PrepU Peds assignment 8
Parents of a school-age child have begun a program of therapy that includes giving the child a token each time the child follows directions. Which theoretical framework provides the background for such a program?
Behavioral theory
The nurse observes an adolescent who appears to be persistently sad, has angry outbursts, has a decreased appetite and complains of headache frequently. Additionally, the mother reports that the teen is somewhat defiant and has been missing her curfews. The nurse recognizes that these are all signs of what problem?
Depression
An adolescent has been diagnosed with bulimia, and the parents are asking how to best deal with this problem. What suggestion should the nurse make to the parents to help care for the adolescent?
Develop a contract with the adolescent, setting goals of behavior and her diet, as well as privileges gained by meeting the contracted goals.
The nurse is caring for a 12-month-old with autism spectrum disorder (ASD). What description would you expect to elicit from his mother on history-taking?
He stares at a rotating wheel on his crib mobile.
The therapy the nurse would expect to see prescribed for an adolescent with anorexia nervosa would be:
counseling to improve feelings of control over her body.
The nurse is discussing substance abuse with an adolescent. Which statement made by the adolescent should the nurse follow up on first?
"I may drink too much on the weekends but I don't drink during the week."
A nurse taking a health history from an adolescent female would become concerned about anorexia if the adolescent made which statement?
"I've been really tired lately, but I'm afraid that if I rest I will get fatter than I am already."
A nurse is explaining the difference between anorexia nervosa and bulimia nervosa. The nurse knows the teaching was effective when the parents make which statement?
"Individuals with bulimia have a normal weight or are slightly overweight."
A 10-year-old girl with ADHD has been on methylphenidate for 6 months. The girl's mother calls and tells the nurse that the medication is ineffective and requests an immediate increase in the child's dosage. What should the nurse say?
"Let's set up an appointment as soon as possible."
An 11-year-old boy has recently been prescribed methylphenidate. The mother calls the pediatrician's office to speak with the advanced practice pediatric nurse practitioner. This mother has been extremely resistant to medication and insists that the medication is not working. How should the nurse respond?
"Tell me what makes you think the medication is not working"
A child is being referred to a mental health specialist, and the parent states expresses worry about being a bad parent and failing the child. What is the nurse's best response?
"There are so many stressors on children today that can't be prevented."
To feed lunch to a child with autism spectrum disorder (ASD), which action would be most important for the nurse to take?
Use a repetitive series of movements.
An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate?
angry outbursts directed at authority figures
A parent brings a child to the pediatric clinic, stating that the child was diagnosed with attention deficit hyperactivity disorder (ADHD). Which symptom does the nurse anticipate finding with this child?
inattention, impulsive, and hyperactivity
The nurse has been working with an adolescent with an eating disorder for several days. What is an indication that she is developing trust in you?
Her telling you that she is still inducing vomiting after each meal
Which behavior typical of children with autism spectrum disorder (ASD) requires you to maintain special care to keep them safe?
Insensitivity to pain
A 10-year-old girl has been referred for evaluation due to difficulties integrating with her peers at her new school. The counselor believes she is at risk for situational low self-esteem due to problematic relationships with both family members and peers. What is the best approach?
Engage the girl in dialogue regarding feelings about self/personal appearance.
A school-age boy is on methylphenidate for ADHD. What negative side effect should the mother be advised to monitor for in the child?
Appetite suppression
When teaching parents of a child with encopresis, what would you stress?
Not punishing the child for encopresis
The nurse is interviewing a 13-year-old girl with depression. During the course of the interview, the girl reveals that her best friend is thinking about committing suicide. Which response by the nurse would be most appropriate?
"Do you know how she is planning to kill herself?"
An adolescent comes to the school nurse and after being quiet for several minutes states, "I think the world will be better when I am gone." Which statement should be the nurse's first response to this adolescent?
"Have you made a plan to commit suicide?"
A parent suspects that their child has taken cocaine. What physical and psychological effects would the nurse tell the parents to monitor for in the child if this were true? Select all that apply.
-increased heart rate and respirations -euphoria -increased body temperature
The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?
A classroom with a plan of study that is followed each day
An adolescent was caught sneaking liquor out of the family liquor cabinet at home. When confronted by the parents, the adolescent admits to have been drinking daily for the last 3 years. When the parents talk to the health care provider about how to intervene for their child, what information would be appropriate to share with them?
Adolescents who have a family history of alcoholism may be more prone to problems with alcohol.
The nurse is preparing a presentation for a local health fair on autism spectrum disorders. What statement is most important in understanding the disorder?
Autism cannot be cured.
An infant diagnosed with nonorganic failure to thrive (NFTT) is being treated in the hospital. Which intervention would the nurse implement for this child to provide increased nutritional intake?
Document all feedings and the infant's response to the feeding.
The nurse is caring for a 13-year-old girl with a nursing diagnosis of Ineffective coping related to inability to deal with life stressors as evidenced by few or no meaningful friendships and low self-esteem. Which intervention would be the priority to promote coping skills?
Encourage her to discuss her thoughts and feelings.
Parents of a school-age child experiencing encopresis are discussing the problem with the child's health care team. Their understanding of this problem is indicated when the parents respond in what manner?
If there is no organic cause for the problem, the family may need to explore counseling for an emotional problem.
A 6-month-old infant presents at the pediatric clinic with his/her mother. The child is very thin, less than 5% on the growth chart, irritable, listless, unresponsive to the nurse, and has poor muscle control. The child has no history of serious illness. When the infant begins to cry, the mother is very slow to respond and the child is not comforted by the mother. The nurse is concerned about the infant because these are signs of:
Nonorganic failure to thrive
What would be the priority goal for the nurse caring for an infant diagnosed with nonorganic failure to thrive?
Provide adequate nutrition for growth.
With all the warnings on cigarette packages and media coverage of the side effects of tobacco use, why do school-age children and adolescents continue to smoke or chew tobacco?
School-age and adolescent children view the threats to their health as far in the future, and the child feels that he or she can stop at any time.
A child has been prescribed methylphenidate to take daily. Which nursing instructions are important to provide to the family?
Stress the need for adequate nutrition.
A mother is concerned about her adolescent daughter's depression. What is the major problem associated with depression that the mother needs to be monitoring her daughter for?
Suicide
In collecting data on a 7-year-old-child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which would most likely be a cause of the child having school phobia?
The child may have a fear of being separated from the mother.
A 6-year-old client has been diagnosed with autism spectrum disorder. Which symptoms would the nurse expect the client to display?
The client spends time alone and shows little interest in making friends.
During adolescence, alcohol is connected to what problem frequently seen in this age group?
automobile accidents
What potential side effect of smoking crack should the nurse teach adolescents about to ensure their understanding of the drug's possible impact?
cardiac arrest
A mother is suspicious that her adolescent has bulimia because the child seems to be dependent upon laxatives and vomits frequently after eating a meal. What physical finding would be most suggestive of this diagnosis?
dental erosions and caries
The football coach notices that one of the players has been more energetic and overly happy lately during practice. The player also got in fight with a teammate last week. The coach contacts the health care provider, concerned that the student is using anabolic steroids. What physical sign would the nurse advise the coach to be on the lookout for that would further validate the illicit drug use?
gynecomastia
An adolescent is being seen in the local clinic for obesity problems. The nurse realizes that which factor would not play a role in this eating disorder?
having a positive self-esteem
Which approach to drug education would be most effective for a group of school-age children?
providing the children with strategies of how to refuse offers of drugs
Rumination disorder is a poorly understood condition of young children. This refers to:
rechewing undigested food.
The nurse is working with a child diagnosed with encopresis. After a complete medical workup has been done, no organic cause has been found for the disorder. The nurse will anticipate the child will next be:
referred for counseling.
A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who is experiencing headaches. Her grades have dropped, and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to:
schedule an immediate history and physical examination.
