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Limit setting
Which of the following would be the most appropriate intervention
for an adolescent who is manipulative and exhibiting aggressive Limit setting involves three steps: informing the client of the rule or
behaviors? limit, explaining the consequences if the client exceeds the limit,
and stating the expected behavior.
Behavior problems can develop when parental figures pay atten-
tion to a child's maladaptive behaviors

The disruptive, defiant behaviors associated with ODD usually

begin at home with parents or parental figures and are more
intense in this setting than in settings outside the home. Con-
sistently giving attention to maladaptive behaviors and ignoring
any positive ones can lead to the development of ODD. With
A nurse is providing community education regarding adolescents
ODD, the problem develops as a result of the parents or parental
with oppositional defiance disorder (ODD). Which point should the
figures to miss opportunities to reward the child for demonstrating
nurse include in the educational session?
positive behaviors but attention, whether it is positive or nega-
tive, is typically given when the child is engaging in maladaptive
behavior. Parents/parental figures play a key role in preventing
or perpetuating ODD. The problem behaviors are learned and
inadvertently reinforced in the home. The most effective treatment
for ODD begins when the child is young, preferably elementary
school-aged. Waiting until adolescence to seek treatment can
render the client more treatment resistant. (less)
A supportive relationship with an adult

A major protective factor against psychopathology stemming from

The nurse is counseling a family with a child who has been
abuse and neglect is the establishment of a supportive relation-
abused by an adult family friend in the past. When explaining the
ship with at least one adult who can provide empathy, consistency,
child's needs to the family, which of the following would be most
and possibly a corrective experience. Long-term psychotherapy
important for the nurse to stress?
and antidepressant medication may or may not be appropriate.
Short-term parental separation would be unlikely because the
abuser was a family friend, not a parent. (less)
• Repeated lying
• Minor shoplifting

Which behaviors should the nurse anticipate in children with mild Repeated lying and minor shoplifting are examples of the mild
conduct disorder? Select all that apply. form of conduct disorder. Behaviors such as conning people and
drinking alcohol are seen with moderate forms of conduct disor-
der. Cruelty to classmates is seen with the severe form of conduct
disorder. (less)
"I want to continue to work with you but I don't accept the language
you have chosen."

Clients with conduct disorder frequently experience rejection. The

client needs support to increase self-esteem while understanding
that behavioral changes are necessary. When working with a
client diagnosed with conduct disorder, the client needs to be
A nurse is seeing an adolescent with a diagnosis of conduct made aware that he or she is an accepted person although a
disorder for the first time to establish goals for treatment. During particular behavior may not be acceptable. Telling the client that
the first meeting, the adolescent yells a profanity at the nurse and "now is not a good time" may be perceived by the client as
states, "This is pointless." What is the nurse's best response? rejection. An opportunity to discuss behavioral change may be
lost if the session does not continue. In this scenario, it is evident
that the adolescent is attempting to mask low self-esteem by
acting tough. Telling the adolescent that the work cannot begin
until he or she is invested in it would indicate the nurse has not
acknowledged this feature of the disorder. Voicing fear that the
client may act out communicates mistrust to the client and can
hinder the development of a therapeutic relationship. (less)
Emphasize the need to seek medical help if suicidal thoughts
arise.

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Selective serotonin re-uptake inhibitor antidepressant medica-
tions may increase the risk of suicidal thinking and behavior
in some children and adolescents. Close monitoring of suicidal
thinking is warranted for the first four weeks of treatment with this
medication. Drowsiness is a common and nonthreatening side
effect of this medication that can last for up to four weeks after
A physician in an outpatient clinic has prescribed fluoxetine
treatment is initiated. The client should be told to expect this side
(Prozac) to a client with intermittent explosive disorder. What
effect but not to stop taking the medication because of it. Appetite
should the nurse include in teaching about this medication?
loss is a side effect that is common in the first four weeks of treat-
ment. It does not persist throughout treatment. Giving the client
this information would be inaccurate. Sleep changes are common
in the first four to six weeks of treatment with this medication.
The client should be warned to expect this change rather than
informing the client that it is not common. (less)
• Give high-fives for following through on a request the first time.
• Offer the child a toy or a game after a week of good behavior at
school.
• Take the child out for ice cream after a weekend free of arguing
or questioning.

Explanation:
A nurse is meeting the parents of an 8-year-old child with oppo-
When offering management training and behavioral interventions
sitional defiant disorder. Which strategies can the nurse offer the
for a child with oppositional defiant disorder, the nurse should
parents to promote the use of positive reinforcement? (Select all
emphasize the importance of rewarding positive behaviors with
that apply.)
praise and re-inforcers such as high fives, treats, or toys/games.
Consequences for the child's defiant behavior, such as throwing
objects during a tantrum or arguing, must be consistent and
not positively rewarded such as by providing a hug and cuddle
or engaging in discussion. Responses to positive and negative
behaviors must be distinct and employed consistently in order to
sustain adaptive behaviors in the child. (less)
• The client has developed new psychiatric symptoms.
• The client has become more aggressive since the last assess-
ment.
• The client has developed symptoms of ODD at a very young age.
A nurse is reassessing a 6-year-old client with oppositional defiant
Development of co-morbid psychiatric disorders, age of onset
disorder (ODD). Which findings would suggest that the patient is
(younger the age worse the prognosis), increased severity of
at a high risk of developing conduct disorder? Select all that apply.
symptoms are factors that determine the prognosis of the ODD
and the development of conduct disorder. Becoming more playful
and talkative are normal changes related to age. These changes
do not indicate the susceptibility of the child to develop conduct
disorder. (less)
The parents should ignore the child's behavior.

Parental behavioral interventions are the mainstay of therapy for

adolescents with ODD. Parents are instructed to ignore maladap-
A nurse is counseling the parents of a child with oppositional
tive behaviors instead of giving the behaviors negative attention.
defiant disorder (ODD). What does the nurse advise the parents
Positive behaviors should be rewarded with praise and reinforcers.
for dealing with the maladaptive behavior of their child?
The parents are asked not to deal with their child in a negative
way, such as scolding or punishing. The child most likely will not
require the help of a psychotherapist. The child may not be able
to understand the inappropriateness of his or her behavior. (less)
Threatening the nurse

Timeout is used to prevent aggression when the client's behavior

The nurse uses the technique of timeout for a client with conduct
starts to escalate, such as yelling or threatening someone. This
disorder. Which problem demonstrated by the client would have
technique helps the client with conduct disorder to gain control
led the nurse to use this intervention?
of emotions and outbursts. This technique may not be useful for
helping the client interact with the nurse, to build better social
relationships, or to perform daily chores. (less)

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Imbalance in the production of serotonin

Childhood abuse, neglect, or maltreatment is often the cause

of intermittent explosive disorder (IED). As the client does not
A 15-year-old client with intermittent explosive disorder gives no have a history of any of these, the client likely has the disorder
history of childhood abuse, neglect, or maltreatment. What could because of other factors. Other etiologic factors include imbalance
be the cause of the disorder in this client? in the production of serotonin and dysfunction of the frontal lobe.
Parietal lobe dysfunction and depleted blood glucose levels are
not associated with IED. Presence of coronary artery disease is
not a known etiologic factor in IED but is strongly correlated with
the disease. (less)
Conduct disorder

Adolescents with conduct disorder are often unmanageable at

A 16 year old male client is highly disruptive in class and has been home and disruptive in the community. They have little empathy
in trouble at home. His mother recently found him torturing a cat. or concern for others. They may be callous and lack appropriate
When she questioned him about how he could hurt an animal, feelings of guilt, although they may express remorse superficially
he laughed at her. Which of the following conditions will the client to avoid punishment. They often blame others for their actions.
most likely be diagnosed with? Risk-taking behaviors such as drinking, smoking, using illegal
substances, experimenting with sex, and participating in crime are
typical. Cruelty to animals or people, destruction of property, theft,
and serious violation of rules are diagnostic criteria. (less)
• A student who repeatedly bullies younger students
• A student who is constantly involved in activities resulting in
damage to school property
• A student who always uses abusive language while speaking to
teachers

Conduct disorder is characterized by persistent behavior that

violates societal norms, rules, laws, and the rights of other peo-
A nurse is performing a general assessment of adolescents in a
ple. The disorder could be in the form of aggression toward
school to identify students with conduct disorder. Which students
people and animals, destruction of property, deceitfulness and
are likely to be identified with the condition, based on the nurse's
theft, and/or serious violation of rules. A student who persistently
assessment? Select all that apply.
abuses younger children may be classified as having conduct
disorder. A student who is constantly involved in activities that
result in damage to school property (destruction of property) may
have conduct disorder. A student who constantly uses extremely
abusive language while speaking to teachers (aggression toward
people) also may have conduct disorder. Having a fight with a
classmate and getting bad grades in a class are not abnormal
behavior in adolescents. (less)
• Set clear limits with consequences
• Keep to regular routines
• Maintain a calm environment

Interventions that can help the parents of a child with ADHD

include: setting clear limits with clear consequences, using few
When assisting the parents of a child diagnosed with ADHD,
words and simplifying instructions; establishing and maintaining a
which of the following would the nurse suggest? Select all that
predictable environment with clear rules and regular routines for
apply.
eating, sleeping, and playing; promoting attention by maintaining a
calm environment with few stimuli; establishing eye contact before
giving directions and asking the child to repeat what was heard;
encouraging the child to do homework in a quiet place outside of a
traffic pattern; and assisting the child to work on one assignment
at a time (reward with a break after each completion). (less)
increased blood pressure
The nurse is conducting a health history of a 35-year-old male
client with a history of intermittent explosive disorder, diagnosed It has been postulated that intermittent explosive disorder is cor-
in adolescence. The nurse should include an assessment of which related with adverse physical outcomes such as coronary artery
health issue? disease, hypertension, stroke, diabetes, arthritis, back/neck pain,
ulcer, headache and other forms of chronic pain. (less)

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To help identify her feelings.

Clients with conduct disorder are tough on the exterior but have
difficulty expressing their feelings and emotions. Keeping a diary
can be very useful to help these clients to identify and express
For which of the following reasons would a nurse ask an adoles-
their emotions and feelings. Keeping a diary would not improve
cent client with conduct disorder to maintain a diary?
problem solving or teach socially acceptable behavior. It also
does not reduce the chances of an angry outburst. The nurse
should teach problem-solving skills, continually involve the client
in age-appropriate discussions, and use techniques such as time-
out to address these challenges. (less)
A 13-year-old boy who has been diagnosed with oppositional Say, "That's not an acceptable thing to say."
defiant disorder has taunted the nurse when she bent over to pick
something up and mocked her weight. How should then nurse A direct, matter-of-fact approach to hostile or inappropriate be-
respond? havior is beneficial when engaging with adolescents.
improving coping skills and self-esteem
A nurse is working with an adolescent client with a diagnosis
Nursing interventions for conduct disorder include teaching and
of conduct disorder. The nurse is helping the client reflect on a
practicing problem-solving skills. In this scenario, the nurse is
situation in which the client became aggressive and asks how the
asking the client to reflect on the situation in order find health-
client could have handled it differently. The nurse is employing
ier, adaptive solutions. Teaching and practicing problem-solving
which intervention?
skills is aimed at the ultimate goal of improving coping skills and
self-esteem for clients with conduct disorder. (less)
• The adolescent may be unwilling to speak to the nurse.
• The adolescent may behave disrespectfully to the nurse.
• The adolescent may make derogatory comments about his par-
ents and teachers.

Adolescents with conduct disorder may act lazy and be unwilling

A nurse is assessing an adolescent with conduct disorder. Which
to be interviewed. They may be disrespectful to the nurse and
should the nurse expect to find in this adolescent? Select all that
other personnel in the healthcare facility. They may also make
apply.
derogatory comments about their parents and teachers. People
with conduct disorder are very unlikely to express grief. They show
no guilt or remorse associated with their acts. These adolescent
are unlikely to be stressed. Clients with conduct disorder are very
unlikely to behave like a hypochondriac and give false complaints
of having a physical illness. (less)
Conduct disorder

Conduct disorder is characterized by serious violations of social

norms, including aggressive behavior, destruction of property, and
cruelty of animals. ODD is characterized by a persistent pattern
Which of the following childhood disorders is characterized by se- of disobedience, argumentativeness, angry outbursts, low frus-
rious violations of social norms, such as destruction of property? tration tolerance, and tendency to blame others for misfortunes.
OCD is characterized by intrusive thoughts that are difficult to
dislodge (obsessions) or ritualized behaviors that the child feels
driven to perform (compulsions). ADHD is a persistent pattern of
inattention, hyperactivity, and impulsiveness that is pervasive and
inappropriate for developmental level. (less)
kleptomania

Kleptomania is characterized by the impulsive, repetitive theft of

items not needed by the person, either for personal use or mon-
etary gain. This problem is more common in females. Pyromania
A nurse is seeing a female client who has been mandated to
is characterized by repeated, intentional fire-setting. Intermittent
counseling sessions after shoplifting numerous times. Which dis-
explosive disorder involves repeated episodes of impulsive, ag-
ruptive behavior disorder is the client most likely experiencing?
gressive, violent behavior and angry verbal outbursts. Children
who respond to pressures by internalizing emotions can see that
result in somatic complaints, withdrawal, isolative behavior and
problems with anxiety and depression. In this case, the client is
engaging in externalizing behaviors. (less)
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The adolescent's behavior poses a danger to others.
A nurse is assessing an adolescent with conduct disorder. The
Risperidone (Risperdol) is given to those clients with conduct
nurse finds that the adolescent has been prescribed risperidone
disorder whose behavior poses a threat to others. Poor social
(Risperdol) by the primary healthcare provider. What would be
behavior and disturbances in concentration need not be treated
the most likely reason for the healthcare provider to prescribe this
with drugs. Unlike in intermittent explosive disorder, the client
drug to the client?
with conduct disorder has no remorse, guilt, or depression after
behaving violently. (less)
conduct disorder

Conduct disorder is characterized by persistent behavior that

violates societal norms, rules, laws, and the rights of others.
These clients have significantly impaired abilities to function in
social, academic, or occupational areas. Symptoms are clustered
A pre-teen client has been considered a neighborhood bully for in four areas: aggression to people and animals, destruction of
several years. Peers avoid him, and the mother says she cannot property, deceitfulness and theft, and serious violation of rules.
believe a thing he tells her. Recently, the client was observed This is an example of moderate conduct. Moderate: The number
shooting at several dogs with a pellet gun and setting fire to a of conduct problems increases as does the amount of harm
vacant lot for the first time. A nurse would assess these behaviors to others. Examples include vandalism, conning others, running
as being most consistent with which disorder? away from home, verbal bullying and intimidation, drinking alcohol,
and sexual promiscuity. Oppositional defiant disorder consists of
an enduring pattern of uncooperative, defiant, disobedient, and
hostile behavior toward authority figures without major antisocial
violations. The behaviors are more pervasive than defiance of
authority. To suffer from pyromania is more than one incidence of
setting a fire. (less)
Teach the client about limit setting and the need for limits.

Clients with conduct disorder may have no knowledge of the

concept of limits and how they can be beneficial. The nurse
A nurse is caring for a client with conduct disorder. The nurse should teach about limit setting and the need for limits, to help
needs to help the client understand the relationship between clients understand the relationship between aberrant behavior
aberrant behavior and the consequences when the behavior is and the consequences when the behavior is problematic. The
problematic. Which nursing intervention is most appropriate to problem-solving process should be taught to clients, as they may
help this client? not know how to solve problems constructively. Appropriate con-
versation and social skills should be taught to clients to assist
them in socializing with others. Clients should be encouraged to
discuss their thoughts and feelings, as this is the first step in
dealing with clients with conduct disorder. (less)
An 11-year-old boy who was caught breaking into a home to steal
money

Which of the following children is most likely to be diagnosed with Crime is a common manifestation of oppositional defiant disorder
oppositional defiant disorder or conduct disorder? and conduct disorder. High-risk sexual behavior may accompany
the disorders but is not diagnostic. Tics and verbal outbursts are
characteristic of Tourette's syndrome. Difficulty in relating to others
is characteristic of autism spectrum disorders. (less)
Adolescents with ODD learn maladaptive behavior at home and
can be perpetuated at school

The treatment of ODD is based on parental behavioral interven-

In a discussion with a group of high school teachers about op-
tions. It is believed that problem behaviors in ODD are learned and
positional defiant disorder (ODD), the nurse says that behavior
reinforced in the home and at school, hence the approach of the
modification of the parents and teachers toward such children
parents and teachers toward the child may help to eliminate this
forms the basis of therapy. What is the most appropriate rationale
disorder at earlier ages. In adolescents, behavioral therapy may
that the nurse gives when asked about this strategy?
also be required along with parental management. It may not be
true that these children are closest to their parents. Such clients
are usually very aggressive and lack a sense of fear of anybody.
(less)
Use 'I' language and express an emotion when setting limits.

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With clients diagnosed with conduct disorder, parents need to
replace old patterns of communicating such as yelling, hitting,
or simply ignoring with more effective communication strategies
such as assertive limit setting. Using 'I' language and identi-
fying an emotion can help the parents set limits in a healthy
way. Consequences will only be effective if something of value
is taken from the client. Many adolescents prefer time alone in
When providing education to the parents of a client with conduct
their rooms. This would not be the most effective information
disorder, which is a valid teaching point?
to provide to the parents. Some parents need to let the client
experience the consequences of their actions rather than rescuing
them. Advocating for the adolescent when the client is disruptive
in school will only perpetuate the negative behavior. Adolescents
with conduct disorder are prone to thrill-seeking, risky behavior
including frequent sexual activity. This should not be normalized
as part of the education provided to the parents. (less)
• Low self-esteem
• Emotional instablity
• Frequent temper outbursts
An adolescent was expelled from school for being extremely
Abusing female students in class is indicative of conduct disorder.
verbally abusive to female students in the classroom. What other
Children with conduct disorder have low self-esteem and fre-
behavioral abnormalities does the nurse expect to find in this
quently lose their temper. Such children show no guilt or remorse
adolescent? Select all that apply.
for their behavior. Therefore, they are unlikely to have anxiety
or depression. Children with conduct disorder are known to be
unemotional, thus they cannot behave in an emotionally unstable
way. (less)
• The client will not hurt others or damage property.
• The client will engage in socially acceptable behavior.
• The client will learn effective problem-solving skills.

If a client undergoes successful treatment, he or she should be

A nurse is developing a plan of care for a client with conduct
able to behave in a socially acceptable manner, display appro-
disorder. Which of the following would be treatment outcomes for
priate problem-solving skills, no longer hurt others or damage
this client? Select all that apply.
property. Clients with conduct disorder usually do not have issues
related to personal hygiene. Such clients do require relief from
anxiety or depression, as they are considered unemotional and do
not show regret or feel any remorse after inappropriate behavior.
(less)
attention deficit hyperactivity disorder
A nurse is assessing a 10-year-old child who is displaying be-
Oppositional defiance disorder is often co-morbid with other psy-
haviors that are consistent with oppositional defiance disorder.
chiatric disorders that need to be treated as well. It is possible
When conducting the assessment, the nurse should also assess
that the oppositional defiance disorder is superimposed on the
for which co-morbidity?
attention deficit hyperactivity disorder because this problem is the
underlying cause of the child's maladaptive behaviors. (less)
"Please tell me more about what you are having difficulty with."

Exploring in depth what the client's mother is having difficulty

with can help the nurse build the parental capacity to address
After completing a series of parent training sessions with par- the behavioral difficulties they are having on their own. Identifying
ents of an 8-year-old client with oppositional defiant disorder, the specific pitfalls can promote problem solving. Meeting with the
child's mother calls the nurse with concerns. The mother states, child individually at the school counseling office takes the child
"What you taught us isn't working, can you please talk to my out of the environment where the behavior is most problematic (in
child about his behavior?" Which is the nurse's most effective the home). Working with the child individually is ineffective as the
response? best treatment for oppositional defiant disorder is to work with the
parents in building their capacity for behavior management. Telling
the mother to bring the client to the nurse's office for another
session communicates that the parents do not already have the
tools to manage the child's behaviors independently. (less)
The adolescent may have limited sensitivity to reward and pun-
ishment.
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The most likely reason for the parent's sense of loss of control and
hope with their adolescents child who has a diagnosis of ODD is
A nurse is counseling the parents of an adolescent client with that the client has a limited ability to make associations between a
oppositional defiant disorder (ODD). The parents state, "We've behavior and the consequences of that behavior—-both negative
tried everything, what else are we supposed to do?"What is the and positive. The parents likely did not neglect to teach the client
most likely reason for the parent's voiced loss of hope? appropriate behavior. Childhood abuse may be a predisposing
factor for ODD. The parents likely did not pamper the client; how-
ever, problem behaviors may have inadvertently reinforced in the
home. (less)
The sibling of the client has conduct disorder.

Most children with conduct disorder have siblings with the same
A nurse is assessing an adolescent with conduct disorder. Which psychiatric disorder. Although it is possible to develop CD if a
statement by the nurse about the adolescent is most likely to be sibling has a mood disorder, the likelihood is higher that the client
true? would also develop a mood disorder. Clients with conduct disorder
will show cruelty to animals. A client with a chronic medical con-
dition is more likely to be able to experience and convey empathy,
eliminating the presence of conduct disorder. (less)
The nurse who provides care under the auspices of a group home Impaired social interaction due to aggressive behavior
is planning the care of a 12-year-old boy who has been referred
to the home by the court system. Knowing that the boy has a The aggression, acting out, and antisocial behavior associated
documented history of conduct disorder, which of the following with conduct disorder create the potential for social alienation in
nursing diagnoses should the nurse prioritize during the boy's a group setting. Such individuals are less likely to withdraw, injure
transition into the group home? themselves, or experience hopelessness. (less)
• Blaming others for problems
• Angry outbursts
• Disobedience

Oppositional defiant disorder is characterized by a persistent

A nurse suspects that a child has oppositional defiant disorder.
pattern of disobedience, argumentativeness, angry outbursts, low
When reviewing the child's history, which of the following would
tolerance for frustration, and tendency to blame others for misfor-
support this suspicion? Select all that apply.
tunes, large and small. Children with oppositional defiant disorder
have trouble making friends and often find themselves in conflict
with adults. Conduct disorder is characterized by more serious
violations of social norms, including aggressive behavior, destruc-
tion of property, and cruelty to animals. (less)
The client only stares at the nurse when asked how the client is
doing today.

An example of an internalizing behavior that can be observed in

clients with disruptive behavior disorders is refraining from talking.
The client who just stares at the nurse when asked a question
The nurse is documenting clinical observations after a therapeutic is demonstrating internalizing behaviors common in disruptive
session with an adolescent client with a disruptive behavior dis- behavior disorders. Not showing up for multiple appointments
order. What should the nurse identify is an internalizing behavior? is an example of truancy, an externalizing behavior common in
disruptive behavior disorders. Telling the nurse that her grand-
mother passed away when, in fact, this is not true, indicates
that the client is lying. Lying is one example of an externalizing
behavior in disruptive behavior disorders. Pushing a chair over
during the therapeutic session is an example of an angry outburst
with aggression. This is an externalizing behavior. (less)
Closed ended
When assessing children, the nurse needs to ask more of which
Children think in more concrete terms; thus, the nurse needs to
type of question compared with assessment of adults?
ask more specific and fewer open-ended questions than would
typically be asked of adults.
• Confessed to hurting the neighbor's dog
• Served after-school detention for repeatedly disobeying the
teaching staff

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• Been regularly accused by family members of "stealing their
stuff"
• Been caught lying on a regular basis
A 14-year-old client's behavior meets the criteria for a conduct
disorder when the nursing assessment documents that the child A 14-year-old client's behavior meets the criteria for a conduct
has (Select all that apply.) disorder when the nursing assessment documents that the child
has done the following: confessed to hurting the neighbor's dog,
served detention, been accused of stealing, and been caught
lying. (less)
• Temperament of the adolescent
• Peer group of the adolescent
• Behavior of parents

A nurse is assessing an adolescent client with oppositional defiant It is believed that interaction of genes, temperament, and adverse
disorder (ODD). What factors influence the development of this social conditions cause oppositional defiant disorder (ODD). Be-
disorder in the adolescent? Select all that apply. havior of the parents suggests genetic linkage. Characteristics of
the peer group is indicative of the adversity of the social conditions
around the adolescent. Eating habits and academic performance
are affected due to ODD, but are not known to be a cause of ODD.
(less)
• Strategies for anger management
• Strategies to avoid alcohol and substance use
• Relaxation techniques
A nurse is planning to educate a client who is diagnosed with
The education imparted by the nurse should focus on helping the
intermittent explosive disorder about self-management strategies
client manage the symptoms associated with intermittent explo-
for the condition. What topics should the nurse address while
sive disorder. The nurse should teach the client relaxation tech-
teaching this client? Select all that apply.
niques, anger management strategies, and strategies to prevent
the use of alcohol and drugs. Clients with IED are unlikely to have
pain or diet-related problems, therefore, these need not be taught
to the client. (less)
• Effective parenting skills
• Skills to improve peer relationships
• Skills to improve academic performance

A nurse is planning to teach parents of children with conduct Family therapy is most desirable to treat school-aged children
disorder about the treatment methods. Which topics should the with conduct disorder. While teaching parents about strategies to
nurse address in the session? Select all that apply. treat this disorder, the nurse should talk about good parenting,
skills to improve peer relationships, and skills to improve academic
performance. Legal procedures for criminal behavior and medica-
tions for conduct and antisocial personality disorder need not be
addressed in this teaching. (less)
Which nursing interventions are focused on promoting safety and • All staff consult the care plan when determining interventions.
compliance when working with a child diagnosed with a conduct • The agreed upon routine is adhered to by all staff members
disorder? Select all that apply. • Time-out is implemented when limits are not respected.
Verbal bullying

The nurse is assessing a child diagnosed with conduct disorder. Verbal bullying is an example of a behavior seen clients exhibiting
Based on which behavior would this client be described as ex- a moderate intensity form of conduct disorder. Truancy is de-
hibiting the disorder at moderate intensity? scribed as a behavior seen in a mild intensity form of the disorder.
Cruelty to animals and attempted robbery are described as a
behavior seen in a severe intensity form of conduct disorder. (less)
The client prefers stealing money over working for it.

The nurse is assessing an adolescent with conduct disorder. The The adolescent with conduct disorder is most likely to steal money
nurse finds that the adolescent is not interested in seeking sum- for survival instead of earning it through employment. Feeling too
mer employment. What is the most likely reason for the client's disturbed to be able to work and feeling that he would be inefficient
disinterest in getting a job? at work are not behaviors related to clients with conduct disorder.
Depression and anxiety are not present in clients with conduct
disorder. (less)

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The adolescent has lots of tattoos and body piercings.

Adolescents with conduct disorder appear normal for their age

A nurse is assessing a 15-year-old adolescent with conduct dis- group but may have an extreme appearance, such as having tat-
order. Which appearance might the nurse see in the adolescent? toos and body piercings. They appear normal in terms of personal
hygiene. These adolescents have no guilt associated with their
behavior, thus they probably will not look terrified. The nurse is
unlikely to observe changes associated with self-harm. (less)
Presence of comorbid psychiatric disorders

Clients with ODD are likely to have comorbid psychiatric symp-

toms related to conditions like attention deficit hyperactivity dis-
A client is diagnosed with oppositional defiant disorder (ODD). order (ADHD). Pharmacological therapy for these comorbid con-
Which assessment finding would indicate that the client needs ditions can be helpful in reducing the severity of ODD symptoms.
medications? Children less than 3 years of age are expected to exhibit behavior
similar to ODD, but this is considered normal and does not require
any therapy. Use of abusive language and hostile behavior toward
parents are signs consistent with ODD and do not require phar-
macological therapy. (less)
a retreat away to regain self-control

A time-out is a retreat to a neutral place so clients can regain

self-control. It is not a punishment, therefore it would be inaccurate
to describe this technique as a consequence for unacceptable
When discussing a school-aged child's behavioral contract with behavior. A time-out should not signal the end of the school
the school staff, how should the nurse most effectively explain a day for the child. Instead, it should be an opportunity to practice
time-out? emotional regulation in order to progressively gain the ability to
tolerate the school environment in a nondisruptive way. A time-out
is not moving the child to sit with a different group of peers. In
order for this technique to be effective, there must be little or no
external stimulus as this may prevent the child's ability to regain
self-control. (less)

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