Chapter 24: Children and Adolescents

Essentials of Psychiatric Mental Health Nursing 7th Edition By Mary C

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Chapter 24: Children and Adolescents

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   Which developmental characteristic should a nurse identify as typical of a client diagnosed with severe intellectual developmental disorder (IDD)?

1. The client can perform some self-care activities independently.
2. The client has more advanced speech development.
3. Other than possible coordination problems, the client’s psychomotor skills are not affected.
4. The client communicates wants and needs by “acting out” behaviors.

 

 

____     2.   Which nursing intervention related to self-care would be most appropriate for a teenager diagnosed with moderate IDD?

1. Meeting all of the client’s self-care needs to avoid injury to the client
2. Providing simple directions and praising client’s independent self-care efforts
3. Avoid interfering with the client’s self-care efforts in order to promote autonomy
4. Encouraging family to meet the client’s self-care needs to promote bonding

 

 

____     3.   A child has been diagnosed with autistic spectrum disorder. The distraught mother cries out, “I’m such a terrible mother. What did I do to cause this?” Which nursing response is most appropriate?

1. “Researchers really don’t know what causes autistic spectrum disorder, but the relationship between autistic disorder and fetal alcohol syndrome is being explored.”
2. “Poor parenting doesn’t cause autistic spectrum disorder. Research has shown that abnormalities in brain structure or function are to blame. This is beyond your control.”
3. “Research has shown that the mother appears to play a greater role in the development of autistic spectrum disorder than the father.”
4. “Lack of early infant bonding with the mother has shown to be a cause of autistic spectrum disorder. Did you breastfeed or bottle-feed?”

 

 

____     4.   In planning care for a child diagnosed with autistic spectrum disorder, which would be a realistic client outcome?

1. The client will communicate all needs verbally by discharge.
2. The client will participate with peers in a team sport by day four.
3. The client will establish trust with at least one caregiver by day five.
4. The client will perform most self-care tasks independently.

 

 

____     5.   After an adolescent diagnosed with attention deficit/hyperactivity disorder (ADHD) begins methylphenidate (Ritalin) therapy, a nurse notes that the adolescent loses 10 pounds in a 2-month period. What is the best explanation for this weight loss?

1. The pharmacological action of Ritalin causes a decrease in appetite.
2. Hyperactivity seen in ADHD causes increased caloric expenditure.
3. Side effects of Ritalin cause nausea, and, therefore, caloric intake is decreased.
4. Increased ability to concentrate allows the client to focus on activities rather than food.

 

MULTIPLE CHOICE

 

  1. ANS:  4

Chapter: Chapter 24, Children and Adolescents

Objective: Identify symptomatology and use the information in the assessment of clients with the aforementioned disorders.

Page: 629

Heading: Table 24-1 Developmental Characteristics of Intellectual Developmental Disorder by Degree of Severity

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 The client would not be able to perform self-care activities independently.
2 The client will not necessarily have advanced speech development.
3 Individuals diagnosed with severe IDD require complete supervision and have minimal verbal skills and poor psychomotor development.
4 The nurse should identify that a client diagnosed with severe IDD may communicate wants and needs by “acting out” behaviors. Severe IDD indicates an IQ between 20 and 34.

 

 

PTS:   1                    CON:  Cognition

 

  1. ANS:  2

Chapter: Chapter 24, Children and Adolescents

Objective: Identify symptomatology and use the information in the assessment of clients with the aforementioned disorders.

Page: 630–631

Heading: Table 24-2 Care Plan for the Child with Intellectual Disability

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 The nurse should allow the client to perform self-care activities independently, but should intervene when necessary.
2 Providing simple directions and praise is an appropriate intervention for a teenager diagnosed with moderate IDD. Individuals with moderate mental retardation can perform some activities independently and may be capable of academic skill to a second-grade level.
3 The nurse should intervene when necessary.
4 The client’s independence should be encouraged.

 

 

PTS:   1                    CON:  Cognition

 

  1. ANS:  2

Chapter: Chapter 24, Children and Adolescents

Objective: Identify symptomatology and use the information in the assessment of clients with the aforementioned disorders.

Page: 631-633

Heading: Neurodevelopmental Disorder > Autism Spectrum Disorder

Integrated Processes: Teaching and Learning

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 This statement may place unintentional blame on the mother.
2 The most appropriate response by the nurse is to explain to the parent that autistic spectrum disorder is believed to be caused by abnormalities in brain structure or function, not poor parenting.
3 This statement is not therapeutic.
4 This statement is inaccurate and may place unintentional blame on the mother.

 

 

PTS:   1                    CON:  Cognition

 

  1. ANS:  3

Chapter: Chapter 24, Children and Adolescents

Objective: Identify symptomatology and use the information in the assessment of clients with the aforementioned disorders.

Page: 634-635

Heading: Table 24-3 Care Plan for the Child with Autism Spectrum Disorder

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Application [Applying]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 It may not be realistic for the client to communicate all needs verbally by discharge.
2 It may not be realistic for the client to participate in a team sport.
3 The most realistic client outcome for a child diagnosed with autistic spectrum disorder is for the client to establish trust with at least one caregiver. Trust should be evidenced by facial responsiveness and eye contact. This outcome relates to the nursing diagnosis impaired social interaction.
4 It may not be realistic for the client to perform self-care tasks independently.

 

 

PTS:   1                    CON:  Cognition

 

  1. ANS:  1

Chapter: Chapter 24, Children and Adolescents

Objective: Identify symptomatology and use the information in the assessment of clients with the aforementioned disorders.

Page: 637–638

Heading: Figure 24-1 Neurobiology of Attention Deficit/Hyperactivity Disorder

Integrated Processes: Nursing Process

Client Need: Psychosocial Integrity

Cognitive Level: Comprehension [Understanding]

Concept: Cognition

Difficulty: Moderate

 

  Feedback
1 The pharmacological action of Ritalin causes a decrease in appetite, which often leads to weight loss.
2 While hyperactivity causes an increased caloric expenditure, it is caused by the use of Ritalin, with decreases appetite.
3 Ritalin does not cause nausea.
4 Methylphenidate is a central nervous symptom stimulant that serves to increase attention span, control hyperactive behaviors, and improve learning ability.

 

 

PTS:   1                    CON:  Cognition

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