Nokea
The nurse is preparing to initiate a behavioral treatment program for a child with encopresis. Which of the following would the nurse most likely implement first?
- A. Administration of mineral oil
- B. Bowel Cleansing
- C. Low-fiber diet
- D. Toilet sitting after each meal
Correct Answer: B
Rationale: For encopresis, the first step is typically bowel cleansing to address any fecal impaction, which can contribute to involuntary soiling. Mineral oil (option A) or toilet sitting (option D) may follow, and a low-fiber diet (option C) is counterproductive, as high fiber is preferred.
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The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: D
Rationale: Clonidine, an alpha-2 agonist, is often used to manage sleep difficulties in children with ADHD, as it has sedative effects. Methylphenidate (option A) and atomoxetine (option B) are stimulants or non-stimulants for ADHD symptoms but may worsen sleep. Bupropion (option C) is an antidepressant and not typically used for ADHD-related sleep issues.
A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include?
- A. Ensuring that a variety of caregivers are available for the child
- B. Providing a consistent, structured environment with predictable routines
- C. Allowing the child frequent visits off the unit to provide stimulation
- D. Sending the child to the time out area if the child repeats phrases continually
Correct Answer: B
Rationale: Children with autism thrive in consistent, structured environments with predictable routines, as these reduce anxiety and support behavioral stability. Option A is counterproductive, as multiple caregivers can disrupt consistency. Option C may overstimulate the child, and option D is inappropriate for managing repetitive behaviors typical of autism.
The nurse is counseling a parent whose child has a communication disorder. Which of the following would the nurse emphasize when teaching the parent about this disorder?
- A. Providing the child with nonverbal activities
- B. Initiating conversations with the child frequently
- C. Stopping the child?s conversation if stuttering begins
- D. Asking the physician for medication to improve the child?s speech
Correct Answer: B
Rationale: Initiating frequent conversations encourages communication practice and skill development, which is key for managing communication disorders. Option A may be helpful but is less central than verbal interaction. Option C is counterproductive, as interrupting stuttering can increase anxiety. Option D is inappropriate, as medication is not typically indicated for communication disorders like stuttering.
A 10-year-old child with Tourette?s disorder is receiving haloperidol as part of his treatment plan. When assessing the child at a follow-up visit, which statement by the child would lead the nurse to suspect that he is experiencing a side effect of the drug?
- A. Sometimes I feel like I?m so sleepy.
- B. I?m eating about the same amount as before.
- C. My muscles seem pretty flexible lately.
- D. I think I?m much more alert with this drug.
Correct Answer: A
Rationale: Haloperidol, an antipsychotic, commonly causes sedation as a side effect, so the child?s report of feeling sleepy (option A) suggests this. Option B (unchanged eating) and option C (flexible muscles) are not typical side effects. Option D (increased alertness) is opposite to haloperidol?s sedative effect.
The nurse is caring for a family with a 3-year-old child who has autism disorders. When developing the teaching plan for the parents, which of the following would the nurse most likely include?
- A. The child is at higher risk for seizure disorders as well.
- B. The child?s IQ will typically be higher than that of other children.
- C. Dyslexia also may be a comorbid condition.
- D. A structured physical environment is an important aspect.
Correct Answer: D
Rationale: A structured physical environment is critical for children with autism, as it provides predictability and reduces sensory overload, aiding in behavior management and learning. Option A is true but less central to a teaching plan unless seizures are present. Option B is incorrect, as autism is often associated with a range of IQ levels, not necessarily higher. Option C is less relevant, as dyslexia is not a common comorbidity with autism.