Deck 24: Children and Adolescents

Question 1

After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD)begins methylphenidate (Ritalin)therapy,a nurse notes that the adolescent loses 10 pounds in a 2-month period.What is the best explanation for this weight loss?

A)The pharmacological action of Ritalin causes a decrease in appetite.
B)Hyperactivity seen in ADHD causes increased caloric expenditure.
C)Side effects of Ritalin cause nausea,and,therefore,caloric intake is decreased.
D)Increased ability to concentrate allows the client to focus on activities rather than food.

Answer 1

The pharmacological action of Ritalin causes a decrease in appetite.

Question 2

Which nursing intervention related to self-care would be most appropriate for a teenager diagnosed with moderate IDD?

A)Meeting all of the client's self-care needs to avoid injury to the client
B)Providing simple directions and praising client's independent self-care efforts
C)Avoid interfering with the client's self-care efforts in order to promote autonomy
D)Encouraging family to meet the client's self-care needs to promote bonding

Answer 2

Providing simple directions and praising client's independent self-care efforts

Question 3

A nursing instructor presents a case study in which a three-year-old child is in constant motion and is unable to sit still during story time.She asks a student to evaluate this child's behavior.Which student response indicates an appropriate evaluation of the situation?

A)"This child's behavior must be evaluated according to developmental norms."
B)"This child has symptoms of attention deficit-hyperactivity disorder."
C)"This child has symptoms of the early stages of autistic disorder."
D)"This child's behavior indicates possible symptoms of oppositional defiant disorder."

Answer 3

"This child's behavior must be evaluated according to developmental norms."

Question 4

A child diagnosed with severe autistic spectrum disorder has the nursing diagnosis disturbed personal identity.Which outcome would best address this client diagnosis?

A)The client will name own body parts as separate from others by day five.
B)The client will establish a means of communicating personal needs by discharge.
C)The client will initiate social interactions with caregivers by day four.
D)The client will not harm self or others by discharge.

Question 5

Which finding should a nurse expect when assessing a child diagnosed with separation anxiety disorder?

A)The child has a history of antisocial behaviors.
B)The child's mother is diagnosed with an anxiety disorder.
C)The child previously had an extroverted temperament.
D)The child's mother and father have an inconsistent parenting style.

Question 6

A preschool child diagnosed with autistic spectrum disorder has been engaging in constant head-banging behavior.Which nursing intervention is appropriate?

A)Place client in restraints until the aggression subsides.
B)Sedate the client with neuroleptic medications.
C)Hold client's head steady and apply a helmet.
D)Distract the client with a variety of games and puzzles.

Question 7

A preschool child is admitted to a psychiatric unit with the diagnosis autistic spectrum disorder.To help the child feel more secure on the unit,which intervention should a nurse include in this client's plan of care?

A)Encourage and reward peer contact.
B)Provide consistent caregivers.
C)Provide a variety of safe daily activities.
D)Maintain close physical contact throughout the day.

Question 8

When planning care for a client,which medication classification should a nurse recognize as effective in the treatment of Tourette's syndrome?

A)Neuroleptic medications
B)Anti-manic medications
C)Tricyclic antidepressant medications
D)Monoamine oxidase inhibitor medications

Question 9

A nursing instructor is teaching about the developmental characteristics of clients diagnosed with moderate intellectual developmental disorder (IDD).Which student statement indicates that further instruction is needed?

A)"These clients can work in a sheltered workshop setting."
B)"These clients can perform some personal care activities."
C)"These clients may have difficulties relating to peers."
D)"These clients can successfully complete elementary school."

Question 10

A nurse assesses an adolescent client diagnosed with conduct disorder who,at the age of 8,was sentenced to juvenile detention.How should the nurse interpret this assessment data?

A)Childhood-onset conduct disorder is more severe than the adolescent-onset type,and these individuals likely develop antisocial personality disorder in adulthood.
B)Childhood-onset conduct disorder is caused by a difficult temperament,and the child is likely to outgrow these behaviors by adulthood.
C)Childhood-onset conduct disorder is diagnosed only when behaviors emerge before the age of 5,and,therefore,improvement is likely.
D)Childhood-onset conduct disorder has no treatment or cure,and children diagnosed with this disorder are likely to develop progressive oppositional defiant disorder.

Question 11

Which developmental characteristic should a nurse identify as typical of a client diagnosed with severe intellectual developmental disorder (IDD)?

A)The client can perform some self-care activities independently.
B)The client has more advanced speech development.
C)Other than possible coordination problems,the client's psychomotor skills are not affected.
D)The client communicates wants and needs by "acting out" behaviors.

Question 12

After studying the DSM-5 criteria for oppositional defiant disorder (ODD),which listed symptom would a student nurse recognize?

A)Arguing and annoying older sibling over the past year
B)Angry and resentful behavior over a three-month period
C)Initiating physical fights for more than 18 months
D)Arguing with authority figures for more than six months

Question 13

A client has an IQ of 47.Which nursing diagnosis best addresses a client problem associated with this degree of IDD?

A)Risk for injury R/T self-mutilation
B)Altered social interaction R/T non-adherence to social convention
C)Altered verbal communication R/T delusional thinking
D)Social isolation R/T severely decreased gross motor skills

Question 14

Which should be the priority nursing intervention when caring for a child diagnosed with conduct disorder?

A)Modify environment to decrease stimulation and provide opportunities for quiet reflection.
B)Convey unconditional acceptance and positive regard.
C)Recognize escalating aggressive behavior and intervene before violence occurs.
D)Provide immediate positive feedback for appropriate behaviors.

Question 15

Which behavioral approach should a nurse use when caring for children diagnosed with disruptive behavior disorders?

A)Involving parents in designing and implementing the treatment process
B)Reinforcing positive actions to encourage repetition of desirable behaviors
C)Providing opportunities to learn appropriate peer interactions
D)Administering psychotropic medications to improve quality of life

Question 16

A child has been diagnosed with autistic spectrum disorder.The distraught mother cries out,"I'm such a terrible mother.What did I do to cause this?" Which nursing response is most appropriate?

A)"Researchers really don't know what causes autistic spectrum disorder,but the relationship between autistic disorder and fetal alcohol syndrome is being explored."
B)"Poor parenting doesn't cause autistic spectrum disorder.Research has shown that abnormalities in brain structure or function are to blame.This is beyond your control."
C)"Research has shown that the mother appears to play a greater role in the development of autistic spectrum disorder than the father."
D)"Lack of early infant bonding with the mother has shown to be a cause of autistic spectrum disorder.Did you breastfeed or bottle-feed?"

Question 17

A physician orders methylphenidate (Ritalin)for a child diagnosed with ADHD.Which information about this medication should the nurse provide to the parents?

A)If one dose of Ritalin is missed,double the next dose.
B)Administer Ritalin to the child after breakfast.
C)Administer Ritalin to the child just prior to bedtime.
D)A side effect of Ritalin is decreased ability to learn.

Question 18

A child has been recently diagnosed with mild IDD.What information about this diagnosis should the nurse include when teaching the child's mother?

A)Children with mild IDD need constant supervision.
B)Children with mild IDD develop academic skills up to a sixth-grade level.
C)Children with mild IDD appear different from their peers.
D)Children with mild IDD have significant sensory-motor impairment.

Question 19

In planning care for a child diagnosed with autistic spectrum disorder,which would be a realistic client outcome?

A)The client will communicate all needs verbally by discharge.
B)The client will participate with peers in a team sport by day four.
C)The client will establish trust with at least one caregiver by day five.
D)The client will perform most self-care tasks independently.

Question 20

A mother questions the decreased effectiveness of methylphenidate (Ritalin),prescribed for her child's ADHD.Which nursing response best addresses the mother's concern?

A)"The physician will probably switch from Ritalin to a central nervous system stimulant."
B)"The physician may prescribe an antihistamine with the Ritalin to improve effectiveness."
C)"Your child has probably developed a tolerance to Ritalin and may need a higher dosage."
D)"Your child has developed sensitivity to Ritalin and may be exhibiting an allergy."

Question 21

Which of the following risk factors,if noted during a family history assessment,should a nurse associate with the development of IDD? (Select all that apply.)

A)A family history of Tay-Sachs disease
B)Childhood meningococcal infection
C)Deprivation of nurturance and social contact
D)History of maternal multiple motor and verbal tics
E)A diagnosis of maternal major depressive disorder

Question 22

The DSM-5 criteria for ODD specifies that: A persistent pattern of angry/irritable mood,argumentative/defiant behavior,or vindictiveness must be evident and last at least ______________ months.

Question 23

Which of the following findings should a nurse identify that would contribute to a client's development of ADHD? (Select all that apply.)

A)The client's father was a smoker.
B)The client was born 7 weeks premature.
C)The client is lactose intolerant.
D)The client has a sibling diagnosed with ADHD.
E)The client has been diagnosed with dyslexia.