Suicidal thoughts may be associated with some somatoform disorders. Which of the following disorder has a higher rate of suicidal ideation and attempts

Correct Answer: D

Rationale: In the context of pediatric NCLEX practice, understanding the association between somatoform disorders and suicidal ideation is crucial for providing comprehensive care to pediatric patients. In this question, the correct answer is D) hypochondriasis. Hypochondriasis, now referred to as illness anxiety disorder in the DSM-5, is characterized by excessive worry about having a serious illness despite medical reassurance. Individuals with hypochondriasis often experience high levels of anxiety related to their health, leading to an increased risk of suicidal ideation and attempts. This heightened risk is primarily due to the intense fear and preoccupation with having a serious illness, which can significantly impact the individual's mental health. Regarding the other options: A) Undifferentiated somatoform disorder is a category that includes various somatic symptoms but does not specifically exhibit the same level of health anxiety and preoccupation as hypochondriasis. B) Conversion disorder involves the presentation of neurological symptoms that cannot be explained by a medical condition, and while distressing, it is not typically associated with the same level of health-related anxiety seen in hypochondriasis. C) Pain disorder is characterized by pain that causes significant distress or impairment, but it is not inherently linked to the same level of health anxiety and fear of serious illness as hypochondriasis. Educationally, this question highlights the importance of recognizing the psychological aspects of somatoform disorders, such as hypochondriasis, and their potential impact on a patient's mental well-being. It emphasizes the need for healthcare providers to assess and address not only the physical symptoms but also the emotional and psychological aspects of these conditions to provide holistic care to pediatric patients.

Correct Answer: A

Rationale: In pediatric patients with autism spectrum disorders (ASDs) experiencing sleep dysregulation, the first-line medication for treatment is melatonin. Melatonin is a hormone that helps regulate the sleep-wake cycle and has been shown to be effective in improving sleep patterns in children with ASDs. Option A (melatonin) is the correct answer because it directly addresses the issue of sleep dysregulation by supplementing the natural hormone that helps regulate sleep. Option B (guanfacine) and Option C (clonidine) are both alpha-2 adrenergic agonists commonly used to treat conditions like ADHD and anxiety, but they are not typically the first choice for addressing sleep issues in children with ASDs. Option D (haloperidol) is an antipsychotic medication that is not indicated for treating sleep dysregulation in ASDs due to its potential for serious side effects and lack of specific efficacy for sleep problems. Educationally, understanding the appropriate medications for managing common issues in pediatric patients with ASDs is essential for healthcare providers working with this population. It is important to consider the unique needs and sensitivities of individuals with ASDs when selecting treatment options to ensure the best outcomes.

Correct Answer: D

Rationale: Conduct disorder in childhood and adolescence is a serious behavioral and emotional disorder characterized by a persistent pattern of violating the rights of others or societal norms. Marital discord within the home is NOT directly associated with conduct disorder. Option A, antisocial behavior, is typically present in individuals with conduct disorder as they often exhibit aggressive and deceitful behavior. Option B, criminality in the father, can be a risk factor for the development of conduct disorder due to genetic and environmental influences. Option C, physical abuse, is a known risk factor for conduct disorder as children who experience abuse are more likely to exhibit disruptive behaviors. In an educational context, understanding the risk factors and associations with conduct disorder is crucial for healthcare providers working with pediatric populations. By recognizing these factors, healthcare providers can intervene early, provide appropriate support, and potentially mitigate the long-term negative outcomes associated with conduct disorder. It is essential to differentiate between normal child behavior and behavior that may indicate a more serious underlying issue requiring intervention and support.

Correct Answer: A

Rationale: In pediatric nursing, understanding the prevalence of psychiatric disorders in children is crucial for providing comprehensive care. In this question, the correct answer is A) smart students. The rationale behind this is that being a "smart student" is not a risk factor for developing psychiatric disorders. In fact, children who excel academically do not have a higher prevalence of psychiatric disorders compared to the general population of children. On the other hand, options B) head trauma, C) mental retardation, and D) epilepsy are all conditions that can increase the risk of developing psychiatric disorders in children. Head trauma can lead to changes in behavior and mood, increasing the likelihood of psychiatric issues. Mental retardation is often associated with co-occurring psychiatric disorders due to cognitive and emotional challenges. Epilepsy, a neurological condition, can also be linked to psychiatric comorbidities. Educationally, this question highlights the importance of recognizing risk factors for psychiatric disorders in children. It emphasizes that while certain conditions may predispose children to mental health issues, academic performance alone is not a determining factor. This knowledge equips nurses to assess and support children's mental well-being comprehensively, considering both medical and psychological aspects.

Correct Answer: D

Rationale: In the context of pediatric mental health, it is crucial for nurses to have a deep understanding of different disorders to provide effective care. Obsessive-compulsive disorder (OCD) is characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions). The correct answer, D) a need for sameness, is not typically associated with OCD but is more commonly seen in conditions like autism spectrum disorder. People with OCD often experience intrusive thoughts that cause anxiety, leading them to perform compulsive behaviors to alleviate that anxiety. Option A) overconcern with body wastes is a common obsession in OCD, where individuals may have excessive fears related to contamination and cleanliness. Option B) prior group A streptococcal infection is associated with a condition called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS), which can manifest as OCD symptoms. Option C) excessive fears is also characteristic of OCD, as individuals may have irrational fears that drive their compulsive behaviors. Understanding these nuances is crucial in differentiating between various pediatric mental health disorders and providing appropriate care to patients.