Chapter 19: Disruptive, Impulse Control, and Conduct Disorders
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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, 4. An adolescent was arrested for prostitution and assault on a parent. The adolescent says, I hate
my parents. They focus all attention on my brother, whos perfect in their eyes. Which type of
therapy might promote the greatest change in the adolescents behavior?
a. Family therapy c. Play therapy
b. Bibliotherapy d. Art therapy
ANS: A
Family therapy focuses on problematic family relationships and interactions. The patient has
identified problems within the family. Play therapy is more appropriate for younger patients. Art
therapy and bibliotherapy would not focus specifically on the identified problem.
5. An adolescent was arrested for prostitution and assault on a parent. The adolescent says, I hate
my parents. They focus all attention on my brother, whos perfect in their eyes. Which nursing
diagnosis is most applicable?
a. Disturbed personal identity related to acting out as evidenced by prostitution
b. Hopelessness related to achievement of role identity as evidenced by feeling
unloved by parents
c. Ineffective coping related to inappropriate methods of seeking parental attention
as evidenced by acting out
d. Impaired parenting related to inequitable feelings toward children as evidenced
by showing preference for one child over another
ANS: C
The patient demonstrates a failure to follow age-appropriate social norms and an inability to
problem solve by using adaptive behaviors to meet lifes demands and roles. The defining
characteristics are not present for the other nursing diagnoses. The patient never mentioned
hopelessness or disturbed personal identity. The problem relates to the patients perceptions of
parental behavior rather than the actual behavior.
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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
HTTPS://PASINGGRADES.COM/
,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.
HTTPS://PASINGGRADES.COM/
, 4. An adolescent was arrested for prostitution and assault on a parent. The adolescent says, I hate
my parents. They focus all attention on my brother, whos perfect in their eyes. Which type of
therapy might promote the greatest change in the adolescents behavior?
a. Family therapy c. Play therapy
b. Bibliotherapy d. Art therapy
ANS: A
Family therapy focuses on problematic family relationships and interactions. The patient has
identified problems within the family. Play therapy is more appropriate for younger patients. Art
therapy and bibliotherapy would not focus specifically on the identified problem.
5. An adolescent was arrested for prostitution and assault on a parent. The adolescent says, I hate
my parents. They focus all attention on my brother, whos perfect in their eyes. Which nursing
diagnosis is most applicable?
a. Disturbed personal identity related to acting out as evidenced by prostitution
b. Hopelessness related to achievement of role identity as evidenced by feeling
unloved by parents
c. Ineffective coping related to inappropriate methods of seeking parental attention
as evidenced by acting out
d. Impaired parenting related to inequitable feelings toward children as evidenced
by showing preference for one child over another
ANS: C
The patient demonstrates a failure to follow age-appropriate social norms and an inability to
problem solve by using adaptive behaviors to meet lifes demands and roles. The defining
characteristics are not present for the other nursing diagnoses. The patient never mentioned
hopelessness or disturbed personal identity. The problem relates to the patients perceptions of
parental behavior rather than the actual behavior.
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