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Chapter 17. Integrative Management of Disordered Impulse Control

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March 31, 2025
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lOMoAR cPSD| 14985576




Chapter 17. Integrative Management of Disordered Impulse Control

MULTIPLE CHOICE

1. A 16-year-old diagnosed with a conduct disorder has been in a residential program for 3
months. Which outcome should occur before discharge?

a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and
consequences.
b. The adolescent identifies friends in the home community who are a positive influence.
c. Temporary placement is arranged with a foster family until the parents complete a parenting
skills class.
d. The adolescent experiences no anger and frustration for 1 week. ANS: A

The adolescent and the parents must agree on a behavioral contract that clearly outlines rules,
expected behaviors, and consequences for misbehavior. It must also include rewards for
following the rules. The adolescent will continue to experience anger and frustration. The
adolescent and parents must continue with family therapy to work on boundary and
communication issues. It is not necessary to separate the adolescent from the family to work
on these issues. Separation is detrimental to the healing process. While it is helpful for the




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adolescent to identify peers who are a positive influence, its more important for behavior to
be managed for an adolescent diagnosed with a conduct disorder.

2. A 15-year-old ran away from home six times and was arrested for shoplifting. The parents
told the court, We cant manage our teenager. The adolescent is physically abusive to the
mother and defiant with the father. Which diagnosis is supported by this adolescents
behavior?

a. Attention deficit hyperactivity disorder (ADHD)
b. Posttraumatic stress disorder (PTSD)
c. Intermittent explosive disorder d. Conduct disorder


ANS: D

Conduct disorders are manifested by a persistent pattern of behavior in which the rights of
others and age-appropriate societal norms are violated. Intermittent explosive disorder is a
pattern of behavioral outbursts characterized by an inability to control aggressive impulses in
adults 18 years and older. Criteria for ADHD and PTSD are not met in the scenario.

3. A 15-year-old was placed in a residential program after truancy, running away, and an arrest
for theft. At the program, the adolescent refused to join in planned activities and pushed a staff
member, causing a fall. Which approach by nursing staff will be most therapeutic?

a. Planned ignoring c. Neutrally permit refusals
b. Establish firm limits d. Coaxing to gain compliance


ANS: B

Firm limits are necessary to ensure physical safety and emotional security. Limit setting will
also protect other patients from the teens thoughtless or aggressive behavior. Permitting
refusals to participate in the treatment plan, ignoring, coaxing, and bargaining are strategies
that do not help the patient learn to abide by rules or structure.




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