Chapter 35: Child Psychiatric Nursing

MULTIPLE CHOICE 1. When assisting a 5-year-old child to develop the ability to delay gratification, it is most valuable for the nurse to: a. teach parents to assign a point system for expected daily activities. b. develop the nurse-patient relationship during unstructured playtime. c. encourage the child to express feelings when feeling frustrated. d. model the ability to delay gratification. ANS: A Nursing interventions that help children learn to delay gratification include a point system to reinforce the behaviors, the use of games with commands such as “stop” and “wait,” and other activities and strategies that teach self-control.DIF: Cognitive Level: Application REF: Text Page: 674 TOP: Nursing Process: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. Which assessment finding most clearly indicates an adolescent has a conduct disorder? a. Misses at least one day of school a month b. Admits to pulling the dog’s ears and tail for “fun” c. Told the teacher that he is usually “sad and confused” d. Consistently awakens during the night and has difficulty falling asleep again ANS: B While children with anxiety, depression, and conduct disorders all share school problems, depression, and altered sleeping patterns, demonstrating aggression toward people or animals is unique to conduct disorders. DIF: Cognitive Level: Application REF: Text Page: 670 TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity 3. What outcome would be most appropriate for the plan of care for a 7-year-old child with a diagnosis of conduct disorder? a. Parents will demonstrate effective parenting skills, thus minimizing conflicts with their child. b. The child will be capable of successfully accomplishing the academic work appropriate of a first grader.c. Parents will institute verbal reprimands as a primary form of consequence for their child’s misbehavior. d. The child will verbalize the pathology of his condition within 6 weeks of beginning behavioral modification therapy. ANS: A An outcome is something that is measurable and specific to the individual. Since the only information available is the diagnosis, the most specific outcome is the one that is directly related to family factors, such as parental conflict and poor parenting. Although academic performance, verbal reprimands, and verbalization of the pathology all are affected by conduct disorders, the behaviors associated with the disorder are most effectively managed by focused parenting techniques that minimize them and the resulting conflicts.