Which criteria must the symptoms of hyperactivity, inattention, and impulsivity meet to confirm the diagnosis of attention-deficit/hyperactivity disorder (ADHD)?
Are confirmed by a diagnostic testing tool.
Worsen in times of severe stress.
Occur both at home and at school.
Are confirmed by supervised clinical observations.
The Correct Answer is C
Choice A rationale
Although diagnostic tools (like rating scales or questionnaires) are often used to gather information from parents and teachers, the diagnosis of ADHD is fundamentally a clinical diagnosis. It is based on a structured clinical interview and the persistence and pervasiveness of symptoms, not merely confirmation by a specific psychological or diagnostic test.
Choice B rationale
While ADHD symptoms can indeed be exacerbated by severe stress, the diagnostic criteria from the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition) mandate that the symptoms must be present for at least 6 months and be inconsistent with the developmental level. They must be present before age 12 and cause clinically significant impairment in functioning, not just worsen under stress.
Choice C rationale
The DSM-5 criteria for ADHD require that the symptoms of inattention, hyperactivity, and impulsivity must be present in two or more settings (e.g., home, school, work, or with friends/relatives). This cross-situational requirement is crucial because it helps to rule out a disorder whose symptoms are simply a reaction to a specific situational stressor or environmental trigger.
Choice D rationale
While clinical observations are a part of the diagnostic process, the diagnosis relies significantly on historical data and reports from parents, teachers, and the individual, using established criteria. Requiring symptoms to be confirmed only by supervised clinical observations would be impractical and insufficient, as symptoms may fluctuate and may not be consistently present during a brief observation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Drowsiness is a common and important side effect of many anxiolytics, especially benzodiazepines, due to their central nervous system depressant properties. However, a key advantage of Buspirone is its lack of significant sedation, as it is a non-benzodiazepine anxiolytic that acts as a partial serotonin (5-HT_1A) agonist, making drowsiness less pronounced and less of a critical teaching point compared to other options.
Choice B rationale
Sleep paralysis, a temporary inability to move or speak while falling asleep or waking up, is a parasomnia, sometimes associated with narcolepsy or stress. It is not a commonly reported or clinically significant side effect directly linked to the partial serotonin (5-HT_1A) agonism mechanism of action of Buspirone.
Choice C rationale
Dizziness is a very common side effect of Buspirone because of its effect on serotonin receptors and potentially some impact on blood pressure regulation upon standing, known as orthostatic hypotension. It is crucial patient teaching to help prevent falls and ensure safety, especially when first starting the medication or changing positions.
Choice D rationale
While some behavioral changes can occur with psychotropic medications, Buspirone is generally well-tolerated with a low risk of dependency or major behavioral disturbances. It does not possess the same potential for paradoxical excitement or disinhibition commonly seen with other anxiolytics like benzodiazepines.
Correct Answer is A
Explanation
Choice A rationale
The working phase is the central phase of the therapeutic relationship, dedicated to problem identification, exploration of stressors, and the development and testing of new coping mechanisms. It is during this phase that the patient's identified issues are intensely explored and resolved as the nurse and patient work collaboratively towards achieving established goals.
Choice B rationale
The preorientation phase occurs before the first face-to-face encounter. The nurse's activities involve data gathering and self-assessment, such as reviewing the patient's chart, understanding the clinical context, and examining their own feelings, to prepare for the interaction. No direct patient issues are explored or resolved here.
Choice C rationale
The orientation phase is the initial period focused on establishing rapport, clarifying roles, setting goals, and establishing a contract for the relationship. While issues are identified, the in-depth work of exploring and resolving those issues has not yet begun; the foundation is merely being laid.
Choice D rationale
The termination phase is the final stage, focusing on summarizing goals achieved, reviewing the experience, and preparing for separation. The primary goal is to conclude the relationship therapeutically and ensure the patient can maintain gains, not to introduce or resolve new major issues.
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