occasional back pain. You report your findings to the health care provider, who orders radiology testing. Kara and her father are instructed to go to the radiology department for x-rays that will determine the degree of her spinal curvature. The radiologist reads the x-rays, which reveal a curve of 10°. You call Kara's father and inform him that no treatment is required at this time, but that Kara should be seen in the office in 6 months for a follow-up. You review Kara's medical record and note that Kara has both a brother and a sister at home. What information should you provide to Kara's father regarding his other children? "Your other daughter will need to be screened for scoliosis. Boys are not at risk for developing the disease." "Your other children should undergo genetic testing to determine if they are at risk for developing scoliosis." "We will make an appointment for your other children to begin physical therapy to avoid developing scoliosis." "Your other children should also be screened for scoliosis."
"Your other children should also be screened for scoliosis."
The community health nurse is working with a group of women from another country who smoke. The nurse is encouraging them to stop smoking before and during pregnancy. The nurse knows that her teaching has been effective when the women state that the reason to stop smoking is to lessen the chance that their children could develop which health problem? Unhappy memories Attention-deficit/hyperactivity disorder (ADHD) A personality disorder Benzodiazepine withdrawal
Attention-deficit/hyperactivity disorder (ADHD)
The nurse is caring for a client who has cerebral palsy. Which independent intervention is appropriate for the nurse to provide? Mood stabilizers should be prescribed to control seizures. Muscle relaxants should be prescribed to control spasms. Range-of-motion (ROM) exercises should be used to promote flexibility and prevent contracture formation. Speech therapy should be provided to promote communication.T
Range-of-motion (ROM) exercises should be used to promote flexibility and prevent contracture formation
The mother of 8-month-old Hannah Morgan is concerned that her daughter, who weighed 8 pounds at birth, is now overweight at 18 pounds. How should the nurse respond to the mother? "At this stage, a child requires a more limited food intake, so Hannah's weight gain should stabilize." "You are correct. Hannah is at risk for obesity, and you should consult with a nutritionist." "Hannah's growth is on target as a baby's birth weight triples in the first year." "Hannah may be slightly under weight, and you should consult with a nutritionist."
"Hannah's growth is on target as a baby's birth weight triples in the first year."
Lainey Fuller, a 10-year-old girl with attention-deficit/hyperactivity disorder (ADHD), has been taking atomoxetine (Strattera) for the past 4 months. It has not improved her symptoms, so her healthcare provider is changing her prescription to methylphenidate (Ritalin). Lainey's mother asks, "Isn't Ritalin a stimulant? That doesn't make any sense. How is a stimulant going to help Lainey get better?" What is the nurse's best response? "Stimulants like Ritalin will cause side effects like headache, increased heart rate, loss of appetite, and insomnia even when they are successful in treating ADHD." "It does seem like the opposite of what should happen, but stimulants help improve focus and attention in children with ADHD and do not increase hyperactivity." "Side effects with Strattera are less serious than with stimulants, but there is an increased risk of suicide in children taking Strattera, which is why we are making the switch." "We will have to watch Lainey's growth carefully when she is taking Ritalin because stimulants can decrease the amount of height and weight she gains."
"It does seem like the opposite of what should happen, but stimulants help improve focus and attention in children with ADHD and do not increase hyperactivity
A 6-year-old child with cerebral palsy who is new to the school district is experiencing severe rigidity and spasticity. Which recommendation would the school nurse make to the child's parents? "Make an appointment with a physical therapist." "Look into special schools for the handicapped." "Discourage the use of a computer." "Offer only low-carbohydrate, low-calorie foods to the child."
"Make an appointment with a physical therapist."
A nurse is caring for a client who has been diagnosed with autism spectrum disorder. His parents cannot understand how their son developed this disorder since there is no family history of it and the client was not subjected to harmful substances. Which response by the nurse is the most appropriate? "Sometimes the specific cause of ASD cannot be determined." "ASD is caused by poor nutritional intake." "ASD is caused by low birth weight." "Factors such as radiation exposure, parental age, or parental disease states can cause chromosomal disorders."
"Sometimes the specific cause of ASD cannot be determined."
Kara asks you how many hours she will need to wear the brace each day. You respond by telling her: "You will need to wear the brace 23 hours a day." "You will need to wear the brace 8 hours each day while you sleep." "You will need to wear the brace at least 12 hours each day." "You only need to wear the brace while you play sports."
"You will need to wear the brace 23 hours a day."
Mr. Justice is concerned that Kara will have to wear a brace. You educate him that scoliosis does not require bracing until the curve reaches: 25 to 30 degrees 20 to 25 degrees 15 to 20 degrees 30 to 35 degrees
25 to 30 degrees
The nurse is providing care to a group of pediatric clients seen for well-child check-ups. Which client may require a more in-depth developmental assessment from the nurse? A newborn born at 39 weeks gestation A toddler receiving age appropriate vaccinations A preschooler who was recently adopted from China An adolescent who is traveling to Europe over summer vacation
A preschooler who was recently adopted from China
Which surgical intervention is not used to treat cerebral palsy (CP)? Achilles tendon shortening Dorsal rhizotomy Surgically implanted intrathecal pump Releasing the hamstrings
Achilles tendon shortening
Jason is a 5-year-old boy with autism spectrum disorder (ASD). He is at the office for his annual physical. Upon entering the room the nurse notices that he is sitting on his mother's lap playing with his teddy bear. He does not respond to the nurse's greeting. Which approach is most appropriate for the nurse to use with Jason? Allow Jason to stay on his mother's lap, keep his teddy bear, and speak to him calmly and concisely. Explain that this is not at all unusual and that there is not much that can be done as this is the normal progression of the disorder. Engage as little as possible with Jason so as not to upset him more and keep to the task at hand
Allow Jason to stay on his mother's lap, keep his teddy bear, and speak to him calmly and concisely.
An 8-year-old boy with attention-deficit/hyperactivity disorder (ADHD) arrives at the clinic for a well visit with his parents. The client's parents appear fatigued and argue with each other when answering questions about the client's home and school routine. The client talks happily about school and new friends he has made this year. The client has been taking methylphenidate (Ritalin) for the past year, and his parents verbalize proper administration and management of the medication. Which is the priority nursing diagnosis for this client? Increased risk for injury Alterations in family processes Impaired socialization Potential for enhanced self-esteem
Alterations in family processes
The nurse is caring for a client recently diagnosed with autism spectrum disorder (ASD). The client's mother asks the nurse about medications that may be prescribed for ASD. Which medication will not be included in the teaching session? Mood stabilizers Selective serotonin reuptake inhibitors (SSRIs) Stimulant agents Antipyretic agents
Antipyretic agents
Which medication is often prescribed for a client with cerebral palsy? Antipsychotics Stimulants Antidepressants Antispasmotics
Antispasmotics
During an assessment, the nurse suspects that an 11-month-old infant is demonstrating manifestations of cerebral palsy. Which assessment finding would bring the nurse to this conclusion? (Select all that apply.) Asymmetric crawling Head lag Arched back Thumb sucking Poor trunk control
Asymmetric crawling Head lag Arched back Poor trunk control
The nurse is educating a 27-year-old client with attention-deficit/hyperactivity disorder (ADHD) who is taking ADHD medications. About which medication would the nurse most likely educate the client? Methylphenidate (Ritalin) Dextroamphetamine (Adderall) Atomoxetine (Strattera) Guanfacine (Intuniv)
Atomoxetine (Strattera)
The mother of 10-year-old Michael Donahue is concerned because her son fidgets and talks a lot, loses things, and doesn't like school work. The nurse should consider that Michael may have which developmental disorder? Cerebral palsy Attention-deficit/hyperactivity disorder Autism spectrum disorder Failure to thrive
Attention-deficit/hyperactivity disorder
Kara was sent for x-rays prior to her follow-up appointment. Kara's x-ray results indicate a curvature of 30 degrees. Based on this diagnostic finding, you teach Kara and her family that she will require which treatment option? Boston brace Occupational therapy Surgery Halo brace
Boston brace
Stacy Capers is a term female newborn diagnosed with an infection contracted in utero. The healthcare provider advises the parents that the newborn may have spastic cerebral palsy (CP) because of a brain insult related to the infection. When talking with the parents, which area of the brain will the nurse indicate is affected by the insult? Multiple areas Cerebellum Cerebral cortex Basal ganglia
Cerebral cortex
During a routine exam, the nurse notices that Emma Adams, a 2-year-old girl, shows signs of inadequate coordination and muscle stiffness. This may indicate that Emma may be suffering from which developmental disorder? Cerebral palsy Autism spectrum disorder Attention-deficit/hyperactivity disorder Failure to thrive
Cerebral palsy
A nurse is caring for a toddler client whose parent suspects the child may have attention-deficit/hyperactivity disorder (ADHD). Which statements should the nurse recognize as true regarding the diagnostic criteria for ADHD? Select all that apply. Diagnostic criteria for ADHD are nonspecific and vary with every child. Children must have 6 or more symptoms that have persisted for 6 or more months with negative impacts. Children must have a physical examination prior to the diagnosis of ADHD to rule out other diseases. Children must have 3 or more symptoms that have persisted for 3 or more months with negative impacts. Children with learning disabilities are often misdiagnosed as having ADHD.
Children must have 6 or more symptoms that have persisted for 6 or more months with negative impacts. Children must have a physical examination prior to the diagnosis of ADHD to rule out other diseases. Children with learning disabilities are often misdiagnosed as having ADHD.
The nurse is assessing a 3-year-old child for symptoms of autism spectrum disorder (ASD). Which assessment finding does not support the diagnosis of ASD? Inability to react accordingly to social clues Displays self-destructive behavior Comprehends language well beyond the complexity of age Engages in repetitive behaviors
Comprehends language well beyond the complexity of age
The parents of Tyler Thomas, a 5-year-old client with mixed cerebral palsy, ask why a baclofen pump is scheduled to be surgically implanted in the child. Which explanation would the nurse give about the purpose of this medication pump? Prevents infections Allows flat-footed walking Increases ankle range of motion Controls muscle spasms
Controls muscle spasms
The nurse is teaching the family of a child who has been prescribed amphetamine mixed salts (Adderall) for attention-deficit/hyperactivity disorder (ADHD). At which time should the nurse instruct the family to provide the medication? Before lunch At bedtime Early in the morning With the evening meal
Early in the morning
In collaboration with a medical team, the nurse is caring for Jason Cox, a 3-month-old infant being treated for failure to thrive. Which type of care should the nurse provide for Jason and his caregivers? Physical therapy Behavioral therapy Psychological testing Education on home safety
Education on home safety
The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD) who wants to play soccer. Which action is the most appropriate for the school nurse to take? Ask the child's mother to get permission from the child's physician to play soccer. Recommend that the child become active in an individual sport, rather than a team sport. Encourage the child to play soccer. Discourage the child from playing a team sport like soccer.
Encourage the child to play soccer.
The nurse assessing a 25-month-old toddler client notices that she is not communicating with words. Which comment by the mother supports the diagnosis of autism spectrum disorder (ASD)? Responds to conversations in the room Enjoys cuddling Likes to play with his siblings Engages in mostly solitary activity
Engages in mostly solitary activity
Which specific types of independent interventions should a nurse provide to a client or client's family who has growth and development alterations? (Select all that apply.) Ensure that the client is properly fitted with orthotic devices, if prescribed Provide speech therapy Prescribe medication for treatment Facilitate connections with support groups and financial aid services Provide instruction on the creation of a safe home environment
Ensure that the client is properly fitted with orthotic devices, if prescribed Facilitate connections with support groups and financial aid services Provide instruction on the creation of a safe home environment
The nurse is educating the parents of a child recently diagnosed with autism spectrum disorder (ASD). The parents ask the nurse how this could have happened. Which etiologies will the nurse include in the response to the client's parents? Select all that apply. Immunologic factors Mercury-containing vaccinations Environmental factors Genetics Neurotransmitters
Environmental factors Genetics Neurotransmitters
The nurse is assessing an adult client with suspected attention-deficit/hyperactivity disorder (ADHD). Which finding would the nurse most likely observe? Excessive talking Stands up mid-interview Squirming in chair Fidgeting with hands or feet
Excessive talking
The nurse is addressing a group of high-risk teen mothers. Which risk factors that can lead to attention-deficit/hyperactivity disorder (ADHD) in children would the nurse describe to the teen mothers? Select all that apply. Exposure to high levels of lead in childhood Poor nutrition Drinking alcohol during pregnancy Lack of proper parenting
Exposure to high levels of lead in childhood Poor nutrition Drinking alcohol during pregnancy Lack of proper parenting
You are providing care to Trevor, a 6-year-old client who is diagnosed with autism spectrum disorder (ASD). As you review the medicalrecord, which item in the health history may have caused Trevor to develop ASD? Appropriate adaptation to new environments Fetal alcohol syndrome Childhood vaccinations Cystic fibrosis
Fetal alcohol syndrome
A nurse is caring for a 10-year-old client who is scheduled to have a tonsillectomy the next day. The nurse has planned a preoperative teaching session for the child, who has a history of attention-deficit/hyperactivity disorder (ADHD). Which teaching technique should the nurse use for this client? Ask other children who have had this procedure to talk to the child. Give instructions verbally and use a picture pamphlet, repeating points more than once. Allow the child to lead the session to gain a sense of control. Play a television show in the background.
Give instructions verbally and use a picture pamphlet, repeating points more than once.
The family of a client diagnosed with autism spectrum disorder (ASD) has opted to begin a gluten-free and casein-free diet. Which food choices indicate appropriate understanding of this diet? Select all that apply. Grilled salmon Soy milk Cornmeal Yogurt Cheese
Grilled salmon
Which assessment findings are specific to the infant stage of growth and development? (Select all that apply.) Jaw proportions change. Growth is associated with body type and quality of feeding. Height increases by about 1 foot. The child requires a more limited food intake. Most growth takes place in long bones.
Growth is associated with body type and quality of feeding. Height increases by about 1 foot.
A 34-year-old client recently diagnosed with attention-deficit/hyperactivity disorder (ADHD) asks the nurse about treatment options. Which treatment options should the nurse describe? Select all that apply. Having an orderly work area Prescribing nonstimulant medication atomoxetine (Strattera) Prescribing stimulant medications such as dexmethylphenidate (Focalin) Allowing for a flexible schedule Maintaining a quiet environment
Having an orderly work area Prescribing non-stimulant medication atomoxetine (Strattera) Maintaining a quiet environment
A team approach is being used to help a middle-age client with autism spectrum disorder (ASD) achieve his full potential. A community center has been engaged to help find a position for him. Which strategy will allow this client to have the best opportunity for success? Those with ASD generally cannot work as the disorder is too debilitating to allow for them to be productive community members. Help the client find a position that will allow him to use his strongest talents. Make sure the job is an easy one. Partner the client with someone else at work so that they can keep an eye on him at all times.
Help the client find a position that will allow him to use his strongest talents..
A 9-month-old child has been diagnosed with ataxic cerebral palsy (CP). Which clinical manifestation would the nurse expect to assess in this client? Hypertonia and persistence primitive reflexes Hemiplegia and hypertonia Hypotonia and muscle instability Tremors and exaggerated posturing
Hypotonia and muscle instability
As compared with boys, girls with attention-deficit/hyperactivity disorder (ADHD) typically show less of which characteristic? Impulsiveness Mood swings Cognitive problems Anxiety
Impulsiveness
A parents group asks the nurse what they would look for if they suspected their child has attention-deficit/hyperactivity disorder (ADHD). Which observations would the nurse have the parents report for further assessment? Select all that apply. Inability to stay on an assigned task to completion Limited attention span when speaking with parent Having difficulty with learning at school Deliberately destroys other people's property Excessive motor activity
Inability to stay on an assigned task to completion Limited attention span when speaking with parent Having difficulty with learning at school Excessive motor activity
The nurse is providing care to a hospitalized child who is diagnosed with autism spectrum disorder. Which intervention is appropriate for this child? Enforcing strict visitation policies Communicating with the child in the same manner as communicating with the parents Encouraging frequent hand washing Incorporating rituals used at home in the hospital environment
Incorporating rituals used at home in the hospital environment
Which factor cause cerebral palsy before or during birth? (Select all that apply.) Neonatal sepsis Injury to periventricular white matter Hyperbilirubinemia Fetal viral infection Premature birth
Injury to periventricular white matter Fetal viral infection Premature birth
Which is a side effect of stimulants used as medication for children with ADHD? Stomach pain Irritability Constipation Insomnia
Insomnia
Kara's father asks you why there is a need for follow-up when the curvature does not need treatment. What is your best response to Mr. Justice's question? Kara requires follow up because curves generally worsen during growth spurts. Would you like to see a different provider in 6 months? The follow-up visit is only a recommendation; because Kara is done growing, it is not required. We can conduct a phone interview to determine if the curvature has gotten worse.
Kara requires follow up because curves generally worsen during growth spurts.
Mr. Justice asks you if Kara will have any activity restrictions after surgery. What is your best response to Mr. Justice's question? Kara should not bend or twist at the waist. Kara should not climb steps following surgery. Kara should be encouraged to ride her bicycle. Kara will no longer be able to go swimming.
Kara should not bend or twist at the waist.
A nurse is assessing an adult client with autism spectrum disorder (ASD). Which characteristic of autism spectrum disorder (ASD) is not likely to be problematic for thisclient? Comprehending nonverbal clues Flexibility of thought Social interaction Language skills and sentence formation
Language skills and sentence formation
Which is a characteristic of attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. Impulsivity is a persistent characteristic in adults Some children have a deficit in acetylcholine in the brain Linked to exposure to excess lead Linked to heredity Often persists into adulthood
Linked to exposure to excess lead Linked to heredity Often persists into adulthood
Which foods should be avoided when a child with autism spectrum disorder (ASD) is being treated with a gluten- and casein-free diet? Select all that apply. Milk Beef Cheese Grain Corn
Milk Cheese Grain
Which are characteristics of cerebral palsy? (Select all that apply.) Muscle stiffness Uncontrolled movements Excessive fidgeting Avoiding eye contact Inadequate balance
Muscle stiffness Uncontrolled movements Inadequate balance
A 1-year-old child is being evaluated for cerebral palsy. When assessing the child, which finding is the nurse least likely to observe? Strabismus Developmental delay Arching of the back Normal muscle tone in all extremities
Normal muscle tone in all extremities
Which are ways in which culture and/or ethnicity can influence growth and development? (Select all that apply.) Identity establishment Nutritional practices Social interaction patterns Temperamental characteristics Genetic variations
Nutritional practices Social interaction patterns Genetic variations
The nurse is providing care to a client diagnosed with failure to thrive (FTT). Which option does the nurse anticipate will be prescribed to treat FTT in this client? Formula feedings by gastric tube Nutritional supplements Proton pump inhibitors Beta-blockers
Nutritional supplements
During an exam, the nurse begins to suspect that a client has cerebral palsy. Upon what does the nurse make this assessment? Observation of uncontrolled movements Observation of inattention and impulsivity Questionnaire about impaired social interaction Screening of weight below the fifth percentile
Observation of uncontrolled movements
The nurse is visiting Gerry James, a 17-year-old adolescent with cerebral palsy (CP). Which would the nurse recommend to assist this client with physical mobility in his planning to begin college in a few months? Use adaptive utensils Obtain a customized wheelchair Receive therapeutic massages every week Learn American sign language
Obtain a customized wheelchair
Which nonpharmacologic therapies are used in the care of a client with cerebral palsy (CP)? (Select all that apply.) Occupational therapy Speech therapy Massage therapy Physical therapy Special education
Occupational therapy Speech therapy Physical therapy Special education
The parents of a 6-year-old client with attention-deficit/hyperactivity disorder (ADHD) are receiving education about the disorder from the nurse. Which statement made by the parents indicates a need for further teaching? "The parts of our child's brain that control self-regulation are slow to develop." "Our child will grow out of the ADHD, so we only have to deal with it a few more years." "Our child is at risk for antisocial behavior and substance abuse if the ADHD is not treated." "Stimuli affect our child more than other children, which causes hyperactivity."
Our child will grow out of the ADHD, so we only have to deal with it a few more years."
During a check-up, the nurse notes that the client has reached physical growth milestones but has not achieved cognitive developmental milestones. Other than developmental disorders, what else should the nurse consider? Cerebral palsy Parental interaction Child temperament Genetic abnormalities
Parental interaction
During a routine examination, Paola Chiappe, a 41-year-old woman, mentions that she has always had difficulty concentrating at work and asks whether there are any strategies to help her focus. While taking Ms. Chiappe's health history, the nurse suspects that the client has previously undiagnosed attention-deficit/hyperactivity disorder (ADHD). Which finding would the nurse most likely assess in Ms. Chiappe? Good listening skills Quiet demeanor Participation in high-risk activities Highly accomplished at work
Participation in high-risk activities
The nurse is preparing to complete a physical examination for a pediatric client diagnosed with autism spectrum disorder (ASD). Which assessment is appropriate for thisclient? Asking about eating patterns Determining hearing acuity Performing a developmental screening Assessing history of injury
Performing a developmental screening
Which interventions should the nurse teach to the parents of a school-age child with attention-deficit/hyperactivity disorder (ADHD)? Select all that apply. Giving time-outs only for the worst negative behaviors Praising all positive behaviors Not asking the healthcare provider to provide "drug holidays" Turning off the television when client is doing homework Maintaining a consistent bedtime routine and time
Praising all positive behaviors Turning off the television when client is doing homework Maintaining a consistent bedtime routine and time
Kara returns for another follow-up appointment. X-rays indicate the curve of her spine is now 45 degrees. The health care provider tells Kara and her father that surgery is recommended. Kara's surgery is scheduled, and you begin education regarding postoperative care. Which information is appropriate to include? Select all that apply. Proper positioning Donating own blood prior to surgery Pain management techniques The importance of deep breathing following surgery Exercises that will decrease the severity of spinal curvature
Proper positioning Donating own blood prior to surgery Pain management techniques The importance of deep breathing following surgery
Kara begins to cry when she learns that she will have to wear a brace to treat her scoliosis. She states, "All my friends are going to make fun of me!" What type of emotional support can you provide to Kara? Select all that apply. Provide Kara with a phone number for a support group of other teenagers with scoliosis. Educate Kara to ignore her friends. Teach Kara how long treatment will be necessary. Educate Kara about why she needs to wear the brace. Teach Kara how to wear the brace.
Provide Kara with a phone number for a support group of other teenagers with scoliosis. Teach Kara how long treatment will be necessary. Educate Kara about why she needs to wear the brace. Teach Kara how to wear the brace.
The nurse is caring for an older adult client who has been diagnosed with failure to thrive and has a caregiver present at the bedside. What role will the nurse assume in this process? Provide behavioral therapy to the client Provide nutritional education to the caregiver Prescribe medication for the treatment of FTT Refer client to genetic counseling
Provide nutritional education to the caregiver
Which is the best intervention for the nurse to implement when caring for a 16-year-old client with attention-deficit/hyperactivity disorder (ADHD)? Allow the client to study in a family room with the television on. Initiate negative consequences for low academic scores. Allow the parents to work out problems on their own. Provide opportunities to increase self-esteem.
Provide opportunities to increase self-esteem
The home care nurse is performing a visit to a child diagnosed with autism spectrum disorder (ASD). Which intervention is appropriate for the nurse to include in the treatment plan for this family? Recommending that the home be a "Therapy Free" zone Encouraging the family to "get over" negative feelings regarding the diagnoses Providing appropriate education regarding what to expect for the child
Providing appropriate education regarding what to expect for the child
The nurse suspects that a client may have attention deficit hyperactivity disorder (ADHD). Upon which assessment technique might the nurse have made this diagnosis? Screening of balance and coordination abilities Questionnaire about temper tantrums and aggression Screening of eye contact and facial expression Questionnaire about study and behavior habits at school and home
Questionnaire about study and behavior habits at school and home
Which diagnostic tools are used to assess developmental status? (select all that apply) Questionnaires Screening tests CT scans Observation MRI
Questionnaires Screening tests Observation
Which medication is not used to control seizures and muscle spasms in CP? Ranitidine Baclofen Botulinum toxin Dantrolene
Ranitdine
Which behavioral therapy can help improve quality of life for the client with ADHD? Increasing stimulation Setting consistent limits Loose classroom supervision Having a flexible routine
Setting consistent limits
Tina White, a 7-year-old African American girl with dyskinetic cerebral palsy, has used a stroller or wheelchair for mobility since birth. During every healthcare provider appointment, on which finding should the nurse focus when assessing this client? Height and weight Persistent newborn reflexes and swallowing Nutrition status and constipation Skin integrity and body alignment
Skin integrity and body alignment
While taking an assessment of Arthur Kim, a 12-year-old boy, Arthur tells the nurse that he is getting bad grades at school, and he repeatedly interrupts to talk about his favorite character from a new movie. The nurse suspects that Arthur might have attention-deficit/hyperactivity disorder (ADHD). Which other finding would the nurse expect when questioning the father about Arthur's behavior? Sleep disturbances High self-esteem Ease in completing tasks Strong friendships with other children
Sleep disturbances
The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD). Which factor within the child's health history should the nurse recognize could be associated with the development of ADHD? The immune response of the child Young parental age at conception Smoking during pregnancy The measles, mumps, and rubella (MMR) vaccine
Smoking during pregnancy
Impairments in which areas are evident by the age of 3 in the child with autism spectrum disorder (ASD)? (Select all that apply.) Social interactions Social adaptability Ability to organize responses to situations Ability to engage in complex thought process Communication
Social interactions Social adaptability Ability to organize responses to situations Communication
Which theory of growth and development proposes that children learn attitudes, beliefs, customs, and values by modeling the behaviors of others? Social learning theory Resiliency theory Temperament theory Behaviorist theory
Social learning theory
The nurse is preparing to provide newly prescribed medication to a female client who has been diagnosed with attention-deficit hyperactivity disorder (ADHD). Which medication information should the nurse include? Anticholinergics Antidepressants Stimulants Antipsychotics
Stimulants
The nurse is preparing educational material for the parents of children with cerebral palsy. Which treatment would the nurse include in this teaching session? (Select all that apply.) Surgery Positioning devices Muscle relaxants Serial casting Low-calorie diet
Surgery Positioning devices Muscle relaxants Serial casting
Which resource will the healthcare provider use to diagnose autism spectrum disorder (ASD)? The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders The Autism Handbook Teaching Social Communication to Families with Autism The Mental Health Rights Manual
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders
The school nurse is administering methylphenidate (Ritalin) to an adolescent male who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD). Even though the drug helps the adolescent with focus and grades, he will not go to the nurse's office at noon for his medication. What should the school nurse suspect is the reason for this adolescent's behavior? The adolescent may fear that this drug may be a "gateway drug" that may lead to abusing other substances. The adolescent may be embarrassed about having to take medicine at school and fear a social stigma. An additional dose of methylphenidate (Ritalin) is not needed while at school. Alternative coping mechanisms to increase focus during classes have been developed.
The adolescent may be embarrassed about having to take medicine at school and fear a social stigma
The nurse is evaluating an adult client with attention-deficit/hyperactivity disorder (ADHD). Which observation indicates to the nurse that treatment has been successful? The client often finishes the nurse's sentences. The client confides that it is embarrassing to have a childish disease. The client reports fewer sleep disturbances. The client asks for a higher dosage of ADHD medication.
The client reports fewer sleep disturbances.
The nurse is planning care for an adult client diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client has a strong social network and does not display much impulsivity but has problems with inattentiveness. Which goal is the priority for the nurse to include in the plan of care? Select all that apply. The client will demonstrate age-appropriate social interactions with peers and family. The client will demonstrate age-appropriate social interactions with peers and family. The client will respect the boundaries of others. The client will remain free of injury. The client will achieve work performance to maximum potential.
The client will achieve work performance to maximum potential. The client will demonstrate age-appropriate social interactions with peers and family.
Which goal is appropriate to include in the plan of care for a client with autism spectrum disorder (ASD) who is hospitalized for a tonsillectomy? The client will not socialize with other children in the same age group. The client will demonstrate behavior that is not self-destructive. The client will try new foods during hospitalization. The client will allow the nurse to perform all activities of daily living.
The client will demonstrate behavior that is not self-destructive.
The school nurse is helping to create an individualized education plan (IEP) for a 12-year-old client with attention-deficit/hyperactivity disorder (ADHD). Which behavioral goal is appropriate to include in the plan of care? The client will achieve school performance to minimum competency. The client will demonstrate a decrease in attentiveness. The client will respect the boundaries of others. The client will accurately manage medication administration.
The client will respect the boundaries of others.
A nurse is conducting a consultation with a client who has a developmental alteration. What should the nurse take into consideration when interacting with the client? (Select all that apply.) The client's literacy skills The client's preferred learning method The client's reliance on social services The client's family history The client's developmental level
The client's literacy skills The client's reliance on social services The client's family history
A nurse is conducting a consultation with a client who has a developmental alteration. What should the nurse take into consideration when interacting with the client? (Select all that apply.) The client's literacy skills The client's preferred learning method The client's reliance on social services The client's family history The client's developmental level
The client's literacy skills The client's preferred learning method The client's developmental level
You prepare Kara for a thorough assessment during her visit. You know that the health care provider will focus the assessment on which systems? Select all that apply. The gastrointestinal (GI) system The genitourinary (GU) system The neurologic system The respiratory system The cardiac system
The neurologic system The respiratory system The cardiac system
The nurse is preparing an educational seminar about early intervention programs to promote growth and development of the child with cerebral palsy (CP). Which information would the nurse include to assist the parents of these children? Explain that vocational training is not appropriate but that assisting with a general job is appropriate The use of adaptive devices to help the child communicate more independently The value of home schooling so that the child will not have to be exposed to children in the school setting The need to use terminology 1 year below the child's development level
The use of adaptive devices to help the child communicate more independently
A 22-year-old client with attention-deficit/hyperactivity disorder (ADHD) is currently taking atomoxetine (Strattera). The client states, "I don't want to be dependent on medication my entire life. I've heard that cutting out sugar from my diet and taking ginkgo biloba might help my ADHD symptoms." Which is the best response by the nurse about complementary and alternative therapies for ADHD? "These are popular alternative treatments, but scientific evidence does not consistently support their effectiveness." "Taking medication isn't really that bad, especially since it is the only effective way to control your symptoms and let you live a normal life." "You can replace your medication with these alternative treatments if you like, but be sure to tell your healthcare provider about them." "Why don't we ask your healthcare provider to prescribe a different medication instead of the one you're taking, if you're worried about it?"
These are popular alternative treatments, but scientific evidence does not consistently support their effectiveness
Which speech pattern anomalies are likely to appear in the young child with autism spectrum disorder (ASD)? Select all that apply. Stuttering Use of the word you to represent I Reiteration of questions as opposed to answering them Enchantment with rhythmic, repetition of verse or song Echolalia
Use of the word you to represent I Reiteration of questions as opposed to answering them Enchantment with rhythmic, repetition of verse or song Echolalia
The nurse suspects that a 6-month-old client may be suffering from failure to thrive (FTT). What aspects of culture should the nurse take into account when performing an assessment of the client? Social interaction patterns in ethnic groups Variances in childrearing practices in ethnic groups Variances in nutritional practices in ethnic groups Educational motivation among ethnic groups
Variances in nutritional practices in ethnic groups
The school nurse is arranging an appointment for a physical examination of an 11-year-old client recently diagnosed with attention-deficit/hyperactivity disorder (ADHD). The client's parent states, "Our child was evaluated at home and here at school, and now we have to make another appointment for a physical? Why?" Which is the best response by the nurse? "The healthcare provider will be able to give you better strategies for helping your child focus at home and at school." "We need to rule out neurological diseases and other health problems in your child that may affect treatment of ADHD." "The physical exam will find out whether your child has other mental health issues, such as depression, anxiety, learning disorder, or conduct disorder." "We need to see whether your child has the physical characteristics that go along with the behaviors of ADHD to correctly diagnose ADHD."
We need to rule out neurological diseases and other health problems in your child that may affect treatment of ADHD
During a routine examination, the mother of a young teen client mentions that her son is constantly eating and is rapidly growing out of many of his clothes. What should the nurse explain to the mother? (Select all that apply.) You can expect height and weight increases to last over the next few years. Nutritional needs increase with growth spurts. Most growth at this age takes place in long bones of the arms and legs. Growth in all children occurs in a cephalocaudal direction. Boys often experience a prepubescent growth spurt at this age.
You can expect height and weight increases to last over the next few years. Nutritional needs increase with growth spurts. Boys often experience a prepubescent growth spurt at this age.
