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A nurse will prepare teaching materials regarding which medication for the parents of a child diagnosed with enuresis?
- A. Haloperidol
- B. Desmopressin
- C. Methylphenidate
- D. Carbamazepine
Correct Answer: B
Rationale: Pharmacological treatment of enuresis commonly includes desmopressin, oxybutynin, various stimulants, indomethacin, and/or SSRI antidepressants. Limited evidence exists for the use of imipramine. None of the other drugs are appropriate to treat enuresis.
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When a 5-year-old child is disruptive, the nurse says, 'You must take a time-out.' The expectation is that the child will demonstrate what behavior?
- A. Go to a quiet room until called for the next meal.
- B. Slowly count to 20 before returning to the group activity.
- C. Sit on the edge of the activity until able to regain self-control.
- D. Sit quietly on the lap of a staff member until able to apologize for the behavior.
Correct Answer: C
Rationale: Time-out is designed so that staff can be consistent in their interventions. Time-out may require having the child sit on the periphery of an activity until he or she gains self-control and reviews the episode with a staff member. Time-out may not require having the child go to a designated room and does not involve special attention such as holding. Having the child count to 10 or 20 is not sufficient.
A 5-year-old child diagnosed with attention-deficit/hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse's best action?
- A. Call for emergency assistance from another staff member.
- B. Instruct the parents to take the child home immediately.
- C. Direct this child to stop, and then comfort the other child.
- D. Take the child into another room with toys to act out feelings.
Correct Answer: D
Rationale: The use of play to express feelings is appropriate; the cognitive and language abilities of the child may require the acting out of feelings if verbal expression is limited. The incorrect options provide no outlet for feelings or opportunity to develop coping skills.
The child most likely to receive propranolol to manage tremors is one diagnosed with which disorder?
- A. Attention-deficit/hyperactivity disorder (ADHD)
- B. Posttraumatic stress disorder (PTSD)
- C. A motor disorder
- D. Separation anxiety
Correct Answer: C
Rationale: Propranolol is useful for managing tremors associated with various motor disorders. This medication is not indicated in any of the other disorders.
A nurse prepares the plan of care for a 15-year-old adolescent diagnosed with moderate intellectual developmental disorder (IDD) is believed capable of ultimately functioning at a second-grade level. What are the highest outcomes realistic for this person to demonstrate within 5 years?
- A. Live unaided in an apartment.
- B. Obtain employment in a local sheltered workshop.
- C. Correctly use public buses to travel in the community.
- D. Independently perform his or her own personal hygiene.
- E. Complete high school or earn a general equivalency diploma (GED).
Correct Answer: B,C,D
Rationale: Individuals with moderate intellectual developmental disorder progress academically to about a second-grade level. These people can learn to travel in familiar areas and perform unskilled or semiskilled work. With supervision, they can function in the community, but independent living is not likely.
A 15-year-old adolescent is referred to a residential program after an arrest for theft and running away from home. At the program, the adolescent refuses to participate in scheduled activities and pushes a staff member, causing a fall. Which approach by the nursing staff would be most therapeutic?
- A. Neutrally permit refusals.
- B. Coax to gain compliance.
- C. Offer rewards in advance.
- D. Establish firm limits.
Correct Answer: D
Rationale: Firm limits are necessary to ensure physical safety and emotional security. Limit setting will also protect other patients from the teenager's thoughtless or aggressive behavior. Permitting refusals to participate in the treatment plan, coaxing, and bargaining are strategies that do not help the patient learn to abide by rules or structure.