,A nurse in a residential foster home is caring for a 17-year-old client with oppositional
defiant disorder. The client is using profanity and refusing to complete assigned chores.
The nurse reminds the client that there are only 5 minutes in which to finish the chores.
The client throws a dirty plate at the wall. How should the nurse respond?
"I am sorry you are feeling so angry tonight but you must still complete your chores."
"You only have a few minutes to complete your chores."
"If you calm down right now I will give you a few extra minutes to complete your chores."
"I find your language offensive and you need to stop talking that way." - CORRECT
ANSWERS-"I am sorry you are feeling so angry tonight but you must still complete your
chores."
An adolescent with an oppositional defiant disorder can frequently demonstrate active
defiance, has frequent anger and is noncompliant with adult requests or limits. In this
situation the nurse's goal is to clearly but empathetically explain the rules and firmly
adhere to them. Telling the adolescent there are only a few minutes to complete the
chores does not exhibit empathy. Nor does the statement "I find your language
offensive." It also does not address the rules. Letting the adolescent have a few extra
minutes only reinforces the negative behavior and does not respect the rules of the
facility.
The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which
finding will the nurse expect to assess?
Slow motor actions
Frequently losing things
Indifferent attachment to a parent
Engaging in dangerous activities - CORRECT ANSWERS-Indifferent attachment to a
parent
A child on the autism spectrum disorder can show a lack of or no attachment to parents.
Motor skills are not expected to be slowed or delayed, because a child with ASD tends
to spend hours in repetetive play and may display bizarre motor and stereotypic
behavior. The child may become completely absorbed in strange repetitive behaviors
such as spinning an object, flipping an electrical switch on and off, or walking around
the room feeling the walls. Frequently losing things can be associated with attention
deficit hyperactivity disorder. Engaging in dangerous activities could be related to a
conduct disorder.
Candace, age 16, is being seen for a long overdue checkup. Her caregiver has come
with her. Candace is calm, pleasant, and in good spirits. The caregiver reports to the
nurse that she is relieved because for the past 6 months Candace has been lethargic,
angry, and sad. The mother reports that since she got her driver's license two days
earlier, her child's mood has changed dramatically. Rather than resist this appointment,
Candace had simply smiled and said, "It won't matter much, but okay, I'll be ready in a
, minute." The nurse recognizes that the child's seeming well-being and drastic change in
behavior should be further investigated to determine if the child:
is planning to commit suicide.
is excited that she can drive now.
has been smoking marijuana.
is experimenting with alcohol. - CORRECT ANSWERS-is planning to commit suicide.
Attempted suicide rarely occurs without warning and usually is preceded by a long
history of emotional problems, difficulty forming relationships, feelings of rejection, and
low self-esteem. Suicidal adolescents may appear suddenly elated after a long period of
acting dejected, and might verbalize their hopelessness with statements such as "I
won't be around much longer," or "After Monday, it won't matter anyhow." Some deaths
reported as accidents, particularly one-car accidents, are thought to be suicides.
The nurse is collecting data from the caregiver of an 8-year-old child who recently
started soiling his underwear each day rather than using the toilet to defecate. How
would the nurse document this in the medical record?
The client has symptoms of encephalopathy.
The client is demonstrating echolalia.
The client is displaying enuresis.
The client has regressed to encopresis. - CORRECT ANSWERS-The client has
regressed to encopresis.
Encopresis is chronic involuntary fecal soiling beyond the age when control is expected
(about 3 years of age). When the client reverts back to this behavior, it is noted as a
regression in development.
The most common use disorder among children and adolescents is:
alcohol.
oxycodone.
ecstasy.
marijuana. - CORRECT ANSWERS-alcohol
Alcohol misuse occurs when a person ingests a quantity sufficient to cause intoxication.
It is also the most common substance use disorder among children and adolescents.
The nurse is caring for a 10-year-old girl with an anxiety disorder. During a physical
examination, which physical finding would the nurse expect?
Patches of hair loss
Watery eyes
Dilated eyes
Absence of nasal hair - CORRECT ANSWERS-Patches of hair loss
defiant disorder. The client is using profanity and refusing to complete assigned chores.
The nurse reminds the client that there are only 5 minutes in which to finish the chores.
The client throws a dirty plate at the wall. How should the nurse respond?
"I am sorry you are feeling so angry tonight but you must still complete your chores."
"You only have a few minutes to complete your chores."
"If you calm down right now I will give you a few extra minutes to complete your chores."
"I find your language offensive and you need to stop talking that way." - CORRECT
ANSWERS-"I am sorry you are feeling so angry tonight but you must still complete your
chores."
An adolescent with an oppositional defiant disorder can frequently demonstrate active
defiance, has frequent anger and is noncompliant with adult requests or limits. In this
situation the nurse's goal is to clearly but empathetically explain the rules and firmly
adhere to them. Telling the adolescent there are only a few minutes to complete the
chores does not exhibit empathy. Nor does the statement "I find your language
offensive." It also does not address the rules. Letting the adolescent have a few extra
minutes only reinforces the negative behavior and does not respect the rules of the
facility.
The nurse is assessing a child diagnosed with autism spectrum disorder (ASD). Which
finding will the nurse expect to assess?
Slow motor actions
Frequently losing things
Indifferent attachment to a parent
Engaging in dangerous activities - CORRECT ANSWERS-Indifferent attachment to a
parent
A child on the autism spectrum disorder can show a lack of or no attachment to parents.
Motor skills are not expected to be slowed or delayed, because a child with ASD tends
to spend hours in repetetive play and may display bizarre motor and stereotypic
behavior. The child may become completely absorbed in strange repetitive behaviors
such as spinning an object, flipping an electrical switch on and off, or walking around
the room feeling the walls. Frequently losing things can be associated with attention
deficit hyperactivity disorder. Engaging in dangerous activities could be related to a
conduct disorder.
Candace, age 16, is being seen for a long overdue checkup. Her caregiver has come
with her. Candace is calm, pleasant, and in good spirits. The caregiver reports to the
nurse that she is relieved because for the past 6 months Candace has been lethargic,
angry, and sad. The mother reports that since she got her driver's license two days
earlier, her child's mood has changed dramatically. Rather than resist this appointment,
Candace had simply smiled and said, "It won't matter much, but okay, I'll be ready in a
, minute." The nurse recognizes that the child's seeming well-being and drastic change in
behavior should be further investigated to determine if the child:
is planning to commit suicide.
is excited that she can drive now.
has been smoking marijuana.
is experimenting with alcohol. - CORRECT ANSWERS-is planning to commit suicide.
Attempted suicide rarely occurs without warning and usually is preceded by a long
history of emotional problems, difficulty forming relationships, feelings of rejection, and
low self-esteem. Suicidal adolescents may appear suddenly elated after a long period of
acting dejected, and might verbalize their hopelessness with statements such as "I
won't be around much longer," or "After Monday, it won't matter anyhow." Some deaths
reported as accidents, particularly one-car accidents, are thought to be suicides.
The nurse is collecting data from the caregiver of an 8-year-old child who recently
started soiling his underwear each day rather than using the toilet to defecate. How
would the nurse document this in the medical record?
The client has symptoms of encephalopathy.
The client is demonstrating echolalia.
The client is displaying enuresis.
The client has regressed to encopresis. - CORRECT ANSWERS-The client has
regressed to encopresis.
Encopresis is chronic involuntary fecal soiling beyond the age when control is expected
(about 3 years of age). When the client reverts back to this behavior, it is noted as a
regression in development.
The most common use disorder among children and adolescents is:
alcohol.
oxycodone.
ecstasy.
marijuana. - CORRECT ANSWERS-alcohol
Alcohol misuse occurs when a person ingests a quantity sufficient to cause intoxication.
It is also the most common substance use disorder among children and adolescents.
The nurse is caring for a 10-year-old girl with an anxiety disorder. During a physical
examination, which physical finding would the nurse expect?
Patches of hair loss
Watery eyes
Dilated eyes
Absence of nasal hair - CORRECT ANSWERS-Patches of hair loss
