Autism Spectrum Disorders
Which statement regarding ASD etiology and epidemiology is true? Autism is higher in non-White ethnicities. Autism is more prevalent in boys than girls. Autism is linked to alcohol abuse in pregnant women. Boys with autism experience more severe retardation than girls.
Autism is higher in non-White ethnicities. Autism has no racial, ethnic, or social boundaries. Autism is more prevalent in boys than girls. Autism is three to four times more prevalent in boys than girls. Autism is linked to alcohol abuse in pregnant women. Autism has not been linked to alcohol or drug abuse in pregnant women. Boys with autism experience more severe retardation than girls. Girls with autism experience more severe retardation than boys with autism.
Which nursing action is most effective in improving the autistic patient's social skills? Coaching the patient to experience the joy of instant gratification Teaching the patient the appropriate time to feel shame versus joy Assisting the patient with activities of daily living like tooth-brushing Helping the patient memorize baseball statistics that can be shared with peers
Coaching the patient to experience the joy of instant gratification The nurse should help the patient to exercise self-control and delayed gratification to help improve social skills. Teaching the patient the appropriate time to feel shame versus joy Teaching the patient appropriate emotional responses helps the patient develop social skills. Assisting the patient with activities of daily living like tooth-brushing Encouraging the patient's involvement in activities of daily living helps develop psychomotor skills, not social skills. Helping the patient memorize baseball statistics that can be shared with peers Helping the patient memorize trivial data does not develop social skills.
Which benefit have patients with ASD demonstrated after beginning medication therapy with an atypical antipsychotic? Improved mood Decreased depression Increased concentration Reduced harmful behaviors
Improved mood Patients with ASD have experienced an improvement in mood when taking antidepressants from the SSRI class. Decreased depression Patients with ASD have experienced decreased depression and anxiety when taking antidepressants from the SSRI class. Increased concentration Patients with ASD have not experienced increased concentration when taking an atypical antipsychotic. Reduced harmful behaviors Patients with ASD have experienced a reduction in aggressive and harmful behaviors when taking an atypical antipsychotic.
Which example demonstrates the cognitive concept of "islands of genius" as seen in ASD? A child who is able to quickly count to 1000. An adolescent who has difficulty reading but can play the guitar. A child who can recite the complete daily area train schedules. An adolescent who can quickly make change for a one hundred dollar bill.
A child who is able to quickly count to 1000. A child who is able to quickly count numbers is not demonstrating "islands of genius." An adolescent who has difficulty reading but can play the guitar. An adolescent who struggles to read but can play the guitar is not demonstrating "islands of genius." A child who can recite the complete daily area train schedules. A child who is able to recite large amounts of insignificant data, such as train schedules, is exhibiting "islands of genius." An adolescent who can quickly make change for a one hundred dollar bill. An adolescent who can quickly make change is not exhibiting "islands of genius."
Which is the priority nursing goal that is included in plan of care for the patient with autism? Safety Balance Structure Limit setting
Safety Maintaining the safety of the child with autism and his or her family is the priority nursing goal in developing the plan of care. Balance Teaching the autistic patient balance is important to the patient's plan of care, but this is not the priority nursing goal. Structure Providing structure for the autistic patient is important, since autistic children thrive in a structured environment, but this is not the priority nursing goal when developing the plan of care. Limit setting Setting limits helps develop social skills in the autistic patient, but this is not the priority nursing goal when developing the plan of care.
Which symptom in an infant may be most indicative of ASD? Decreased crying Lack of eye contact Fixation with objects Stereotypical movement
Decreased crying Decreased crying is not a normal symptom associated with ASD in infants. Lack of eye contact Lack of eye contact, lack of facial expressions, and disinterest in others are signs of ASD in an infant. Fixation with objects Fixation with particular objects is seen in children, not infants, with ASD. Stereotypical movement Stereotypical movement is seen in children, not infants, with ASD.
The nurse is providing care for a child with ASD. The nurse rewards the child for following directions with stickers of the child's favorite cartoon character. Which goal of the treatment plan does this action best support? Encourage use of impulse control and delayed gratification Encourage concepts of identity, body image, and self-esteem Facilitate the expression of appropriate emotional responses Facilitate the development of cause and effect and problem solving
Encourage use of impulse control and delayed gratification Rewarding the child for following directions does not encourage the use of impulse control and delaying gratification. Encourage concepts of identity, body image, and self-esteem Patients with ASD often have difficulty with identity, body image, self-esteem, and self-awareness. When the nurse rewards the patient with stickers, this encourages the concept of self-esteem. Facilitate the expression of appropriate emotional responses Rewarding the child for following directions does not facilitate the expression of appropriate emotional responses. Facilitate the development of cause and effect and problem solving Rewarding the child for following directions does not facilitate the development of cause and effect and problem solving.
Which are behaviors associated with autism spectrum disorder (ASD)? Select all that apply. Excessive tongue lolling Extreme resistance to change Stereotypical repetitive speech Fixation with particular objects Emotional attachment to soft objects
Excessive tongue lolling Excessive tongue lolling is not a behavior associated with ASD. Extreme resistance to change Children with ASD are very resistant to change or activities that occur outside of their regular schedules. Stereotypical repetitive speech Stereotypical repetitive speech, such as repeating a song's lyrics over and over, is a behavior associated with ASD. Fixation with particular objects Fixation with particular objects, such as a toy car and watching the wheels go round and round, is a behavior associated with ASD. Emotional attachment to soft objects Children with ASD have difficulty forming emotional attachments to people. However, they have attachments to unusual objects such as rubber bands or pieces of string.
The nurse teaches the parents of an autistic child how to implement structure in the home. Which is an example of structure by the parents? Keeping plastic bags out of the child's reach. Allowing the child to select favorite lunch foods. Teaching the child not to interrupt others when speaking. Administering the child's medication every day after breakfast.
Keeping plastic bags out of the child's reach. Keeping plastic bags out of the child's reach fosters an environment of safety, not of structure. Allowing the child to select favorite lunch foods. Allowing the child to select favorite foods is fostering choice and independence in the child. This is not an example of providing structure. Teaching the child not to interrupt others when speaking. Teaching a child not to interrupt others when speaking is an example of a societal norm and is not related to structure. Administering the child's medication every day after breakfast. Administering medications at the same time every day creates a consistent routine that creates a structured environment.
The nurse informs an adolescent autistic patient that the use of cell phones is not permitted during the nursing assessment. Which social development skill is the nurse exhibiting? Norms Balance Structure Limit setting
Norms Norms are society's expectations of behavior. The nurse is not exhibiting a societal norm by asking the autistic patient not to use the cell phone. Balance Balance occurs when the nurse helps the autistic patient balance dependence with independence. The nurse is not exhibiting balance by asking the autistic patient not to use the cell phone. Structure Structure involves maintaining consistent routines. The nurse is not exhibiting structure by asking the autistic patient not to use the cell phone. Limit setting The nurse is exhibiting limit setting by asking the autistic patient not to use the cell phone.
A patient with ASD is demonstrating tantrums, self-injurious behavior, and aggression. Which medication would the nurse anticipate administering? Paroxetine Venlafaxine Risperidone Methylphenidate
Paroxetine Paroxetine is an example of a SSRI used to treat depression. It is not an example of an atypical antipsychotic. Venlafaxine Venlafaxine is an example of a SNRI used to treat depression. It is not an example of an atypical antipsychotic. Risperidone Risperidone is an atypical antipsychotic that is used to treat symptoms of tantrums, tics, self-injurious behavior, and aggression in patients with ASD. Methylphenidate Methylphenidate is a stimulant, not an atypical antipsychotic, used in the treatment of ASD symptoms.
Which type of treatment does the nurse facilitate for young children with ASD? Referral to a neurologist Enrollment in a special school Referral to an early intervention program Admission to a children's psychiatric unit
Referral to a neurologist A referral to a neurologist for a child with ASD is not necessary, unless the child is exhibiting neurological symptoms that fall outside of the diagnosis of ASD. Enrollment in a special school Young autistic children may benefit from enrollment in a special school that caters to autistic children, but this is not a general treatment option for most autistic children. Referral to an early intervention program Young autistic children are typically referred to an early intervention program where they may receive care in nursery school, day treatment programs, and special education classes. Admission to a children's psychiatric unit Admitting a young child to a psychiatric unit for treatment of ASD is not appropriate.
Which nursing diagnosis for the patient with ASD holds the highest priority for the nurse? Risk for self-mutilation Risk of failure to develop Impaired verbal communication Delayed growth and development
Risk for self-mutilation Risk for self-mutilation involves the autistic patient's safety and is of highest priority for the nurse. Risk of failure to develop Risk of failure to develop is an important nursing diagnosis, but it is not of highest priority for the nurse. Impaired verbal communication Impaired verbal communication is an important nursing diagnosis, but it is not of highest priority for the nurse. Delayed growth and development Delayed growth and development is an important nursing diagnosis, but it is not the highest priority for the nurse.
Which family-oriented nursing diagnoses should the nurse include in the autistic patient's plan of care? Select all that apply. Self-care deficit Disabled parental role Risk for self-mutilation Impaired social interaction Disturbed personal identity
Self-care deficit Self-care deficit is an important nursing diagnosis for the family of an autistic child, because the family will often ignore their own needs in lieu of caring for their autistic child. Disabled parental role The parental role in a family with an autistic child is often compromised and even disabled. Risk for self-mutilation Risk for self-mutilation is a nursing diagnosis that is appropriate for an autistic patient, not the patient's family. Impaired social interaction Impaired social interaction is a nursing diagnosis that is appropriate for an autistic patient, but is not necessarily true of families with an autistic patient. Disturbed personal identity Disturbed personal identity is an appropriate nursing diagnosis for an autistic patient, but it not necessarily true of family members of an autistic patient.
Which factors are important for the nurse to assess in the patient with ASD? Select all that apply. Signs of abuse Loss of memory Bonding with parents Medication side effects Rapid progression of symptoms
Signs of abuse Autistic patients are at high risk for abuse, so the nurse must carefully monitor the patient for signs of physical and emotional abuse. Loss of memory Patients with ASD experience cognitive challenges, such as mental retardation, but these patients do not typically experience a loss of memory. Bonding with parents Parents may have difficulty bonding with their autistic child, so it is important that the nurse assess the parent-child relationship. Medication side effects Most patients with ASD are prescribed antidepressants and/or atypical antipsychotics. It is important that the nurse closely monitor autistic patients for any medication side effects. Rapid progression of symptoms Rapid progression of symptoms is not associated with ASD.
Which factors are most associated with the causes of ASD? Select all that apply. Social Genetic Metabolic Socioeconomic Environmental
Social Social factors are not associated with the cause of ASD. Genetic Genetic factors, such as Fragile X syndrome and tuberous sclerosis, have been associated with ASD. Metabolic Metabolic factors, such as oxidative stress and metabolic impairment, have been linked to ASD. Socioeconomic Socioeconomic factors, including family income or education level, are not linked to ASD. Environmental Parental exposure to the chemicals thalidomide and valproic acid have been linked to increased risk of autism.
Which class of antidepressant is most successful in the treatment of ASD symptoms? Tricyclic antidepressants (TCAs) Monoamine oxidase inhibitors (MAOIs) Serotonin selective reuptake inhibitors (SSRIs) Serotonin-norepinephrine reuptake inhibitors (SNRIs)
Tricyclic antidepressants (TCAs) TCAs are successful in treating symptoms of depression, but they are not the most successful pharmacological treatment of ASD symptoms. Monoamine oxidase inhibitors (MAOIs) MAOIs are not used in the treatment of ASD symptoms due to their numerous drug and food interactions. Serotonin selective reuptake inhibitors (SSRIs) SSRIs are the type of antidepressant that has been most successful in treating ASD symptoms of depression and anxiety. SSRIs have allowed ASD patients to gain more tolerance of new situations. Serotonin-norepinephrine reuptake inhibitors (SNRIs) SNRIs are successful in treating the symptoms of depression and anxiety, but they are not the most successful pharmacological treatment of ASD symptoms.
Which communication problems are common in patients with ASD? Select all that apply. Using a loud, shouting voice Speaking in a monotone voice Screaming in a persistent manner Using a sing-song pitch and rhythm Repeating song lyrics out of context during a conversation
Using a loud, shouting voice Using a loud, shouting voice is not a common communication problem associated with ASD patients. Speaking in a monotone voice Patients with ASD may speak in a monotone voice with no inflection of emotion. Screaming in a persistent manner Persistent screaming is not a common communication problem found in ASD. Using a sing-song pitch and rhythm Using a sing-song pitch and rhythm instead of a normal speaking voice is common in patients with ASD. Repeating song lyrics out of context during a conversation Patients with ASD may repeat lyrics to commercials or songs during conversations when the content of these lyrics do not parallel the conversation's content.
