An 11 year old boy is restless & hardly ever sits on his seat & roams around the hall, & whole of the class has difficulty to concentrate. This boy is suffering from:

Appeared in: BHU NO-2019

Explanation

The symptoms described—restlessness, inability to stay seated, and roaming—are hallmark characteristics of the hyperactivity component of Attention Deficit Hyperactivity Disorder (ADHD).
ADHD is defined by a persistent pattern of inattention and/or hyperactivity-impulsivity that is more frequent and severe than is typically observed in individuals at a comparable level of development.
The child's behavior directly impacts his and others' ability to function in the classroom, which is a key diagnostic criterion for ADHD.
According to the DSM-5, hyperactivity symptoms include fidgeting, leaving one's seat, running or climbing inappropriately, and being constantly 'on the go'.

Why Other Options Were Wrong

Option A: Depression in children typically presents with symptoms like sadness, irritability, social withdrawal, and loss of energy or interest, not the excessive motor activity (hyperactivity) described in the scenario.
Option C: Schizophrenia is a severe psychotic illness characterized by hallucinations, delusions, and disorganized thought. It is rare in pre-adolescent children and does not primarily manifest as hyperactivity.
Option D: Conduct disorder involves a persistent pattern of behavior that violates the basic rights of others or major age-appropriate societal norms. This includes aggression, destruction of property, deceitfulness, or theft. The scenario describes restlessness and an inability to focus, not malicious or antisocial acts.

Related Visual

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnosis of childhood neurobehavioral disorders based on classroom behavior as background academic context rather than a clinical decision trigger.
Nurses, especially school nurses, are often the first healthcare professionals to identify children who may have ADHD. Recognizing the signs is crucial for early referral, diagnosis, and intervention.
Management of ADHD is multimodal, involving behavioral therapy, parent training, and classroom accommodations. Nurses play a key role in educating families and teachers and monitoring the effectiveness and side effects of medications if prescribed.
Untreated ADHD can lead to poor academic performance, low self-esteem, and difficulties with social relationships, highlighting the importance of timely and appropriate support.

How to Approach the Question

First, carefully read the clinical scenario and identify the key presenting behaviors of the 11-year-old boy: restlessness, inability to stay seated, and roaming.
Note the impact of the behavior: it disrupts the entire class, indicating a significant level of impairment.
Systematically evaluate each option against the described symptoms.
For 'Depression disorder', ask if the symptoms match low mood and energy. They do not; they show high energy.
For 'ADHD', ask if the symptoms match the criteria for hyperactivity and impulsivity. They are a classic fit.
For 'Schizophrenia', ask if there are any signs of psychosis. There are none.

Concept Tested & Keywords

Concept Tested: Diagnosis of childhood neurobehavioral disorders based on classroom behavior.
Stem keywords: 11 year old boy, restless, hardly ever sits, roams around, difficulty to concentrate
Lead-in keywords: suffering from
Clinical cues: The patient is an 11-year-old boy, an age where ADHD symptoms are commonly identified in a school setting.
Clinical cues: The behavior is disruptive to the entire class, indicating a significant impairment in social and academic functioning.

Question ID

Qx4VA4WcYZx7OM7o9qX3Th

Reference Book

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 15512-15514

E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 49-51

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 607-609

Practise the full BHU NO-2019

Attempt every question from this paper in a timed mock, then review the full solution for each one.

Attempt this paper Attempt in the NPrep app