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The school nurse is caring for a 7-year-old child who has demonstrated a significantly lower-than-average score for mental age on standardized tests in reading. However, the child?s IQ scores were within the average range. The nurse interprets this information as suggesting which of the following?
- A. Communication disorder
- B. Attention deficit hyperactivity disorder
- C. Asperger syndrome
- D. Dyslexia
Correct Answer: D
Rationale: A significantly lower reading score despite an average IQ suggests dyslexia, a learning disorder affecting reading and language processing. Option A is too broad, as communication disorders encompass more than reading issues. Option B (ADHD) typically affects attention, not specifically reading. Option C (Asperger?s) is less likely, as it primarily involves social and behavioral challenges, not reading-specific deficits.
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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.
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 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.
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 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.