TEST BANK FOR Dulcan’s Textbook of Child and Adolescent
Psychiatry
2. Which nursing intervention related to self-care would be most appropriate for a
teenager diagnosed with moderate intellectual disability?
A. Meeting all of the clients self-care needs to avoid injury
B. Providing simple directions and praising clients independent self-care efforts
C. Avoiding interference with the clients self-care efforts in order to promote autonomy
D. Encouraging family to meet the clients self-care needs to promote bonding - ANS: B
Providing simple directions and praise is an appropriate intervention for a teenager
diagnosed with moderate intellectual disability. Individuals with moderate intellectual
disability can perform some activities independently and may be capable of academic
skill to a second-grade level.
1. Which developmental characteristic should a nurse identify as typical of a client
diagnosed with severe intellectual disability?
A. The client can perform some self-care activities independently.
B. The client has advanced speech development.
C. Other than possible coordination problems, the clients psychomotor skills are not
affected.
D. The client communicates wants and needs by acting out behaviors. - ANS: D
The nurse should identify that a client diagnosed with severe intellectual disability may
communicate wants and needs by acting out behaviors. Severe intellectual disability
indicates an IQ between 20 and 34. Individuals diagnosed with severe intellectual
disability require complete supervision and have minimal verbal skills and poor
psychomotor development.
3. A child has been diagnosed with autism spectrum disorder. The distraught mother
cries out, Im such a terrible mother. What did I do to cause this? Which nursing reply is
most appropriate?
A. Researchers really dont know what causes autistic disorder, but the relationship
between autistic disorder and fetal alcohol syndrome is being explored.
B. Poor parenting doesnt cause autism. Research has shown that abnormalities in brain
structure and/or function are to blame. This is beyond your control.
C. Research has shown that the mother appears to play a greater role in the
development of this disorder than the father.
D. Lack of early infant bonding with the mother has shown to be a cause of autistic
disorder. Did you breastfeed or bottle-feed? - ANS: B
The most appropriate reply by the nurse is to explain to the parent that autism spectrum
disorder is believed to be caused by abnormalities in brain structure and/or function, not
, poor parenting. Autism spectrum disorder occurs in approximately 6 per 1,000 children
and is about four times more likely to occur in boys.
4. In planning care for a child diagnosed with autistic spectrum disorder, which would be
a realistic client outcome?
A. The client will communicate all needs verbally by discharge.
B. The client will participate with peers in a team sport by day 4.
C. The client will establish trust with at least one caregiver by day 5.
D. The client will perform most self-care tasks independently. - ANS: C
The most realistic client outcome for a child diagnosed with autism spectrum disorder is
for the client to
establish trust with at least one caregiver. Trust should be evidenced by facial
responsiveness and eye contact. This outcome relates to the nursing diagnosis
impaired social interaction.
5. After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD)
begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10
pounds in a 2-month period. What is the best explanation for this weight loss?
A. The pharmacological action of Ritalin causes a decrease in appetite.
B. Hyperactivity seen in ADHD causes increased caloric expenditure.
C. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased.
D. Increased ability to concentrate allows the client to focus on activities rather than
food. - ANS: A
The pharmacological action of Ritalin causes a decrease in appetite that often leads to
weight loss. Methylphenidate (Ritalin) is a central nervous symptom stimulant that
serves to increase attention span, control hyperactive behaviors, and improve learning
ability for clients diagnosed with ADHD.
6. An adolescent client who was diagnosed with conduct disorder at the age of 8 is
sentenced to juvenile detention after bringing a gun to school. How should the nurse
apply knowledge of conduct disorder to this clients situation?
A. Childhood-onset conduct disorder is more severe than the adolescent-onset type,
and these individuals likely develop antisocial personality disorder in adulthood.
B. Childhood-onset conduct disorder is caused by a difficult temperament, and the child
is likely to outgrow these behaviors by adulthood.
C. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before
the age of 5, and therefore improvement is likely.
D. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed
with this disorder are likely to develop progressive oppositional defiant disorder. - ANS:
A
The nurse should apply knowledge of conduct disorder to determine that childhood-
onset conduct disorder is more severe than adolescent-onset type. These individuals
are likely to develop antisocial personality disorder in adulthood. Individuals with this
Psychiatry
2. Which nursing intervention related to self-care would be most appropriate for a
teenager diagnosed with moderate intellectual disability?
A. Meeting all of the clients self-care needs to avoid injury
B. Providing simple directions and praising clients independent self-care efforts
C. Avoiding interference with the clients self-care efforts in order to promote autonomy
D. Encouraging family to meet the clients self-care needs to promote bonding - ANS: B
Providing simple directions and praise is an appropriate intervention for a teenager
diagnosed with moderate intellectual disability. Individuals with moderate intellectual
disability can perform some activities independently and may be capable of academic
skill to a second-grade level.
1. Which developmental characteristic should a nurse identify as typical of a client
diagnosed with severe intellectual disability?
A. The client can perform some self-care activities independently.
B. The client has advanced speech development.
C. Other than possible coordination problems, the clients psychomotor skills are not
affected.
D. The client communicates wants and needs by acting out behaviors. - ANS: D
The nurse should identify that a client diagnosed with severe intellectual disability may
communicate wants and needs by acting out behaviors. Severe intellectual disability
indicates an IQ between 20 and 34. Individuals diagnosed with severe intellectual
disability require complete supervision and have minimal verbal skills and poor
psychomotor development.
3. A child has been diagnosed with autism spectrum disorder. The distraught mother
cries out, Im such a terrible mother. What did I do to cause this? Which nursing reply is
most appropriate?
A. Researchers really dont know what causes autistic disorder, but the relationship
between autistic disorder and fetal alcohol syndrome is being explored.
B. Poor parenting doesnt cause autism. Research has shown that abnormalities in brain
structure and/or function are to blame. This is beyond your control.
C. Research has shown that the mother appears to play a greater role in the
development of this disorder than the father.
D. Lack of early infant bonding with the mother has shown to be a cause of autistic
disorder. Did you breastfeed or bottle-feed? - ANS: B
The most appropriate reply by the nurse is to explain to the parent that autism spectrum
disorder is believed to be caused by abnormalities in brain structure and/or function, not
, poor parenting. Autism spectrum disorder occurs in approximately 6 per 1,000 children
and is about four times more likely to occur in boys.
4. In planning care for a child diagnosed with autistic spectrum disorder, which would be
a realistic client outcome?
A. The client will communicate all needs verbally by discharge.
B. The client will participate with peers in a team sport by day 4.
C. The client will establish trust with at least one caregiver by day 5.
D. The client will perform most self-care tasks independently. - ANS: C
The most realistic client outcome for a child diagnosed with autism spectrum disorder is
for the client to
establish trust with at least one caregiver. Trust should be evidenced by facial
responsiveness and eye contact. This outcome relates to the nursing diagnosis
impaired social interaction.
5. After an adolescent diagnosed with attention deficit-hyperactivity disorder (ADHD)
begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10
pounds in a 2-month period. What is the best explanation for this weight loss?
A. The pharmacological action of Ritalin causes a decrease in appetite.
B. Hyperactivity seen in ADHD causes increased caloric expenditure.
C. Side effects of Ritalin cause nausea; therefore, caloric intake is decreased.
D. Increased ability to concentrate allows the client to focus on activities rather than
food. - ANS: A
The pharmacological action of Ritalin causes a decrease in appetite that often leads to
weight loss. Methylphenidate (Ritalin) is a central nervous symptom stimulant that
serves to increase attention span, control hyperactive behaviors, and improve learning
ability for clients diagnosed with ADHD.
6. An adolescent client who was diagnosed with conduct disorder at the age of 8 is
sentenced to juvenile detention after bringing a gun to school. How should the nurse
apply knowledge of conduct disorder to this clients situation?
A. Childhood-onset conduct disorder is more severe than the adolescent-onset type,
and these individuals likely develop antisocial personality disorder in adulthood.
B. Childhood-onset conduct disorder is caused by a difficult temperament, and the child
is likely to outgrow these behaviors by adulthood.
C. Childhood-onset conduct disorder is diagnosed only when behaviors emerge before
the age of 5, and therefore improvement is likely.
D. Childhood-onset conduct disorder has no treatment or cure, and children diagnosed
with this disorder are likely to develop progressive oppositional defiant disorder. - ANS:
A
The nurse should apply knowledge of conduct disorder to determine that childhood-
onset conduct disorder is more severe than adolescent-onset type. These individuals
are likely to develop antisocial personality disorder in adulthood. Individuals with this
