Chapter 50-Nursing Care of the Child With an Alteration in Behavior, Cognition, or Development

8. The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder?

"He has frequent temper tantrums."

6. The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability?

"He seems to be speaking words less and less frequently."

24. After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state which of the following?

"If he misbehaves, we need to punish him instead of reward him."

1. The nurse is teaching the mother of a 12-year-old boy about the risk factors associated with drug and alcohol abuse. Which response by the mother indicates a need for further teaching?

"Just because his friends are experimenting does not mean that he will."

11. A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. Which of the following would the nurse include when teaching the child and his parents about this drug?

"Take this drug every day in the morning when you wake up."

10. The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate?

"You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea."

22. A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply.

A) Allowing for breaks when tics occur C) Using a tape recorder to take notes

21. A nurse is preparing a teaching session for a group of parents with children newly diagnosed with attention deficit/hyperactivity disorder (ADHD). When explaining this disorder to the parents, which of the following would the nurse include as being involved? Select all answers that apply.

A) Impulsivity B) Inattention C) Distractibility D) Hyperactivity

4. The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions?

Attention deficit/hyperactivity disorder

25. A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. Which of the following would the nurse identify as characteristic of this disorder? Select all answers that apply.

B) Initiator of physical fights D) Truancy E) Arrest for arson

15. Which of the following would lead the nurse to suspect that an adolescent has bulimia?

Calluses on back of knuckles

17. A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy?

Cognitive therapy

5. A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. Which of the following would be most important for the nurse to do first?

Encourage a discussion of the child's thoughts and feelings

18. A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. Which of the following would the nurse be least likely to include?

Focus the child's attention on the negative behavior.

2. The nurse is caring for an adolescent girl with anorexia nervosa. Which of the following findings would indicate to the nurse that the girl requires hospitalization?

Food refusal

20. A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign?

Inability to say a single word by 16 months

12. When reviewing the medical record of a child, which of the following would the nurse interpret as the most sensitive indicator of intellectual disability?

Language delay

13. A school-age child diagnosed with depression is receiving antidepressant therapy. The nurse would instruct the parents to notify the physician immediately if the child demonstrates which of the following?

Loss of interest

19. The nurse is reviewing the medical record of a child who has dyspraxia. The nurse understands that this child experiences difficulty with which of the following?

Manual dexterity and coordination

26. The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason?

Minimize stimuli that exacerbate the child's undesired behaviors

27. A child is prescribed trazodone. Which of the following would the nurse be least likely to include in the plan of care related to this drug?

Monitoring for tardive dyskinesia

23. When assessing the adolescent with anorexia, which of the following would the nurse expect to find?

Murmur

3. The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which of the following?

Obsessive-compulsive disorder

7. A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist specializing in which type of therapy?

Play therapy

16. A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs?

Selective serotonin reuptake inhibitor

9. The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which of the following?

Sensory integration dysfunction

14. A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which of the following as an indicator of possible child abuse?

Sexual behavior that correlates with the child's developmental age