Chapter 19: Childhood and Adolescent Mental Health Issues

The single most common symptom of autism is: A. Inability to grasp reality. B. Impaired social interaction. C. Acting out behaviors. D. Diminished affect.

ANS: B Though all of these behaviors may occur at some time in autism, impaired social interaction is the overriding symptom that occurs in this disorder.

A boy with a conduct disorder diagnosis would be most likely to have which symptom? A. Withdrawal B. Ritualistic behavior C. Class bully D. Class clown

ANS: C A pattern of bullying is a common sign of conduct disorder. Responses A and B may reflect autism.

You are caring for a 13-year-old boy with a diagnosis of conduct disorder. Which of the following would you be most likely to expect given this diagnosis? A. Severe separation anxiety from parents B. Making up stories to make him appear more important C. History of cruelty to schoolmates and pets D. Insomnia and anorexia nervosa

ANS: C Conduct disorder is associated with long-term problems with defiance, rule-breaking, and violating the basic rights of others.

Which of the following statements about attention deficit hyperactivity disorder (ADHD) are true? (Select all that apply) A. ADHD is more common in boys than in girls. B. Children with ADHD tend to be of below-average intelligence. C. ADHD is caused by dysfunctional parental relationships. D. Children with ADHD are often treated with the use of stimulants. E. Children with ADHD often benefit from behavior modification tools like limit setting, reward systems, and positive reinforcement. F. Even though we think of ADHD as a disorder in children, adults can also have it.

ANS: A, D, E, F Children with ADHD tend to be of above normal intelligence but often dont function at those levels. The causes of ADHD are more associated with brain dysfunction and genetic factors.

Which of the following is the most common childhood mental disorder? A. ADHD B. Aspergers syndrome C. Conduct disorder D. Enuresis

ANS: A ADHD (attention deficit /hyperactivity disorder) is the most common mental disorder in the 8 to 15 year old age group.

Marty is a 15-year-old boy whose parents have brought him to a mental health clinic for evaluation. They are concerned because his grades have fallen and he has become angry and sometimes even violent. He spends long periods of time alone and does not want to see his friends. The parents report that he has never been a bad boy nor had problems in school. They are worried about the changes in his behavior. Which of the following is the most likely cause? A. Depression B. Running around with a tough crowd C. Normal adolescent phase D. Attention deficit hyperactivity disorder

ANS: A In addition to classic symptoms of depression, adolescents often display irritability and problems in school performance. This is not normal teen behavior. Because Marty has been functioning well in school up until now, it is unlikely that ADHD would be exhibited at this point.

Which of the following statements is true about the differences in mental health problems between children and adults? A. Children are affected by the same stressors as adults, but to different degrees and with different manifestations. B. Childrens mental health disorders are generally much less severe and resolve more quickly than do those of adults. C. Childrens mental health problems are different from those of adults because their brains are wired differently. D. Children have better means of working off stresses than do adults.

ANS: A Mental health disorders in children have many similarities and differences from the same disorders in adults. The other responses are not correct.

Which of the following statements by your ADHD childs parents indicate they need further teaching? A. We will establish firm but reasonable limits on his behavior. B. We will give him his medication at night so it wont decrease his appetite. C. We will set him up in a special program at his school so we he will get extra attention. D. We will work to ensure he gets 8 hours of sleep a night.

ANS: B Stimulant medications are given for treatment of ADHD. These can cause insomnia if given later in the day.

Suzanne is a 10-year-old girl who has been diagnosed as experiencing depression. What is likely to be the most effective way to help Suzanne express her feelings? A. Have her participate in a group therapy session with other young children who are depressed. B. Ask her to draw some pictures about things that shes been thinking about. C. Arrange for individual psychotherapy sessions with a psychiatrist. D. Observe her actions but dont seek to draw her out into conversation.

ANS: B Younger children who may have more difficulty verbally expressing feelings may be able to draw them.

Marie is 16 years old. She has been referred to the clinic by the nurse at her school because she started a fight with a younger girl and hurt her badly. The school nurse reports that Marie has been troublesome beforeskipping school, bullying, and smoking on school grounds on several occasions. Of the following, which diagnosis is most likely? A. Bipolar depression B. Paranoid schizophrenia C. Conduct disorder D. Dysthymic disorder

ANS: C Conduct disorder is characterized by a pattern of aggressive behavior and violating the rights of others, including defiance and rule breaking. The other responses are psychiatric disorders that would not be the most likely diagnosis given Maries behavior.

Which of the following would be the first priority for nurses caring for autistic children? A. Assist the psychiatrist and mental health team in providing treatments to cure the disorder. B. Determine which of the two different types of autism the child has. C. Discourage and prevent self-destructive behavior. D. Provide behavior modification tools, specifically limit setting and reward systems.

ANS: C Safety is the primary nursing intervention. Behavior medication tools are important, but safety comes first. Autism at this point is not curable. Determining the type of autism is not a nursing goal.

The nurse knows that stimulant medication for ADHD should be administered: A. At bedtime, to coincide with rising cortisol levels. B. Only on school days to improve performance. C. On an empty stomach. D. With breakfast and lunch.

ANS: D Because these medications can contribute to insomnia, it is best to administer them earlier in the day with food. These are generally taken daily unless the doctor orders a drug holiday.

Joey is a 5-year-old who is causing his parents a lot of concern. His mother reports that he bounces off the walls all the time and cant focus on any one thing for very long. He is impulsive and has recently ran right out into the street in front of the familys home. His teacher has told his parents that he has done similar things at school. The nurse understands that: A. Joey shows all the signs of having ADHD and should probably be placed on Ritalin as soon as possible. B. Joey is just an active, healthy child who needs to be disciplined more effectively. C. Joey could be autistic, and additional testing will have to be done to confirm the diagnosis. D. Joey shows signs of having ADHD, but is too young for that diagnosis to be made definitively now.

ANS: D Definitive diagnosis of ADHD should not be made before age 7 because developmentally the child has a shorter attention span.