A nurse is assisting the guardians of a school-age child who has oppositional defiant disorder in identifying strategies to promote positive behavior. Which of the following strategies should the nurse recommend? (Select one that does not apply)

Correct Answer: B

Rationale: Oppositional defiant disorder (ODD) involves defiance and hostility toward authority. Effective strategies include: (C) a reward system to reinforce positive behavior, which aligns with behavioral therapy principles; (D) school sports to channel energy and build social skills; and (E) consistency in addressing unacceptable behavior to establish clear boundaries, a cornerstone of ODD management. (A) undermines authority by giving the child control over rules, and (B) may reinforce negative behavior by focusing on it.

Correct Answer: C

Rationale: Living with an alcoholic parent (C) poses the highest risk due to environmental stress, neglect, and potential abuse, which are strong predictors of psychiatric disorders. (A) indicates genetic risk but is less direct than immediate environment; (B) and (D) lack evidence as primary risk factors.

Correct Answer: C

Rationale: The behaviors suggest ADHD or a behavioral disorder. (C) reducing loneliness and increasing self-esteem could address aggression and social issues, though the question lacks a perfect fit. (A) is vague, (B) is extreme for outpatient symptoms, and (D) doesn’t match the primary issues of inattention and aggression.

Correct Answer: C

Rationale: Acceptance and trust (C) are foundational in therapeutic relationships, providing security to impulsive children, fostering cooperation. (A) is partial, (B) is beneficial but less core, and (D) is ideal but not the primary principle here.

Correct Answer: D

Rationale: Rocking for extended periods (D) is a repetitive, self-soothing behavior strongly associated with ASD. (A) is developmental, (B) expected at 3, and (C) typical separation anxiety, none specific to ASD.