Mental Health Chapter 23

A 10-year-old client diagnosed with conduct disorder is currently in the stabilization phase of care. Which client outcome would be appropriate in the stabilization phase?

"Demonstrate effective problem-solving and coping skills."

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?"

While interviewing a client with conduct disorder, the nurse asks the client about having friends in school. What is the mostlikely response of the client?

"I don't want to be friends with the stupid idiots at school."

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

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 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 mostappropriate response of the nurse to the parents?

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

The nurse is talking with the parents of a child suspected of having a conduct disorder. Which statement made by the parents indicates the behavior of a conduct disorder?

"We found that our child has been stealing items and money and hiding them."

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

"You must stop throwing things. Let's talk about what may be frustrating you."

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."

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 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 Temperament of the adolescent Peer group of the adolescent

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 educating a group of parents about conduct disorder. According to the nurse, which children are most at risk for developing conduct disorder? Select all that apply.

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

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

Conduct disorder

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

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.

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.

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 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 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 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.

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.

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.

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.

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.

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.

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

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

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 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

A pediatric client has a history of repeated, intentional fire-setting behaviors. Which diagnosis should the client be assessed for?

pyromania

A 13-year-old client is being assessed by the psychiatric-mental health nurse. Upon assessment, the client reveals that they believe that the world is aggressive and threatening and they respond likewise. Which aspect of the assessment would the nurse document the findings in the medical record?

thought process and content

A psychiatric-mental health nurse is assessing an 11-year-old child experiencing problems with emotional regulation. Which assessment finding would the nurse document as internalizing behavior?

withdraw