Deck 22: Neurodevelopmental Disorders

Question 1

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply.

A) The child displays little eye contact with others.
B) The child thrives on changes in routine.
C) The child makes few facial expressions toward others.
D) The child does not like repetition.
E) The child answers questions verbally.

Answer 1

The child displays little eye contact with others.
The child makes few facial expressions toward others.
The child does not like repetition.

Question 2

A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is,

A) It is recommended that you wait until the child is older to vaccinate.
B) There are safer alternative immunizations available now.
C) There has been no research to establish a relationship between vaccines and autism.
D) The risks do not outweigh the benefits of immunization against childhood diseases.

Answer 2

There has been no research to establish a relationship between vaccines and autism.

Question 3

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD). Which of the following behaviors reported by the parent would be consistent with this diagnosis?

A) The child interrupts others.
B) The child has been hoarding objects.
C) The child has lots of friends.
D) The child is excelling academically in school.

Answer 3

The child interrupts others.

Question 4

Which of the following symptoms are characteristic of ADHD? Select all that apply.

A) Enuresis
B) Inattentiveness
C) Encopresis
D) Overactivity
E) Impulsiveness

Question 5

Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.

A) Social phobia
B) Bipolar disorder
C) Obsessiveñcompulsive disorder
D) Major depression
E) Alcohol dependence

Question 6

A nurse asks an assigned client, How are you doing today? The client responds with doing today, doing today, doing today. Which speech pattern disturbance is this an example of?

A) Reactive attachment disorder
B) Stereotypic movement disorder
C) Selective mutism
D) Echolalia

Question 7

Which of the following terms describes the repeating of one's own words or sounds?

A) Coprolalia
B) Palilalia
C) Echolalia
D) None of the above

Question 8

Which of the following disorders involves problems with forming sounds associated with speech?

A) Phonologic disorder
B) Mixed receptiveñexpressive language disorder
C) Expressive language disorder
D) Stuttering

Question 9

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate?

A) Give the child rewards for resisting tantrums.
B) Reason with the child why tantrums are not effective.
C) Place the child in a time-out when tantrums occur.
D) Explore the use of antipsychotic medications to control tantrums.

Question 10

A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice?

A) Give the child his medicine at night.
B) Have the child eat a good breakfast and snacks late in the day and at bedtime.
C) Limit the number of calories the child eats each day.
D) Let the child take daytime naps.

Question 11

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

A) Break tasks into small steps.
B) Let the child complete tasks at his own pace.
C) Offer rewards when all tasks are completed.
D) Set a time limit to complete all tasks.

Question 12

Which of the following would be important circumstances to gather assessment data for a child with ADHD? Select all that apply.

A) Direct observation of the child
B) Reviewing the client's record
C) Interviewing the client's parents
D) Interviewing the client's teachers
E) Assessing the client in a group of peers

Question 13

Which one of the following nursing interventions should take priority for a child with ADHD?

A) Structured daily routine
B) Ensuring the child's safety and that of others
C) Simplifying instructions and directions
D) Improved role performance

Question 14

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step?

A) I need to talk to you.
B) Stop that right now.
C) You are going to hurt yourself.
D) Why are you jumping off the bed?

Question 15

The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following?

A) Your son is a cute child, but he needs to calm down.
B) It must be difficult to handle your son at home.
C) You need to take a firmer approach with your son.
D) Your son sure is active.

Question 16

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?

A) Increased impulsivity or hyperactive behavior
B) Lack of appetite for lunch
C) Sleepiness or drowsiness
D) Social isolation from peers

Question 17

The parents of an autistic child ask the nurse, Will my child ever be normal? Which would be the most appropriate response by the nurse?

A) You seem worried about your child's future.
B) Autistic children can fully recover with the right treatment and education.
C) Your child should outgrow autistic traits by adolescence.
D) Your child will probably always have some autistic traits.

Question 18

The parents of a child with ADHD express to the nurse, We get so frustrated when our son never minds us. Which parenting strategies should the nurse discuss with the parents? Select all that apply.

A) Use time-out for behavior control.
B) Provide occasional rewards and consequences for behavior.
C) Give verbal reprimands for negative behavior.
D) Resist giving praise until fully compliant with requests.
E) Use a point system for positive and negative behavior.

Question 19

Which one of the following statements about educating parents of a child with ADHD is true?

A) It is unimportant to educate the family members about ADHD as they already know the problem too well.
B) Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful.
C) It is important for the nurse to spend the majority of his or her time with parents of children with ADHD in talking to the parents.
D) If the child receives special school services under the Individuals with Disabilities Education Act, there is no need for further services.

Question 20

A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply.

A) Medication alone will adequately treat children with ADHD.
B) It is important for parents of children with ADHD to learn how to rebuild their child's self-esteem.
C) Because raising a child with ADHD can be frustrating and exhausting, it often helps parents to attend support groups that can provide information and encouragement from other parents with the same problems.
D) ADHD is not the fault of the parents or the child, and that techniques and school programs are available to help.
E) Children with ADHD do not qualify for special school services under the Individuals with Disabilities Education Act.

Question 21

When teaching the parents of a child with attention deficit hyperactivity disorder (ADHD), which statement by the parents would indicate the need for further teaching?

A) We'll have him do his homework at the kitchen table with his brothers and sisters.
B) We'll make sure he completes one task before going on to another.
C) We'll set up rules with specific times for eating, sleeping, and playing.
D) We'll use simple, clear directions and instructions.

Question 22

Which statement would indicate that medication teaching for the parents of a 6-year-old child with attention deficit hyperactivity disorder (ADHD) has been effective?

A) We'll teach him the proper way to take the medication, so he can manage it independently.
B) We'll be sure he takes Ritalin at the same time every day, just before bedtime.
C) We're so glad that Ritalin will eliminate the problems of ADHD.
D) We'll be sure to record his weight on a weekly basis.

Question 23

The mother of a 15-year-old boy tells the nurse that her son is becoming more assertive in conflict situations and wants to get a job. She asks if it is healthy for a 15-year-old to be so independent. Which is valid information for the nurse to offer the mother?

A) His behaviors reflect normal growth and development.
B) He is overly independent.
C) It sounds like he is trying to avoid her.
D) She should observe for signs of substance abuse.

Question 24

The nurse understands that when working with a child with a mental health problem, the family must be included in the care. Which is one of the best ways the nurse can advocate for the child?

A) Support transferring the child to a healthy living environment.
B) Teach the parents age-appropriate expectations of the child.
C) Reinforce the parents' expectations of the child's behavior.
D) Interpret the child's thoughts and feelings to the parent.

Question 25

For which reason is it crucial for nurses to advocate for children and adolescents regarding psychiatric disorders?

A) It is much more difficult to diagnose psychiatric disorders in children and adolescents.
B) It is not necessary because psychiatric disorders do not occur in children and adolescents.
C) Children and adolescents experience some of the same mental health problems as adults.
D) Psychiatric disorders in children manifest themselves very quickly.

Question 26

For which reasons is it more difficult to diagnose psychiatric disorders in children than in adults? Select all that apply.

A) Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening.
B) Because they are constantly changing and developing, children are unable to discriminate unusual or unwanted symptoms from normal feelings and sensations.
C) Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level.
D) Sometimes, children outgrow psychiatric disorders.
E) Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria as for adults.

Question 27

The nurse has been working with the family of a small child with a psychiatric disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best action for the nurse at this time?

A) Review effective disciplinary practices with the parents again.
B) Refer the parents to a family therapist.
C) Try to remember that the parents are trying to the best of their ability to carry out the suggestions.
D) Explore alternative living arrangements for the child.

Question 28

When the prognosis of improvement in a child with psychiatric disorders is poor, what can the nurse do to positively influence children and adolescents and their parents?

A) Continue to remind the child and parents that the prognosis for improvement is very poor.
B) Encourage the parents to believe that the child will recover spontaneously.
C) Assist the child and the parents to develop coping mechanisms.
D) Focus on their problems instead of their strengths and assets.