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NUR225 EXAM 3 - Practice Questions with Rationales PowerPoint Questions and Answers
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NUR225 EXAM 3 - Practice Questions with Rationales PowerPoint Questions and Answers
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NUR225 EXAM 3 - Practice Questionswith Rationales PowerPoint Questions
and Answers
A client diagnosed with autism spectrum disorder was recently admitted to the hospital.
This client grabs a toy and hits another child. Which is the most appropriate nursing
action?
a) Isolate the client for 24 hours.
b) Encourage the client to explain the hostile behavior.
c) Assume a nonpunitive attitude and remove the client from the conflict.
d) Call the parents for input regarding behavioral management. - Answer-c) Assume a
nonpunitive attitude and remove the client from the conflict.
C is correct. The nurse must intervene, using a nonpunitive approach, to provide a safe
environment by removing the client from the conflict. The client diagnosed with autism
spectrum disorder cannot be expected to limit personal behavior. The test taking
strategy used was the safety umbrella.
A is incorrect. Autism spectrum disorders are characterized by a withdrawal of the child
into the self and into a fantasy world of his or her own creation. Isolating the child can
increase this withdrawal behavior. It is appropriate to remove the client from the
situation in order to provide safety for the client and other children.
B is incorrect. The child diagnosed with autism spectrum disorder has deficits in
developing, maintaining, and understanding relationships and could not be expected to
explain the reason for hostile thoughts or feelings.
D is incorrect. Obtaining parental input could assist the nurse in planning individualized
care, but because the nurse must act quickly in this situation to provide a safe
environment, it is not an appropriate, timely intervention.
An adolescent diagnosed with attention-deficit/hyperactivity disorder (ADHD) is having
difficulty maintaining concentration in the inpatient milieu. Which nursing intervention
would help improve the client's task performance?
a) Mandate that the client remain in her room until all homework is complete.
b) Remove privileges if homework is not completed within a 2-hour period.
c) Encourage dividing tasks into smaller, attainable steps and reward successful
completion.
d) Seek a physician's order to discontinue the stimulant methylphenidate (Ritalin). -
Answer-c) Encourage dividing tasks into smaller, attainable steps and reward
successful completion.
, C is correct. A client with a short attention span can be overwhelmed with large tasks.
Rewards for task completion are more successful than punishments for task completion
failure. Positive reinforcements increase self-esteem and provide incentives for future
positive behaviors. The test taking strategy used is most effective and least restrictive.
A is incorrect. It is important to establish goals that allow the client to complete a part of
the task, not all the homework, and to reward each step completion with positive
reinforcement. Short-term goals are not so overwhelming to the adolescent with a short
attention span.
B is incorrect. Rewards for task completion are more successful than are punishments
for task completion failure. Positive reinforcements increase self-esteem and provide
incentives for future positive behaviors.
D is incorrect. Methylphenidate (Ritalin), which is classified as a stimulant, acts to
decrease hyperactivity in a client diagnosed with ADHD. This medication should not be
discontinued, because it will help to increase concentration and therefore lead to more
successful task completion.
Which is a potential side effect from the prolonged use of methylphenidate (Ritalin)?
a) Psychosis
b) A decreased intelligence quotient (IQ)
c) Sore throat
d) A decrease in rate of growth and development - Answer-d) A decrease in rate of
growth and development
D is correct. A temporary decrease in the rate of growth and development may be a
side effect of Ritalin therapy. Remember these drugs are stimulants and suppress the
appetite thus it is important for the nurse to monitor growth and development.
Remember also to give just before meals or just after meals to ensure the client can eat
as they will depress the appetite once the medication begins working in 30 to 40
minutes after being ingested. Typically stomach upset is not a problem but can be taken
with food. Allow snacks to supplement the diet if needed.
A is incorrect. The side effects of Ritalin therapy do not include psychosis.
B is incorrect. The side effects of Ritalin therapy do not include a decreased IQ. Instead
it helps the student have a longer attention span in order to focus and concentrate.
C is incorrect. The side effects of Ritalin therapy do not include sore throat.
. Joey, a 12-year-old boy diagnosed with ADHD, is being assessed to determine
appropriateness for behavioral therapy-based group treatment. The nurse should also
assess for symptoms of which disorders that commonly co-occur with ADHD? Select all
that apply.
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