NURS 311 Quiz 10

122. A child with attention deficit hyperactivity disorder (ADHD) often becomes frustrated and loses control. A nurse uses a variety of graduated techniques to manage disruptive behaviors. List the following interventions in order from the least invasive to the most invasive technique. 1. Placing the child in a time-out 2. Monitoring behavior for cues of rising anxiety 3. Using a signal to remind the child to use self-control 4. Avoiding situations that usually precipitates frustration 5. Refocusing the child's behavior with a specific directive

4, 2, 3, 5, 1

97. A nurse is caring for a preschool-age child with a history of physical and sexual abuse. What is the most advantageous therapy for this child? A. Play B. Group C. Family D. Psychodrama

A. Play

95. A client is admitted to the acute medical unit for severe amphetamine intoxication. Which medications should a nurse anticipate will be prescribed to counteract the effects of stimulant intoxication? SATA A. Diazepam B. Propranolol C. Benztropine D. BuPROPion E. Amitriptyline

A. Diazepam B. Propranolol

119. An 8-year-old child is diagnosed with oppositional defiant disorder. What behavior should the nurse identify that supports this diagnosis? A. Is easily distracted B. Argues with adults C. Lies to obtain favors D. Initiates physical fights

B. Argues with adults

88. A client with schizophrenia is actively psychotic, and a new medication regimen is prescribed. A student nurse asks the primary nurse, "Which of the prescribed medications will be most helpful for reducing psychotic signs and symptoms?" What should the nurse respond? A. Citalopram (Celexa) B. Ziprasidone (Geodon) C. Benztropine (Cogentin) D. Acetaminophen with hydrocodone (Lortab)

B. Ziprasidone (Geodon)

123. An adolescent with a conduct disorder is receiving behavioral therapy to attempt to limit activities that violate societal norms. A specific outcome criterion unique for adolescents with this problem is "The client will: A. exhibit increased impulse control." B. identify two positive personal attributes." C. demonstrate respect for the rights of others." D. use age-appropriate play activities with at least one peer."

C. demonstrate respect for the rights of others."

100. A nurse is planning care for a group of hospitalized children. Which age group does the nurse anticipate will have the most problem with separation anxiety? A. 12 to 18 years B. 5 to 11 1/2 years C. 6 to 30 months D. 36 to 59 months

C. 6 to 30 months

96. A client with mild Alzheimer disease has been taking galantamine (Razadyne), and the health care provider prescribes paroxetine (Paxil) for depression. For what effect should a nurse assess the client when these medications are taken concurrently? A. Allergic B. Dystonic C. Additive D. Extrapyramidal

C. Additive

98. A 3-year-old child is diagnosed with autism. Which behaviors should the nurse expect when assessing this child? SATA A. Imitates others B. Seeks physical contact C. Avoids eye-to-eye contact D. Engages in cooperative play E. Performs repetitive activities F. Displays interest in children rather than adults

C. Avoids eye-to-eye contact E. Performs repetitive activities

99. A nurse uses behavior modification to foster toilet training efforts in a cognitively impaired child. What reward should the nurse provide to reinforce appropriate use of the toilet? A. Candy bar B. Piece of fruit C. Hug with praise D. Choice of rewards

C. Hug with praise

89. A client with a psychosis is receiving olanzapine (Zydis). What is important for a nurse to consider when administering this drug? A. It can be given intramuscularly B. A special tyramine-free diet is required C. It dissolves instantly after oral administration D. An empty stomach increases its effectiveness

C. It dissolves instantly after oral administration

110. A nurse is teaching the parent of a child with attention deficit hyperactivity disorder (ADHD). What should the nurse include as the most frequently prescribed medication for this disorder? A. Lorazepam (Ativan) B. Haloperidol (Haldol) C. Methylphenidate (Ritalin) D. Methocarbamol (Robaxin)

C. Methylphenidate (Ritalin)

103. For what most common characteristic of autism should a nurse assess a child suspected of having this disorder? A. Responds to any stimulus B. Responds to physical contact C. Seems unresponsive to the environment D. Interacts with children rather than adults

C. Seems unresponsive to the environment

91. A client with schizophrenia is taking benztropine (Cogentin) in conjunction with an antipsychotic. The client tells a nurse, "Sometimes I forget to take the Cogentin." What should the nurse teach the client to do if this happens again? A. Use 2 pills at the next regularly scheduled dose B. Notify the health care provider about the missed dose immediately C. Take a dose as soon as possible, up to 2 hours before the next dose D. Skip the dose, and then take the regularly scheduled dose 2 hours early

C. Take a dose as soon as possible, up to 2 hours before the next dose

111. A hyperactive 9-year-old child with a history of attention deficit hyperactivity disorder (ADHD) is admitted for observation after a motor vehicle collision. What should be the focus of nursing actions when teaching about personal safety? A. Requesting that the child write at least three safety rules B. Asking the child to verbalize as many safety rules as possible C. Talking with the child about the importance of using a seat belt D. Encouraging the child to talk with other children about their opinions of safety rules

C. Talking with the child about the importance of using a seat belt

116. A nurse anticipates that children with attention deficit hyperactivity disorder (ADHD) may be learning-disabled. This means that these children: A. will probably not be self-directed learners B. have intellectual deficits that interfere with learning C. experience perceptual difficulties that interfere with learning D. are performing usually two grade levels below their age norm

C. experience perceptual difficulties that interfere with learning

107. A 10-year-old child who was diagnosed with autism at the age of 3 attends a school for developmentally disabled children and lives with the parents. The child has frequent episodes of self-biting behavior, banging the head, and needing help with feeding and toileting. The priority nursing goal for this child is "The child will: A. control repetitive behaviors." B. be able to feed independently." C. remain safe from self-inflicted injury." D. develop control of urinary elimination."

C. remain safe from self-inflicted injury."

102. What is the prognosis for a normal productive life for a child diagnosed with autism? A. Dependent on an early diagnosis B. Often related to the child's overall temperament C. Ensured as long as the child attends a school tailored to meet needs D. Unlikely because of interference with so many parameters of functioning

D. Unlikely because of interference with so many parameters of functioning

108. When planning activities for a child with autism, the nurse considers that autistic children respond best to: A. loud, cheerful music B. large-group activities C. individuals in small groups D. their own self-stimulating acts

D. their own self-stimulating acts

94. Olanzapine (Zyprexa) is prescribed for a client who experienced agranulocytosis from Clozapine (Clozaril). Which statement indicate that the nurse's teaching about olanzapine has been effective? SATA A. "I need to be careful that I do not gain too much weight." B. "I should be careful so I don't nick myself when I shave." C. "This medication should help me enjoy pleasurable activities." D. "I will have to remember to take my benztropine (Cogentin)." E. "Restlessness can occur when I am taking this medication."

A. "I need to be careful that I do not gain too much weight." C. "This medication should help me enjoy pleasurable activities."

115. The parent of a child with a tentative diagnosis of attention deficit hyperactivity disorder (ADHD) arrives at the pediatric clinic insisting on receiving a prescription for medication that will control the child's behaviors. What is the nurse's best response? A. "It must be frustrating to deal with your child's behavior." B. "Have you considered any alternative to using medications?" C. "Perhaps you are looking for an easy solution to the problem." D. "Let me teach you about the side effects of medication use for ADHD."

A. "It must be frustrating to deal with your child's behavior."

104. A nurse is assessing a child suspected of having autism. At what age does the nurse determine that the signs of autism initially may be evident? A. 2 years of age B. 6 years of age C. 6 months of age D. 1 to 3 months of age

A. 2 years of age

112. A 4-year-old child is diagnosed with attention deficit hyperactivity disorder (ADHD). What information about the child's behavior should the nurse expect when obtaining a health history from the parents? SATA A. Is impulsive B. Talks excessively C. Is spiteful and vindictive D. Annoys others deliberately E. Plays video games for hours F. Does not follow through or finish tasks

A. Is impulsive B. Talks excessively E. Plays video games for hours F. Does not follow through or finish tasks

105. For which clinical indication should a nurse observe a child suspected of being autistic? A. Lack of eye contact B. Crying for attention C. Catatonic-like rigidity D. Engaging in parallel play

A. Lack of eye contact

87. A client is receiving doxepin (Silenor). For which most dangerous side effect of tricyclic antidepressants should a nurse monitor the client? A. Mydriasis B. Dry mouth C. Constipation D. Urinary retention

A. Mydriasis

109. A nurse is interviewing a child with attention deficit disorder. For which major characteristic should the nurse assess this child? A. Overreaction to stimuli B. Continued use of rituals C. Delayed speech development D. Inability to use abstract thought

A. Overreaction to stimuli

120. An adolescent with the diagnosis of conduct disorder since the age of 9 is placed in a residential facility. The adolescent has a history of fighting, stealing, vandalizing property, and running away from home. The adolescent is aggressive, has no friends, and has been suspended from school repeatedly. What is the nurse's priority when developing a plan of care? A. Preventing violence B. Encouraging insight C. Supporting self-esteem D. Promoting social interaction

A. Preventing violence

90. Antipsychotic drugs can cause extrapyramidal side effects. Which responses should the nurse document as indicating pseudoparkinsonism? SATA A. Rigidity B. Tremors C. Mydriasis D. Photophobia E. Bradykinesia

A. Rigidity B. Tremors E. Bradykinesia

114. What childhood problem has legal as well as emotional aspects and cannot be ignored? A. School phobias B. Fear of animals C. Fear of monsters D. Sleep disturbances

A. School phobias

92. Olanzapine (Zyprexa) is prescribed for a client with bipolar disorder, manic episode. What cautionary advice should the nurse give the client? A. Sit up slowly B. Report double vision C. Expect increased salivation D. Take the medication on an empty stomach

A. Sit up slowly

121. A nurse works with school-age children who have conduct disorder, childhood-onset type. The nurse considers that these children are at risk for progressing to an additional disorder during adolescence. For signs of what disorder should the nurse assess their present behavior? A. Oppositional defiant B. Antisocial personality C. Pervasive developmental D. Attention deficit hyperactivity

B. Antisocial personality

93. Neuroleptic malignant syndrome is a potentially fatal reaction to antipsychotic therapy. What signs and symptoms of this syndrome should the nurse identify? SATA A. Jaundice B. Diaphoresis C. Hyperrigidity D. Hyperthermia E. Photosensitivity

B. Diaphoresis C. Hyperrigidity D. Hyperthermia

106. A 6-year-old with autism is nonverbal and has limited eye-contact. What should a nurse do initially to promote social interaction? A. Encourage the child to sing songs with the nurse B. Engage in parallel play while sitting next to the child C. Provide opportunities for the child to play with other children D. Use therapeutic holding when the child does not respond to verbal interactions

B. Engage in parallel play while sitting next to the child

101. A nurse considers that autism is a form of a pervasive developmental disorder (PDD). Which factor unique to autism differentiates it from other forms of PDD? A. Has less severe linguistic handicaps B. Has an early onset before 36 months of age C. Is the only form that does not include seizures D. Is the only form that does not include mental retardation

B. Has an early onset before 36 months of age

117. A nurse is teaching the parents of a child with attention deficit hyperactivity disorder (ADHD) about the prescribed medication methylphenidate (Ritalin). What time should the daily dose be administered? A. Before breakfast B. Just after breakfast C. Immediately before lunch D. As soon as the child awakens

B. Just after breakfast

113. A nurse is counseling the family of a child with school phobia. What should the parents be taught to do? A. Accompany the child to the classroom B. Return the child to school immediately C. Instruct the child as to why school attendance is necessary D. Allow the child to enter the classroom before other children

B. Return the child to school immediately

118. A child is diagnosed with attention deficit hyperactivity disorder (ADHD). What is a strategy that the nurse should teach the parents to assist in coping with this disorder? A. Orient the child to reality B. Reward appropriate conduct C. Suppress feelings of frustration D. Use restraints when behavior is out of control

B. Reward appropriate conduct