MOD 25.2 Autism Spectrum Disorders

The nurse is caring for a child who is diagnosed with autism spectrum disorder (ASD). The child's parents ask the nurse, "What is the cause of ASD in our child?" Which response by the nurse is accurate? "ASD is most likely caused due a problem with the neurons in the frontal and temporal lobes of your child's brain." "ASD is caused by problems in the parietal and frontal lobes of your child's brain." "ASD is caused by trauma that happened at birth." "ASD is caused by arrested development of the brain in the uterus."

"ASD is most likely caused due a problem with the neurons in the frontal and temporal lobes of your child's brain." While the exact cause of ASD is unknown, it is thought to result from genetic abnormalities of the neurons in the frontal and temporal lobes. The construction of the brain is atypical in comparison to those without autism. MRIs and other imaging have shown there are abnormalities of neurons of the cerebral cortex. The frontal and temporal lobes are particularly susceptible to these abnormal neuron patches. The frontal lobe is responsible for social behaviors, motor function, problem solving, and other higher functions. The temporal lobe is responsible for language and sensory input. It is not caused by issues in the parietal lobe, by trauma at birth, or arrested development in utero.

The nurse is discussing the need for early diagnosis and treatment of autism spectrum disorder (ASD) with parents of children suspected of having the condition. Which statement should the nurse include? "Early diagnosis and treatment gives your child the best chance of becoming a fully functioning adult." "Early diagnosis and treatment provides the only means for a cure of ASD." "Early diagnosis and treatment provides the best way to ensure that your child can be admitted to an assisted living facility as an adult." "Early diagnosis and treatment prevents your child from developing any other mental condition."

"Early diagnosis and treatment gives your child the best chance of becoming a fully functioning adult." Early diagnosis and treatment of ASD provides access to treatments and therapies that give patients the best chance to become fully functioning adults. Undiagnosed or untreated ASD decreases quality of life and the likelihood that comorbid conditions such as depression will be identified. ASD is a lifelong condition and is not "cured." Early detection and treatment does not prevent the development of any other mental condition but allows for the early diagnosis and treatment of depression or anxiety. It does not help the adult with ASD enter into an assistive living facility. Additional Learning

The nurse is discussing medications that are used in treatment of autism spectrum disorder (ASD) with a parent of a child who was recently diagnosed with the condition. Which statement by the parent indicates the need for further teaching? "I will give my child aspirin to help with the symptoms of ASD. "I will monitor my child closely with any new medications." "I will note if my child has any increase in negative behaviors from medication. "I will watch to see if my child has any suicidal thoughts."

"I will give my child aspirin to help with the symptoms of ASD. Antipyretic agents are used to decrease body temperature and would not be appropriate for use in the treatment of a patient diagnosed with ASD. Children with autism might not respond to medications as other children do. Some negative behaviors might increase with medications. Other medications may cause severe depression and suicidal thoughts. Children with autism should be monitored closely when starting new medications. Previous

The nurse is assessing a 2-year-old toddler who is diagnosed with autism spectrum disorder. Which comment by the mother should lead the nurse to question the diagnosis? "My child loves to play with others." "My child engages in mostly solitary activity." "My child does not enjoy cuddling." "My child does not respond to conversations in the room."

"My child loves to play with others." The fact that the toddler enjoys playing with others would not support a diagnosis of ASD, while preferring solitary activity would support an ASD diagnosis. Many, but not all, children with ASD would not like to play with siblings, enjoy cuddling, or respond to conversation in the room.

The nurse is presenting to a group of parents whose children are suspected of having autism spectrum disorder (ASD). Which statement by the nurse should be included? "The features of autism are typically apparent by the time a child is 3 years of age." "You should notice deficits in your child by the age of 5." "A feature of ASD is the ability to understand nonverbal behavior." "A child with ASD should be able to successfully engage in imaginative play."

"The features of autism are typically apparent by the time a child is 3 years of age." The essential features of ASD (social deficits, language impairment, and repetitive behaviors) typically become apparent by the time a child is 3 years of age, not 5. The child with ASD is unable to read nonverbal behavior or engage in imaginative play.

The nurse is caring for a child who is diagnosed with autism spectrum disorder (ASD). The child's parents tell the nurse, "All tests were negative, so how did they diagnose our child with ASD?" Which response by the nurse is correct? "The presence of certain criteria outlined in the DSM-5 is the basis for your child's diagnosis." "Since all the tests are negative, ASD is the only answer left." "Your child's ASD was diagnosed by a special test that you were not aware of." "Your child has a positive electroencephalogram, which points to the presence of ASD."

"The presence of certain criteria outlined in the DSM-5 is the basis for your child's diagnosis." There is no diagnostic test or imaging that can diagnose autism. The presence of certain criteria, as outlined in the DSM-5, is the basis for diagnosis. The fact that all tests are negative does not necessarily point to ASD; certain criteria must also be present. A positive electroencephalogram (EEG) is used to rule out ASD.

The nurse is discussing nonpharmacologic interventions with the parents of a young child who was recently diagnosed with autism spectrum disorder (ASD). Which statement by the parents indicates that teaching was successful? "We are going to investigate applied behavior analysis as treatment." "I'm contacting my doctor to request starting chelation therapy." "I'm going to begin to give my child mineral solutions." "We will start encouraging echolalia in our child's speech."

"We are going to investigate applied behavior analysis as treatment." Applied behavior analysis is a form of behavior modification therapy that rewards the patient with ASD for positive behaviors like making eye contact or completing a sentence. Chelation therapy and mineral solutions are unproven and dangerous therapies. Echolalia is a compulsive parroting of a word or phrase that has just been spoken by another.

The nurse is teaching parents how to communicate with their child who is diagnosed with autism spectrum disorder (ASD). Which statement by the parents indicates that further teaching is necessary? "We will use more complete sentences in talking with our child." "We will use pictures in talking with our child." "We will take our child to speech and language therapy." "We will try using sign language with our child."

"We will use more complete sentences in talking with our child." Patients with ASD have difficulties communicating. To improve communication, parents should use short, direct sentences. Pictures or other visual aids or sign language may also be used to enhance communication. The patient should benefit from speech and language therapy.

The nurse is planning care for a young, nonverbal patient with autism spectrum disorder. In order to plan the best care for the child, which question is most important for the nurse to ask the child's parents? "What are some of your child's rituals that we can incorporate into daily care?" "How do you supervise your child to prevent infection?" "Which one method of communication is best to use with your child?" "How do you complete the activities for daily living for your child?"

"What are some of your child's rituals that we can incorporate into daily care?" An appropriate intervention for a patient with ASD is to incorporate the patient's rituals into daily care. The nurse would supervise the patient closely to enhance safety, not to prevent infection. The nurse would adapt communication style to meet the needs of the patient. The nurse would encourage the patient to participate fully in care. Therefore, the nurse would not complete all activities of daily living for the patient.

The nurse is conducting a teaching session for parents of children who have been diagnosed with autism spectrum disorder (ASD). A parent asks, "My child is high functioning. What should I expect of him as an adult?" Which response by the nurse is best? "Your child will most likely continue to struggle with communication skills." "Your child will comprehend nonverbal cues." "Your child will function normally with social interaction." Unselected "Your child will most likely function independently."

"Your child will most likely continue to struggle with communication skills." Even high-functioning adults with ASD continue to struggle with communication skills, especially understanding nonverbal communication and socialization. Many adults with ASD cannot function independently.

The parents of a child with autism spectrum disorder (ASD) tell the nurse that they have decided to try nutrition therapy. Which diet should the nurse expect will be suggested for the child? A gluten-free, casein-free diet A low-fat, low-sodium diet The Paleo diet The Atkins diet

A gluten-free, casein-free diet A popular option for treating ASD is a gluten-free, casein-free diet. Since there is anecdotal evidence that the behavior of some children improves on this diet, many parents opt to try it with their children. A low-fat, low-sodium diet and the Paleo diet are used to treat heart disease. The Atkins diet is a reduced-carbohydrate diet.

Which medication should the nurse expect to find on the medication administration record​ (MAR) for a child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Stimulant B. Beta blocker C. ​Angiotensin-converting enzyme​ (ACE) inhibitor D. Selective serotonin reuptake inhibitor​ (SSRI) E. Mood stabilizer

A. Stimulant D. Selective serotonin reuptake inhibitor​ (SSRI) E. Mood stabilizer Rationale: While there is no medication to cure​ ASD, medications are prescribed to manage behaviors and symptoms. These medications include​ stimulants, SSRIs, and mood stabilizers. ACE inhibitors and beta blockers are used to treat hypertension.

While assessing a 5-year-old boy with autism spectrum disorder (ASD), the nurse notices that the boy is standing near his mother playing with a teddy bear and does not respond to the nurse's greeting. Which approach is most appropriate for the nurse to use? Allowing the patient to stay next to his mother with the teddy bear and speaking to him calmly and concisely Explaining that this is not at all unusual and that there is not much that can be done, because this is the normal progression of the disorder Engaging as little as possible with the patient, so as not to upset him more, and keeping to the task at hand Telling the mother that her son is too old to play with teddy bears

Allowing the patient to stay next to his mother with the teddy bear and speaking to him calmly and concisely It is best to allow the patient to stay near his mother and keep the teddy bear, which will help him accept the new environment and activities that will be taking place. Using the patient's name before saying hello will help him recognize that he is being spoken to. The other answers would not be helpful to the patient.

The nurse is teaching a new colleague about medications that are used to treat autism spectrum disorder (ASD). When the nurse asks the colleague to list the medications that may be used, which response indicates a need for further teaching? Antipyretic agents Stimulant agents Selective serotonin reuptake inhibitors (SSRIs) Mood stabilizers

Antipyretic agents Medications that are used in the treatment of ASD include stimulant agents, SSRIs, and mood stabilizers. Antipyretic agents are used to decrease body temperature and would not be appropriate for use in the treatment of a patient who is diagnosed with ASD.

The graduate nurse is caring for a family with a child who was recently diagnosed with autism spectrum disorder (ASD) and is discussing treatment options for the child. Which goal of collaborative therapy would require correction from the preceptor? Behavior modification through electroconvulsive therapy Advocating for parent support and coping groups Use of focusing techniques and behavior management Implementing treatments that decrease maladaptive behaviors such as rigidity and stereotypy

Behavior modification through electroconvulsive therapy The goals of therapy for a child with ASD and their family include advocating for parent support and coping groups, using focused techniques and behavior management, and implementing treatments that decrease maladaptive behaviors. While behavior modification may be a goal of treatment, electroconvulsive therapy is not a treatment option for children with ASD.

The parents of a child who is diagnosed with autism spectrum disorder (ASD) tell the nurse that they wish to put their child on a gluten-free, casein-free diet. Which foods should the nurse instruct the parents to avoid feeding their child? Bread and milk Fish and fruit Red meat and green, leafy vegetables Rice and eggs

Bread and milk A gluten-free, casein-free diet eliminates the proteins found in wheat and dairy products. The child should avoid bread, milk, and cheese because they are made from grains or dairy. All other foods can be consumed.

he nurse is reviewing the medical record of a​ 6-year-old client diagnosed with autism spectrum disorder​ (ASD). Which item in the health history should the nurse consider may have been a factor in the client developing​ ASD? A. Appropriate adaptation to new environments B. Postterm birth C. Fetal alcohol syndrome D. Childhood vaccinations

C. Fetal alcohol syndrome Rationale: The ingestion of​ alcohol, tobacco, and toxic substances has been known to cause birth defects.​ Therefore, fetal alcohol syndrome could possibly be a factor in the development of ASD. Childhood vaccinations have not been proven to cause ASD. Appropriate adaptation to new environments and postterm birth have no link to ASD.

The nurse is developing a plan of care for a client diagnosed with autism spectrum disorder​ (ASD). Which nursing diagnosis is most appropriate for the nurse to​ include? A. ​Macrocephaly, Risk for B. ​Infection, Risk for C. ​Communication: Verbal, Impaired D. Airway​ Clearance, Ineffective

C. ​Communication: Verbal, Impaired ​Rationale: ​Communication: Verbal, Impaired is an appropriate nursing diagnosis for a client with ASD. ​Macrocephaly, Risk for is not a nursing diagnosis. The client with ASD is not at risk for infection or ineffective airway clearance.​ (NANDA-I ©2014)

The nurse is assessing a 3-year-old child for symptoms of autism spectrum disorder (ASD). Which assessment finding should lead the nurse to question the diagnosis? Comprehends language well beyond the complexity of age Inability to react accordingly to social clues Engages in repetitive behaviors Displays self-destructive behavior

Comprehends language well beyond the complexity of age While children with autism may have high IQs, they do not understand the nuances of language and therefore do not comprehend well beyond the complexity of their age, so this is not a clinical manifestation that supports the diagnosis. Clinical manifestations that support the diagnosis of ASD include the inability to react accordingly to social cues, engaging in repetitive behaviors, and displaying self-destructive behavior.

The nurse is caring for an elderly patient with a history of autism spectrum disorder (ASD). For which condition should the nurse screen the patient? Depression Schizophrenia Diabetes mellitus Unselected Gout

Depression The elderly patient with ASD has an increased likelihood of developing depression. Schizophrenia does not develop as a result of ASD. There is no evidence that patients with ASD are more likely to develop gout or diabetes mellitus than the normal population.

The nurse is preparing discharge teaching for the parents of a child who is diagnosed with autism spectrum disorder (ASD). Which instruction should the nurse include? Encouraging repetition of treatments at home Emphasizing that the patient will never be normal Avoiding childhood vaccinations until adulthood Teaching the patient to consume foods that are rich in gluten

Encouraging repetition of treatments at home The nurse would encourage repetition of treatments for a patient at home in order to enhance effective treatment. It is not appropriate for the nurse to emphasize that the patient will never be normal. It is not necessary to avoid childhood vaccinations. The nurse would teach the patient not to consume foods that are rich in gluten.

The nurse is reviewing the medical record of a 6-year-old patient who is diagnosed with autism spectrum disorder (ASD). Which item in the health history should the nurse consider may have been a factor in the patient's development of ASD? Fetal alcohol syndrome Appropriate adaptation to new environments Childhood vaccinations Cystic fibrosis

Fetal alcohol syndrome History of maternal alcohol use during pregnancy may have contributed to the development of ASD. Childhood vaccinations and cystic fibrosis are not linked to ASD. The ability to adapt to new environments is an appropriate goal, not a cause, for a patient who is diagnosed with ASD.

The parents of a child diagnosed with autism spectrum disorder (ASD) are trying to determine why their child has the disorder. In response, the nurse should include which etiology? Genetic factors Chemical factors Psychological factors Toxins

Genetic factors Genetic factors are seen as being one of the associated causes of autism spectrum disorder. Those with autism have defects in the genes and gene expression in the areas of cell-cycle expression. The other responses are not thought to cause ASD.

he nurse admits a child suspected of having autism spectrum disorder (ASD). Which test to aid in the diagnosis should the nurse question? Head x-ray Electrocardiogram (EEG) Computerized tomography (CT) scan Lead screening

Head x-ray

The nurse takes a team approach to help a middle-age patient who is diagnosed with autism spectrum disorder (ASD) achieve their full potential. The nurse uses a community center to help find a job for the patient. Which strategy should the nurse engage to allow this patient to have the best opportunity for success? Helping the patient find a position that will allow them to use their strongest talents Making sure the job is an easy one Partnering the patient with someone else at work so that they can keep an eye on them at all times None, as those with ASD generally cannot work because the disorder is too debilitating to allow them to be productive community members

Helping the patient find a position that will allow them to use their strongest talents Individuals with ASD have the greatest chance of success with training and finding opportunities that use their strengths. Many are active members of the community, while others need more support.

The nurse is caring for a patient who is diagnosed with autism spectrum disorder (ASD). Which nursing intervention is most appropriate for the nurse to use? Incorporating the patient's rituals into daily care Supervising the patient closely to prevent infection Using one method of communication with the patient Completing activities of daily living for the patient

Incorporating the patient's rituals into daily care An appropriate intervention for a patient with ASD is to incorporate the patient's rituals into daily care. The nurse would supervise the patient closely to enhance safety, not to prevent infection. The nurse would adapt communication style to meet the needs of the patient. The nurse would encourage the patient to participate fully in care. Therefore, the nurse would not complete all activities of daily living for the patient.

he nurse is assessing a high-functioning adult patient who is diagnosed with autism spectrum disorder (ASD). The nurse will most likely observe which characteristic in this patient? Language skills and sentence formation Comprehending nonverbal clues Social interaction Flexibility of thought

Language skills and sentence formation A high-functioning adult with ASD will most likely have language skills and be able to form full sentences, however, they may still have difficulty comprehending nonverbal cues, difficulty in social interactions, and difficulty in flexibility of thought.

The nurse is teaching about autism spectrum disorder to a group of community members. Which risk factor should the nurse include? Maternal age over 40 Female gender Paternal age less than 20 Parents who are close in age

Maternal age over 40 Risk factors for autism spectrum disorder (ASD) include advanced maternal age (greater than 40), paternal age greater than 50, male gender, and having parents with an age disparity of greater than 10 years.

A preschool-age patient was recently diagnosed with autism spectrum disorder (ASD). The nurse should consider which observation of the patient to be supportive of the diagnosis? Rocking on the exam table Sitting quietly during the assessment Wanting to be held by the parent during the assessment Actively participating with the nurse during the assessment

Rocking on the exam table Performing a physical assessment of patients with ASD can present many challenges. Patients diagnosed with ASD may not sit still for the assessment and can display flapping, rocking or head-banging as a way to self-soothe during the assessment process. Patients who have sensory deficits or behaviors often do not like being touched and show a disinterest in being cuddled. These patients also do not like quick transitions and generally will not actively participate in the assessment process.

The nurse is planning the care for a patient who is admitted to the hospital for a tonsillectomy. The patient is also diagnosed with autism spectrum disorder (ASD). Which goal is appropriate for the nurse to include in the plan of care for the patient? The patient will demonstrate behavior that is not self-destructive. The patient will try new foods during hospitalization. The patient will allow the nurse to perform all activities of daily living. The patient will not socialize with other children in the same age group.

The patient will demonstrate behavior that is not self-destructive. An appropriate goal for this patient is to demonstrate behaviors that are not self-destructive. It is important for the child who is diagnosed with ASD to maintain home rituals. Therefore, it is not appropriate for the patient to try new foods during hospitalization. The patient should have a goal of independently performing activities of daily living during hospitalization. The nurse would encourage socialization with other children in the same age group, not discourage it.

The nurse is assessing a​ high-functioning adult client who is diagnosed with autism spectrum disorder​ (ASD). Which characteristic of ASD should the nurse anticipate this client will demonstrate during the nursing​ assessment? (Select all that​ apply.) A. Understanding body language B. Having trouble with double meanings C. Displaying problems with sentence structure D. Lacking the ability to participate in small talk E. Choosing inappropriate topics to discuss

​ A. Understanding body language B. Having trouble with double meanings D. Lacking the ability to participate in small talk E. Choosing inappropriate topics to discuss Rationale: Socialization and​ communication, especially understanding nonverbal​ communication, are lifelong struggles for the adult with ASD. Behaviors that the nurse will anticipate during the assessment include choosing inappropriate topics to​ discuss, not engaging in small​ talk, understanding body​ language, and having trouble with double meanings. The nurse would not expect the adult client with ASD to display problems with sentence structure.

Which intervention is most appropriate for the nurse to include in the plan of care for a child with autism spectrum disorder​ (ASD)? A. Scheduling procedures for different times each day B. Encouraging the​ client's family to bring in familiar objects from home C. Putting the television on loud to provide stimulation for the client D. Rearranging the hospital room until a comfortable arrangement is found

​ B. Encouraging the​ client's family to bring in familiar objects from home Rationale: Clients with ASD need structure and a predictable course of action. Bringing in familiar objects from home provides comfort for the client. It is important for the nurse to be oriented to the room and care should be taken not to relocate objects in the environment. Clients with ASD are sensitive to loud noises and bright​ lights, so the television should be turned off to minimize stimuli that may distress the client. Procedures should be scheduled for the same time to maintain predictability.

The nurse is teaching the parents of a child recently diagnosed with autism spectrum disorder​ (ASD). Which etiologies should the nurse​ include? (Select all that​ apply.) A. Neurotransmitters B. ​Mercury-containing vaccinations C. Environmental factors D. Genetics E. Immunologic factors

​ A. Neurotransmitters C. Environmental factors D. Genetics E. Immunologic factors Rationale: The etiology of ASD is​ uncertain, but it is believed to be the result of an intricate​ co-action between​ genetic, immunologic, and environmental circumstances. There is research being conducted on the role of​ neurotransmitters, such as dopamine and serotonin. There is no evidence that​ mercury-containing vaccinations cause autism.

The nurse is assessing a​ 3-year-old child with autism spectrum disorder​ (ASD). In which area should the nurse expect to find​ impairments? (Select all that​ apply.) A. Ability to organize responses to situations B. Social interactions C. Ability to engage in complex thought process D. Social adaptability E. Communication

​A. Ability to organize responses to situations C. Ability to engage in complex thought process D. Social adaptability E. Communication Rationale: Impairments are noted in the social interactions and ability to adapt socially at the appropriate age level. The young child with ASD will have a decreased ability to communicate as well as an inability to organize situational responses.​ Developmentally, the​ 3-year-old is not old enough for complex thought.

The nurse admitting a child who is suspected of having autism spectrum disorder​ (ASD) knows that it is necessary to rule out medical causes for the​ child's behavior before diagnosing ASD. Which diagnostic test should the nurse anticipate will be ordered for the​ client? (Select all that​ apply.) A. DNA analysis B. Electroencephalography C. CT scan D. KUB​ x-ray E. ABG

​A. DNA analysis B. Electroencephalography C. CT scan Rationale: To rule out medical causes for behavior in a suspected ASD​ client, the healthcare provider should order a CT scan or​ MRI, DNA​ analysis, lead​ screening, and electroencephalography. A KUB​ x-ray is a radiograph of the​ kidneys, ureters, and bladder. ABGs are arterial blood gases and are used to measure the amounts of oxygen and carbon dioxide in the blood. They are not used to rule out ASD.

Which assessment finding should the nurse expect in a child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Echolalia B. Reiteration of questions as opposed to answering them C. Enchantment with rhythmic repetition of verse or song D. Stuttering E. Use of the word you to represent I

​A. Echolalia B. Reiteration of questions as opposed to answering them C. Enchantment with rhythmic repetition of verse or song E. Use of the word you to represent I Rationale: Echolalia​ (parroting a particular word or​ phrase), repetition of inquiries rather than responding to​ them, using you to represent ​I, and fascination with things that are lyrical in nature such as a song or verse are typical speech pattern abnormalities for children diagnosed with ASD. Stuttering is not a clinical manifestation associated with ASD.

Which teaching point is important for the nurse to include in the plan of care for a client who is diagnosed with autism spectrum disorder​ (ASD)? A. Establishing a routine B. Focusing on limitations in order to see progress in care C. Keeping the same pediatric healthcare provider for all children in the family D. Maintaining the home as a​ treatment-free zone

​A. Establishing a routine Rationale: Clients who are diagnosed with ASD thrive when routines are established and followed. The family should consider seeking a healthcare provider who has experience in treating a child with ASD. Therapies must be practiced and implemented in the home environment in order to be effective. The family would focus on the​ child's strengths, not the​ child's limitations.

Which instruction should the nurse include when teaching the parents of a​ 3-year-old child with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Providing methods to decrease the incidence of head banging B. Establishing therapies to assist with building play skills C. Providing for play with other children of the same age D. Administering stimulants to calm repetitive motions E. Teaching problem solving regarding client issues

​A. Providing methods to decrease the incidence of head banging B. Establishing therapies to assist with building play skills C. Providing for play with other children of the same age E. Teaching problem solving regarding client issues Rationale: Clients with ASD have behaviors that interfere with functioning and can be harmful to​ them, such as banging their head or hitting solid objects. Provide clients who have ASD with early physical and occupational therapy that may be beneficial in developing some play and social skills. Clients with ASD may keep themselves in​ isolation, and assisting the clients to be able to be in the presence of others is a focus of treatment. The client with autism spectrum disorder may not progress to living​ independently; therefore, parents need to learn​ problem-solving skills to assist them and the client throughout life. Stimulants are a​ pharmacologic, not​ nonpharmacologic, treatment for autism spectrum disorder.

Study Plan 25-2.3.3 The nurse is teaching the family of a client diagnosed with autism spectrum disorder​ (ASD) about a​ gluten-free and​ casein-free diet. Which food should the nurse​ include? (Select all that​ apply.) A. Soy milk B. Cheese C. Cornmeal D. Yogurt E. Grilled salmon

​A. Soy milk C. Cornmeal E. Grilled salmon Rationale: A​ gluten-free and​ casein-free diet eliminates wheat and dairy products. Foods that support a​ gluten-free and​ casein-free diet include​ cornmeal, grilled​ salmon, and soy milk. Cheese and yogurt are​ casein-rich foods.​ Therefore, they should be avoided.

Which intervention is an appropriate nonpharmacologic treatment for the nurse to include in the plan of care for a client with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Encouraging parents not to vaccinate their children B. Establishing support for the parents and family C. Creating an environment that is conducive to positive behavior management D. Teaching the family about studies on complementary care E. Promoting enhanced communication

​B. Establishing support for the parents and family C. Creating an environment that is conducive to positive behavior management D. Teaching the family about studies on complementary care E. Promoting enhanced communication Rationale: Children with ASD will benefit from the following nonpharmacologic treatment​ options: establishing support for the parents and​ family; creating an environment that is conducive to positive behavior​ management; promoting enhanced​ communication; and educating the family about studies on the use of complementary care. Discouraging parents from vaccinating their children is not an appropriate treatment option for children with ASD.

The nurse is teaching the parents of a child with autism spectrum disorder​ (ASD) who is being treated with a​ gluten-free and​ casein-free diet. Which food should the nurse teach the parents to eliminate in the​ child's diet?​ (Select all that​ apply.) A. Corn B. Grain C. Milk D. Beef E. Cheese

​B. Grain C. Milk E. Cheese Rationale: Foods that should be avoided include grains and dairy​ products, such as milk and cheese. Corn and beef can be consumed when following a​ gluten-free and​ casein-free diet. Clients considering a​ gluten-free and​ casein-free diet should be referred for​ counseling, so as to be able to meet the​ child's nutritional needs.

The nurse assesses a child suspected of having autism spectrum disorder​ (ASD). Which behavior noted in the assessment supports the​ diagnosis? (Select all that​ apply.) A. Deep set eyes B. Stereotypy C. Emotional calm D. An aversion to being touched E. Echolalia

​B. Stereotypy D. An aversion to being touched E. Echolalia Rationale: Behaviors indicative of ASD include stereotypy​ (rigid and obsessive​ behavior), echolalia​ (the compulsive parroting of a word or phrase just stated by​ another), and an aversion to being touched. Emotional lability​ (rapid, significant mood​ changes), not emotional​ calm, is a clinical manifestation of ASD. ASD does not manifest in any physical signs.

The nurse is planning care for a client who is diagnosed with autism spectrum disorder​ (ASD). Which goal is appropriate for the nurse to​ include? A. The client will engage in private activities to stimulate learning. B. The client will demonstrate negative communication skills. C. The client will display developmental progress. D. The client will remain free from infection.

​C. The client will display developmental progress. Rationale: An appropriate goal when providing care to a client diagnosed with ASD is for the client to display developmental progress. Other appropriate goals include the client remaining free of​ injury, the client demonstrating positive communication​ skills, and the client participating in activities with family members or small groups of peers.

Which instruction should the nurse include when teaching parents strategies to enhance communication with a child diagnosed with autism spectrum disorder​ (ASD)? (Select all that​ apply.) A. Speaking loudly B. Using complex words to stimulate the​ child's vocabulary C. Using​ pictures, computers, or other visual aids D. Using​ short, direct sentences E. Considering using sign language

​C. Using​ pictures, computers, or other visual aids D. Using​ short, direct sentences E. Considering using sign language Rationale: Clients with ASD have impaired communication skills. Strategies to improve communication include using​ short, direct sentences that are easy to​ understand, supplementing verbal communication with the use of​ pictures, computers, or other visual​ aids, and using sign language. Deafness is not a clinical manifestation of​ ASD, so speaking loudly will not improve communication and will distress the client.​ Simple, not​ complex, words and sentences are best for communication with the client with ASD.

Which resource should the nurse expect the healthcare provider to use to confirm the diagnosis of autism spectrum disorder​ (ASD)? A. The Mental Health Rights Manual B. The Autism Handbook C. Teaching Social Communication to Families with Autism D. Diagnostic and Statistical Manual of Mental Disorders

​D. Diagnostic and Statistical Manual of Mental Disorders Rationale: Criteria for diagnosis can be found in the American Psychiatric​ Association's Diagnostic and Statistical Manual of Mental Disorders​, 5th edition​ (DSM-5), which includes screening tests to identify tendencies consistent with ASD. Although the other resources may be helpful in teaching the client and the family about​ ASD, they are not used as a diagnostic tool.

The nurse is assessing a toddler client for an upper respiratory infection. The nurse suspects the child may have autism spectrum disorder​ (ASD). Which behavior caused the​ nurse's suspicion? A. Crying after the administration of immunizations B. Playing with the other children and toys while awaiting the nurse C. Speaking to the nurse in sentences D. Having a tantrum when touched by the nurse

​D. Having a tantrum when touched by the nurse Rationale: An assessment finding that supports the diagnosis of ASD is having a tantrum when touched by the healthcare provider. It is not uncommon for the child with ASD to display an inability to attend and systematize situational reactions. Playing with other​ children, speaking to the nurse in​ sentences, and crying after the administration of immunizations are not findings that support ASD. These assessment findings are age appropriate for the client.

The home care nurse is visiting a child diagnosed with autism spectrum disorder​ (ASD). Which intervention is appropriate for the nurse to include in the treatment plan for this​ family? A. Focusing on the​ child's limitations B. Recommending that the home be a​ therapy-free zone C. Encouraging the family to get over negative feelings regarding the diagnosis D. Providing appropriate education regarding what to expect for the child

​D. Providing appropriate education regarding what to expect for the child Rationale: An appropriate intervention for the family of a child diagnosed with ASD is for the nurse to provide education about what to expect. The nurse would encourage the family to grieve the loss of the​ "perfect child" and encourage the parents to focus on the​ child's strengths and talents. In order for therapy to be​ effective, the nurse would recommend that treatments be continued at home.