Nokea
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.
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A 5-year-old child moves and talks constantly. The child awakens before the parents every morning. The child attends kindergarten, but the teacher reports difficulty handling the behavior. What is this child's most likely problem?
- A. Tic disorder
- B. Oppositional defiant disorder (ODD)
- C. Intellectual development disorder (IDD)
- D. Attention-deficit/hyperactivity disorder (ADHD)
Correct Answer: D
Rationale: The constant motion and excessive talkativeness suggest ADHD. Tic disorder is associated with stereotypical, rapid, and involuntary motor movements. Developmental delays would be observed if intellectual development disorder was present. ODD includes serious violations of the rights of others.
Which behavior indicates that the treatment plan for a child diagnosed with autism spectrum disorder was effective?
- A. Plays with one toy for 90 minutes.
- B. Repeats words spoken by a parent.
- C. Holds the parent's hand while walking.
- D. Spins around and claps hands while walking.
Correct Answer: C
Rationale: Holding the hand of another person suggests relatedness. Usually, a child with autism would resist holding someone's hand and stand or walk alone, perhaps flapping arms or moving in a stereotypical pattern. The other options reflect behaviors that are consistent with autistic disorder.
A nurse prepares to lead a discussion at a community health center regarding children's health. The nurse wants to use current terminology when teaching about these issues. Which terms are appropriate for the nurse to use?
- A. Mental retardation
- B. Asperger's disorder
- C. Autism spectrum disorder
- D. Pervasive developmental disorder
- E. Intellectual development disorder
Correct Answer: C,E
Rationale: The terms 'Autism spectrum disorder' and 'Intellectual development disorder' are current and appropriate, as they reflect the terminology used in the DSM-5. 'Mental retardation' and 'Pervasive developmental disorder' are outdated, and 'Asperger's disorder' is no longer used as a distinct diagnosis, as it is now included under autism spectrum disorder.
A parent diagnosed with schizophrenia and her 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a shelter volunteer. The child says, 'My three friends and I got an A on our school science project.' The nurse can assess that the child is demonstrating what characteristic?
- A. Resiliency
- B. Shy temperament
- C. Early posttraumatic stress disorder
- D. Uses intellectualization to deal with problems
Correct Answer: A
Rationale: Resiliency enables a child to handle the stresses of a difficult childhood. Resilient children can adapt to changes in the environment, take advantage of nurturing relationships with adults other than parents, distance themselves from emotional chaos occurring within the family, learn, and use problem-solving skills. None of the distractors demonstrate a means of handling stress.
Which finding would prompt the nurse to carefully assess an 8-year-old child for development of a psychiatric disorder?
- A. Being raised by a parent with chronic major depressive disorder
- B. Moving to three new homes over a 2-year period
- C. Not being promoted to the next grade
- D. Having an imaginary friend
Correct Answer: A
Rationale: If the caregiver is unable to respond positively to the child, there is an increased risk of insecure attachment, developmental problems, and mental disorders. The chronicity of the parent's depression means it has been a consistent stressor. The other factors do not create ongoing stress.