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Foundations of Psychiatric Mental Health Nursing 6th Edition Varcarolis Halter Test Bank

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Foundations of Psychiatric Mental Health Nursing 6th Edition Varcarolis Halter Test Bank

ISBN-13: 978-1416066675

ISBN-10: 1416066675

 

 

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Foundations of Psychiatric Mental Health Nursing 6th Edition Varcarolis Halter Test Bank

ISBN-13: 978-1416066675

ISBN-10: 1416066675

 

 

 

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Varcarolis: Foundations of Psychiatric Mental Health Nursing, 6th Edition

Chapter 28: Disorders of Children and Adolescents

Test Bank

MULTIPLE CHOICE

  1. The parent of a 4-year-old says, “My child moves constantly. I try to get him interested in toys, but he is easily distracted. He talks all the time and is awake every morning before I am. I enrolled him in preschool, but the teacher could not handle him.” The child’s problem meets criteria for:
a. attention deficit hyperactivity disorder.
b. pervasive developmental disorder.
c. posttraumatic stress disorder.
d. oppositional defiant disorder.

 

ANS:   A

Excessive motion, distractibility, and excessive talkativeness characterize attention deficit hyperactivity disorder (ADHD). The behaviors presented in the scenario do not support the distracters. Developmental delays would be seen if pervasive developmental disorder were present. Oppositional defiant disorder would include serious violations of the rights of others.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 627, 641-642

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. A child has excessive motor activity and talking that interfere with academic performance. Which aspect of the child’s care and treatment would a clinical nurse specialist, but not a nurse generalist, perform?
a. Evaluating responses to nursing actions
b. Formulating nursing diagnoses
c. Planning nursing interventions
d. Providing psychotherapy

 

ANS:   D

The clinical nurse specialist role includes individual, group, and family psychotherapist; educator of nurses, other professions, and the community; clinical supervisor; consultant to professional and nonprofessional groups; and researcher. The distracters describe actions of a nurse generalist.

 

DIF:    Cognitive Level: Application             REF:    Text Page: N/A (prior learning)

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Psychosocial Integrity

 

  1. A nurse assesses a 4-year-old with hyperactive, impulsive behavior. Which developmental task should the child have achieved?
a. Separation from parents and ability to socialize outside the family
b. Forming satisfactory relationships with peers
c. Ability to generate abstract ideas
d. A sense of autonomy

 

ANS:   D

A 4-year-old should have attained the developmental tasks of children aged 1 1/2 to 3 years: autonomy. The distracters relate to older children.

 

DIF:    Cognitive Level: Application

REF:    Text Pages: 626, 633 + prior learning; see Chapter 2

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Sustained release methylphenidate (Concerta) was administered to a child with ADHD. Which finding best indicates the medication was effective?
a. Increased expressiveness in communication 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

Improvement in the child’s hyperactivity, distractibility, and play indicates the medication was effective. The distracters are more relevant for a child with pervasive developmental disorder or anxiety disorder.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 643-644

TOP:    Nursing Process: Evaluation              MSC:   Client Needs: Psychosocial Integrity

 

  1. A 5-year-old with ADHD bounces out of a chair in the waiting room and begins to slap another child. What is the nurse’s best action?
a. Call for emergency assistance from other staff.
b. Direct the child to stop. Comfort the other child.
c. Instruct the parents to take the child home immediately.
d. Take the child to another room with toys to act out feelings.

 

ANS:   D

Use of play to express feelings is appropriate because the cognitive and language abilities of the child may require acting out of feelings if verbal expression is limited. This action also distracts the child. The distracters provide no outlet for feelings or opportunity to develop coping skills.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 645-646

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 16-year-old with a conduct disorder was placed in therapeutic foster care. Which outcome should be met 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. Placement with the foster family continues until the parents finish a parenting skills class.
d. The teen has an absence of anger and frustration for one week.

 

ANS:   A

The patient and the parents must participate and 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. It is not necessary to separate the patient from the family to work on these issues, and separation is detrimental to the healing process.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 642-645

TOP:    Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A child with ADHD will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications?
a. Monoamine oxidase inhibitors
b. Antipsychotic medications
c. Anxiolytic medications
d. Psychostimulant drugs

 

ANS:   D

Psychostimulant drugs, such as methylphenidate and pemoline (Cylert), increase blood flow to the brain and have proved helpful in reducing hyperactivity in persons with attention deficit hyperactivity disorder. The other medication categories listed are not indicated.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 643-644

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Physiological Integrity

 

  1. Shortly after the parents announced that they were divorcing, a 15-year-old stopped participating in sports, sat alone at lunch, and avoided friends. The adolescent told the school nurse, “I would rather stay in my room and listen to music. It’s easier than talking to my friends about what is happening in my family.” Which nursing diagnosis is most applicable?
a. Decisional conflict
b. Chronic low self-esteem
c. Disturbed personal identity
d. Impaired social interaction

 

ANS:   D

This diagnosis refers to aloneness that the patient perceives negatively, even when self-imposed. The teen displays self-imposed isolation from peers and family. The distracters are not supported by data in the scenario.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Pages: 627, 630, 632, 640

TOP:    Nursing Process: Nursing Diagnosis

MSC:   Client Needs: Psychosocial Integrity

 

  1. Shortly after the parents announced that they were divorcing, a 15-year-old stopped participating in cheerleading, sat alone at lunch, and avoided former friends. The adolescent told the school nurse, “All the other kids have families. If my parents loved me, they would work out their problems.” Which nursing intervention would be most appropriate?
a. Develop a plan for activities of daily living.
b. Communicate disbelief relative to the patient’s feelings.
c. Assist the patient to distinguish reality from perceptions.
d. Assess and document the patient’s level of fatigue daily.

 

ANS:   C

The patient’s perception that all the other kids are from two-parent households and that she is different is not based on reality. Helping the adolescent to test the accuracy of his/her perceptions will be helpful.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Pages: 632, 649

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Psychosocial Integrity

 

  1. A nurse works with an adolescent who is moody and withdrawn because the teen’s parents are divorcing. Establishing a therapeutic alliance is a priority because:
a. focusing on the strengths of an individual increases the individual’s self-esteem.
b. the adolescent should express feelings and not keep them internalized.
c. acceptance and trust convey feelings of security to the adolescent.
d. therapeutic activities provide an outlet for tension.

 

ANS:   C

Trust is frequently an issue because the child or adolescent may never have had a trusting relationship with an adult. In this patient’s situation, the trust she once had in her parents has been shattered, robbing her of feelings of security. Only the key relates to the therapeutic alliance.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 634-645

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Psychosocial Integrity

 

  1. When assessing a 2-year-old with suspected autistic disorder, a nurse would expect:
a. hyperactivity and attention deficits.
b. failure to develop interpersonal skills.
c. a history of disobedience and destructive acts.
d. high levels of anxiety when separated from the parent.

 

ANS:   B

Autistic disorder involves distortions in development of social skills and language that include perception, motor movement, attention, and reality testing. Caretakers nearly always mention the child’s failure to develop interpersonal skills. The distracters are more relevant to ADHD, separation anxiety, and conduct disorder.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 637-639

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. A 5-year-old cries and screams from the time the parents leave the child at kindergarten until picked up 6 hours later; however, this child is calm and relaxed when with the parents. The parents ask the nurse, “What should we do?” Select the nurse’s best advice.
a. “Send a picture of yourself to school to keep with the child.”
b. “Arrange with the teacher to let the child call home at play time.”
c. “Talk with the school about withdrawing the child until maturity increases.”
d. “Talk with your health care provider about a referral to a mental health clinic.”

 

ANS:   D

Separation anxiety disorder becomes apparent when the child is separated from the attachment figure. Often, the first time separation occurs is when the child goes to kindergarten or nursery school. Separation anxiety may be based on the child’s fear that something will happen to the attachment figure. The other options are short-term fixes. The child needs professional intervention.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 646-647

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Psychosocial Integrity

 

  1. A 15-year-old is referred to the mental health clinic by juvenile court after an arrest for vandalism and running away from home six times. The teen has been physically abusive to the mother and defiant to the father. The adolescent’s problem is most consistent with criteria for:
a. attention-deficit hyperactivity disorder.
b. adolescent depression.
c. conduct disorder.
d. autistic disorder.

 

ANS:   C

Conduct disorders are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. The patient’s clinical manifestations do not coincide with criteria of the other disorders.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 642-643

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. A 15-year-old was referred to a residential program after an arrest for theft and multiple episodes of running away from home. At the program, the adolescent refused to participate in scheduled activities and pushed a staff member, causing a fall. Which approach by nursing staff will be most therapeutic?
a. Neutrally permit refusals.
b. Offer rewards in advance.
c. Plead for compliance.
d. Establish firm limits.

 

ANS:   D

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, pleading, and bargaining are strategies that do not help the patient learn to abide by rules or structure.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 645-646

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A 15-year-old was referred to the mental health clinic by juvenile court after an arrest for prostitution and assault on the mother. The teen tells the nurse, “I hate my parents. They focus all attention on my brother. He’s perfect in their eyes.” Which type of therapy might promote the greatest change in the adolescent’s behavior?
a. Family therapy
b. Bibliotherapy
c. Play therapy
d. Art therapy

 

ANS:   A

Family therapy would focus on problematic family relationships and interactions. The patient had already identified problems within the family.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 634-637

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Psychosocial Integrity

 

  1. A 15-year-old was referred to the mental health clinic by juvenile court after an arrest for vandalism and assault on a teacher. The teen tells the nurse, “I hate my parents. They focus all attention on my brother, who is perfect in their eyes.” Which nursing diagnosis applies?
a. Chronic low self-esteem related to feelings of guilt, as evidenced by believing a brother is the parental favorite
b. Hopelessness related to feeling unloved by parents, as evidenced by assaulting a teacher
c. Ineffective coping related to seeking parental attention, as evidenced by acting out
d. Disturbed personal identity related to acting out, as evidenced by vandalism

 

ANS:   C

The patient demonstrates an inability to problem solve by using adaptive behaviors to meet life’s demands and roles. The defining characteristics are not present for the other nursing diagnoses listed. The patient has not indicated hopelessness, low self-esteem, or disturbed personal identity.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 640

TOP:    Nursing Process: Nursing Diagnosis

MSC:   Client Needs: Psychosocial Integrity

 

  1. Which factor places a child most at risk for development of a psychiatric disorder?
a. Moving to three new homes over a 2-year period
b. Not being promoted to the next grade at the completion of a school year
c. Developmental milestones achieved on schedule
d. Being raised by a mother with chronic major depression

 

ANS:   D

Statistics show that maternal psychiatric disorders are associated with increased psychiatric disorders in children. The chronicity of the parent’s depression means it has been a consistent stressor. The other factors are not as risk enhancing.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 630

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

 

  1. Which child shows behaviors indicative of mental illness?
a. Age 3 months: cries after feeding until burped; sucks thumb
b. Age 9 months: does not eat vegetables; likes to be rocked
c. Age 3 years: mute; passive toward adults; twirls when walking
d. Age 6 years: developed enuresis after the birth of a sibling

 

ANS:   C

Symptoms consistent with pervasive developmental disorder are evident in the key. The behaviors of the other children are within normal ranges.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 637

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. The child most likely to receive risperidone (Risperdal) to manage symptoms is one diagnosed with:
a. attention deficit hyperactivity disorder.
b. pervasive developmental disorder.
c. obsessive-compulsive disorder.
d. posttraumatic stress disorder.

 

ANS:   B

Risperidone is useful for relieving irritability and labile affect of some children with pervasive developmental disorders. It is not indicated in any of the other disorders.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 638

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Physiological Integrity

 

  1. A child known as the neighborhood bully recently set fire to a dumpster outside a supermarket. The parents report, “This event happened after our child was suspended from school for fighting.” These behaviors are most consistent with:
a. conduct disorder.
b. Asperger’s disorder.
c. attention deficit disorder.
d. pervasive developmental disorder.

 

ANS:   A

The behaviors are most consistent with criteria for conduct disorder, which includes aggression against people and animals; destruction of property; deceitfulness; rule violations; and impairment in social, academic, or occupational functioning.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 642

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. The parent of a child with Tourette’s disorder says, “My child’s tics come and go. I think my child is faking them.” Select the accurate response by the nurse.
a. “Perhaps your child was misdiagnosed.”
b. “Your observation indicates the medication is effective.”
c. “Tics often change frequency or severity. That does not mean they are not real.”
d. “This finding indicates worsening of the condition. Let’s review how you’ve been giving the child’s medication.”

 

ANS:   C

Tics are sudden rapid, involuntary, repetitive movements or vocalizations characteristic of Tourette’s disorder. They often fluctuate in frequency and severity and are reduced or absent during sleep.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 649

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Physiological Integrity

 

  1. An 11-year-old diagnosed with oppositional defiant disorder becomes angry over the rules at a residential treatment program and begins shouting at the nurse. What might be the best method to defuse the situation?
a. Say to the child, “Tell me how you’re feeling right now.”
b. Take the child swimming at the center’s pool.
c. Administer an anxiolytic medication.
d. Call staff to seclude the child.

 

ANS:   B

Redirecting the expression of feelings into nondestructive, age-appropriate behaviors such as a physical activity helps the child learn how to modulate the expression of feelings and exert self-control. This is the least restrictive alternative of those listed and should be tried before resorting to more restrictive measures. A shouting child will not likely engage in a discussion about feelings.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Pages: 645-646

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. An adolescent acts out in disruptive ways. When this patient threatens to throw a billiard ball at another adolescent, which comment by the nurse would set limits?
a. “Attention everyone: we are all going to the craft room.”
b. “You will be taken to seclusion if you throw that ball.”
c. “Do not throw the ball. Put it back on the pool table.”
d. “Please do not lose control of your emotions.”

 

ANS:   C

Setting limits uses clear, sharp statements about prohibited behavior and guidance for performing a behavior that is expected. The distracters represent a threat, use of restructuring (which would be inappropriate in this instance), and a direct appeal to the child’s developing self-control that may be ineffective.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 645-646

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. When a 5-year-old is disruptive, the nurse says, “You must take a time-out.” The expectation is that the child will:
a. go to a quiet room until called for the next meal.
b. slowly count to 20 before returning to the milieu.
c. sit on the edge of the activity until able to regain self-control.
d. sit quietly with a staff member until able to apologize for the behavior.

 

ANS:   C

Time-out is designed so that staff can be consistent in their interventions. Time-out may require going to a designated room or sitting on the periphery of an activity until the child gains self-control and reviews the episode with a staff member. Time-out does not involve special attention. Counting to 10 or 20 is not sufficient.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 635

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. Parents of a child with ADHD tell the nurse, “We try to teach our child how to behave, but it doesn’t help. We feel as though we are terrible parents.” Select the nurse’s most helpful response.
a. Refer the parents for pastoral counseling.
b. Discuss how traumatic life events precipitate ADHD.
c. Explain the correlation between ADHD and parental conflict.
d. Provide information about the relationship between ADHD and biochemical abnormalities.

 

ANS:   D

Abnormalities in dopamine receptors and transporters are implicated in ADHD. Parents who understand the possible biochemical causation may be less likely to blame their parenting methods for the child’s behavior. The other options have no relevance to ADHD.

 

DIF:    Cognitive Level: Application             REF:    Text Pages: 629, 645

TOP:    Nursing Process: Implementation

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. A 9-year-old has feelings of self-blame related to the parents’ recent divorce. Which therapy is likely to be helpful for this child?
a. Cognitive behavioral therapy
b. Therapeutic drawing
c. Behavioral therapy
d. Pharmacotherapy

 

ANS:   B

Therapeutic drawing will provide an opportunity for the child to express thoughts, feelings, and tensions. The distracters are not indicated based on the scenario.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 636

TOP:    Nursing Process: Implementation      MSC:   Client Needs: Psychosocial Integrity

 

  1. A parent with schizophrenia and 10-year-old child live in a homeless shelter. The child has adapted to shelter life and formed a relationship with a supportive volunteer. The child says, “My three best friends and I got an A on our school science project.” Which assessment applies?
a. The child displays resilience.
b. Risk factors for substance abuse are evident.
c. The child is at risk for posttraumatic stress disorder.
d. The child uses intellectualization to deal with problems.

 

ANS:   A

Resiliency enables a child to handle the stresses of a difficult childhood. Resilient children can adapt to changes in the environment, take advantage of nurturing relationships with adults other than parents, distance themselves from emotional chaos occurring within the family, and learn and use problem-solving skills. The other options are not supported by data given in the scenario.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 630

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. A parent with schizophrenia and 10-year-old child live in a homeless shelter. The child has adapted to shelter life. The child says, “I have three good friends at school. We talk about lots of things and sit together at lunch.” Select the nurse’s best action.
a. Recommend foster home placement of the child.
b. Refer the parent to the domestic violence program.
c. Refer the child for evaluation of emerging developmental problems.
d. Foster the child’s healthy characteristics and existing environmental supports.

 

ANS:   D

Because the child shows no evidence of poor mental health, the best action would be to foster existing healthy characteristics and environmental supports. No other option is necessary or appropriate under the current circumstances.

 

DIF:    Cognitive Level: Analysis                  REF:    Text Pages: 632, 634-637

TOP:    Nursing Process: Planning

MSC:   Client Needs: Safe and Effective Care Environment

 

  1. A child said, “I just want to die. No one likes me. Other kids laugh at me, but I do not know why. They will always laugh at me.” When asked about a suicide plan, the child replied, “I’ll jump from the bridge near my home. My father threw kittens off the bridge, and they died because they couldn’t swim.” Suicide risk is:
a. absent.
b. low.
c. moderate.
d. high.

 

ANS:   D

The suicide risk is high. The child is experiencing feelings of hopelessness and helplessness. The method described is lethal, and the means to carry out the plan are available.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 633

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. An 11-year-old has Asperger’s disorder. Which assessment finding supports this diagnosis?
a. Mutism
b. Tics and twitching
c. Severe developmental delays
d. Restricted and repetitive patterns of behavior

 

ANS:   D

Most children with Asperger’s syndrome manifest restricted and repetitive patterns of behavior as their major symptoms. Idiosyncratic interests may also occur. Verbal skills are rarely impaired. Tics and twitching are more often a part of the clinical picture of Tourette’s syndrome. Severe developmental delays are part of the clinical picture of autism rather than Asperger’s syndrome.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Page: 639

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. Assessment data for a 9-year-old shows blurting out answers before a question is complete, inability to take turns, and persistently interrupting conversations of others. These behaviors relate primarily to:
a. hyperactivity.
b. impulsivity.
c. inattention.
d. defiance.

ANS:   B

These behaviors are most directly related to impulsivity. Hyperactive behaviors are more physical in nature, such as running, pushing, and the inability to sit. Inattention is demonstrated by failure to listen. Defiance is demonstrated by willfully doing what an authority figure has said not to do.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Page: 641

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

MULTIPLE RESPONSE

  1. Which assessment findings indicate an adolescent is mentally healthy? Select all that apply. The adolescent:
a. is able to describe future career interests.
b. believes his/her community is a safe place to live.
c. frequently sends and receives text messages with friends.
d. states academic problems result from the father’s harsh discipline.
e. shoplifts designer jeans when the parents say, “We cannot afford it.”

 

ANS:   A, B, C

The correct answers show that an adolescent sees the world as safe and supportive, has a developing identity and healthy self-concept, and is able to adapt to new situations.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 632

TOP:    Nursing Process: Assessment            MSC:   Client Needs: Psychosocial Integrity

 

  1. A nurse prepares to implement bibliotherapy in a pediatric psychiatric unit. Which resources will be most helpful? Select all that apply.
a. Children’s books
b. Building blocks
c. Librarian
d. Games
e. Paint

 

ANS:   A, C

Bibliotherapy uses literature to help children express feelings, gain insight, and learn new coping skills. Children’s books and a librarian are helpful resources. Paint would be useful for therapeutic drawing. Games would be useful for therapeutic games. Building blocks would be useful for play therapy.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 637

TOP:    Nursing Process: Planning                 MSC:   Client Needs: Psychosocial Integrity

 

  1. Which health problems are likely to have familial patterns? Select all that apply.
a. Posttraumatic stress disorder
b. Separation anxiety disorder
c. Adjustment disorder
d. Asperger’s disorder
e. Tourette’s disorder

 

ANS:   D, E

Asperger’s and Tourette’s disorders have genetic links and tend to occur in familial patterns. The distracters result from environmental and situational events.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Pages: 639, 649

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. The nurse on an adolescent psychiatric unit assesses a newly admitted 14-year-old. Which findings should the nurse document as aspects of the developmental history? Select all that apply.
a. Severe acne
b. Apgar score 10
c. Allergic to penicillin
d. Reports frequent nightmares
e. Had sexual intercourse one time with a childhood friend

 

ANS:   B, D, E

Neonatal data, sleep patterns, and sexual activity are aspects of the developmental history. Acne and an allergy to penicillin would be documented under the medical history.

 

DIF:    Cognitive Level: Application             REF:    Text Page: 632

TOP:    Nursing Process: Assessment

MSC:   Client Needs: Health Promotion and Maintenance

 

  1. Which mental health problems for children and adolescents may respond favorably to atypical antipsychotic medications? Select all that apply.
a. ADHD
b. Tic disorders
c. Generalized anxiety disorder
d. Posttraumatic stress disorder
e. Pervasive developmental disorder

 

ANS:   B, E

Atypical antipsychotic medications are commonly prescribed for tic disorders and pervasive developmental disorders. These drugs are not expected treatment for the other conditions listed.

 

DIF:    Cognitive Level: Comprehension      REF:    Text Page: 638

TOP:    Nursing Process: Evaluation              MSC:   Client Needs: Physiological Integrity