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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.
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A nurse is assessing an 8-year-old girl with a mood disorder. Which of the following would the nurse most likely expect to assess?
- A. Statement from the child that she feels sad
- B. Behavioral problems
- C. Recurrent obsessions
- D. Ritualistic behavior
Correct Answer: A
Rationale: Mood disorders in children, such as depression, often present with verbalized feelings of sadness (option A). Behavioral problems (option B) may occur but are less specific. Options C and D are more characteristic of obsessive-compulsive disorder, not a mood disorder.
A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder?
- A. Anxiety
- B. Depression
- C. Schizophrenia
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder is an externalizing disorder characterized by behaviors like aggression and rule-breaking, which are outwardly directed. Anxiety (option A), depression (option B), and schizophrenia (option C) are internalizing or psychotic disorders, not externalizing.
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.
A 12-year-old child is brought to the mental health clinic by his parents because of a court-ordered evaluation. When assessing the child, which of the following would lead the nurse to suspect that the child has a conduct disorder? Select all that apply.
- A. Destruction of neighbor?s car on two separate occasions
- B. Arrests for petty larceny several times
- C. Repetitive disobedience of parents
- D. Blaming of others for problems
- E. Evidence of overt lying
Correct Answer: A,B,C,D,E
Rationale: Conduct disorder involves persistent patterns of behavior that violate societal norms or others? rights. Destruction of property (A), petty larceny (B), disobedience (C), blaming others (D), and lying (E) are all indicative of conduct disorder, as they reflect aggression, deceit, and rule-breaking.
After teaching the parents of a child diagnosed with ADHD about the disorder and its treatment, the nurse determines that the teaching has been effective when the parents state which of the following?
- A. We need to remember that our son is not a bad kid; he just has difficulty with impulse control and attention.
- B. We need to be careful so he doesn?t develop a substance abuse problem as he grows older.
- C. We should stop the medication after 2 months to see how effective it is in really controlling his symptoms.
- D. We should set up regular routines for him but not worry if he violates the limits once in a while.
Correct Answer: A
Rationale: The statement in option A reflects an accurate understanding of ADHD as a disorder of impulse control and attention, not a reflection of the child?s character, indicating effective teaching. Option B is a concern but not directly related to core understanding. Option C is incorrect, as stopping medication abruptly is not advisable. Option D is partially correct but downplays the importance of consistent limits.