EATING DISORDER

1. Nurse Naomi observes Ashley who is hospitalized on an eating disorder unit during
mealtimes and for 1 hour after eating. An explanation for this intervention is:
A. To reinforce the behavioral contact
B. To prevent purging behaviors
C. To develop a trusting relationship
D. To maintain focus on the importance of nutrition

2. Caroline is diagnosed with anorexia nervosa and is admitted to the special eating disorder
unit. The initial treatment priority for her is:
A. To promote the client’s independence
B. To determine her current body image
C. To identify family interaction patterns
D. To initiate a refeeding program

3. Nurse Donald is planning a psychoeducational discussion for a group of adolescent

clients with anorexia nervosa. Which of the following topics would Nurse Donald select to
enhance understanding about central issues in this disorder?
A. Peer pressure and substance abuse
B. Self-esteem and self-control
C. Anger management
D. Parental expectations

4. Nurse Eugenia understands that her client Michelle who is bulimic feels shame and guilt
over binge eating and purging. This disorder is therefore considered:
A. Ego-dystonic
B. Ego-enhancing
C. Ego-syntonic
D. Ego-distorting

5. The psychoanalytic theory explains the etiology of anorexia nervosa as:

A. Family dynamics that lead to enmeshment of members
B. The achievement of secondary gain through control of eating
C. The incorporation of thinness as an ideal body image
D. A conflict between mother and child over separation and individualization

A high school senior is diagnosed with anorexia nervosa and is hospitalized for severe
malnutrition. The treatment team is planning to use behavior modification. What rationale
should a nurse identify as the reasoning behind this therapy choice?
A. This therapy will increase the client's motivation to gain weight.
B. This therapy will reward the client for perfectionist achievements.
C. This therapy will provide the client with control over behavioral choices.
D. This therapy will protect the client from parental overindulgence.

Family dynamics are thought to be a major influence in the development of anorexia

nervosa. Which information related to a client's home environment should a nurse associate
with the development of this disorder?
A. The home environment maintains loose personal boundaries.
B. The home environment places an overemphasis on food.
C. The home environment is overprotective and demands perfection.
D. The home environment condones corporal punishment.

A client's altered body image is evidenced by claims of "feeling fat" even though the client is
emaciated. Which is the appropriate outcome criterion for this client's problem?
A. The client will consume adequate calories to sustain normal weight.
B. The client will cease strenuous exercise programs.
C. The client will perceive an ideal body weight and shape as normal.
D. The client will not express a preoccupation with food.

A nurse observes dental deterioration when assessing a client diagnosed with bulimia
nervosa. What explains this assessment finding?
A. The emesis produced during purging is acidic and corrodes the tooth enamel.
B. Purging causes the depletion of dietary calcium.
C. Food is rapidly ingested without proper mastication.
D. Poor dental and oral hygiene leads to dental caries.

Why are behavior modification programs the treatment of choice for clients diagnosed with
eating disorders?
A. These programs help clients correct distorted body image.
B. These programs address underlying client anger.
C. These programs help clients manage uncontrollable behaviors.
D. These programs allow clients to maintain control.

A potential Olympic figure skater collapses during practice and is hospitalized for severe
malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects the
underlying etiology of this disorder?
A. "Skaters need to be thin to improve their daily performance."
B. "All the skaters on the team are following an approved 1,200-calorie diet."
C. "When I lose skating competitions, I also lose my appetite."
D. "I am angry at my mother. I can only get her approval when I win competitions."

The family of a client diagnosed with anorexia nervosa becomes defensive when the
treatment team calls for a family meeting. Which is the appropriate nursing reply?
A. "Tell me why this family meeting is causing you to be defensive. All clients are required to
participate in two family sessions."
B. "Eating disorders have been correlated to certain familial patterns; without addressing
these, your child's condition will not improve."
C. "Family dynamics are not linked to eating disorders. The meeting is to provide your child
with family support."
D. "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration
in family processes needs to be addressed."

A client diagnosed with bulimia nervosa has been attending a mental health clinic for several
months. Which factor should a nurse identify as an appropriate indicator of a positive client
behavioral change?
A. The client gains 2 pounds in 1 week.
B. The client focuses conversations on nutritious food.
C. The client demonstrates healthy coping mechanisms that decrease anxiety.
D. The client verbalizes an understanding of the etiology of the disorder.
A morbidly obese client is prescribed an anorexiant medication. The nurse should prepare to
teach the client about which medication?
A. Diazepam (Valium)
B. Dexfenfluramine (Redux)
C. Sibutramine (Meridia)
D. Pemoline (Cylert)

A nursing instructor is teaching students about the differences between the symptoms of
anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates
that learning has occurred?
A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas
clients diagnosed with bulimia nervosa do not."
B. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients
diagnosed with anorexia nervosa do not."
C. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo,
whereas clients diagnosed with anorexia nervosa do not."
D. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients
diagnosed with bulimia nervosa do not."

A client diagnosed with bulimia nervosa is to receive fluoxetine (Prozac) by oral solution. The
medication is supplied in a 100 mL bottle. The label reads 20 mg/5 mL. The doctor orders 60
mg q day. Which dose of this medication should the nurse dispense?
A. 25 mL
B. 20 mL
C. 15 mL
D. 10 mL

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical
diagnosis of anorexia nervosa. Which nursing diagnosis would take priority at this time?
A. Ineffective coping R/T food obsession
B. Altered nutrition: less than body requirements R/T inadequate food intake
C. Risk for injury R/T suicidal tendencies
D. Altered body image R/T perceived obesity

A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is
the most appropriate, correctly written short-term outcome for this client?
A. The client will use stress-reducing techniques to avoid purging.
B. The client will discuss chaos in personal life and be able to verbalize a link to purging.
C. The client will gain 2 pounds prior to the next weekly appointment.
D. The client will remain free of signs and symptoms of malnutrition and dehydration.

When a community health nurse arrives at the home of a client diagnosed with bulimia
nervosa, the nurse finds the client on the floor unconscious. The client has a history of using
laxatives for purging. To what would the nurse attribute this client's symptoms?
A. Increased creatinine and blood urea nitrogen (BUN) levels
B. Abnormal electroencephalogram (EEG)
C. Metabolic acidosis
D. Metabolic alkalosis

A group of nurses are discussing how food is used in their families and the effects this might
have on their ability to work with clients diagnosed with eating disorders. Which of these
nurses will probably be most effective with these clients?
A. The nurse who understands the importance of three balanced meals a day
B. The nurse who permits children to have dessert only after finishing the food on their plate
C. The nurse who refuses to engage in power struggles related to food consumption
D. The nurse who grew up poor and frequently did not have enough food to eat

A nurse working with a client diagnosed with bulimia nervosa asks the client to recall a time
in life when food could be consumed without purging. Which is the purpose of this nursing
intervention?
A. To gain additional information about the progression of the disease process
B. To emphasize that the client is capable of consuming food without purging
C. To incorporate specific foods into the meal plan to reflect pleasant memories
D. To assist the client to become more compliant with the treatment plan

A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total
body weight. Which subjective client response would the nurse assess to support this
medical diagnosis?
A. "I do not use any laxatives or diuretics to lose weight."
B. "I am losing lots of hair. It's coming out in handfuls."
C. "I know that I am thin, but I refuse to be fat!"
D. "I don't know why people are worried. I need to lose this weight."

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then
purging when alone, is assigned to a client diagnosed with bulimia nervosa. Which is an
appropriate outcome related to this nursing diagnosis?
A. The client will identify two alternative methods of dealing with isolation by day 3.
B. The client will appropriately express angry feelings about lack of control by week 2.
C. The client will verbalize two positive self attributes by day 3.
D. The client will list five ways that the body reacts to bingeing and purging.

A nurse responsible for conducting group therapy on an eating disorder unit schedules the
sessions immediately after meals. Which is the rationale for scheduling group therapy at this
time?
A. To shift the clients' focus from food to psychotherapy
B. To prevent the use of maladaptive defense mechanisms
C. To promote the processing of anxiety associated with eating
D. To focus on weight control mechanisms and food preparation

Which nursing intervention is appropriate when caring for clients diagnosed with either
anorexia nervosa or bulimia nervosa?
A. Provide privacy during meals.
B. Remain with the client for at least 1 hour after the meal.
C. Encourage the client to keep a journal to document types of food consumed.
D. Restrict client privileges when provided food is not completely consumed.

A nurse should identify topiramate (Topamax) as the drug of choice for which of the following
conditions? (Select all that apply.)
A. Binge eating with obesity
B. Bingeing and purging with a diagnosis of bulimia nervosa
C. Weight loss with a diagnosis of anorexia nervosa
D. Amenorrhea with a diagnosis of anorexia nervosa
E. Emaciation with a diagnosis of bulimia nervosa

Family dynamics are thought to be a major influence in the development of anorexia

nervosa. Which information related to a client's home environment should a nurse associate
with the development of this disorder?
A. The home environment maintains loose personal boundaries.
B. The home environment places an overemphasis on food.
C. The home environment is overprotective and demands perfection.
D. The home environment condones corporal punishment.

A client's altered body image is evidenced by claims of "feeling fat" even though the client is
emaciated. Which is the appropriate outcome criterion for this client's problem?
A. The client will consume adequate calories to sustain normal weight.
B. The client will cease strenuous exercise programs.
C. The client will perceive an ideal body weight and shape as normal.
D. The client will not express a preoccupation with food.

A nurse observes dental deterioration when assessing a client diagnosed with bulimia
nervosa. What explains this assessment finding?
A. The emesis produced during purging is acidic and corrodes the tooth enamel.
B. Purging causes the depletion of dietary calcium.
C. Food is rapidly ingested without proper mastication.
D. Poor dental and oral hygiene leads to dental caries.

Why are behavior modification programs the treatment of choice for clients diagnosed with
eating disorders?
A. These programs help clients correct distorted body image.
B. These programs address underlying client anger.
C. These programs help clients manage uncontrollable behaviors.
D. These programs allow clients to maintain control.

A potential Olympic figure skater collapses during practice and is hospitalized for severe
malnutrition. Anorexia nervosa is diagnosed. Which client statement best reflects the
underlying etiology of this disorder?
A. "Skaters need to be thin to improve their daily performance."
B. "All the skaters on the team are following an approved 1,200-calorie diet."
C. "When I lose skating competitions, I also lose my appetite."
D. "I am angry at my mother. I can only get her approval when I win competitions."

The family of a client diagnosed with anorexia nervosa becomes defensive when the
treatment team calls for a family meeting. Which is the appropriate nursing reply?
A. "Tell me why this family meeting is causing you to be defensive. All clients are required to
participate in two family sessions."
B. "Eating disorders have been correlated to certain familial patterns; without addressing
these, your child's condition will not improve."
C. "Family dynamics are not linked to eating disorders. The meeting is to provide your child
with family support."
D. "Clients diagnosed with anorexia nervosa are part of the family system, and any alteration
in family processes needs to be addressed."
A client diagnosed with bulimia nervosa has been attending a mental health clinic for several
months. Which factor should a nurse identify as an appropriate indicator of a positive client
behavioral change?
A. The client gains 2 pounds in 1 week.
B. The client focuses conversations on nutritious food.
C. The client demonstrates healthy coping mechanisms that decrease anxiety.
D. The client verbalizes an understanding of the etiology of the disorder.

A nursing instructor is teaching students about the differences between the symptoms of
anorexia nervosa and the symptoms of bulimia nervosa. Which student statement indicates
that learning has occurred?
A. "Clients diagnosed with anorexia nervosa experience extreme nutritional deficits, whereas
clients diagnosed with bulimia nervosa do not."
B. "Clients diagnosed with bulimia nervosa experience amenorrhea, whereas clients
diagnosed with anorexia nervosa do not."
C. "Clients diagnosed with bulimia nervosa experience hypotension, edema, and lanugo,
whereas clients diagnosed with anorexia nervosa do not."
D. "Clients diagnosed with anorexia nervosa have eroded tooth enamel, whereas clients
diagnosed with bulimia nervosa do not."

A client who is 5 foot 6 inches tall and weighs 98 pounds is admitted with a medical
diagnosis of anorexia nervosa. Which nursing diagnosis would take priority at this time?
A. Ineffective coping R/T food obsession
B. Altered nutrition: less than body requirements R/T inadequate food intake
C. Risk for injury R/T suicidal tendencies
D. Altered body image R/T perceived obesity

A nurse is seeing a client in an outpatient clinic for treatment of anorexia nervosa. Which is
the most appropriate, correctly written short-term outcome for this client?
A. The client will use stress-reducing techniques to avoid purging.
B. The client will discuss chaos in personal life and be able to verbalize a link to purging.
C. The client will gain 2 pounds prior to the next weekly appointment.
D. The client will remain free of signs and symptoms of malnutrition and dehydration.

When a community health nurse arrives at the home of a client diagnosed with bulimia
nervosa, the nurse finds the client on the floor unconscious. The client has a history of using
laxatives for purging. To what would the nurse attribute this client's symptoms?
A. Increased creatinine and blood urea nitrogen (BUN) levels
B. Abnormal electroencephalogram (EEG)
C. Metabolic acidosis
D. Metabolic alkalosis

A group of nurses are discussing how food is used in their families and the effects this might
have on their ability to work with clients diagnosed with eating disorders. Which of these
nurses will probably be most effective with these clients?
A. The nurse who understands the importance of three balanced meals a day
B. The nurse who permits children to have dessert only after finishing the food on their plate
C. The nurse who refuses to engage in power struggles related to food consumption
D. The nurse who grew up poor and frequently did not have enough food to eat
A client diagnosed with anorexia nervosa stopped eating 5 months ago and lost 25% of total
body weight. Which subjective client response would the nurse assess to support this
medical diagnosis?
A. "I do not use any laxatives or diuretics to lose weight."
B. "I am losing lots of hair. It's coming out in handfuls."
C. "I know that I am thin, but I refuse to be fat!"
D. "I don't know why people are worried. I need to lose this weight."

A nursing diagnosis of ineffective coping R/T feelings of loneliness AEB bingeing then
purging when alone, is assigned to a client diagnosed with bulimia nervosa. Which is an
appropriate outcome related to this nursing diagnosis?
A. The client will identify two alternative methods of dealing with isolation by day 3.
B. The client will appropriately express angry feelings about lack of control by week 2.
C. The client will verbalize two positive self attributes by day 3.
D. The client will list five ways that the body reacts to bingeing and purging.

A nurse responsible for conducting group therapy on an eating disorder unit schedules the
sessions immediately after meals. Which is the rationale for scheduling group therapy at this
time?
A. To shift the clients' focus from food to psychotherapy
B. To prevent the use of maladaptive defense mechanisms
C. To promote the processing of anxiety associated with eating
D. To focus on weight control mechanisms and food preparation

Which nursing intervention is appropriate when caring for clients diagnosed with either
anorexia nervosa or bulimia nervosa?
A. Provide privacy during meals.
B. Remain with the client for at least 1 hour after the meal.
C. Encourage the client to keep a journal to document types of food consumed.
D. Restrict client privileges when provided food is not completely consumed.

How do cultural stereotypes contribute to the development of eating disorders?

A Eating disorders result from biological and genetic factors.
B There is a strong emphasis on low body weight justifying high self-esteem.
C Cultural stereotypes increase an individual's insight regarding his or her own personal
weight issues.
D The stereotypes identify the population at risk for developing eating disorders.

According to the family systems theory, family behavior characteristics associated with
anorexia include (select all that apply):
A Isolation between family members.
B Successful conflict resolutio
C Unclear boundaries between family members.
D Family members' preoccupation with food and eating.
E Individual autonomy.

The most common coexisting mental health issue associated with anorexia and bulimia is:
A Anxiety.
B Agoraphobia.
C Depression.
D Panic attacks.
A nurse is teaching a group of adolescents about the risk factors and complications of
anorexia nervosa. Which of the following complications should the nurse stress as the most
serious?
A Increased risk of mortality
B Depression
C Ineffective family relationships
D Ineffective coping skills

Which of the following objective data would the nurse expect to find in the client with
anorexia nervosa?
A A score of 13 on the Mini-Mental State Exam
B Feeling isolated and lonely
C Osteoporosis
D Preoccupation with food

The nursing diagnosis for a client with bulimia is Fluid Volume Deficit. Nursing interventions
specific to the fluid volume deficit include:
A Weighing the client after each meal.
B Monitoring the client for at least 1 hour after meals.
C Monitoring body temperature every 4 hours.
D Ensuring daily consumption of 1000 to 2000 mL of liquid.

Educational guidelines for family members of clients with eating disorders include:
A Expecting a full recovery within 6 months of starting treatment.
B Scheduling family activities that include food.
C Expressing love and affection both verbally and physically.
D Recognizing the client's need to have his or her behaviors controlled by family members.

The nurse observes a client admitted with anorexia nervosa doing repeated, vigorous sit-
ups. The most appropriate action from the nurse is to:
A Tell the client she cannot do exercises.
B Allow the client to complete the exercise routine.
C Take away the client's visitor privileges.
D Interrupt the behavior and offer to walk with the client.

The nurse is assessing a client with severe anorexia nervosa. Which of the following
physical findings should be immediately reported to the physician?
A Pulse rate of 102
B Blood pressure of 80/40mm Hg
C Amenorrhea
D Urine output of 50cc/hour

The nurse is reviewing a questionnaire completed by an adolescent client. Which

predisposing factor may increase the client's risk for an eating disorder? (Select all that
apply.)
The client reports a history of childhood abuse.
The client's mother has a history of bulimia nervosa.
The client lists alprazolam (Xanax) on the home medication list.
The client lists "checkout clerk in a grocery store" as the occupation.
The client reports good family support and a healthy friendship network
The nurse is assessing a client who is obese and reports eating to the point of discomfort at
least twice a week for the past year. The client denies the use of laxatives, self-induced
vomiting, ipecac syrup, or enemas and reports feeling unable to control the behavior. The
client feels embarrassed and has stopped going out with friends. Which eating disorder
should the nurse suspect?
Purging
Anorexia nervosa
Binge-eating disorder
Bulimia nervosa

A client presents at the urgent care clinic and states, "My heart feels like it's skipping beats."
The client also reports always feeling cold, and has a BMI of 18. The nurse suspects
anorexia. Which other clinical manifestation should the nurse assess? (Select all that apply.)
Strenuous exercise
Feelings of euphoria
Extreme perfectionism
Obsession over body shape
Rigidity and the need to control situations

A client is discussing her feelings regarding her eating disorder with the nurse. The client
shares that when she looks in a mirror, she sees herself as fat even though her BMI is 18.
With which thought pattern is this statement consistent?
Therapeutic relationship
Deception
Purging
Body image distortion

The parents of a teenage girl bring their daughter to the healthcare provider, citing their
increasing concern about the teen's weight and their suspicion that their daughter has
anorexia nervosa (AN). During assessment, the nurse notes a BMI of 16.75 kg/m2. In which
category does the client fall, according to DSM-5 criteria and considering the severity of
anorexia nervosa?
Mild
Moderate
Extreme
Severe

Which statement should the nurse include in a presentation regarding eating disorders?
(Select all that apply.)
Eating disorders can cause malnutrition.
Teenagers are the only age group with eating disorders.
Excessive exercise can be associated with an eating disorder.
Diet pills and laxatives are not used by people with eating disorders.
Electrolyte imbalance is a common problem associated with eating disorders.

The nurse is providing a teaching session to care providers concerning the identification of
eating disorders (EDs) in the pediatric population. Which statement would help pediatric care
providers identify EDs in younger clients?
"Unwillingness to try new foods is an early indication of EDs in young clients."
"EDs in younger clients are often associated with anxiety disorders."
"EDs are less likely in younger clients with a history of obesity."
"Younger clients with EDs tend to be boys."

The family of a teen with anorexia nervosa is discussing treatment options with the nurse.
They would like to find an inpatient program to treat their child, who has a BMI of 17 kg/m2.
How should the nurse respond?
"An inpatient stay would be a good idea if you can afford it as they have the highest success
rates."
"At this point, family and group therapy would be a better option than an inpatient program."
"What would your child rather do? If the client isn't interested in an inpatient program, it
probably won't be effective."
"Initially, it is best to start with a structured day treatment program rather than an inpatient
stay."

The nurse is working with an adult who has been dealing with an eating disorder for the past
year. The client asks the nurse about mindfulness as an approach. Which evidence
concerning mindfulness should the nurse include in the response to the client? (Select all
that apply.)
Decreases binge eating
Decreases food cravings
Limits the likelihood of relapse
Decreases body image concerns
Promotes a more complete recovery

A client is brought to the emergency department after being found unconscious by her
daughter. The daughter reports that her mother has been struggling with eating disorders for
"as long as I can remember" and has been in and out of treatment programs for bulimia
nervosa. Which test should the nurse expect the healthcare provider to order? (Select all
that apply.)
Urinalysis
Electrocardiography (ECG)
Blood glucose monitoring
Computerized tomography (CT) scan
Comprehensive metabolic panel (CMP)

The nurse meets the family of a teen who has been struggling with an eating disorder. The
family expresses a preference to try complementary approaches initially to address the
teen's behaviors. Which complementary therapies should the nurse recommend? (Select all
that apply.)
Yoga
Herbs
Massage
Meditation
Acupuncture

The nurse is counseling a teen with anorexia nervosa (AN) who is trying to manage the
disorder. Which type of therapy should the nurse discuss with the client?
Schema-focused therapy
Dialectical behavior therapy
Family therapy
Daily fluoxetine therapy
The healthcare provider has diagnosed a binge-eating disorder in a client. Which common
complication of this disorder requires further testing? (Select all that apply.)
Obesity
Osteoporosis
Heart disease
Type 2 diabetes
Gallbladder disease

A client is hospitalized for anorexia nervosa. The client's BMI on admission is 14.8 kg/m2.
The client has been started on an antidepressant, cognitive-behavioral therapy (CBT), and a
weight-restoration plan. Monitoring for which possible complication should be a priority for
the nurse as the client begins eating again?
Refeeding syndrome
Increased depression
Purging
Edema

The nurse is completing a physical assessment of a young adult who is being evaluated for
anorexia. Which component should the nurse include in the nursing assessment? (Select all
that apply.)
Attitude toward food
Condition of the teeth
Body mass index (BMI)
Current medication list
Cognitive function findings

The nurse and a client with an eating disorder have set up a behavioral contract to guide the
client toward healthier eating patterns. Which goal should be incorporated in the contract?
(Select all that apply.)
The client will not engage in purging behaviors.
The client will maintain adequate calorie intake.
The client will attend and participate in therapy.
The client will limit exercise to 30 minutes per day.
The client will stop compulsive thinking about weight.

The nurse is preparing a plan of care for a client whose anorexia nervosa is complicated by
dehydration and a cardiac arrhythmia. Which outcome should the nurse consider positive for
this client? (Select all that apply.)
The client remained free of injury.
The client increased nutritional intake by 20%.
The client had a 24-hour fluid intake of 600 mL.
The client attended therapy sessions as scheduled.
The client stated that she liked how she looked in the new dress.

The nurse plans care for a client being treated for an eating disorder. Which question should
the nurse ask to encourage the client to re-experience positive emotions?
"Can you describe things that trigger eating disordered behaviors for you?"
"What kinds of things did you enjoy doing before the eating disorder took over?"
"Do you use alcohol to help deal with the feelings and emotions you're experiencing?"
"Do you feel that the environment you live and work in contributes to high amounts of stress
for you?"
A client with an eating disorder has been hospitalized for medical stabilization. Which
intervention should the nurse include to address energy expenditure?
Monitoring cardiovascular and respiratory response to activity
Limiting the client's activity and restricting exercise
Monitoring vital signs and electrolyte levels
Eliminating caffeine and other stimulants from the client's diet

The nurse is reviewing a questionnaire completed by an adolescent client. Which

predisposing factor may increase the client's risk for an eating disorder? (Select all that
apply.)
The client reports a history of childhood abuse.
The client's mother has a history of bulimia nervosa.
The client lists alprazolam (Xanax) on the home medication list.
The client lists "checkout clerk in a grocery store" as the occupation.
The client reports good family support and a healthy friendship network.

The client also reports always feeling cold, and has a BMI of 18. The nurse suspects
anorexia. Which other clinical manifestation should the nurse assess? (Select all that apply.)
Strenuous exercise
Feelings of euphoria
Extreme perfectionism
Obsession over body shape
Rigidity and the need to control situations

1) Which of the following is a diagnostic criterion for anorexia nervosa in DSM-IV-TR?

A refusal to maintain a minimal body weight
A pathological fear of gaining weight
A distorted body image in which, even when clearly emaciated, sufferers continue to insist
they are overweight
All of the above

2) In Restricted Type anorexia nervosa, self-starvation is NOT associated with which of the
following?
a) Concurrent purging
b) Socialising
c) Body dysmorphic issues
d) Eating only certain food types

3) In Binge-Eating/Purging Type anorexia nervosa, self-starvation is associated with:

a) Not eating to help control weight gain
b) Not being bothered about weight gain
c) Regularly engaging in purging activities to help control weight gain
d) Eating only certain food types

4) High rates of comorbidity exist between anorexia and other Axis I and Axis II disorders.
What percentage of anorexia sufferers who also have a lifelong diagnosis of major
depression?
a) 50-68%
b) 30-40%
c) 20-30%
d) 70-80%
5) In Bulimia Nervosa, the purging sub-type, vomiting is the most common form of purging.
What percentage of sufferers present with this type of purging?
a) 50-60%
b) 80-90%
c) 15-25%
d) 50-60%

6) In Bulimia nervosa, the nonpurging sub-type, a behaviour which is used to compensate

for binging is
a) Exercise
b) Controlling intake of certain food types
c) Withdrawing from social interaction
d) Controlling carbohydrate intake

7) Individuals with bulimia have a perceived lack of control over their eating behaviour, and
often report which of the following?
a) High levels of self-disgust
b) Low self-esteem
c) High levels of depression
d) All of the above

8) Evidence suggests a link between bulimia and Axis II borderline personality disorders
(BPD). What percent of women with bulimia meet the criteria for a personality disorder?
a) 45-55%
b) 33-61%
c) 20-30%
d) 60-65%

9) Which of the following figures represents the prevalence of binge-eating disorder in the
general population?
a) 1-3%
b) 5-10%
c) 15-18%
d) 7-9%

10) St. Catherine of Siena began self-starvation at the age of 16 years and continued until
her death in 1380 (at the age of 32). This was termed by Bell (1985) as?
a) Anorexia nervosa
b) Religious fervour
c) Holy Anorexia
d) Saintly anorexia

11) In the 17th century, which of the following terms was used to describe a disorder
characterised by large food intake followed by vomiting?
a) Bulimia nervosa
b) Vomitoria
c) Fames canina
d) Nuxcanina
12) Pick one of the following familial factors that plays a role in the development of eating
disorders?
a) Parental attitudes to sex
b) Parental obesity
c) Parental attitudes to the media
d) Parental attitudes to education

13) Community based twin studies suggest a heritability component of eating disorders
which may be greater than:
a) 20%
b) 80%
c) 50%
d) 10%

14) In animal research, lesions to which part of the brain have been shown to cause appetite
loss, resulting in a self-starvation syndrome?
a) a) Lateral hypothalamus
b) b) Cerebellum
c) c) Amygdala
d) d) Basal ganglia

SOMATORORM DISORDER

A client is being assessed for complex somatic symptom disorder. Which client statement
would the nurse interpret as most likely supporting this diagnosis?
a) "It seems like I am always having diarrhea at the most inconvenient times."
b) "It's like my foot is asleep all the time; I can't feel anything that touches my foot."
c) "I am always in pain; there is nothing I can do to relieve it."
d) "I'm losing weight no matter what or how much I eat."

The nurse is caring for a client with complex somatic symptom disorder. When assessing
this client, the nurse would be especially alert for symptoms of which of the following?
a) Bipolar disorder
b) Depression
c) Avoidant personality disorder
d) Delirium

A client has made multiple visits to the clinic. The nurse suspects that the client may be
experiencing complex somatic symptom disorder based on which of the following?
a) Indications that parents were always in "good health"
b) Expressions of concern about psychological problems
c) Reports of the same symptoms repeatedly
d) Evidence of a need for social support from her friends

Somatoform disorders are characterized by which of the following?

a) Self-induced disease states or faked symptoms to garner attention
b) Physical symptoms coupled with extreme focus on emotional state
c) Severe physical symptoms that cannot be explained by any organic or physical pathology
d) Self-inflicted injuries

A client who has been having difficulty functioning in his daily life comes to the nurse and
states, "I'm really afraid. I've had these funny feelings in my stomach. I'm scared that I might
have cancer." The client has been seen by numerous health care professionals and no
evidence of cancer has been demonstrated. The nurse suspects which of the following?
a) Hypochondriasis
b) Functional neurologic symptom disorder
c) Conversion disorder
d) Factitious disorder

The nurse obtains a psychosocial history from a client who may have psychological factors
affecting his medical condition. Which of the following should the nurse recognize as
pertinent to this diagnosis?
a) No physiologic cause has been found for his symptoms.
b) His symptoms subside with appropriate medical treatment.
c) He is able to articulate the cause of his psychological distress.
d) His symptoms are related to conscious motives.

The most severe form of factitious disorder includes which of the following?
a) Munchausen's syndrome
b) Hypochondriasis
c) Alexithymia
d) Malingering

A nurse is preparing a plan of care for a client diagnosed with body dysmorphic disorder.
Which nursing diagnosis would the nurse most likely identify as the priority?
a) Disturbed Body Image
b) Risk for Other-Directed Violence
c) Low Self-Esteem
d) Ineffective Coping

A client's family member asks the nurse, "What is a conversion disorder?" Which of the
following is the best response by the nurse?
a) It is a preoccupation with the fear that one has a serious disease.
b) It involves unexplained, usually sudden, deficits in sensory or motor function.
c) It is a preoccupation with an imagined or exaggerated defect in physical appearance.
d) It is characterized by multiple physical symptoms.

A client with complex somatic symptom disorder is complaining of significant pain in the
joints. When providing care to this client, which of the following would be most important for
the nurse to keep in mind?
a) The client's experience of pain is real.
b) Outcomes need to reflect the biologic aspects of the pain.
c) Opioid analgesics are the primary mode of therapy.
d) Complementary therapies are usually of little benefit.

The nurse is caring for a client in the neighborhood clinic. The client tells the nurse that ever
since he was an adolescent, he has avoided social situations because he has "one ear that
is obviously bigger than the other ear." The nurse observes that one of the client's ears does
not appear to be larger than the other ear. The nurse suspects that the client may be
experiencing which of the following?
a) Factitious disorder
b) Functional neurologic symptoms
c) Complex somatic symptom disorder
d) Body dysmorphic disorder
A client diagnosed with factitious disorder tells the nurse an incredible story about how he
overcame a tremendous disability. Based on the client's history, the nurse knows that the
story is not all true. The client is exhibiting which of the following?
a) Hypochondriasis
b) Alexithymia
c) Malingering
d) Pseudologia fantastica

All of the following disease processes are caused by stress except which one?
a) Hypertension
b) Colitis
c) Deep vein thrombosis
d) Diabetes

Which of the following mental health disorders is characterized by a fear of developing a

serious illness based on a misinterpretation of body sensation?
a) Alexithymia
b) Conversion disorder
c) Body dysmorphic disorder
d) Hypochondriasis

Clients with a somatization disorder typically do what?

a) Have a history of going to many different providers without satisfaction
b) Avoid playing the sick role and resist attention from healthcare providers
c) Minimize their medical history
d) Discuss feelings and express needs verbally

Over the past 5 years, a client has had two exploratory surgeries and numerous
examinations for severe abdominal pain. All diagnostic and laboratory results have been
negative for organic problems. The client has had vague descriptions of periods of anxiety
and depression, and has continued to seek medical assistance for the abdominal pain and
various other physical problems. The nurse would assess this client as using which of the
following defense mechanisms?
a) Somatization
b) Dissociation
c) Repression
d) Displacement

A client is admitted to the mental health unit because she was found trying to inject diluted
feces into her hospitalized child's intravenous line. The client has a history of similar
attempts of harming the child. The nurse would most likely suspect which of the following?
a) Functional neurologic symptoms
b) Munchausen's syndrome by proxy
c) Borderline personality disorder
d) Schizoid personality traits

The nurse is studying the medical record of a client who reports blindness. The record
indicates there is no ocular abnormality. The client doesn't seem upset by the blindness.
What is the client's most likely diagnosis? Choose the best answer.
a) Hypochondriasis
b) Optic nerve dysfunction
c) Conversion disorder
d) Somatic symptom disorder

Which of the following drug classifications has been shown to be effective in treating
somatization disorders?
a) Antipsychotics
b) Antimanics
c) SSRIs
d) Antianxiety medications

Medications have been tried for somatization disorder. Which of the following drugs have
been shown to be effective in some cases?
a) Antianxiety agents
b) SSRIs
c) Antipsychotics
d) Antihypertensive drugs

A client with complex somatic symptom disorder is complaining of significant pain in the
joints. When providing care to this client, which would be most important for the nurse to
keep in mind?
Opioid analgesics are the primary mode of therapy.
Complementary therapies are usually of little benefit.
The client's experience of pain is real.
Outcomes need to reflect the biologic aspects of the pain.

A client has been admitted to a hospital with the inability to move the client's right arm. The
client has a diagnosis of conversion reaction. Which consequence of this condition would be
an example of primary gain?
Medical leave from the client's high-stress job
Avoidance of jury duty
Attention from the client's spouse and children
Relief from anxiety

With treatment, conversion disorder often remits in a few weeks but recurs in approximately
which percentage of clients?
0.25
0.35
0.5
0.1

The primary factor that differentiates somatization disorders from conversion disorders is
what?
Conversion disorders are always targeted at the respiratory system.
Somatization disorders affect multiple organ systems, whereas conversion disorders usually
involve only one system.
Somatization disorders are conscious, whereas conversion disorders are unconscious.
Somatization disorders usually affect the cardiac system, whereas conversion disorders do
not.
The la belle indifference occurs in which somatoform disorder?
Body dysmorphic disorder
Hypochondriasis
Somatization disorder
Conversion disorder

A nurse is caring for a client with somatic symptom illness. The health care provider has
prescribed sertraline, 80 mg, to the client. What should the nurse monitor the client for after
administering the drug? Select all that apply.
Insomnia
Rashes
Diarrhea
Sweating
Dry mouth

The nurse is caring for a client with conversion disorder. The client reports having paralysis
of the right side of the body. Which action by the nurse would constitute a secondary gain?
Talking about family and friends with the client
Teaching the client techniques of meditation and relaxation
Feeding the client during mealtime
Discussing coping strategies that the client used in the past

A client is prescribed sertraline for treatment of a somatoform disorder. The nurse would
instruct the client to be alert to which side effect?
Constipation
Headache
Vomiting
Increased appetite

Which drug classification has been shown to be effective in treating somatization disorders?
Antimanics
Antipsychotics
Selective serotonin reuptake inhibitors
Antianxiety medications

A student nurse asks the mental health nurse about when somatic symptom disorder (SSD)
usually begins. The nurse responds by saying that the first symptoms often appear during
which time?
After age 40 years
Mid 30s
Early 20s
Adolescence

The primary reason for considering cultural issues when caring for the client with
somatization disorders is what?
Somatization disorders are characterized by middle-class, Caucasian value expressions.
Somatization disorders usually only occur in the United States.
Somatization disorders differ in type and frequency of symptoms and depend on the culture
in which they are expressed.
Somatization disorders are only seen in a few cultures.
Which would be most important for a nurse to do when caring for a client with somatic
symptom disorder?
Ensure adherence to counseling
Administer prescribed pharmacotherapy
Develop a sound, positive nurse-client relationship
Assist in developing a daily routine
Develop a sound, positive nurse-client relationship

A client's family member asks the nurse, "What is a conversion disorder?" Which is the best
response by the nurse?
It involves unexplained, usually sudden, deficits in sensory or motor function.
It is a preoccupation with the fear that one has a serious disease.
It is a preoccupation with an imagined or exaggerated defect in physical appearance.
It is characterized by multiple physical symptoms.

Clients from which continent or country may have symptoms of somatization disorder that
include the nondelusional sensation of worms in the head or ants under the skin?
China
Greece
Africa
North America

A nurse is assessing a client with hypochondriasis. Which signs could the nurse expect to
find in the client? Select all that apply.
The client is reluctant to participate in psychiatric treatment programs.
The client reports having visited many physicians or hospitals.
The client does not believe in the use of over-the-counter medications.
The client will discuss many emotional problems.
The client is preoccupied with the self.

A nurse is assessing a client with conversion disorder. The client complains that the client's
left side is paralyzed. Which statement made by the client would indicate "la belle
indifférence"?
"I am not able to walk or do anything at all. I am totally dependent on my mom."
"My paralysis doesn't bother me. I have accepted my disability."
"I am sure I will get well soon. This problem won't persist for long."
"Please do something to cure me. I am a burden to everybody."

Which disease process is influenced by stress and emotions?

Bipolar disorder
Hypotension
Diabetes
Deep vein thrombosis

"What causes this condition?" Which response by the nurse would be most accurate?
"The symptoms reflect an emotion that your spouse cannot verbalize."
"The symptoms reflect an internal preoccupation with events."
"Your spouse is experiencing chronic stress that causes hypoarousal."
"There is definitely an underlying genetic link for this disorder."
The major difference between somatoform disorders and factitious disorders is what?
In somatoform disorders, clients consciously seek attention.
In somatoform disorders, clients are not consciously aware that they are meeting needs
through physical complaints.
In factitious disorders, clients are unaware that their symptoms are not real.
Factitious disorders respond much more readily to psychopharmacologic treatment than do
somatoform disorders.

Which medication classification has been shown to be effective in some cases of

somatoform disorders?
Serotonin reuptake inhibitors (SSRIs)
Antipsychotics
Antimanics
Antibiotics

Which is an inaccurate statement regarding malingering?

People who malinger have no real physical symptoms.
It is the intentional production of false or grossly exaggerated physical or psychological
symptoms.
People who malinger usually do not stop the physical symptoms when given a reward.
It is motivated by external incentives.

Which is the name given to a direct external benefit that being sick provides, such as relief
from anxiety?
Primary gain
Secondary gain
La belle indifference
Malingering

A nurse is caring for a client with conversion disorder. What immediate outcomes (within a
week) indicate successful therapy for the client? Select all that apply.
The client will express feelings related to inadequacy and fear.
The client will identify the conflict underlying the physical symptoms experienced.
The client will communicate the steps to solving the problems.
The client will communicate knowledge of the illness.
The client will discuss problems and solve conflicts with family or friends.

Which term describes the conversion of unexpressed emotions into physical symptoms?
Psychosomatic
Somatization
La belle indifference
Hysteria

1. During a community visit, volunteer nurses teach stress management to the participants.
The nurses will most likely advocate which belief as a method of coping with stressful life
events?
A. Avoidance of stress is an important goal for living.
B. Control over one’s response to stress is possible.
C. Most people have no control over their level of stress.
D. Significant others are important to provide care and concern.
2. The nurse evaluates the treatment of Mrs. Montez with somatoform disorder as successful
if:
A. Mrs. Montez practices self-medication rather than changing health care providers.
B. Mrs. Montez recognizes that physical symptoms increase anxiety level.
C. Mrs. Montez researches treatment protocols for various illnesses.
D. Mrs. Montez verbalizes anxiety directly rather than displacing it.

3. David is preoccupied with numerous bodily complaints even after a careful diagnostic
workup reveals no physiologic problems. Which nursing intervention would be therapeutic for
him?
A. Acknowledge that the complaints are real to the client, and refocus the client on other
concerns and problems.
B. Challenge the physical complaints by confronting the client with the normal diagnostic
findings.
C. Ignore the client’s complaints, but request that the client keeps a list of all symptoms.
D. Listen to the client’s complaints carefully, and question him about specific symptoms.

4. Charina, a college student who frequently visited the health center during the past year
with multiple vague complaints of GI symptoms before course examinations. Although
physical causes have been eliminated, the student continues to express her belief that she
has a serious illness. These symptoms are typically of which of the following disorders?
A. Conversion disorder.
B. Depersonalization.
C. Hypochondriasis.
D. Somatization disorder.

5. Aldo, with a somatoform pain disorder may obtain secondary gain. Which of the following
statement refers to a secondary gain?
A. It brings some stability to the family.
B. It decreases the preoccupation with the physical illness.
C. It enables the client to avoid some unpleasant activity.
D. It promotes emotional support or attention for the client.

1) When an individual is suffering from body dysmorphic disorder the symptoms include:
a) Having unnecessary invasive procedures
b) Becoming obsessionally concerned about imagined or minor physical defects in their
appearance.
c) Feelings of hopelessness
d) All of the above

2) Somatoform disorders include which of the following:

a) Conversion disorder
b) Somatization disorder
c) Hypochondriasis
d) All of the above

3) Individuals with somatoform disorders may often display a surprising indifference about
their symptoms- especially when the symptoms to most people would be disturbing (e.g.
blindness, paralysis). This is sometimes known as
a) Vive la difference
b) Quelle difference
c) la belle indifference
d) Que ce que se la difference

4) In order to assume the sick role, Intentionally produced Physical or psychological

symptoms are known as?
a) factitious disorder
b) conversion disorder
c) somatization disorder
d) hypochondriasis

5) An extreme form of factitious disorder is known as

a) MacDonald's syndrome
b) Munkaiser's syndrome
c) Munchausen's syndrome
d) Manchester Syndrome

6) Sometimes parents or carers make up or induce physical illnesses in others (such as their
children) and this is known as
a) MacDonald's by proxy
b) Munchausen's by proxy
c) Munkaiser's by proxy
d) Manchester's by proxy

7) Which of the following is a basic feature of Conversion Disorder?

a) symptoms or deficits affecting voluntary motor or sensory function suggestive of an
underlying medical or neurological condition
b) these symptoms must cause the individual significant distress
c) impair social, occupational or other functioning
d) All of the above

8) A Symptom of Conversion Disorder, where numbness begins at the wrist and is

experienced evenly across the hand and all fingers, is known as
a) Hand paralysis
b) Glove anaesthesia
c) Hand anaesthesia
d) Glove paralysis

9) Before conversion disorder was included in the DSM, it popularly known in

psychodynamic circles as what?
a) Hysteria
b) histrionics
c) mental paralysis
d) repression

10) Even though a thorough medical examination fails to identify any underlying medical
condition, an individual with Hypochondriasis will have a preoccupation with fears of having
or contracting a serious disease or illness based on a misinterpretation of bodily signs or
symptoms. This preoccupation can be with which of the following?
a) bodily functions
b) minor physical abnormalities
c) vague and ambiguous bodily sensations
d) all of the above

11) In Pain Disorder, which of the following are considered as central features?
a) The pain itself (and not any other feature of the physical symptoms) is the
predominant focus of the individual's complaints.
b) The pain causes significant distress
c) The pain causes impairment in social, occupational or other functioning
d) All of the above

12) The essential psychodynamic view of somatoform disorders is one of

a) repression analysis
b) ego state resolution
c) conflict-resolution
d) script analysis

13) There are many similarities between the behaviour of the individual with conversion
disorder or somatization disorder and the effects of which of the following?
a) hypnosis
b) hysteria
c) anxiety
d) catastrophisation

14) Sometimes parents view all underlying problems (including psychological ones) as being
physical rather than emotional. Consequently many individuals may learn to describe
emotional symptoms in physical terms and in extreme cases begin to adopt which of the
following?
a) Learned hopelessness
b) A sick role
c) Demand characteristics
d) Psychotic tendencies

15) In somatoform disorders the sufferer sometimes believes they have physical deficits or
symptoms that are significant and threatening. However, in most cases there is little or no
medical justification for these beliefs. Such cognitive biases are termed:
a) Cognitive dissonance
b) Hypochondrial biases
c) Interpretation biases
d) Overt reaction biases

16) Individuals with hypochondriasis are inclined to actively seek out and accept information
which confirms their own view of their medical state, but they ignore or reject arguments
against their own beliefs. This is known as :
a) A reasoning bias
b) A memory bias
c) Cognitive dissonance
d) Inflated knowledge structure

17) Sufferers of pain disorder usually fear pain itself rather than the illness, injury or disease
that might give rise to pain, and so when experiencing pain they have a tendency to
catastrophise it. This results in which of the following?
a) Individuals have a bias towards attending to pain
b) Individuals are unable to distract themselves from pain-related thoughts
c) Individuals are impaired in their ability to use pain distraction coping strategies
d) All of the above

18) Information biases acquired by those with somatoform disorders are developed by a
range of experiences, and these representations provide inappropriate templates by which
information is selected and interpreted. These are known as:
a) Rogue representations
b) Deviant representations
c) Biased representations
d) Maladaptive representations

19) Which form of treatment for somatoform disorders has been found to be significantly
more effective than no treatment control conditions:
a) Exposure and response prevention
b) Behavioural stress management
c) Cognitive restructuring
d) Psychotherapy

20) Sometimes Behavioural methods can be used to prevent and extinguish undesirable
behaviours associated with somatoform disorders. These include which of the following?
a) Behavioural stress management
b) Exposure and response prevention
c) Cognitive restructuring
d) Psychotherapy

21) For pain disorder, Cognitive Behavioural Therapy for pain would normally include which
of the following?
a) Educating the client about factors that can influence the experience of chronic pain
b) Cognitive and behavioural procedures designed to increase physical activity and
adaptive responses to pain
c) Training in skills designed to modify the perception of pain
d) All of the above

22) Individuals with body dysmorphic disorder often exhibit rapid improvement in symptoms
when treated with which types of drugs?
a) Benzodiazepines
b) Antibiotics
c) SSRIs or tricyclic antidepressants
d) Antihistamines

23) Cognitive and information processing biases are common features of somatoform
disorders. Which of the following are considered to be these types of biases?
a) Interpretation biases
b) Reasoning biases
c) Catastrophizing of symptoms
d) All of the above

24) Which of the following procedures involves injecting radioactive molecules into the
bloodstream:
a) Positron emission tomography (PET)
b) Functional magnetic resonance imaging (FMRI)
c) Magnetic resonance imaging
d) Computerised axial tomography

25) According to a study, the observed mothers playing with medically related toys with their
4-8 year-old children. who exhibited somatization symptoms were:
a) Significantly less responsive to their children
b) Did not respond to their children
c) Significantly more responsive to their children
d) Were excessively responsive

26) Which of the following is not a disadvantage of adopting a sick role ?

a) Loss of power
b) loss of pleasure
c) Loss of influence
d) Loss of responsibility

27) Which of the following is not a common motor symptom in Conversion Disorder?
a) paralysis,
b) impaired balance
c) urinary retention
d) double vision

28) According to research by Rief, Buhlmann, Wilhelm, Borkenhagen et al. (2006).what

percentage of individuals with body dysmorphic disorder reported suicidal ideation?
a) 19%
b) 29%
c) 39%
d) 49%

29) The prevalence rate for hypochondriasis in the general population is estimated to be
a) 3-7%
b) 5-7%
c) 1-5%
d) 7-11%

30) Body dysmorphic disorder can also occur in those who are preoccupied with their
musculature, and it is often associated with excessive weight training and the use of body-
building anabolic steroids (Olivardia, Pope & Hudson, 2000). Such an obsession is known as
a) Shape dysmorphia
b Fit fetish
c) Tone dysmorphia
d) Muscle dysmorphia

NEURODEVELOPMENTAL DISORDER

Which type of intervention may be helpful for children who are bullies?
Social skills training
Bibliotherapy
Art therapy
Play therapy
A nurse is assessing a child with attention deficit hyperactivity disorder (ADHD). For every
question asked by the nurse, the child answers, "I don't know." What is the most likely
reason for the child to respond in this way?
The child is not willing to answer the nurse.
The child is not able to understand what the nurse is asking.
The child does not like talking to the nurse.
The child is not paying attention to the nurse's questions.

Assessment of an 8-year-old client reveals communication difficulties and an inability to

manage age-appropriate tasks. The child undergoes standardized testing. An intelligent
quotient (IQ) of which would support a diagnosis of intellectual disability?
65
95
75
85

During a comprehensive assessment of a child, which person does the nurse interview first?
child
parent
caregiver
grandparents

What materials would assist the preschool age child to develop rapport with the nurse?
Select all that apply.
Paint and an easel
Puppets
Video games
Puzzles
Dress up clothes

A nurse is working with a child undergoing behavioral modification therapy for attention
deficit hyperactivity disorder (ADHD). The nurse finds that the child is thin. What could be
the most likely reason for this observation?
The child finds food distasteful.
The child has decreased appetite.
The child is genetically predisposed to being thin.
The child cannot sit through meals.

A nurse is caring for a child with attention deficit hyperactivity disorder (ADHD). The child is
given medication and behavioral modification therapy to treat the condition. Which outcome
achieved within 3 days would indicate successful therapy?
The child is able to express positive statements about the self.
The child is able to demonstrate successful interaction with family members over a long
period of time.
The child is able to interact and to develop successful peer relationships.
The child is able to complete assignments or tasks with assistance.

A child with an existing diagnosis of attention deficit hyperactivity disorder shows signs and
symptoms of depression. Which would most likely be prescribed?
Tricylic antidepressant
Selective serotonin and norepinephrine reuptake inhibitor (SSNRI)
Mood stabilizer
Monoamine oxidase inhibitor

Which are nursing actions that support active listening? Select all that apply.
Interrupt conversations to ask more questions
Use a computer to write out observations
Use appropriate vocabulary
Use reflective comments
Sit with arms and legs crossed

Which action provides first-hand information about the issue and reinforces interest in the
child's viewpoint during the assessment?
Inquire about the school report card.
Solicit information regarding after school activities the child is involved in.
Request that the child interpret the parent's concerns.
Ask about the history of the current problem.

An adolescent client says the client has become bored with the video game that has been
used as a reward for positive behavior. Which is the most effective intervention for this
client?
Tell the client that the client no longer has to clean the client's room in order to play.
Reinforce to the client that the client selected the video game and the client needs to stick
with it.
Tell the client that the client has to use this video game to ensure understanding of value.
Let the client choose another reward that would be more fun.

A nurse is developing the plan of care for a 6-year-old child diagnosed with attention deficit
hyperactive disorder (ADHD). The nurse identifies interventions to address which behavior
issues? Select all that apply.
Does not acknowledge others' right to select group activities
Frequently acts out during class "quiet time"
Throws a temper tantrum when asked to clean up toys
Gently asks a peer to share a particular toy
Has a habit of not waiting for a turn
Throws a temper tantrum when asked to clean up toys

Which medication is effective in 70% to 80% of children with attention deficit hyperactivity
disorder (ADHD)?
Amphetamine
Pemoline
Dextroamphetamine
Methylphenidate

After educating a group of students on attention deficit hyperactivity disorder (ADHD), the
instructor determines that additional education is required when the group identifies which as
a typical characteristic?
Hyperactivity
Inattention
Impulsiveness
Language difficulty
Which is a disturbance of the normal fluency and time patterning of speech?
Phonologic disorder
Stuttering
Mixed receptive-expressive language disorder
Expressive language disorder

The nurse working with pediatric clients knows the importance of checking for developmental
delays, which not only slow the child's progress but also are often associated with what?
Bullying
Normalization
Resilience
Development of poor self-esteem

The client is 6-year-old who has been diagnosed with autism spectrum disorder. Which
symptom would the client display?
The client has multiple motor tics and several vocal tics.
The client has an irresistible urge to pull out the client's own hair.
The client becomes overly attached to those around the client.
The client spends time alone with little interest in making friends.

Below average intellectual functioning is initially diagnosed when an intelligence quotient

(IQ) is below which level?
20
50
35
70

A nurse is using limit setting with a child hospitalized for a psychiatric disorder. Which
statement made by the nurse would reflect appropriate limit setting? Select all that apply.
"Swearing is not allowed here on the unit."
"When you feel like swearing come and talk to me."
"Swearing is a sign of disrespect."
"Unit rules are made to keep everyone safe."
"You will lose television privileges for 24 hours if you ignore a unit rule."

Which intervention assists the nurse to gain rapport with the child and parent?
Greet the child in friendly, personal way.
Give paperwork to caregiver to complete.
Discuss the history with the caregiver.
Introduce child and caregiver to staff.

Which aspect of managing a child with attention deficit hyperactivity disorder (ADHD) may
often be overlooked in the treatment plan?
Effects on school performance
Effects on parents' coping styles
Effects on the marriage
Effects on siblings

Which question is an appropriate question that provides information regarding a child's self-
concept?
"Do you have friends at school?"
"Do you get along with your parents about food?"
"If you were stranded on an island, what three things would you want to have?"
"What do you want to do when you grow up?"

The nurse understands the importance of developing rapport with family members before the
evaluation when caring for children with psychiatric disorders. The main reason for doing this
is what?
Reducing cost of stay
Reducing length of stay
Reducing anxiety
Reducing fear of rejection

A nurse is assessing a 2-year-old child diagnosed with autism spectrum disorder. Which
findings does the nurse expect to find on assessment? Select all that apply.
The child becomes frightened when left alone.
The child becomes upset with minor changes in routine.
The child avoids eye contact.
The child is extremely playful.
The child does not relate to parents.

A nurse is assessing an 8-year-old child. The child is unable to dress the self and is not able
to manipulate toys, such as building blocks. The child stutters while talking. The child does
not have impaired motor coordination. What is the most likely diagnosis of the child?
Developmental coordination disorder
Tic disorder
Cerebral palsy
Learning disorder

A nurse is assessing a child who had an episode of passing feces in the classroom. The
child has no other disabilities. The nurse concludes that the child had intentional encopresis.
Which other condition is the child likely to have?
Expressive language disorder
Conduct disorder
Tourette's disorder
Rett's disorder

After teaching a group of nursing students about intellectual disability, the instructor
determines that the teaching was successful when the students identify which as
the most common etiology?
Perinatal complications
Environment
Genetic syndromes
Exposure to hazardous chemicals

A child with attention deficit hyperactivity disorder (ADHD) has been prescribed
dextroamphetamine. For what effects should the nurse tell the parents to monitor the child?
Select all that apply.
Weight loss
Weight gain
Hypotension
Insomnia
Appetite suppression
Insomnia

When asking about a client's spiritual life, which question is appropriate?

"Do you believe in God?"
"Can you share with me about your parent's religious preference?"
"Tell me about your faith background."
"Do you go to church?"

The mental health nurse assesses for the most common mental health disorder found in
children when asking which question?
"What makes you afraid or nervous?"
"Are you sad often?"
"Do you ever hear voices in your head telling you what to do?"
"Do you ever get scolded at school for not sitting still?

The parents of a toddler are distraught that the toddler has been diagnosed with autism
spectrum disorder. When providing care for the child and the parents, the nurse understands
that autism spectrum disorder is thought to be caused by what?
Perinatal hypoxia
Genetic factors
Immunizations containing mercury
Impaired attachment in infancy

The nurse is assessing a child with tic disorder. The nurse documents in the assessment
sheet that the child exhibits coprolalia. What might be be interpreted from this?
The child grunts repeatedly.
The child continuously repeats socially unacceptable words.
The child continuously repeats the last heard phrase.
The child repeatedly shrugs the shoulders.

The parents of a 2-year-old child complain to the nurse that their child is always dismantling
toys, scribbling on the walls, and running all around the place and that it is very difficult to
control the child's behavior. What is the most appropriate response from the nurse?
"Therapy will help to calm your child."
"Your child may develop violent behavior in the future."
"I will refer your child to the psychology clinic."
"At this child's age, these behaviors are expected."

When performing a spiritual assessment on a child, the nurse and child discuss church
attendance and practices that are most important to the child. Which domain is the nurse
addressing when doing this assessment?
All of the above
Biologic
Psychological
Social

A nurse is assessing language development of a 2-year-old. What is a normal language

pattern for a 2-year-old?
"Apple pie"
"Want eat"
"Go"
"Mama"

A nurse is talking to a 7-year-old. The child describes in detail a family pet who recently died.
Which response by the nurse is appropriate?
I am sad for your loss.
How long did you have the dog?
I need to interview another client.
When are you going to get another dog?

A 9-year-old client with attention deficit hyperactivity disorder (ADHD) has been placed on
the stimulant methylphenidate. The nurse knows that the teaching has been effective when
the client's parents state what?
"The client may have some side effects, like insomnia, loss of appetite, or weight loss, but
they are rare."
"The client knows that the client only needs to take this medication once every 12 hours."
"We'll bring the client in every week to get blood levels drawn."
"The client will have an effect from this drug in about 2 weeks."

When a client repeatedly vocalizes an obscene phrase and imitates the motions of a staff
member, the nurse documents that the client is most likely exhibiting symptoms of what
disorder?
Tourette's syndrome
Autism spectrum disorder
Mixed receptive-expressive language disorder
Phonological disorder

Nurses who work in a pediatric psychiatric-mental health facility should do what?

Ensure that their professional life is a higher priority than their personal life.
Ensure that their own physical and mental health needs are placed above those of the
clients.
Develop self-awareness of issues that remind them of their own childhood and adolescence.
Use self-disclosure of personal struggles with problems of childhood and adolescence with
clients.

A 7-year-old client experiences tics, which have become increasingly frequent in recent
months. How should the nurse educate the client's teacher to respond to the tics?
Provide rewards when the client goes long periods without having any tics.
Place the client in a private, low-stimulation environment whenever possible to prevent the
client's tics.
Set firm limits about where, when, and how the client exhibits the tics.
Teach the client's classmates that the tics are not something that the client can control.

A nurse is speaking to the parents of a child with attention deficit hyperactivity disorder
(ADHD). The parents ask the nurse about the reason for the child's underachievement in
academics. What explanation given by the nurse is most appropriate?
"Your child has trouble following the teacher's directions."
"Your child does not attend classes."
"Your child has difficulty with reading and writing."
"Your child has impaired cognitive abilities."

A nurse is speaking to the peers of a child with attention deficit hyperactivity disorder
(ADHD). The nurse finds that these children do not like the child and do not want to include
the child during play. What are the likely reasons for the children feeling this way? Select all
that apply.
The child doesn't follow the rules of the game.
The child constantly interrupts while playing.
The child cannot move or play as quickly as the other children.
The child is not cooperative while playing.
The child abuses other children.

After teaching a group of nursing students about pharmacotherapy and attention deficit
hyperactivity disorder (ADHD), the instructor determines that the education was successful
when they identify which agent as the first line choice?
Atomoxetine
Bupropion
Clonidine
Guanfacine

Which are included in the mental health comprehensive evaluation of children and
adolescents? Select all that apply.
school records
laboratory values
medical history
a full set of vital signs
mental status examination

The nurse is preparing to meet with the parents after interviewing the child. Which is the
nurse's best opening question to the parents?
"Can you describe a situation where your child has had problems with peer socialization?"
"Tell me about the school issues of your child."
"Describe the current problem and what are the leading causes of the problem."
"How have things been in your family?"

Which activity would assist the adolescent to establish rapport with the nurse?
dress up clothes
board games
interview
video games

Which is an example of egocentrism by an adolescent?

only eats food from a particular store
does not talk much because they think they are being watched by others
is willing to assist with any social event
shares stories about parents and siblings

A nurse completes a Global Assessment of Functioning (GAF) scale on an adolescent

during an assessment. The nurse calculates a 55. What is the analysis of the score?
No impairment
A low level of impairment
A high level of impairment
A moderate level of impairment

When describing intellectual disability to a group of parents, a nurse would identify which
intelligent quotient (or less) as the usual threshold?
50
60
70
80

Which term describes the use of socially unacceptable words, which are frequently
obscene?
Palilalia
Coprolalia
None of the above
Echolalia

Which condition is characterized by multiple motor tics and one or more vocal tics many
times throughout the day for 1 year or more?
Attention deficit hyperactivity disorder
Asperger's syndrome
Tourette syndrome
Trichotillomania

The nurse is counseling a family whose child has autism. When describing this condition,
which would the nurse most likely include?
Connection to ineffective parental practices
Onset before child is 2.5 years old
Girls are more frequently affected than boys
Detection after the child enters school

A nurse is caring for a child with attention deficit hyperactivity disorder. The nurse asks the
child to draw pictures of the child and family members. What is the most likely rationale for
this intervention?
To reduce hyperactivity in the child
To reward the child for adaptive behavior
To help the child self-express
To release excessive energy

A variety of areas are assessed during the mental status examination. Which are sections of
the mental status examination? Select all that apply.
gross and fine motor movement
intellectual functioning
religious background
cognition
academic interests

Which is an antidepressant used to treat attention deficit hyperactivity disorder (ADHD)?

Pemoline
Dextreamphetamine
Amphetamine
Atomoxetine

Which medication classification is used in the treatment of tic disorders?

Anxiolytics
Antipsychotics
Antidepressants
Antimanics

The nurse is teaching the parents of a child with involuntary enuresis about methods to
manage the condition. Which intervention does the nurse recommend to the parents?
The child's dietary patterns should be changed.
The child should begin therapeutic play.
The child needs to be taught special exercises.
The child should use pads with a warning bell.

There are two steps necessary in an assessment interview between a child and caregiver.
Which are the steps? Select all that apply.
Develop a treatment alliance.
Assess interactions between child and caregiver.
Determine school goals for the child.
Diagnosis problems and develop a plan of care.

A school-aged child tells that nurse that the child does not like school anymore and their
parent is upset about their poor grades. Which is main concern about this client?
Mental issues to perform the tasks necessary for performance in the classroom
Religious issues and ability to conform to them while in the school setting
Emotional problems focusing on peer adjustment and school
Social issues regarding participating in school activities

1. What are Neurodevelopmental Disorders Commonly Referred to as?

A Chemical Imbalances
B Childhood Disorders
C Brain Impairments

2. What are Some Conditions of Autism?

A Inability to comprehend written language and verbal tics
B Hyperactivity and constant fidgeting
C Challenges with social skills, repetitive behaviors, and speech

3. How Common is Autism?

A 5 in every 15,000
B 20 in every 5,000
C 4 in every 10,000
D 10 in every 10,000

4.At What Age is Autism typically diagnosed?

A24 Months
B5 Years
C3 Years
D30 Months
5.What are the Common Conditions of ADHD?
A Easily Distracted and Forgetful
B Failure to comprehend written language
C Inability to express emotions

6. How Prevalent is Dyslexia?

A 5-15%
B 40%
C 5-20%
D 60%

7. What are Some Issues Associated with Dyslexia?

A Failure to focus
B Has multiple verbal tics on the daily
C Behavioral and emotional

8. What is the Main Cause of Dyslexia?

AChemical Imbalance
BGenetics
C Environment
D Influential

9. How Common is Tourettes?

A 3-4%
B 05-3%
C 5-10%
10. What Disorders are Commonly Associated with Tourettes?
A ADD and OCD
B Dyslexia
C OCD and ADHD
D Autism

The nurse is assessing a 16 month old child during a well-baby checkup. Which of the
following behaviors would be consistent with autism spectrum disorder? Select all that apply
A) The child displays little eye contact with others
B) The child thrives on changes in routine
C) The child makes few facial expressions toward others
D) The child does not like repetition
E) The child answers questions verbally

A mother expresses concern to the nurse that the child's regularly scheduled vaccines may
not be safe. The mother states that she has heard reports that they cause autism. The most
appropriate response by the nurse is?
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 immunizations against childhood diseases

A parent is concerned that his child might suffer from attention deficit hyperactivity disorder
(ADHD). Which of the following behaviors reported by the parents would be consistent with
this diagnosis?
A) The child interrupts others
B) The child has been hoarding objects
C) The child has lots of friends
D) The child is excelling academically in school

Which of the following symptoms are characteristic of ADHD? SATA

A) Enuresis (bedwetting)
B) Inattentiveness
C) Encopresis (fecal incontinence)
D) Overactivity
E) Impulsiveness

Which of the following are common coexisting psychiatric disorders for adults with ADHD?
SATA
A) Social phobia
B) Bipolar disorder
C) OCD
D) Major depression
E) Alcohol dependence

A nurse asks an assigned client "How are you doing today?" The clients responds with
"doing today, doing today, doing today". Which speech pattern disturbance is this an
example of?
A) reactive attachment disorder
B) stereotypic movement disorder
C) selective movement disorder
D) Echolalia

7. Which of the following terms describes the repeating of one's own words or sounds?
A) Coprolalia
B) Palilalia
C) Echolalia
D) None of the above

Which of the following disorders involves problems with forming sounds associated with
speech?
A) Phonologic disorder
B) Mixed receptive expressive language disorder
C) Expressive language disorder
D) Stuttering

A parent of a child with autism spectrum disorder asks the nurse if there is anything that can
be done to control a child's tantrums. Which options should the nurse inform the parents that
may appropriate?
A) Give them child rewards for resisting tantrum
B) Reason with the child why tantrums are not effective
C) Place the child in a time-out when tantrums occur
D) Explore the use of antipsychotics medications to control tantrums

A child with ADHD complains to his parents that he does not like the side effects of his
medicine, Adderall. The parents ask the nurse for suggestions to reduce the medication's
negative side effects. The nurse can best help the parents by offering which advice?
A) Give the child his medicine are night
B) Have the child eat a good breakfast and snacks late in the day and at bedtime
C) Limit the number of calories the child eats each day
D) Let the child take daytime naps

The nurse is assisting a child with ADHD to complete his ADLS. Which is the best approach
for nurse to use with this child?
A) Break tasks into small steps
B) Let the child complete task at his own pace
C) Offer rewards when all tasks are completed
D) Set a time limit to complete all tasks

This approach prevents overwhelming the child and provides the opportunity for
feedback about each set of problems he or she completes.
Which of the following would be important circumstances to gather assessment date for a
child with ADHD? SATA
A) Direct observation of 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

Which one of the following nursing interventions should take priority for a child with ADHD?
A) structured daily routine
B) ensuring the child's safety and that of others
C) simplifying instructions and directions
D) improved role performance

An 8 year old with ADHD is jumping off the bed onto a chair. Which should be the nurse's
first step?
A) "I need to talk to you"
B) "Stop that right now"
C) "You are going to hurt yourself"
D) "Why are you jumping off the bed?"

The mother of a 6 year old boy with ADHD asks to speak to the nurse about her son's
disruptive behavior. The nurse would be most therapeutic by saying which of the following?
A) "Your son is a cute child, but he needs to calm down"
B) "It must be difficult to handle your son at home"
C) "You need to take a firmer approach with your son"
D) "Your son sure is active

A child with ADHD is taking methylphenidate (RITALIN) in divided does. If the child takes the
first does at 8 AM, which behavior might the school nurse expect to see at noon?
A) increased impulsivity or hyperactive behavior
B) lack of appetite for lunch
C) sleepiness or drowsiness
D) social isolation from peers
The parents of an autistic child ask the nurse, "Will my child ever be normal?" Which would
be the most appropriate response by the nurse?
A) "You seem worried about your child's future"
B) "Autistic children can fully recover with the right treatment and education"
C) "Your child should outgrow autistic traits by adolescence"
D) "Your child will probably always have some autistic traits"

The parents of a child with ADHD express to the nurse "We get so frustrated when our son
never minds us." Which parenting strategies should the nurse discuss with the parents?
SATA
A) Use time-out 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.

Which of the following statements about educating parents of a child with ADHD is true?
A) It is unimportant to educate the family members about ADHD as they already know the
problem too well.
B) Parents feel empowered and relieved to have specific strategies that can help them and
their child be more successful.
C) It is important for the nurse to spend the majority of his or her time with parents of
children with ADHD in talking to the parents.
D) If the child receives special school services under the Individuals with Disabilities
Education Act, there is no need for further services.

A nurse is providing education to a group of parents who have children with ADHD. Which of
the following statements would be accurate and should be included in the education? SATA
A) Medication alone will adequately treat children with ADHD.
B) It is important for parents of children with ADHD to learn how to rebuild their child's self-
esteem.
C) Because raising a child with ADHD can be frustrating and exhausting, it often helps
parents to attend support groups that can provide information and encouragement from
other parents with the same problems.
D) ADHD is not the fault of the parents or the child, and that techniques and school
programs are available to help.
E) Children with ADHD do not qualify for special school services under the Individuals with
Disabilities Education Act.

When teaching the parents of a child with ADHD which statement by the parents would
indicate the need for further teaching?
A) "We'll have him do his homework at the kitchen table with his brothers and sisters"
B) "We'll make sure he completes one task before going on to another"
C) "We'll set up rules with specific time for eating, sleeping, and playing"
D) "We'll use simple, clear directions and instructions"

Which statement would indicate that medication teaching for the parents of a 6 year old child
with ADHD has been effective?
A) "We'll teach him the proper way to take the medication, so he can manage it
independently"
B) "We'll be sure he takes Ritalin are the same time every day, just before bedtime"
C) "We're so glad that Ritalin will eliminate the problems of ADHD"
D) "We'll be sure to record his weight on a weekly basis"

The mother of a 15 year old boy tells the nurse that her son is becoming more assertive in
conflict situations and wants to get a job. She asks if it is healthy for a 15 year old to be so
independent. Which is valid information for the nurse to offer the mother?
A) His behaviors reflect normal growth and development
B) He is overly independent
C) It sounds like he is trying to avoid her
D) She should observe for signs of substance abuse

The nurse understands that when working with a child with a mental health problem, the
family must be included in the care. Which is one of the best ways a nurse can advocate for
the child?
A) Support transferring the child to a healthy living environment
B) Teach the parents age-appropriate expectations of the child
C) Reinforce the parents' expectations of the child's behavior
D) Interpret the child's thoughts and feelings to the parent

For which reason is it crucial for nurse to advocate for children and adolescents regarding
psychiatric disorders?
A) It is much more difficult to diagnose psychiatric disorder in children and adolescents
B) It is not necessary because psychiatric disorders do not occur in children and adolescents
C) Children and adolescents experiences some of the same mental health problems as
adults
D) Psychiatric disorders in children manifest themselves very quickly

For which reasons is it more difficult to diagnose psychiatric disorders in children than in
adults? SATA
A) Children usually lack the abstract cognitive abilities and verbal skills to describe what is
happening.
B) Because they are constantly changing and developing, children are unable to discriminate
unusual or unwanted symptoms from normal feelings and sensations.
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.
E) Children and adolescents experience some of the same mental health problems as adults
and are diagnosed using the same criteria as for adults.

The nurse has been working with the family of a small child with a psychiatric disorder. The
nurse is feeling very frustrated because the parents refuse to implement effective parenting
skills that the nurse has been taught. What 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) Try to remember that the parents are trying to the best of their ability to carry out the
suggestions
D) Explore alternative living arrangements for the child

When the prognosis of improvement in a child with psychiatric disorders is poor, what can
the nurse do to positively influence children and adolescents and their parents?
A) Continue to remind the child and parents that the prognosis for improvement is very poor.
B) Encourage the parents to believe that the child will recover spontaneously.
C) Assist the child and the parents to develop coping mechanisms.
D) Focus on their problems instead of their strengths and assets.

A child is taking pemoline (Cylert) for ADHD. The nurse must be aware of which side effect?
a.Decreased thyroid-stimulating hormone
b.Decreased red blood cell count
c.Elevated white blood cell count
d.Elevated liver function tests

Teaching for methylphenidate (Ritalin) should include which information?

a.Give the medication after meals.
b.Give the medication when the child becomes overactive.
c.Increase the child's fluid intake when he or she is taking the medication.
d.Check the child's temperature daily.

The nurse would expect to see all the following symptoms in a child with ADHD, except
a.distractibility and forgetfulness.
b.excessive running, climbing, and fidgeting.
c.moody, sullen, and pouting behavior.
d.interrupting others and inability to take turns.

The nurse is teaching a 12-year-old with intellectual disability about medications. Which
intervention is essential?
a.Speak slowly and distinctly.
b.Teach the information to the parents only.
c.Use pictures rather than printed words.
d.Validate client understanding of teaching.

Which is used to treat enuresis?

a.Imipramine (Tofranil)
b.Methylphenidate (Ritalin)
c.Olanzapine (Zyprexa)
d.Risperidone (Risperdal)

The nurse is assessing an adult client with ADHD. The nurse expects which to be present?
a.Difficulty remembering appointments
b.Falling asleep at work
c.Problems getting started on a project
d.Lack of motivation to do tasks

The nurse recognizes which as a common behavioral sign of autism?

a.Clinging behavior toward parents
b.Creative imaginative play with peers
c.Early language development
d.Indifference to being hugged or held

A 7-year-old child with ADHD is taking clonidine (Kapvay). Common side effects include
a.appetite suppression.
b.dizziness.
c.dry mouth.
d.hypotension.
e.insomnia.
f.nausea.

A teaching plan for the parents of a child with ADHD should include
a.allowing as much time as needed to complete any task.
b.allowing the child to decide when to do homework.
c.giving instructions in short simple steps.
d.keeping track of positive comments that the child is given.
e.providing a reward system for completion of daily tasks.
f.spending time at the end of the day reviewing the child's behavior.

1. Which factor presents the highest risk for a child to develop a psychiatric disorder?
a. Having an uncle with schizophrenia
c. Living with an alcoholic parent
b. Being the oldest child in a family
d. Being an only child

2. 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

3. Which behavior indicates that the treatment plan for a child diagnosed with an autism
spectrum disorder was effective? The child:
a. plays with one toy for 30 minutes.
b. repeats words spoken by a parent.
c. holds the parents hand while walking.
d. spins around and claps hands while walking.

4. 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.

5. 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)
c. Methyphenidate (Ritalin)
b. Imipramine (Tofranil)
d. Carbamazepine (Tegretol)

6. 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

7. A desired outcome for a 12-year-old diagnosed with attention deficit hyperactivity disorder
(ADHD) is to improve relationships with other children. Which treatment modality should the
nurse suggest for the plan of care?
a. Reality therapy
c. Social skills group
b. Simple restitution
d. Insight-oriented group therapy

8. The parent of a 6-year-old says, My child is in constant motion and talks all the time. My
child isnt interested in toys but is out of bed every morning before me. The childs behavior is
most consistent with diagnostic criteria for:
a. communication disorder.
b. stereotypic movement disorder.
c. intellectual development disorder.
d. attention deficit hyperactivity disorder.

9. A child diagnosed with attention deficit hyperactivity disorder had this nursing diagnosis:
impaired social interaction related to excessive neuronal activity as evidenced by aggression
and demanding behavior with others. Which finding indicates the plan of care was effective?
The child:
a. has an improved ability to identify anxiety and use self-control strategies.
b. has increased expressiveness in communication with others.
c. shows increased responsiveness to authority figures.
d. engages in cooperative play with other children.

10. When a 5-year-old diagnosed with attention deficit hyperactivity disorder (ADHD)
bounces out of a chair and runs over and slaps another child, what is the nurses best
action?
a. Instruct the parents to take the aggressive child home.
b. Direct the aggressive child to stop immediately.
c. Call for emergency assistance from other staff.
d. Take the aggressive child to another room.

11. A child diagnosed with attention deficit hyperactivity disorder will begin medication
therapy. The nurse should prepare a plan to teach the family about which classification of
medications?
a. Central nervous system stimulants
c. Antipsychotics
b. Tricyclic antidepressants
d. Anxiolytics

12. Soon after parents announced they were divorcing, a child stopped participating in
sports, sat alone at lunch, and avoided former friends. The child told the school nurse, If my
parents loved me, they would work out their problems. Which nursing diagnosis has the
highest priority?
a. Social isolation
c. Chronic low self-esteem
b. Decisional conflict
d. Disturbed personal identity

13. A nurse works with a child who is sad and irritable because the childs parents are
divorcing. Why is establishing a therapeutic alliance with this child a priority?
a. Therapeutic relationships provide an outlet for tension.
b. Focusing on the strengths increases a persons self-esteem.
c. Acceptance and trust convey feelings of security to the child.
d. The child should express feelings rather than internalize them.

14. 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.

15. A 4-year-old cries for 5 minutes when the parents leave the child at preschool. The
parents ask the nurse, What should we do? Select the nurses best response.
a. Ask the teacher to let the child call you at play time.
b. Withdraw the child from preschool until maturity increases.
c. Remain with your child for the first hour of preschool time.
d. Give your child a kiss before you leave the preschool program.

16. Which assessment finding would cause the nurse to consider a child to be most at risk
for the development of mental illness?

a. The child has been raised by a parent with chronic major depression.
b. The childs best friend was absent from the childs birthday party.
c. The child was not promoted to the next grade one year.
d. The child moved to three new homes over a 2-year period.

17. The child prescribed an antipsychotic medication to manage violent behavior is one most
likely diagnosed with:
a. attention deficit hyperactivity disorder.
b. posttraumatic stress disorder.
c. communication disorder.
d. an anxiety disorder.

18. A child reports to the school nurse of being verbally bullied by an aggressive classmate.
What is the nurses best first action?
a. Give notice to the chief administrator at the school regarding the events.
b. Encourage the victimized child to share feelings about the experience.
c. Encourage the victimized child to ignore the bullying behavior.
d. Discuss the events with the aggressive classmate.
19. Assessment data for a 7-year-old reveals an inability to take turns, blurting out answers
to questions before a question is complete, and frequently interrupting others conversations.
How should the nurse document these behaviors?
a. Disobedience
c. Impulsivity
b. Hyperactivity
d. Anxiety

20. A child diagnosed with attention deficit hyperactivity disorder (ADHD) shows
hyperactivity, aggression, and impaired play. The health care provider prescribed
amphetamine salts (Adderall). The nurse should monitor for which desired behavior?
a. Increased expressiveness in communication with others
b. Abilities to identify anxiety and implement self-control strategies
c. Improved abilities to participate in cooperative play with other children
d. Tolerates social interactions for short periods without disruption or frustration

21. When group therapy is prescribed as a treatment modality, the nurse would suggest
placement of a 9-year-old in a group that uses:
a. guided imagery.
b. talk focused on a specific issue.
c. play and talk about a play activity.
d. group discussion about selected topics.

22. Which child demonstrates behaviors indicative of a neurodevelopmental disorder?

a. A 4-year-old who stuttered for 3 weeks after the birth of a sibling
b. A 9-month-old who does not eat vegetables and likes to be rocked
c. A 3-month-old who cries after feeding until burped and sucks a thumb
d. A 3-year-old who is mute, passive toward adults, and twirls while walking

23. 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?

24. When a 5-year-old is disruptive, the nurse says, You must take a time-out. The
expectation is that the child will:
a. go to a quiet room until called for the next activity.
b. slowly count to 20 before returning to the group activity.
c. sit on the edge of the activity until able to regain self-control.
d. sit quietly on the lap of a staff member until able to apologize for the behavior.

25. A parent diagnosed with schizophrenia and 13-year-old child live in a homeless shelter.
The child formed a trusting relationship with a shelter volunteer. The child says, My three
friends and I got an A on our school science project. The nurse can assess that the child:
a. displays resiliency.
b. has a passive temperament.
c. is at risk for posttraumatic stress disorder.
d. uses intellectualization to deal with problems.
1. A nurse prepares to lead a discussion at a community health center regarding childrens
health problems. The nurse wants to use current terminology when discussing these issues.
Which terms are appropriate for the nurse to use? Select all that apply.
a. Autism
b. Bullying
c. Mental retardation
d. Autism spectrum disorder
e. Intellectual development disorder

2. A nurse prepares the plan of care for a 15-year-old diagnosed with moderate intellectual
developmental disorder. What are the highest outcomes that are realistic for this patient?
Within 5 years, the patient will: (select all that apply)
a. graduate from high school.
b. live independently in an apartment.
c. independently perform own personal hygiene.
d. obtain employment in a local sheltered workshop.
e. correctly use public buses to travel in the community.

3. At the time of a home visit, the nurse notices that each parent and child in a family has his
or her own personal online communication device. Each member of the family is in a
different area of the home. Which nursing actions are appropriate? Select all that apply.
a.Report the finding to the official child protection social services agency.
b.Educate all members of the family about risks associated with cyberbullying.
c.Talk with the parents about parental controls on the childrens communication devices.
d. Encourage the family to schedule daily time together without communication devices.
e. Obtain the familys network password and examine online sites family members have
visited.