Complicated questions
A 12-year-old child is brought to the mental health clinic by the child's parents because of a court-ordered evaluation. When assessing the child, which would lead the nurse to suspect that the child has a conduct disorder? Select all that apply. Repetitive disobedience of parents Blaming of others for problems Arrests for petty larceny several times Evidence of overt lying Destruction of neighbor's car on two separate occasions
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A 59-year-old has just been diagnosed with early-stage dementia. The client is experiencing mild forgetfulness but can function normally. The client lives with a spouse and adult child, who is a single parent of two. When planning care for this family, which of the goals should the nurse identify as a priority? The caregivers will demonstrate effective coping strategies to prevent burnout. The family will identify resources to meet caregiving needs. The client will discuss emotional response to diagnosis. The client will maintain self-care abilities as long as possible.
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A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 AM, which behavior might the school nurse expect to see at noon? Increased impulsivity or hyperactive behavior Lack of appetite for lunch Sleepiness or drowsiness Social isolation from peers
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A client is diagnosed with intermittent explosive disorder (IED). What drugs are likely to be prescribed for the client? Select all that apply. Stimulant drugs Antipsychotic drugs Mood-stabilizing drugs Barbiturates Antidepressant drugs
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A client is diagnosed with oppositional defiant disorder (ODD). Which assessment finding would indicate that the client needs medications? Extreme hostile behavior toward the parents Use of abusive language by the client Presence of comorbid psychiatric disorders Less than 3 years of age
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A new nurse has been working with clients with Alzheimer's disease for almost 6 months. During a staff meeting, the nurse expresses frustration because the same instructions have to be given to clients on a daily basis. The nurse states, "I feel like all my work doesn't do them any good." Which suggestion would be most appropriate for the supervisor to make initially? Cease giving instructions because the clients will not remember them anyway. Try to stay supportive and meet the clients' needs at the current moment. Seek counseling if personal feelings get in the way of client care. Consider transferring to a different client care specialty area.
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A nurse can assist a patient and family in which aspects of substance abuse relapse prevention? Select all that apply. A. Rehearsing techniques to handle anticipated stressful situations B. Advising the patient to accept residential treatment if relapse occurs C. Assisting the patient to identify life skills needed for effective coping D. Isolating self from significant others and social situations until sobriety is established E. Teaching the patient about the physical changes to expect as the body adapts to functioning without substances
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A nurse is assessing a 9-year-old child diagnosed with conduct disorder. Which advice should the nurse give the child's parents regarding treatment of the disorder? "Your child requires individualized behavioral therapy." "Your child requires your support and motivation." "Your child needs to be incarcerated." "Your child should be sent to boot camp."
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A nurse is caring for a client with conversion disorder. What immediate outcomes (within a week) indicate successful therapy for the client? Select all that apply. The client will communicate knowledge of the illness. The client will express feelings related to inadequacy and fear. The client will communicate the steps to solving the problems. The client will discuss problems and solve conflicts with family or friends. The client will identify the conflict underlying the physical symptoms experienced.
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A nurse is caring for a client with delirium. The nurse assesses the client's activities of daily living on a daily basis. What is the most likely reason for assessing these so frequently? To assess for fluctuation in the client's capabilities To assess the prognosis of the client after therapy To ensure the client establishes a daily routine To ensure the client is involved in therapy
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A nurse is counseling the parents of a child who is showing early-onset of moderate-type conduct disorder. Which challenges does the nurse anticipate for this child in the future if early intervention is not carried out successfully? Select all that apply. The child may difficulty having good interpersonal relationships. The child may perform badly in academics. The child may develop attention deficit hyperactivity disorder. The child may be susceptible to substance abuse. The child may be unable to support himself.
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A nurse is describing the various etiologies and risk factors associated with ADHD. Which of the following would the nurse include? Select all that apply. Genetics Overcrowded living conditions Marital discord Poverty Family stress
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A nurse is educating a group of parents about conduct disorder. According to the nurse which children are most at risk for developing conduct disorder? Select all that apply. Children with a resilient nature Children with poor peer relationships Children neglected by their parents Children with emotional instability Children with low self-esteem
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A nurse is giving instructions to a client diagnosed with delirium. What might the nurse repeat the instructions frequently? Select all that apply. The client may have impaired recent and immediate memory. The client may not understand what the nurse is saying. The client may have abnormal thought processing. The client may have poor judgment. The client may have impaired attention.
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A nurse is reading a journal article about children and somatic symptom disorder. Which of the following would the nurse expect to find as the most common symptoms reported by children with this disorder? Select all that apply. Diarrhea Fatigue Tingling in the hands Abdominal pain Nausea Headache
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A nurse is using limit setting with a child hospitalized for a psychiatric disorder. Which statement made by the nurse would reflect appropriate limit setting? Select all that apply "Swearing is not allowed here on the unit." "When you feel like swearing come and talk to me." "Swearing is a sign of disrespect." "Unit rules are made to keep everyone safe." "You will lose television privileges for 24 hours if you ignore a unit rule."
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A nurse suspects that a child has oppositional defiant disorder. When reviewing the child's history, which of the following would support this suspicion? Select all that apply. Disobedience Angry outbursts Cruelty to animals Destruction of property Blaming others for problems
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A pediatric nurse realizes that people react differently to the same situation as a result of temperament, which is evidenced by which of the following? Select all that apply Development of regular patterns Number of friends to interact with Gender How one approaches a situation Activity level
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After educating a group of nurses on Alzheimer's disease and appropriate nursing care, the group leader determines that the education was successful when the nurses identify which as the foundation for providing care to the client and family? Functional independence Therapeutic relationship Injury prevention Medication therapy
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An actor has prepared extensively for his first stage production. On the morning of the opening of the play, the actor awakens with laryngitis. From which disorder is the actor most likely suffering? Acute upper respiratory infection Conversion disorder Hysteria Somatization disorder
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Based on the psychosocial theory associated with somatic symptom illnesses, the mental health nurse suspects that a client who frequently fails to meet deadlines at work claiming reoccurring "stomach problems" is what? Select all that apply. Displaying somatizing behavior Being rewarded for this behavior Not consciously causing the "stomach problems" Likely to give up the behavior when it is identified as a mental health issue Not experiencing any negative repercussions at work
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Emotion-focused coping strategies are designed to accomplish which of the following outcomes? Helping the client manage difficult situations more effectively Helping the client manage the intensity of symptoms Teaching the client the relationship between stress and physical symptoms Relieving the client's physical symptoms
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One of the most important goals of treatment for clients with somatoform disorders is which of the following? Managing the client's use of medical services Restricting the client's use of medical services Resolving the physical symptoms Having the client accept that the physical symptoms are related to stress
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The nurse has concluded the assessment of a client recently diagnosed with somatic symptom disorder. The client states the client's most significant source of stress is that "No one believes how sick I am." The client's physical complaints include fatigue, loss of appetite, and frequent urination. Based on these data, the most appropriate nursing diagnosis is what? A. Ineffective coping related to unresolved psychological issues as evidenced by inability to express feelings verbally Chronic low self-esteem related to physical symptoms that inhibit the client's daily functioning Risk for spiritual distress related to feelings of isolation Hopelessness related to chronicity of symptoms as evidenced by dependency
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The nurse has encouraged the client with a somatic symptom illness to keep a journal. Which treatment outcome might be met by journaling? The nurse will control external stressors that trigger the patient's physical symptoms. The nurse will assess the onset of physical symptoms. The client will express emotions privately. The client will identify the occurrence of physical symptoms when stressed.
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The nurse is assessing the practical skills diagnosed with intellectual disability. Which of the following would the nurse assess? select all that apply Occupational skills Use of money Activities of daily living Ability to follow rules Self-esteem
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The nurse is caring for a client with delirium. Which interventions may help manage this client? Select all that apply. Speak in simple sentences. Encourage the client to follow a regular routine. Use matter-of-fact approach when assuming tasks the client can no longer perform. Provide orienting verbal cues when talking with the client. Allow adequate time for the client to comprehend and respond.
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The nurse is teaching a 12-year-old with intellectual disability about medications. Which of the following interventions is essential? Speak slowly and distinctly. Teach the information to the parents only. Use pictures rather than printed words. Validate client understanding of teaching.
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The nurse is teaching basic physical exercises and meditation techniques to a client recently diagnosed with conversion disorder. What outcome does the nurse expect from teaching the client these exercises? Choose the best answer. The exercises may help the client understand the conflict underlying the disorder The exercises may help the client express feelings of fear, anger, guilt, or inadequacy The exercises may help the client manage stress underlying the disorder The exercises may distract the client from the physical disability
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The nurse is using limit setting with a child diagnosed with conduct disorder. Which statement reflects the most effective way for the nurse to set limits with the child? "That is not allowed here. You will lose a privilege. You need to stop." "Stop what you are doing. Go to your room." "I would appreciate if you would not do that." "Why do you do these things?"
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The nurse understands that effective limit setting for children includes (select all that apply) allowing the child to participate in defining limits consistent enforcement of limit by entire team explaining the consequences of exceeding limits informing the child of the rule or limit negotiation of reasonable requests for change in limits providing 3 or 4 cues or prompts to follow the established limit
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The nurse who provides care under the auspices of a group home is planning the care of a 12-year-old boy who has been referred to the home by the court system. Knowing that the boy has a documented history of conduct disorder, which of the following nursing diagnoses should the nurse prioritize during the boy's transition into the group home? Risk for Injury related to poor safety awareness Hopelessness related to separation from family Impaired Social Interaction due to withdrawal Impaired Social Interaction due to alienation from others secondary to aggressive acts
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The nurse who provides care under the auspices of a group home is planning the care of a 12-year-old client who has been referred to the home by the court system. Knowing that the client has a documented history of conduct disorder, which nursing diagnosis should the nurse prioritize during the client's transition into the group home? Risk for injury related to poor safety awareness Impaired social interaction due to aggressive behavior Impaired social interaction due to withdrawal Hopelessness related to separation from family
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The personal benefit derived from blocking psychological conflict from conscious awareness is called what? Primary gain Secondary gain La belle indifference Sick role reward
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What genetic and environmental factors influence the growth and development of children? Select all that apply DNA transcription activity level adaptability temperament rhythmicity
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When assessing a client with delirium, the nurse will expect to see__________. Select all that apply. aphasia. confusion. impaired level of consciousness. long-term memory impairment. mood fluctuations. rapid onset of symptoms.
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When describing the treatment plan for a child with ADHD, which of the following would the nurse identify as an important area to address? Select all that apply. School accommodations Individual treatment Supportive services Medications Family treatment
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Which are important points for the nurse to consider when working with clients with disruptive behavior disorders and their families? Select all that apply. Most behavior disorders are caused by being raised by parents who had behavior disorders in their own childhoods. Remember to focus on the client's strengths and assets, as well as their problems. Transient conduct disorders are common in all children. Avoid a "blaming" attitude toward clients and/or families. Focus on positive actions to improve situations and/or behaviors.
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Which is the most commonly used treatment for oppositional defiant disorder? Pharmacologic treatment Parent training models of behavioral interventions Individual therapy "Boot camp"
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Which may be concerns that a nurse has when caring for clients who have conduct disorders? Select all that apply. Thinking that the client should be able to refrain from hostility and aggression through use of will power. Having conflicted feelings regarding holding clients accountable for their behaviors without having a punitive attitude. Discussing feelings, fears, or frustrations with colleagues. Having anxiety and fears for the nurse's personal safety Believing that aggression is the most productive way to deal with aggression.
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Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply Social phobia Bipolar disorder Obsessive compulsive disorder Major depression Alcohol dependence
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Which of the following statements by the caregiver of a client newly diagnosed with dementia requires further intervention by the nurse? "I will remind Mother of things she has forgotten." "I will keep Mother busy with favorite activities as long as she can participate." "I will try to find new and different things to do every day." "I will encourage Mother to talk about her friends and family."
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