Medical and nursing management of children with behavioural disorders
Time: 15:00
A nurse is caring for a school-age child newly prescribed methylphenidate (Ritalin) for ADHD. Which of the following is a crucial side effect to monitor and educate the family about?
[a] Significant weight gain.
[b] Excessive sleepiness (somnolence).
[c] Appetite suppression and insomnia.
[d] Bradycardia and hypotension.
The defining characteristic of Oppositional Defiant Disorder (ODD) in a child is a persistent pattern of:
[a] Severe violation of the rights of others, such as physical cruelty.
[b] Angry/irritable mood, argumentative behavior, and vindictiveness towards authority figures.
[c] Inattention and inability to focus in school settings.
[d] Repetitive motor movements and vocal tics.
What is the most appropriate initial nursing intervention when a child with a behavioral disorder begins to escalate and become agitated?
[a] Immediately place the child in seclusion.
[b] Firmly tell the child to stop their behavior.
[c] Use a calm voice, provide personal space, and attempt to verbally de-escalate.
[d] Ignore the behavior, as it is likely for attention.
Which behavioral therapy technique involves rewarding a child with points or stickers for desired behaviors, which can later be exchanged for a prize or privilege?
[a] Time-out.
[b] Aversion therapy.
[c] Token economy.
[d] Cognitive restructuring.
A key feature that distinguishes Conduct Disorder (CD) from Oppositional Defiant Disorder (ODD) is:
[a] The child's age at the onset of symptoms.
[b] The presence of an irritable mood.
[c] A pattern of behavior that violates the basic rights of others or major societal norms.
[d] Arguing with adults and refusing to comply with rules.
A nurse is monitoring a child taking risperidone (Risperdal), an atypical antipsychotic, for aggression related to Autism Spectrum Disorder. The nurse should be especially vigilant for which common metabolic side effect?
[a] Weight loss.
[b] Hypoglycemia.
[c] Significant weight gain and hyperglycemia.
[d] Decreased cholesterol levels.
The most important element in creating a therapeutic milieu for children with behavioral disorders on an inpatient unit is:
[a] Allowing children complete freedom to make their own choices.
[b] Providing a consistent, structured environment with clear rules and expectations.
[c] Ensuring the environment is constantly stimulating with many activities.
[d] Minimizing contact with family members to reduce stress.
The nurse is educating parents about using a "time-out" as a disciplinary technique. The nurse should explain that the primary purpose of a time-out is to:
[a] Punish the child for their misbehavior.
[b] Make the child feel remorseful.
[c] Remove the child from a reinforcing environment to help them calm down.
[d] Isolate the child from their peers.
Parent Management Training (PMT) is a highly effective intervention for ODD. Its primary focus is on:
[a] Providing psychotherapy for the parents' own issues.
[b] Teaching the child better ways to communicate.
[c] Coaching parents on how to use positive reinforcement and effective discipline strategies.
[d] Exploring the family's unconscious dynamics from childhood.
A child with Autism Spectrum Disorder (ASD) is non-verbal and becomes frustrated when trying to communicate their needs. Which nursing intervention is most appropriate?
[a] Encouraging the child to use spoken words only.
[b] Introducing a Picture Exchange Communication System (PECS).
[c] Speaking to the child in a louder voice.
[d] Guessing what the child wants to reduce frustration.
What is the priority nursing diagnosis for a child with Conduct Disorder who has a history of physical aggression towards peers and animals?
[a] Ineffective coping.
[b] Impaired social interaction.
[c] Chronic low self-esteem.
[d] Risk for other-directed violence.
When educating a family about a new prescription for an SSRI like fluoxetine (Prozac) for their adolescent with depression, the nurse must include a warning about which potential risk, especially in the initial weeks of treatment?
[a] High potential for addiction.
[b] Increased risk of suicidal thoughts and behaviors.
[c] Development of severe hypertension.
[d] Rapid weight loss.
A child is diagnosed with Tourette's Syndrome. The nurse knows this diagnosis requires the presence of:
[a] Only multiple motor tics.
[b] Only one or more vocal tics.
[c] Both multiple motor tics and at least one vocal tic for more than a year.
[d] Tics that only occur during periods of high stress.
A 7-year-old child exhibits extreme distress when separated from their parents to go to school, worries constantly that something bad will happen to them, and complains of stomach aches. This is characteristic of:
[a] Oppositional Defiant Disorder.
[b] Normal developmental behavior.
[c] Separation Anxiety Disorder.
[d] Attention-Deficit/Hyperactivity Disorder.
Cognitive Behavioral Therapy (CBT) is an effective treatment for anxiety in children. The primary goal of CBT is to:
[a] Uncover unconscious conflicts from the child's past.
[b] Help the child identify and change distorted thought patterns and behaviors.
[c] Focus solely on positive reinforcement for brave behaviors.
[d] Teach parents how to manage their child's anxiety for them.
A nurse is preparing to administer clonidine, an alpha-2 adrenergic agonist, to a child with ADHD. Which assessment is essential before giving the medication?
[a] Height and weight.
[b] Respiratory rate.
[c] Blood pressure and heart rate.
[d] Abdominal girth.
A teenager with depression states, "It doesn't matter what I do, nothing ever works out for me." Which of the following is the most therapeutic response by the nurse?
[a] "You should try to think more positively."
[b] "Why do you feel that way?"
[c] "That's not true, you have a lot going for you."
[d] "It sounds like you're feeling very hopeless. Let's talk more about that."
The most effective way to document a child's behavioral outburst is to:
[a] State that the child was angry and manipulative.
[b] Objectively describe the behavior, what preceded it, and the staff's response.
[c] Write a brief note stating, "child had a tantrum."
[d] Ask the child's parents to write their interpretation of the event.
A nurse is working with parents to develop an Individualized Education Program (IEP) for their child with ADHD. In this situation, the nurse is primarily functioning in the role of:
[a] A primary caregiver.
[b] A diagnostician.
[c] An advocate.
[d] A researcher.
Which medication is a non-stimulant used in the treatment of ADHD and is often chosen when there are concerns about stimulant side effects or substance abuse potential?
[a] Dextroamphetamine (Dexedrine).
[b] Atomoxetine (Strattera).
[c] Sertraline (Zoloft).
[d] Lorazepam (Ativan).
The initial step in a comprehensive nursing assessment for a child with a suspected behavioral disorder is:
[a] Recommending a specific medication.
[b] Administering a standardized intelligence test.
No comments: