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A child is expelled from school for repeated fighting and vandalizing school property. The school nurse and counselor meet with the parents to explain that the child may benefit from counseling as the child is experiencing signs of which disorder?
- A. Oppositional defiant disorder
- B. Asperger's syndrome
- C. Attention deficit hyperactivity disorder
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder involves persistent antisocial behaviors like fighting and vandalism, impairing function, unlike ODD (defiance without major violations), Asperger's (social and behavioral issues), or ADHD (inattention and impulsivity).
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Which may be concerns that a nurse has when caring for clients who have conduct disorders?
- A. Thinking that the client should be able to refrain from hostility and aggression through use of will power.
- B. Having conflicted feelings regarding holding clients accountable for their behaviors without having a punitive attitude.
- C. Discussing feelings, fears, or frustrations with colleagues.
- D. Having anxiety and fears for the nurse's personal safety.
- E. Believing that aggression is the most productive way to deal with aggression.
Correct Answer: A,B,D
Rationale: Nurses may struggle with misconceptions about willpower, balancing accountability, and safety concerns, but discussing feelings is constructive, and aggression is not productive.
Which steps are involved in limit setting?
- A. State expected behavior.
- B. Inform clients or the rule or limit.
- C. Threaten incarceration.
- D. Explain the consequences if clients exceed the limit.
- E. Occasionally limit enforcement
Correct Answer: A,B,D
Rationale: Limit setting includes stating rules, consequences, and expected behavior, not threatening incarceration or inconsistent enforcement.
The nurse understands that when working with a child with a disruptive behavior disorder, the family must be included in the care. Which is one of the best ways the nurse can advocate for the child?
- A. Support transferring the child to a healthy living environment.
- B. Teach the parents age-appropriate expectations of the child.
- C. Reinforce the parents' expectations of the child's behavior.
- D. Interpret the child's thoughts and feelings to the parent.
Correct Answer: B
Rationale: Teaching age-appropriate expectations empowers parents to support the child effectively, unlike transferring, reinforcing parental expectations, or interpreting feelings.
Which are most likely included in the history of a child with conduct disorder?
- A. Disturbed relationships with peers
- B. Major antisocial violations
- C. Aggression toward people or animals
- D. Destruction of property
- E. Serious violation of rules
Correct Answer: A,C,D,E
Rationale: Conduct disorder history includes peer issues, aggression, property destruction, and rule violations, but major antisocial violations are not specified.
An 11-year-old child talks to the school nurse about a single episode of disruptive behavior in class. The child states, 'I had a stomachache and felt like vomiting. I couldn't help it. I was just so mad at my dad.' Which would be the most appropriate response by the nurse?
- A. I can see that you're angry. Let's look at better ways to express it
- B. I can understand your anger, but you can't disrupt the classroom
- C. If you can get rid of your anger, perhaps your stomachache will go away.
- D. Perhaps it would be helpful if you let your dad know you're angry.
Correct Answer: A
Rationale: Teaching the child to express anger appropriately addresses the behavior constructively, unlike focusing on classroom rules, linking physical symptoms to anger, or redirecting to the parent.