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A client with conduct disorder starts yelling at another client and calling the client insulting names. Which is the most appropriate response by the nurse?
- A. How would you feel if someone yelled at you like that?
- B. What's the matter with you? Don't you know any better?
- C. Yelling at others is unacceptable. You need to let staff know you're upset
- D. You're still having problems controlling your anger
Correct Answer: C
Rationale: Stating that yelling is unacceptable and directing the client to inform staff focuses on the behavior non-judgmentally, unlike questioning feelings, criticizing, or assuming ongoing issues.
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The nurse has been working with the family of a small child with oppositional defiant disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best nursing action at this time?
- A. Review effective disciplinary practices with the parents again.
- B. Refer the parents to a family therapist.
- C. Try to remember that the parents are trying to the best of their ability to carry out the suggestions.
- D. Explore alternative living arrangements for the child.
Correct Answer: C
Rationale: Acknowledging parental challenges fosters understanding and collaboration, avoiding premature re-teaching, therapy referral, or removal of the child.
The nurse is meeting with a family of a client with conduct disorder. The nurse discusses changes the parents can make to help their child change problematic behaviors. Which parenting technique would the nurse encourage the parents to use?
- A. Provide consistent consequences for behaviors.
- B. Set earlier curfews than the child's peers adhere to.
- C. Release the child from household responsibilities until he can demonstrate dependable behavior.
- D. Avoid discussing feelings and expectations with the child.
Correct Answer: A
Rationale: Consistent consequences reinforce appropriate behavior, unlike overly strict curfews, avoiding responsibilities, or not discussing feelings.
Which are important points for the nurse to consider when working with clients with disruptive behavior disorders and their families?
- A. Most behavior disorders are caused by being raised by parents who had behavior disorders in their own childhoods.
- B. Remember to focus on the client's strengths and assets, as well as their problems.
- C. Transient conduct disorders are common in all children.
- D. Avoid a blaming attitude toward clients and/or families.
- E. Focus on positive actions to improve situations and/or behaviors.
Correct Answer: B,D,E
Rationale: Focusing on strengths, avoiding blame, and promoting positive actions are key, but behavior disorders have multiple causes, and conduct disorders are not common in all children.
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.
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.