Chapter 21: Impulse Control Disorders

Chapter 21: Impulse Control Disorders

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A 16-year-old diagnosed with a conduct disorder has been in a residential program for 3 months. Which outcome should occur before discharge?

ANS:  A

The adolescent 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 adolescent will continue to experience anger and frustration. The adolescent and parents must continue with family therapy to work on boundary and communication issues. It is not necessary to separate the adolescent from the family to work on these issues.  Separation is detrimental to the healing process.  While it is helpful for the adolescent to identify peers who are a positive influence, it’s more important for behavior to be managed for an adolescent diagnosed with a conduct disorder.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 406 (Table 21-2) | Page 408 (Box 21-1) | Page 409

TOP:   Nursing Process: Outcomes Identification

MSC:  Client Needs: Psychosocial Integrity

2. A 15-year-old ran away from home six times and was arrested for shoplifting.  The parents told the court, “We can’t manage our teenager.” The adolescent is physically abusive to the mother and defiant with the father. Which diagnosis is supported by this adolescent’s behavior?

ANS:  D

Conduct disorders are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older.  Criteria for ADHD and PTSD are not met in the scenario.

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 402-403 (Table 21-1)               TOP:   Nursing Process: Assessment

MSC:  Client Needs: Psychosocial Integrity

3. A 15-year-old was placed in a residential program after truancy, running away, and an arrest for theft. At the program, the adolescent refused to join in planned activities and pushed a staff member, causing a fall. Which approach by nursing staff will be most therapeutic?

ANS:  B

Firm limits are necessary to ensure physical safety and emotional security. Limit setting will also protect other patients from the teen’s thoughtless or aggressive behavior. Permitting refusals to participate in the treatment plan, ignoring, coaxing, and bargaining are strategies that do not help the patient learn to abide by rules or structure.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 406-408 (Box 21-1) | Page 409                                 TOP:   Nursing Process: Planning

MSC:  Client Needs: Psychosocial Integrity

4. An adolescent was arrested for prostitution and assault on a parent. The adolescent says, “I hate my parents. They focus all attention on my brother, who’s perfect in their eyes.” Which type of therapy might promote the greatest change in the adolescent’s behavior?

ANS:  A

Family therapy focuses on problematic family relationships and interactions. The patient has identified problems within the family.  Play therapy is more appropriate for younger patients.  Art therapy and bibliotherapy would not focus specifically on the identified problem.

PTS:   1                    DIF:    Cognitive Level: Apply (Application)

REF:   Page 407        TOP:   Nursing Process: Planning

MSC:   Client Needs: Psychosocial Integrity