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The nurse has been working with the family of a small child with oppositional defiant disorder. The nurse is feeling very frustrated because the parents refuse to implement effective parenting skills that the nurse has taught. What is the best nursing action at this time?
- A. Review effective disciplinary practices with the parents again.
- B. Refer the parents to a family therapist.
- C. Try to remember that the parents are trying to the best of their ability to carry out the suggestions.
- D. Explore alternative living arrangements for the child.
Correct Answer: C
Rationale: Acknowledging parental challenges fosters understanding and collaboration, avoiding premature re-teaching, therapy referral, or removal of the child.
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The nurse is using limit setting with a child diagnosed with conduct disorder. Which statement reflects the most effective way for the nurse to set limits with the child?
- A. That is not allowed here. You will lose a privilege. You need to stop.
- B. Stop what you are doing. Go to your room.
- C. I would appreciate if you would not do that
- D. Why do you do these things?
Correct Answer: A
Rationale: Effective limit setting involves stating the rule, consequences, and expected behavior, as in choice A, unlike vague requests, punitive commands, or questioning motives.
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 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.
A child is expelled from school for repeated fighting and vandalizing school property. The school nurse and counselor meet with the parents to explain that the child may benefit from counseling as the child is experiencing signs of which disorder?
- A. Oppositional defiant disorder
- B. Asperger's syndrome
- C. Attention deficit hyperactivity disorder
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder involves persistent antisocial behaviors like fighting and vandalism, impairing function, unlike ODD (defiance without major violations), Asperger's (social and behavioral issues), or ADHD (inattention and impulsivity).
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.