Deck 27: Disorders of Children and Adolescents

Question 1

When a 5-year-old diagnosed with attention deficit-hyperactivity disorder bounces out of a chair and runs over and slaps another child, what is the nurse's best action?

A) Instruct the parents to take the aggressive child home.
B) Direct the aggressive child to stop immediately.
C) Call for emergency assistance from other staff.
D) Take the aggressive child to another room.

Answer 1

Take the aggressive child to another room.

Question 2

Soon after parents announced they were divorcing, their child stopped participating in sports, sat alone at lunch, and avoided former friends. The child told the school nurse, "If my parents loved me, they would work out their problems." Which nursing diagnosis has the highest priority?

A) Social isolation
B) Decisional conflict
C) Chronic low self-esteem
D) Disturbed personal identity

Answer 2

Social isolation

Question 3

A child diagnosed with attention deficit-hyperactivity disorder (ADHD) shows hyperactivity, aggression, and impaired play. The health care provider prescribed amphetamine (Adderall XR). For which desired behaviour should the nurse monitor?

A) Increased expressiveness in communication with others
B) Abilities to identify anxiety and implement self-control strategies
C) Improved ability to participate in cooperative play with other children
D) Ability to tolerate social interactions for short periods without disruption or frustration

Answer 3

Improved ability to participate in cooperative play with other children

Question 4

A child reports to the school nurse that he was verbally bullied by an aggressive classmate. What is the nurse's best first action?

A) Give notice to the chief administrator at the school regarding the events.
B) Encourage the victimized child to share feelings about the experience.
C) Encourage the victimized child to ignore the bullying behaviour.
D) Discuss the events with the aggressive classmate.

Question 5

A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child's disorder?

A) The child has occasional toileting accidents.
B) The child is unable to read children's books.
C) The child cries when separated from a parent.
D) The child continuously rocks in place for 30 minutes.

Question 6

A child diagnosed with attention deficit-hyperactivity disorder had this nursing diagnosis: Impaired social interaction related to excessive neuronal activity as evidenced by aggression and demanding behaviour with others. Which finding indicates the plan of care was effective?

A) The child has an improved ability to identify anxiety and use self-control strategies.
B) The child has increased expressiveness in communication with others.
C) The child shows increased responsiveness to authority figures.
D) The child engages in cooperative play with other children.

Question 7

What is the nurse's priority focused assessment for adverse effects in a child taking methylphenidate (Ritalin) for attention deficit-hyperactivity disorder (ADHD)?

A) Dystonia, akinesia, and extrapyramidal symptoms
B) Bradycardia and hypotensive episodes
C) Sleep disturbances and weight loss
D) Neuroleptic malignant syndrome

Question 8

Which factor presents the highest risk for a child to develop a psychiatric disorder?

A) Having an uncle with schizophrenia
B) Being the oldest child in a family
C) Living with a depressed parent
D) Being an only child

Question 9

Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness?

A) The child has been raised by a parent with chronic major depression.
B) The child's best friend was absent from the child's birthday party.
C) The child was not promoted to the next grade one year.
D) The child moved to three new homes over a 2-year period.

Question 10

A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, "What should we do?" Select the nurse's best response.

A) "Ask the teacher to let the child call you at play time."
B) "Withdraw the child from preschool until maturity increases."
C) "Remain with your child for the first hour of preschool time."
D) "Give your child a kiss before you leave the preschool program."

Question 11

A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit-hyperactivity disorder. Which medication will the information focus on?

A) Paroxetine (Paxil)
B) Citalopram (Celexa)
C) Methylphenidate (Ritalin)
D) Carbamazepine (Tegretol)

Question 12

The parent of a 6-year-old says, "My child is in constant motion and talks all the time. My child isn't interested in toys but is out of bed every morning before me." The child's behaviour is most consistent with diagnostic criteria for which of the following?

A) Communication disorder
B) Stereotypic movement disorder
C) Intellectual development disorder
D) Attention deficit-hyperactivity disorder

Question 13

The child who has been prescribed an antipsychotic medication to manage violent behaviour was most likely diagnosed with which of the following?

A) Attention deficit-hyperactivity disorder
B) Post-traumatic stress disorder
C) Communication disorder
D) An anxiety disorder

Question 14

A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, is inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to do which of the following?

A) Promote integration of self-concept
B) Provide inpatient treatment for the child
C) Reduce loneliness and increase self-esteem
D) Improve language and communication skills

Question 15

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders?

A) Impaired social interaction related to difficulty relating to others
B) Chronic low self-esteem related to excessive negative feedback
C) Deficient fluid volume related to abnormal eating habits
D) Anxiety related to nightmares and repetitive activities

Question 16

Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers to questions before a question is complete, and frequently interrupting others' conversations. How should the nurse document these behaviours?

A) Defiance
B) Hyperactivity
C) Impulsivity
D) Anxiety

Question 17

A desired outcome for a 12-year-old diagnosed with attention deficit-hyperactivity disorder is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care?

A) Reality therapy
B) Simple restitution
C) Social skills group
D) Insight-oriented group therapy

Question 18

A nurse works with a child who is sad and irritable because the child's parents are divorcing. Why is establishing a therapeutic alliance with this child a priority?

A) Therapeutic relationships provide an outlet for tension.
B) Focusing on the strengths increases a person's self-esteem.
C) Acceptance and trust convey feelings of security to the child.
D) The child should express feelings rather than internalize them.

Question 19

Which behaviour indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective?

A) The child plays with one toy for 30 minutes.
B) The child repeats words spoken by a parent.
C) The child holds the parent's hand while walking.
D) The child spins around and claps hands while walking.

Question 20

A child diagnosed with attention deficit-hyperactivity disorder will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications?

A) Psychostimulants
B) Tricyclic antidepressants
C) Antipsychotics
D) Anxiolytics

Question 21

When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses which of the following?

A) Guided imagery
B) Talk focused on a specific issue
C) Play and talk about a play activity
D) Group discussion about selected topics

Question 22

A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual developmental disorder. What are the highest outcomes that are realistic for this patient? Within 5 years, the patient will be able to do which of the following?

A) Graduate from high school
B) Live independently in an apartment
C) Independently perform own personal hygiene
D) Obtain employment in a local sheltered workshop
E) Correctly use public buses to travel in the community

Question 23

At the time of a home visit, the nurse notices that each parent and child in a family has his or her own personal online communication device. Each member of the family is in a different area of the home. Which nursing actions are appropriate?

A) Report the finding to the official child protection social services agency.
B) Educate all members of the family about risks associated with cyberbullying.
C) Talk with the parents about parental controls on the children's communication devices.
D) Encourage the family to schedule daily time together without communication devices.
E) Obtain the family's network password and examine online sites family members have visited.

Question 24

The parent of a child diagnosed with Tourette's disorder says to the nurse, "I think my child is faking the tics because they come and go." Which response by the nurse is accurate?

A) "Perhaps your child was misdiagnosed."
B) "Your observation indicates the medication is effective."
C) "Tics often change frequency or severity. That doesn't mean they aren't real."
D) "This finding is unexpected. How have you been administering your child's medication?"

Question 25

A parent diagnosed with schizophrenia and a 13-year-old child live in a homeless shelter. The child formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." What does this allow the nurse to assess about the child?

A) That the child displays resiliency
B) That the child has a passive temperament
C) That the child is at risk for post-traumatic stress disorder
D) That the child uses intellectualization to deal with problems

Question 26

When a 5-year-old is disruptive, the nurse says, "You must take a time out." The expectation is that the child will do which of the following?

A) Go to a quiet room until called for the next activity
B) Slowly count to 20 before returning to the group activity
C) Sit on the edge of the activity until able to regain self-control
D) Sit quietly on the lap of a staff member until able to apologize for the behaviour

Question 27

Which child demonstrates behaviours indicative of a neurodevelopmental disorder?

A) A 4-year-old who stuttered for 3 weeks after the birth of a sibling
B) A 9-month-old who does not eat vegetables and likes to be rocked
C) A 3-month-old who cries after feeding until burped, then sucks a thumb
D) A 3-year-old who is mute, passive toward adults, and twirls while walking

Question 28

A nurse prepares to lead a discussion at a community health centre regarding children's health problems. The nurse wants to use current terminology when discussing these issues. Which terms are appropriate for the nurse to use?

A) Autism
B) Bullying
C) Mental retardation
D) Autism spectrum disorder
E) Intellectual development disorder