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Psychiatric Nursing 7th Edition Keltner Steele Test Bank

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Psychiatric Nursing 7th Edition Keltner Steele Test Bank

ISBN-13: 978-0323185790

ISBN-10: 0323185797

 

Description

Psychiatric Nursing 7th Edition Keltner Steele Test Bank

ISBN-13: 978-0323185790

ISBN-10: 0323185797

 

 

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Below you will find some free nursing test bank questions from this test bank:

 

Chapter 34: Children and Adolescents

 

MULTIPLE CHOICE

 

  1. Which factor presents the most imminent risk for a child to develop a psychiatric disorder?
a.Having an uncle with schizophrenia
b.Living in a middle-income family
c.Being the oldest child in a family
d.Living with an alcoholic parent

 

 

ANS:  D

Having a parent with a substance abuse problem has been designated an adverse psychosocial condition that increases the risk of a child developing a psychiatric condition. Being in a middle-income family and being the oldest child are not considered psychosocial adversity. Having a family history of schizophrenia presents a risk, but an alcoholic parent in the family is more imminent.

 

DIF:    Cognitive level: Applying                REF:   pp. 449-450

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

 

  1. Which behavior indicates that the treatment plan for a child diagnosed with autistic disorder has been effective? The child:
a.plays with one toy for 30 minutes.
b.repeats words spoken by a parent.
c.holds the parent’s hand while walking.
d.spins around and claps hands while walking.

 

 

ANS:  C

Holding the hand of another person suggests relatedness. Usually, a child with autism would resist holding someone’s hand and stand or walk alone, perhaps flapping arms or moving in a stereotyped pattern. The other options reflect behaviors that are consistent with autistic disorder.

 

DIF:    Cognitive level: Analyzing              REF:   p. 452             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Psychosocial Integrity

 

  1. A kindergartener is disruptive to the class. This child is unable to sit for expected lengths of time, inattentive to the teacher, and aggressive toward others, bursting out talking while the teacher is talking. Other children shun this child. The nurse plans interventions designed to:
a.provide inpatient treatment for the child.
b.reduce loneliness and increase self-esteem.
c.improve language and communication skills.
d.promote individuation and integration of self-concept.

 

 

ANS:  B

Because of their disruptive behaviors, children with attention deficit–hyperactivity disorder (ADHD) often receive negative feedback from parents, teachers, and peers, leading to self-esteem disturbance. These same behaviors lead peers to avoid the child with ADHD, who seems reckless and impulsive, and can rarely finish games, leaving the child with ADHD vulnerable to loneliness. The other options might or might not be relevant but are not the priority. The child does not need inpatient treatment at this time.

 

DIF:    Cognitive level: Applying                REF:   p. 452             TOP:   Nursing process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

  1. A nurse will prepare teaching materials regarding which drug for the parents of a child diagnosed with ADHD?
a.Paroxetine (Paxil)
b.Imipramine (Tofranil)
c.Methylphenidate (Ritalin)
d.Carbamazepine (Tegretol)

 

 

ANS:  C

Central nervous system (CNS) stimulants are the drugs of choice for treating children with ADHD. Methylphenidate and dexedrine are commonly used. None of the other drugs are psychostimulants used to treat ADHD.

 

DIF:    Cognitive level: Understanding        REF:   p. 456             TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity

 

  1. A desired outcome for a 12-year-old diagnosed with autism is to improve relationships with other children. Which treatment modality should the nurse suggest for the plan of care?
a.Reality therapy
b.Social skills group
c.Response prevention
d.Insight-oriented group therapy

 

 

ANS:  B

Social skills training teaches the child to recognize the impact of his or her behavior on others. It uses instruction, role-playing, and positive reinforcement to enhance social outcomes. The other therapies would have lesser to no impact on peer relationships.

 

DIF:    Cognitive level: Applying                REF:   p. 452             TOP:   Nursing process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

  1. Which finding necessitates immediate nursing action for a child being treated for depression with a selective serotonin reuptake inhibitor (SSRI)?
a.Oversedation
b.Behavioral activation
c.Anticholinergic effects
d.Extrapyramidal symptoms

 

 

ANS:  B

Behavioral activation, a common side effect of SSRI therapy, is demonstrated by motor restlessness, insomnia, hypomania, and disinhibition. Suicidal thoughts and planning are thought to be associated with behavioral activation, so individuals should be monitored closely as depression lifts. The other drug side effects are associated with typical antipsychotics and tricyclic antidepressants.

 

DIF:    Cognitive level: Applying                REF:   p. 455

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

 

  1. A child being treated for which of the following has a high risk for suicide and should be monitored closely?
a.Depression with fluoxetine (Prozac)
b.ADHD with methylphenidate (Ritalin)
c.Bipolar disorder with aripiprazole (Abilify)
d.Asperger’s disorder with social skills training

 

 

ANS:  A

The child being treated for depression with fluoxetine is at risk for behavioral activation, a drug side effect. Increased suicide risk is part of the behavioral activation complex. The drugs mentioned in the other options do not place the individual in the same risk category as fluoxetine.

 

DIF:    Cognitive level: Analyzing              REF:   p. 455

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

 

  1. The parent of an 8-year-old says, “My child is in constant motion and talks all the time. My child isn’t interested in toys, but is out of bed every morning before I am and into trouble.” The child’s problem is most consistent with:
a.anxiety disorder.
b.Asperger’s disorder.
c.pervasive developmental disorder.
d.ADHD.

 

 

ANS:  D

The excessive motion, distractibility, and excessive talkativeness are seen in ADHD. The behaviors presented in the scenario do not suggest the other possible choices. Developmental delays would be seen if pervasive developmental disorder or Asperger’s disorder were present.

 

DIF:    Cognitive level: Applying                REF:   p. 452

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

 

  1. A child with ADHD had this nursing diagnosis: impaired social interaction, related to excessive neuronal activity, as evidenced by aggressiveness and dysfunctional play with others. Which finding indicates the plan of care was effective?
a.Improved ability to identify anxiety and use self-control strategies
b.Increased expressiveness in communication with others
c.Engages in cooperative play with other children
d.Increased responsiveness to authority figures

 

 

ANS:  C

The goal should be directly related to the defining characteristics of the nursing diagnosis; in this case improvement in the child’s aggressiveness and play. The distracters are more relevant for a child with pervasive developmental disorder or anxiety disorder.

 

DIF:    Cognitive level: Applying                REF:   p. 452             TOP:   Nursing process: Evaluation

MSC:  NCLEX: Psychosocial Integrity

 

  1. In the waiting room a 5-year-old child diagnosed with ADHD bounces out of a chair, runs over to another child, and slaps the other child. What is the nurse’s best action?
a.Direct the aggressive child to stop immediately.
b.Call for emergency assistance from other staff.
c.Instruct the parents to take the child home.
d.Take the child to another waiting area.

 

 

ANS:  D

The nurse should manage the milieu with structure and limit-setting. Removing the aggressive child to another waiting area is an appropriate consequence for the aggressiveness. Directing the child to stop will not be effective. This is not an emergency situation. Intervention is needed rather than sending the child away.

 

DIF:    Cognitive level: Applying                REF:   p. 456

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

 

  1. A child diagnosed with ADHD will begin medication therapy. The nurse should prepare a plan to teach the family about which classification of medications?
a.Central nervous system stimulants
b.Tricyclic antidepressants
c.Antipsychotics
d.Anxiolytics

 

 

ANS:  A

CNS stimulants, such as methylphenidate (Ritalin) and pemoline (Cylert), increase blood flow to the brain and have proved helpful in reducing hyperactivity in children and adolescents with ADHD. The other medication categories listed would not be appropriate.

 

DIF:    Cognitive level: Applying                REF:   p. 456             TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity

 

  1. A nurse assesses a 3-year-old child diagnosed with autistic disorder. Which finding is most associated with the child’s disorder?
a.Toilet training complete
b.Inability to identify colors
c.Failure to develop interpersonal skills
d.Anxiety when separated from a parent

 

 

ANS:  C

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 expected behaviors for a 3-year-old child.

 

DIF:    Cognitive level: Applying                REF:   p. 452

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

 

  1. A 14-year-old is sent to a residential program after arrests for truancy and assault. At the program, the teen refused to participate in scheduled activities and pushed a staff member, causing a fall. Which strategy by nursing staff is indicated?
a.Begin social skills training.
b.Coax to gain compliance.
c.Neutrally allow refusals.
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, coaxing, and bargaining are strategies that do not help the patient learn to abide by rules or structure.

 

DIF:    Cognitive level: Applying                REF:   p. 456             TOP:   Nursing process: Planning

MSC:  NCLEX: Psychosocial Integrity

 

  1. Which assessment finding would cause the nurse to consider a child to be most at risk for the development of mental illness?
a.The child has been raised by a parent with chronic major depression.
b.The child’s best friend was absent from the child’s birthday party.
c.The child was not promoted to the next grade one year.
d.The child moved to three new homes over a 2-year period.

 

 

ANS:  A

Statistics indicate that children raised by a depressed parent have an increased risk of developing an emotional disorder. 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: Analyzing              REF:   pp. 449-450

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

 

  1. The child most likely to receive risperidone (Risperdal) to manage symptoms is one diagnosed with:
a.ADHD.
b.PTSD.
c.anxiety disorder.
d.autistic disorder.

 

 

ANS:  D

Risperidone (Risperdal) is useful for relieving irritability and labile affect demonstrated by some autistic children. It is not indicated in any of the other disorders.

 

DIF:    Cognitive level: Applying                REF:   p. 456             TOP:   Nursing process: Planning

MSC:  NCLEX: Physiologic Integrity

 

  1. A child complains to the school nurse about painful verbal bullying by an aggressive classmate. What is the nurse’s best first action?
a.Give notice to the chief administrator at the school regarding the events.
b.Support the victimized child to share feelings about the experience.
c.Encourage the victimized child to ignore the bullying behavior.
d.Discuss the events with the aggressive classmate.

 

 

ANS:  B

The behaviors by the bullying child create emotional pain and present the risk for physical pain. The nurse should first listen to the child’s complaints and validate the child for reporting the events. Later, school authorities should be notified. School administrators are the most appropriate personnel to deal with the bullying child. The behavior should not be ignored; it will only get worse.

 

DIF:    Cognitive level: Applying                REF:   p. 453

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

  1. An adolescent in a residential program threatens to throw a pool ball at another adolescent. Which comment by the nurse would set limits?
a.“You will be taken to seclusion if you throw that ball.”
b.“Do not throw the ball. Put it back on the pool table.”
c.“Attention everyone: We’re all going to the gym.”
d.“Please do not lose control of your behavior.”

 

 

ANS:  B

Setting limits uses clear, sharp statements about which behavior is not allowed 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: Applying                REF:   p. 456

TOP:   Nursing process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

MULTIPLE RESPONSE

 

  1. Which behaviors are indicative of bullying by a child? Select all that apply.
a.Recruits other children to avoid a child who wears glasses
b.Consistently calls another child “fat” and “stupid”
c.Accidentally trips another child, resulting in a fall
d.Repeatedly steals another child’s lunch money
e.Plays a practical joke on another child

 

 

ANS:  A, B, D

Bullying can be verbal, relational, or physical. It is repetitive and intentionally produces harm or pain in another person. Playful teasing, one-time aggression, and joking do not meet the criteria for bullying.

 

DIF:    Cognitive level: Understanding        REF:   pp. 453-454

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