Deck 35: Child Psychiatric Nursing

Question 1

When planning immediate care for a child based on a biopsychosocial assessment,the nurse initially addresses any dysfunction in the:

A) biological development of the child.
B) effect of medical illness on the child.
C) social support systems available to the child.
D) child's mastery of specific ego competency skills.

Answer 1

child's mastery of specific ego competency skills.

Question 2

Which assessment finding most clearly indicates an adolescent has a conduct disorder?

A) Misses at least one day of school a month
B) Admits to pulling the dog's ears and tail for "fun"
C) Told the teacher that he is usually "sad and confused"
D) Consistently awakens during the night and has difficulty falling asleep again

Answer 2

Admits to pulling the dog's ears and tail for "fun"

Question 3

Which question would be most appropriate to ask when attempting to determine a 6-year-old child's ability to establish trusting relationships after being diagnosed with an anxiety disorder?

A) "Do you like making new friends?"
B) "Is it important to be liked by people?"
C) "What would you do if your favorite toy got broken?
D) "How do you feel when you can't have something you want?"

Answer 3

"Do you like making new friends?"

Question 4

When planning care for a school-age child who has been diagnosed with an anxiety disorder,which measure would the nurse include initially in the treatment plan?

A) Securing the support of the child's teacher
B) Identifying any mental illness in the family history
C) Providing the child with individual relaxation training
D) Exploring the possible admission of the child to a residential facility

Question 5

Which statement best indicates that a child diagnosed with attention-deficit disorder (ADD) has difficulty tolerating frustration?

A) The child's sibling says, "He just can't seem to finish anything he starts."
B) The child says, "I guess I understand why it wasn't nice to do what I did."
C) The child's parent says, "He never stands up for himself. Even when he knows he's right, he'll give in to someone else."
D) The child's parent says, "He never believes me when I tell him he looks fine for a kid his age. He thinks he's fat and ugly."

Question 6

Which nursing intervention would be most effective when assisting a child with attention-deficit/hyperactivity disorder (ADHD) to learn to use good hygiene measures each morning?

A) Have the child watch parents groom and dress each morning.
B) Stay with the child while talking them through each activity every morning.
C) Add a new activity to the morning care routine each time the child masters a task.
D) Dress the child slowly and encourage him or her to practice redressing again alone.

Question 7

When assisting a 5-year-old child to develop the ability to delay gratification,it is most valuable for the nurse to:

A) teach parents to assign a point system for expected daily activities.
B) develop the nurse-patient relationship during unstructured playtime.
C) encourage the child to express feelings when feeling frustrated.
D) model the ability to delay gratification.

Question 8

Which observation gives the best indication that an adolescent is able to effectively balance relaxation and work?

A) After being reminded to clean his bedroom the child goes back to playing computer games.
B) When found sitting quietly in the living room the child indicates to parents that the behavior is a way to relax.
C) The child enjoys several group sports and delivers newspapers before school for 25 families in the neighborhood.
D) The child seems to enjoy participating in activities such as cleaning and learning complicated software on the family computer.

Question 9

A child confides to a nurse,"My uncle tried to play with me-you know,fondle me-when he picked me up after school.My parents will be upset if they find out.They'll blame me because I like it when he tickles me." Which communication by the nurse would be the most therapeutic?

A) "You feel your parents will blame you rather than your uncle?"
B) "I'd like for you to tell me more specifically what your uncle did to you."
C) "Don't be afraid; I'll be there to talk to your parents about what your uncle did."
D) "I'm sure your parents will believe you; they know you wouldn't lie about this."

Question 10

Nursing care for a child with attention-deficit/hyperactivity disorder (ADHD) usually includes which therapeutic component?

A) Foster care
B) Institutionalization
C) Stimulant drug therapy
D) Cognitive processing games

Question 11

What outcome would be most appropriate for the plan of care for a 7-year-old child with a diagnosis of conduct disorder?

A) Parents will demonstrate effective parenting skills, thus minimizing conflicts with their child.
B) The child will be capable of successfully accomplishing the academic work appropriate of a first grader.
C) Parents will institute verbal reprimands as a primary form of consequence for their child's misbehavior.
D) The child will verbalize the pathology of his condition within 6 weeks of beginning behavioral modification therapy.

Question 12

A group of 10-year-old children are playing a board game.Which of these patient outcomes would the nurse evaluate as evidence of a favorable response to the frustration of losing?

A) The child congratulates the winner.
B) The child walks away to read a book.
C) The child invites another child to join.
D) The child wants an immediate rematch.

Question 13

When a 14-year-old child reports feeling "like I just want to blow that person's head off," the school nurse's initial reaction is to:

A) report the statement to parents, police, and school authorities.
B) say to the child, "Tell me what you mean when you say that."
C) restate, "You're feeling really angry with this person right now, aren't you?"
D) confer with other staff by asking, "What do you think the child meant by that?"

Question 14

Which medication would the nurse expect to include in a care plan for an adolescent with a history of conduct disorder and violent behaviors?

A) Antianxiety agents
B) Antipsychotic medications
C) Antihistamine medications
D) Antidepressant medications

Question 15

The parents of a 7-year-old child recently adopted from another country report that their child has frequent headaches,a poor appetite,and isn't doing well in school.The nurse should initially:

A) draw a family genogram.
B) talk with the child about the symptoms.
C) hold an intervention that includes all involved parties.
D) perform a culturally congruent comprehensive assessment.

Question 16

When assisting a child to learn to express personal feelings verbally without hurting a playmate's feeling,the nurse encourages the child to first:

A) play with imaginary friends.
B) play the role of the other child.
C) avoid competitive games like baseball.
D) use nonverbal mannerisms like frowning.

Question 17

A parent complains that his child "won't tie her shoes even though she's capable of doing it." Which response by a nurse is most therapeutic?

A) "Why is it so important to you that she tie her shoes?"
B) "What have you done to try to encourage her to tie her shoes?"
C) "Let your daughter go with her shoes untied. Don't you think she will soon tire of tripping over her shoelaces?"
D) "It sounds as if your daughter is seeking attention. How much quality time do you typically spend with her each day?"

Question 18

When attempting to modify unacceptable behaviors exhibited by an aggressive and self-destructive child,which nursing intervention would be most therapeutic while being the least restrictive?

A) Informing the child that physical restraints will be used to remodel behavior
B) Requiring the child to interact only with staff when unable to behave
C) Encouraging the child to engage in only low-stimulation activities
D) Secluding the patient with a time-out for inappropriate behavior

Question 19

Which response by a nurse is most therapeutic in response to parents who are concerned that their child has been drawing sexually explicit pictures?

A) "Are you sure your child fully understood what it was that was being drawn?"
B) "What did your child say when asked about why the drawings were made?"
C) "Most children experiment with this type of behavior at a certain age."
D) "I will need your permission to speak directly with your child."

Question 20

A child has a history of anxiety disorder.Which statement by the child supports this diagnosis?

A) "I don't need to go to school like some other kids.
B) "School is really boring so I don't like to go there."
C) "My stomach aches in the morning so I can't go to school."
D) "My parents can't make me go to school if I don't want to."

Question 21

Which characteristic best indicates that a child has many resiliency factors?

A) The ability to throw a ball farther than most other children on the team
B) A healthy relationship with a "Big Brothers" volunteer despite having an abusive parent
C) The ability to win writing awards in school despite a diagnosis of attention-deficit/hyperactivity disorder (ADHD)
D) A history of physical abuse by a parent and recent placement in a supportive foster home

Question 22

Which statement by a child best indicates the child may be experiencing symptoms of depression?

A) "I don't like to play outside. Besides, I've got so much homework and my parents expect me to be a good student."
B) "I have some friends at school but there's no one my age who lives in my neighborhood. I watch television and play with my video games."
C) "I've got some friends, but they are older than me. Sometimes we play together but not all the time since they want to do things I'm not old enough to do."
D) "I don't know; I don't think about school much. It's just a place I have to go every day. I guess it's alright. Some of the kids are nice, and I like the food."

Question 23

Which child should be assessed for attention-deficit/hyperactivity disorder (ADHD)?

A) A second-grade child reads at a first-grade level. The child cries when left by a parent but loves to run races in the schoolyard at recess.
B) A fourth-grade child loves to daydream during class and regularly entertains the class with original stories. The child does not enjoy reading.
C) A third-grade child is on detention for the third time this month and is considered the class clown. The child often volunteers to read aloud.
D) A second-grade child is withdrawn and plays alone most school days. The child can read a third-grade storybook.

Question 24

A nurse is meeting with an adolescent who appears to be better able to cope with anxiety because of compliance with the treatment plan.Which statement by the adolescent confirms that belief?"

A) "I went to the school dance last week. I didn't dance, but I didn't leave either. I stayed until the end. Next time I'm going to try to talk with some of the kids."
B) "I went to the ball game last week with my friend. We met a couple of other people from school that were there. It was fun, and I really enjoyed myself."
C) "I wish the other kids in my school would include me in their game of basketball. I would play if I could."
D) "I'm going to call one of the kids in my class next week so we can play ball or something."

Question 25

A nurse is working with primary school-age children diagnosed with psychiatric disorders.To most therapeutically address low self-esteem issues the nurse should:

A) give positive feedback for small goal accomplishment.
B) reward all acceptable behavior with positive feedback.
C) set major goals so that they can strive for accomplishments.
D) encourage active participation in a peer self-esteem self-help group.