Disorders of children and adolescents Flashcards
Which factor presents the highest risk for a child to develop a psychiatric disorder?
a.Having an uncle with schizophrenia
b.Being the oldest child in a family
c.Living with a depressed parent
d Being an only child
ANS: C
A child with a parent with depression is at risk for developing an anxiety disorder, mood disorder, conduct disorder, or substance use. The parent’s inability to model effective coping strategies can lead to learned helplessness, the creation of anxiety or apathy, and an inability to master the environment. Being in a middle-income family and being the oldest child do not represent psychosocial adversity. Having a family history of schizophrenia presents a risk, but an alcoholic parent in the family offers a greater risk.
Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders?
a.Impaired social interaction related to difficulty relating to others
b.Chronic low self-esteem related to excessive negative feedback
c.Deficient fluid volume related to abnormal eating habits
d.Anxiety related to nightmares and repetitive activities
ANS: A
This disorder affects the normal development of the brain in social interaction and communication skills. People with autism spectrum disorder (ASD) typically have difficulties in verbal and nonverbal communication, social interactions, and leisure or play activities. Language is often delayed and deviant, further complicating relationship issues. The other nursing diagnoses might not be appropriate in all cases.
Which behaviour indicates that the treatment plan for a child diagnosed with an autism spectrum disorder was effective?
a.The child plays with one toy for 30 minutes.
b.The child repeats words spoken by a parent.
c.The child holds the parent’s hand while walking.
d.The child spins around and claps hands while walking.
ANS: C
A characteristic of a child with autism spectrum disorder (ASD) is an indifference or aversion to affection and physical contact. Holding the hand of another person suggests relatedness. Usually, a child with ASD would resist holding someone’s hand and stand or walk alone, perhaps flapping arms or moving in a stereotyped pattern. The incorrect options reflect behaviours that are consistent with ASDs.
A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to do which of the following?
a.Promote integration of self-concept
b.Provide inpatient treatment for the child
c.Reduce loneliness and increase self-esteem
d.Improve language and communication skills
ANS: C
Because of their disruptive behaviours, children with attention deficit-hyperactivity disorder (ADHD) often receive negative feedback from parents, teachers, and peers, leading to self-esteem disturbance. These behaviours also cause peers to avoid the child with ADHD, leaving the child with ADHD vulnerable to loneliness. The child does not need inpatient treatment at this time. The incorrect options may or may not be relevant.
A nurse works with a child who is sad and irritable because the child’s parents are divorcing. Why is establishing a therapeutic alliance with this child a priority?
a.Therapeutic relationships provide an outlet for tension.
b.Focusing on the strengths increases a person’s self-esteem.
c.Acceptance and trust convey feelings of security to the child.
d.The child should express feelings rather than internalize them.
ANS: C
The initial interview is key to building trust and rapport. Trust is frequently an issue because the child may question his or her trusting relationship with the parents. In this situation, the trust the child once had in the parents has been disrupted, reducing feelings of security. The correct answer is the most global response.
A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the child’s disorder?
a.The child has occasional toileting accidents.
b.The child is unable to read children’s books.
c.The child cries when separated from a parent.
d.The child continuously rocks in place for 30 minutes.
ANS: D
Autism spectrum disorder (ASD) involves distortions in development of social skills and language that include perception, motor movement, attention, and reality testing. Body rocking for extended periods suggests ASD. The distracters are expected findings for a 3-year-old.
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, “What should we do?” Select the nurse’s best response.
a.“Ask the teacher to let the child call you at play time.”
b.“Withdraw the child from preschool until maturity increases.”
c.Remain with your child for the first hour of preschool time.”
d.“Give your child a kiss before you leave the preschool program.”
ANS: D
The child demonstrates age-appropriate behaviour for a 4-year-old. The nurse should reassure the parents. The distracters are over-reactions.
Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness?
a.The child has been raised by a parent with chronic major depression.
b.The child’s best friend was absent from the child’s birthday party.
c.The child was not promoted to the next grade one year.
d.The child moved to three new homes over a 2-year period.
ANS: A
Children raised by a depressed parent have an increased risk of developing an emotional disorder. Familial risk factors correlate with child psychiatric disorders, including severe marital discord, low socioeconomic status, large families and overcrowding, parental criminality, maternal psychiatric disorders, and foster-care placement. The chronicity of the parent’s depression means it has been a consistent stressor. The other factors are not as risk- enhancing.
When group therapy is prescribed as a treatment modality, the nurse would suggest placement of a 9-year-old in a group that uses which of the following?
a.Guided imagery
b.Talk focused on a specific issue
c.Play and talk about a play activity
d.Group discussion about selected topics
ANS: C
Group therapy for young children takes the form of play. For elementary school children, therapy combines play and talk about the activity. For adolescents, group therapy involves more talking.
A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The parents ask the nurse, “What should we do?” Select the nurse’s best response.
a.Ask the teacher to let the child call you at play time.”
b.“Withdraw the child from preschool until maturity increases.”
c.Remain with your child for the first hour of preschool time.”
d.Give your child a kiss before you leave the preschool program.”
ANS: D
The child demonstrates age-appropriate behaviour for a 4-year-old. The nurse should reassure the parents. The distracters are over-reactions.
