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.
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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 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 counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include?
- A. Connection to ineffective parental practices
- B. Detection after the child enters school
- C. Onset before child is 2.5 years old
- D. Girls are more frequently affected than boys
Correct Answer: C
Rationale: Autism spectrum disorder (ASD) is characterized by symptoms that typically appear before the age of 3, often by 2.5 years, including challenges in social interaction and communication. Option A is incorrect, as autism is not caused by parenting practices but is neurodevelopmental. Option B is misleading, as detection often occurs before school age. Option D is false, as boys are more frequently affected than girls.
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 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.
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