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The parent of a child diagnosed with Tourette's disorder says to the nurse, 'I think my child is faking the tics because they come and go.' Which response by the nurse is accurate?
- A. Perhaps your child was misdiagnosed.
- B. Your observation indicates the medication is effective.
- C. Tics often change frequency or severity. That does not mean they aren't real.
- D. This finding is unexpected. How have you been administering your child's medication?
Correct Answer: C
Rationale: Tics are sudden, rapid, involuntary, repetitive movements, or vocalizations characteristic of Tourette's disorder. They often fluctuate in frequency and severity and are reduced or absent during sleep.
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A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter. The child has formed a trusting relationship with a volunteer. The teen says, 'I have three good friends at school. We talk and sit together at lunch.' What is the nurse's best suggestion to the treatment team?
- A. Suggest foster home placement.
- B. Seek assistance from an intimate partner violence program.
- C. Make referrals for existing and emerging developmental problems.
- D. Encourage healthy characteristics and existing environmental supports.
Correct Answer: D
Rationale: Because the teenager shows no evidence of poor mental health, the best action would be to foster existing healthy characteristics and environmental supports. No other option is necessary or appropriate under the current circumstances.
Which behavior indicates that the treatment plan for a child diagnosed with autism spectrum disorder was effective?
- A. Plays with one toy for 90 minutes.
- B. Repeats words spoken by a parent.
- C. Holds the parent's hand while walking.
- D. Spins around and claps hands while walking.
Correct Answer: C
Rationale: Holding the hand of another person suggests relatedness. Usually, a child with autism would resist holding someone's hand and stand or walk alone, perhaps flapping arms or moving in a stereotypical pattern. The other options reflect behaviors that are consistent with autistic disorder.
The health care provider prescribes medication for a child diagnosed with attention-deficit/hyperactivity disorder (ADHD). What is the desired behavior for which the nurse should monitor?
- A. Increased expressiveness in communicating with others.
- B. Improved ability for cooperative play with other children.
- C. Ability to identify anxiety and implement self-control strategies.
- D. Improved socialization skills with other children and authority figures.
Correct Answer: B
Rationale: The goal is improvement in the child's hyperactivity, distractibility, and play. The incorrect options are more relevant for a child with a developmental or anxiety disorder.
A nurse prepares to lead a discussion at a community health center regarding children's health. The nurse wants to use current terminology when teaching about these issues. Which terms are appropriate for the nurse to use?
- A. Mental retardation
- B. Asperger's disorder
- C. Autism spectrum disorder
- D. Pervasive developmental disorder
- E. Intellectual development disorder
Correct Answer: C,E
Rationale: The terms 'Autism spectrum disorder' and 'Intellectual development disorder' are current and appropriate, as they reflect the terminology used in the DSM-5. 'Mental retardation' and 'Pervasive developmental disorder' are outdated, and 'Asperger's disorder' is no longer used as a distinct diagnosis, as it is now included under autism spectrum disorder.
A 4-year-old child cries and screams from the time the parents leave the child at preschool until the child is picked up 4 hours later. The child is calm and relaxed when the parents are present. The parents ask, 'What should we do?' What is the nurse's best recommendation?
- A. Send a picture of yourself to school to keep with the child.
- B. Arrange with the teacher to let the child call home at playtime.
- C. Talk with the school about withdrawing the child until maturity increases.
- D. Talk with your health care provider about a referral to a mental health professional.
Correct Answer: D
Rationale: Separation anxiety disorder becomes apparent when the child is separated from the attachment figure. The symptoms are considered normal up to age 1. Often, the first-time separation occurs when the child goes to kindergarten or nursery school. Separation anxiety may be based on the child's fear that something will happen to the attachment figure. The child needs professional help. None of the distractors accounts for the severity and length of the child's reaction.