Exam 3: Chapter 23: Disruptive Behavior

A nurse is assessing a 10-year-old child who is displaying behaviors that are consistent with oppositional defiance disorder. When conducting the assessment, the nurse should also assess for which co-morbidity? attention deficit hyperactivity disorder schizophrenia cognitive impairment kleptomania

ADHD

A 14-year-old client's behavior meets the criteria for a conduct disorder when the nursing assessment documents that the child has what? Select all that apply. Confessed to hurting the neighbor's dog Served after-school detention for repeatedly disobeying the teaching staff Been regularly accused by family members of "stealing their stuff" Been caught lying on a regular basis Resorted to threatening to cut the self when angry

Confessed to hurting the neighbor's dog Served after-school detention for repeatedly disobeying the teaching staff Been regularly accused by family members of "stealing their stuff" Been caught lying on a regular basis

A nurse is performing a general assessment of adolescents in a school to identify students with conduct disorder. Which students are likely to be identified with the condition, based on the nurse's assessment? Select all that apply. A student who has had a fight with a classmate A student who repeatedly bullies younger students A student who persistently gets poor grades A student who is constantly involved in activities resulting in damage to school property A student who always uses abusive language while speaking to teachers

a student who repeatedly bullies younger students a student who is constantly involved in activities resulting in damage to school property a student who always uses abusive language while speaking to teachers

A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply. Antidepressants Typical antipsychotics Mood-stabilizing agents Stimulants Barbiturates

antidepressants mood-stabilizing agents NOTE: The client is likely to be prescribed antidepressant drugs, such as fluoxetine. The client may also be prescribed mood-stabilizing drugs, such as valproic acid and phenytoin. These drugs are used to reduce excessive irritability and anger impulses.

A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent? Select all that apply. Behavior of parents Eating habits of the adolescent Temperament of the adolescent Peer group of the adolescent Academic performance of the adolescent

behavior of parents temperament of the adolescent peer group of the adolescent

A nurse is providing training for parents of a child diagnosed with a disruptive behavior disorder involving the use of "time out." When describing how to implement this, which step would the nurse identify as the first step? Having the child recount the reason for the time out Clearly identifying what is required for the child Informing the child what will happen because of the behavior Placing the child in a designated area removed from others

clearly identifying what is required for the child NOTE: When implementing "time out," the first step is to label the behavior that the child is expected to perform, or cease performing. Then the child is informed that if he or she does not perform the expected behavior or stop the unacceptable behavior, time out will be given

A nurse is caring for an adolescent with conduct disorder. The nurse tries to involve the client in discussions on age-related topics such as books, current trends, and movies. What is the nurse trying to accomplish by doing this? Teach the client to deal with problems. Help the client develop peer relationships. Evaluate the client's frustration tolerance. Teach about the relationship between behavior and its consequences.

help the client develop peer relationships NOTE: Engaging clients with conduct disorder in conversation on age-related topics helps them practice how to interact as other adolescents do. This should help the client to develop peer relationships.

A high school teacher has referred an adolescent to the school health nurse for repeated episodes of aggressive behavior and verbalizing profanities loudly at other students in the class. The adolescent can sometimes be apologetic. The nurse should suspect which disruptive behavior disorder? intermittent explosive disorder conduct disorder oppositional defiant disorder pyromania

intermittent explosive disorder

A nurse is reviewing information about disruptive behavior disorders in children. Which finding best describes this clinical diagnosis? It is more likely to occur in females than males. Sexual promiscuity is seen equally across genders. Behavioral responses are consistent across genders. It can lead to increased risk of other mental health disorders.

it can lead to increase risk of other mental health disorders

A nurse is teaching parents of a child with a disruptive behavior disorder how to use "time-out." The nurse determines the education was successful when the parents identify which as the first step? Labeling the behavior Giving the child a warning Identifying the consequence of the unacceptable behavior Instituting the time out

labeling the behavior

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications? Less than 3 years of age Use of abusive language by the client Presence of comorbid psychiatric disorders Extreme hostile behavior toward the parents

presence of comorbid psychiatric disorders

Which statement, made by the parent of a teen diagnosed with conduct disorder, demonstrates effective parenting? "You will lose your driving privileges for a week if you don't clean your room today." "When are you going to learn that bullying is not acceptable behavior?" "A person your age knows better than to skip school." "Do you understand that you hurt your sister's feelings when you call her names?"

you will lose your driving privileges for a week if you dont clean your room today

A nurse is assessing a 9-year-old child diagnosed with conduct disorder. Which advice should the nurse give the child's parents regarding treatment of the disorder? "Your child needs to be incarcerated." "Your child should be sent to boot camp." "You will need to be involved in the therapeutic process for your child." "Your child requires individualized therapy."

you will need to be involved in the therapeutic process for your child

Children with conduct disorder may be diagnosed with which disorder as adults? Antisocial personality disorder Schizophrenia Bipolar disorder Depression

antisocial personality disorder

Which childhood disorder is characterized by serious violations of social norms, such as destruction of property? Conduct disorder Oppositional defiant disorder (ODD) Obsessive-compulsive disorder (OCD) Attention deficit hyperactivity disorder (ADHD)

conduct disorder

A nurse is speaking to parents of a child at school. The parents tell the nurse that their child has a calm temperament. However, the child experiences bed wetting at night when exposed to new situations. If emotionally upset, the child is unable to articulate feelings and prefers to cry alone. What psychiatric disorder is this child likely to develop in the future? Depression Conduct disorder Oppositional defiant disorder Antisocial personality disorder

depression NOTE: According to the parents, the child prefers to be left alone when disturbed emotionally. This behavior indicates that the child has the tendency to internalize emotions. Such children are likely to develop anxiety and depression.

A 12-year-old child is brought to the mental health clinic by the child's parents because of a court-ordered evaluation. When assessing the child, which would lead the nurse to suspect that the child has a conduct disorder? Select all that apply. Destruction of neighbor's car on two separate occasions Arrests for petty larceny several times Repetitive disobedience of parents Blaming of others for problems Evidence of overt lying

destruction of neighbor's car on two separate occasions arrests for petty larceny several times evidence of overt lying

A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session? Select all that apply. Effective parenting skills Skills to improve peer relationships Legal procedures for criminal behavior Skills to improve academic performance Sedative medications for conduct and antisocial personality disorder

effective parenting skills skills to improve peer relationships skills to improve academic performance

Which would be an appropriate intervention for a child diagnosed with conduct disorder? Have the child accept responsibility for individual behavior Allow self-monitoring of the child's own behavior Avoid limiting setting to decrease confrontation Allow the child increased control over situations

have the client accept responsibility for individual behavior

A nurse is assessing students in a school to determine those at risk of developing conduct disorder. To help determine each child's risk, which questions should the nurse ask the parents? Select all that apply. "Have you caught your child drinking alcohol?" "Does your child have sleep issues?" "Does your child have friends in school?" "Are there any disturbances in your marital life?" "Is your child extremely stressed from schoolwork?"

have you caught your child drinking alcohol does your child have friends in school are there any disturbances in your marital life

A nurse is assessing an adolescent with oppositional defiant disorder (ODD). Other than disruptive behavior, what other findings might the nurse expect to see during the assessment? Select all that apply. Impaired decision making Impaired physical ability Impaired attention Impaired problem-solving abilities Impaired sense of direction

impaired decision making impaired attention impaired problem-solving abilities

The nurse who provides care under the auspices of a group home is planning the care of a 12-year-old client who has been referred to the home by the court system. Knowing that the client has a documented history of conduct disorder, which nursing diagnosis should the nurse prioritize during the client's transition into the group home? Impaired social interaction due to withdrawal Impaired social interaction due to aggressive behavior Risk for injury related to poor safety awareness Hopelessness related to separation from family

impaired social interaction due to aggression behavior

A nurse is working with an adolescent client with a diagnosis of conduct disorder. The nurse is helping the client reflect on a situation in which the client became aggressive and asks how the client could have handled it differently. The nurse is employing which intervention? improving coping skills and self-esteem promoting social interaction increasing treatment compliance providing client education

improving coping skills and self-esteem

Which would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors? Limit setting Time out Self-esteem enhancement Social skills training

limit setting NOTE: Limit setting involves three steps: informing the client of the rule or limit, explaining the consequences if the client exceeds the limit, and stating the expected behavior.

A school counselor has made a referral to the school health nurse for a 14-year-old client who has been bringing alcohol to school in a water bottle. The client was overheard talking about having multiple sexual partners over the past week. This client can be accurately identified as having which intensity level of conduct disorder? does not meet criteria for conduct disorder mild conduct problems moderate conduct disorder severe conduct disorder

moderate conduct disorder NOTE: Moderate intensity of conduct disorder is characterized by an increase in the number of conduct problems as well as the amount of harm to others. Examples of moderate conduct disorder include drinking alcohol and sexual promiscuity. The client does meet the criteria for conduct disorder. Mild conduct problems cause relatively minor harm to others. Examples include repeated lying and truancy. Severe conduct disorder is characterized by a person having many conduct problems that cause considerable harm to others. Examples include forced sex, cruelty to animals, and use of weapons.

A nurse is planning to educate a client who is diagnosed with intermittent explosive disorder about self-management strategies for the condition. What topics should the nurse address while teaching this client? Select all that apply. Strategies to eliminate pain Relaxation techniques A healthy diet regimen Strategies for anger management Strategies to avoid alcohol and substance use

relaxation techniques strategies for anger management strategies to avoid alcohol and substance abuse

During dinner time on an inpatient unit, an adolescent client throws a tray across the table. What would be an effective use of limit setting with this client? Remind the client about the behavior contract. Take the client into a quiet area for a therapy session. Encourage the client to log the event in a diary. Role-model how to be social during meals.

remind the client about the behavior contract NOTE: In order to decrease violence and increase compliance with treatment, it is important for the nurse to remind the client about the behavior contract. The contract outlines expected behaviors, limits, and rewards to increase treatment compliance.

A nurse is counseling the parents of a client with conduct disorder. The nurse tells them that they should be vigilant in watching for certain behaviors that their child is prone to exhibit. Which behaviors would the nurse want the parents to watch for? Select all that apply. Smoking Binge eating Suicidal tendencies Alcohol and substance abuse Early onset of sexual behavior

smoking alcohol and substance abuse early onset of sexual behavior

A family is concerned about their school-aged child who keeps getting into fights. The parents state that the child does not listen, is aggressive toward others, and prefers to be alone. What is the best nursing response to the stated concerns? Suggest that the family bring in the child so that a direct assessment can be made. Offer community support groups to help the child focus on group activities. Schedule the family and child for a therapy session. Contact the health care provider for a referral to a psychologist.

suggest that the family brings in the child so that a direct assessment can be made

A nurse is caring for a client with conduct disorder. The nurse needs to help the client understand the relationship between aberrant behavior and the consequences when the behavior is problematic. Which nursing intervention is most appropriate to help this client? Teach the client the problem-solving process. Teach appropriate conversation and social skills. Teach the client about limit setting and the need for limits. Encourage the client to discuss thoughts and feelings.

teach the client about limiting setting and the need for limits

A nurse working with an adolescent client diagnosed with disruptive behavior disorder is developing a plan of care to improve outcomes. Which nursing action best supports the use of social skills training? Teach the client to count to 10 before providing a response. Teach to the client to role-play to help internalize responses. Have the client enroll in a work study after-school program. Provide written material to assist with decision-making.

teach the client to role-play to help internalize responses NOTE: Social skills training is used to help clients who have diagnosed disruptive behaviors because it focuses on developing interpersonal communication skills whereby the individual can learn adaptive responses to improve outcomes. Role-playing enables the individual to see the perceived interactions and develop adaptations for improved responses.

A nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent has been prescribed risperidone by the primary health care provider. What would be the most likely reason for the health care provider to prescribe this drug to the client? The adolescent has poor social behavior. The adolescent's behavior poses a danger to others. The adolescent is experiencing disturbances in concentration. The adolescent is depressed because of the inappropriate behavior.

the adolescent's behavior poses a danger to others

A nurse is counseling the parents of a 5-year-old child with oppositional defiant disorder (ODD). What type of management does the nurse suggest to help the parents deal with the disorder? The child can be managed by ensuring punishments are suited to the behavior. The child can be managed if given psychotropic drugs. The child can be managed if admitted to a juvenile home. The child can be managed if the parents modify their own behavior.

the child can be managed if the parents modify their own behavior

Which responses to an emotional stressor would indicate that a child is at risk for conduct disorder? Select all that apply. The child has crying spells. The child screams loudly. The child stops talking. The child goes to a secluded place. The child breaks things around her or him.

the child screams loudly the child breaks things around her and him

A nurse is assessing an adolescent with conduct disorder. Which should the nurse expect to find in this adolescent? Select all that apply. The adolescent may be unwilling to speak to the nurse. The adolescent may behave disrespectfully to the nurse. The adolescent may sob because of guilt for behavior. The adolescent may have physical manifestations related to stress. The adolescent may give false reports of having a physical illness. The adolescent may make derogatory comments about parents and teachers.

the client may be unwilling to speak to the nurse the adolescent may behave disrespectfully to the nurse the adolescent may make derogatory comments about parents and teachers

The nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent is not interested in seeking summer employment. What is the most likely reason for the client's disinterest in getting a job? The client prefers stealing money over working for it. The client feels that the client is too disturbed to work. The client feels that the client will not be efficient in the workplace. The client feels that depression and anxiety would interfere with working.

the client prefers stealing money over working it

A nurse is developing a plan of care for a client with conduct disorder. Which would be treatment outcomes for this client? Select all that apply. The client will have a hygienic lifestyle. The client will engage in socially acceptable behavior. The client will learn effective problem-solving skills. The client will not hurt others or damage property. The client will be relieved of anxiety and depression.

the client will engage in socially acceptable behavior the client will learn effective problem- solving skills the client will not hurt other or damage property

A nurse is caring for a client with conduct disorder. The nurse tells the client, "It is not appropriate for you to break things in this center every time you get angry. You should inform me when you get angry. If you break anything else in the facility, you will not be allowed to play video games for a week." What is the statement indicative of? The nurse is trying to teach limit setting. The nurse is trying to teach social skills. The nurse is trying to teach problem-solving skills. The nurse is trying to teach coping skills.

the nurse is trying to teach limit setting

A nurse is studying the medical records of a client with conduct disorder. The nurse finds that the client was prescribed lithium. What would be the most likely reason for prescribing this drug for this client? Risk of developing seizures The presence of aggression Predisposition to kleptomania Difficulty with decision-making skills

the presence of aggression NOTE: Clients with conduct disorder who are aggressive can sometimes be prescribed medications such as mood stabilizers that have antiaggression properties such as lithium.

A nurse observes a middle school student having an angry outburst in the hallway. The nurse is aware that the student has these outbursts frequently. The nurse suspects that the student has intermittent explosive disorder (IED). What other assessment findings would support this conclusion? Select all that apply. The student has had an anger episode that lasted more than 30 minutes. The student has caused extensive damage to school property. The student has experienced anger episodes over very minor events. The student has no sense of guilt or remorse after the anger outburst. The student has had outbursts of anger without any warning.

the student has caused extensive damage to school property the student has experienced anger episodes over very minor events the student has had outbursts of anger without any warning

A nurse is caring for a client with conduct disorder who injures people around the client when angry. Which is the primary goal for intervention in this case? To reduce the aggression of the client. To help the client express his/her feelings. To help the client develop good peer relationships. To ensure safety of others.

to ensure the safety of others

When providing education to the parents of a client with conduct disorder, which is a valid teaching point? Use 'I' language and express an emotion when setting limits. Tell the adolescent to go to their room as a consequence for using profanity. Act as the adolescent's advocate at school when the client is disruptive. Provide reassurance that frequent sexual activity is normal in adolescence.

use "I" language and express and emotion when setting limits

The nurse is assessing a child diagnosed with conduct disorder. Based on which behavior would this client be described as exhibiting the disorder at moderate intensity? Truancy Verbal bullying Cruelty to animals Attempted robbery

verbal bullying NOTE: Verbal bullying is an example of a behavior seen in clients exhibiting a moderate intensity form of conduct disorder. Truancy is described as a behavior seen in a mild intensity form of the disorder. Cruelty to animals and attempted robbery are described as a behavior seen in a severe intensity form of conduct disorder.

The nurse is teaching the parents of a child with conduct disorder about methods to deal with their child's detention from school for breaking science equipment. What advice should the nurse give the parents to deal with the situation? "You should be supportive of the school for taking this step regarding your child's inappropriate behavior." "You should punish your child so that the child never repeats the same mistake at school." "You should file a case against the school for punishing your child so severely." "You should be supportive of your child as your child might be very depressed after receiving detention."

you should be supportive of the school for taking this step regarding your child's inappropriate behavior