Question 1

The nurse is caring for an adolescent girl with anorexia nervosa. Which of the following findings would indicate to the nurse that the girl requires hospitalization?

Accepted Answer

Food refusal in a patient with anorexia nervosa is a critical sign that may necessitate hospitalization due to the risk of severe malnutrition and electrolyte imbalances, which can be life-threatening.

Question 2

The nurse is caring for an adolescent girl with a suspected anxiety disorder. The girl states that she is constantly double-checking that she has unplugged her curling iron and must make sure that everything is in perfect order in her room before she leaves the house. The nurse interprets these findings as indicating which of the following?

Accepted Answer

The behaviors described, such as the need to double-check things and ensure everything is in perfect order, are characteristic of Obsessive-Compulsive Disorder (OCD), where individuals have compulsions (repetitive behaviors) to manage their anxiety stemming from obsessions (persistent, unwanted thoughts).

Question 3

The nurse is caring for a 7-year-old with Tourette syndrome. The nurse would be alert for which of the following comorbid conditions?

Accepted Answer

C

Question 4

A nurse is caring for a 10-year-old boy with a nursing diagnosis of ineffective coping related to an inability to deal with stressors secondary to anxiety. Which of the following would be most important for the nurse to do first?

Accepted Answer

Encouraging a discussion of the child's thoughts and feelings is a fundamental step in addressing ineffective coping related to anxiety. It helps in understanding the specific stressors and the child's perspective, which is crucial for planning further interventions.

Question 5

The nurse is caring for a 3-year-old boy. The parents are concerned that he is exhibiting signs of cognitive delays. Which statement by the parents would lead the nurse to suspect autism spectrum disorder rather than possible learning disability?

Accepted Answer

The statement "He seems to be speaking words less and less frequently" suggests regression in language skills, which is more characteristic of autism spectrum disorder than a learning disability. Autism can involve a loss of previously acquired skills, whereas learning disabilities typically involve consistent difficulties in learning specific skills without regression.

Question 6

A nurse is caring for a 5-year-old girl with depression. The girl is having difficulty coping with her feelings of sadness and fear, which stem from her parents' separation and recent divorce. The girl has been prescribed antidepressant medication but the mother thinks the girl would benefit from therapy. The nurse anticipates a referral to a therapist specializing in which type of therapy?

Accepted Answer

Play therapy is particularly effective for children as it uses play, a natural medium of communication for children, to help them express their feelings, thoughts, and experiences in a therapeutic setting. It is especially suitable for a 5-year-old dealing with emotional issues stemming from her parents' separation and divorce.

Question 7

The nurse is caring for a 13-year-old boy with a history of inappropriate behavior. Which statement by the mother would lead the nurse to suspect oppositional defiant disorder rather than conduct disorder?

Accepted Answer

Oppositional Defiant Disorder (ODD) is characterized by a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness. Frequent temper tantrums are more indicative of ODD. Conduct disorder involves more serious violations of social norms and rules, such as stealing significant amounts of money, cruelty to animals, and deceitfulness, which align with the behaviors described in the other options.

Question 8

The nurse is caring for a 5-year-old. The child's mother reports that he is extremely sensitive to sounds that most people do not notice and that he prefers complete silence. She explains that the boy is resisting going to school due to the noise and commotion. Additionally, the mother states that he will only wear 100% cotton clothing with all of the tags cut out. The nurse interprets these findings as indicating which of the following?

Accepted Answer

The child's extreme sensitivity to sounds and specific clothing preferences suggest sensory integration dysfunction, a condition where the brain has trouble receiving and responding to information that comes in through the senses. This can lead to difficulties processing sensory information such as sound and touch, as described in the scenario.

Question 9

The nurse is caring for a child with bipolar disorder. The child is taking lithium as ordered. The parents inquire about the potential side effects. Which response by the nurse would be most appropriate?

Accepted Answer

Lithium can cause side effects such as excessive urination and thirst, tremor, nausea, weight gain, and diarrhea, which are common and should be monitored.

Question 10

A child with attention deficit/hyperactivity disorder is prescribed long-acting methylphenidate. Which of the following would the nurse include when teaching the child and his parents about this drug?

Accepted Answer

Long-acting methylphenidate is designed to be taken once daily, typically in the morning, to manage symptoms of ADHD throughout the day without the need for multiple doses.

Question 11

When reviewing the medical record of a child, which of the following would the nurse interpret as the most sensitive indicator of intellectual disability?

Accepted Answer

Language delay is often the most sensitive indicator of intellectual disability in children, as it directly reflects developmental milestones related to cognitive and intellectual abilities.

Question 12

A school-age child diagnosed with depression is receiving antidepressant therapy. The nurse would instruct the parents to notify the physician immediately if the child demonstrates which of the following?

Accepted Answer

Loss of interest in activities can be a sign of worsening depression or suicidal ideation, which requires immediate attention when observed in a child on antidepressant therapy.

Question 13

A nurse is providing an in-service program on child abuse for a group of newly hired nurses. When evaluating the effectiveness of the teaching, the nurse determines a need for additional review when the group identifies which of the following as an indicator of possible child abuse?

Accepted Answer

Sexual behavior that correlates with the child's developmental age is not an indicator of possible child abuse. This choice reflects normal behavior, whereas the other options (A, B, C) are potential indicators of abuse.

Question 14

Which of the following would lead the nurse to suspect that an adolescent has bulimia?

Accepted Answer

Calluses on the back of the knuckles, also known as Russell's sign, can occur from self-induced vomiting, a common behavior in individuals with bulimia nervosa. This happens when the knuckles come into repeated contact with the teeth during the act of inducing vomiting.

Question 15

A child with depression is prescribed fluoxetine. The nurse identifies this as belonging to which class of drugs?

Accepted Answer

Fluoxetine is classified as a Selective Serotonin Reuptake Inhibitor (SSRI), which is commonly prescribed for depression and anxiety disorders by increasing the levels of serotonin in the brain.

Question 16

A child is receiving therapy in which he is learning to replace automatic negative thought patterns with alternative ones. The nurse interprets this as which type of therapy?

Accepted Answer

Cognitive therapy focuses on identifying and changing distorted or unhelpful thought patterns, which is what the child is doing by learning to replace automatic negative thoughts with alternative ones.

Question 17

A nurse is preparing a program for a parent group about various techniques that can be used to manage behavior. Which of the following would the nurse be least likely to include?

Accepted Answer

Focusing a child's attention on negative behavior is generally not recommended as a behavior management technique. Instead, positive reinforcement, setting limits, ignoring inappropriate behaviors when safe to do so, and providing feedback for positive behavior are more effective strategies. This approach helps in building a positive self-image and encourages desirable behaviors.

Question 18

The nurse is reviewing the medical record of a child who has dyspraxia. The nurse understands that this child experiences difficulty with which of the following?

Accepted Answer

Dyspraxia, also known as developmental coordination disorder (DCD), primarily affects manual dexterity and coordination, making tasks that require fine motor skills challenging for the individual.

Question 19

A nurse is conducting a screening program for autism in infants and children. Which of the following would the nurse identify as a warning sign?

Accepted Answer

Inability to say a single word by 16 months is a recognized warning sign for autism spectrum disorders.

Question 20

A school nurse is working with the parents of an 8-year-old who has Tourette syndrome on how best to accommodate the child. Which of the following would be most helpful? Select all answers that apply.

Accepted Answer

The answer of A school nurse is working with the...

Quiz 50: Nursing Care of the Child With an Alteration in Behavior, Cognition, or Development