Disruptive Behavior Disorders

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

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."

A nurse is caring for a 10-year-old child with conduct disorder. The child starts throwing stones at the staff. What statement made by the nurse to control the child's behavior is most appropriate?

"You may injure people around you. If you feel angry, you could always come and talk to me or another nurse."

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 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 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

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.

Children with conduct disorder may be diagnosed with which disorder as adults?

Antisocial personality disorder

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

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.

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 would the nurse identify as the first step?

Clearly identifying what is required for the child

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

Conduct disorder

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 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.

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 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 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

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.

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 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 Alcohol and substance abuse Early onset of sexual behavior

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. 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.

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 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 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.

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

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 ensure safety of others.

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

To help identify feelings.

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 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

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 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