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A nurse is assessing a child who is suspected of having attention deficit hyperactivity disorder. Which of the following would the nurse identify as reflecting impulsiveness in the child?
- A. Inability to wait his turn
- B. Restlessness
- C. Difficulty completing a task
- D. Risk-taking behavior
Correct Answer: A
Rationale: Inability to wait one?s turn is a hallmark of impulsiveness in ADHD, as it reflects acting without forethought. Option B (restlessness) relates to hyperactivity, and option C (difficulty completing tasks) reflects inattention. Option D (risk-taking) may occur but is less specific to impulsiveness than waiting difficulties.
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The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder?
- A. Providing the child with nonverbal activities
- B. Initiating conversations with the child frequently
- C. Stopping the child?s conversation if stuttering begins
- D. Asking the physician for medication to improve the child?s speech
Correct Answer: B
Rationale: Initiating frequent conversations encourages communication practice and skill development, which is key for managing communication disorders. Option A may be helpful but is less central than verbal interaction. Option C is counterproductive, as interrupting stuttering can increase anxiety. Option D is inappropriate, as medication is not typically indicated for communication disorders like stuttering.
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: D
Rationale: Clonidine, an alpha-2 agonist, is often used to manage sleep difficulties in children with ADHD, as it has sedative effects. Methylphenidate (option A) and atomoxetine (option B) are stimulants or non-stimulants for ADHD symptoms but may worsen sleep. Bupropion (option C) is an antidepressant and not typically used for ADHD-related sleep issues.
The school nurse is caring for a 7-year-old child who has demonstrated a significantly lower-than-average score for mental age on standardized tests in reading. However, the child?s IQ scores were within the average range. The nurse interprets this information as suggesting which of the following?
- A. Communication disorder
- B. Attention deficit hyperactivity disorder
- C. Asperger syndrome
- D. Dyslexia
Correct Answer: D
Rationale: A significantly lower reading score despite an average IQ suggests dyslexia, a learning disorder affecting reading and language processing. Option A is too broad, as communication disorders encompass more than reading issues. Option B (ADHD) typically affects attention, not specifically reading. Option C (Asperger?s) is less likely, as it primarily involves social and behavioral challenges, not reading-specific deficits.
The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, 'He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum.' Based on this information, the nurse identifies which nursing diagnosis as the priority?
- A. Self-Care Deficits related to repeated tantrums
- B. Risk for Injury related to Asperger disorder
- C. Ineffective Family Coping related to having a child with Asperger disorder
- D. Risk for Social Isolation related to poor social skills of the child
Correct Answer: D
Rationale: The child?s poor social skills and resulting lack of playmates directly point to the nursing diagnosis of Risk for Social Isolation, as this is a primary concern based on the mother?s statement. Option A is less relevant, as tantrums do not directly relate to self-care deficits. Option B is not supported, as no immediate physical danger is described. Option C may apply but is less specific than social isolation in this context.
After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state which of the following?
- A. We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention.
- B. We need to be careful so he doesn?t develop a substance abuse problem as he grows older.
- C. We should stop the medication after 2 months to see how effective it is in really controlling his symptoms.
- D. We should set up regular routines for him but not worry if he violates the limits once in a while.
Correct Answer: A
Rationale: The statement in option A reflects an accurate understanding of ADHD as a disorder of impulse control and attention, not a reflection of the child?s character, indicating effective teaching. Option B is a concern but not directly related to core understanding. Option C is incorrect, as stopping medication abruptly is not advisable. Option D is partially correct but downplays the importance of consistent limits.