Childhood and neurodevelopmental disorders EAQ
Detailed Questions and Expert Answers
A child diagnosed with an autism spectrum disorder (ASD) will demonstrate
impaired development in:
1 - Adhering to routines
2 - Eye-hand coordination
3 - Swallowing and chewing
4 - Playing with other children - ANS 4
Autism affects the normal development of the brain in social interaction and
communication skills. Symptoms associated with autism spectrum disorders
include significant deficits in social relatedness, including communication,
nonverbal behavior, and age-appropriate interaction.
During an assessment, the nurse finds that a patient says "wabbit" for "rabbit" and
omits most of the sounds. Which neurodevelopmental disorder is the patient likely
to have?
1 - Learning disorder
2 - Communication disorder
3 - Intellectual development disorder
4 - Attention-deficit/hyperactivity disorder - ANS 2
Patients having communication disorder often have problems with making sounds.
They tend to distort, add, or omit some sounds. They often lack fluency while
speaking and may repeat the words because of stammering. In intellectual
development disorder, patients have problems in intellectual functioning and are
,unable to reason and judge in age-appropriate activities. In learning disorder,
patients have reduced reading and writing skills. They have difficulty in doing
mathematics and expressing their emotions. Patients suffering from attention-
deficit/hyperactivity disorder have reduced attention and are often impulsive and
hyperactive.
The nurse is caring for a toddler with a mental disorder. The nurse identifies that
the toddler finds it difficult to communicate with the staff. What action does the
nurse take next during the assessment?
1 - Make use of play therapy.
2 - Make use of bibliotherapy.
3 - Make use of journaling therapy.
4 - Make use of therapeutic drawing. - ANS 1
Play therapy is an effective medium for children with difficulties in verbal
communication. Children are provided with toys, art supplies, molding clay, blocks,
and puppets. Toddlers with mental disorders communicate with help of these toys
as models. Bibliotherapy, journaling therapy, and therapeutic drawing are not
used for assessing toddlers with mental disorders because these children may not
have adequate cognitive development to perform these tasks. Bibliotherapy is
used for older patients who are able to read and understand the materials
provided. Journaling therapy is effective when designing treatment protocols for
adolescents. Therapeutic drawing is used for younger patients who are able to
express their views in the form of pictographic representation.
When a child demonstrates a temperament that prompts the mother to say, "She
is just so different from me; I just can't seem to connect with her," the nurse will:
1 - Suggest that the child's father become her primary caregiver
,2 - Encourage the mother to consider attending parenting classes
3 - Counsel the mother regarding ways to better bond with her child
4 - Educate the father regarding signs that the child is being physically abused -
ANS 1
All people have temperaments, and the fit between the child and parent's
temperament is critical to the child's development. The caregiver's role in shaping
that relationship is of primary importance, and the nurse can intervene to teach
parents ways to modify their behaviors to improve the interaction.
A nurse observed that during play therapy, a patient is unable to follow the rules
of the game and has conflict with peers. Which of these drugs would you
anticipate would be administered to the patient?
1 - Naltrexone
2 - Methylphenidate
3 - Diphenhydramine
4 - Botulinum toxin type A - ANS 2
A patient with attention-deficit/hyperactivity disorder does not follow rules in a
game and has conflicts with peers. Methylphenidate is a physicostimulant drug
used in attention-deficit/hyperactivity disorder. Botulinum toxin type A is given in
Tourette syndrome to calm the muscles. Naltrexone is an opioid antagonist that is
usually given in Tourette syndrome to block the euphoric responses.
Diphenhydramine is an antihistaminic drug prescribed for allergies.
The nurse instructs the parent of a child with attention-deficit/hyperactivity
disorder (ADHD) to administer methylphenidate before 4 PM. Which side effect is
the nurse addressing by giving this instruction?
, 1 - Nausea
2 - Insomnia
3 - Lethargy
4 - Anorexia - ANS 2
Insomnia is a side effect associated with methylphenidate. Administering the drug
during nighttime hours would not allow the child to sleep at night. Therefore, the
drug should be administered when the child is usually awake, in the morning or
afternoon hours. Nausea is not associated with methylphenidate. Lethargy and
appetite suppression are also side effects associated with methylphenidate. Taking
the drug before 4 PM will not prevent these side effects.
The parent of a child diagnosed with Tourette syndrome says to the nurse, "I think
my child is faking the tics because they occur in different places at different times."
Select the correct response by the nurse.
1 - "Children diagnosed with Tourette syndrome often try to manipulate their
caregivers by faking tics."
2 - "The movements are real. Tics can occur anywhere in the body and can change
in frequency and severity."
3 - "Distract your child by planning activities with other children. That will help the
tics stop permanently."
4 - "This finding indicates a worsening of your child's disorder. Let's discuss this
change with the health care provider." - ANS 2
Motor tics usually involve the head but can involve the torso or limbs. They change
in location, frequency, and severity over time. The nurse should provide accurate
information to the parent. The child may be embarrassed if tics occur in the
community.
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