Deck 50: Nursing Care of the Child With an Alteration in Behavior, Cognition, or Development

Question 1

The nurse is caring for an adolescent girl with anorexia nervosa. Which of the following findings would indicate to the nurse that the girl requires hospitalization?

A) Weight gain of one-half pound per week
B) Food refusal
C) Body mass index of 18
D) Soft, sparse body hair and dry, sallow skin

Answer 1

Food refusal

Question 2

The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which of the following?

A) Generalized anxiety disorder
B) Posttraumatic stress disorder
C) Social phobia
D) Obsessive-compulsive disorder

Answer 2

Obsessive-compulsive disorder

Question 3

The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions?

A) Depression
B) Anxiety disorder
C) Attention deficit/hyperactivity disorder
D) Asperger syndrome

Answer 3

Attention deficit/hyperactivity disorder

Question 4

A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. Which of the following would be most important for the nurse to do first?

A) Set clear limits on the child's behavior
B) Teach the child problem-solving skills
C) Encourage a discussion of the child's thoughts and feelings
D) Role model appropriate social and conversation skills

Question 5

The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability?

A) "He is not speaking in complete sentences."
B) "We can understand a lot of what he says, but no one else can."
C) "He seems to be speaking words less and less frequently."
D) "He is unable to sit still for a short story."

Question 6

A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist specializing in which type of therapy?

A) Individual therapy
B) Play therapy
C) Behavioral therapy
D) Hypnosis

Question 7

The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder?

A) "He has frequent temper tantrums."
B) "He was pulling the neighbor's dog around by his leash."
C) "He is constantly lying to me."
D) "He has stolen hundreds of dollars from my purse."

Question 8

The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which of the following?

A) Anxiety disorder
B) Sensory integration dysfunction
C) Depression
D) Obsessive-compulsive disorder

Question 9

The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate?

A) "You might see excessive urination and thirst, tremor, nausea, weight gain, and diarrhea."
B) "He might experience a significant decrease in his appetite and difficulty sleeping."
C) "You need to watch for dry mouth, urinary retention, and constipation."
D) "This medication can cause seizures, agitation, headache, and nausea."

Question 10

A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. Which of the following would the nurse include when teaching the child and his parents about this drug?

A) "Give the drug three times a day: morning, midday, and after school."
B) "This drug may cause drowsiness, so be careful when doing things."
C) "Some increase in appetite may occur, so watch how much you eat."
D) "Take this drug every day in the morning when you wake up."

Question 11

When reviewing the medical record of a child, which of the following would the nurse interpret as the most sensitive indicator of intellectual disability?

A) History of seizures
B) Preterm birth
C) Vision deficit
D) Language delay

Question 12

A school-age child diagnosed with depression is receiving antidepressant therapy. The nurse would instruct the parents to notify the physician immediately if the child demonstrates which of the following?

A) Loss of interest
B) Gastric upset
C) Sedation
D) Urinary retention

Question 13

A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which of the following as an indicator of possible child abuse?

A) Consistent delays in seeking treatment for the child's injuries
B) Frequent changes in history information with visits
C) Injuries that are inconsistent with the reported traumatic event
D) Sexual behavior that correlates with the child's developmental age

Question 14

Which of the following would lead the nurse to suspect that an adolescent has bulimia?

A) Body mass index less than 17
B) Calluses on back of knuckles
C) Nail pitting
D) Bradycardia

Question 15

A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs?

A) Atypical antidepressant
B) Tricyclic antidepressant
C) Selective serotonin reuptake inhibitor
D) Psychostimulant

Question 16

A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy?

A) Cognitive therapy
B) Behavioral therapy
C) Milieu therapy
D) Individual therapy

Question 17

A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. Which of the following would the nurse be least likely to include?

A) Focus the child's attention on the negative behavior.
B) Set limits with the child for responsible behavior.
C) Ignore inappropriate behaviors.
D) Provide positive feedback for self-control efforts.

Question 18

The nurse is reviewing the medical record of a child who has dyspraxia. The nurse understands that this child experiences difficulty with which of the following?

A) Reading and writing
B) Mathematics and computation
C) Manual dexterity and coordination
D) Composition and spelling

Question 19

A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign?

A) Lack of babbling by 6 months
B) Inability to say a single word by 16 months
C) Lack of gestures by 8 months
D) Inability to use two words by 18 months

Question 20

A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply.

A) Allowing for breaks when tics occur
B) Providing for "time-outs" during the day
C) Using a tape recorder to take notes
D) Ensuring a specified amount of time for test taking
E) Implementing a reward system for behavior

Question 21

After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state which of the following?

A) "If he starts to act out, we'll have him do a time-out to help him refocus."
B) "We can use a reward system when he behaves appropriately."
C) "If he misbehaves, we need to punish him instead of reward him."
D) "We need to help him set realistic goals that he can achieve."

Question 22

A nurse is reviewing the medical record of an 11-year-old child with a conduct disorder. Which of the following would the nurse identify as characteristic of this disorder? Select all answers that apply.

A) Easily annoyed
B) Initiator of physical fights
C) Temper tantrums
D) Truancy
E) Arrest for arson

Question 23

The nurse identifies a nursing diagnosis of impaired social interaction related to altered social skills as evidenced by impulsivity and intrusive behavior. The nurse plans to identify factors that aggravate the child's behavior for which reason?

A) Minimize stimuli that exacerbate the child's undesired behaviors
B) Improve the child's ability to deal with external stressors
C) Promote increased ability to follow through
D) Encourage the child to adopt expectations into his routine

Question 24

A child is prescribed trazodone. Which of the following would the nurse be least likely to include in the plan of care related to this drug?

A) Monitoring blood pressure for orthostatic hypotension
B) Assessing the child for sedation and drowsiness
C) Administering the drug with a snack
D) Monitoring for tardive dyskinesia