Question 1

A nurse is assessing a child with a depressive disorder. Which symptom is likely to be manifested by the child?&#10;A) Increased nighttime waking&#10;B) Impulsivity and distractibility&#10;C) Carelessness and inattention to details&#10;D) Refusal to leave the house

Accepted Answer

Sleep pattern disturbances are often associated with depression. These include insomnia or hypersomnia. Impulsivity and distractibility are manifestations of attention-deficit hyperactivity disorder (ADHD). A diminished ability to think or concentrate, carelessness, and inattention to details are clinical manifestations of a depressive disorder. A refusal to leave the house, even to play with friends, is characteristic of separation anxiety disorder.

Question 2

A nurse is teaching parents about symptoms associated with suicide. Which statement about suicide should the nurse include in the teaching plan?&#10;A) Children younger than 10 years of age do not attempt suicide.&#10;B) A child who attempts suicide is usually depressed and has low self-esteem.&#10;C) Suicide is usually an isolated event in a school community.&#10;D) The suicide rate among females is higher than among males.

Accepted Answer

Poor self-concept and depression contribute significantly to suicidal behaviors. Children as young as 3 years of age who have attempted suicide have been evaluated and found to be
 cognizant of their actions. It is common for suicide to occur in a cluster within a community (e.g., schools). Males have a higher incidence of both suicide attempts and completed suicides.

Question 3

A nurse is teaching parents about family relationship patterns associated with eating disorders. Which family relationship pattern should the nurse teach that is consistent for an adolescent female diagnosed with an eating disorder?

A) The adolescent is viewed as an extension of the parent.
B) There is an overprotective mother and an emotionally distant father.
C) The mother is domineering and the father is passive.
D) The adolescent is the youngest child or is an only child.

The adolescent is viewed as an extension of the parent.

Accepted Answer

One of the most salient factors associated with eating disorders is enmeshed family relationships in which the child is considered to be an extension of the parent or is viewed as a means of meeting the parents needs. The family dynamics for males with anorexia are reported to include a mother who is overinvolved with the child and a father who typifies a strong, cultural image. A domineering mother and passive father are not characteristic of the family dynamics associated with eating disorders. Birth order and number of children in the family were not identified as factors in enmeshed family relationships.

Question 4

A parent of a child with a psychosocial disorder states, I dont know how my child developed this problem. The nurse should base a response on which information?&#10;A) Neurobiological, family, and sociocultural factors can contribute to the development of psychosocial disorders in children.&#10;B) Like many conditions affecting children, the etiology of psychosocial disorders is unknown.&#10;C) The majority of psychosocial disorders have a clear pattern of genetic inheritance.&#10;D) Dysfunctional family patterns are usually identified as the cause of a psychosocial disorder.

Accepted Answer

Psychosocial disorders are responses to stress and may be manifested as disturbances in feeling, body functions, behavior, or performance. The etiology of many psychosocial disorders in children can be identified. Some psychosocial disorders are inheritable disorders. Others have been identified as having a familial predisposition. Research consistently shows that psychosocial disorders are caused by a combination of predisposing or inherent factors and environmental or interactional factors.

Question 5

A nurse is caring for a child admitted for substance abuse. The nurse plans care with the recognition that substance abuse primarily affects which organ of the body?&#10;A) Heart&#10;B) Liver&#10;C) Brain&#10;D) Lungs

Accepted Answer

The primary affect of substance abuse is on the brain and residually on the rest of the body. Although an excessive amount of a chemical can cause cardiac abnormalities, the brain is the most commonly affected organ. Long-term alcohol use is known to impair the liver; however, brain function is decreased by any amount of alcohol intake. The pulmonary system is not the primary target; however, one commonly abused drug known to cause pulmonary problems is tobacco.

Question 6

Which should be the most appropriate nursing intervention for the infant who is not gaining weight?&#10;A) Instruct the primary caregiver on proper feeding techniques.&#10;B) Observe and document the parentinfant interaction.&#10;C) Assign different nurses to care for the infant.&#10;D) Feed the infant on a predetermined schedule.

Accepted Answer

Observation and documentation of the parentinfant interaction may offer insight into the cause of malnutrition. Instruction alone is not the best teaching strategy. Role modeling and supervised practice along with parental instruction will facilitate the parents learning to feed the infant. A consistent caregiver will facilitate trust in the infant. The infants caloric intake is increased by feeding the infant on demand rather than on a schedule.

Question 7

Which statement made by a parent of a toddler who is not gaining weight indicates the need for education about feeding small children?&#10;A) He doesnt want to eat, so I put the cereal in his bottle.&#10;B) I put him in a high chair for meals and snacks.&#10;C) I turn off the television and we eat together for every meal.&#10;D) I try to feed him at the same times every day.

Accepted Answer

Large quantities of cereal or baby food in bottles do not provide sufficient nutritional intake for the small child. The young child should be placed in a high chair for feeding. Distraction during feedings, such as watching television, is identified as a reason for inadequate nutritional intake in young children. Having the parents or others eat with the child makes meals and snacks a pleasant time. A regular pattern or schedule for meals facilitates nutritional intake.

Question 8

Which intervention should the nurse teach parents about caring for an infant experiencing drug withdrawal?&#10;A) Keep rooms in the home well lighted.&#10;B) Play music or the television continuously.&#10;C) Organize care to minimize disruptions.&#10;D) Let the infant calm himself if irritable.

Accepted Answer

The infants care should be coordinated to limit the number of times the infant is disturbed. Light levels should be maintained at the minimum necessary level. Sound levels should be kept to the
 minimum necessary level. Comfort measures should be provided immediately when the infant exhibits irritability.

Question 9

A nurse is caring for an infant with neonatal abstinence syndrome. Which manifestation should the nurse expect to assess?&#10;A) Weight gain&#10;B) Respiratory acidosis&#10;C) High-pitched persistent cry&#10;D) Hypotonus

Accepted Answer

A high-pitched persistent cry is one of the many manifestations of infant drug withdrawal. The infant undergoing drug withdrawal may lose weight or fail to gain weight. Respiratory alkalosis and respiratory distress are manifestations of withdrawal. An infant undergoing drug withdrawal would have hypertonus, hyperreflexia, and hyperactivity.

Question 10

A nurse is assessing a child with attention-deficit hyperactivity disorder (ADHD). Which manifestation should the nurse not expect to assess?&#10;A) Talking incessantly&#10;B) Blurting out the answers to questions before the questions have been completed&#10;C) Acting withdrawn in social situations&#10;D) Fidgeting with hands or feet

Accepted Answer

The child with ADHD tends to be talkative, often interrupting conversations, rather than withdrawn in social situations. Talking excessively is a characteristic of impulsivity/hyperactivity. Blurting out the answers to questions before the questions have been completed is an indication of the impulse control that is often lacking in children with ADHD. The child with ADHD tends to be talkative, often interrupting conversations, rather than withdrawn in social situations.

Deck 3: Abuse in the Family and Community