Review Practice Excercise 2

ATTENTION-DEFICIT/HYPERACTIVITY DISORDER (ADHD) > Mental Health

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Practice Excercise 2

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Total Questions : 5

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Question 1:

A nurse obtains a health history for a client diagnosed with attention-deficit/hyperactivity disorder (ADHD). Which behaviors should the nurse expect? Select all that apply

A. Impulsivity. B. Excessive talking. C. Spiteful behavior. D. Deliberately annoying others. E. Prolonged video gaming. F. Failure to complete tasks.

Answer and Explanation

Choice A:

Impulsivity is a hallmark of ADHD due to impaired inhibitory control in the prefrontal cortex. Clients act without forethought, interrupt conversations, and engage in risk-taking behaviors. This stems from deficient executive functioning and altered catecholamine signaling. Impulsivity and executive dysfunction define the disorder.

Choice B:

Excessive talking reflects hyperactivity and poor self-regulation. Clients often dominate conversations, interrupt others, and struggle with quiet activities. This behavior arises from cortical disinhibition and impaired attention modulation. Hyperactivity and disinhibition make this a classic ADHD manifestation.

Choice C:

Spiteful behavior is more consistent with oppositional defiant disorder, not ADHD. ADHD involves impulsivity and distractibility, but not intentional hostility. The underlying pathology is attentional dysregulation, not deliberate aggression. Hostility and vindictiveness are not diagnostic features of ADHD.

Choice D:

Deliberately annoying others is typical of oppositional defiant disorder. ADHD clients may irritate others unintentionally due to impulsivity, but purposeful provocation is not characteristic. The neurobiology involves attentional deficits, not intentional defiance. Provocation and defiance distinguish ODD from ADHD.

Choice E:

Prolonged video gaming is a behavioral choice, not a diagnostic criterion. While ADHD clients may struggle with time management, excessive gaming is not a defining feature. It reflects environmental reinforcement, not intrinsic pathology. Behavioral addiction and environmental influence explain this, not ADHD.

Choice F:

Failure to complete tasks is a core feature of inattention. Clients begin activities but leave them unfinished due to distractibility and poor sustained focus. This results from impaired working memory and deficient organizational skills. Inattention and distractibility explain this presentation.

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Question 2:

A nurse assesses a client with the inattentive presentation of attention-deficit/hyperactivity disorder (ADHD). Which behavior is most consistent with this presentation?

A. Difficulty sustaining attention during tasks. B. Frequent physical restlessness. C. Excessive talking and interrupting others. D. Engaging in risk-taking behaviors.

Answer and Explanation

Choice A:

Difficulty sustaining attention during tasks is the hallmark of inattentive ADHD. Clients struggle with prolonged focus, make careless mistakes, and fail to follow through on instructions. This results from impaired executive functioning and deficient catecholamine signaling. Inattention and distractibility define this subtype.

Choice B:

Frequent physical restlessness is characteristic of hyperactive-impulsive ADHD. It involves fidgeting, inability to remain seated, and excessive motor activity. Inattentive presentation lacks prominent hyperactivity and motor agitation, making this inconsistent with the described subtype.

Choice C:

Excessive talking and interrupting others reflect hyperactive-impulsive ADHD. Clients with inattentive presentation do not display verbal overactivity. The pathology involves attentional deficits, not disinhibition or verbal impulsivity, so this is not consistent.

Choice D:

Engaging in risk-taking behaviors is linked to impulsivity and poor inhibitory control, typical of hyperactive-impulsive ADHD. Inattentive presentation is defined by distractibility and poor sustained focus, not impulsivity or risk-taking, making this incorrect.

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Question 3:

A nurse is assessing a client with the hyperactive-impulsive presentation of attention-deficit/hyperactivity disorder (ADHD). Which finding should the nurse expect?

A. Fidgeting and inability to remain seated. B. Daydreaming during conversations. C. Slow task completion. D. Avoidance of group activities.

Answer and Explanation

Choice A:

Fidgeting and inability to remain seated are classic features of hyperactive-impulsive ADHD. Clients show constant movement, tapping, or squirming due to cortical disinhibition. This reflects impaired inhibitory control and excessive motor drive. Hyperactivity and restlessness define this subtype.

Choice B:

Daydreaming during conversations is typical of inattentive ADHD. It reflects distractibility and poor sustained focus, not hyperactivity. The pathology involves inattention and cognitive drift, making this inconsistent with hyperactive-impulsive presentation.

Choice C:

Slow task completion is linked to inattentive ADHD due to poor organization and distractibility. Hyperactive-impulsive clients act quickly, often without forethought, but do not exhibit prolonged task delays. Disorganization and inattention explain slow completion, not hyperactivity.

Choice D:

Avoidance of group activities is more consistent with social anxiety or autism spectrum disorder. Hyperactive-impulsive ADHD clients often seek stimulation and interaction, though disruptive. Social withdrawal and avoidance are not defining features of this subtype.

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Question 4:

A nurse is selecting an intervention for a client with attention-deficit/hyperactivity disorder (ADHD). Which activity is most appropriate for a client with ADHD?

A. Monopoly. B. Volleyball. C. Pool swimming. D. Checkers.

Answer and Explanation

Choice A:

Monopoly requires prolonged attention, strategic planning, and sustained focus, which ADHD clients struggle with. The slow pace and extended cognitive demand exacerbate distractibility. Inattention and poor concentration make this unsuitable.

Choice B:

Volleyball is appropriate because it provides structured rules, teamwork, and continuous physical movement. The activity channels hyperactivity into organized play, enhances attention through rapid responses, and promotes social interaction. Structure and movement make it ideal for ADHD management.

Choice C:

Pool swimming, while physically engaging, lacks the structured group interaction and rapid attention shifts that benefit ADHD clients. It may reduce hyperactivity but does not reinforce social skills or teamwork, limiting therapeutic value.

Choice D:

Checkers demands sustained concentration and patience, which ADHD clients often lack. The sedentary nature fails to channel hyperactivity, and the cognitive load may increase frustration. Distractibility and restlessness make this inappropriate.

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Question 5:

A nurse anticipates that a client with attention-deficit/hyperactivity disorder (ADHD) may be learning-disabled. This means the client:

A. Is not self-directed. B. Has intellectual impairment. C. Experiences perceptual difficulties that interfere with learning. D. Performs two grade levels below age norms.

Answer and Explanation

Choice A:

Not being self-directed reflects motivational or behavioral issues, not learning disability. Learning disability is neurologically based, involving processing deficits, not lack of initiative or independence.

Choice B:

Intellectual impairment is distinct from learning disability. Clients with learning disabilities have normal intelligence but specific deficits in processing. Cognition and IQ remain intact, differentiating it from intellectual disability.

Choice C:

Experiences perceptual difficulties that interfere with learning defines a learning disability. Clients have intact intelligence but impaired processing of auditory or visual input. This leads to difficulties in reading, writing, or mathematics. Perception and processing deficits are central features.

Choice D:

Performing two grade levels below age norms may be a consequence of learning disability but is not its definition. The defining feature is impaired information processing, not academic performance alone.

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Practice Excercise 2

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