🤓CHP 28 PREP U
conduct disorder
A 16-year-old client is highly disruptive in class and has been in trouble at home. The parent recently found the adolescent torturing a cat. When questioned, the adolescent laughed. What condition might the client be suffering from?
Individual psychotherapy sessions
A 9-year-old boy was in a car accident. The child is suffering from posttraumatic stress disorder. Which would be the best approach for treatment?
"You appear to be feeling very angry tonight, but you must still complete your chores."
A nurse in a residential foster home is caring for a 17-year-old girl with conduct disorder. The adolescent is using profanity and refusing to complete the assigned chores. The nurse reminds the adolescent that there are only five minutes in which to finish. The adolescent throws a dirty plate at the wall. Which response would be most appropriate?
automobile accidents
During adolescence, alcohol is connected to what problem frequently seen in this age group?
The child may have a fear of being separated from the parent.
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?
Parental knowledge deficit related to health care needs for a child with an intellectual disability
The health care provider has recently informed parents that their child has an intellectual disability. The parents express the need for information and help with the important decisions they need to make concerning care of their child. What is an appropriate nursing diagnosis for this situation?
alcohol.
The most common use disorder among children and adolescents is:
"You can speak with your doctor about extended-release medications for the treatment of ADHD."
The mother of a 10-year-old boy phones the school nurse. The child has attention deficit/hyperactivity disorder (ADHD) and must go to the office to take medication at lunchtime. The child informed the mother that classmates have been making fun of him because he no longer wants to take the medication. Which is the nurse's best response?
Use a repetitive series of movements.
To feed lunch to a child with autism spectrum disorder (ASD), which action would be mostimportant for the nurse to take?
providing the children with strategies of how to refuse offers of drugs
Which approach to drug education would be most effective for a group of school-age children?
The child constantly pats his or her legs.
Which sign or symptom suggests that a 5-year-old child who does not maintain eye contact or speak may have autism spectrum disorder (ASD)?
"Tell me exactly how you would hurt yourself."
While interviewing a depressed adolescent, it is revealed that the client has considered hurting oneself. What question is the nurse's priority?
"Tell me exactly how you would hurt yourself."
While interviewing an adolescent client with depression, the client reveals to the nurse that he has considered hurting himself. Which response by the nurse would be most appropriate?
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.
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?
"Tell me why you believe the medication is not working."
A pediatric client has recently been prescribed methylphenidate. The parent calls the office and insists the medication is not working. How will the nurse respond?
The adolescent telling the nurse purging occurs after each meal.
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?
Menstrual problems
A nurse is caring for a 17-year-old female client with bulimia. Which complication of this disease may the nurse see in this child?
"HIPAA prevents nurses from disclosing confidential information from parents."
A nurse is discussing concerns about possible child abuse (child mistreatment) with the nursing supervisor. Which statement by the nurse requires correction by the supervisor?
"There are many behaviors that can be thought of as signs of autism spectrum disorders, but only a health care provider can confirm the diagnosis."
The parents of an 18-month-old toddler are concerned that their toddler no longer makes eye contact, does not respond to their smiles or other facial expressions, does not point to toys, and no longer speaks. They said that their toddler used to be able to say "mama" or "dada." The parents started noticing these changes in behavior 3 months ago. Which information can be provided to the parents?
a classroom with a plan of study that is followed each day
The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?
"Do you know how she is planning to kill herself?"
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?
The child will have a complete physical exam.
The nurse is working with school-aged children who are having enuresis or encopresis. What will most likely be the first step in this child's treatment?
A lack of concentration
The nurse suspects that a child is demonstrating signs of attention deficit hyperactivity disorder (ADHD). What behavior did the nurse most likely assess in this child?
"If they refuse to eat, we need to sit with them and not let them leave the table until they do eat something."
The nursing educator has completed an educational program for new nurses on eating disorders in teenagers. Which statement by a participant would indicate a need for further education?
Encourage her to discuss her thoughts and feelings.
The nurse is caring for a 13-year-old girl with a nursing diagnosis of "Ineffective coping related to inability to deal with life stressors as evidenced by few or no meaningful friendships and low self-esteem." Which intervention would be the priority to promote coping skills?
cardiac arrhythmias, confusion, seizures
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 complications that signal refeeding syndrome?
referrals to counseling services
The nurse is caring for an adolescent diagnosed with anorexia nervosa. Which education will the nurse include in the client's discharge teaching?
"Children with autism spectrum disorder enrolled in public schools can have an individualized educational plan to help meet their specific needs."
The nurse is speaking with the parent of a 2-year-old toddler recently diagnosed with autism spectrum disorder. The parent asks about educational programs for the toddler. What is the bestresponse by the nurse?
Provide a structured environment Be fair but firm, and stick to rules Give short and clear explanations
The nurse is working closely with the parent of a 6-year-old client who was just diagnosed with attention deficit/hyperactivity disorder (ADHD). Which methods used in behavior modification would be appropriate for this child? Select all that apply.
referred for counseling
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?
"She recently trampled our neighbor's flower bed."
The nurse is caring for a 10-year-old girl with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect possible conduct disorder?
Keep a log of the child's visits and contact the parents if the visits continue.
A 10-year-old girl has been visiting the school nurse 3 to 4 times a week reporting somatic symptoms of a stomach ache. She spends a few minutes in the nurse's office and then returns to class. This has been an ongoing for almost 2 weeks. Which action by the nurse would be mostappropriate?
"Let's set up an appointment as soon as possible."
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?
abdomen
A nurse is examining a 4-year-old child with various injuries in multiple places. Which site of injury would introduce suspicion of abuse?
"A definitive cause can be found for every developmental disorder."
A nursing student is learning about developmental disorders. The nursing instructor realizes that further instruction is necessary when the student makes which statement?
patches of hair loss
The nurse is caring for a 10-year-old girl with an anxiety disorder. During a physical examination, which physical finding would the nurse expect?
"Does your child interact with you when playing?"
A parent expresses concern that the child has an autism spectrum disorder. The nurse obtains a health history of the symptoms to understand the parent's concern. Which question would the nurse ask first?
"Let's sit down and talk about your concerns."
A 15-year-old adolescent has been evaluated and diagnosed with major depression. The health care provider has prescribed paroxetine, a selective serotonin reuptake inhibitor. The parent refuses to let the adolescent take the medicine because the parent has read about several suicides of adolescents who have been on this medicine. What nursing response is best?
"There are no medications available to cure autism spectrum disorder."
A 2-year-old child has been diagnosed with autism spectrum disorder. The parents ask the nurse for a treatment that will cure the disorder. Which is the best response by the nurse?
malnourished with frequent absences from school
A 5-year-old child has frequent visits to the school nurse's office. Which assessment data should alert the nurse that this child may be a victim of physical neglect?
Ask to speak to the child separate from the family.
A family includes a 9-year-old child. The nurse suspects that the family has caregiver-fabricated illness (formerly Munchausen syndrome by proxy). Which nursing intervention is best when assessing the child and family in the pediatrician's office?
schedule an immediate history and physical examination.
A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who is experiencing headaches. Her grades have dropped, and she is sleeping late and going to bed early every night. The nurse advises the mother that the first priority should be to:
scheduling an immediate history and physical examination
A mother is telling the school nurse about her concerns regarding her 13-year-old daughter, who reports headaches. The child's grades have dropped, and the child is sleeping late and going to bed early every night. Which would the nurse identify as the priority?
history of child abuse (child mistreatment) female gender, between 12 to 16 years of age lack of adequate family support
A nurse has been asked to conduct a presentation on human trafficking. When preparing the presentation, the nurse will include which factor(s) as placing individuals at risk? Select all that apply.
"I am sorry you are feeling so angry tonight but you must still complete your chores."
A nurse in a residential foster home is caring for a 17-year-old client with oppositional defiant disorder. The client is using profanity and refusing to complete assigned chores. The nurse reminds the client that there are only 5 minutes in which to finish the chores. The client throws a dirty plate at the wall. How should the nurse respond?
ensuring that the child remains safe
A nurse is assessing a child whom the nurse suspects is a victim of physical abuse. Assessment reveals numerous bruises on the thighs and upper back in various stages of healing. The child's caregiver is present in the examination room. Which aspect of care is the priority?
angry outbursts directed at authority figures
An adolescent has been diagnosed with oppositional defiant disorder. Which symptom does the nurse anticipate?
"Does your child come and hug you or seek comfort from you?"
Parents of a 36-month-old child confide in the clinic nurse that their child does not speak and spends hours staring at their ceiling fan. They are worried that their child may have autism spectrum disorder. Which question would be important for the nurse to ask the parents?
The child constantly stares at a rotating wheel on the crib mobile.
The nurse is caring for a 12-month-old child diagnosed with an autism spectrum disorder. What information from the mother during the health history should the nurse identify as being consistent with the disorder?
The child constantly opens and closes the hands.
The nurse is conducting an assessment of a 5-year-old client. During the assessment, the nurse notes that the child does not maintain eye contact or speak. The nurse suspects an autism spectrum disorder. Which additional finding would help support the nurse's suspicion?
dyslexia
The nurse is talking with the parents of a child who has been identified as having a learning disability. The parents state that their child performs well on oral examinations but otherwise struggles on exams. The nurse is aware that the parents are describing which disorder?
is planning to commit suicide.
A 16-year-old girl is being seen for a long-overdue checkup. Her caregiver has come with her. She is calm, pleasant, and in good spirits. The caregiver reports to the nurse that she is relieved because for the past 6 months the teenager has been lethargic, angry, and sad. The mother reports that since she got her driver's license two days earlier, her child's mood has changed dramatically. Rather than resist this appointment, the girl had simply smiled and said, "It won't matter much, but okay, I'll be ready in a minute." The nurse recognizes that the child's seeming well-being and drastic change in behavior should be further investigated to determine if the child: