**Chapter 11: Childhood and Neurodevelopmental Disorders

Which factor presents the highest risk for a child to develop a psychiatric disorder?

a. Having an uncle with schizophrenia

b. Being the oldest child in a family

c. Living with an alcoholic parent

d. Being an only child

c. Living with an alcoholic parent

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 do not represent psychosocial adversity. Having a family history of schizophrenia presents a risk, but an alcoholic parent in the family offers a greater risk.

Which nursing diagnosis is universally applicable for children diagnosed with autism spectrum disorders?

a. Impaired social interaction related to difficulty relating to others

b. Chronic low self-esteem related to excessive negative feedback

c. Deficient fluid volume related to abnormal eating habits

d. Anxiety related to nightmares and repetitive activities

a. Impaired social interaction related to difficulty relating to others

Children diagnosed with autism spectrum disorders display profoundly disturbed social relatedness. They seem aloof and indifferent to others, often preferring inanimate objects to human interaction. Language is often delayed and deviant, further complicating relationship issues. The other nursing diagnoses might not be appropriate in all cases.

A kindergartener is disruptive in class. This child is unable to sit for expected lengths of time, inattentive to the teacher, screams while the teacher is talking, and is aggressive toward other children. The nurse plans interventions designed to:

a. promote integration of self-concept.

b. provide inpatient treatment for the child.

c. reduce loneliness and increase self-esteem.

d. improve language and communication skills.

c. reduce loneliness and increase self-esteem.

Because of their disruptive behaviors, children with ADHD often receive negative feedback from parents, teachers, and peers, leading to self-esteem disturbance. These behaviors also cause peers to avoid the child with ADHD, leaving the child with ADHD vulnerable to loneliness. The child does not need inpatient treatment at this time. The incorrect options might or might not be relevant.

A nurse will prepare teaching materials for the parents of a child newly diagnosed with attention deficit hyperactivity disorder (ADHD). Which medication will the information focus on?

a. Paroxetine (Paxil)

b. Imipramine (Tofranil)

c. Methyphenidate (Ritalin)

d. Carbamazepine (Tegretol)

c. Methyphenidate (Ritalin)

CNS stimulants are the drugs of choice for treating children with ADHD: Ritalin and dexedrine are commonly used. None of the other drugs are psychostimulants used to treat ADHD.

What is the nurses priority focused assessment for side effects in a child taking methylphenidate (Ritalin) for attention deficit hyperactivity disorder (ADHD)?

a. Dystonia, akinesia, and extrapyramidal symptoms

b. Bradycardia and hypotensive episodes

c. Sleep disturbances and weight loss

d. Neuroleptic malignant syndrome

c. Sleep disturbances and weight loss

The most common side effects are gastrointestinal disturbances, reduced appetite, weight loss, urinary retention, dizziness, fatigue, and insomnia. Weight loss has the potential to interfere with the childs growth and development. The distracters relate to side effects of conventional antipsychotic medications.

A nurse assesses a 3-year-old diagnosed with an autism spectrum disorder. Which finding is most associated with the childs disorder? The child:

a. has occasional toileting accidents.

b. is unable to read childrens books.

c. cries when separated from a parent.

d. continuously rocks in place for 30 minutes.

d. continuously rocks in place for 30 minutes.

Autism spectrum disorder involves distortions in development of social skills and language that include perception, motor movement, attention, and reality testing. Body rocking for extended periods suggests autism spectrum disorder. The distracters are expected findings for a 3-year-old.

The parent of a child diagnosed with Tourettes disorder says to the nurse, I think my child is faking the tics because they come and go. Which response by the nurse is accurate?

a. Perhaps your child was misdiagnosed.

b. Your observation indicates the medication is effective.

c. Tics often change frequency or severity. That doesnt mean they arent real.

d. This finding is unexpected. How have you been administering your childs medication?

c. Tics often change frequency or severity. That doesnt mean they arent real.

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