Nokea
A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following?
- A. Selective serotonin reuptake inhibitor
- B. Psychostimulant
- C. Noradrenergic reuptake inhibitor
- D. Alpha agonist
Correct Answer: B
Rationale: Methylphenidate is a psychostimulant used to treat ADHD by increasing dopamine and norepinephrine levels to improve attention and impulse control. Option A (SSRI) is for depression, option C (noradrenergic reuptake inhibitor) describes drugs like atomoxetine, and option D (alpha agonist) includes drugs like clonidine.
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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.
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 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.
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
- A. Locating suitable residential placement for the child
- B. Finding a foster home for the child
- C. Achieving independent functioning of the child as an adult
- D. Preventing the onset of psychiatric disorders in the child
Correct Answer: C
Rationale: For a child with mild mental retardation, realistic long-term goals focus on maximizing independence to the extent possible. Mild mental retardation typically allows individuals to achieve some level of independent functioning as adults, such as living in supported environments or performing simple jobs with guidance. Options A and B (residential placement or foster home) are premature and not necessarily appropriate for mild cases, as they imply more severe disability. Option D is less feasible, as psychiatric disorders may not be preventable due to the complexity of mental health conditions.
The nurse is caring for a 3½-year-old child with autism who has been hospitalized. The child rocks continuously without any danger present to the child?s safety. Which intervention by the nurse would be most appropriate?
- A. Continue to monitor the child?s behaviors.
- B. Hold the child until the child stops rocking.
- C. Ignore the child?s rocking behavior.
- D. Place the child in a time out area until the rocking stops.
Correct Answer: C
Rationale: Rocking is a common self-soothing behavior in children with autism and is not harmful in this context. Ignoring the behavior (option C) is most appropriate, as it avoids reinforcing or escalating the behavior while ensuring safety. Option A is passive and less specific. Options B and D could distress the child and are inappropriate for non-harmful behaviors.