Mental Health Prep U Chapter 23

Which observation demonstrates the effective use of cognitive behavioral therapy with a client diagnosed with intermittent explosive disorder?

"Do you usually have an explosive episode after a work day?"

A nurse is assessing a client with oppositional defiant disorder (ODD). What questions related to the disorder should the nurse ask the parents while taking the history of the client? Select all that apply. "Does your child get confused much of the time?" "Does your child have difficulty paying attention?" "Does your child suddenly wake up at night from nightmares?" "Is your child extremely obsessed with sports?" "Does your child get extremely upset for getting poor grades in school?

"Does your child get confused much of the time?" "Does your child have difficulty paying attention?" "Does your child get extremely upset for getting poor grades in school?

A nurse is assessing a 2-year-old child in a child and family outpatient mental health clinic. The parents tell the nurse that the child can be combative when the child's wants are not met. The parents describe the child as "defiant." What is the most appropriate response of the nurse to the parents?

"It sounds like very challenging behavior, testing is quite normal at this age."

A nurse is speaking to the parents of a 15-year-old client who has been suspended from school for physically abusing classmates. The client has had many warnings from school staff; however, the client's behavior persists. What other statements by the parents would lead the nurse to suspect this client has conduct disorder? Select all that apply. "My child is consistently performing poorly academically." "My child feels guilty and regrets the inappropriate behavior." "My child does not have any friends." "My child cries a lot and does not want to be alone." "My child is extremely well-behaved at home."

"My child is consistently performing poorly academically." "My child does not have any friends."

The parents of a 15-year-old adolescent report that their child is behaving abnormally. After obtaining the history of the client, the nurse responds by telling the parents that their child's behavior is normal for his age. What would the parents have told the nurse regarding their child? Select all that apply. "Our child has no friends at school." "Our child spends more time playing than studying." "Our child has difficulty learning and understanding concepts." "Our child doesn't listen to us, preferring to listen to friends." "Our child is an extreme pessimist and tends to stay away from everybody."

"Our child spends more time playing than studying." "Our child doesn't listen to us, preferring to listen to friends."

After completing a series of parent training sessions with parents of an 8-year-old client with oppositional defiant disorder, the child's mother calls the nurse with concerns. The mother states, "What you taught us isn't working. Can you please talk to my child about his behavior?" Which is the nurse's most effective response?

"Please tell me more about what you are having difficulty with."

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."

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."

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?

"You will need to be involved in the therapeutic process for your child."

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 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

In a discussion with a group of high school teachers about oppositional defiant disorder (ODD), the nurse says that behavior modification of the parents and teachers toward such children forms the basis of therapy. What is the most appropriate rationale that the nurse gives when asked about this strategy?

Adolescents with ODD learn maladaptive behavior at home and it can be perpetuated at school.

Which interventions should a nurse teach the parents of a child with conduct disorder? Select all that apply. Advise them to avoid rescuing their child. Reassure them that the child will become normal with time. Explain about age-appropriate activities and expectations. Encourage them to seek proper treatment for their own problems. Explore whether they feel authentic love for the child.

Advise them to avoid rescuing their child. Explain about age-appropriate activities and expectations. Encourage them to seek proper treatment for their own problems.

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

Alcohol and substance abuse Early onset of sexual behavior Smoking

A nurse suspects that an adolescent has oppositional defiant disorder (ODD). In which situation will the client most likely display behavior consistent with ODD?

At home while confronting parents

Children with low self-esteem Children with poor peer relationships Children with a resilient nature Children with emotional instability Children neglected by their parents

Children neglected by their parents Children with low self-esteem Children with poor peer relationships

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 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 problem-solving therapy?

Consider alternative approaches based on their individual merits.

In clients with conduct disorder, reactivity of the autonomic nervous system is reduced. Which sign related to this physiological abnormality can be seen in clients with conduct disorder?

Decreased social inhibitions

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

A nurse is meeting the parents of an 8-year-old child with oppositional defiant disorder. Which strategies can the nurse offer the parents to promote the use of positive reinforcement? (Select all that apply.) Give high-fives for following through on a request the first time. Offer the child a toy or a game after a week of good behavior at school. Take the child out for ice cream after a weekend free of arguing or questioning. Provide hugs and cuddles when the child and throwing objects during a tantrum. Engage in discussion with the child when the child is arguing.

Give high-fives for following through on a request the first time. Offer the child a toy or a game after a week of good behavior at school. Take the child out for ice cream after a weekend free of arguing or questioning.

Which would be an appropriate intervention for a child diagnosed with conduct disorder?

Have the child accept responsibility for individual behavior

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?

Help the client develop peer relationships.

A 15-year-old client with intermittent explosive disorder (IED) gives no history of childhood abuse, neglect, or maltreatment. What could be the cause of the disorder in this client?

Imbalance in the production of serotonin

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 attention Impaired problem-solving abilities Impaired decision making

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 aggressive behavior

An adolescent client demonstrates callous and unemotional behavior in the absence of extreme aggressive behavior and mood disturbances. The client has a diagnosis of conduct disorder. Which treatment would be most effective for this client?

Individualized behavior therapy

A nurse is reviewing information about disruptive behavior disorders in children. Which finding best describes this clinical diagnosis?

It can lead to increased 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

Which would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors?

Limit setting

A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications?

Presence of comorbid psychiatric disorders

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 use

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.

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.

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 about limit 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 to the client to role-play to help internalize responses.

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

Temperament of the adolescent Peer group of the adolescent Behavior of parents

A nurse is assessing a 15-year-old adolescent with conduct disorder. Which appearance might the nurse see in the adolescent?

The adolescent has lots of tattoos and body piercings.

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 adolescent 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.

A nurse is counseling the parents of an adolescent client with oppositional defiant disorder (ODD). The parents state, "We've tried everything, what else are we supposed to do?" What is the most likely reason for the parents' voiced loss of hope?

The adolescent may have limited sensitivity to reward and punishment.

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'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 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 or him.

The nurse is documenting clinical observations after a therapeutic session with an adolescent client with a disruptive behavior disorder. What should the nurse identify is an internalizing behavior?

The client only stares at the nurse when asked how the client is doing today.

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.

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 others or damage property.

After teaching a group of nursing students about kleptomania, the instructor determines that the education was successful when the students state what?

The disorder is difficult to detect and treat.

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?

The presence of aggression

A nurse is assessing an adolescent with conduct disorder. Which statement by the nurse about the adolescent is most likely to be true?

The sibling of the client has conduct disorder.

A family with a child who has a conduct disorder tells the nurse they are increasingly frustrated in their attempts to make things better at home. What suggestion(s) should the nurse make that would lead to decreased frustration? Select all that apply. Provide rewards instead of punishments for problematic behavior. Try to think of alternative responses to the child's behavior. Offer role-playing scenarios to address specific needs. Suggest respite care breaks for parents during the week. Consider making small changes rather than large changes.

Try to think of alternative responses to the child's behavior. Offer role-playing scenarios to address specific needs. Suggest respite care breaks for parents during the week. Consider making small changes rather than large changes.

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.

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?

Verbal bullying

The nurse is interviewing the parents of a child with conduct disorder. Which question is appropriate for the nurse to ask?

What type of discipline do you use at home?"

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

Which childhood disorder is characterized by serious violations of social norms, such as destruction of property?

conduct disorder

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?

ensure safety of others

Which behaviors should the nurse anticipate in children with mild conduct disorder? Select all that apply. Conning people Repeated lying Drinking alcohol Minor shoplifting Cruelty to classmates

lying and shoplifting

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?

moderate conduct disorder

Which factor will most influence a nurse's interaction with a child diagnosed with conduct disorder?

personal values regarding child rearing

The nurse uses the technique of time-out for a client with conduct disorder. Which problem demonstrated by the client would have led the nurse to use this intervention?

threatening the nurse

For which reason would a nurse ask an adolescent client with conduct disorder to maintain a diary?

to help identify feelings

A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply. Antidepressant drugs Antipsychotic drugs Mood-stabilizing drugs Stimulant drugs Barbiturates

vMood-stabilizing drugs Antidepressant drugs