Peds Chapter 42: PrepU
What is the most difficult risk factor for a child to overcome related to substance abuse?
Home environment where there is drug or alcohol abuse
The nurse has been working for several days with an adolescent who has anorexia nervosa. What is an indication that the adolescent is developing trust in the nurse?
The adolescent telling the nurse purging occurs after each meal.
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?"
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 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."
A 15-year-old girl has been evaluated and diagnosed with major depression. The health care provider has prescribed paroxetine, a selective serotonin reuptake inhibitor. The mother of the girl refuses to let her take the medicine because she has read about several suicides of teenagers who have been on this medicine. What nursing response is best at this time?
"Let's sit down and talk about your concerns."
The nurse is caring for a child with attention deficit hyperactivity disorder who is experiencing insomnia related to the prescribed psychostimulant. The parents are considering stopping the medication and want to know if there are other options. Which response by the nurse would be most appropriate?
"Speak to the doctor about atomoxetine."
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
During adolescence, alcohol is connected to what problem frequently seen in this age group?
Automobile accidents
An 11-year-old client has come to the school nurse more than 15 times for somatic complaints during the first quarter of school and has subsequently left school after each visit. What should the school nurse do?
Contact the child's parents to discuss the situation.
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
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.
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.
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 medication?
Methylphenidate
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
The nursing instructor is teaching a group of pediatric nursing students about the stages of substance abuse in children. Which behavior is associated with Stage 3—Preoccupation with the Mood Swing?
Promises to quit or attempts to quit
Rumination disorder is a poorly understood condition of young children. This refers to:
Rechewing undigested food.
The nurse is caring for an adolescent diagnosed with anorexia nervosa. Which education will the nurse include in the client's discharge teaching?
Referrals to counseling services
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. What follow-up will the nurse expect?
Referred for counseling
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.
The school nurse suspects that a girl at her school is experiencing school phobia. She has missed numerous days from school and reports a stomach ache and some vomiting and has a low-grade fever. The symptoms subside when the child is permitted to stay home. What intervention would be appropriate for this child?
Set up a meeting between the parents and school officials to help the child return to school without experiencing her symptoms.
While interviewing a depressed adolescent client, it is revealed that the client has considered hurting himself. What should the nurse ask?
"Tell me exactly how you would hurt yourself."
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 positive self-esteem
A nurse is conducting a mental status examination with a 5-year-old boy who is playing with trains and blocks of different colors. He repeats the same actions with the trains over and over again throughout the examination. Which of the following questions would be most appropriate?
Why does that red train keep crashing into all of the other trains?
The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol use. Which response by the parent indicates a need for further teaching?
"Just because his friends are experimenting does not mean that he will."
A child is being referred to a mental health specialist, and the parent 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."
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
Parents are reluctant to accept that their preschooler has attention deficit hyperactivity disorder (ADHD), so the nurse is explaining the commonly seen characteristics of this syndrome. Which characteristics would the nurse include in her explanation? Select all that apply.
Easily distracted Failure to complete tasks before going on to another one Impulsiveness
When teaching parents of a child with encopresis, what would the nurse stress?
Not punishing the child for encopresis
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 parent.
A 6-year-old client has been diagnosed with an 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.
A 15-year-old student has been referred by the homeroom teacher to the school nurse for evaluation. The teacher is concerned that the student may be suffering from major depression. Who should be the primary source of information to investigate the concerns about the student?
The student
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.