Deck 26: Children and Adolescents

Question 1

A 5-year-old child moves and talks constantly. The child awakens before the parents every morning. The child attends kindergarten, but the teacher reports difficulty handling the behavior. What is this child's most likely problem?

A) Tic disorder
B) Oppositional defiant disorder (ODD)
C) Intellectual development disorder (IDD)
D) Attention deficit hyperactivity disorder (ADHD)

Answer 1

Attention deficit hyperactivity disorder (ADHD)

Question 2

A nurse assesses the four children below. Which assessment findings should prompt the nurse to refer the child for further evaluation?

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

Answer 2

3-year-old who is mute, passive toward adults, and twirls while walking

Question 3

A 4-year-old child cries and screams from the time the parents leave the child at preschool until the child is picked up 4 hours later. The child is calm and relaxed when the parents are present. The parents ask, "What should we do?" What is the nurse's best recommendation?

A) "Send a picture of yourself to school to keep with the child."
B) "Arrange with the teacher to let the child call home at playtime."
C) "Talk with the school about withdrawing the child until maturity increases."
D) "Talk with your health care provider about a referral to a mental health professional."

Answer 3

"Talk with your health care provider about a referral to a mental health professional."

Question 4

A 15-year-old adolescent is referred to a residential program after an arrest for theft and running away from home. At the program, the adolescent refuses to participate in scheduled activities and pushes a staff member, causing a fall. Which approach by the nursing staff would be most therapeutic?

A) Neutrally permit refusals
B) Coax to gain compliance
C) Offer rewards in advance
D) Establish firm limits

Question 5

A nurse will prepare teaching materials regarding which medication for the parents of a child diagnosed with enuresis?

A) Haloperidol (Haldol)
B) Desmopressin (DDAVP)
C) Methylphenidate (Ritalin)
D) Carbamazepine (Tegretol)

Question 6

An adolescent diagnosed with generalized anxiety disorder says, "My parents focus all their attention on my brother instead of me. He's perfect in their eyes." Which type of therapy might promote the greatest change in this adolescent's behavior?

A) Bibliotherapy
B) Play therapy
C) Family therapy
D) Behavior modification therapy

Question 7

A child diagnosed with attention deficit hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications?

A) Central nervous system stimulants and non-stimulants
B) Monoamine oxidase inhibitors (MAOIs)
C) Antipsychotic medications
D) Anxiolytic medications

Question 8

A 5-year-old child diagnosed with attention deficit hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse's best action?

A) Call for emergency assistance from another staff member.
B) Instruct the parents to take the child home immediately.
C) Direct this child to stop, and then comfort the other child.
D) Take the child into another room with toys to act out feelings.

Question 9

Shortly after a 15-year-old's parents announce a plan to divorce, the adolescent stops participating in sports, sits alone at lunch, and avoids former friends. The adolescent says, "All the other kids have families. If my parents loved me, then they would stay together." Which nursing intervention is most appropriate?

A) Develop a plan for activities of daily living.
B) Communicate disbelief relative to the adolescent's feelings.
C) Assist the adolescent to differentiate reality from perceptions.
D) Assess and document the adolescent's level of depression daily.

Question 10

A 12-year-old child has been the neighborhood bully for several years. The parents say, "We can't believe anything our child says." Recently, the child shot a dog with a pellet gun and set fire to a trash bin outside a store. The child's behaviors are most consistent with:

A) conduct disorder (CD).
B) defiance of authority.
C) anxiety over separation from a parent.
D) attention deficit hyperactivity disorder (ADHD).

Question 11

A 15-year-old adolescent has run away from home six times. After the adolescent was arrested for prostitution, the parents told the court, "We can't manage our teenager." The adolescent is physically abusive to the mother and defiant with the father. The adolescent's problem is most consistent with criteria for:

A) attention deficit hyperactivity disorder (ADHD).
B) childhood depression.
C) conduct disorder (CD).
D) autism spectrum disorder (ASD).

Question 12

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 does not mean they aren't real."
D) "This finding is unexpected. How have you been administering your child's medication?"

Question 13

When assessing a 2-year-old diagnosed with autism spectrum disorder, a nurse expects:

A) hyperactivity and attention deficits.
B) failure to develop interpersonal skills.
C) history of disobedience and destructive acts.
D) high levels of anxiety when separated from a parent.

Question 14

Which finding would prompt the nurse to carefully assess an 8-year-old child for development of a psychiatric disorder?

A) Being raised by a parent with chronic major depressive disorder
B) Moving to three new homes over a 2-year period
C) Not being promoted to the next grade
D) Having an imaginary friend

Question 15

The child most likely to receive propranolol (Inderal) to manage tremors is one diagnosed with:

A) attention deficit hyperactivity disorder (ADHD).
B) posttraumatic stress disorder (PTSD).
C) a motor disorder.
D) separation anxiety.

Question 16

The health care provider prescribes medication for a child diagnosed with attention deficit hyperactivity disorder (ADHD). The desired behavior for which the nurse should monitor is:

A) increased expressiveness in communicating with others.
B) improved ability for cooperative play with other children.
C) ability to identify anxiety and implement self-control strategies.
D) improved socialization skills with other children and authority figures.

Question 17

A desired outcome for a 12-year-old diagnosed with oppositional defiant disorder (ODD) is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care?

A) Bibliotherapy
B) Music therapy
C) Social skills groups
D) Behavior modification

Question 18

When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that uses:

A) play activities exclusively.
B) group discussion exclusively.
C) talk focused on a specific issue.
D) play and then talk about the play activity.

Question 19

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

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

Question 20

An 11-year-old child, who has been diagnosed with oppositional defiant disorder (ODD), becomes angry over the rules at a residential treatment program and begins shouting at the nurse. Select the best method to defuse the situation.

A) Assign the child to a short time-out.
B) Administer an antipsychotic medication.
C) Place the child in a therapeutic hold.
D) Call a staff member to seclude the child.

Question 21

A nurse prepares to lead a discussion at a community health center regarding children's health. The nurse wants to use current terminology when teaching about these issues. Which terms are appropriate for the nurse to use? (Select all that apply.)

A) Mental retardation
B) Asperger's disorder
C) Autism spectrum disorder
D) Pervasive developmental disorder
E) Intellectual development disorder

Question 22

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

A) go to a quiet room until called for the next meal.
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 behavior.

Question 23

A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a volunteer. The teen says, "I have three good friends at school. We talk and sit together at lunch." What is the nurse's best suggestion to the treatment team?

A) Suggest foster home placement.
B) Seek assistance from an intimate partner violence program.
C) Make referrals for existing and emerging developmental problems.
D) Encourage healthy characteristics and existing environmental supports.

Question 24

A nurse prepares the plan of care for a 15-year-old adolescent diagnosed with moderate intellectual developmental disorder (IDD). What are the highest outcomes realistic for this person? (Select all that apply.) Within 5 years, the person will:

A) live unaided in an apartment.
B) obtain employment in a local sheltered workshop.
C) correctly use public buses to travel in the community.
D) independently perform his or her own personal hygiene.
E) complete high school or earn a general equivalency diploma (GED).

Question 25

A parent diagnosed with schizophrenia and her 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a shelter volunteer. The child says, "My three friends and I got an A on our school science project." The nurse can assess that the child:

A) displays resiliency.
B) has a difficult temperament.
C) is at risk for posttraumatic stress disorder.
D) uses intellectualization to deal with problems.

Question 26

What are the primary distinguishing factors between the behavior of children diagnosed with oppositional defiant disorder (ODD) and those diagnosed with conduct disorder (CD)? (Select all that apply.) The child diagnosed with:

A) ODD relives traumatic events by acting them out.
B) ODD tests limits and disobeys authority figures.
C) ODD has difficulty separating from the parents.
D) CD uses stereotypical or repetitive language.
E) CD often violates the rights of others.

Question 27

Which behavior indicates that the treatment plan for a child diagnosed with autism spectrum disorder was effective? The child:

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