C HAPTER 21: I MPULSE C ONTROL D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. The famil y of a child diagnosed with an impulse control disorder needs
help to function more adaptivel y. Which aspect of the child‘s pla n of care
will be provided by an advanced practice nurse rather than a staff nurse?
a. Leading an activit y group
b. Providing positive feedback
c. Formulating nursing diagnoses
d. Dialectical behavioral therapy (DBT)
ANS: D
The advanced practice nurse role includes individual, group, and
famil y psychotherapist; educator of nurses, other professions, and the
communit y; clinical supervisor; consultant to professional and
nonprofessional groups; and researcher. DBT is an aspect of
ps ychotherapy. The distracters describ e actions of a nurse generalist.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 21- 31 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Shortl y after the parents announced that they were divor cing, a 15-year-
old became truant from school and assaulted a friend. The adolescent told
, the school nurse, ―I‘d rather stay in m y room and listen to music. It‘s
easier than thinking about what is happening in m y famil y.‖ Which nursing
diagnosis is most ap plicable?
a. Chronic low self -esteem related to role within the famil y
b. Decisional conflict related to compliance with school requirements
c. Defensive coping related to adjustment to changes in famil y
relationships
d. Disturbed personal identit y related to self -perceptions of changing
famil y dynamics
ANS: C
Depression is often associated with impulse control disorder. The
correct nursing diagnosis refers to the patient‘s dysfunctional
management of feelings associated with upcoming changes to the
famil y. The teen displays self-imposed isolation. The distracters are
not supported by data in the scenario.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF:
Pages 21-27, 45 (Table 21-2) TOP: Nursing Process:
Diagnosis/Anal ysis MSC: Client Needs: Psychosocial
Integrit y
3. A child known as the neighborhood bull y says, ―Nobody can tell me what
to do.‖ After receiving a poor grade on a science project, this child
secretl y loaded a virus on the teacher‘s computer. These behaviors support
a diagnosis of
a. CD.
b. ODD.
c. intermittent explosive disorder.
d. ADHD.
, ANS: B
ODD is a repeated and persistent pattern of having an angry and
irritable mood in conjunction with demonstrating defiant and vindictive
behavior. Loading a virus is a vindictive behavior in retribution for a
poor grade. Persons with CD are aggressive against people and
animals; destroy propert y; are deceitful; violate rules; and have
impaired social, academic, or occupational functioning. There is no
evidence of explosiveness or distractibility.
PTS: 1 DIF: Cognitiv e Level: Understand (Comprehension)
REF: Pages 21 -3 to 5, 44 (Table 21 -1) TOP: Nursing
Process: Assessment MSC: Client Needs: Psychosocial
Integrit y
4. An 11-year-old diagnosed with ODD becomes angry over the rules at a
residential treatment program and b egins shouting at the nurse. What is
the nurse‘s initial action to defuse the situation?
a. Say to the child, ―Tell me how you‘re feeling right now.‖
b. Take the child swimming at the facilit y‘s pool.
c. Establish a behavioral contract with the child.
d. Administer an anxiolytic medication.
ANS: B
Redirecting the expression of feelings into nondestructiv e, age-
appropriate behaviors such as a physical activit y helps the child learn
how to modulate the expression of feelings and exert self -control. This
is the least restrictive alternative and should be tried before resorting
to measures that are more restr ictive. A shouting child will not likel y
Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. The famil y of a child diagnosed with an impulse control disorder needs
help to function more adaptivel y. Which aspect of the child‘s pla n of care
will be provided by an advanced practice nurse rather than a staff nurse?
a. Leading an activit y group
b. Providing positive feedback
c. Formulating nursing diagnoses
d. Dialectical behavioral therapy (DBT)
ANS: D
The advanced practice nurse role includes individual, group, and
famil y psychotherapist; educator of nurses, other professions, and the
communit y; clinical supervisor; consultant to professional and
nonprofessional groups; and researcher. DBT is an aspect of
ps ychotherapy. The distracters describ e actions of a nurse generalist.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: Page 21- 31 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
2. Shortl y after the parents announced that they were divor cing, a 15-year-
old became truant from school and assaulted a friend. The adolescent told
, the school nurse, ―I‘d rather stay in m y room and listen to music. It‘s
easier than thinking about what is happening in m y famil y.‖ Which nursing
diagnosis is most ap plicable?
a. Chronic low self -esteem related to role within the famil y
b. Decisional conflict related to compliance with school requirements
c. Defensive coping related to adjustment to changes in famil y
relationships
d. Disturbed personal identit y related to self -perceptions of changing
famil y dynamics
ANS: C
Depression is often associated with impulse control disorder. The
correct nursing diagnosis refers to the patient‘s dysfunctional
management of feelings associated with upcoming changes to the
famil y. The teen displays self-imposed isolation. The distracters are
not supported by data in the scenario.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF:
Pages 21-27, 45 (Table 21-2) TOP: Nursing Process:
Diagnosis/Anal ysis MSC: Client Needs: Psychosocial
Integrit y
3. A child known as the neighborhood bull y says, ―Nobody can tell me what
to do.‖ After receiving a poor grade on a science project, this child
secretl y loaded a virus on the teacher‘s computer. These behaviors support
a diagnosis of
a. CD.
b. ODD.
c. intermittent explosive disorder.
d. ADHD.
, ANS: B
ODD is a repeated and persistent pattern of having an angry and
irritable mood in conjunction with demonstrating defiant and vindictive
behavior. Loading a virus is a vindictive behavior in retribution for a
poor grade. Persons with CD are aggressive against people and
animals; destroy propert y; are deceitful; violate rules; and have
impaired social, academic, or occupational functioning. There is no
evidence of explosiveness or distractibility.
PTS: 1 DIF: Cognitiv e Level: Understand (Comprehension)
REF: Pages 21 -3 to 5, 44 (Table 21 -1) TOP: Nursing
Process: Assessment MSC: Client Needs: Psychosocial
Integrit y
4. An 11-year-old diagnosed with ODD becomes angry over the rules at a
residential treatment program and b egins shouting at the nurse. What is
the nurse‘s initial action to defuse the situation?
a. Say to the child, ―Tell me how you‘re feeling right now.‖
b. Take the child swimming at the facilit y‘s pool.
c. Establish a behavioral contract with the child.
d. Administer an anxiolytic medication.
ANS: B
Redirecting the expression of feelings into nondestructiv e, age-
appropriate behaviors such as a physical activit y helps the child learn
how to modulate the expression of feelings and exert self -control. This
is the least restrictive alternative and should be tried before resorting
to measures that are more restr ictive. A shouting child will not likel y
