TEST BANK Chapter 26: Children and Adolescents Varcarolis: Essentials of Psychiatric Mental Health Nursing: A Communication Approach to Evidence-Based Care

An 11-year-old child, who has been diagnosed with oppositional defiant disorder (ODD), becomes angry over the rules at a residential treatment program and begins shouting at the nurse. What is the best method to defuse the situation? a. Assign the child to a short time-out. b. Administer an antipsychotic medication. c. Place the child in a therapeutic hold. d. Call a staff member to seclude the child.

a. Assign the child to a short time-out.

Which finding would prompt the nurse to carefully assess an 8-year-old child for development of a psychiatric disorder? a. Being raised by a parent with chronic major depressive disorder b. Moving to three new homes over a 2-year period c. Not being promoted to the next grade d. Having an imaginary friend

a. Being raised by a parent with chronic major depressive disorder

A child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications? a. Central nervous system stimulants and nonstimulants b. Monoamine oxidase inhibitors (MAOIs) c. Antipsychotic medications d. Anxiolytic medications

a. Central nervous system stimulants and nonstimulants Central nervous system stimulants and nonstimulants increase blood flow to the brain and have proven helpful in reducing hyperactivity in children and adolescents with ADHD. The other medication categories listed would not be appropriate.

A parent diagnosed with schizophrenia and her 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child is demonstrating what characteristic? a. Resiliency b. Shy temperament c. Early posttraumatic stress disorder d. Uses intellectualization to deal with problems

a. Resiliency

When assessing a 2-year-old diagnosed with autism spectrum disorder, what should a nurse expects? a. Hyperactivity and attention deficits b. Failure to develop interpersonal social skills c. History of disobedience and destructive acts d. High levels of anxiety when separated from a parent

b. Failure to develop interpersonal social skills

The health care provider prescribes medication for a child diagnosed with attention-deficit/hyperactivity disorder (ADHD). What is the desired behavior for which the nurse should monitor? a. Increased expressiveness in communicating with others. b. Improved ability for cooperative play with other children. c. Ability to identify anxiety and implement self-control strategies. d. Improved socialization skills with other children and authority figures.

b. Improved ability for cooperative play with other children.

What are the primary distinguishing factors between the behavior of children diagnosed with oppositional defiant disorder (ODD) and those diagnosed with conduct disorder (CD)? The child diagnosed with: (Select all that apply.) a. ODD relives traumatic events by acting them out. b. ODD tests limits and disobeys authority figures. c. ODD has difficulty separating from the parents. d. CD uses stereotypical or repetitive language. e. CD often violates the rights of others.

b. ODD tests limits and disobeys authority figures. e. CD often violates the rights of others.

A nurse prepares the plan of care for a 15-year-old adolescent diagnosed with moderate intellectual developmental disorder (IDD) is believed capable of ultimately functioning at a second-grade level. What are the highest outcomes realistic for this person to demonstrate within 5 years? (Select all that apply.) a. Live unaided in an apartment. b. Obtain employment in a local sheltered workshop. c. Correctly use public buses to travel in the community. d. Independently perform his or her own personal hygiene. e. Complete high school or earn a general equivalency diploma (GED).

b. Obtain employment in a local sheltered workshop. c. Correctly use public buses to travel in the community. d. Independently perform his or her own personal hygiene.

The child most likely to receive propranolol to manage tremors is one diagnosed with which disorder? a. Attention-deficit/hyperactivity disorder (ADHD) b. Posttraumatic stress disorder (PTSD) c. A motor disorder d. Separation anxiety

c. A motor disorder Propranolol is useful for managing tremors associated with various motor disorders. This medication is not indicated in any of the other disorders.

Shortly after a 15-year-old's parents announce a plan to divorce, the adolescent stops participating in sports, sits alone at lunch, and avoids former friends. The adolescent says, "All the other kids have families. If my parents loved me, then they would stay together." Which nursing intervention is most appropriate? a. Develop a plan for activities of daily living. b. Communicate disbelief relative to the adolescent's feelings. c. Assist the adolescent to differentiate reality from perceptions. d. Assess and document the adolescent's level of depression daily

c. Assist the adolescent to differentiate reality from perceptions.

A nurse prepares to lead a discussion at a community health center regarding children's health. The nurse wants to use current terminology when teaching about these issues. Which terms are appropriate for the nurse to use? (Select all that apply.) a. Mental retardation b. Asperger's disorder c. Autism spectrum disorder d. Pervasive developmental disorder e. Intellectual development disorder

c. Autism spectrum disorder e. Intellectual development disorder Using dated terminology contributes to the stigma and misconceptions about mental illness. It's important for the nurse to use current terminology. The term mental retardation has been replaced with intellectual development disorder. The term autism spectrum disorder now encompasses Asperger's disorder and pervasive developmental disorder.

A nurse will prepare teaching materials regarding which medication for the parents of a child diagnosed with enuresis? a. Haloperidol b. Desmopressin c. Methylphenidate d. Carbamazepine

c. Methylphenidate Pharmacological treatment of enuresis commonly includes desmopressin, oxybutynin, various stimulants, indomethacin, and/or SSRI antidepressants. Limited evidence exists for the use of imipramine. None of the other drugs are appropriate to treat enuresis.

When a 5-year-old child is disruptive, the nurse says, "You must take a time-out." The expectation is that the child will demonstrate what behavior? a. Go to a quiet room until called for the next meal. b. Slowly count to 20 before returning to the group activity. c. Sit on the edge of the activity until able to regain self-control. d. Sit quietly on the lap of a staff member until able to apologize for the behavior.

c. Sit on the edge of the activity until able to regain self-control.

A desired outcome for a 12-year-old diagnosed with oppositional defiant disorder (ODD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care? a. Bibliotherapy b. Music therapy c. Social skills groups d. Behavior modification

c. Social skills groups

A 4-year-old child cries and screams from the time the parents leave the child at preschool until the child is picked up 4 hours later. The child is calm and relaxed when the parents are present. The parents ask, "What should we do?" What is the nurse's best recommendation? a. "Send a picture of yourself to school to keep with the child." b. "Arrange with the teacher to let the child call home at playtime." c. "Talk with the school about withdrawing the child until maturity increases." d. "Talk with your health care provider about a referral to a mental health professional."

d. "Talk with your health care provider about a referral to a mental health professional."

A nurse assesses the four children below. Which assessment findings should prompt the nurse to refer the child for further evaluation? a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling. b. A 9-month-old who does not eat vegetables and likes to be rocked. c. A 3-month-old who cries after feeding until burped and sucks a thumb. d. A 3-year-old who is mute, passive toward adults, and twirls while walking.

d. A 3-year-old who is mute, passive toward adults, and twirls while walking.

A nurse assesses a 3-year-old diagnosed with autism spectrum disorder. Which finding is most associated with the child's disorder? a. Has occasional toileting accidents. b. Is unable to read children's books. c. Cries when separated from a parent. d. Continuously rocks in place for 30 minutes.

d. Continuously rocks in place for 30 minutes. Autism spectrum disorder involves distortions in development of social skills and language that include perception, motor movement, attention, and reality testing. Body rocking for extended periods suggests autism spectrum disorder. The distracters are expected findings for a 3-year-old.

A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a volunteer. The teen says, "I have three good friends at school. We talk and sit together at lunch." What is the nurse's best suggestion to the treatment team? a. Suggest foster home placement. b. Seek assistance from an intimate partner violence program. c. Make referrals for existing and emerging developmental problems. d. Encourage healthy characteristics and existing environmental supports

d. Encourage healthy characteristics and existing environmental supports

When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that focuses on what? a. Play activities exclusively. b. Group discussion exclusively. c. Talk focused on a specific issue. d. Play and then talk about the play activity

d. Play and then talk about the play activity