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The mother of a child with Asperger disorder tells the nurse that her child has few playmates. She states, 'He has such poor social skills with other children, and he strongly rejects any change in his routine by throwing a tantrum.' Based on this information, the nurse identifies which nursing diagnosis as the priority?
- A. Self-Care Deficits related to repeated tantrums
- B. Risk for Injury related to Asperger disorder
- C. Ineffective Family Coping related to having a child with Asperger disorder
- D. Risk for Social Isolation related to poor social skills of the child
Correct Answer: D
Rationale: The child?s poor social skills and resulting lack of playmates directly point to the nursing diagnosis of Risk for Social Isolation, as this is a primary concern based on the mother?s statement. Option A is less relevant, as tantrums do not directly relate to self-care deficits. Option B is not supported, as no immediate physical danger is described. Option C may apply but is less specific than social isolation in this context.
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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.
A group of nurses is reviewing medications used to treat attention deficit hyperactivity disorder. The students demonstrate understanding of the information when they identify methylphenidate as which of the following?
- A. Selective serotonin reuptake inhibitor
- B. Psychostimulant
- C. Noradrenergic reuptake inhibitor
- D. Alpha agonist
Correct Answer: B
Rationale: Methylphenidate is a psychostimulant used to treat ADHD by increasing dopamine and norepinephrine levels to improve attention and impulse control. Option A (SSRI) is for depression, option C (noradrenergic reuptake inhibitor) describes drugs like atomoxetine, and option D (alpha agonist) includes drugs like clonidine.
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.
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.
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.