Ch 33 ?'s

Which information should the nurse include in the teaching plan for the parents of a child who is diagnosed with autism spectrum disorder (ASD) as methods to increase the child's socialization? 1. Create a reward system when the child interacts with a person. 2. Punish the child when the child's social behaviors are inappropriate. 3. Use dolls to demonstrate appropriate social interactions to the child. 4. Enroll the child in a day care facility to encourage interaction with other children.

1 This is appropriate treatment involving behavior modification.

You care for a 12-month-old with autistic disorder. Which of the following descriptions would you expect to elicit from his mother on history-taking? a) He stares at a rotating wheel on his crib mobile. b) He already speaks in complete sentences. c) He sleeps at least 12 out of every 24 hours. d) He responds warmly to his father but not to his mother.

a) He stares at a rotating wheel on his crib mobile. Children with autistic disorder seem fascinated by whirling or spinning toys or objects. They are nonverbal and have difficulty forming close relationships.

Which of the following signs and symptoms suggest that a 5-year-old boy who does not maintain eye contact or speak may be autistic? a) The child constantly pats his legs. b) The child has a long face and prominent jaw. c) The child has a slight decrease in head circumference. d) The child is highly active and inattentive.

a. The child constantly pats his legs. Repetitive motor mannerisms such as the boy constantly patting his legs are a typical behavior pattern for autistic disorder. A high level of activity and inattentiveness are typical symptoms of mental retardation. A decrease in head circumference suggests malnutrition or decelerating brain growth. A long face and prominent jaw are symptoms of fragile X syndrome.

Which of the following characteristics are commonly noted in the child with anorexia nervosa? a) The child is impulsive and inattentive when spoken to. b) The child has rigid study skills and ritualistic behavior. c) The child is inactive and participates in sedentary activites. d) The child has trouble sitting still and is figety.

b) The child has rigid study skills and ritualistic behavior. Anorexic children often are described as successful students who tend to be perfectionists and are always trying to please parents, teachers, and other adults. They may make demands on themselves for cleanliness and order in their environment, or they may engage in rigid schedules for studying and other ritualistic behavior.

Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with attention deficit/ hyperactivity disorder (ADHD)? Select all that apply. 1. Arm flapping 2. Language delays 3. Ritualistic behavior 4. Impulsive behavior 5. Sleep disturbances

4 5 Impulsive behavior is a clinical manifestation associated with ADHD. Sleep disturbance is a clinical manifestation associated with ADHD.

You have been working with an adolescent with an eating disorder for several days. Which of the following is an indication that she is developing trust in you? a) Her saying to you that she'll follow your orders but not those of the nurse on the next shift b) Her saying to you that she trusts you more than anyone else c) Her telling you that she is now ready to eat again d) Her telling you that she is still inducing vomiting after each meal

D An adolescent has to be able to trust an adult before she can share confidences.

A nurse is conducting developmental assessments on several children in the day-care setting. Which child(ren) does the nurse identify as having development delays? Standard Text: Select all that apply. 1. An 18-month-old toddler who is unable to phrase sentences 2. A 5-year-old who is unable to button his shirt 3. A 6-year-old who is unable to sit still for a short story 4. A 2-year-old who is unable to cut with scissors 5. A 2-year-old who cannot recite her phone number

2,3 Rationale 1: A developmental milestone that can indicate learning disability is a kindergartener's being unable to button his shirt. Inability to phrase sentences is considered a delay if not done by 2-1/2 years, inability to sit still for a short story is considered a delay if the child is 3 to 5 years old, and being unable to cut with scissors indicates a delay if not done by kindergarten age. Reciting the phone number is not appropriate for a 2-year-old.

A child diagnosed with autism spectrum disorder (ASD) is admitted to the hospital with dehydration. Which should the nurse include in the plan of care for this child? 1. Discourage the parents from bringing favorite toys from home that might be lost. 2. Take the child on a tour of the pediatric unit. 3. Assign the child to a single-bed hospital room. 4. Take the child to the playroom for arts and crafts.

3 A single room is the best place for an autistic child if the child must be hospitalized.

Which nursing action assists in the diagnosis of mental health and cognitive disorders that occur during childhood? 1. Monitoring vital signs 2. Administering prescribed medications 3. Conducting a developmental assessment 4. Documenting an accurate history and physical

3 Conducting a developmental assessment is a nursing action that assists in the diagnosis of mental health and cognitive disorders in pediatric clients.

Which factor, noted by the nurse during the pediatric health history portion of the assessment process, would indicate the child is at risk for attention deficit/hyperactivity disorder (ADHD)? 1. Measles, mumps, and rubella vaccine 2. Advanced parental age 3. Prenatal exposure to smoke 4. Immune response

3 Research shows that a mother's use of cigarettes during pregnancy can increase the risk for ADHD.

Which statement from the parent of a child diagnosed with attention deficit/hyperactivity disorder (ADHD) indicates the need for further education by the nurse? 1. "I will develop a reward system for desired behaviors." 2. "I will take my child to the physician every 3 months for a weight and height check." 3. "I will let him do his homework while he is watching his favorite television show." 4. "I will stick to the same routine each day after school."

3 This child should do homework in a quiet environment, away from distractions.

Which activities should the nurse include in the plan of care for a child diagnosed with attention deficit/hyperactivity disorder (ADHD) to improve behavior and learning? Select all that apply. 1. Asking the mother to seek a prescription for methylphenidate (Ritalin) for the child 2. Placing the child's desk at the back of the room to reduce distractions 3. Developing a consistent routine for the classroom 4. Limiting the decorations in the classroom 5. Determining areas where the child performs well and using these areas to promote self-esteem

3. Developing a consistent routine for the classroom 4. Limiting the decorations in the classroom 5. Determining areas where the child performs well and using these areas to promote self-esteem Consistency is important for the child with ADD/ADHD and reduces impulsive behavior. Decorations are distracting and should be limited. This is appropriate and will help reduce "acting out" behaviors.

Which of the following signs and symptoms suggest that a 5-year-old boy who does not maintain eye contact or speak may be autistic? a) The child constantly opens and closes his hands. b) The child has a long face and prominent jaw. c) The child has a slight decrease in head circumference. d) The child is highly active and inattentive.

A Repetitive motor mannerisms such as constantly opening and closing the hands are a typical behavior pattern for autistic disorder. A high level of activity and inattentiveness are typical symptoms of mental retardation. Decrease in head circumference suggests malnutrition or decelerating brain growth. A long face and prominent jaw are symptoms of fragile X syndrome.

A child with ADHD is placed on methylphenidate (Ritalin) therapy. Which of the following symptoms may children on Ritalin develop? a) Anorexia b) Sleepiness c) Rapid increase in height d) Hypotension

A Ritalin typically causes a loss of appetite. Weighing the child periodically to detect whether this has led to a loss of weight is important.

The 18-month-old toddler has been brought into the pediatrician's office by his parents. Which of the following findings are warning signs that the toddler may be autistic based on what he should be able to do according to his age? Select all that apply. a) The child does not use any words b) The child cannot jump rope c) The child does not speak in short sentences d) The toddler does not exhibit attempts to communicate by pointing to objects e) The parents stated that the toddler has never "babbled"

A D E An 18-month-old toddler should have babbled by 12 months. He should be using gestures and using single words to communicate. The use of sentences to communicate and the ability to jump rope would be expected later.

The nurse in the well-child clinic observes that a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, "Oh, yeah," and happily climbs back up. The nurse suspects that which of the following applies to this child? a) The child is autistic. b) The child has failure to thrive. c) The child has attention deficit hyperactive disorder. d) The child has an addicted caregiver.

C The child with ADHD may have these characteristics: Impulsiveness, easy distractibility, frequent fidgeting or squirming, difficulty sitting still, problems following through on instructions despite being able to understand them, inattentiveness when being spoken to, frequent losing of things, going from one uncompleted activity to another, difficulty taking turns, frequent excessive talking, and engaging in dangerous activities without considering the consequences.

The nurse is caring for a girl with anorexia who has been hospitalized with unstable vital signs and food refusal. The girl requires enteral nutrition. The nurse is alert for which of the complications that signal re-feeding syndrome? a) Bradycardia with ectopy b) Hypothermia and irregular pulse c) Cardiac arrhythmias, confusion, seizures d) Orthostatic hypotension

C The nurse should be aware that rapid nutritional replacement in the severely malnourished can lead to refeeding syndrome. Refeeding syndrome is characterized by cardiovascular, hematologic, and neurologic complications such as cardiac arrhythmias, confusion, and seizures. Orthostatic hypotension, hypertension, and irregular and decreased pulses are complications of anorexia but do not characterize refeeding syndrome.

A school-age client is prescribed Adderall (amphetamine mixed salts) for attention deficit hyperactivity disorder (ADHD). At which time is it most appropriate for the nurse to teach the parents to administer this medication? 1. At bedtime 2. Before lunch 3. With the evening meal 4. Early in the morning

Correct Answer: 4 Rationale 1: A side effect of Adderall can be insomnia. Administering the medication early in the day can help alleviate the effect of insomnia.

The nurse is obtaining the history of an adolescent female who is suspected of having anorexia nervosa. Which of the following would the nurse expect to find? Select all that apply. a) Diarrhea b) Desire for perfectionism c) Warm hands and feet d) Syncope e) Secondary amenorrhea

b) Desire for perfectionism d) Syncope e) Secondary amenorrhea he adolescent with anorexia may have a history of constipation, syncope, secondary amenorrhea, abdominal pain, and periodic episodes of cold hands and feet. In addition, the child's self-concept reveals multiple fears, high need for acceptance, disordered body image, and perfectionism.

Which behavior typical of children with autistic disorder requires you to maintain special care to keep them safe? a) A fascination with bright colors b) Insensitivity to pain c) Loss of hearing for high frequencies d) A craving for salt

b) Insensitivity to pain A number of children with autistic disorder demonstrate poor sensation of pain and, thus, bite their hands or bang their heads repeatedly.

The nurse is caring for a 10-year-old recently diagnosed with attention deficit/hyperactivity disorder (ADHD). The nurse would expect to provide teaching regarding which of the following medications? a) Buspirone b) Methylphenidate c) Fluoxetine d) Trazodone

b) Methylphenidate Methylphenidate is a psychostimulant commonly prescribed for ADHD. Trazodone is used to treat depression. Buspirone is used for anxiety. Fluoxetine is used for depression.

The mother of an 8-year-old boy is concerned that her son has attention-deficit/hyperactivity disorder. She describes the symptoms he demonstrates. Which of the following behaviors should the nurse recognize as an example of impulsiveness? a) Constantly fidgeting in his chair and shaking his foot b) Repeating words or phrases spoken by others c) Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission d) Inability to answer a question posed by his teacher because he was daydreaming

c) Jumping out of his seat in the middle of class and running to the bathroom without the teacher's permission The disorder is characterized by three major behaviors: inattention, impulsiveness, and hyperactivity. Inattention makes children become easily distracted and often may not seem to listen or complete tasks effectively. Impulsiveness causes them to act before they think and therefore to have difficulty with such tasks as awaiting turns. With hyperactivity, children may shift excessively from one activity to another, exhibit excessive or exaggerated muscular activity, such as excessive climbing onto objects, constant fidgeting, or aimless or haphazard running. Repeating words or phrases spoken by others is echolalia and is associated with autistic spectrum disorder.

Which clinical manifestations should the nurse expect when conducting an assessment for a child who is diagnosed with autism spectrum disorder (ASD)? Select all that apply. 1. Arm flapping 2. Language delays 3. Ritualistic behavior 4. Impulsive behavior 5. Sleep disturbances

1 2 3 .Arm flapping is a clinical manifestation associated with ASD. Language delay is a clinical manifestation associated with ASD . Ritualistic behavior is a clinical manifestation associated with ASD.

Which child should the nurse refer for further assessment due to a probable diagnosis for autism spectrum disorder (ASD)? 1. A 4-year-old girl who doesn't make eye contact with mother and resists the mother's touch 2. A 3-year-old boy who joins one group of children, then moves to another group of children without joining their activities 3. An 18-month-old child who walks around the area using the furniture to provide balance 4. A 6-year-old boy who chatters constantly to anyone who will listen

1. A 4-year-old girl who doesn't make eye contact with mother and resists the mother's touch Although boys are affected more often than girls, lack of eye contact and resistance to physical touch are common symptoms of autism

The nurse is observing a group of two and three year olds in a play group setting. Which of the following behaviors noted in one of the children indicates to the nurse that the child may be autistic? a) While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack. b) A child flips the light switch off and on until the caregiver asks her to stop and join the other children in playing. c) A child playing in the kitchen area pretends to pour a glass of milk and repeats this over and over. d) After another child takes a toy, the child cries and stomps his feet

A autistic children become completely absorbed in strange repetitive behaviors such as spinning an object, flipping an electrical switch on and off, or walking around the room feeling the walls. If these movements are interrupted or if objects in the environment are moved, a violent temper tantrum may result. These tantrums may include self-destructive acts such as hand biting and head banging. Although infants and toddlers normally are self-centered, ritualistic, and prone to displays of temper, autistic children show these characteristics to an extreme degree coupled with an almost total lack of response to other people.

The nurse is teaching the parents of a very young client newly diagnosed with​ attention-deficit/hyperactivity disorder​ (ADHD) about the newly prescribed medication methylphenidate​ (Ritalin). Which instruction should the nurse​ include? A. Give the medication first thing in the morning. B. Observe the child for excessive sleepiness. C. Give the medication prior to going to bed at night. D. Restrict the amount of calories that the client eats each day.

A Rationale: The parents should give the medication first thing in the morning to ensure attentiveness and alertness during the day at school. This medication should not be given at bedtime because it can cause insomnia. The client should be observed for​ insomnia, rather than excessive sleepiness.​ Lastly, the client should be encouraged to consume an adequate amount of calories because this medication can also cause anorexia.

A parents group asks the nurse what they should look for if they suspect their​ school-age child has ​ attention-deficit/hyperactivity disorder​ (ADHD). Which observation should the nurse instruct the parents to report to their​ child's healthcare provider​ (HCP) for further​ assessment? (Select all that​ apply.) A. Excessive motor activity B. Deliberately destroying other​ people's property C. Inability to stay on an assigned task to completion D. Having difficulty with learning at school E. Limited attention span when speaking with parent

A. ​Excessive motor activity C. Inability to stay on an assigned task to completion D. Having difficulty with learning at school E. Limited attention span when speaking with parent Rationale: The required findings for a diagnosis of ADHD are limited attention​ span, an inability to stay on an assigned​ task, and excessive motor activity with the inability to sit still for more than a few minutes. Clients with ADHD are frequently labeled as poor achievers with difficulty learning. While many of the behaviors of ADHD in adolescence and adulthood could be considered​ antisocial, such as destruction of​ property, this type of behavior would be less likely to occur in a younger child. Both children and adolescents with ADHD sometimes struggle with making and maintaining friends.

The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder with a group of school nurses. Which of the following would be an appropriate learning setting for a child with ADHD? a) A classroom with windows facing a playground. b) A classroom with tables and chairs rather than individual desks. c) A classroom with a plan of study that is followed each day. d) A classroom in which children self-select their activities.

C For the child with ADHD the learning situations should be structured so that the child has minimal distractions and a supportive teacher. Special arrangements can be made to provide an educational atmosphere that is supportive for the child without the need for the child to leave the classroom.

The nurse is planning care for a child recently diagnosed with autism. Which of the following interventions will the nurse initiate for the family? a. Suggest using many different babysitters when parents are going out. b. Suggest allowing the child privacy in the bathroom. c. Provide teaching to help the child meet developmental milestones. d. Suggest that the family enroll the child in daycare.

C The child with autism often has developmental delays that the parents notice and for which they seek treatment. Helping the family to work with the child to optimize developmental growth is a priority intervention. Daycare placement generally provides too much stimulation for the child with autism. The child needs stable caregivers in order to learn to trust others. Safety is a priority, especially in the bathroom, where supervision is needed.

A nurse is planning preoperative teaching for a school-age client scheduled to have a tonsillectomy. The client has a history of attention deficit hyperactivity disorder (ADHD). Which intervention will the nurse include in the plan of care? 1. Give instructions verbally and use a picture pamphlet, repeating points more than once. 2. Ask other children who have had this procedure to talk to the child. 3. Allow the child to lead the session to gain a sense of control. 4. Play a television show in the background.

Correct Answer: 1 Rationale 1: A teaching session for a child with ADHD should foster attention. Giving instructions verbally and in written form, repeating points, will improve learning for a child with ADHD. The environment needs to be quiet, with minimal distractions. A child who has difficulty concentrating should not lead the session even though the child needs to feel in control. Talking to other children who have had this procedure may not foster understanding, because this child has ADHD. Distractions such as noise from a television should be minimized.

The mother of a teenage female client recently diagnosed with​ attention-deficit/hyperactivity disorder​ (ADHD) tells the​ nurse, "Our daughter has a male cousin who has​ ADHD, but he​ doesn't act anything like​ her." Which response should the nurse make to explain the​ difference? A. ​"Girls with ADHD tend to be diagnosed earlier than​ boys." B. ​"Girls with ADHD tend to show fewer language problems than boys with​ ADHD." C. ​"Girls with ADHD tend to show more aggression than boys with​ ADHD." D. ​"Girls with ADHD tend to show less impulsiveness than boys with​ ADHD."

D Rationale: Girls with ADHD tend to show less aggression and impulsiveness than boys with ADHD.​ However, girls show more​ anxiety, mood​ swings, social​ withdrawal, rejection, and cognitive and language problems. Girls are usually​ older, not​ younger, than boys at the time of diagnosis.

The nurse is working with a group of caregivers of school-age children diagnosed with attention deficit hyperactivity disorder. Which of the following statements would be most appropriate for the nurse to make to this group of caregivers? a) "These children study better with quiet background music such as the radio or a CD." b) "These children function best if given a set of instructions and then left to do the task." c) "A frequent change in routine will be helpful so the child does not get bored." d) "The medications your child is on may cause a decreased appetite."

D earning situations should be structured so that the child has minimal distractions. Structured, consistent guidance from the caregivers is needed. Medication is used for some children and these medications may suppress the appetite and affect the child's growth. The child should be given only one simple instruction at a time. Limiting distractions, using consistency, and offering praise for accomplishments are invaluable.

The nurse is evaluating a 3-year-old with a developmental delay. Which assessment finding would indicate this child might have a type of autistic spectrum disorder? a. The child enjoys imaginative play. b. The child goes to bed without a nighttime routine. c. The child is using echolalia. d. The child does not enjoy playing frequently with the same toy

C Abnormal communication patterns, including echolalia (repeating words spoken to the child), are symptoms of autism. The autistic child exhibits obsessive behavior such as playing repeatedly with the same toy and having a rigid bedtime routine. The autistic child does not typically engage in imaginative play.

Which interventions should the nurse include in the plan of care for a child who is diagnosed with an intellectual disability? Select all that apply. 1. Providing emotional support to the family 2. Maintaining a safe environment for the client 3. Educating the family that maintenance of activities of daily living (ADL) is impossible to achieve 4. Participating in the individualized education program (IEP) process 5. Recommending permanent institutionalization

1 2 4 The nurse should include interventions in the plan of care for a child diagnosed with an intellectual disability that support the family. The nurse should include interventions in the plan of care for a child diagnosed with an intellectual disability that maintain a safe environment.The nurse should participate in the IEP process for a child who is diagnosed with an intellectual disability.

1The nurse is assessing a 4-year-old child with a possible alteration in mental health. Which findings indicate a need for further investigation? Select all that apply. 1. Fails to make eye contact 2. Flinches when touched on the arm 3. History of limited prenatal care and precipitate delivery 4. Head circumference has not changed in over 1 year 5. Flat facial expressions

1. Fails to make eye contact 2. Flinches when touched on the arm 3. History of limited prenatal care and precipitate delivery 5. Flat facial expressions Making eye contact with the nurse and caregiver is part of the child's overall affect and social skills. A child who fails to make eye contact may have an alteration in mental health. Flinching may indicate a desire to avoid contact; this can indicate a mental health issue and should be further evaluated. History of prenatal care and delivery can help determine potential alterations in mental health in a child. Affect can be determined by facial expression and response to the nurse, helping to determine mental health. Page Ref: 1487 Cognitive Level: Applying Client Need/Sub: Psychosocial Integrity Standards: QSEN Competencies: III.B.3. Base individualized care plan on patient values, clinical expertise and evidence | AACN Essential Competencies: III.6. Integrate evidence, clinical judgment, interprofessional perspectives and patient preferences in planning, implementing, and evaluating outcomes of care | NLN Competencies: Quality and Safety: Knowledge: Current best practices | Nursing/Integrated Concepts: Nursing Process: Assessment Learning Outcome: 55.1 Define mental health and describe major mental health alterations in childhood. MNL Learning Outcome: 8.1.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children; 8.2.1. Examine etiology, risk factors, pathophysiology, and clinical manifestations as seen in children.

A nurse is caring for four pediatric clients in the hospital. Which client should the nurse refer for play therapy? 1. An adolescent with asthma 2. A preschool-age child with a fractured femur 3. A school-age child having an appendectomy 4. An infant with sepsis

2 Rationale 1: Play therapy is often used with preschool and school-age children who are experiencing anxiety, stress, and other specific nonpsychotic mental disorders. In this case, the child who experiences a condition that requires longer hospitalization and recovery, such as a fracture of the femur, should be referred for play therapy. The adolescent with asthma, the school-age child having an appendectomy, and the infant with sepsis do not have as high a need for play therapy as the preschool child with a broken bone.

The child has been diagnosed with attention deficit hyperactivity disorder (ADHD) and has been prescribed methylphenidate (Ritalin). Which of the following findings are most likely adverse effects related to this type of medication? Select all that apply. a) The child complains that his head hurts at times b) The child has been more irritable since beginning methylphenidate (Ritalin) c) The child has gained weight since beginning methylphenidate (Ritalin) d) The child complains that he has developed abdominal pain e) The child's parents state that he sleeps much longer than he used to

A B D Common side effects related to the use of psychostimulants are: headaches, irritability, and abdominal pain. Children typically exhibit a decreased appetite and may have difficulty with insomnia.

The parents state that the behavior of a child with​ attention-deficit/hyperactivity disorder​ (ADHD) is creating stress for the environment in their home. Which suggestion should the nurse encourage the parents to consider to minimize this​ stress? (Select all that​ apply.) A. Set boundaries and consequences. B. Make a schedule for​ bedtime, meals, and recreational activities. C. Allow the child as many choices as possible to decrease conflict in the home. D. Provide appropriate rewards when the child meets expected behavior. E. Allow the child to listen to music during study time.

A. Set boundaries and consequences. B. Make a schedule for​ bedtime, meals, and recreational activities. D Provide appropriate rewards when the child meets expected behavior. Rationale: Boundaries and consequences should be set for the child. When the child meets expected​ behaviors, appropriate rewards such as playing outside or riding a bike for 30 minutes should be allowed to continue to reinforce positive behaviors.​ Additionally, providing a schedule of​ activities, meals, and bedtime will provide structure within the home. The child should not listen to music during study time. And the child should not be allowed as many choices as possible because the child needs specific boundaries and expectations.

A child with suspected autism is assessed by the nurse. Which of the following would be an appropriate intervention by the nurse? a. Let the child sit in the waiting room as long as possible to reduce movement. b. Use speech and pictures to communicate with the child. c. While caring for the child, move the child to several different areas of the office. d. Play music at a high volume.

B The nurse should use short, direct sentences when possible to communicate with the autistic child. If the child responds well to visual cues, pictures can work well. Music at a high volume will agitate the child, as will letting the child sit in an unfamiliar environment or moving the child frequently.

To feed lunch to a child with autistic disorder, which of the following actions would be most important to take? a) Allow the child to ask questions about the procedure. b) Don't allow him to see the spoon approach his mouth. c) Use a repetitive series of movements. d) Use an authoritarian manner to gain control.

C Children with autistic disorder typically enjoy repetitive movements or the same action over and over.

An adolescent client diagnosed with attention deficit hyperactivity disorder (ADHD) is interested in playing the drums in the school band. Which action by the nurse is the most appropriate? 1. Recommend the child take private lessons and not join the band. 2. Encourage the child to join the band. 3. Consult with the healthcare provider about allowing participation in band activities. 4. Discourage the child from playing in the band.

Correct Answer: 2 Rationale 1: A child with ADHD may lack connectedness with other children. Participation in a school activity where the rules of working with others can be learned should be encouraged.

The family of a preschool-age client diagnosed with an intellectual disability is expressing difficulty with managing the care needs of the child. Which nursing diagnosis is most appropriate for this situation? 1. Hopelessness Related to Terminal Condition of the Child 2. Compromised Family Coping Related to the Child's Developmental Variations 3. Family Processes That are Dysfunctional Related to a Child with Intellectual Disability 4. Impaired Parenting Related to Poor Parenting Skills

Correct Answer: 2 Rationale 1: The family is compromised but not dysfunctional. Hopelessness and impaired parenting are not appropriate in the given situation.

A school-age client diagnosed with autism is admitted to the hospital because of recent vomiting and diarrhea. Which intervention by the nurse is most appropriate upon admission? 1. Take the child on a quick tour of the whole unit. 2. Take the child to the playroom immediately for arts and crafts. 3. Orient the child to the hospital room with minimal distractions. 4. Admit the child to a four-bed unit with small children.

Correct Answer: 3 Rationale 1: Autistic children interpret and respond to the environment differently from other individuals. The child needs to be oriented to new settings and adjusts best to a quiet, controlled environment. A hospital room with only one other child is best.

The parents of an adolescent are concerned about his mental health and have brought the adolescent into the physician's office for an evaluation. Which of the following statements by the child's parents indicates that the child may have a mental health disorder? Select all that apply. a) "He has lost 10 pounds over the last 4 months." b) "He used to be a straight-A student and now he's bringing home Cs and Ds." c) "He hangs out with the same kids he always has." d) "He still enjoys playing a lot of baseball." e) "He has started sleeping for only 3 hours each night."

a) "He has lost 10 pounds over the last 4 months." b) "He used to be a straight-A student and now he's bringing home Cs and Ds." e) "He has started sleeping for only 3 hours each night." Altered sleep patterns, weight loss, and problems at school are commonly found in children with mental health disorders. There also may be alterations in friendships and changes in extracurricular activity participation.

The mother of a 10-year-old boy with attention deficit hyperactivity disorder (ADHD) contacts the school nurse. She is upset because her son has been made to feel different by his peers because he has to visit the nurse's office for a lunch time dose of medication. The boy is threatening to stop taking his medication. How should the nurse respond? a) "You may want to talk to your physician about an extended release medication" b) "He should ignore the children, he needs this medication" c) "I can have the teacher speak with the other children" d) "Remind him that his schoolwork may deteriorate"

a) "You may want to talk to your physician about an extended release medication" The nurse should encourage the family to explore with their physician the option of one of the newer extended-release or once daily ADHD medications. The other statements are not helpful and do not address the mother's or boy's concerns.

Which statement by an adolescent with anorexia nervosa would be most typical of an adolescent with this disorder? a) "I'd like to gain weight but just can't." b) "I'm afraid that someone is poisoning my food." c) "I'd like to grow up to be a model." d) "I feel chubby no matter what I wear."

d) "I feel chubby no matter what I wear." Children with eating disorders tend to think of themselves as overweight. This distorted body image leads them to diet excessively.

The nurse is teaching the parents of a very young client newly diagnosed with​ attention-deficit/hyperactivity disorder​ (ADHD) regarding therapeutic interventions. Which intervention should the nurse encourage the parents to implement during study time at​ home? (Select all that​ apply.) A. Administer stimulant medication at least 30 minutes prior to studying. B. Reduce environmental stimuli such as music and television. C. Provide a​ clutter-free area to study. D. Give the child a snack to eat during study time. E. Allow the child as much screen time as he desires.

​B. reduce environmental stimuli such as music and television. C. provide a​ clutter-free area to study. Rationale: During study​ time, the client should have a​ quiet, clutter-free area to study and complete homework assignments. Giving the child a snack would provide a distraction during study​ time, so this should happen either before or after study time. Minimizing screen time is an important environmental control that should be implemented. Stimulant medications are administered first thing in the​ morning, not prior to tasks.