Chapter 23: Disruptive Behavior Disorders

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."

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. Adolescents with ODD are closest to their parents and teachers. Adolescents with ODD only fear their parents and teachers. Adolescents with ODD are less aggressive toward parents and teachers.

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

Children and adolescents with oppositional defiance disorder (ODD) and conduct disorder may be diagnosed with __________ personality disorder as adults.

Antisocial

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

Antisocial personality disorder

A nurse is providing community education regarding adolescents with oppositional defiance disorder (ODD). Which point should the nurse include in the educational session? Behavior problems can develop when parental figures pay attention to a child's maladaptive behaviors. Rewarding positive behaviors consistently can lead to ODD. Parental roles do not influence the development of ODD. It is ideal if parents can wait until adolescence to seek treatment.

Behavior problems can develop when parental figures pay attention to a child's maladaptive behaviors.

__________ disorder is characterized by persistent behavior that violates social norms, rules, law, and the rights of others.

Conduct

For limit setting to be effective, the __________ must have meaning for the client.

Consequences

True or False: During intermittent explosive disorder (IED), physical injury is not likely to occur.

False

True or False: There appears to be no genetic risk for conduct disorder.

False

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 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? Family therapy Group therapy Medication Individualized behavior therapy

Individualized behavior therapy

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 increased risk of other mental health disorders.

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 limit setting and the need for limits.

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 parents may have not taught appropriate behavior to the adolescent. The adolescent may have limited sensitivity to reward and punishment. The adolescent may have been abused in childhood. The parents may have been pampering the adolescent too much.

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 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.

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 client has not shown up for three consecutive appointments. The client tells the nurse the client's grandmother died when this is not true. The client pushed over a chair during the session.

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

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.

A nurse is developing a plan of care for an adolescent with conduct disorder. What changes in behavior should the nurse expect to find in the client within the first 3 days if therapy is proceeding successfully? Select all that apply. The client will start developing relationships with peers. The client will verbalize feelings and emotions. The client will assess personal strengths and weaknesses. The client will show improvement in academic performance. The client will have learned strategies for solving the client's own problems.

The client will verbalize feelings and emotions. The client will have learned strategies for solving the client's own problems.

A nurse is assessing a 14-year-old adolescent who is known for constantly bullying children. On assessment, the nurse finds that the adolescent had early onset conduct disorder. What other findings during the assessment are suggestive of early onset conduct disorder? Select all that apply. The client does not have extremely aggressive behavior. The maladaptive behavior started before the age of 10 years. The client does not have normal peer relationships. The client is susceptible to developing antisocial personality disorder. The client has never abused the children physically.

The maladaptive behavior started before the age of 10 years. The client does not have normal peer relationships.

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

__________ is a retreat to a neutral place so clients can regain self-control.

Time-out

For which reason would a nurse ask an adolescent client with conduct disorder to maintain a diary? To help identify feelings. To improve problem solving skills. To help learn socially acceptable behavior. To help reduce the chances of having outbursts of anger.

To help identify feelings.

True or False: As many as 30% to 50% of children diagnosed with conduct disorder are diagnosed with antisocial personality disorder as adults.

True

True or False: Disruptive behavior associated with oppositional defiance disorder (ODD) is more intense in the home than in other settings.

True

True or False: Treatment for intermittent explosive disorder (IED) includes the antidepressant fluoxetine.

True

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 an emotion when setting limits.

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

attention deficit hyperactivity 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

__________ in following the plan for a client diagnosed with conduct disorder is essential to decrease manipulation.

consistency

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

The nurse is conducting a health history of a 35-year-old male client with a history of intermittent explosive disorder, diagnosed in adolescence. The nurse should include an assessment of which health issue? increased blood pressure blood disorders obesity hearing loss

increased blood pressure

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

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