Module 9 Pt. 1

An adolescent client diagnosed with attention-deficit/hyperactivity disorder (ADHD) is being counseled in the clinic for daily stressors. For which common comorbidity should the nurse assess regularly to identify and treat early within the client?

substance use

A pediatric client diagnosed with attention-deficit/hyperactivity disorder (ADHD) is participating in behavioral strategies to assist with daily functioning. In the session, the nurse is utilizing play techniques to understand the child's thoughts and feelings and to promote communication. Which type of play is the nurse utilizing with the client?

therapeutic play

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate. The parent reports that the child is having trouble sleeping. When assessing this report, which question would be most appropriate for the nurse to ask?

when does the child take the last dose of medications

After educating a group of students on attention deficit hyperactivity disorder (ADHD), the instructor determines that additional education is required when the group identifies which as a typical characteristic?

language difficulty

The nurse is caring for a pediatric client diagnosed with attention-deficit/hyperactivity disorder (ADHD) who is having difficulty with school due to inattentiveness and hyperactivity. Which medication will the nurse anticipate most likely being prescribed for the client to help with these symptoms?

methylphenidate

The nurse is counseling a family whose child has autism. When describing this condition, which would the nurse most likely include?

onset before child is 2.5 years old

Which type of intervention may be helpful for children who are bullies?

social skills training

A nurse in the Emergency Department (ED) suspects that a child has been abused. Which action should the nurse take immediately?

start process of contacting authorities

The parents of a toddler are distraught that the toddler has been diagnosed with autism spectrum disorder. When providing care for the child and the parents, the nurse understands that autism spectrum disorder is thought to be caused by what?

Genetic factors

After teaching a group of nursing students about intellectual disability, the instructor determines that the teaching was successful when the students identify which as the most common etiology?

Genetic syndrome

A parent informs the nurse that they are concerned that their child might suffer from attention-deficit/hyperactivity disorder (ADHD). The child cannot sit still, running all over the house, and having difficulty in school. Which is the best response by the nurse?

"From what you are describing, ADHD may be a possibility, and we will refer you to a specialist for screening."

A client with a tic disorder tells the nurse that they are experiencing more complex motor tics and verbal tics lately but they get better when occupied with a task. Which question will be most appropriate to ask the client to determine the best option for decreasing these symptoms?

"Have you been experiencing an increase in stress lately?"

An adult client diagnosed with social phobia is being treated in the clinic. Which screening question should the nurse ask the client to assess for the possible comorbidity of attention-deficit/hyperactivity disorder (ADHD)?

"How often do you have difficulty getting things in order when you have to do a task that requires organization?"

The nurse has provided education to the parent of a child diagnosed with attention-deficit/hyperactivity disorder (ADHD) being prescribed methylphenidate. Which statement made by the parent would indicate a need for further teaching?

"I will expect my child to not need as much sleep on this medication."

The nurse provides care to a child whose parents recently separated and are planning to divorce. The child's parents ask the nurse how they can help their child deal with the situation. Which response by the nurse is appropriate?

"It is important that you help your child by not speaking negatively about the other."

The nurse provides education to parents of a newborn who also have a young school-age child at home. The parents are concerned about sibling rivalry. Which statement does the nurse include in the teaching session to assist with the transition?

"It is important to include your older child in the care of your new baby."

The nurse is assessing a 2-year-old child during a wellness checkup. Which statement(s) by the parent indicate that the child needs to be screened for autism spectrum disorder? Select all that apply.

"My child rarely makes eye contact with me or siblings." "I notice that my child has very few facial expressions to situations." "There is no spontaneous play at all and will only plays with one object."

A nurse working with children with autism spectrum disorder (ASD) hears an unlicensed assistive personnel (UAP) stating, "I don't know why we put in so much time educating these parents, they don't seem to care what we say." Which is the best response to the UAP about the importance of educating parents of children with ASD?

"We help parents feel relieved to have specific strategies that can help them and their child be more successful."

After educating the parents of a child diagnosed with attention deficit hyperactivity disorder (ADHD) on the disorder and its treatment, the nurse determines that the education has been effective when the parents make which statement?

"We need to remember that our child is not a bad kid but just has difficulty with impulse control and attention."

The nurse is educating parents of a child with attention-deficit/hyperactivity disorder (ADHD)about the prescription for atomoxetine. Which client statement(s) indicate that the education is effective? Select all that apply.

"We will need to bring our child in for routine liver function testing."; "If our child reports a dry mouth, we can give sugar free candy or gum."' "It is better to give the medication with food."; "We need to monitor appetites since the medication may suppress appetite."

A parent of a child who is diagnosed with mild-to-moderate intellectual developmental disorder is upset and states, "Am I going to have to put my child in an institution?" Which is the most therapeutic response by the nurse?

"Your child will be able to receive care at home and in the community."

Assessment of an 8-year-old client reveals communication difficulties and an inability to manage age-appropriate tasks. The child undergoes standardized testing. An intelligent quotient (IQ) of which would support a diagnosis of intellectual disability?

65

Below average intellectual functioning is initially diagnosed when an intelligence quotient (IQ) is below which level?

70

The parent of a child with attention deficit hyperactivity disorder (ADHD) is prescribed pemoline for treatment. When evaluating the laboratory studies of the child, which result will the nurse report to the health care provider?

AST 65 U/L (1.1 μkat/L)

The nurse plans an educational session for parents of adolescents for mental health promotion. Which peer group-level intervention will the nurse include in the session?

Alternative recreation activities

A nurse is assessing a child suspected of having autism spectrum disorder. Which behavior(s) assessed by the nurse correlates with this diagnosis? Select all that apply.

Echolalia Delayed language skills

A nurse is assessing a child who had an episode of passing feces in the classroom. The child has no other disabilities. The nurse concludes that the child had intentional encopresis. Which other condition is the child likely to have?

Conduct disorder

Which term describes the use of socially unacceptable words, which are frequently obscene?

Coprolalia

Nurses who work in a pediatric psychiatric-mental health facility should do what?

Develop self-awareness of issues that remind them of their own childhood and adolescence.

The nurse working with pediatric clients knows the importance of checking for developmental delays, which not only slow the child's progress but also are often associated with what?

Development of poor self-esteem

A nurse is assessing an 8-year-old child. The child is unable to dress without assistance and is not able to manipulate toys, such as building blocks. The child stutters while talking. The difficulty with motor coordination was first noted after the child started to attend school, and it is not an aspect of a general underlying medical condition. What is the most likely diagnosis of the child?

Developmental coordination disorder

A 9-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on the stimulant methylphenidate. The nurse knows that the teaching has been effective when the client's parents make which statement?

Ensure the child's safety due to impulsiveness.

The nurse is planning the care for a child with attention-deficit/hyperactivity disorder (ADHD). When discussing interventions with the parent, which nursing intervention will be the highest priority?

Ensure the child's safety due to impulsiveness.

The nurse is assessing a child with autism spectrum disorder. After reading the medical history, the nurse finds that the child engages in stereotypical motor behavior. Which observation of the child made by the nurse might be indicative of stereotypical motor behavior?

Flapping hands repeatedly

A nurse is studying the brain images of children with attention deficit hyperactivity disorder (ADHD). In these images, the nurse would find abnormalities related to which area of the brain?

Frontal

An adolescent client says the client has become bored with the video game that has been used as a reward for positive behavior. Which is the most effective intervention for this client?

Let the client choose another reward that would be more fun.

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity disorder (ADHD)?

Methylphenidate

The nurse is developing a care plan for a client diagnosed with attention deficit hyperactivity disorder (ADHD). The nurse teaches the client to take the last dose of dextroamphetamine when?

Noon

The nurse is teaching a client's parents about managing the child's tic disorder. The nurse explains that it is extremely important for the child to get plenty of rest. What is the primary reason for the nurse to provide this education? Choose the best answer.

Physical stress and fatigue can increase symptoms in tic disorder.

A psychiatric-mental health nurse is caring for a client diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which nursing action(s) are appropriate when caring for a client diagnosed with ADHD? Select all that apply.

Provide close supervision.; Provide clear directions about acceptable and unacceptable behavior.; Get the client's full attention before speaking.; Minimize changes to the daily routine.

A child with autistic spectrum disorder (ASD) is displaying temper tantrums. Which is the priority goal of treatment related to this issue?

Reduce behavioral symptoms.

The school nurse is talking with the parent of a 7-year-old child who is having difficulty in the classroom due to a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The child is having difficulty paying attention, listening, and completing tasks. Which suggestion can the nurse give for improvement to the parent?

Request that the child be seated in front of the teacher in the classroom.

Assessment of a child with autism spectrum disorder reveals stereotypic behavior. Which behavior would the nurse most likely document being demonstrated by the child? Select all that apply.

Rocking Hand flapping Head banging

A child with an existing diagnosis of attention deficit hyperactivity disorder shows signs and symptoms of depression. Which would most likely be prescribed?

Selective serotonin and norepinephrine reuptake inhibitor (SSNRI)

When performing a spiritual assessment on a child, the nurse and child discuss church attendance and practices that are most important to the child. Which domain is the nurse addressing when doing this assessment?

Social

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Substance abuse disorders

The parents of a child with attention deficit hyperactivity disorder (ADHD) bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives the first dose of methylphenidate at about 7:30 a.m. every morning before leaving for school. The teacher and school nurse have noticed a return in the child's overactivity and distractibility just before lunch. The child's second dose is scheduled for about 12 p.m. Which might the nurse suggest as a possible solution to control the child's symptoms a bit more effectively?

Switch to a longer-acting preparation.

A nurse is providing education to a group of parents who have children with attention-deficit/hyperactivity disorder (ADHD). Which information will the nurse include in the education? Select all that apply.

Take the time to learn how to rebuild a child's self-esteem; Support groups can provide information and encouragement from others; ADHD is not the fault of the parents or the child.

A pediatric client is being assessed for intellectual developmental disorder. Which aspect in the client's history would alert the nurse to the potential cause of the disorder?

Tay-Sachs disease

A 7-year-old client experiences tics, which have become increasingly frequent in recent months. How should the nurse educate the client's teacher to respond to the tics?

Teach the client's classmates that the tics are not something that the client can control.

A nurse is working with a child undergoing behavioral modification therapy for attention deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be the most likely reason for this observation?

The child cannot sit through meals.

The nurse is assessing a child with tic disorder. The nurse documents in the assessment sheet that the child exhibits coprolalia. What might be be interpreted from this?

The child continuously repeats socially unacceptable words.

The nurse expects the child with expressive language disorder is likely to present with which nursing assessment finding?

The child has difficulty forming complete sentences.

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The child is given medication and behavioral modification therapy to treat the condition. Which outcome achieved within 3 days would indicate successful therapy?

The child is able to complete assignments or tasks with assistance.

The nursing is caring for a child in the pediatric outpatient clinic being treated with imipramine for the treatment of enuresis. Which report by the parent is of most concern to the nurse?

The child is having decreased urinary output and difficulty urinating.

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder (ADHD). The nurse finds that these children do not like the child and do not want to include the child during play. What are the likely reasons for the children feeling this way? Select all that apply.

The child is not cooperative while playing. The child constantly interrupts while playing. The child doesn't follow the rules of the game.

A nurse is assessing a child with attention deficit hyperactivity disorder (ADHD). For every question asked by the nurse, the child answers, "I don't know." What is the most likely reason for the child to respond in this way?

The child is not paying attention to the nurse's questions.

A child has been prescribed methylphenidate for treatment of attention deficit hyperactivity disorder (ADHD). Which observation is indicative to the nurse that a potential problem exists?

The child reports eyes feeling tired.

The nurse conducts wellness assessments for a child who is homeless and currently living in a shelter with a parent. Which issue(s) are a priority for the nurse to monitor for during the assessment process? Select all that apply.

The presence of anxiety Fine motor delays Has not developed appropriate language skills

The parent of a 6-year-old child with autism spectrum disorder (ASD) informs the nurse that the temper tantrums are getting difficult to control and the parent is afraid of what the child will do to themself and other family members. Which option will the nurse discuss with the parent to help manage the behaviors?

The use of antipsychotic medications may be helpful with the tantrums and aggression.

A nurse is caring for a child with attention deficit hyperactivity disorder. The nurse asks the child to draw pictures of the child and family members. What is the most likely rationale for this intervention?

To help the child self-express

A psychiatric-mental health nurse is reviewing an article about genetics and the role in the development of a childhood psychiatric disorder. The nurse demonstrates understanding of this information by identifying which disorder as being genetically transmitted?

Tourette's syndrome

When a client repeatedly vocalizes an obscene phrase and imitates the motions of a staff member, the nurse documents that the client is most likely exhibiting symptoms of what disorder?

Tourette's syndrome

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed dextroamphetamine. For what effects should the nurse tell the parents to monitor the child? Select all that apply.

Weight loss Appetite suppression Insomnia

Which child has the greatest risk for exhibiting bullying behaviors?

a school-age male who has divorced parents and a history of physical abuse

A psychiatric-mental health nurse is assessing a pediatric client. Upon assessment, the client repeats the last-heard sound from other people. Which observation would the nurse document in the client's medical record?

echolalia

A psychiatric-mental health nurse is teaching a client and their family about attention-deficit/hyperactivity disorder (ADHD). Which teaching concept(s) should be included in the educational session? Select all that apply.

referral to support groups; accurate administration of medication and possible side effects; assisting the parents to achieve a balance of praising and correcting the child's behavior; assisting parents to identify behavioral approaches to be used at home.

A pediatric client is being assessed in the clinic for a diagnosis of autism spectrum disorder (ASD). The client's parent describes that the client bangs their head repeatedly at times. Which assessment finding should be documented by the nurse?

stereotyped motor behavior