Chapter 21: Impulse Control Disorders Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition MULTIPLE CHOICE 1. A 16-year-old diagnosed with a conduct disorder (CD) has been in a residential program for 3
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months. Which outcome should occur before discharge? a. The adolescent and parents create and agree to a behavioral contract with rules, rewards, and consequences. b. The adolescent identifies friends in the home community who are a positive influence. c. Temporary placement is arranged with a foster family until the parents complete a parenting skills class. d. The adolescent experiences no anger and frustration for 1 week. ANS: A
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The adolescent and the parents must agree on a behavioral contract that clearly outlines rules, expected behaviors, and consequences for misbehavior. It must also include rewards for following the rules. The adolescent will continue to experience anger and frustration. The adolescent and parents must continue with family therapy to work on boundary and communication issues. It is not necessary to separate the adolescent from the family to work on these issues. Separation is detrimental to the healing process. While it is helpful for the adolescent to identify peers who are a positive influence, it is more important for behavior to be managed for an adolescent diagnosed with a CD.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 21-27, 28, 30, 45 (Table 21-2) TOP: Nursing Process: Outcomes Identification MSC: Client Needs: Psychosocial Integrity 2. A 15-year-old ran away from home six times and was arrested for shoplifting. The parents
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told the Court, “We can’t manage our teenager.” The adolescent is physically abusive to the mother and defiant with the father. Which diagnosis is supported by this adolescent’s behavior? a. Attention deficit hyperactivity disorder (ADHD) b. Posttraumatic stress disorder (PTSD) c. Intermittent explosive disorder d. CD
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ANS: D
CDs are manifested by a persistent pattern of behavior in which the rights of others and age-appropriate societal norms are violated. Intermittent explosive disorder is a pattern of behavioral outbursts characterized by an inability to control aggressive impulses in adults 18 years and older. Criteria for ADHD and PTSD are not met in the scenario. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 21-17, 44 (Table 21-1) TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
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