Pediatric Mental Health

Question 1

Describe the Resilient Child.

Answer 1

Adaptability to changes in the environment
Ability to form nurturing relationships w/ other adults when the parent is not available
Ability to distance self from emotional chaos
Good social intelligence
Good problem-solving skills

Question 2

What are the general interventions for children and adolescents?

Answer 2

Family therapy
Group therapy
Behavioural therapy
Cognitive behavioural therapy
Mind-Body therapies

Question 3

What is Mutual Storytelling?

Answer 3

Make up a story, with beginning, middle, and end, and morale of the story, therapist retells story with a healthier resolution

Question 4

What is the Neurodevelopmental Disorder?

Answer 4

Group of disease
Cause abnormal functions of the brain or CNS
Impairment can be seen in: Language, Speech, Memory, Learning, Motor skills

Question 5

What does Neurodevelopmental Disorders are included?

Answer 5

Intellectual disorder
Communication disorder
Autism Spectrum Disorder
Attention-deficit/Hyperactivity disorder
Specific learning disorder
Motor disorder

Question 6

What includes in the Specific learning disorder?

Answer 6

Dyslexia (reading)
Dyscalculia (math)
Dysgraphia (written expression)

Question 7

Describe the Autism Spectrum Disorder.

Answer 7

Neurobiological disability
Developmental disability
Appears during first 3 years of life
70-80% in identical twins
LARGE SPECTRUM OF FUNCTIONALITY

Question 8

What. are the Symptoms of a child that has Autism Spectrum Disorder?

Answer 8

-Impairment in communication and imaginative activity
Language delay or absence of language
Stereotypical or repetitive use of language
Lack of spontaneous make-believe or imaginative play
Failure to imitate others’ activities or words
-Impairment in social interactions
-Markedly restricted, stereotypical patterns of behaviour, interest, activities

Question 9

What are the implementations with Neurodevelopmental Disorder?

Answer 9

Autism: Applied Behavioural analysis (ABA) & Intensive Behavioural Intervention (IBI)
Behaviour management plans
Medication management

Question 10

Describe the Oppositional Defiant Disorder.

Answer 10

Angry, irritable mood, defiant, vindictive behaviour
Social difficulties, conflicts w/authority figures, academic problems
Evidence before 8 yrs old until puberty more common in males

Question 11

Describe the Conduct Disorder.

Answer 11

Aggressive, Destructive, Deceitful Behaviour, Violation of rules
Behaviour is persistent, No disregard for others/rules
SEVERE lack of empathy, lack of insight

Question 12

What are the complications with a children with Conduct Disorder?

Answer 12

Academic failure
School suspensions and dropout
Juvenile delinquency
Drug & alcohol abuse
Juvenile court involvement

Question 13

What are the techniques used for managing Disruptive Behaviour?

Answer 13

Behavioural contract
Counselling
Modelling
Role-playing
Planned ignoring
Additional affection
Use of humour
Clarification
Restructuring 
Limit setting
Simple restitution

Question 14

What are the criterias to be diagnosed with Disruptive Mood Dysregulation Disorder?

Answer 14

must be irritable, anger, have temper tantrums in at least 2 of the following settings (school, home, peers)
Irritability is severe, chronic
Before 18yrs old
Rare psychotic symptoms
Temper outbursts

Question 15

Describe the Post-Traumatic Stress Disorder.

Answer 15

Exposure to traumatic event
Anxiety, dissociative symptoms
Re-experience of trauma

Younger children: Internalized anxiety
Adolescents: Externalized anxiety

Question 16

The nurse is assessing a teenage patient for suicidal risk. Which patient response requires immediate further nursing assessment?

a. This statement does not indicate that there is a plan or an identified method.
b. This statement does not indicate that there is intent.
c. Patients who acknowledge the existence of a plan for suicide or have a demonstrated accessibility to the method for carrying out the plan should be assessed further. This patient knows where medications are kept, which indicates accessibility to carry out a plan.
d. This statement does not indicate that there is current intent or a plan.

Answer 16

c. Patients who acknowledge the existence of a plan for suicide or have a demonstrated accessibility to the method for carrying out the plan should be assessed further. This patient knows where medications are kept, which indicates accessibility to carry out a plan.

Question 17

The nurse meets with the parents of a child diagnosed with conduct disorder. What advice from the nurse is most appropriate?

a. The use of time out temporarily separates the child from an environment when an inappropriate behaviour has occurred. This technique helps to discourage such behaviours and gives the child time to “calm down” and gain self-control.
b. Ignoring this action may result in injury.
c. This action does not discourage inappropriate behaviours.
d. This action does not give the child an opportunity to calm down.

Answer 17

a. The use of time out temporarily separates the child from an environment when an inappropriate behaviour has occurred. This technique helps to discourage such behaviours and gives the child time to “calm down” and gain self-control.

Question 18

The nurse is caring for a 9-year-old patient who will be entering a freedom room. Which activity should the nurse anticipate the child would engage in?

a. A freedom room is a type of quiet room that contains items for relaxation and meditation, like music and yoga mats. The child is encouraged to express freely and work through feelings of anger or sadness in privacy with staff support.
b. Another type of quiet room, the feelings room, is carpeted and supplied with soft objects that can be punched or thrown.
c. The time-out area is one in which a child can go to sit until self-control is regained and the inappropriate behaviour can be reviewed with a staff member.
d. Another type of quiet room, the feelings room, is carpeted and supplied with soft objects that can be punched or thrown.

Answer 18

a. A freedom room is a type of quiet room that contains items for relaxation and meditation, like music and yoga mats. The child is encouraged to express freely and work through feelings of anger or sadness in privacy with staff support.

Question 19

A 7-year-old male who has not met earlier normal expectations in cognitive and language development and who has difficulty establishing friendships with other schoolchildren develops a fascination with the water foundation in his neighbourhood. Which condition should the nurse anticipate?

a. Intellectual development disorder typically appears during a child’s first three years of life
b. A child with a major depressive episode would more likely present with alterations in mood, such as irritability or withdrawal, and earlier cognitive development is usually normal.
c. Tourette’s disorder typically begins between the ages of 4 and 6.
d. Typically, autism spectrum disorders appear during a child’s first 3 years of life. Individuals with ASD can have impairment in communication with delay in or absence of language. These children are preoccupied with repetitive activities (e.g., pouring water).

Answer 19

d. Typically, autism spectrum disorders appear during a child’s first 3 years of life. Individuals with ASD can have impairment in communication with delay in or absence of language. These children are preoccupied with repetitive activities (e.g., pouring water).

Question 20

The school nurse is assessing Than, who has been coming to the office the past week with cuts and bruises for treatment. What must the nurse include in his assessment?

a. This assessment would occur after bullying has been assessed.
b. The relationship priority for the nurse is to establish rapport.
c. Children and adolescents who are victims of bullying from peers tend to blame themselves and do not report these episodes to parents or others and need to be directly asked about being bullied.
d. The assessment conducted to date does not warrant this intervention.

Answer 20

c. Children and adolescents who are victims of bullying from peers tend to blame themselves and do not report these episodes to parents or others and need to be directly asked about being bullied.

Question 21

Name at least three realistic outcomes for a child with NDD.

Answer 21

1. Follows simple rules of interactive games with peers
2. Directs messages appropriately
3. Expresses emotions during play activities

Question 22

Which interventions are the most important for a child with NDD? Identify at least six.

Answer 22

1. Explore the impact of the child’s behaviours on family life and the impact of the other members’ behaviour on the child.
2. Assist the immediate and extended family to access available and supportive individuals and systems.
3. Discuss how to make home a safe environment—especially in regard to potential weapons, drugs, and so forth—and attempt to talk to members separately when possible.
4. Discuss realistic behavioural goals and how to set them; problem-solve potential problems.
5. Teach behaviour modification techniques. With the parents, role-play them in different problem situations that might arise with their child.
6. Give support and encouragement as parents learn to apply new techniques.
7. Provide education about medications.

Question 23

Jasmine is a 16-year-old who is attending an appointment with her nurse–therapist at the local community health clinic. Jasmine has been diagnosed with depression.

a. Based on current research, what themes would you expect to hear as Jasmine describes her experiences of depression?

Answer 23

1. Struggle to make sense of the situation
2. Spiralling down
3. Withdrawal
4. Self-harm

Question 24

Jasmine is a 16-year-old who is attending an appointment with her nurse–therapist at the local community health clinic. Jasmine has been diagnosed with depression.
As you complete a mental status exam, what area of assessment is essential?

Answer 24

Because many adolescents experience suicidal thoughts, it is essential that a risk assessment be completed.