An 11-year-old, who is diagnosed with oppositional defiant disorder, becomes angry and disruptive over the rules of the day treatment program. The nurse should de-escalate the situation by:

calling staff to place the child in the locked seclusion room.

placing the child in physical restraints.

providing a prn anxiolytic medication.

suggesting that the child go into the gym and shoot some baskets.

Answer and Explanation

The Correct Answer is D

D. It offers the child a constructive way to release pent-up energy and frustration in a safe and non- confrontational manner. Physical activity can be a helpful tool in managing anger and disruptive behavior, as it allows the child to channel their emotions into a productive activity.
A. This option is not appropriate because it involves isolating the child in a locked room, which could further escalate the situation and may traumatize the child. Seclusion should only be used as a last resort in situations where the child or others are at risk of harm.
B. Physical restraints should only be used as a last resort in situations where the child poses an immediate danger to themselves or others. Using physical restraints can escalate the situation and may cause physical and psychological harm to the child.
C. Medication may be prescribed to manage symptoms of oppositional defiant disorder. However, using a PRN (as needed) anxiolytic medication to manage acute agitation should only be done under the guidance of a healthcare provider.

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Correct Answer is C

Explanation

C. Splitting is characterized by viewing people and situations in extremes, either all good or all bad, without recognizing the complexity that usually exists in most circumstances. This black-and-white thinking can lead to rapidly shifting perceptions of others, as seen in the client's sudden change from idealizing the nurse to devaluing them.
A. Denial is a defense mechanism where the individual refuses to accept reality or acknowledge an aspect of reality that is apparent to others. In this scenario, the client is not denying any aspect of reality.
B. Separation-individuation is a developmental process where individuals establish autonomy and a sense of self separate from others, particularly from primary caregivers. This process is more relevant in infancy and early childhood.
D. Reaction formation is a defense mechanism where an individual behaves in a manner opposite to their true feelings or impulses. In this scenario, the client's expression of hatred towards the nurse does not appear to be a case of reaction formation, as there is no indication that the client actually harbors feelings of care or admiration towards the nurse.

A. fluphenazine. B. methylphenidate. C. diazepam. D. haloperidol.

Correct Answer is B

Explanation

B. Methylphenidate is a central nervous system stimulant commonly used in the treatment of ADHD. It works by increasing the levels of certain neurotransmitters in the brain, which helps improve attention, focus, and impulse control in individuals with ADHD. Teaching the family about methylphenidate would be appropriate as it is one of the most commonly prescribed medications for ADHD.
A. Fluphenazine is an antipsychotic medication primarily used to treat psychotic disorders such as schizophrenia and bipolar disorder. It is not typically used as a first-line treatment for ADHD
C. Diazepam is a benzodiazepine medication primarily used to treat anxiety disorders, muscle spasms, and seizures. It is not indicated for the treatment of ADHD.
D. Haloperidol is an antipsychotic medication primarily used to treat psychotic disorders and severe behavioral disturbances. It is not a first-line treatment for ADHD.

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An 11-year-old, who is diagnosed with oppositional defiant disorder, becomes angry and disruptive over the rules of the day treatment program. The nurse should de-escalate the situation by:

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Naxlex Comprehensive Predictor Exams

The nurse has recently set limits for a client with borderline personality disorder. The client tells the nurse, "You used to care about me. I thought you were wonderful. Now I can see that I was mistaken. You are hateful." This outburst can be assessed as:

Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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