C HAPTER 21: I MPULSE C ONTROL D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Shortl y after the parents announced that they were divorcing, a 15 -year-
old became truant from school and assaulted a friend. The adolescent told
the school nurse, Id rather stay in m y room and listen to music. Its easie
than thinking about what is happeni ng in m y famil y. Which nursing
diagnosis is most applicable?
a. Chronic low self -esteem related to role within the famil y
b. Decisional conflict related to compliance with school requirements
c. Ineffective coping related to adjustment to changes in famil y
relationships
d. Disturbed personal identit y related to self -perceptions of changing
famil y dynamics
ANS: C
Depression is often associated with impulse control disorder. The
correct nursing diagnosis refers to the patients dysfunctional
management of feelings asso ciated with upcoming changes to the
famil y. The teen displays self -imposed isolation. The distracters are
not supported by data in the scenario.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 395
TOP: Nursing Process: Diagnosis/Anal ysis MSC: Client
Needs: Psychosocial Integrit y
,2. A child known as the neighborhood bull y says, Nobody can tell me what
to do. After receiving a poor grade on a science project, this child secretl y
loaded a virus on the teachers computer. These behaviors support a
diagnosis of:
a. conduct disorder.
b. oppositional defiant disorder.
c. intermittent explosive disorder.
d. attention deficit hyperactivit y disorder.
ANS: B
Oppositional defiant disorder is a repeated and persistent pattern of
having an angry and irritable mood in conjunc tion with demonstrating
defiant and vindictive behavior. Loading a virus is a vindictive
behavior in retribution for a poor grade. Persons with conduct disorder
are aggressive against people and animals; destroy propert y; are
deceitful; violate rules; and have impaired social, academic, or
occupational functioning. There is no evidence of explosiveness or
distractibilit y.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 393 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integr it y
3. An 11-year-old diagnosed with oppositional defiant disorder becomes
angry over the rules at a residential treatment program and begins
shouting at the nurse. What is the nurses initial action to defuse the
situation?
a. Say to the child, Tell me how you re feeling right now.
, b. Take the child swimming at the programs pool.
c. Establish a behavioral contract with the child.
d. Administer an anxiolytic medication.
ANS: B
Redirecting the expression of feelings into nondestructive, age -
appropriate behaviors such as a physical activit y helps the child learn
how to modulate the expression of feelings and exert self -control. This
is the least restrictive alternative and should be tried before resorting
to measures that are more restrictive. A shouting child will not likel y
engage in a discussion about feelings. A behavioral contract could be
considered later, but first the situation must be defused.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 399
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
4. Parents of an adolescent diagnosed with a conduct disorder say, We dont
know how to respond when our child breaks the rules in our house. Is
there any treatment that might help us? Which therapy is likely to be
helpful for these parents?
a. Parent-child interaction therapy (PC IT)
b. Behavior modification therapy
c. Multi-systemic therapy (MST)
d. Pharmacotherapy
ANS: A
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Shortl y after the parents announced that they were divorcing, a 15 -year-
old became truant from school and assaulted a friend. The adolescent told
the school nurse, Id rather stay in m y room and listen to music. Its easie
than thinking about what is happeni ng in m y famil y. Which nursing
diagnosis is most applicable?
a. Chronic low self -esteem related to role within the famil y
b. Decisional conflict related to compliance with school requirements
c. Ineffective coping related to adjustment to changes in famil y
relationships
d. Disturbed personal identit y related to self -perceptions of changing
famil y dynamics
ANS: C
Depression is often associated with impulse control disorder. The
correct nursing diagnosis refers to the patients dysfunctional
management of feelings asso ciated with upcoming changes to the
famil y. The teen displays self -imposed isolation. The distracters are
not supported by data in the scenario.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 395
TOP: Nursing Process: Diagnosis/Anal ysis MSC: Client
Needs: Psychosocial Integrit y
,2. A child known as the neighborhood bull y says, Nobody can tell me what
to do. After receiving a poor grade on a science project, this child secretl y
loaded a virus on the teachers computer. These behaviors support a
diagnosis of:
a. conduct disorder.
b. oppositional defiant disorder.
c. intermittent explosive disorder.
d. attention deficit hyperactivit y disorder.
ANS: B
Oppositional defiant disorder is a repeated and persistent pattern of
having an angry and irritable mood in conjunc tion with demonstrating
defiant and vindictive behavior. Loading a virus is a vindictive
behavior in retribution for a poor grade. Persons with conduct disorder
are aggressive against people and animals; destroy propert y; are
deceitful; violate rules; and have impaired social, academic, or
occupational functioning. There is no evidence of explosiveness or
distractibilit y.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 393 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integr it y
3. An 11-year-old diagnosed with oppositional defiant disorder becomes
angry over the rules at a residential treatment program and begins
shouting at the nurse. What is the nurses initial action to defuse the
situation?
a. Say to the child, Tell me how you re feeling right now.
, b. Take the child swimming at the programs pool.
c. Establish a behavioral contract with the child.
d. Administer an anxiolytic medication.
ANS: B
Redirecting the expression of feelings into nondestructive, age -
appropriate behaviors such as a physical activit y helps the child learn
how to modulate the expression of feelings and exert self -control. This
is the least restrictive alternative and should be tried before resorting
to measures that are more restrictive. A shouting child will not likel y
engage in a discussion about feelings. A behavioral contract could be
considered later, but first the situation must be defused.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 399
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
4. Parents of an adolescent diagnosed with a conduct disorder say, We dont
know how to respond when our child breaks the rules in our house. Is
there any treatment that might help us? Which therapy is likely to be
helpful for these parents?
a. Parent-child interaction therapy (PC IT)
b. Behavior modification therapy
c. Multi-systemic therapy (MST)
d. Pharmacotherapy
ANS: A
