PREP U CHPT 23
Imbalance in the production of serotonin
A 15-year-old client with intermittent explosive disorder (IED) gives no history of childhood abuse, neglect, or maltreatment. What could be the cause of the disorder in this client?
intermittent explosive disorder
A high school teacher has referred an adolescent to the school health nurse for repeated episodes of aggressive behavior and verbalizing profanities loudly at other students in the class. The adolescent can sometimes be apologetic. The nurse should suspect which disruptive behavior disorder?
attention-deficit/hyperactivity disorder (ADHD)
A nurse is assessing a 10-year-old child who is displaying behaviors that are consistent with oppositional defiance disorder. When conducting the assessment, the nurse should also assess for which co-morbidity?
Depression Drug abuse Hyperactivity
A nurse is assessing a 13-year-old client with intermittent explosive disorder (IED). The nurse suspects that the client has other psychiatric disorders. What findings would lead the nurse to conclude this?
The adolescent has lots of tattoos and body piercings.
A nurse is assessing a 15-year-old adolescent with conduct disorder. Which appearance might the nurse see in the adolescent?
"It sounds like very challenging behavior, testing is quite normal at this age."
A nurse is assessing a 2-year-old child in a child and family outpatient mental health clinic. The parents tell the nurse that the child can be combative when the child's wants are not met. The parents describe the child as "defiant." What is the most appropriate response of the nurse to the parents?
Behavior of parents Temperament of the adolescent Peer group of the adolescent
A nurse is assessing an adolescent client with oppositional defiant disorder (ODD). What factors influence the development of this disorder in the adolescent?
The adolescent's behavior poses a danger to others.
A nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent has been prescribed risperidone by the primary health care provider. What would be the most likely reason for the health care provider to prescribe this drug to the client?
The sibling of the client has conduct disorder.
A nurse is assessing an adolescent with conduct disorder. Which statement by the nurse about the adolescent is most likely to be true?
To ensure safety of others.
A nurse is caring for a client with conduct disorder who injures people around the client when angry. Which is the primary goal for intervention in this case?
Teach the client about limit setting and the need for limits.
A nurse is caring for a client with conduct disorder. The nurse needs to help the client understand the relationship between aberrant behavior and the consequences when the behavior is problematic. Which nursing intervention is most appropriate to help this client?
Help the client develop peer relationships.
A nurse is caring for an adolescent with conduct disorder. The nurse tries to involve the client in discussions on age-related topics such as books, current trends, and movies. What is the nurse trying to accomplish by doing this?
Smoking Alcohol and substance abuse Early onset of sexual behavior
A nurse is counseling the parents of a client with conduct disorder. The nurse tells them that they should be vigilant in watching for certain behaviors that their child is prone to exhibit. Which behaviors would the nurse want the parents to watch for?
The adolescent may have limited sensitivity to reward and punishment.
A nurse is counseling the parents of an adolescent client with oppositional defiant disorder (ODD). The parents state, "We've tried everything, what else are we supposed to do?" What is the most likely reason for the parents' voiced loss of hope?
The client will engage in socially acceptable behavior. The client will learn effective problem-solving skills. The client will not hurt others or damage property.
A nurse is developing a plan of care for a client with conduct disorder. Which would be treatment outcomes for this client?
Offer the child a toy or a game after a week of good behavior at school. Take the child out for ice cream after a weekend free of arguing or questioning. Give high-fives for following through on a request the first time.
A nurse is meeting the parents of an 8-year-old child with oppositional defiant disorder. Which strategies can the nurse offer the parents to promote the use of positive reinforcement?
A student who repeatedly bullies younger students A student who is constantly involved in activities resulting in damage to school property A student who always uses abusive language while speaking to teachers
A nurse is performing a general assessment of adolescents in a school to identify students with conduct disorder. Which students are likely to be identified with the condition, based on the nurse's assessment?
Effective parenting skills Skills to improve peer relationships Skills to improve academic performance
A nurse is planning to teach parents of children with conduct disorder about the treatment methods. Which topics should the nurse address in the session?
Behavior problems can develop when parental figures pay attention to a child's maladaptive behaviors.
A nurse is providing community education regarding adolescents with oppositional defiance disorder (ODD). Which point should the nurse include in the educational session?
"I want to continue to work with you but I don't accept the language you have chosen."
A nurse is seeing an adolescent with a diagnosis of conduct disorder for the first time to establish goals for treatment. During the first meeting, the adolescent yells a profanity at the nurse and states, "This is pointless." What is the nurse's best response?
The presence of aggression
A nurse is studying the medical records of a client with conduct disorder. The nurse finds that the client was prescribed lithium. What would be the most likely reason for prescribing this drug for this client?
improving coping skills and self-esteem
A nurse is working with an adolescent client with a diagnosis of conduct disorder. The nurse is helping the client reflect on a situation in which the client became aggressive and asks how the client could have handled it differently. The nurse is employing which intervention?
At home while confronting parents
A nurse suspects that an adolescent has oppositional defiant disorder (ODD). In which situation will the client most likely display behavior consistent with ODD?
"Please tell me more about what you are having difficulty with."
After completing a series of parent training sessions with parents of an 8-year-old client with oppositional defiant disorder, the child's mother calls the nurse with concerns. The mother states, "What you taught us isn't working. Can you please talk to my child about his behavior?" Which is the nurse's most effective response?
The disorder is difficult to detect and treat.
After teaching a group of nursing students about kleptomania, the instructor determines that the education was successful when the students state what?
Individualized behavior therapy
An adolescent client demonstrates callous and unemotional behavior in the absence of extreme aggressive behavior and mood disturbances. The client has a diagnosis of conduct disorder. Which treatment would be most effective for this client?
Antisocial personality disorder
Children with conduct disorder may be diagnosed with which disorder as adults?
severe intensity form of conduct disorder
Cruelty to animals and attempted robbery are described as a behavior seen in a
To help identify feelings.
For which reason would a nurse ask an adolescent client with conduct disorder to maintain a diary?
Adolescents with ODD learn maladaptive behavior at home and it can be perpetuated at school.
In a discussion with a group of high school teachers about oppositional defiant disorder (ODD), the nurse says that behavior modification of the parents and teachers toward such children forms the basis of therapy. What is the most appropriate rationale that the nurse gives when asked about this strategy?
verbal bullying
The nurse is assessing a child diagnosed with conduct disorder. Based on which behavior would this client be described as exhibiting the disorder at moderate intensity?
The client prefers stealing money over working for it.
The nurse is assessing an adolescent with conduct disorder. The nurse finds that the adolescent is not interested in seeking summer employment. What is the most likely reason for the client's disinterest in getting a job?
The client only stares at the nurse when asked how the client is doing today.
The nurse is documenting clinical observations after a therapeutic session with an adolescent client with a disruptive behavior disorder. What should the nurse identify is an internalizing behavior?
What type of discipline do you use at home?"
The nurse is interviewing the parents of a child with conduct disorder. Which question is appropriate for the nurse to ask?
"You should be supportive of the school for taking this step regarding your child's inappropriate behavior."
The nurse is teaching the parents of a child with conduct disorder about methods to deal with their child's detention from school for breaking science equipment. What advice should the nurse give the parents to deal with the situation?
Threatening the nurse
The nurse uses the technique of time-out for a client with conduct disorder. Which problem demonstrated by the client would have led the nurse to use this intervention?
Impaired social interaction due to aggressive behavior
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?
"Our child spends more time playing than studying." "Our child doesn't listen to us, preferring to listen to friends."
The parents of a 15-year-old adolescent report that their child is behaving abnormally. After obtaining the history of the client, the nurse responds by telling the parents that their child's behavior is normal for his age. What would the parents have told the nurse regarding their child?
moderate intensity form of conduct disorder.
Verbal bullying is an example of a behavior seen in clients exhibiting a
Use 'I' language and express an emotion when setting limits.
When providing education to the parents of a client with conduct disorder, which is a valid teaching point?
Conduct Disorder (CD)
Which childhood disorder is characterized by serious violations of social norms, such as destruction of property?
Conduct disorder
Which childhood disorder is characterized by serious violations of social norms, such as destruction of property?
"Do you usually have an explosive episode after a work day?"
Which observation demonstrates the effective use of cognitive behavioral therapy with a client diagnosed with intermittent explosive disorder?
"You will lose your driving privileges for a week if you don't clean your room today."
Which statement, made by the parent of a teen diagnosed with conduct disorder, demonstrates effective parenting?
Have the child accept responsibility for individual behavior
Which would be an appropriate intervention for a child diagnosed with conduct disorder?
limit setting
Which would be the most appropriate intervention for an adolescent who is manipulative and exhibiting aggressive behaviors?
Truancy
is described as a behavior seen in a mild intensity form of the disorder.
