Chapter 26: Children and Adolescents

Chapter 26: Children and Adolescents

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A 5-year-old child moves and talks constantly, is easily distracted, and does not listen to the parents. The child awakens before the parents every morning. The child attended kindergarten, but the teacher could not handle the behavior. What is this child’s most likely problem?

a.	Mental retardation
b.	Oppositional defiant disorder (ODD)
c.	Pervasive developmental disorder
d.	Attention deficit hyperactivity disorder (ADHD)

 

 

ANS:  D

The excessive motion, distractibility, and excessive talkativeness suggest ADHD. Developmental delays would be observed if either a pervasive developmental disorder or mental retardation were present. ODD includes serious violations of the rights of others.

 

DIF:    Cognitive Level: Application           REF:   Pages: 494-496

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

2. A child with attention deficit hyperactivity disorder (ADHD) has hyperactivity, distractibility, and impaired play. The health care provider prescribed methylphenidate (Concerta). The desired behavior for which the nurse should monitor is:

a.	increased expressiveness in communicating with others
b.	improved ability to participate in play with other children
c.	ability to identify anxiety and implement self-control strategies
d.	improved socialization skills with other children and authority figures

 

 

ANS:  B

The goal is improvement in the child’s hyperactivity, distractibility, and play. The remaining options are more relevant for a child with a pervasive developmental or anxiety disorder.

 

DIF:    Cognitive Level: Application           REF:   Pages: 495-496

TOP:   Nursing Process: Outcomes Identification

MSC:  NCLEX: Psychosocial Integrity

 

3. A 5-year-old child with attention deficit hyperactivity disorder (ADHD) bounces out of a chair in the waiting room, runs across the room, and begins to slap another child. What is the nurse’s best action?

a.	Call for emergency assistance from another staff member.
b.	Instruct the parents to take the child home immediately.
c.	Direct this child to stop, and then comfort the other child.
d.	Take the child into another room with toys to act out feelings.

 

 

ANS:  D

The use of play to express feelings is appropriate; the cognitive and language abilities of the child may require the acting out of feelings if verbal expression is limited. The remaining options provide no outlet for feelings or opportunity to develop coping skills.

 

DIF:    Cognitive Level: Application           REF:   Pages: 495-496

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Safe, Effective Care Environment

 

4. A 16-year-old adolescent with a conduct disorder (CD) has been in a residential program for 3 months. Which outcome should occur before discharge?

a.	The teen and parents create and consent to a behavioral contract with rules, rewards, and consequences.
b.	The teen completes an application to enter a military academy for continued structure and discipline.
c.	The teen is temporarily placed with a foster family until the parents complete a parenting skills class.
d.	The teen has an absence of anger and frustration for 1 week.

 

 

ANS:  A

The patient and the parents must agree on a behavioral contract that clearly outlines rules, expected behaviors, and consequences for misbehavior. It must also include rewards for following the rules. The patient will continue to experience anger and frustration. The patient and parents must continue with family therapy to work on boundary and communication issues. Separating the patient from the family to work on these issues is not necessary, and separation is detrimental to the healing process.

 

DIF:    Cognitive Level: Application           REF:   Pages: 497-498

TOP:   Nursing Process: Outcomes Identification

MSC:  NCLEX: Psychosocial Integrity