Ch . 22 - Neurodevelopmental Disorders

The nurse is assessing a 2-year-old child during a wellness checkup. Which statement(s) by the parent indicate that the child needs to be screened for autism spectrum disorder? Select all that apply.

A. "My child rarely makes eye contact with me or siblings."

B. "My child loves to have a difference in routines daily."

C. "I notice that my child has very few facial expressions to situations."

D. "There is no spontaneous play at all and will only plays with one object.

E. "Will answer questions when asked with a one-word response."

A. "My child rarely makes eye contact with me or siblings."

C. "I notice that my child has very few facial expressions to situations."

D. "There is no spontaneous play at all and will only plays with one object.

A parent expresses concern to the nurse that the child's regularly scheduled measles, mumps, and rubella (MMR) vaccines may not be safe and cause autism. Which is the most appropriate response by the nurse?

A. "It is recommended that you wait until the child is older to vaccinate."

B. "There are safer alternative immunizations available now."

C. "There has been no research to establish a relationship between vaccines and autism."

D. "The risks do not outweigh the benefits of immunization against childhood diseases."

C. "There has been no research to establish a relationship between vaccines and autism."

A parent informs the nurse that they are concerned that the parent's child might suffer from attention-deficit/hyperactivity disorder (ADHD). The child can sit still, running all over the house, and having difficulty in school. Which is the best response by the nurse?

A. "From what you are describing, ADHD may be a possibility and we will refer you to a specialist for screening."

B. "All children can be like that and it may be a disciplinary issue and not a symptom of ADHD."

C. "Not all children do well in school and parents have a very high expectation of achievement."

D. "You should be sure to talk to the health care provider about prescribing medication for treatment."

A. "From what you are describing, ADHD may be a possibility and we will refer you to a specialist for screening."

The nurse is educating parents of a child with attention-deficit/hyperactivity disorder (ADHD)about the prescription for atomoxetine. Which client statement(s) indicate that the education is effective? Select all that apply.

A. "We will need to bring our child in for routine liver function testing."

B. "Prior to the administration of the medication, a chest x-ray will be done."

C. "If our child reports a dry mouth, we can give sugar free candy or gum."

D. "It is better to give the medication with food."

E. "We need to monitor appetites since the medication may suppress appetite."

A. "We will need to bring our child in for routine liver function testing."

C. "If our child reports a dry mouth, we can give sugar free candy or gum."

D. "It is better to give the medication with food."

E. "We need to monitor appetites since the medication may suppress appetite."

A child with attention-deficit/hyperactivity disorder (ADHD) arrives with a parent for a scheduled checkup. The nurse assesses that the child looks thin and has lost several pounds since the last

visit 6 months ago. Which action will the nurse take to improve the child's nutritional status?

A. Stop all medication for treatment until the child regains the weight.

B. Have the child sit at the table for three large meals a day with the family.

C. Encourage the parents to include finger foods several times a day.

D. Add milk shakes and other foods high in sugar to increase weight gain.

C. Encourage the parents to include finger foods several times a day.

The nurse observe a child with attention-deficit/hyperactivity disorder (ADHD) grab another child in a group session. Which response by the nurse is most effective in stopping the behavior?

A. "If you can't sit still in the group, you will not be allowed to attend again."

B. "It's ok to want to make new friends and show you affection to them."

C. "It's not alright to grab other children. When you want something, ask them."

D. "I am sure that your parents do not allow you to act this way at home, do they?"

C. "It's not alright to grab other children. When you want something, ask them."

The school nurse is talking with the parent of a 7-year-old child who is having difficulty in the classroom due to a diagnosis of attention-deficit/hyperactivity disorder (ADHD). The child is having

difficulty paying attention, listening, and completing tasks. Which suggestion can the nurse give for improvement to the parent?

A. Allow the child to listen to music with headphones while completing class work.

B. Request that the child be seated in front of the teacher in the classroom.

C. Encourage the parent to increase the dosage of medication the child is taking.

D. Have the child do the majority of school work on a computer in the classroom.

B. Request that the child be seated in front of the teacher in the classroom.

A child with attention-deficit/hyperactivity disorder (ADHD) tells the parents that they do not like how the medication makes them feel and the parents ask the nurse what they can do to decrease the side effects. Which is the best response by the nurse?

A. Give the child the medicine at night.

B. Have the child eat breakfast and snacks later in the day and bedtime.

C. Limit the number of calories the child eats each day.

D. Let the child take daytime naps.

B. Have the child eat breakfast and snacks later in the day and bedtime.

The nurse is assisting a child with attention-deficit/hyperactivity disorder (ADHD) to complete the child's activities of daily living. Which is the best approach for nurse to use with this child?

A. Break tasks into small steps.

B. Let the child complete tasks at the child's own pace.

C. Offer rewards when all tasks are completed.

D. Set a time limit to complete all tasks.

A. Break tasks into small steps.

The nurse is preparing to bring a child and their parents into the examination room to see the health care provider. Which are the best way(s) for the nurse to assess the child for attention- deficit/hyperactivity disorder (ADHD)? Select all that apply.

A. Directly observing the child

B. Reviewing the client's record

C. Interviewing the client's parents

D. Interviewing the client's teachers

E. Assessing the client in a group of peers

A. Directly observing the child

C. Interviewing the client's parents

D. Interviewing the client's teachers

E. Assessing the client in a group of peers

The nurse is planning the care for a child with attention-deficit/hyperactivity disorder (ADHD). When discussing interventions with the parent, which nursing intervention will be the highest priority?

A. Provide a structured daily routine.

B. Ensure the child's safety due to impulsiveness.

C. Simplify instructions and directions with only one step at a time.

D. Improve role performance.

B. Ensure the child's safety due to impulsiveness.

An 8-year-old with attention-deficit/hyperactivity disorder is jumping off the bed onto a chair. Which response by the nurse would be most appropriate?

A. "I need to talk to you."

B. "Stop jumping on the bed now."

C. "You are going to hurt yourself."

D. "Why are you jumping off the bed?"

B. "Stop jumping on the bed now."

The parent of a 6-year-old child with autism spectrum disorder (ASD) informs the nurse that the temper tantrums are getting difficult to control and the parent is afraid of what the child will do to themself and other family members. Which option will the nurse discuss with the parent to help manage the behaviors?

A. These behaviors are difficult to manage, but they will get better as the child ages.

B. The use of antipsychotic medications may be helpful with the tantrums and aggression.

C. The parent will need to take a firmer disciplinary approach with the child.

D. The child may require inpatient care since this is not a typical behavior of ASD.

B. The use of antipsychotic medications may be helpful with the tantrums and aggression.

The parents of a child with attention-deficit/hyperactivity disorder (ADHD) express to the nurse, "We get so frustrated when our child never listens to us." Which parenting strategies will the nurse discuss with the parents? Select all that apply.

A. Use appropriate time-out strategies for behavior control.

B. Provide occasional rewards and consequences for behavior.

C. Give verbal reprimands for negative behavior.

D. Resist giving praise until fully compliant with requests.

E. Use a point system for positive and negative behavior.

A. Use appropriate time-out strategies for behavior control.

C. Give verbal reprimands for negative behavior.

E. Use a point system for positive and negative behavior.

A nurse working with children with autism spectrum disorder (ASD) hears an unlicensed assistive personnel (UAP) stating, "I don't know why we put in so much time educating these parents, they

don't seem to care what we say." Which is the best response to the UAP about the importance of educating parents of children with ASD?

A. "I understand how you feel. The parents are too overwhelmed to really hear what we say."

B. "We help parents feel relieved to have specific strategies that can help them and their child be more successful."

C. "The parents are the ones paying for the care that their child is receiving so we are obligated to teach."

D. "Any parent who has a child who receives special school services has to be educated about care ."

B. "We help parents feel relieved to have specific strategies that can help them and their child be more successful."

A nurse is providing education to a group of parents who have children with attention- deficit/hyperactivity disorder (ADHD). Which information will the nurse include in the education? Select all that apply.

A. Placing your child on medication alone will be adequate treatment.

B. Take the time to learn how to rebuild a child's self-esteem.

C. Support groups can provide information and encouragement from others.

D. ADHD is not the fault of the parents or the child.

E. Children with ADHD do not qualify for special school services.

B. Take the time to learn how to rebuild a child's self-esteem.

C. Support groups can provide information and encouragement from others.

D. ADHD is not the fault of the parents or the child.

The nurse is educating parents of a child with attention-deficit/hyperactivity disorder (ADHD). Which statement by the parents would indicate the need for further teaching?

A. "We'll have the child do homework at the kitchen table with the child's siblings."

B. "We'll make sure the child completes one task before going on to another."

C. "We'll set up rules with specific times for eating, sleeping, and playing."

D. "We'll use simple, clear directions and instructions."

A. "We'll have the child do homework at the kitchen table with the child's siblings."

The nurse is talking with a parent of a 12-year-old child with autism spectrum disorder (ASD) about behavior that has deteriorated recently. Which is the best response by the nurse?

A. "It is likely an effect of hormonal changes."

B. "The child may need medication to control these behaviors."

C. "It may be a reaction to the overprotection of parents."

D. "Since this is a progressive illness, behavior will get worse."

A. "It is likely an effect of hormonal changes."

The nurse is working with a school-age child who is being evaluated for a mental health disorder. The parents of the child ask the nurse why the health care staff is having such a difficult time diagnosing the child. Which is the best response by the nurse? Select all that apply.

A. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening.

B. Children are constantly changing and developing and unable to discriminate unusual symptoms from normal feelings.

C. Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level.

D. Sometimes, children "outgrow" psychiatric disorders at different stages of life.

E. Children and adolescents experience some of the same mental health problems as adults and are diagnosed using the same criteria.

A. Children usually lack the abstract cognitive abilities and verbal skills to describe what is happening.

B. Children are constantly changing and developing and unable to discriminate unusual symptoms from normal feelings.

C. Behaviors that are appropriate for a child of one developmental level may be inappropriate for a child of a different developmental level.

The nurse has been working with the family of a small child with attention-deficit/hyperactivity disorder (ADHD). The nurse feels very frustrated because the parents refuse to implement the effective parenting skills that the nurse has taught. Which is the best action for the nurse at this time?

A. Review effective disciplinary practices with the parents again.

B. Refer the parents to a family therapist.

C. Praise the parents for doing their best in a difficult situation.

D. Explore alternative living arrangements for the child.

C. Praise the parents for doing their best in a difficult situation.

A client with a tic disorder tells the nurse that they are experiencing more complex motor tics and verbal tics lately but they get better when occupied with a task. Which question will be most appropriate to ask the client to determine the best option for decreasing these symptoms?

A. "Have you been experiencing an increase in stress lately?"

B. "Is there any changes that you have made to your diet?"

C. "Are you taking any new medications?

D. "Have you developed any new allergies?"

A. "Have you been experiencing an increase in stress lately?"

A nurse is teaching a family how to best help their child who has been recently diagnosed with a neurodevelopmental disorder. Which statement indicates to the nurse that teaching has been effective?

A. "We will be able to do more things with our family."

B. "We will be able to enjoy more structure in our home."

C. "We will be able to go to the races every weekend like we used to."

D. "We will be able to go on the bus tour with our church group."

B. "We will be able to enjoy more structure in our home."

The parent of a child with attention-deficit/hyperactivity disorder (ADHD) tells the school nurse that the child's teacher has called a conference. Which statement is true regarding evaluation of treatment for the child with ADHD?

A. The child notices the change in treatment before anyone else.

B. The change is subtle and gets noticed at the follow-up visit.

C. It is the siblings that notice the change in behavior first.

D. The parents or teacher notice positive outcomes of treatment.

D. The parents or teacher notice positive outcomes of treatment.

A parent of a child who is diagnosed with mild-to-moderate intellectual developmental disorder is upset and states, "Am I going to have to put my child in an institution?" Which is the most therapeutic response by the nurse?

A. "It all depends on the behavioral issues that the child experiences."

B. "Your child will be able to receive care at home and in the community."

C. "You may need to consider residential or day care services for your child."

D. "You will need to receive intensive education to be able to care for your child at home."

B. "Your child will be able to receive care at home and in the community."

A young adolescent client arrives in the outpatient clinic and demonstrates various motor and vocal tics. The client is emotional and states that other children avoid them and call them horrible names.

Which prescription by the health care provider will the nurse educate the client and parent about?

A. Risperidone

B. Lithium

C. Methylphenidate

D. Atomoxetine

A. Risperidone

The nursing is caring for a child in the pediatric outpatient clinic being treated with imipramine for the treatment of enuresis. Which report by the parent is of most concern to the nurse?

A. The parent states the child is having a bowel movement every other day.

B. The parent states the child is sleepy for about 2 hours after taking the pill.

C. The child reports nausea after taking the pill relieved with food.

D. The child is having decreased urinary output and difficulty urinating.

D. The child is having decreased urinary output and difficulty urinating.