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A nurse is providing parent training for parents of a child diagnosed with a disruptive behavior disorder involving the use of time out. When describing how to implement this, which of the following would the nurse identify as the first step?
- A. Having the child recount the reason for the time out
- B. Clearly identifying what is required for the child
- C. Informing the child what will happen because of the behavior
- D. Placing the child in a designated area removed from others
Correct Answer: B
Rationale: The first step in implementing time out is to clearly identify the expected behavior (option B), as this sets the foundation for the child to understand what actions lead to consequences. Options A, C, and D follow later in the process.
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A 10-year-old child with Tourette?s disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow-up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug?
- A. Sometimes I feel like I?m so sleepy.
- B. I?m eating about the same amount as before.
- C. My muscles seem pretty flexible lately.
- D. I think I?m much more alert with this drug.
Correct Answer: A
Rationale: Haloperidol, an antipsychotic, commonly causes sedation as a side effect, so the child?s report of feeling sleepy (option A) suggests this. Option B (unchanged eating) and option C (flexible muscles) are not typical side effects. Option D (increased alertness) is opposite to haloperidol?s sedative effect.
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.
A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder?
- A. Anxiety
- B. Depression
- C. Schizophrenia
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder is an externalizing disorder characterized by behaviors like aggression and rule-breaking, which are outwardly directed. Anxiety (option A), depression (option B), and schizophrenia (option C) are internalizing or psychotic disorders, not externalizing.
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 nurse is caring for a family with a 3-year-old child who has autism disorders. When developing the teaching plan for the parents, which of the following would the nurse most likely include?
- A. The child is at higher risk for seizure disorders as well.
- B. The child?s IQ will typically be higher than that of other children.
- C. Dyslexia also may be a comorbid condition.
- D. A structured physical environment is an important aspect.
Correct Answer: D
Rationale: A structured physical environment is critical for children with autism, as it provides predictability and reduces sensory overload, aiding in behavior management and learning. Option A is true but less central to a teaching plan unless seizures are present. Option B is incorrect, as autism is often associated with a range of IQ levels, not necessarily higher. Option C is less relevant, as dyslexia is not a common comorbidity with autism.