Question 1

A child has been diagnosed with autism spectrum disorder (ASD). The distraught mother cries out, &#34;I'm such a terrible mother. What did I do to cause this?&#34; Which nursing reply is most appropriate?&#10;A) &#34;Researchers really don't know what causes autistic disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored.&#34;&#10;B) &#34;Poor parenting doesn't cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control.&#34;&#10;C) &#34;Research has shown that the mother appears to play a greater role in the development of this disorder than does the father.&#34;&#10;D) &#34;Lack of early infant bonding with the mother has shown to be a cause of autistic disorder. Did you breastfeed or bottle feed?&#34;&#10;

Accepted Answer

1.This is incorrect. There is not a relationship between ASD and fetal alcohol syndrome.
2.This is correct. ASD is believed to be caused by abnormalities in brain structure and/or function, not poor parenting. ASD occurs in approximately 6 per 1000 children and is about four times more likely to occur in boys.
3.This is incorrect. Although maternal infection can play a role in ASD, there is no evidence that the mother causes ASD and not the father.
4.This is incorrect. There is no correlation between bottle-feeding or breastfeeding leading to ASD.

Question 2

The nurse is caring for a client who blinks when the nurse asks a question and coughs when the nurse looks at him. Which condition does the nurse suspect?&#10;A) Oppositional defiant disorder (ODD)&#10;B) ASD&#10;C) Tourette's disorder&#10;D) Conduct disorder&#10;

Accepted Answer

1.This is incorrect. A child with ODD does not exhibit vocal or motor tics.
2.This is incorrect. A child with ASD does not exhibit vocal or motor tics.
3.This is correct. The blinking is an example of a motor tic, and the coughing is a type of vocal tic, both of which are exhibited by individuals with Tourette's disorder.
4.This is incorrect. Vocal and motor tics are not exhibited by individuals with conduct disorder.

Question 3

An adolescent client who was diagnosed with conduct disorder at the age of 8 years is sentenced to juvenile detention after bringing a gun to school. Which statement indicates the nurse's understanding of conduct disorder related to this client's situation?

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 years; 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 ODD.

Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.

Accepted Answer

1.This is correct. Childhood-onset conduct disorder is more severe than the adolescent-onset type. These individuals are likely to develop antisocial personality disorder in adulthood. Individuals with this subtype are usually boys, frequently display physical aggression, and have disturbed peer relationships.
2.This is incorrect. Conduct disorder is related to temperament but can lead to more serious disorders into adulthood if not treated.
3.This is incorrect. Childhood-onset conduct disorder is diagnosed prior to age 10 years.
4.This is incorrect. Untreated ODD typically develops into conduct disorder. Individuals with both ODD and conduct disorder can seek treatment.

Question 4

The nurse is assessing a 14-year-old client who is receiving aripiprazole. Which side effect would be of most concern to the nurse?&#10;A) Dizziness&#10;B) Headache&#10;C) Nausea&#10;D) Tremor&#10;

Accepted Answer

1.This is incorrect. Dizziness is a common side effect of aripiprazole.
2.This is incorrect. Headache is a common side effect of aripiprazole.
3.This is incorrect. Nausea is a common side effect of aripiprazole.
4.This is correct. The nurse would be concerned if the client experienced tremor. This could be indicative of extrapyramidal disorder, and the client may need to stop taking the medications.

Question 5

The nurse is visiting with a child with suspected ADHD. Which statement by the parent supports the nurse's suspicion?&#10;A) &#34;My child has been doing poorly in his schoolwork because he can't stay in his seat.&#34;&#10;B) &#34;My son never takes responsibility for his actions. It is always someone else's fault.&#34;&#10;C) &#34;My daughter told me she saw my son kick our neighbor's dog.&#34;&#10;D) &#34;I wish I could get my son to eat other foods. All he will eat are chips because they are crunchy.&#34;&#10;

Accepted Answer

1.This is correct. This statement describes the difficulty associated with completing schoolwork and struggling to stay in one's seat associated with ADHD.
2.This is incorrect. Deflecting blame on another describes ODD.
3.This is incorrect. Intentional cruelty to animals describes conduct disorder.
4.This is incorrect. A child who only eats certain textures likely has a diagnosis of ASD.

Question 6

Sophie is 11 years old and has a diagnosis of ADHD. Her parents report and provide documentation from her teachers that Sophie is distracted easily and is unable to complete classroom activities, even in the presence of minimal stimulation. A nursing diagnosis of noncompliance with task expectations has been determined, with a short-term goal that Sophie will participate in and cooperate during therapeutic activities. Which nursing intervention is most appropriate?

A) Establish goals that allow Sophie to complete part of the task, rewarding each step completion with a break for physical activity.
B) Ask Sophie to repeat instructions to you.
C) Provide assistance on a one-to-one basis, beginning with simple, concrete instructions.
D) Provide an environment for task efforts that is as free of distractions as possible.

Accepted Answer

1.This is incorrect. Giving breaks as a reward is a long-term goal.
2.This is incorrect. Repeating instructions is a long-term goal.
3.This is incorrect. This is an example of a long-term goal.
4.This is correct. A distraction-free environment is essential for successful task efforts with this client.

Question 7

The nurse is caring for a 16-year-old client with ASD who is receiving risperidone for agitation. For which effects would the nurse monitor the client? Select all that apply.&#10;A) Signs of bruising&#10;B) Improved mood&#10;C) Weight gain of 20 lb in 1 month&#10;D) Elevated blood glucose level&#10;E) Uncontrolled jaw movements&#10;

Accepted Answer

1.This is incorrect. Risperidone does not cause bruising or bleeding.
2.This is incorrect. The therapeutic effect of risperidone is improved mood.
3.This is correct. A dramatic increase in weight should be reported.
4.This is correct. Hyperglycemia is an adverse effect of risperidone.
5.This is correct. Uncontrolled jaw movements could be indicative of an extrapyramidal symptom and should be reported to the health-care provider.

Deck 16: Children and Adolescents