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 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.
The nurse is giving a presentation comparing and contrasting autism disorder and Asperger syndrome. Which of the following would the nurse include as differentiating Asperger syndrome from autism disorder?
- A. Children typically do not engage in stereotypic behavior.
- B. They display age-appropriate intelligence.
- C. The children often reverse pronouns when speaking.
- D. They appear aloof and indifferent to others.
Correct Answer: B
Rationale: Asperger syndrome is distinguished from autism by the presence of age-appropriate intelligence and language development, though social challenges persist. Option A is incorrect, as stereotypic behaviors may still occur in Asperger?s. Option C is more typical of autism, not Asperger?s. Option D applies to both conditions and does not differentiate them.
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
- A. Locating suitable residential placement for the child
- B. Finding a foster home for the child
- C. Achieving independent functioning of the child as an adult
- D. Preventing the onset of psychiatric disorders in the child
Correct Answer: C
Rationale: For a child with mild mental retardation, realistic long-term goals focus on maximizing independence to the extent possible. Mild mental retardation typically allows individuals to achieve some level of independent functioning as adults, such as living in supported environments or performing simple jobs with guidance. Options A and B (residential placement or foster home) are premature and not necessarily appropriate for mild cases, as they imply more severe disability. Option D is less feasible, as psychiatric disorders may not be preventable due to the complexity of mental health conditions.
The nurse is counseling a family whose child has autism. When describing this condition, which of the following would the nurse most likely include?
- A. Connection to ineffective parental practices
- B. Detection after the child enters school
- C. Onset before child is 2.5 years old
- D. Girls are more frequently affected than boys
Correct Answer: C
Rationale: Autism spectrum disorder (ASD) is characterized by symptoms that typically appear before the age of 3, often by 2.5 years, including challenges in social interaction and communication. Option A is incorrect, as autism is not caused by parenting practices but is neurodevelopmental. Option B is misleading, as detection often occurs before school age. Option D is false, as boys are more frequently affected than girls.
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.