ch 22 NCLEX questions

Which common disorder of childhood accounts for the most referrals in children? Autism Intellectual disability Conduct disorder Attention deficit hyperactivity disorder (ADHD)

Attention deficit hyperactivity disorder (ADHD) Rationale:ADHD, a common disorder of childhood, accounts for most referrals in children. A child who suffers from ADHD often exhibits poor academic performance, strain family relations, and is rejected by peers.

A nurse is assessing a child who had an episode of passing feces in the classroom. The child has no other disabilities. The nurse concludes that the child had intentional encopresis. Which other condition is the child likely to have? Conduct disorder Tourette's disorder Expressive language disorder Rett's disorder

Conduct disorder Rationale:Intentional passing of feces in inappropriate places like the classroom is referred to as intentional encopresis. This condition is mostly associated with conduct disorder or oppositional defiant disorder. The child does not show any impairment in normal functioning. Rett's disorder is a type of pervasive developmental disorder characterized by the development of multiple deficits over a period of normal functioning. In Tourette's disorder, the child engages in multiple motor and vocal stereotypical behaviors. In expressive language disorder, the child has difficulty communicating through verbal or sign language. Such behavior is not evident in the assessment.

Which is considered a hyperactive/impulsive behavior seen in attention deficit hyperactivity disorder (ADHD)? Avoiding tasks requiring mental effort Making careless mistakes Frequent forgetfulness in daily activities Inability to play quietly

Inability to play quietly Rationale:Inability to play quietly is a hyperactive/impulsive behavior seen in ADHD. Inattentive behaviors include avoiding tasks that require mental effort, making careless mistakes, and being forgetful in daily activities.

A psychiatric-mental health nurse is reviewing an article about genetics and the role in the development of a childhood psychiatric disorder. The nurse demonstrates understanding of this information by identifying which disorder as being genetically transmitted? Tourette's syndrome depression anxiety disorder bulimia

Tourette's syndrome Rationale:Many childhood psychiatric disorders, such as autism, intellectual disability, developmental learning disorders, some language disorders (e.g., dyslexia), attention deficit hyperactivity disorder (ADHD), and Tourette's syndrome, appear to be genetically transmitted. Research increasingly shows that major psychiatric disorders (e.g., depression, anxiety disorder, schizophrenia, bipolar disorder, substance abuse) run in families but are not necessarily identified as being genetically transmitted.

Which medication classification is used in the treatment of tic disorders? Antidepressants Antimanics Anxiolytics Antipsychotics

Antipsychotics Rationale:Tic disorders are usually treated with risperidone or olanzapine.

Which is an antidepressant used to treat attention deficit hyperactivity disorder (ADHD)? Atomoxetine Amphetamine Dextreamphetamine Pemoline

Atomoxetine Rationale:Atomexetine is an antidepressant used for the treatment of ADHD. All of the other options are stimulants.

Which term describes the use of socially unacceptable words, which are frequently obscene? None of the above Palilalia Coprolalia Echolalia

Coprolalia Rationale:Coprolalia is the use of socially unacceptable words, which are frequently obscene. Palilalia is the repeating of one's own words or sounds. Echolalia is the repeating of the last heard sound, word, or phrase.

The nurse is developing a care plan for a client diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse teaches the client to take the last dose of dextroamphetamine when? At 6 p.m. At noon At 9 p.m. Early in the afternoon

Early in the afternoon Rationale:Giving stimulants during daytime hours usually effectively combats insomnia, which is a side effect of stimulants.

A child is taking methylphenidate for treatment of attention deficit hyperactivity disorder (ADHD). Which side effect must be monitored in this child? Growth delays Increased appetite Weight gain Polyuria

Growth delays Rationale:Nursing considerations when administering methylphenidate include monitoring appetite suppression or growth delays.

A nurse is developing the plan of care for a 6-year-old child diagnosed with attention deficit hyperactive disorder (ADHD). The nurse identifies interventions to address which behavior issues? Select all that apply. Has a habit of not waiting for a turn Frequently acts out during class "quiet time" Does not acknowledge others' right to select group activities Throws a temper tantrum when asked to clean up toys Gently asks a peer to share a particular toy

Has a habit of not waiting for a turn Frequently acts out during class "quiet time" Does not acknowledge others' right to select group activities Throws a temper tantrum when asked to clean up toys Rationale:The care plan of a 6-year-old child diagnosed with ADHD includes interventions to help manage the client's temper tantrums and acting out, refusal to acknowledge others' right to select group activities, and habit of not waiting for their turn, and to prevent physically intrusive behavior while playing.

A nurse is caring for a child with enuresis. The child does not have any abnormalities associated with development or behavior. Which drug would the child be prescribed to treat the condition? Imipramine Atomoxetine Dextroamphetamine Risperidone

Imipramine Rationale:Imipramine is an antidepressant drug with a side effect of urinary retention. This drug is commonly used to treat enuresis. The child has no abnormalities associate with behavior, thus the child will not be prescribed psychotropic drug like risperidone. Atomoxetine is an antidepressant drug used to treat attention deficit hyperactivity disorder; this drug is not prescribed for a child with enuresis. Dextroamphetamine is also an antidepressant drug used to treat hyperactivity, impulsivity, and mood lability in children with attention deficit hyperactivity disorder.

A nurse is assessing a child with attention deficit hyperactivity disorder. Which assessment finding is the nurse likely to see in this child? Select all that apply. Impulsiveness Overactivity Stuttering Attentiveness Stereotypical movements

Impulsiveness Overactivity Rationale:Attention deficit hyperactivity disorder is characterized by behaviors like overactivity, impulsiveness, and inattentiveness. Stuttering is a language disorder; it is not associated with attention deficit hyperactivity disorder. The child has attention deficit. Unlike in tic disorder, stereotypical movements are not seen in children with attention deficit hyperactivity disorder.

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)? Pemoline Dextroamphetamine Amphetamine Methylphenidate

Methylphenidate Rationale:Methylphenidate, a common medication for treating ADHD, is effective in 70% to 80% of children who have ADHD. The other stimulants dextroamphetamine and pemoline, and the amphetamine compound Adderall are used to treat ADHD, but they are not as effective as methylphenidate.

Which is an inattentive behavior seen in attention deficit hyperactivity disorder (ADHD)? Missing details Interrupting Talking excessively Fidgeting

Missing details Rationale:Missing details is an inattentive behavior seen in ADHD. Hyperactive/impulsive behaviors include fidgeting, interrupting, and talking excessively.

Assessment of a child with autism spectrum disorder reveals stereotypic behavior. Which behavior would the nurse most likely document being demonstrated by the child? Rocking Head banging Pronoun reversal Hand flapping Word repetition

Rocking Head banging Hand flapping Rationale:Stereotypic behavior incudes self-stimulating, nonfunctional, repetitive behaviors such as rocking, hand flapping, and head banging. Word repetition (echolalia) and pronoun reversal are communication difficulties.

Which is a disturbance of the normal fluency and time patterning of speech? Phonologic disorder Mixed receptive-expressive language disorder Stuttering Expressive language disorder

Stuttering Rationale:Stuttering is a disturbance of the normal fluency and time patterning of speech. Phonologic disorder involves problems with articulation. Mixed receptive-expressive language disorder includes problems of expressive language disorder along with difficulty understanding and determining the meaning of words and sentences. Expressive language disorder involves an impaired ability to communicate through verbal and sign language.

A nurse is assessing a 2-year-old child diagnosed with autism spectrum disorder. Which findings does the nurse expect to find on assessment? Select all that apply. The child becomes upset with minor changes in routine. The child does not relate to parents. The child is extremely playful. The child avoids eye contact. The child becomes frightened when left alone.

The child becomes upset with minor changes in routine. The child does not relate to parents. The child avoids eye contact. Rationale:Children with autism spectrum disorder tend to avoid eye contact with people. They do not identify or relate to their parents and remain detached. These children get upset with minor changes in routine. Children with autism spectrum disroder do not enjoy engaging in play or make-believe with toys. These children do not get frightened if left alone; in fact, they prefer being left alone.

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The child is given medication and behavioral modification therapy to treat the condition. Which outcome achieved within 3 days would indicate successful therapy? The child is able to complete assignments or tasks with assistance. The child is able to demonstrate successful interaction with family members over a long period of time. The child is able to express positive statements about the self. The child is able to interact and to develop successful peer relationships.

The child is able to complete assignments or tasks with assistance. Rationale:If within 3 days of starting treatment the child with ADHD is able to complete work or assignments with assistance, then this indicates successful therapy. Being able to express positive statements about himself or herself cannot be expected of the child after only 3 days of therapy. The child's ability to develop peer relationships would also not be demonstrated within this time. After 3 days of therapy, the children with ADHD would be able to demonstrate changes like being able to listen to others. They would not be able to interact with family members for a long period of time.

The nurse is teaching the parents of a child with involuntary enuresis about methods to manage the condition. Which intervention does the nurse recommend to the parents? The child should use pads with a warning bell. The child should begin therapeutic play. The child needs to be taught special exercises. The child's dietary patterns should be changed.

The child should use pads with a warning bell. Rationale:The use of pads with a warning bell as well as positive reinforcement has been shown to help resolve the elimination disorder. This behavioral modification may help the child to void urine voluntarily over a period of time. The child does not pass urine voluntarily, so a change in diet will not help the child. Exercise does not help treat involuntary enuresis. Therapeutic play is used to promote communication in children.

A nurse is using limit setting with a child hospitalized for a psychiatric disorder. Which statement made by the nurse would reflect appropriate limit setting? Select all that apply. "Swearing is a sign of disrespect." "Swearing is not allowed here on the unit." "When you feel like swearing come and talk to me." "You will lose television privileges for 24 hours if you ignore a unit rule." "Unit rules are made to keep everyone safe."

"Swearing is not allowed here on the unit." "When you feel like swearing come and talk to me." "You will lose television privileges for 24 hours if you ignore a unit rule." Rationale:Limit setting involves three steps: 1. Inform clients of the rule or limit. 2. Explain the consequences if clients exceed the limit. 3. State expected behavior. The remaining options are explanations as to why swearing is not allowed.

A 9-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the client's parents state what? "The client will have an effect from this drug in about 2 weeks." "The client knows that the client only needs to take this medication once every 12 hours." "The client may have some side effects, like insomnia, loss of appetite, or weight loss, but they are rare." "We'll bring the client in every week to get blood levels drawn."

"The client may have some side effects, like insomnia, loss of appetite, or weight loss, but they are rare." Rationale:The most common side effects of common medications used to treat ADHD, such as methylphenidate, include insomnia, loss of appetite, and weight loss or failure to gain weight.