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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.
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An 11-year-old child, who has been diagnosed with oppositional defiant disorder (ODD), becomes angry over the rules at a residential treatment program and begins shouting at the nurse. What is the best method to defuse the situation?
- A. Assign the child to a short time-out.
- B. Administer an antipsychotic medication.
- C. Place the child in a therapeutic hold.
- D. Call a staff member to seclude the child.
Correct Answer: A
Rationale: Time-out is a useful strategy for interrupting the angry expression of feelings and allows the child an opportunity to exert self-control. This method is the least restrictive alternative of those listed and should be tried before resorting to more restrictive measures.
A child diagnosed with attention-deficit/hyperactivity disorder (ADHD) is going to begin medication therapy. The nurse should plan to teach the family about which classification of medications?
- A. Central nervous system stimulants and nonstimulants
- B. Monoamine oxidase inhibitors (MAOIs)
- C. Antipsychotic medications
- D. Anxiolytic medications
Correct Answer: A
Rationale: Central nervous system stimulants and nonstimulants increase blood flow to the brain and have proven helpful in reducing hyperactivity in children and adolescents with ADHD. The other medication categories listed would not be appropriate.
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.
A nurse assesses the four children below. Which assessment findings should prompt the nurse to refer the child for further evaluation?
- A. A 4-year-old who stuttered for 3 weeks after the birth of a sibling.
- B. A 9-month-old who does not eat vegetables and likes to be rocked.
- C. A 3-month-old who cries after feeding until burped and sucks a thumb.
- D. A 3-year-old who is mute, passive toward adults, and twirls while walking.
Correct Answer: D
Rationale: Symptoms consistent with an autistic spectrum disorder (ASD) are evident in the correct answer. The behaviors of the other children are expected and within normal ranges.
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.