Psych Test 5 Chapter 21-24

was a pervasive developmental disorder characterized by the same impairments of social interaction and restricted interests or behaviors seen in autism spectrum disorder, but there is no language or cognitive delays. Motor clumsiness is common. This rare disorder occurs more often in boys than in girls, and the effects are generally lifelong.

Asperger's disorder

techniques can help children to express themselves, for example, by drawing pictures of themselves, their family, and peers. These techniques are especially useful when children are unable or unwilling to express themselves verbally.

Creative play

are characterized by persistent patterns of behavior that involve anger, hostility, and/or aggression toward people and property. This category includes oppositional defiant disorder (ODD), conduct disorder, and intermittent explosive disorder (IED).

DISRUPTIVE BEHAVIOR DISORDERS

is acting out an anxiety-producing situation such as allowing the child to be a doctor or use a stethoscope or other equipment to take care of a patient (a doll).

Dramatic play

Self-Concept Clients focus only on the physical part of themselves. They are unlikely to think about personal characteristics. What are they?

Emotion-focused coping strategies Problem-focused coping strategies

include progressive relaxation, deep breathing, guided imagery, and distractions such as music or other activities.

Emotion-focused strategies

Communication Disorder disorder involves an impaired ability to communicate through verbal and sign languages. The child has difficulty learning new words and speaking in complete and correct sentences; his or her speech is limited. expressive language disorder includes the problems of expressive language disorder along with difficulty understanding (receiving) and determining the meaning of words and sentences. Both disorders can be present at birth (developmental) or may be acquired as a result of neurologic injury or insult to the brain. involves problems with articulation (forming sounds that are part of speech). Stuttering is a disturbance of the normal fluency and time patterning of speech. This disorder and stuttering run in families and occur more frequently in boys than in girls.

Expressive language Mixed receptive Phonologic disorder

Children with autism display little ___ _____ with and make few facial expressions toward others; they use limited ____ to communicate. They have limited capacity to relate to peers or parents. They lack spontaneous enjoyment, express no moods or emotional affect, and cannot engage in play or make-believe with toys. There is little intelligible speech.

Eye contact Gestures

imposed on self, occurs when a person intentionally produces or feigns physical or psychological symptoms solely to gain attention.

Factitious disorder

medications (treatment) for somatic symptom illness

Fluoxetine (Prozac) Paroxetine (Paxil) Sertraline (Zoloft)

The child has some conduct problems that cause relatively minor harm to others. Examples include repeated lying, truancy, minor shoplifting, and staying out late without permission. The number of conduct problems increases as does the amount of harm to others. Examples include vandalism, conning others, running away from home, verbal bullying and intimidation, drinking alcohol, and sexual promiscuity The person has many conduct problems that cause considerable harm to others. Examples include forced sex, cruelty to animals, physical fights, cruelty to peers, use of a weapon, burglary, robbery, and violation of previous parole or probation requirements.

Mild: Moderate: Severe:

a factitious disorder where the person intentionally causes injury or physical symptoms to self to gain attention and sympathy from health-care providers, family, and others

Munchausen's syndrome

when a person inflicts illness or injury on someone else to gain the attention of emergency medical personnel or to be a hero for "saving" the victim

Munchausen's syndrome by proxy

involves problems with articulation (forming sounds that are part of speech). Stuttering is a disturbance of the normal fluency and time patterning of speech. Phonologic disorder and stuttering run in families and occur more frequently in boys than in girls.

Phonologic disorder

include learning problem-solving methods, applying the process to identified problems, and role-playing interactions with others.

Problem-focused coping strategies

was identified as a type of pervasive developmental disorder characterized by the development of multiple deficits after a period of normal functioning.

Rett's disorder

A client with somatic symptom disorder has been attending group therapy. Which of the following statements indicates that therapy is having a positive outcome for this client? a. "I feel better physically just from getting a chance to talk." b. "I haven't said much, but I get a lot from listening to others." c. "I shouldn't complain too much; my problems aren't as bad as others'." d. "The other people in this group have emotional problems."

a

Teaching for methylphenidate (Ritalin) should include which of the following? Give the medication after meals. Give the medication when the child becomes overactive. Increase the child's fluid intake when he or she is taking the medication. Take the child's temperature daily.

a

The client's family asks the nurse, "What is illness anxiety disorder?" The best response by the nurse is, "Illness anxiety disorder is a. a persistent preoccupation with getting a serious disease." b. an illness not fully explained by a diagnosed medical condition." c. characterized by a variety of symptoms over a number of years." d. the eventual result of excessive worrying about diseases."

a

The nurse is assessing an adult client with ADD. The nurse expects which of the following to be present? Difficulty remembering appointments Falling asleep at work Problems getting started on a project Lack of motivation to do tasks

a

Which of the following is normal adolescent behavior? Being critical of self and others Defiant, negative, and depressed behavior Frequent hypochondriacal complaints Unwillingness to assume greater autonomy

a

Which of the following is true about clients with illness anxiety disorder? a. They may interpret normal body sensations as signs of disease. b. They often exaggerate or fabricate physical symptoms for attention. c. They do not show signs of distress about their physical symptoms. d. All the above are true statements.

a

Which of the following is used to treat enuresis? Imipramine (Tofranil) Methylphenidate (Ritalin) Olanzapine (Zyprexa) Risperidone (Risperdal)

a

Symptoms od Conduct Disorder are clustered in four areas: aggression to people and animals, destruction of property, deceitfulness and theft, and serious violation of rules

aggression to people and animals destruction of property deceitfulness and theft serious violation of rules

Studies have shown that both teachers and peers perceive children with ADHD as more

aggressive, more bossy, and less likable

Sensorium and Intellectual Processes Clients are

alert and oriented.

characterized by inattentiveness, overactivity, and impulsiveness

attention deficit hyperactivity disorder (ADHD)

neurodevelopmental disorder first seen in childhood, conceptualized across a continuum with symptoms varying from mild to severe; may include communication deficits, problems building social relationships, overdependence on routines, and high level of sensitivity to the environment

autism spectrum disorder

A nurse assessing a client with intermittent explosive disorder (IED) would expect which of the following? Blaming others for provoking angry outbursts Difficulty coping with ordinary life stressors Lack of remorse for aggressive behavior Premeditated aggressive outbursts to get what the client wants

b

An effective nursing intervention for the impulsive and aggressive behaviors that accompany conduct disorder is assertiveness training. consistent limit setting. negotiation of rules. open expression of feelings.

b

Emotion-focused coping strategies are designed to accomplish which of the following outcomes? a. Helping the client manage difficult situations more effectively b. Helping the client manage the intensity of symptoms c. Teaching the client the relationship between stress and physical symptoms d. Relieving the client's physical symptoms

b

The nurse has completed teaching sessions for parents about conduct disorder. Which of the following statements indicates a need for further teaching? "Being consistent with rules at home will probably be a real challenge for me and my child." "It helps to know that these problems will get better as my child gets older." "Real progress for our child is likely to take several weeks or even months." "We need to set up a system of rewards and consequences for our child's behaviors."

b

The nurse is caring for a client with a conversion disorder. Which of the following assessments will the nurse expect to see? a. Extreme distress over the physical symptom b. Indifference about the physical symptom c. Labile mood d. Multiple physical complaints

b

The goals of treatment of children with autism are to reduce _______ _______ (e.g., stereotyped motor behaviors) and to promote learning and development, particularly the acquisition of _______ _____

behavioral symptoms language skills.

Autism spectrum disorder, formerly called autistic disorder, or just autism, is more prevalent in boys or girls

boys

A client who developed numbness in the right hand could not play the piano at a scheduled recital. The consequence of the symptom, not having to perform, is best described as emotion-focused coping phobia primary gain secondary gain

c

The nurse would expect to see all the following symptoms in a child with ADHD except easily distracted and forgetful. excessive running, climbing, and fidgeting. moody, sullen, and pouting behavior. interrupts others and can't take turns.

c

Which of the following statements would indicate that teaching about somatic symptom disorder has been effective? a. "The doctor believes I am faking my symptoms." b. "If I try harder to control my symptoms, I will feel better." c. "I will feel better when I begin handling stress more effectively." d. "Nothing will help me feel better physically."

c

Children with conduct disorder often exhibit ______ and _______ behavior, similar to that seen in adults with antisocial personality disorder.

callous and unemotional

characteristics such as lack of empathy, lack of remorse for bad behavior, shallow or superficial emotions, and no concern for problematic behaviors or issues

callous and unemotional traits

characterized by persistent antisocial behavior in children and adolescents that significantly impairs their ability to function in social, academic, or occupational areas

conduct disorder

clients may make up answers to fill in memory gaps; usually associated with organic brain problems

confabulation:

The primary treatment for delirium is to identify and treat any causal or

contributing medical conditions.

involves unexplained, usually sudden deficits in sensory or motor function related to an emotional conflict the client experiences but does not handle directly

conversion disorder

. A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which of the following side effects? Decreased thyroid-stimulating hormone Decreased red blood cell count Elevated white blood cell count Elevated liver function tests

d

Parents of a child with oppositional defiant disorder (ODD) are referred to a parent management training program. The parents ask the nurse what to expect from these sessions. The best response by the nurse is "This is a method of parenting that involves negotiation of responsibilities with your child." "This is a support group for parents to discuss the difficulties they are having with their children." "You will have a chance to learn how to manage all of your child's negative behaviors." "You will learn behavior management techniques to use at home with your child."

d

Paroxetine (Paxil) has been prescribed for a client with asomatic symptom illness. The nurse instructs the client to watch for which of the following side effects? a. Constipation b. Increased appetite c. Increased flatulence d. Nausea

d

The nurse is teaching a 12-year-old with intellectual disability about medications. Which of the following interventions is essential? Speak slowly and distinctly. Teach the information to the parents only. Use pictures rather than printed words. Validate client understanding of teaching.

d

The nurse recognizes which of the following as a common behavioral sign of autism? Clinging behavior toward parents Creative imaginative play with peers Early language development Indifference to being hugged or held

d

a syndrome that involves a disturbance of consciousness accompanied by a change in cognition

delirium:

a mental disorder that involves multiple cognitive deficits, initially involving memory impairment with progressive deterioration that includes all cognitive functioning

dementia:

APPLICATION OF THE NURSING PROCESS: ATTENTION DEFICIT HYPERACTIVITY DISORDER Assessment During assessment, the nurse gathers information through ______ ______ and from the child's parents, day care providers (if any), and teachers.

direct observation

preoccupation with the fear that one has a serious disease

disease conviction

preoccupation with the fear that one will get a serious disease

disease phobia

The childhood-onset type involves symptoms before 10 years of age, including physical aggression toward others and

disturbed peer relationships

techniques to assist clients to relax and reduce feelings of stress

emotion-focused coping strategies

the repeated passage of feces into inappropriate places, such as clothing or the floor, by a child who is at least 4 years of age either chronologically or developmentally

encopresis:

the repeated voiding of urine during the day or at night into clothing or bed by a child at least 5 years of age either chronologically or developmentally

enuresis

Thought Process and Content Clients who somatize do not experience disordered thought processes. The content of their thinking is primarily about often ______ physical concerns; for example, when they have a simple cold, they may be convinced it is pneumonia.

exaggerated

Clients with hypochondriasis focus on the ____ _ _____ _____ _____ ___ __ ______ _ ____, as seen in clients with other somatoform disorders.

fear of serious illness rather than the existence of illness

Treatment for IED includes medications, such as

fluoxetine (Prozac) lithium anticonvulsant mood stabilizers such as valproic acid (Depakote) phenytoin (Dilantin) topiramate (Topimax) oxcarbazepine (Trileptal).

Short-term inpatient treatment is used when behaviors such as head banging or tantrums are out of control.

head banging or tantrums are out of control.

preoccupation with the fear that one has a serious disease or will get a serious disease; also called

hypochondriasis

Judgment and Insight Exaggerated responses to their physical health may affect clients'

judgment.

a seeming lack of concern or distress; a key feature of conversion disorder associated with conversion disorder

la belle indifférence:

Low self-esteem and poor social skills are common in children with

learning disorders.

the intentional production of false or grossly exaggerated physical or psychological symptoms

malingering

These adolescents are less likely to be aggressive, and they have more

normal peer relationships.

Onset and Clinical Course Socially, peers may _____ or even ridicule the child for his or her behavior.

ostracize

Self-Concept Clients focus only on the ______part of themselves. They are unlikely to think about _____ characteristics

physical personal

the relief of anxiety achieved by performing the specific anxiety-driven behavior; the direct external benefits that being sick provides, such as relief of anxiety, conflict, or distress

primary gain

techniques used to resolve or change a person's behavior or situation or to manage life stressors

problem-focused coping strategies

Clients with delirium often have a disturbance of _______ _______. They may be restless and hyperactive, frequently picking at bedclothes or making sudden, uncoordinated attempts to get out of bed.

psychomotor behavior.

Give ADHD kids what

reward

Tic disorders tend to run in families. Abnormal transmission of the neurotransmitter dopamine is thought to play a part in tic disorders. Tic disorders usually are treated with ______ (_____) or ________ (________), which are atypical antipsychotics.

risperidone (Risperdal) olanzapine (Zyprexa)

the internal or personal benefits received from others because one is sick, such as attention from family members, comfort measures, and being excused from usual responsibilities or tasks

secondary gain

Intervention Decreasing Violence and Increasing Compliance with Treatment The nurse must protect others from the manipulative or aggressive behaviors common with these clients. He or she must ___ _____ on unacceptable behavior at the beginning of treatment.

set limits

characterized by multiple, recurrent physical symptoms in a variety of bodily systems that have no organic or medical basis; also called somatization disorder

somatic symptom disorder

repetitive, seemingly purposeless movements; may include waving, rocking, twirling objects, biting fingernails, banging the head, biting or hitting oneself, or picking at the skin or body orifices. Seen in Autistic patients.

stereotyped motor behavior

play techniques are used to understand the child's thoughts and feelings and to promote communication

therapeutic play

a sudden, rapid, recurrent, nonrhythmic, stereotyped motor movement or vocalization

tic

involves repeated episodes of impulsive, aggressive, violent behavior and angry verbal outbursts, usually lasting less than 30 minutes.

Intermittent explosive disorder (IED)

The onset of IED is usually by __ to __ years of age

13 21

Autism spectrum disorder, formerly called autistic disorder, or just autism, it is identified usually by __ months and no later than __ years of age.

18 3

A certain level of oppositional behavior is common in children and adolescents; indeed, it is almost expected at some phases such as

2 to 3 years of age and in early adolescence.

Chapter 21

Chapter 21

Chapter 22

Chapter 22

Chapter 23

Chapter 23

Chapter 24

Chapter 24

was a pervasive developmental disorder, characterized by marked regression in multiple areas of functioning after at least 2 years of apparently normal growth and development.

Childhood disintegrative disorder

is the preferred term for what has been called mental retardation, a term often used in a disparaging manner to bully or ridicule individuals with impaired cognitive abilities.

Intellectual disability

The intensity of the emotional outburst is grossly out of proportion to the stressor or situation. In other words, a very minor issue or occurrence may result in rage, aggression, and assault of others.

Intermittent explosive disorder (IED)

consists of an enduring pattern of uncooperative, defiant, disobedient, and hostile behavior toward authority figures without major antisocial violations. Associated with ***encopresis***

Oppositional defiant disorder

malingering is a symptomatic disease. T or F

T

involves multiple motor tics and one or more vocal tics, which occur many times a day for more than 1 year

Tourette's disorder