After teaching the parents of a child with attention deficit/hyperactivity disorder about ways to control the child's behavior, the nurse determines a need for additional teaching when the parents state:
"If he starts to act out, we'll have him do a time-out to help him refocus.”.
"We can use a reward system when he behaves appropriately.”.
"If he misbehaves, we need to punish him instead of reward him.”.
"We need to help him set realistic goals that he can achieve.”. —
The Correct Answer is C
Choice A rationale
Time-outs are an effective behavioral strategy for children with attention deficit/hyperactivity disorder (ADHD) because they remove the child from an overstimulating or reinforcing environment, allowing them to calm down and regain self-control. This technique supports the management of impulsive or disruptive behaviors by providing a structured pause.
Choice B rationale
A positive reward system is a highly recommended intervention for managing ADHD behavior, as these children respond well to immediate and consistent reinforcement for desirable actions. Rewards motivate them to practice and internalize appropriate behaviors, focusing on positive achievements rather out of negative consequences.
Choice C rationale
Punishing misbehavior instead of using positive reinforcement or logical consequences is generally ineffective and detrimental for children with ADHD. Effective management focuses on structure, positive feedback for desired behavior, and clear, immediate, non-physical consequences, not purely on punitive measures, which can worsen self-esteem and compliance.
Choice D rationale
Helping the child with ADHD set realistic, achievable goals is essential for building self-efficacy and confidence. Breaking down tasks into smaller, manageable steps reduces feelings of overwhelm and allows the child to experience success, which is a powerful motivator for continued effort and behavioral control.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
While a shunt insertion for hydrocephalus aims to drain excess cerebrospinal fluid and reduce intracranial pressure, thereby minimizing brain damage, it does not completely eliminate the risk of developmental problems. The extent of pre-existing neurological damage influences long-term outcomes, and some children may still experience learning disabilities or motor deficits requiring ongoing therapy and support.
Choice B rationale
The risk of shunt infection is present throughout the device's life, although the greatest risk does occur in the early post-operative period, typically within the first few months. Infections can be caused by skin flora introduced during surgery and can lead to serious complications like ventriculitis or septicemia, often requiring shunt removal and IV antibiotics.
Choice C rationale
Shunts have a fixed length; as the child grows, the distal catheter (the end draining the fluid) may no longer reach the peritoneal cavity or atrium, leading to shunt malfunction. Furthermore, components can fail over time due to wear or blockage, necessitating surgical revisions or replacement throughout the individual's lifetime to maintain proper cerebrospinal fluid drainage.
Choice D rationale
A ventriculoperitoneal or ventriculoatrial shunt is a palliative measure that manages the primary complication of hydrocephalus, which is increased intracranial pressure. However, shunts are prone to complications such as malfunction due to blockage, disconnection, or infection, and they do not cure the underlying cause, meaning that further complications remain a possibility.
Correct Answer is D
Explanation
Choice A rationale
Circumcision is a surgical procedure that removes the foreskin of the penis. While it is associated with a lower risk of acquiring some sexually transmitted infections like HIV, it does not prevent all of them, making condom use and safe sexual practices the primary preventive measures. Furthermore, this statement is not a balanced, educational response for undecided parents, who require comprehensive information on risks and benefits.
Choice B rationale
Maintaining adequate hygiene is possible in both circumcised and uncircumcised males. For uncircumcised males, proper hygiene involves gently retracting the foreskin daily after infancy to cleanse the glans, preventing the accumulation of smegma. This statement presents an exaggerated and often incorrect difficulty, failing to provide factual, unbiased information to the parents.
Choice C rationale
While the procedure is associated with pain, standard practice involves administering appropriate pain management, such as a dorsal penile nerve block or topical anesthetic, along with non-pharmacologic measures like sucrose solution and non-nutritive sucking. Therefore, the pain is controllable, and this statement is insufficient to guide a final parental decision.
Choice D rationale
The nurse's role is to provide objective information and support the parents' decision-making process, not to give a personal recommendation or push a specific viewpoint. Recommending a discussion with the healthcare provider ensures the parents receive a detailed, evidence-based review of both the potential medical benefits and risks associated with the procedure.
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