Deck 23: Children and Adolescents

Question 1

A mother questions the decreased effectiveness of methylphenidate (Ritalin) prescribed for her child's ADHD. Which nursing response best addresses the mother's concern?

A) "The health-care provider will probably switch from Ritalin to a central nervous system stimulant."
B) "The health-care provider may prescribe an antihistamine with the Ritalin to improve effectiveness."
C) "Your child has probably developed a tolerance to Ritalin and may need a higher dosage."
D) "Your child has developed sensitivity to Ritalin and may be exhibiting an allergy."

Answer 1

"Your child has probably developed a tolerance to Ritalin and may need a higher dosage."

Question 2

Which student statement indicates that further instruction is needed regarding developmental characteristics of individuals with moderate IDD?

A) "These clients can work in a sheltered workshop setting."
B) "These clients can perform some personal care activities."
C) "These clients may have difficulties relating to peers."
D) "These clients can successfully complete elementary school."

Answer 2

"These clients can successfully complete elementary school."

Question 3

A nursing instructor presents a case study in which a three-year-old child is in constant motion and is unable to sit still during story time. She asks a student to evaluate this child's behavior. Which student response indicates an appropriate evaluation of the situation?

A) "This child's behavior must be evaluated according to developmental norms."
B) "This child has symptoms of attention deficit/hyperactivity disorder."
C) "This child has symptoms of the early stages of autism spectrum disorder."
D) "This child's behavior indicates possible symptoms of oppositional defiant disorder."

Answer 3

"This child's behavior must be evaluated according to developmental norms."

Question 4

Which would the nurse identify as risk factors related to family dynamics for predisposition to a conduct disorder?

A) Stable residence
B) Consistency in discipline
C) Excessive supervision
D) Economic stressors

Question 5

In planning care for a child diagnosed with autism spectrum disorder, which would be a realistic client outcome?

A) The client will communicate all needs verbally by discharge.
B) The client will participate with peers in a team sport by day four.
C) The client will establish trust with at least one caregiver by day five.
D) The client will perform most self-care tasks independently.

Question 6

Which nursing intervention related to self-care would be most appropriate for a child diagnosed with moderate IDD?

A) Meeting all of the client's self-care needs to avoid injury to the client
B) Providing simple directions and praising client's independent self-care efforts
C) Avoid interfering with the client's self-care efforts in order to promote autonomy
D) Encouraging family to meet the client's self-care needs to promote bonding

Question 7

Which finding would a nurse expect when assessing a child diagnosed with separation anxiety disorder?

A) The child has a history of antisocial behaviors.
B) The child's mother was stressed during the pregnancy.
C) The child previously had an extroverted temperament.
D) The child's mother and father have an inconsistent parenting style.

Question 8

When planning care for a client, which medication classification would a nurse recognize as effective in the treatment of Tourette's syndrome?

A) Antipsychotic medications
B) Antimanic medications
C) Tricyclic antidepressant medications
D) Monoamine oxidase inhibitor medications

Question 9

A child has been diagnosed with autism spectrum disorder. The distraught mother cries out, "I'm such a terrible mother. What did I do to cause this?" Which nursing response is most appropriate?

A) "Researchers really don't know what causes autism spectrum disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored."
B) "Poor parenting doesn't cause autism spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control."
C) "Research has shown that the mother appears to play a greater role in the development of autism spectrum disorder than the father."
D) "Lack of early infant bonding with the mother has shown to be a cause of autism spectrum disorder. Did you breastfeed or bottle-feed?"

Question 10

After an adolescent diagnosed with attention deficit/hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. Which is the best explanation for this weight loss?

A) The pharmacological action of Ritalin causes a decrease in appetite.
B) Hyperactivity seen in ADHD causes increased caloric expenditure.
C) Side effects of Ritalin cause nausea, and, therefore, caloric intake is decreased.
D) Increased ability to concentrate allows the client to focus on activities rather than food.

Question 11

Which developmental characteristic would a nurse identify as typical of a client diagnosed with severe intellectual developmental disorder (IDD)?

A) The client can perform some self-care activities independently.
B) The client has more advanced speech development.
C) Other than possible coordination problems, the client's psychomotor skills are not affected.
D) The client communicates wants and needs by "acting out" behaviors.

Question 12

Which would be the priority nursing intervention when caring for a child diagnosed with conduct disorder?

A) Modify environment to decrease stimulation and provide opportunities for quiet reflection.
B) Convey unconditional acceptance and positive regard.
C) Recognize escalating aggressive behavior and intervene before violence occurs.
D) Provide immediate positive feedback for appropriate behaviors.

Question 13

A nurse assesses an adolescent client diagnosed with conduct disorder who, at the age of 8, was sentenced to juvenile detention. How would the nurse interpret this assessment data?

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, and, 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 oppositional defiant disorder.

Question 14

A preschool child is admitted to a psychiatric unit with a diagnosis of autism spectrum disorder. To help the child feel more secure on the unit, which intervention would a nurse include in this client's plan of care?

A) Encourage and reward peer contact.
B) Provide consistent caregivers.
C) Provide a variety of safe daily activities.
D) Maintain close physical contact throughout the day.

Question 15

A preschool child diagnosed with autism spectrum disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate?

A) Place client in restraints until the aggression subsides.
B) Sedate the client with antipsychotic medications.
C) Hold the client's head steady and apply a helmet.
D) Distract the client with a variety of games and puzzles.

Question 16

Which of the following risk factors, if noted during a family history assessment, would a nurse associate with the development of IDD? (Select all that apply.)

A) A family history of Tay-Sachs disease
B) Childhood meningococcal infection
C) Deprivation of nurturance and social contact
D) A diagnosis of maternal major depressive disorder

Question 17

Which information about mild IDD would the nurse include when teaching the child's mother?

A) Children with mild IDD need constant supervision.
B) Children with mild IDD develop academic skills up to a sixth-grade level.
C) Children with mild IDD appear different from their peers.
D) Children with mild IDD have significant sensory-motor impairment.

Question 18

A child diagnosed with severe autism spectrum disorder has the nursing diagnosis disturbed personal identity. Which outcome would best address this client diagnosis?

A) The client will name own body parts as separate from others by day five.
B) The client will establish a means of communicating personal needs by discharge.
C) The client will initiate social interactions with caregivers by day four.
D) The client will not harm self or others by discharge.

Question 19

A client has an IQ of 47. Which nursing diagnosis best addresses a client problem associated with this degree of IDD?

A) Risk for injury R/T self-mutilation
B) Altered social interaction R/T nonadherence to social convention
C) Altered verbal communication R/T delusional thinking
D) Social isolation R/T severely decreased gross motor skills

Question 20

Which behavioral approach would a nurse use when caring for children diagnosed with disruptive behavior disorders?

A) Involving parents in designing and implementing the treatment process
B) Reinforcing positive actions to encourage repetition of desirable behaviors
C) Providing opportunities to learn appropriate peer interactions
D) Administering psychotropic medications to improve quality of life

Question 21

Which of the following findings would a nurse identify that would contribute to a client's development of ADHD? (Select all that apply.)

A) The client's father was a smoker.
B) The client had a low birth weight.
C) The client is lactose intolerant.
D) The client has a sibling diagnosed with ADHD.
E) The client has been diagnosed with dyslexia.