Nokea
The nurse counsels parents that the early school years create nervous tension in the child manifested by which abnormal behavior(s)? (Select all that apply.)
- A. Masturbation
- B. Food fads
- C. Stuttering
- D. Aggressive behavior
- E. Nonnutritive sucking
Correct Answer: C,D,E
Rationale: Stuttering, aggressive behavior, and nonnutritive sucking that appear suddenly are clues to increased nervous tension in the young school-age child.
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The nurse is assessing a 16-year-old female for characteristics of anorexia nervosa. Which assessment finding(s) would lead the nurse to suspect the possibility of this diagnosis? (Select all that apply.)
- A. Amenorrhea
- B. Severe weight loss
- C. Oily skin
- D. Hypertension
- E. Lanugo on back
Correct Answer: A,B,E
Rationale: Primary symptoms of anorexia nervosa include severe weight loss, amenorrhea, and lanugo hair over the back and extremities.
A nurse is hired to work in a psychiatric facility on a unit specializing in obsessive-compulsive disorders (OCD). Which diagnoses might the nurse expect to encounter? (Select all that apply.)
- A. Trichotillomania
- B. Hoarding disorder
- C. Excoriation disorder
- D. Body dysmorphic disorder
- E. Oppositional defiant disorder
Correct Answer: A,B,C,D
Rationale: Trichotillomania, hoarding disorder, excoriation disorder, and body dysmorphic disorder are forms of OCD, while oppositional defiant disorder is not.
Which statement made by a parent of an adolescent with anorexia nervosa indicates an understanding of this condition?
- A. There really isn't anything to worry about. Don't they say you can never be too thin?'
- B. My daughter just doesn't have much of an appetite.'
- C. She is just trying to punish me for divorcing her father.'
- D. She seems to see herself as fat, even though her weight is below normal.'
Correct Answer: D
Rationale: Individuals with anorexia nervosa have a disturbed body image, which this parent correctly recognizes.
A 9-year-old child has been admitted to the hospital after 'huffing' lighter fluid and is in a high euphoric state. For what should the nurse assess?
- A. Depressed respirations
- B. Severe vomiting
- C. Frightening hallucinations
- D. Elevation of temperature
Correct Answer: A
Rationale: Inhaling hydrocarbons depresses the central nervous system, including respiratory rate and general sensorium.
A child is diagnosed with attention-deficit hyperactivity disorder (ADHD). Which characteristics would the nurse assess in this child? (Select all that apply.)
- A. Social anxiety
- B. Impulsivity
- C. Hyperactivity
- D. Distractibility
- E. Inattention
Correct Answer: B,C,D,E
Rationale: ADHD is characterized by inattention, hyperactivity, impulsivity, and distractibility.