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A 15-year-old adolescent has run away from home six times. After the adolescent was arrested for prostitution, the parents told the court, 'We can't manage our teenager.' The adolescent is physically abusive to the mother and defiant with the father. The adolescent's problem is most consistent with criteria for which disorder?
- A. Attention-deficit/hyperactivity disorder (ADHD)
- B. Childhood depression
- C. Conduct disorder (CD)
- D. Autism spectrum disorder (ASD)
Correct Answer: C
Rationale: CDs are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. The Diagnostic and Statistical Manual of Mental Disorders (5th edition) (DSM-5) identifies CDs as serious violations of rules. The patient's clinical manifestations do not coincide with the other disorders listed.
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A 5-year-old child diagnosed with attention-deficit/hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse's best action?
- A. Call for emergency assistance from another staff member.
- B. Instruct the parents to take the child home immediately.
- C. Direct this child to stop, and then comfort the other child.
- D. Take the child into another room with toys to act out feelings.
Correct Answer: D
Rationale: The use of play to express feelings is appropriate; the cognitive and language abilities of the child may require the acting out of feelings if verbal expression is limited. The incorrect options provide no outlet for feelings or opportunity to develop coping skills.
When group therapy is to be used as a treatment modality, the nurse should suggest placing a 9-year-old in a group that focuses on what?
- A. Play activities exclusively.
- B. Group discussion exclusively.
- C. Talk focused on a specific issue.
- D. Play and then talk about the play activity.
Correct Answer: D
Rationale: 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.
The parent of a child diagnosed with Tourette's disorder says to the nurse, 'I think my child is faking the tics because they come and go.' Which response by the nurse is accurate?
- A. Perhaps your child was misdiagnosed.
- B. Your observation indicates the medication is effective.
- C. Tics often change frequency or severity. That does not mean they aren't real.
- D. This finding is unexpected. How have you been administering your child's medication?
Correct Answer: C
Rationale: Tics are sudden, rapid, involuntary, repetitive movements, or vocalizations characteristic of Tourette's disorder. They often fluctuate in frequency and severity and are reduced or absent during sleep.
Which behavior indicates that the treatment plan for a child diagnosed with autism spectrum disorder was effective?
- A. Plays with one toy for 90 minutes.
- B. Repeats words spoken by a parent.
- C. Holds the parent's hand while walking.
- D. Spins around and claps hands while walking.
Correct Answer: C
Rationale: Holding the hand of another person suggests relatedness. Usually, a child with autism would resist holding someone's hand and stand or walk alone, perhaps flapping arms or moving in a stereotypical pattern. The other options reflect behaviors that are consistent with autistic disorder.
The child most likely to receive propranolol to manage tremors is one diagnosed with which disorder?
- A. Attention-deficit/hyperactivity disorder (ADHD)
- B. Posttraumatic stress disorder (PTSD)
- C. A motor disorder
- D. Separation anxiety
Correct Answer: C
Rationale: Propranolol is useful for managing tremors associated with various motor disorders. This medication is not indicated in any of the other disorders.