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A 12-year-old child is brought to the mental health clinic by his parents because of a court-ordered evaluation. When assessing the child, which of the following would lead the nurse to suspect that the child has a conduct disorder? Select all that apply.
- A. Destruction of neighbor?s car on two separate occasions
- B. Arrests for petty larceny several times
- C. Repetitive disobedience of parents
- D. Blaming of others for problems
- E. Evidence of overt lying
Correct Answer: A,B,C,D,E
Rationale: Conduct disorder involves persistent patterns of behavior that violate societal norms or others? rights. Destruction of property (A), petty larceny (B), disobedience (C), blaming others (D), and lying (E) are all indicative of conduct disorder, as they reflect aggression, deceit, and rule-breaking.
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A nurse is assessing an 8-year-old girl with a mood disorder. Which of the following would the nurse most likely expect to assess?
- A. Statement from the child that she feels sad
- B. Behavioral problems
- C. Recurrent obsessions
- D. Ritualistic behavior
Correct Answer: A
Rationale: Mood disorders in children, such as depression, often present with verbalized feelings of sadness (option A). Behavioral problems (option B) may occur but are less specific. Options C and D are more characteristic of obsessive-compulsive disorder, not a mood disorder.
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: D
Rationale: Clonidine, an alpha-2 agonist, is often used to manage sleep difficulties in children with ADHD, as it has sedative effects. Methylphenidate (option A) and atomoxetine (option B) are stimulants or non-stimulants for ADHD symptoms but may worsen sleep. Bupropion (option C) is an antidepressant and not typically used for ADHD-related sleep issues.
The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include?
- A. Connection to ineffective parental practices
- B. Detection after the child enters school
- C. Onset before child is 2.5 years old
- D. Girls are more frequently affected than boys
Correct Answer: C
Rationale: Autism spectrum disorder (ASD) is characterized by symptoms that typically appear before the age of 3, often by 2.5 years, including challenges in social interaction and communication. Option A is incorrect, as autism is not caused by parenting practices but is neurodevelopmental. Option B is misleading, as detection often occurs before school age. Option D is false, as boys are more frequently affected than girls.
The parents of a child with ADHD bring the child for a follow-up visit. During the visit, they tell the nurse that the child receives his first dose of methylphenidate (Ritalin) at about 7:30 AM every morning before leaving for school. The teacher and school nurse have noticed a return in the child?s overactivity and distractibility just before lunch. The child?s second dose is scheduled for about 12 noon. Which of the following might the nurse suggest as a possible solution to control the child?s symptoms a bit more effectively?
- A. Giving the second dose at 1 PM or later.
- B. Switching to a longer acting preparation.
- C. Splitting the early morning dose in half.
- D. Switching to another class of medication
Correct Answer: B
Rationale: Switching to a longer-acting preparation of methylphenidate can provide more consistent symptom control throughout the morning, addressing the return of symptoms before lunch. Delaying the second dose (option A) may prolong symptoms, splitting the dose (option C) may not provide adequate coverage, and switching medication classes (option D) is unnecessary without further evaluation.
A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step?
- A. Having the child recount the reason for the time out
- B. Clearly identifying what is required for the child
- C. Informing the child what will happen because of the behavior
- D. Placing the child in a designated area removed from others
Correct Answer: B
Rationale: The first step in implementing time out is to clearly identify the expected behavior (option B), as this sets the foundation for the child to understand what actions lead to consequences. Options A, C, and D follow later in the process.