MHVide beck Ch22 NCLEX

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1. Chapter 22The nurse is assessing a 16 -month-old child during a well-baby checkup. Which of the following behaviors would be consistent withautism spectrum disorder? Select all that apply.1.A) The child displays little eye contact with others.2.B) The child thrives on changes in routine.3. C) The child makes few facial expressions toward others.4. D) The child does not like repetition.5. E) The child answers questions verbally.Ans: A, C, DFeedback:Children with autism display little eye contact with and make few facialexpressions toward others; they use limited gestures to communicate. Theyhave limited capacity to relate to peers or parents. They lack spontaneousenjoyment express no moods or emotional affect and cannot engage in playor make-believe with toys. There is little intelligible speech. These childrenengage in stereotyped motor behaviors such as hand flapping, body twisting,or head banging.2. A mother expresses concern to the nurse that the child's regularlyscheduled vaccines may not be safe. The mother states that she has heardreports that they cause autism. The most appropriate response by the nurseis,1.A) ilt is recommended that you wait until the child is older tovaccinate.!2.B) iThere are safer alternative immunizations available now.i3. C) iThere has been no research to establish a relationship betweenvaccines andautism.i4.D) iThe risks do not outweigh the benefits of immunization againstchildhooddiseases!Ans: C

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Feedback:The National Institute of Child Health and Human Development, Centers forDisease control (CDC) and the Academy of Pediatrics have all conductedresearch studies for several years and have concluded that there is norelationship between vaccines and autism and that the MMR vaccine is safe.Page 13. A parent is concerned that his child might suffer from attention deficithyperactivity disorder (ADHD). Which of the following behaviors reported bythe parent would be consistent with this diagnosis?1.A) The child interrupts others.2.B) The child has been hoarding objects.3. c) The child has lots of friends.4. D) The child is excelling academically in school..Ans: AFeedback:By the time the child starts school, symptoms of ADHD begin to interferesignificantly with behavior and performance. He or she cannot listen todirections or complete tasks. The child interrupts and blurts out answersbefore questions are completed. Academic performance suffers because thechild makes hurried, careless mistakes in schoolwork, often loses or forgetshomework assignments, and fails to follow directions. Socially, peers mayostracize or even ridicule the child for his or her behavior. The child oftenloses necessary things.4. Which of the following symptoms are characteristic of ADHD? Select allthat apply.1.A) Enuresis2. B) Inattentiveness3. C) Encopresis4.D)Overactivity5. E)Impulsiveness

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Ans: B, D, EFeedback:ADHD is characterized by inattentiveness, overactivity, and impulsiveness.Encopresis is the repeated passage of feces into inappropriate places suchas clothing or the floor by a child who is at least 4 years of age eitherchronologically or developmentally. Enuresis is the repeated voiding of urineduring the day or at night into clothing or bed by a child at least 5 years ofage either chronologically or developmentally. Encopresis and enuresis areelimination disorders that are unrelated to ADHD.Page 25. Which of the following are common coexisting psychiatric disorders foradults with ADHD? Select all that apply.1.A) Social phobia2.B) Bipolar disorder3. C) Obsessivencompulsive disorder4. D) Major depression5. E) Alcohol dependenceAns: A, B, D, EFeedback:Approximately 70% to 75% of adults with ADHD have at least one coexistingpsychiatric diagnosis, with social phobia, bipolar disorder, major depression,and alcohol dependence being the most common.6. A nurse asks an assigned client, iHow are you doing today?i The clientresponds with idoing today, doing today, doing today.i Which speech patterndisturbance is this an example of?1.A) Reactive attachment disorder2.B) Stereotypic movement disorder3. C) Selective mutism4.D) EcholaliaAns: D

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Feedback:Echolalia is repeating the last heard sound, word, or phrase. Stereotypicmovement disorders include waving, rocking, twirling objects, bitingfingernails, handing the head, biting or hitting oneself, or picking at the skinor body orifices. Selective mutism is characterized by persistent failure tospeak in social situations where speaking is expected.7. Which of the following terms describes the repeating of one's own wordsor sounds?1.A) Coprolalia2. B)Palilalia3. C) Echolalia4. D) None of the aboveAns: BFeedback:Palilalia is the repeating of one's own words or sounds. Coprolalia is the useof socially unacceptable words, which are frequently obscene. Echolalia isthe repeating of the last heard sound, word, or phrase.Page 38. Which of the following disorders involves problems with forming soundsassociated with speech?1.A) Phonologic disorder2.B) Mixed receptivenexpressive language disorder3. c) Expressive language disorder4.D)StutteringAns: AFeedback:Phonologic disorder involves problems with articulation. Mixedreceptivefiexpressive language disorder includes problems of expressivelanguage disorder along with difficulty understanding and determining themeaning of words and sentences. Expressive language disorder involves animpaired ability to communicate through verbal and sign language.

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Stuttering is a disturbance of the normal fluency and time patterning ofspeech.9. A parent of a child with autism spectrum disorder asks the nurse if there isanything that can be done to control the child's tantrums. Which optionshould the nurse inform the parents that may be appropriate?1.A) Give the child rewards for resisting tantrums.2.B) Reason with the child why tantrums are not effective.3. C) Place the child in a time-out when tantrums occur.4. D) Explore the use of antipsychotic medications to control tantrums.Ans: DFeedback:Pharmacologic treatment with antipsychotics, such as haloperidol (Haldol) orrisperidone (Risperdal), may be effective for specific target symptoms suchas temper tantrums, aggressiveness, self-injury, hyperactivity, andstereotyped behaviors.10. A child with ADHD complains to his parents that he does not like the sideeffects of his medicine, Adderall. The parents ask the nurse for suggestionsto reduce the medication's negative side effects. The nurse can best help theparents by offering which advice?1.A) Give the child his medicine at night.2.B) Have the child eat a good breakfast and snacks late in the day andat bedtime.3. C) Limit the number of calories the child eats each day.4. D) Let the child take daytime naps.Ans: BFeedback:Giving stimulants during daytime hours usually effectively combatsinsomnia. Eating a good breakfast with the morning dose and substantialnutritious snacks late in the day and at bedtime helps the child to maintainan adequate dietary intake. Daytime napping for a child with ADHD isunrealistic and not developmentally necessary.

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