A nurse is caring for a school-age child.
Nurses' Notes
First visit:
A child is brought to the clinic accompanied by guardians. The guardians have received feedback from the child's teacher that the child has become disinterested in schoolwork and has difficulty paying attention during class. The child often loses their school supplies.
The guardians report that the child demonstrates these behaviors at home as well. The child refuses to participate in household chores, keeps their room untidy, does not clean up when told to, and is generally careless and disinterested. On assessing, the child is found to be talkative, restless, and easily distracted.
2 weeks later.
The child's guardians report that the child seems to be doing better at school. The child is improving at paying attention during class and completing assignments on time.
For each assessment finding, specify if the finding is consistent with attention deficit hyperactivity disorder (ADHD) or intellectual disability (ID). Each finding may support more than 1 disease process.
Intellectual impairment
Losing necessary things
Impaired language skills
Hyperreactivity to sensory input
Interrupting others
The Correct Answer is {"A":{"answers":"A, B"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"}}
A. Intellectual impairment
- The correct answer is ID.
- Intellectual impairment is a core feature of ID, which is characterized by significant limitations in intellectual functioning and adaptive behavior that are present before age 18.
- Intellectual impairment can sometimes be a feature of ADHD, but it's not a defining characteristic. ADHD, or Attention Deficit Hyperactivity Disorder, primarily involves difficulties with attention, hyperactivity, and impulsivity. However, some individuals with ADHD may also experience challenges with certain aspects of cognitive function, such as executive function, working memory, and processing speed. These difficulties can sometimes be mistaken for intellectual impairment, but it's important to note that ADHD itself does not necessarily indicate lower intelligence. ADHD is a neurodevelopmental disorder that affects individuals differently, and many people with ADHD have average or above-average intelligence..
B. Losing necessary things
- The correct answer is ADHD.
- Losing necessary things is a common symptom of ADHD, especially in the inattentive subtype. Children with ADHD may have difficulty organizing their belongings, remembering where they put them, or keeping track of them.
- Losing necessary things is not a specific indicator of ID, although children with ID may also have difficulties with memory and organization.
C. Impaired language skills
- The correct answer is ID.
- Impaired language skills are often associated with ID, as language development depends on cognitive abilities and social interactions. Children with ID may have delays or difficulties in acquiring, understanding, or using spoken or written language.
- Impaired language skills are not a typical feature of ADHD, although some children with ADHD may have coexisting language disorders or learning disabilities.
D. Hyperreactivity to sensory input
- The correct answer is ADHD.
- Hyperreactivity to sensory input is a possible manifestation of ADHD, especially in the hyperactive-impulsive subtype. Children with ADHD may be easily distracted by external stimuli, such as noises, lights, or movements, or may seek sensory stimulation by fidgeting, touching, or moving around.
- Hyperreactivity to sensory input is not a characteristic of ID, although some children with ID may also have sensory processing issues or autism spectrum disorder.
E. Interrupting others
- The correct answer is ADHD.
- Interrupting others is another common sign of ADHD, especially in the hyperactive-impulsive subtype. Children with ADHD may have difficulty waiting their turn, following social rules, or respecting others' boundaries. They may blurt out answers, comments, or questions without thinking or listening.
- Interrupting others is not a typical behavior of children with ID, although some children with ID may also have social skill deficits or communication problems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Autonomy is the ethical principle that respects the right of clients to make their own decisions and choices regarding their health care. Informed consent is a process that ensures that clients are fully informed of the benefits, risks, alternatives, and consequences of a proposed treatment or procedure, and that they voluntarily agree to it.
B. Nonmaleficence is the ethical principle that obliges health care providers to do no harm to clients, either intentionally or unintentionally. Informed consent does not directly promote this principle, although it may help to prevent harm by disclosing potential risks and complications.
C. Justice is the ethical principle that requires fair and equal treatment of all clients, regardless of their personal characteristics, preferences, or values. Informed consent does not directly promote this principle, although it may help to ensure that clients are not coerced or manipulated into accepting a treatment or procedure that they do not want or need.
D. Fidelity is the ethical principle that requires health care providers to be faithful and loyal to their clients, and to honor their commitments and promises. Informed consent does not directly promote this principle, although it may help to establish trust and rapport between clients and providers.
Correct Answer is D
Explanation
A. Clean the mouthpiece with warm water every 2 weeks. This is incorrect because the mouthpiece should be cleaned with warm water at least once a week, or more often if used frequently, to prevent bacterial growth and contamination.
B. Wait 10 seconds between inhalations. This is incorrect because the recommended time interval between inhalations is 1 minute, not 10 seconds, to allow adequate absorption of the medication and prevent overdose or side effects.
C. Take a quick inhalation when pressing the dispenser. This is incorrect because a quick inhalation can cause poor coordination of hand-mouth movement and result in less medication reaching the lungs. The nurse should instruct the child to take a slow, deep inhalation when pressing the dispenser, hold their breath for 10 seconds, and exhale slowly.
D. Take the medication 15 min before playing sports. This is correct because albuterol is a short-acting bronchodilator that can prevent exercise-induced bronchospasm. The nurse should teach the child to take the medication before engaging in physical activity that can trigger asthma symptoms, such as sports, cold weather, or allergens.
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