CHAPTER 35: PSYCHOSOCIAL ALTERATIONS My Nursing Test Banks

CHAPTER 35: PSYCHOSOCIAL ALTERATIONS

MULTIPLE CHOICE

1.In individual therapy involving a child or adolescent, who decides what will be shared with caregivers?

a.

the child or adolescent

c.

the parents or guardian

b.

the therapist

d.

the therapist and the child

ANS: D

Feedback

A

Incorrect: Individual therapy involves a child or adolescent and the therapist. They both decide what will be shared with caregivers.

B

Incorrect: The therapist alone does not decide what will be shared with caregivers.

C

Incorrect: The parents or guardian do not decide what will be shared with the caregivers. Parents or caregivers are not in the session during individual therapy, but they are an important part of a comprehensive treatment program.

D

Correct: In individual therapy involving a child or adolescent, the therapist and the child decide what will be shared with caregivers. Older children may request that caregivers be denied access to their records.

PTS: 1 REF: p. 1346 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Comprehension

2.The focus of family therapy is:

a.

the identified problem person

b.

solving family problems

c.

relationships and communication patterns among family members

d.

to resolve crises as well as to decrease anxiety and fears of members

ANS: C

Feedback

A

Incorrect: The focus of family therapy is not the identified problem person.

B

Incorrect: The focus of family therapy is not solving family problems.

C

Correct: The focus of family therapy is the relationships and communication patterns among family members. The therapist looks at the childs symptoms or problems as a reflection of the familys problems. The goal is to improve family interactions, improve communication, and help each member achieve autonomy, independence, and self-effectiveness.

D

Incorrect: The focus of family therapy is not to resolve crises as well as to decrease anxiety and fears of members.

PTS: 1 REF: p. 1346 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Comprehension

3.The major focus of play therapy is to:

a.

help the child reveal emotions, feelings, and problems

b.

get the child to relax and be less anxious and upset

c.

teach the child how to play fairly and share toys with others

d.

evaluate whether the child has masculine or feminine type of play

ANS: A

Feedback

A

Correct: The major focus of play therapy is to help the child reveal emotions, feelings, and problems.

B

Incorrect: The major focus of play therapy is not to get the child to relax and be less anxious and upset. Feelings such as anxiety may be revealed through play. The therapist is available to help the child understand her or his emotions and respond to these emotions.

C

Incorrect: The major focus of play therapy is not to teach the child how to play fairly and share toys with others.

D

Incorrect: The major focus of play therapy is not to evaluate whether the child has masculine or feminine type of play.

PTS:1REF:p. 1346 Treatment Modalities

OBJ: Cognitive Level: Comprehension

4.Which of the following disorders is the most commonly encountered neurobehavioral disorder of childhood?

a.

antisocial personality disorder

c.

eating disorders

b.

school phobia

d.

attention-deficit hyperactivity disorder

ANS: D

Feedback

A

Incorrect: Antisocial personality disorder is not the most commonly encountered neurobehavioral disorder of childhood.

B

Incorrect: School phobia is not the most commonly encountered neurobehavioral disorder of childhood.

C

Incorrect: Eating disorders are not the most commonly encountered neurobehavioral disorders of childhood.

D

Correct: The most commonly encountered neurobehavioral disorder of childhood is attention-deficit hyperactivity disorder. It is also among the most prevalent chronic health conditions of school-age children.

PTS: 1 REF: p. 1346 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Comprehension

5.Which of the following is the basic impairment in attention-deficit hyperactivity disorder?

a.

inability to complete tasks due to distractibility and forgetting the task at hand

b.

too few inhibiting behaviors, causing problems in learning self-regulation behaviors

c.

hyperactivity and acting as if motor driven

d.

inattention to safety issues with resulting high-risk behavior

ANS: B

Feedback

A

Incorrect: The basic impairment in attention-deficit hyperactivity disorder is not the inability to complete tasks due to distractibility and forgetting the task at hand. This is a manifestation of the symptom of inattention.

B

Correct: The basic impairment in attention-deficit hyperactivity disorder is too few inhibiting behaviors, causing problems in learning self-regulation behaviors. This deficiency of internal self-regulation typically results in school difficulties, academic underachievement, low self-esteem, and difficulties with family and social relationships.

C

Incorrect: The basic impairment in attention-deficit hyperactivity disorder is not hyperactivity and acting as if motor driven. This is a manifestation of the symptom of hyperactivity.

D

Incorrect: The basic impairment in attention-deficit hyperactivity disorder is not inattention to safety issues with resulting high-risk behavior.

PTS: 1 REF: p. 1347 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Application

6.Attention-deficit hyperactivity disorder (ADHD) is viewed as a disorder that will be present:

a.

until the child is in junior high school and then will disappear

b.

until the high school years and then be resolved

c.

through the high school years and then diminish

d.

as a chronic disorder that persists into adulthood

ANS: D

Feedback

A

Incorrect: ADHD is not viewed as a disorder that will be present until the child is in junior high school and then will disappear.

B

Incorrect: ADHD is not viewed as a disorder that will be present until the high school years and then be resolved.

C

Incorrect: ADHD is not viewed as a disorder that will be present through the high school years and then diminish.

D

Correct: ADHD is viewed as a chronic disorder that persists into adulthood.

PTS: 1 REF: p. 1347 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Application

7.The school nurse is working with a child suspected of having attention-deficit hyperactivity disorder (ADHD) by some of his teachers. The nurse is aware that some other conditions can produce behaviors similar to ADHD. Which of the following conditions, in addition to hearing problems and learning disabilities, can be mistaken for ADHD?

a.

anxiety or depression, and absence seizures

b.

personality disorders and anxiety disorders

c.

low self-esteem and efforts to cover it up

d.

immaturity and or regression

ANS: A

Feedback

A

Correct: Anxiety or depression, and absence seizures can be mistaken for ADHD as well as hearing problems and learning disabilities. Disruptive or unresponsive behavior, symptoms of ADHD, can be caused by anxiety or depression. Attention lapses caused by absence seizures can produce behaviors similar to ADHD.

B

Incorrect: Personality disorders and anxiety disorders are not mistaken for ADHD. ADHD is frequently associated with anxiety disorders but not personality disorders.

C

Incorrect: Low self-esteem and efforts to cover it up usually do not produce behaviors similar to ADHD. Low self-esteem can result from having ADHD related to a lack of peer relationships and positive feedback, and academic underachievement.

D

Incorrect: Immaturity and or regression do not produce behaviors similar to ADHD.

PTS: 1 REF: p. 1348 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Application

8.There are three subtypes of attention-deficit hyperactivity disorder; one type is primarily of the inattentive type. Which of the following behaviors by a child would the nurse recognize as matching the diagnostic criteria under inattention?

a.

fidgets with hands or feet

b.

acts as if motor driven

c.

gives answers before questions are completed

d.

has difficulty organizing tasks and activities

ANS: D

Feedback

A

Incorrect: Fidgets with hands or feet and squirms then seated are behaviors that match the diagnostic criteria under hyperactivity.

B

Incorrect: Acts as if motor driven are behaviors that match the diagnostic criteria under hyperactivity.

C

Incorrect: Giving answers before questions are completed match the diagnostic criteria under impulsivity.

D

Correct: Difficulty organizing tasks and activities and difficulty sustaining attention with tasks are behaviors that match the diagnostic criteria under inattention.

PTS: 1 REF: p. 1348 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Application

9.In order for a child to be diagnosed with attention-deficit hyperactivity disorder, a child must meet 6 of 9 diagnostic criteria and these symptoms must be present in two or more settings and have persisted for how long?

a.

at least 3 months

c.

between 8 and 10 months

b.

at least 6 months

d.

between 11 and 12 months

ANS: B

Feedback

A

Incorrect: These symptoms must have persisted for at least 6 months, not at least 3 months.

B

Correct: In order for a child to be diagnosed with ADHD, a child must meet 6 of 9 diagnostic criteria and these symptoms must be present in two or more settings and have persisted for at least 6 months.

C

Incorrect: These symptoms must have persisted for at least 6 months, not between 8 and 10 months.

D

Incorrect: These symptoms must have persisted for at least 6 months, not between 11 and 12 months.

PTS: 1 REF: p. 1347 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Comprehension

10.To be diagnosed with attention-deficit hyperactivity disorder (ADHD), a child must have at least 6 of 9 symptoms of inattention and 6 of 9 symptoms of hyperactivity or impulsivity. Also, the symptoms must have occurred in two or more settings; persisted for 6 or more months; adversely affected functioning in school, work, or social situations; and been present before what age?

a.

4 years

c.

6 years

b.

5 years

d.

7 years

ANS: D

Feedback

A

Incorrect: The symptoms of ADHD do not have to be present before 4 years of age.

B

Incorrect: The symptoms of ADHD do not have to be present before 5 years of age.

C

Incorrect: The symptoms of ADHD do not have to be present before 6 years of age.

D

Correct: The symptoms of ADHD must have been present before 7 years of age.

PTS:1REF:p. 1349 Mood Disorders

OBJ: Cognitive Level: Comprehension

11.Behavioral management of attention-deficit hyperactivity disorder includes which of the following methods?

a.

aversive therapy

b.

extinction

c.

clear definition of acceptable and unacceptable behaviors and accompanying consequences and rewards

d.

strict rules and strict punishments for breaking a rule, even the first time, with no warning periods but only enforcement

ANS: C

Feedback

A

Incorrect: Behavioral management of ADHD does not include aversive therapy.

B

Incorrect: Behavioral management of ADHD does not include extinction.

C

Correct: Behavioral management of ADHD includes clear definition of acceptable and unacceptable behaviors and accompanying consequences and rewards. It also includes assisting the child to follow rules, complete tasks, and improve self-control, and providing positive feedback for appropriate behavior.

D

Incorrect: Behavioral management of ADHD does not include strict rules and strict punishments for breaking a rule, even the first time, with no warning periods but only enforcement.

PTS: 1 REF: p. 1350 Attention-Deficit Hyperactivity Disorder

OBJ: Cognitive Level: Application

12.A child diagnosed with attention-deficit hyperactivity disorder has been on methylphenidate (Ritalin) for several months. The physician orders a drug holiday. Which of the following is the most likely reason for the drug holiday?

a.

to give the parents a break from having to administer the medication

b.

to determine if the drug is still necessary every day or necessary at all

c.

to save money because the drug is very expensive

d.

to reverse the adverse side effects of this drug

ANS: B

Feedback

A

Incorrect: The physician would not order a drug holiday to give the parents a break from having to administer the medication.

B

Correct: The physician may order a drug holiday to determine if the drug is still necessary every day or necessary at all.

C

Incorrect: The physician would not order a drug holiday to save money because Ritalin is not expensive then compared with another medication to treat ADHD called Strattera.

D

Incorrect: The physician would not order a drug holiday to reverse the adverse side effects of this drug. The most common adverse side effects include anorexia, weight loss, abdominal pain, headache, insomnia, tachycardia, and hypertension. If these side effects are unacceptable to the child or caregivers, other medications may be used.

PTS:1REF:p. 1350 Psychosocial Alterations

OBJ: Cognitive Level: Application

13.The nurse is working with the caregivers of a child who has attention-deficit hyperactivity disorder. The caregivers ask the nurse to help them figure out how to get their child to pay better attention to instructions because then they tell her to do something, she never seems to recall what they asked her to do or she completes only part of the task. She is having the same problem at school. What is the best intervention the nurse can suggest?

a.

Give only one or two instructions at a time, and break new tasks into smaller parts, teaching each part separately.

b.

Write all the instructions out in detail, and give the written instructions to the child to use while completing the task.

c.

Offer a reward for completing tasks, and have an appropriate punishment for not completing work.

d.

Have another child who is organized and completes the tasks to work with and tutor their child.

ANS: A

Feedback

A

Correct: The best intervention the nurse can suggest is to give only one or two instructions at a time, and break new tasks into smaller parts, teaching each part separately. Instructions should be given as simply and clearly as possible, demonstrating if necessary. Have the child repeat the instructions back to the caregiver.

B

Incorrect: The nurse should not suggest writing all the instructions out in detail, and giving the written instructions to the child to use while completing the task. Only one or two instructions should be given at a time, not all of them.

C

Incorrect: The nurse should suggest offering a reward such as praise for completing tasks, but not having an appropriate punishment for incomplete work.

D

Incorrect: The best intervention the nurse can suggest is not to have another child who is organized and completes the tasks to work with and tutor their child.

PTS:1REF:p. 1351 Mood Disorders

OBJ: Cognitive Level: Application

14.The nurse is working with the parents of a child with attention-deficit hyperactivity disorder. The child is on methylphenidate (Ritalin). Which of the following actions by the nurse would be most helpful in getting the parents to comply with the medication regimen?

a.

Talk to the parents about the benefits of the medication more than the side effects associated with the medication.

b.

Talk with the parents about several children who have been helped by taking Ritalin.

c.

Explore the parents feelings and concerns about the medication.

d.

Contract with the parents to try the child on Ritalin for a month and reevaluate at that time.

ANS: C

Feedback

A

Incorrect: Caregivers will monitor medication administration for their child; therefore, awareness of side effects is essential. Talking about the benefits predominately is not appropriate.

B

Incorrect: Talking about several children who have been helped by taking Ritalin is not the most helpful intervention. The nurse needs to know the caregivers feelings and concerns about their child taking the medication.

C

Correct: The nurse works with the family to encourage compliance and explores their feelings and concerns that might impede this. Some caregivers fear they are drugging their child by giving the medication. Others are concerned that giving their child a stimulant medication will lead to drug addiction in later life. There is compelling evidence that early medication treatment with stimulants in childhood significantly reduces the risk for subsequent substance use disorders.

D

Incorrect: This is not an appropriate nursing intervention. This type of decision should be made between the physician and caregivers.

PTS:1REF:p. 1350 Mood Disorders

OBJ: Cognitive Level: Application

15.The nurse is working with a child who has a diagnosis of attention-deficit hyperactivity disorder and is taking a stimulant medication. The child has lost weight and is short for his age group. The nurse will talk with the parents about this weight loss and the lag in growth attainment. The nurse will most likely explain this to the parents in which of the following ways?

a.

The weight loss and growth lag are due to the energy that a hyperactive child burns, and this will eventually be corrected by the stimulant.

b.

Children on stimulants often lose weight and have a lag in growth, so we need to talk with the pediatrician about how to minimize these side effects.

c.

The child is at an age there weight loss is normal, and the child may soon have a growth spurt.

d.

Some children are just slender and short for their age group and this may be a genetically caused phenomenon.

ANS: B

Feedback

A

Incorrect: This is an incorrect statement.

B

Correct: Growth rate may be decreased, and weight loss is common during the first few months of treatment because of appetite suppression. Talking with the pediatrician about how to minimize these side effects is appropriate; however, appetite may return to normal with long-term use.

C

Incorrect: Since the age of the child is unknown, this may not be a true statement.

D

Incorrect: Although this statement is true, the weight loss and lag in growth is due to appetite suppression of stimulants.

PTS:1REF:p. 1350 Suicide

OBJ: Cognitive Level: Application

16.The nurse working with children who have a major depressive disorder (MDD) will notice that these children, compared to adults with major depressive disorder, are:

a.

less depressed and more closely resemble an adult with dysthymic disorder

b.

unlikely to exhibit any of the signs of depression that adults exhibit

c.

easier to treat and they have a sort of depression that responds readily to medication

d.

more irritable, express more anxiety, and verbalize more about somatic complaints

ANS: D

Feedback

A

Incorrect: Children who have MDD are not less depressed compared with adults with MDD and do not more closely resemble an adult with dysthymic disorder.

B

Incorrect: The clinical picture of a child with MDD may be similar to that of an adult, but children may not spontaneously express feelings of sadness and worthlessness.

C

Incorrect: This is not a true statement.

D

Correct: Compared to adults, depressed children are more irritable, express more anxiety (such as school or social phobia), and verbalize more about somatic complaints like headaches and stomachaches.

PTS:1REF:p. 1352 Suicide

OBJ: Cognitive Level: Application

17.The nurse assessing a child or adolescent with a diagnosis of dysthymic disorder (DD) will find which of the following symptoms?

a.

a depressed or irritable mood for most of the day, on most days, for 2 or more years, and low energy or fatigue

b.

severe shaking of the hands then trying to hold a glass of water or other object

c.

a depression that is deeper, more acute, and more likely to lead to suicide than major depressive disorder

d.

labile mood and hyperactive thyroid with an increase in circulating thyroid hormones and associated symptoms

ANS: A

Feedback

A

Correct: A child or adolescent with a diagnosis of dysthymic disorder (DD) will exhibit a depressed or irritable mood for most of the day, on most days, for 2 or more years, and low energy or fatigue.

B

Incorrect: These are not symptoms of DD.

C

Incorrect: DD consists of a persistent long-term depressed mood that is less intense but more chaotic than in MDD. Children with DD are not more likely to attempt or commit suicide than those with MDD.

D

Incorrect: This is a false statement.

PTS:1REF:p. 1351 Suicide

OBJ: Cognitive Level: Application

18.The school nurse is working with children from various cultures. The nurse notices that one of the foreign-born students seems to be silent and avoids eye contact with the principal, teachers, and other adults. The nurse decides to do further assessment before reaching a conclusion about the cause of this behavior. Which of the following is the most likely cause of the silence and avoiding eye contact?

a.

one of the depressive disorders

c.

poor English language skills

b.

low self-esteem

d.

cultural norms

ANS: D

Feedback

A

Incorrect: A depressive disorders is not the most likely cause of the silence and avoiding eye contact in a foreign-born child.

B

Incorrect: Children with low self-esteem may tend to be silent and avoid eye contact; however, this student is foreign-born.

C

Incorrect: Poor English language skills are not the most likely cause of the silence and avoiding eye contact.

D

Correct: Children from many cultures are encouraged to be silent and to avoid direct eye contact then in the presence of authority figures. These behaviors can easily be misinterpreted as indicators of depression.

PTS:1REF:p. 1353 Suicide

OBJ: Cognitive Level: Application

19.The school nurse working with a group of adolescents with mood disorders is aware that the third leading cause of death in 10- to 19-year-olds is which of the following?

a.

automobile accidents

c.

suicide

b.

drug overdose

d.

disease

ANS: C

Feedback

A

Incorrect: Automobile accidents are not the third leading cause of death in 10- to 19-year-olds.

B

Incorrect: Drug overdose is not the third leading cause of death in 10- to-19 year olds.

C

Correct: Suicide is the third leading cause of death in 10- to 19-year-olds.

D

Incorrect: Disease is not the third leading cause of death in 10- to 19-year-olds.

PTS:1REF:p. 1355 Suicide

OBJ: Cognitive Level: Comprehension

20.The school nurse notices that one of the adolescents who is in a peer support group is talking about not being around long and is giving away some belongings. The nurse suspects this adolescent may be thinking about suicide. Which of the following interventions would be best?

a.

Ask the adolescent: Have you ever thought about killing yourself or wishing you were dead?

b.

Report the suspicions to the principal, the vice principal, and adolescents teachers.

c.

Talk with the family of the adolescent, and ask them if they have any idea about what is going on with their child.

d.

Talk with the peers of the adolescent, and ask them to watch this adolescent and find out what is going on.

ANS: A

Feedback

A

Correct: Adolescents with high risk behaviors and high risk factors should be asked directly about suicide. This is an appropriate question to ask.

B

Incorrect: This is not the best intervention.

C

Incorrect: Obtaining information about individual and family members history of depression and suicide attempts, mood changes, cognitive changes including suicidal ideation, and expressions of despondency and hopelessness from caregivers is essential. However, asking them if they have any idea about what is going on with their child is not adequate.

D

Incorrect: Obtaining information as mentioned above from the adolescents peers is appropriate. However, asking them to watch this adolescent and find out what is going on is not appropriate.

PTS:1REF:p. 1357 Suicide

OBJ: Cognitive Level: Application

21.An adolescent hospitalized after a suicide attempt is due to be discharged after a weeklong stay in the psychiatric unit. The nurse assessing this adolescent notices that the child has a dramatic lifting of the depression and seems cheerful. The nurses best course of action is to do which of the following?

a.

Talk with the parents about the positive change in mood.

b.

Call the psychiatrist immediately to notify her of the mood change, and ask that the psychiatrist assess this adolescent prior to discharge.

c.

Wait until the parents come, do discharge teaching, and release the adolescent to go home.

d.

Watch the adolescent closely to see if this is a sign that the depression is truly resolved or if the adolescent is going into mania.

ANS: B

Feedback

A

Incorrect: This is not the best course of action because the adolescents symptoms indicate a decision to commit suicide.

B

Correct: This is the best course of action. A sudden change in affect for the better or a dramatic lifting of depression may be an indication that the adolescent has resolved the ambivalence about living or dying and has made the decision to commit suicide.

C

Incorrect: This is not appropriate because this adolescent should be evaluated by the psychiatrist immediately and not released to go home until this has occurred. If the individual is not at high risk, she or he should be followed up closely.

D

Incorrect: This is an incorrect action because the symptoms indicate a resolution to commit suicide and not movement into mania.

PTS:1REF:p. 1357 Suicide

OBJ: Cognitive Level: Application

22.The nurse working with children and adolescents who talk about suicide intentions is aware that those at highest risk of completing the suicide are those who:

a.

have a single caregiver who psychologically abuses them

b.

suffer from depression or some mood disorder

c.

describe a plan to use a firearm and have access to a firearm and ammunition

d.

are talking about saving up some of their pills and taking them all at once

ANS: C

Feedback

A

Incorrect: Children and adolescents with a history of physical or sexual abuse, not psychological abuse, are at higher risk for suicide but not the highest.

B

Incorrect: Children and adolescents who suffer from depression or some mood disorder are at higher risk for suicide but not the highest.

C

Correct: Children and adolescents who are at the highest risk for suicide have a well-thought-out plan that includes the method, place, time, clear intent, and no rescue plan. The degree of intent is related to the lethality of the method. Use of a firearm has a high degree of lethality, and access to a firearm and ammunition further increases the chance of a successful suicide.

D

Incorrect: Children and adolescents who talk about saving up some of their pills and taking them all at once are not at the highest risk for suicide.

PTS:1REF:p. 1356 Suicide

OBJ: Cognitive Level: Application

23.Which of the following things must the nurse teach caregivers of children and adolescents as a primary prevention of suicide?

a.

what to say to their child then the child is suicidal

b.

how to manage the medication of an adolescent who is suicidal

c.

to work with the treatment team then the adolescent is hospitalized

d.

to identify risk factors for suicide and signs of depression

ANS: D

Feedback

A

Incorrect: As a primary prevention of suicide the nurse does not teach caregivers what to say to their child then the child is suicidal.

B

Incorrect: As a primary prevention of suicide the nurse does not teach caregivers how to manage the medication of an adolescent who is suicidal.

C

Incorrect: This is not an example of primary prevention but of secondary prevention.

D

Correct: As a primary prevention of suicide the nurse must teach caregivers of children and adolescents to identify risk factors for suicide and signs of depression.

PTS:1REF:p. 1357 Psychosocial Alterations

OBJ: Cognitive Level: Application

24.Nurses on the unit have been working with an adolescent who was discharged a couple of days ago. The nurses receive word that this adolescent has just been found dead from a self-inflicted gunshot wound. Which of the following things would most help these nurses?

a.

a debriefing session with an opportunity to work through their own feelings of self-blame, grief, or guilt

b.

details of how the adolescent planned and went about the work of killing himself

c.

a visit to the funeral home to view the adolescent and talk with his family and friends

d.

talking with the caregivers or parents of the adolescent who committed suicide

ANS: A

Feedback

A

Correct: A debriefing session with an opportunity to work through their own feelings of self-blame, grief, or guilt would most help these nurses. Debriefing sessions and support groups may be a routine part of work environments to support nurses after a client successfully commits suicide.

B

Incorrect: Details of how the adolescent planned and went about the work of killing himself would not most help these nurses.

C

Incorrect: A visit to the funeral home to view the adolescent and talk with his family and friends would not most help these nurses.

D

Incorrect: Talking with the caregivers or parents of the adolescent who committed suicide would not most help these nurses.

PTS:1REF:p. 1358 Suicide

OBJ: Cognitive Level: Application

25.The essential feature of separation anxiety disorder (SAD) is marked anxiety about separation from major attachment figures, home, or familiar surroundings, which:

a.

is repeated every time the child is in similar circumstances

b.

lasts at least 2 weeks and is repeated several times a year

c.

is beyond that expected for the childs developmental level

d.

cannot be resolved with the usual distraction or ignoring

ANS: C

Feedback

A

Incorrect: This is not an essential feature of SAD.

B

Incorrect: This is not an essential feature of SAD. The individual must have symptoms for at least 4 weeks and an age of onset before 18 years.

C

Correct: The essential feature of SAD is marked anxiety about separation from major attachment figures, home, or familiar surroundings, which is beyond that expected for the childs developmental level. The worry is persistent and excessive and is associated with significant distress or impairment. Typically, the child fears separation or loss will occur as a result of a catastrophic event such as death, kidnapping, or serious accident.

D

Incorrect: This is not an essential feature of SAD.

PTS:1REF:p. 1358 Suicide

OBJ: Cognitive Level: Comprehension

26.The nurse assessing a child suspected of having school phobia is aware that which of the following contributes to caregivers ineffectiveness in helping the child with school phobia or with refusing to return to school?

a.

wanting to discipline or disciplining the child

b.

ambivalent feelings by the caregiver

c.

lack of information about school phobia

d.

being busy with work and other involvements

ANS: B

Feedback

A

Incorrect: Wanting to discipline or disciplining the child does not contribute to caregivers ineffectiveness in helping to return the child to school.

B

Correct: Caregivers often have ambivalent feelings about their childs attendance at school, which contributes to their ineffectiveness in helping to return the child to school.

C

Incorrect: Lack of information about school phobia does not contribute to caregivers ineffectiveness in helping to return the child to school.

D

Incorrect: Being busy with work and other involvements does not contribute to caregivers ineffectiveness in helping to return the child to school.

PTS:1REF:p. 1358 Anxiety Disorders

OBJ: Cognitive Level: Application

27.Children with generalized anxiety disorder (GAD) can best be described as:

a.

excessive worriers who worry even then school and social successes indicate they have nothing to worry about

b.

worried about nothing in particular but feeling worried all the time even if no cause can be found

c.

worried about everything, every waking minute, and being unable to accomplish any work

d.

having a low level of worry but being consistently at this same level of worry

ANS: A

Feedback

A

Correct: Children with (GAD) can best be described as excessive worriers who worry even then school and social successes indicate they have nothing to worry about. They worry about things such as school performance, future events, peer relationships, social acceptability, competency, and pleasing others. The worry causes impairment in functioning, occurs more days than not for at least 6 months.

B

Incorrect: This is an incorrect statement. Children with (GAD) worry about a number of events or activities such as school performance, future events, peer relationships, social acceptability, competency, and pleasing others.

C

Incorrect: Children with GAD do not worry about everything, but they find it difficult to control the worry and have difficulty concentrating.

D

Incorrect: Children with GAD have an excessive level of worry, not a low level.

PTS:1REF:p. 1358 Eating Disorders

OBJ: Cognitive Level: Comprehension

28.The nurse assessing a school-aged child with separation anxiety disorder (SAD) will most likely find that the child has been exhibiting which of the following behaviors?

a.

aggression toward other children and especially any siblings

b.

refusing to eat in what seems to be an effort to get attention

c.

exhibiting complaints of stomachaches, headaches, nausea, vomiting, and low-grade fevers without any physiological cause

d.

refusing to leave home and sometimes even refusing to leave the bedroom and familiar belongings for days or even weeks at a time

ANS: C

Feedback

A

Incorrect: These behaviors are not exhibited in the child with SAD.

B

Incorrect: These behaviors are not exhibited in the child with SAD.

C

Correct: The child with SAD exhibits complaints of stomachaches, headaches, nausea, vomiting, and low-grade fevers without any physiological cause. When separation from major attachment figures occurs or is anticipated, these symptoms are exhibited.

D

Incorrect: These behaviors are not exhibited in the child with SAD. However, the child has difficulty attending school, participating in extracurricular activities, and attending sleepovers.

PTS:1REF:p. 1358 Substance Abuse

OBJ: Cognitive Level: Application

29.The school nurse observes an adolescent who always brings his lunch and eats in isolation from others. In class and groups this young man looks uncomfortable then called on to speak and has taken some teasing from peers for blushing and sweating then interacting in a group. The school nurse will do further assessment with the adolescent and his caregivers because these symptoms are most consistent with those found in which of the following conditions?

a.

social isolation disorder

c.

social phobia disorder

b.

schizoid disorder

d.

separation anxiety disorder

ANS: C

Feedback

A

Incorrect: These symptoms are not consistent with those found in social isolation disorder.

B

Incorrect: These symptoms are not consistent with those found in schizoid disorder.

C

Correct: These symptoms are most consistent with those found in social phobia disorder.

D

Incorrect: These symptoms are not consistent with those found in SAD.

PTS:1REF:p. 1358 Psychosocial Alterations

OBJ: Cognitive Level: Comprehension

30.Which of the following outcomes would the nurse evaluate as a goal met for a child who has been given a nursing diagnosis of Fear related to separation from caregiver:

a.

Child stayed overnight with a peer.

b.

Child stated he or she will go to camp for a week.

c.

Parent has devised a reward system for the child staying 1 hour or more without the parent present.

d.

Caregiver reports the child seems less nervous then talking about separation.

ANS: A

Feedback

A

Correct: For a child who has been given a nursing diagnosis of Fear related to separation from caregiver, staying overnight with a peer indicates a goal has been met.

B

Incorrect: This outcome is a goal in the future and has not yet been met.

C

Incorrect: This outcome is a goal in the future and has not yet been met.

D

Incorrect: This is not the correct response.

PTS:1REF:p. 1360 Psychosocial Alterations

OBJ: Cognitive Level: Application

COMPLETION

1.The parents of a child with failure to thrive have questioned how many calories their infant will need. The nurse is aware that children with failure to thrive need to receive ____________________% of their recommended daily caloric intake.

ANS:

150

one hundred fifty

Children with failure to thrive require 150% of their recommended daily caloric intake, based upon their expected, not actual, weight.

PTS:1REF:p. 1370 Treatment Modalities

OBJ: Cognitive Level: Application

MULTIPLE RESPONSE

1.Which of the following are appropriate goals in working with a child or adolescent with a diagnosis of anorexia nervosa? Select all that apply.

a.

weight gain to within 5% of ideal body weight within 1 weeks time frame

b.

weight gain to within 10% of ideal body weight at a gain of 1-2 pounds per week

c.

eat 100% of a 2,500-calorie diet each day

d.

eat a balanced diet with sufficient calories to allow weight gain

ANS: B, D

Feedback

Correct

When working with a child or adolescent with anorexia nervosa, appropriate goals include weight gain to within 10% of body weight at 1-2 pounds of weight gain per week.

The client should be encouraged to eat a balanced diet with sufficient calories to allow weight gain.

Incorrect

Weight gain to within 5% of the ideal body weight within 1 weeks time would require rapid weight to be gained too quickly. This rapid weight gain is medically unsafe and may lead to cardiac overload and death.

Weight gain should not be too rapid, such as that which would occur with eating 100% of a 2,500-calorie diet daily.

PTS:1REF:p. 1365 Treatment Modalities

OBJ: Cognitive Level: Application

Leave a Reply