Nokea
An 11-year-old child talks to the school nurse about a single episode of disruptive behavior in class. The child states, 'I had a stomachache and felt like vomiting. I couldn't help it. I was just so mad at my dad.' Which would be the most appropriate response by the nurse?
- A. I can see that you're angry. Let's look at better ways to express it
- B. I can understand your anger, but you can't disrupt the classroom
- C. If you can get rid of your anger, perhaps your stomachache will go away.
- D. Perhaps it would be helpful if you let your dad know you're angry.
Correct Answer: A
Rationale: Teaching the child to express anger appropriately addresses the behavior constructively, unlike focusing on classroom rules, linking physical symptoms to anger, or redirecting to the parent.
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A client with conduct disorder starts yelling at another client and calling the client insulting names. Which is the most appropriate response by the nurse?
- A. How would you feel if someone yelled at you like that?
- B. What's the matter with you? Don't you know any better?
- C. Yelling at others is unacceptable. You need to let staff know you're upset
- D. You're still having problems controlling your anger
Correct Answer: C
Rationale: Stating that yelling is unacceptable and directing the client to inform staff focuses on the behavior non-judgmentally, unlike questioning feelings, criticizing, or assuming ongoing issues.
Which are most likely included in the history of a child with conduct disorder?
- A. Disturbed relationships with peers
- B. Major antisocial violations
- C. Aggression toward people or animals
- D. Destruction of property
- E. Serious violation of rules
Correct Answer: A,C,D,E
Rationale: Conduct disorder history includes peer issues, aggression, property destruction, and rule violations, but major antisocial violations are not specified.
A child has been displaying behaviors associated with conduct disorder. The nurse should further assess for which common risk factors seen in children with conduct disorder.
- A. Poor family functioning
- B. Strict disciplinary practices
- C. Family history of substance abuse
- D. Possible child abuse
- E. Poverty conditions
Correct Answer: A,C,D,E
Rationale: Risk factors for conduct disorder include poor family functioning, substance abuse history, child abuse, and poverty, but strict discipline is not specifically listed as a common risk factor.
Which is an effective way for parents to deal with problem behaviors in children and to prevent later development of conduct disorders?
- A. Administering medications
- B. Avoiding setting limits
- C. Group-based parenting classes
- D. Being overprotective of the child
Correct Answer: C
Rationale: Group-based parenting classes teach effective strategies to manage behaviors, unlike medications, avoiding limits, or overprotection.
Which are characteristics of intermittent explosive disorder (IED)?
- A. The episode may occur with seemingly no warning.
- B. They usually last less than 30 minutes.
- C. Afterward, the person with IED will not have any remorse.
- D. It involves repeated episodes of impulsive, aggressive, violent behavior, and angry verbal outbursts.
- E. The intensity of the emotional outburst is usually within proportion to the stressor or situation.
Correct Answer: A,B,D
Rationale: IED is characterized by sudden, short (<30 min), impulsive, aggressive outbursts disproportionate to the trigger, often followed by remorse, not lack of it.