Question 1

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply.

Accepted Answer

Children with autism display little eye contact with and make few facial expressions toward others; they use limited gestures to communicate. They have limited capacity to relate to peers or parents. They lack spontaneous enjoyment, express no moods or emotional affect, and cannot engage in play or make-believe with toys. There is little intelligible speech. These children engage in stereotyped motor behaviors such as hand flapping, body twisting, or head banging.

Question 2

A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is,

Accepted Answer

The National Institute of Child Health and Human Development, Centers for Disease control (CDC) and the Academy of Pediatrics have all conducted research studies for several years and have concluded that there is no relationship between vaccines and autism and that the MMR vaccine is safe.

Question 3

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD). Which of the following behaviors reported by the parent would be consistent with this diagnosis?

Accepted Answer

By the time the child starts school, symptoms of ADHD begin to interfere significantly with behavior and performance. He or she cannot listen to directions or complete tasks. The child interrupts and blurts out answers before questions are completed. Academic performance suffers because the child makes hurried, careless mistakes in schoolwork, often loses or forgets homework assignments, and fails to follow directions. Socially, peers may ostracize or even ridicule the child for his or her behavior. The child often loses necessary things.

Question 4

Which of the following symptoms are characteristic of ADHD? Select all that apply.

Accepted Answer

ADHD is characterized by inattentiveness, overactivity, and impulsiveness. Encopresis is the repeated passage of feces into inappropriate places such as clothing or the floor by a child who is at least 4 years of age either chronologically or developmentally. Enuresis is the repeated voiding of urine during the day or at night into clothing or bed by a child at least 5 years of age either chronologically or developmentally. Encopresis and enuresis are elimination disorders that are unrelated to ADHD.

Question 5

Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.

Accepted Answer

Approximately 70% to 75% of adults with ADHD have at least one coexisting psychiatric diagnosis, with social phobia, bipolar disorder, major depression, and alcohol dependence being the most common.

Question 6

A nurse asks an assigned client, How are you doing today? The client responds with doing today, doing today, doing today. Which speech pattern disturbance is this an example of?

Accepted Answer

Echolalia is repeating the last heard sound, word, or phrase. Stereotypic movement disorders include waving, rocking, twirling objects, biting fingernails, handing the head, biting or hitting oneself, or picking at the skin or body orifices. Selective mutism is characterized by persistent failure to speak in social situations where speaking is expected.

Question 7

Which of the following terms describes the repeating of one's own words or sounds?

Accepted Answer

Palilalia is the repeating of one's own words or sounds. Coprolalia is the use of socially unacceptable words, which are frequently obscene. Echolalia is the repeating of the last heard sound, word, or phrase.

Question 8

Which of the following disorders involves problems with forming sounds associated with speech?

Accepted Answer

Phonologic disorder involves problems with articulation. Mixed receptiveñexpressive language disorder includes problems of expressive language disorder along with difficulty understanding and determining the meaning of words and sentences.
Expressive language disorder involves an impaired ability to communicate through verbal and sign language. Stuttering is a disturbance of the normal fluency and time patterning of speech.

Question 9

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate?

Accepted Answer

Pharmacologic treatment with antipsychotics, such as haloperidol (Haldol) or risperidone (Risperdal), may be effective for specific target symptoms such as temper tantrums, aggressiveness, self-injury, hyperactivity, and stereotyped behaviors.

Question 10

A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice?

Accepted Answer

Giving stimulants during daytime hours usually effectively combats insomnia. Eating a good breakfast with the morning dose and substantial nutritious snacks late in the day and at bedtime helps the child to maintain an adequate dietary intake. Daytime napping for a child with ADHD is unrealistic and not developmentally necessary.

Question 11

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

Accepted Answer

Before beginning any task, adults must gain the child's full attention. The adult should tell the child what needs to be done and break the task into smaller steps if necessary. This approach prevents overwhelming the child and provides the opportunity for feedback about each set of problems he or she completes.

Question 12

Which of the following would be important circumstances to gather assessment data for a child with ADHD? Select all that apply.

Accepted Answer

During assessment, the nurse gathers information through direct observation and from the child's parents, day care providers (if any), and teachers. Assessing the child in a group of peers is likely to yield useful information because the child's behavior may be subdued or different in a focused one-to-one interaction with the nurse. Reviewing the client's record will not yield much assessment data.

Question 13

Which one of the following nursing interventions should take priority for a child with ADHD?

Accepted Answer

Safety of the child and others is always a priority. The other nursing interventions are appropriate for a child with ADHD, but the priority is safety.

Question 14

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step?

Accepted Answer

If the child is engaged in a potentially dangerous activity, the first step is to stop the behavior. Attempting to talk to or reason with a child engaged in a dangerous activity is unlikely to succeed because his or her ability to pay attention and to listen is limited.

Question 15

The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following?

Accepted Answer

Parents find themselves chronically exhausted mentally and physically. Parents need support and reassurance, and making a statement about the difficulties of handling the child at home validates the mother's feelings. It is not appropriate to say, Your son is a cute child, but he needs to calm down. It may make the parents defensive to say, You need to take a firmer approach with your son. Your son sure is active is not a therapeutic response.

Question 16

A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 _AM, which behavior might the school nurse expect to see at noon?

Accepted Answer

Ritalin has a short half-life, so doses are needed about every 4 hours during the day to maintain symptom control. Giving stimulants during daytime hours usually effectively combats insomnia.

Question 17

The parents of an autistic child ask the nurse, Will my child ever be normal? Which would be the most appropriate response by the nurse?

Accepted Answer

Autistic traits persist into adulthood, and most people with autism remain dependent to some degree on others. Manifestations vary from little speech and poor daily living skills throughout life to adequate social skills that allow relatively independent functioning. Social skills rarely improve enough to permit marriage and child rearing.

Question 18

The parents of a child with ADHD express to the nurse, We get so frustrated when our son never minds us. Which parenting strategies should the nurse discuss with the parents? Select all that apply.

Accepted Answer

Educating parents and helping them with parenting strategies are crucial components of effective treatment of ADHD. Effective approaches include providing consistent rewards and consequences for behavior, offering consistent praise, using time-out, and giving verbal reprimands. Additional strategies are issuing daily report cards for behavior and using point systems for positive and negative behavior.

Question 19

Which one of the following statements about educating parents of a child with ADHD is true?

Accepted Answer

Parents feel empowered and relieved to have specific strategies that can help them and their child be more successful. Including parents in planning and providing care for the child with ADHD is important. The nurse must listen to the parents' feelings. The education of a child with ADHD is important, but the child is only in school for part of their day. The parents must deal with the child and the other aspects of the child's life at all times.

Question 20

A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply.

Accepted Answer

Although medication can help reduce hyperactivity and inattention and allow the child to focus during school, it is by no means a cure-all. The child needs strategies and practice to improve social skills and academic performance. Because these children are often not diagnosed until the second or third grade, they may have missed much basic learning for reading and math. Parents should know that it takes time for them to catch up with other children of the same age. Most of these children have low self-esteem because they have been labeled as having behavior problems and have been corrected continually by parents and teachers for not listening, not paying attention, and misbehaving. Parents must understand how to help rebuild their child's self-esteem.
Parents should give positive comments as much as possible to encourage the child and acknowledge his or her strengths. One technique to help parents to achieve a good balance is to ask them to count the number of times they praise or criticize their child each day for several days. ADHD is not the fault of the parents or the child, and that techniques and school programs are available to help. Children with ADHD do qualify for special school services under the Individuals with Disabilities Education Act.

Quiz 22: Neurodevelopmental Disorders

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply.

A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is,

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD) . Which of the following behaviors reported by the parent would be consistent with this diagnosis?

Which of the following symptoms are characteristic of ADHD? Select all that apply.

Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.

A nurse asks an assigned client, How are you doing today? The client responds with doing today, doing today, doing today. Which speech pattern disturbance is this an example of?

Which of the following terms describes the repeating of one's own words or sounds?

Which of the following disorders involves problems with forming sounds associated with speech?

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate?

A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice?

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

Which of the following would be important circumstances to gather assessment data for a child with ADHD? Select all that apply.

Which one of the following nursing interventions should take priority for a child with ADHD?

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step?

The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following?

A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 _AM, which behavior might the school nurse expect to see at noon?

The parents of an autistic child ask the nurse, Will my child ever be normal? Which would be the most appropriate response by the nurse?

The parents of a child with ADHD express to the nurse, We get so frustrated when our son never minds us. Which parenting strategies should the nurse discuss with the parents? Select all that apply.

Which one of the following statements about educating parents of a child with ADHD is true?

A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply.

Quiz 22: Neurodevelopmental Disorders

The nurse is assessing a 16-month-old child during a well-baby checkup. Which of the following behaviors would be consistent with autism spectrum disorder? Select all that apply.

A mother expresses concern to the nurse that the child's regularly scheduled vaccines may not be safe. The mother states that she has heard reports that they cause autism. The most appropriate response by the nurse is,

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder (ADHD) . Which of the following behaviors reported by the parent would be consistent with this diagnosis?

Which of the following symptoms are characteristic of ADHD? Select all that apply.

Which of the following are common coexisting psychiatric disorders for adults with ADHD? Select all that apply.

A nurse asks an assigned client, How are you doing today? The client responds with doing today, doing today, doing today. Which speech pattern disturbance is this an example of?

Which of the following terms describes the repeating of one's own words or sounds?

Which of the following disorders involves problems with forming sounds associated with speech?

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can be done to control the child's tantrums. Which option should the nurse inform the parents that may be appropriate?

A child with ADHD complains to his parents that he does not like the side effects of his medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's negative side effects. The nurse can best help the parents by offering which advice?

The nurse is assisting a child with ADHD to complete his ADLs. Which is the best approach for nurse to use with this child?

Which of the following would be important circumstances to gather assessment data for a child with ADHD? Select all that apply.

Which one of the following nursing interventions should take priority for a child with ADHD?

An 8-year-old with attention deficit hyperactivity disorder is jumping off the bed onto a chair. Which should be the nurse's first step?

The mother of a 6-year-old boy with attention deficit hyperactivity disorder asks to speak to the nurse about her son's disruptive behavior. The nurse would be most therapeutic by saying which of the following?

A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 AM, which behavior might the school nurse expect to see at noon?

The parents of an autistic child ask the nurse, Will my child ever be normal? Which would be the most appropriate response by the nurse?

The parents of a child with ADHD express to the nurse, We get so frustrated when our son never minds us. Which parenting strategies should the nurse discuss with the parents? Select all that apply.

Which one of the following statements about educating parents of a child with ADHD is true?

A nurse is providing education to a group of parents who have children with ADHD. Which of the following statements would be accurate and should be included in the education? Select all that apply.

A child with attention deficit hyperactivity disorder is taking methylphenidate (Ritalin) in divided doses. If the child takes the first dose at 8 _AM, which behavior might the school nurse expect to see at noon?