Deck 22: Caring for the Child With a Psychosocial or Cognitive Condition

Question 1

A child diagnosed with depression is given the nursing diagnosis of situational low self-esteem.Which statement by the child indicates that a short-term goal has been met?

A)"I have to sleep a lot when I feel sad,sometimes until noon!"
B)"I wish I didn't make so many mistakes in my homework."
C)"My mom makes me special cookies when I am feeling sad."
D)"When I was feeling bad,I remembered my great science project."

Answer 1

"When I was feeling bad,I remembered my great science project."

Question 2

A parent calls the clinic to clarify discharge instructions for his child,who was just diagnosed with major depression.The parent states "I was told to watch for anhedonia.What does that mean?" Which explanation by the nurse is the most appropriate?

A)Flat affect and absence of emotions
B)Lack of personal hygiene and grooming
C)Loss of interest in activities once enjoyed
D)Self-mutilation or engaging in self-harm

Answer 2

Loss of interest in activities once enjoyed

Question 3

A child has been diagnosed with oppositional defiant disorder (ODD).The parents ask the nurse what risk factors the child has for this disorder.Which response by the nurse is the most appropriate?

A)"I am not sure;you can ask the doctor during your appointment."
B)"It seems to be an inherited problem from a recessive gene."
C)"The etiology seems to be complex,with multiple causes."
D)"Unfortunately,nobody knows what causes this condition."

Answer 3

"The etiology seems to be complex,with multiple causes."

Question 4

An advanced practice nurse is working with a child diagnosed with oppositional defiant disorder.What action by the nurse is most appropriate?

A)Assess the child's performance at school.
B)Facilitate genetic testing for the entire family.
C)Screen the child for other psychosocial problems.
D)Warn the parents not to leave siblings alone with the child.

Question 5

A school nurse is speaking with the parents of a child identified as possibly being at risk of suicide.Which question by the nurse is the priority during the nursing assessment?

A)"Do you have any guns in your home?"
B)"Does your child have any close friends?"
C)"Has your child been hoarding objects?"
D)"Is your child ever left alone at home?"

Question 6

A nurse is interviewing a mother of two children,ages 5 and 14.They were in a hotel fire a year ago in which their father was killed.The mother is concerned because the younger child has nightmares.The older child does not seem to have any problems.What action by the nurse is the most appropriate?

A)Ask the mother about physical injuries to the children.
B)Determine if the mother sought counseling after the fire.
C)Focus the appointment on the younger child only.
D)Inquire if the older child avoids hotels,even on television.

Question 7

A nurse is assessing children for reactive attachment disorder (RAD).Which child would the nurse identify as being at highest risk for this disorder?

A)Adopted from foreign orphanage
B)Given care by extended family
C)Placed in day care at 3 months
D)Unmarried,cohabitating parents

Question 8

The nurse is working with the family of a child with conduct disorder (CD).The parents are very stressed and fighting a great deal.What action by the nurse is the most appropriate?

A)Assess the family for sleep disturbances.
B)Question the parents about alcohol intake.
C)Refer the family to a weekend respite program.
D)Suggest the parents enter couples' counseling.

Question 9

Parents of a teen diagnosed with schizophrenia report being exhausted and overly stressed.Which action by the nurse is most appropriate?

A)Ask if the parents are getting enough sleep.
B)Assess if the family is still in counseling.
C)Refer the family to a support organization.
D)Request medication to calm the parents.

Question 10

A father brings his child to the clinic with complaints that the child jumps around,gestures continuously with the hands,and makes grunting noises.He wants to know if the child has attention deficit-hyperactivity disorder (ADHD).What response by the nurse is the most appropriate?

A)"Does your child have risks for obsessive-compulsive disorder?"
B)"I don't think so;that sounds more like a tic disorder."
C)"Possibly;those are some classic symptoms of ADHD."
D)"Yes,that definitely sounds like ADHD to me."

Question 11

A mother requests information on caring for her child just adopted from a foreign orphanage.The mother has heard of reactive attachment disorder (RAD)and wants to provide an environment that is appropriate for this child.What suggestion by the nurse is the most appropriate?

A)Ignore temper tantrums and crying fits.
B)Post a schedule of daily activities such as meals.
C)Put the child in psychotherapy.
D)Teach the child "stranger danger."

Question 12

When working with immigrant and refugee families,what strategy by the nurse is likely to have the most positive impact?

A)Avoid anticipatory guidance and focus on immediate problems.
B)Praise the families often for what they are doing well.
C)Refer them to social services agencies that work with immigrants.
D)Teach them the laws and customs regarding discipline in the United States.

Question 13

A child with attention deficit-hyperactivity disorder (ADHD)is in the clinic with parents,who complain that even though they are following the treatment plan,the child is not improving.What action can the nurse suggest to improve the effectiveness of the plan?

A)Consult with the school nurse to follow through with behavior logs.
B)Ensure the entire family is continuing to keep counseling appointments.
C)Reassure the parents that it takes a long time to see changes in behavior.
D)Teach the parents about herbal and diet therapies they can try at home.

Question 14

A nurse is working with the parents of a child who has the following complaints: fatigue,insomnia,persistent irritable mood,and significant weight loss.Which discharge instruction is the priority?

A)Encourage the child to eat more protein.
B)Enroll the child in after-school activities.
C)Establish a routine bedtime and wake time.
D)Ensure the child is safe at all times.

Question 15

A faculty member is explaining the impact of immigration on mental health to a group of nursing students.What information should the faculty member provide?

A)Immigrants have multiple sources for health care,so their needs should be met.
B)Meeting basic human needs often outweighs the need for mental health.
C)Refugees and immigrants do not often have mental health problems.
D)Because immigrants do not speak English,mental health assessment is difficult.

Question 16

A nurse is educating the parents of a child diagnosed with major depression prescribed a selective serotonin reuptake inhibitor (SSRI).The parents do not want to fill the prescription because they have heard SSRIs increase the risk of suicide in children.Which statement by the nurse is most appropriate?

A)"I will convey your concerns to your health-care provider."
B)"If you don't want your child to take the medication,don't fill it."
C)"SSRIs have been used for many years to treat depression."
D)"This information is controversial,so watch your child carefully."

Question 17

A nurse is working with a family whose child has bipolar disorder.Which item is the most appropriate for the nurse to including in the teaching session for this child and family?

A)Ensure the child follows all house rules;do not give in.
B)Instruct family that if mania is uncontrollable,hospitalization is required.
C)Protect younger children from sexually aggressive behaviors.
D)Provide routine and structure and appropriate freedom.

Question 18

A mother brings her child to the clinic requesting a selective serotonin reuptake inhibitor (SSRI)to help treat her daughter's posttraumatic stress disorder (PTSD).Which rationale will the nurse use when responding to the child's mother?

A)Children have too many side effects from SSRIs.
B)Research shows that treating specific symptoms is better.
C)SSRIs have a long history of successful use in PTSD.
D)This classification of drugs has rarely been used in PTSD.

Question 19

A nurse wishes to increase an at-risk child's resilience.What action by the nurse would be most helpful?

A)Assist the child in recognizing internal resources.
B)Help the child see that others are worse off.
C)Instruct the child to "toughen up."
D)Teach the child therapeutic communication skills.

Question 20

The pediatric nurse is assessing a child who complains of a stomach ache.This is the child's fourth visit to the clinic for the same problem,and there has not been a diagnosis yet.What action by the nurse is best?

A)Ask about child's functioning and development.
B)Instruct the mother not to keep the child home from school.
C)Obtain a thorough family history from the mother.
D)Perform an abdominal exam and document findings.

Question 21

A nurse is working with the family of a child who is overweight.What action by the nurse is most appropriate?

A)Help the family identify fun activities.
B)Instruct the child to exercise for an hour each day.
C)Place the child on a restricted-calorie diet.
D)Set a weight-loss goal for the child.

Question 22

A nurse is making a referral for a family whose teenage daughter has anorexia nervosa.Which referral is the most appropriate?

A)Crisis intervention counseling
B)Family-oriented therapy
C)Multidisciplinary team
D)Psychiatrist

Question 23

A nurse is teaching a class to new mothers who are also high school students.What action by the nurse is the most appropriate in order to decrease the risk of child maltreatment?

A)Explain the laws regarding child abuse and neglect.
B)Provide education on normal childhood development.
C)Refer all the young mothers to a social service agency.
D)Teach the mothers signs and symptoms of abuse.

Question 24

A student nurse wants to know what substances adolescents are at highest risk for abusing.Which information is the most appropriate for the pediatric nurse to share with the student?

A)It depends on what is popular at the time in their schools.
B)Alcohol and prescription drugs,because they are in most homes.
C)Substance abuse varies greatly between age groups and level of school.
D)There are no reliable data on substances abused most by adolescents.

Question 25

A pregnant woman asks the nurse how much alcohol must be consumed to put her fetus at risk of fetal alcohol spectrum disorder.What answer by the nurse is the most appropriate?

A)Any alcohol during the third trimester
B)Any amount at any time during the pregnancy
C)More than 2 drinks/day in the first trimester
D)Three or more drinks/day throughout pregnancy

Question 26

A community nurse approaches the organization's manager wanting to set up screening for risk factors for Tourette's syndrome in children.Which response by the manager is the most appropriate?

A)Allocate funding for a family psychosocial or cognitive condition screening.
B)Deny the request because Tourette's syndrome has very little impact.
C)Explain that Tourette's syndrome is most likely inherited.
D)Facilitate cooperative agreements with a community laboratory facility.

Question 27

A nurse is assessing a child who has a large head,an elongated face,and prominent ears.Which discharge instruction is most important?

A)"Create a family pedigree so I can assess for Down syndrome."
B)"Please make an appointment with a pediatric cardiologist."
C)"We will call you regarding a referral for genetic testing."
D)"You will need to abstain from alcohol in your next pregnancy."

Question 28

A nurse has identified substance abuse in an adolescent.In addition to a treatment center referral,what other referral is most important?

A)Counseling for parents
B)Law enforcement
C)Mental health provider
D)Social services agencies

Question 29

A nurse is caring for a child with attention deficit-hyperactivity disorder (ADHD).Which medications does the nurse anticipate may be prescribed for this child? (Select all that apply.)

A)Adderall (amphetamine salts)
B)Haldol (haloperidol)
C)Prozac (fluoxetine hydrochloride)
D)Ritalin (methylphenidate hydrochloride)
E)Strattera (atomoxetine)

Question 30

The mental health nurse is preparing a presentation for nurses who work with pediatric patients.Which barriers to mental health screening should the nurse include in the presentation? (Select all that apply.)

A)Belief that children do not have psychosocial or cognitive conditions
B)Family shame related to psychosocial or cognitive conditions
C)High level of health literacy regarding psychosocial or cognitive conditions
D)Minimizing of psychosocial or cognitive conditions symptoms by health-care providers
E)Stigma of psychosocial or cognitive conditions in society

Question 31

A pediatric nurse is explaining child abuse and neglect to a class of nursing students.Which information does this nurse provide the students during the presentation? (Select all that apply.)

A)Children with disabilities are at higher risk.
B)Diagnosing physical child abuse is easy and quick.
C)Each week,about 5 children die from abuse.
D)Neglect is most common,but is difficult to identify.
E)Unexplained,recurrent conditions may be caused by abuse.

Question 32

The nurse is assessing a child for an anxiety disorder.What manifestations noted by the nurse are common to all anxiety disorders? (Select all that apply.)

A)Distress or avoidance of feared situations
B)Does not go away or gets worse over time
C)Impaired functioning or development
D)Leads to avoiding social situations
E)Physical symptoms such as palpitations and sweating

Question 33

A nurse is teaching a classroom of middle school students sleep hygiene.Which information does the nurse provide? (Select all that apply.)

A)Create a healthy environment for sleep in your room.
B)Go to bed at the same time every night of the week.
C)Only use your bed for sleeping and reading.
D)Set your cell phone to vibrate or low volume.
E)Turn off your computer 1 hour before bedtime.

Question 34

A child has the possible diagnosis of autism spectrum.While awaiting the results of further testing,which action by the nurse is the most appropriate?

A)Continue to monitor the child for late signs of autism.
B)Reassure the parents that concerns are probably not valid.
C)Refer the child to audiology to rule out a hearing impairment.
D)Wait for results before referring the child to early intervention or a local school program.

Question 35

A mother brings a child to the clinic with concerns about attention deficit-hyperactivity disorder (ADHD).Which behavioral assessment findings support this diagnosis? (Select all that apply.)

A)Compulsive "collecting"
B)Inability to stay in chair for a meal
C)Nonstop talking
D)Refusal to complete homework
E)Sleeping whenever possible

Question 36

A nurse is assessing families in the community for child maltreatment.Which family would the nurse identify as being at highest risk?

A)Children involved in many activities
B)Family with multiple children
C)Older parents with only children
D)Single mother living in poverty

Question 37

A nurse in the pediatric clinic suspects a patient is the victim of child abuse.What action takes priority?

A)Ask a coworker to confirm the suspicions.
B)Confront the parents with this information.
C)Document the findings in the child's chart.
D)Report the suspicions according to state law.

Question 38

A child with Down's syndrome has been admitted to the hospital with a respiratory condition and is producing thick,tenacious mucus.Which nursing action is the priority?

A)Ensuring a patent airway
B)Involving child-life therapy
C)Preventing nosocomial infection
D)Relieving stress at hospitalization

Question 39

A nurse is providing education to the parents of a child who has anxiety.Using the FRIENDS strategy for managing anxiety,what techniques does the nurse teach? (Select all that apply.)

A)Explore plans
B)Fight the anxiety
C)Inner thoughts
D)Reward yourself
E)Stay calm

Question 40

A nurse working with at-risk children recognizes that vulnerability to psychosocial or cognitive disorders depends on which risk factors? (Select all that apply.)

A)Environment
B)Genetics
C)Immunity
D)Temperament
E)Timing of exposure