Chapter 33

Question 1

Which developmental characteristic should a nurse identify as typical of a client diagnosed with severe intellectual disability?

Answer 1

The client communicates wants and needs by “acting out” behaviors.

Question 2

Which nursing intervention related to self-care would be most appropriate for a teenager diagnosed with moderate intellectual disability?

Answer 2

Providing simple directions and praising client’s independent self-care efforts

Question 3

A child has been diagnosed with autism spectrum disorder. The distraught mother cries out, “I’m such a terrible mother. What did I do to cause this?” Which nursing reply is most appropriate?

Answer 3

“Poor parenting doesn’t cause autism. Research has shown that abnormalities in brain structure and/or function are to blame. This is beyond your control.”

Question 4

In planning care for a child diagnosed with autistic spectrum disorder, which would be a realistic client outcome?

Answer 4

The client will establish trust with at least one caregiver by day 5.

Question 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?

Answer 5

The pharmacological action of Ritalin causes a decrease in appetite.

Question 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 client’s situation?

Answer 6

Childhood-onset conduct disorder is more severe than the adolescent-onset type, and these individuals likely develop antisocial personality disorder in adulthood.

Question 7

Which finding would be most likely in a child diagnosed with separation anxiety disorder?

Answer 7

The child’s mother is diagnosed with an anxiety disorder.

Question 8

A child has been recently diagnosed with mild intellectual disability (ID). What information about this diagnosis should the nurse include when teaching the child’s mother?

Answer 8

Children with mild ID develop academic skills up to a sixth-grade level.

Question 9

A nursing instructor is teaching about the developmental characteristics of clients diagnosed with moderate intellectual disability (ID). Which student statement indicates that further instruction is needed?

Answer 9

“These clients can successfully complete elementary school.”

Question 10

Which nursing intervention should be prioritized when caring for a child diagnosed with intellectual disability?

Answer 10

Modify the child’s environment to promote independence and encourage impulse control.

Question 11

A preschool child is admitted to a psychiatric unit with a diagnosis of autism spectrum disorder. To help the child feel more secure on the unit, which intervention should a nurse include in this client’s plan of care?

Answer 11

Provide consistent caregivers.

Question 12

A preschool child diagnosed with autism spectrum disorder has been engaging in constant head-banging behavior. Which nursing intervention is appropriate?

Answer 12

Hold client’s head steady and apply a helmet.

Question 13

When planning care for a client, which medication classification should a nurse recognize as effective in the treatment of Tourette’s disorder?

Answer 13

Antipsychotic medications

Question 14

Which behavioral approach should a nurse utilize when caring for children diagnosed with disruptive behavior disorders?

Answer 14

Reinforcing positive actions to encourage repetition of desired behaviors

Question 15

A child diagnosed with autism spectrum disorder has the nursing diagnosis of disturbed personal identity. Which outcome would best address this client’s diagnosis?

Answer 15

The client will name own body parts as separate from others by day 5.

Question 16

A nursing instructor presents a case study in which a 3-year-old child is in constant motion and is unable to sit still during story time. The instructor asks a student to evaluate this child’s behavior. Which student response indicates an appropriate evaluation of the situation?

Answer 16

“This child’s behavior must be evaluated according to developmental norms.”

Question 17

A client has an IQ of 47. Which nursing diagnosis best addresses a client problem associated with this degree of intellectual disability?

Answer 17

Altered social interaction R/T nonadherence to social convention

Question 18

A physician orders methylphenidate (Ritalin) for a child diagnosed with attention deficit-hyperactivity disorder (ADHD). Which information about this medication should the nurse provide to the parents?

Answer 18

Administer Ritalin to the child after breakfast.

Question 19

Which should be the priority nursing intervention when caring for a child diagnosed with conduct disorder?

Answer 19

Recognize escalating aggressive behaviors and intervene before violence occurs.

Question 20

A mother questions the decreased effectiveness of methylphenidate (Ritalin), prescribed for her child’s attention deficit-hyperactivity disorder (ADHD). Which nursing reply best addresses the mother’s concern?

Answer 20

“Your child has probably developed a tolerance to Ritalin and may need a higher dosage.”

Question 21

A nurse has taken report for the evening shift on an adolescent inpatient unit. Which client should the nurse address first?

Answer 21

A client diagnosed with conduct disorder who is verbally abusing a peer in the milieu

Question 22

A 6-year-old client is prescribed methylphenidate (Ritalin) for a diagnosis of attention deficit-hyperactivity disorder (ADHD). When teaching the parents about this medication, which nursing statement explains how Ritalin works?

Answer 22

“How Ritalin works is unknown. Although it is a stimulant, it does combat the symptoms of ADHD.”

Question 23

An 8-year-old client diagnosed with attention deficit-hyperactivity disorder (ADHD) was admitted 5 days ago for management of temper tantrums. What would be a priority nursing intervention during the termination phase of the nurse–client relationship?

Answer 23

Ask the client to demonstrate learned coping skills without direction from the nurse.

Question 24

A child diagnosed with attention deficit-hyperactivity disorder (ADHD) is having difficulty completing homework assignments. What information should the nurse include when teaching the parents about task performance improvement?

Answer 24

The parents should divide the homework task into smaller steps and provide an activity break.

Question 25

A nursing instructor is teaching about pharmacological treatments for attention deficit-hyperactivity disorder (ADHD). Which information about atomoxetine (Strattera) should be included in the lesson plan?

Answer 25

Strattera, unlike methylphenidate (Ritalin), is a selective norepinephrine reuptake inhibitor.

Question 26

Which of the following risk factors noted during a family history assessment should a nurse associate with the potential development of intellectual disability? Select all that apply.
A. A family history of Tay-Sachs disease
B. Childhood meningococcal infection
C. Deprivation of nurturance and social contact
D. History of maternal multiple motor and verbal tics
E. A diagnosis of maternal major depressive disorder

Answer 26

A, B, C

Question 27

Which of the following interventions should a nurse anticipate implementing when planning care for children diagnosed with attention deficit-hyperactivity disorder (ADHD)? Select all that apply.
A. Behavior modification
B. Antianxiety medications
C. Competitive group sports
D. Group therapy
E. Family therapy

Answer 27

A, D, E

Question 28

The nurse should recognize which of the following findings contribute to a client’s development of attention deficit-hyperactivity disorder (ADHD)? Select all that apply.
A. The client’s father was a smoker.
B. The client was born 7 weeks premature.
C. The client is lactose intolerant.
D. The client has a sibling diagnosed with ADHD.
E. The client has been diagnosed with dyslexia.

Answer 28

B, D