Question 1

The mother of a school-age child is distraught over the ongoing oppositional behavior demonstrated by the child at home and at school. Which nursing diagnosis should the nurse select as appropriate for the child and family at this time?

A) Risk for self-directed violence related to impulsivity
B) Situational low self-esteem related to lack of successful coping strategies
C) Impaired social interaction related to short attention span and distractibility
D) Interrupted family processes related to inability of child to follow instructions

Interrupted family processes related to inability of child to follow instructions

Accepted Answer

Oppositional defiant disorders consist of long-term hostile, negativistic, or defiant behaviors that result in disturbed functioning in academic and social domains. Children typically have difficulty controlling their temper; such anger is often directed at an authority figure. The disorder develops most frequently in late preschool or early school age. The diagnosis most appropriate for this child and parent is interrupted family processes. There is no evidence to suggest that the child is at risk for self-directed violence, low self-esteem, or impaired social interaction.

Question 2

An extremely thin preadolescent is being assessed by the nurse. Which patient statement should the nurse identify as being consistent with that of a person with anorexia nervosa?&#10;A) &#34;I'd like to grow up to be a model.&#34;&#10;B) &#34;I'd like to gain weight but just can't.&#34;&#10;C) &#34;I feel chubby no matter what I wear.&#34;&#10;D) &#34;I'm afraid that someone is poisoning my food.&#34;

Accepted Answer

Characteristics of a child with anorexia nervosa include a severely distorted body image with an intense fear of gaining weight or becoming fat. The goal to be a model is not consistent with that of anorexia nervosa. The inability to gain weight is not a characteristic of anorexia nervosa. The fear of food being poisoned is a characteristic of paranoid behavior.

Question 3

The community health nurse is working with the school district to provide an educational program on the 2020 National Health Goals to address cognitive and mental health disorders in children. Which topics should the nurse emphasize in this program? (Select all that apply.)

A) Stress-reduction techniques
B) Manifestations of stress in children
C) Recognizing depression in children
D) Strategies for oppositional behavior
E) Nutrition and adequate weight gain

Stress-reduction techniques
Manifestations of stress in children
Recognizing depression in children
Nutrition and adequate weight gain

Accepted Answer

Nurses can help the nation achieve the 2020 National Health Goals to address cognitive and mental health disorders in children by educating parents about nutrition and inadequate weight gain; educating families about ways to reduce stress; and identifying children in school and health care settings who demonstrate a high level of stress, depression, or other symptoms of mental illness.

Question 4

The nurse is caring for a 6-month-old infant who is diagnosed with rumination disorder. For which additional health problems should the nurse plan to assess this patient?&#10;A) Cardiac disorders&#10;B) Respiratory problems&#10;C) Cognitive development&#10;D) Urinary tract malformation

Accepted Answer

A rumination disorder is the act of regurgitating and then reswallowing previously digested food. Even though it is rare, it usually affects infants between the ages of 3 and 12 months and is seen most often in children who are cognitively challenged.
Rumination disorder is not associated with cardiac, respiratory, or urinary tract problems.

Question 5

The nurse is preparing teaching materials for the parents of a child with encopresis. What information should the nurse emphasize during this teaching?&#10;A) Not punishing the child for the condition&#10;B) Necessity for giving 4 to 6 tablespoons of Kaopectate per day&#10;C) Need for keeping the child close to bathroom facilities at all times&#10;D) Importance of cleaning the child immediately after an accident occurs

Accepted Answer

Encopresis is the inappropriate passage of stool in places not culturally appropriate for that purpose. Parents should not punish the child for encopresis but rather to pay as little attention as possible to bowel accidents and to give praise for days when encopresis does not occur. The child does not need Kaopectate every day. The child does not need to be close to bathroom facilities at all times. The child does not experience diarrhea soiling after accidents would not be of a high priority for teaching.

Question 6

The mother of an 11-month-old infant is concerned that the child is developing autism because the child likes to rock on the hands and knees in the crib before going to sleep. What should the nurse respond to this mother's concern?

A) "Rocking means the child is hungry."
B) "Rocking is abnormal behavior associated with autism."
C) "Rocking can be seen as a form of self-stimulation."
D) "Be sure to pad the crib so the child does not hurt the head while rocking."

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Accepted Answer

Rocking is hypothesized as being a form of self-stimulation. The child with autism will engage in constant body rocking. Because the child likes to perform body rocking before going to sleep and not constantly, it is more likely being used by the child as a form of self-stimulation. Rocking does not mean that the child is hungry. Rocking is not only seen in autism. The mother did not express concern that the child is banging the head on the crib while rocking so padding the crib might not be appropriate at this time.

Question 7

The nurse is planning educational materials to help the parents care for a cognitively challenged child at home. What should the nurse include in this teaching? (Select all that apply.)&#10;A) Provide generous praise.&#10;B) Reduce environmental stimulation.&#10;C) Scold for not learning abstract concepts.&#10;D) Break a large task down into smaller steps.&#10;E) Demonstrate the skill that the child is to perform.

Accepted Answer

Guidelines for teaching the cognitively challenged child include providing generous praise, reducing environmental stimulation, breaking a task down into smaller steps, and demonstrating the skill to be performed. Cognitively challenged children may have difficulty with learning abstract concepts and should not be scolded.

Question 8

The community nurse is visiting a family with a mildly cognitively challenged child at home. Which observation indicates that the family is adjusting to this child's learning capacity?&#10;A) Older sibling teases the child and uses the term &#34;dummy.&#34;&#10;B) Father tells the child to play with a toy while the adults talk.&#10;C) Parents support and engage the child in family conversation.&#10;D) Mother tells the child to stop making a mess on the kitchen table.

Accepted Answer

About 85% of children who are cognitively challenged have an IQ of 50 to 70 and may be referred to as "educable" by a school system. During early years, these children learn social and communication skills and are often not too distinguishable from average infants or toddlers. The parent's behavior of supporting and engaging the child in family conversation indicates that the family is adjusting to the child's learning capacity.
Teasing the child and calling names indicates intolerance of the child's learning capacity. Telling the child to play while the adults talk or scolding for making a mess indicate that the family is not adjusting to the child's learning capacity.

Question 9

The nurse suspects that a child is demonstrating signs of attention deficit hyperactivity disorder (ADHD). What behavior did the nurse most likely assess in this child?&#10;A) Unrealistic fears&#10;B) A lack of concentration&#10;C) Persistent disobedience&#10;D) A lack of affection for others

Accepted Answer

Attention deficit hyperactivity disorder (ADHD) is characterized by three major behaviors: inattention, impulsiveness, and hyperactivity. Inattention or a lack of concentration makes children become easily distracted and often may not seem to listen or complete tasks effectively. Unrealistic fears, persistent disobedience, and a lack of affection for others are not characteristics of ADHD.

Question 10

A child with attention deficit hyperactivity disorder (ADHD) is prescribed methylphenidate hydrochloride (Ritalin). What should the nurse instruct the parents regarding an adverse effect of this medication?

A) Anorexia
B) Sleepiness
C) Garbled speech
D) Rapid increase in height

Accepted Answer

An adverse effect of methylphenidate hydrochloride (Ritalin) is anorexia. Sleepiness and garbled speech are not adverse effects of this medication. Children taking this medication can develop growth suppression and not accelerated growth in height.

Question 11

For which child's behavior should the nurse identify as having characteristics of separation anxiety disorder?&#10;A) An 8-month-old who cries when left with strangers&#10;B) A 7-year-old who withdraws from contact with all strangers&#10;C) An 8-year-old who will not stay overnight at a friend's house&#10;D) A 10-year-old who complains of headaches if he has a test in school

Accepted Answer

The answer of For which child's behavior should the nurse...

Question 12

The nurse is caring for a 12-month-old child diagnosed with autistic disorder. What information from the mother during the health history should the nurse identify as being consistent with the health problem?

A) The child speaks in complete sentences.
B) The child sleeps at least 12 out of every 24 hours.
C) The child responds warmly to the father but not to the mother.
D) The child constantly stares at a rotating wheel on the crib mobile.

Accepted Answer

The answer of The nurse is caring for a 12-month-old...

Question 13

After an assessment, the nurse believes that a school-age child is at risk for developing a mental health disorder. Which assessment data will the nurse use to plan the care for this child? (Select all that apply.)

A) Parents recently divorced
B) Father unemployed and mother not always home
C) Learning to play the clarinet in music class in school
D) Expected to care for younger siblings while mother sleeps
E) History of multiple injuries obtained from a motor vehicle crash

Accepted Answer

The answer of After an assessment, the nurse believes that...

Question 14

A school-age child is admitted to the mental health unit with the diagnosis of schizophrenia. What manifestations of this disorder should the nurse recognize when assessing this patient? (Select all that apply.)

A) Paranoia
B) Quiet but responsive
C) Talking about suicide
D) Illogical speech pattern
E) Auditory hallucinations

Accepted Answer

The answer of A school-age child is admitted to the...

Question 15

The nurse suspects that a school-age child has Tourette syndrome. What did the nurse most likely assess in this patient?&#10;A) Flat affect&#10;B) Shouting obscenities&#10;C) Playing quietly alone&#10;D) Running wildly in circles

Accepted Answer

The answer of The nurse suspects that a school-age child...

Deck 54: Nursing Care of a Family When a Child Has an Intellectual or Mental Health Disorder