25.B: Autism Spectrum Disorder (ASD)

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.Using​ pictures, computers, or other visual aids B.Considering using sign language C.Using complex words to stimulate the​ child's vocabulary D.Using​ short, direct sentences E.Speaking loudly

A, B, D ​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.

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. Having a tantrum when touched by the nurse B. Playing with the other children and toys while awaiting the nurse C. Crying after the administration of immunizations D. Speaking to the nurse in sentences

A. 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 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? a. Advocating for parent support and coping groups b. Use of focusing techniques and behavior management c. Implementing treatments that decrease maladaptive behaviors such as rigidity and stereotype d. Behavior modification through electroconvulsive therapy

d. 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.

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? a. Sitting quietly during the assessment b. Wanting to be held by the parent during the assessment c. Actively participating with the nurse during the assessment d. Rocking on the exam table

d. 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? a. The patient will try new foods during hospitalization. b. The patient will allow the nurse to perform all activities of daily living. c. The patient will not socialize with other children in the same age group. d. The patient will demonstrate behavior that is not self-destructive.

d. 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 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.Echolalia C.Emotional calm D.Stereotypy E.An aversion to being touched

B, D, E ​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.

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. Beta blocker B.​ Angiotensin-converting enzyme​ (ACE) inhibitor C. Mood stabilizer D. Selective serotonin reuptake inhibitor​ (SSRI) E. Stimulant

C, D, E 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.

Mothers of age greater than ___ years and fathers of age ___ years are at greater risk to have a child with autism than other ages.

Mothers of age greater than 30 years and fathers of age 50 years are at greater risk to have a child with autism than other ages.

A child with autism will likely present with which of the following? [SATA] a. Sterotypy b. Extreme aversion to touch, loud noises, and bright lights c. Echolalia d. Emotional lability e. Using "you" in place of "I" when speaking f. Anger management issues

a, b, c, d, e

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? a. "The features of autism are typically apparent by the time a child is 3 years of age." b. "You should notice deficits in your child by the age of 5." c. "A feature of ASD is the ability to understand nonverbal behavior." d. "A child with ASD should be able to successfully engage in imaginative play."

a. "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 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? a. "We will use more complete sentences in talking with our child." b. "We will use pictures in talking with our child." c. "We will take our child to speech and language therapy." d. "We will try using sign language with our child."

a. "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? a. "What are some of your child's rituals that we can incorporate into daily care?" b. "How do you supervise your child to prevent infection?" c. "Which one method of communication is best to use with your child?" d. "How do you complete the activities for daily living for your child?"

a. "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 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? a. Bread and milk b. Fish and fruit c. Red meat and green, leafy vegetables d. Rice and eggs

a. 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.

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? a. Depression b. Schizophrenia c. Diabetes mellitus d. Gout

a. 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.

A compulsive parroting of a word or phrase just spoken by another seen in ASD. a. Echolalia b. Sterotypy c. Stimulants d. Hyperkinesis

a. Echolalia

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? a. Genetic factors b. Chemical factors c. Psychological factors d. Toxins

a. 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.

Autism spectrum disorder is more common in a. Males b. Females

a. Males 1 in 42 males 1 in 189 females

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

a. Maternal age over 40

Which of the following are core characteristics of autism? [SATA] a. Hyperactivity/impulsiveness b. Social deficits c. Lack of appetite d. Language impairment e. Repetitive behaviors

b, d, e

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? a. "Early diagnosis and treatment provides the only means for a cure of ASD." b. "Early diagnosis and treatment gives your child the best chance of becoming a fully functioning adult." c. "Early diagnosis and treatment provides the best way to ensure that your child can be admitted to an assisted living facility as an adult." d. "Early diagnosis and treatment prevents your child from developing any other mental condition."

b. "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.

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? a. "I'm contacting my doctor to request starting chelation therapy." b. "We are going to investigate applied behavior analysis as treatment." c. "I'm going to begin to give my child mineral solutions." d. "We will start encouraging echolalia in our child's speech."

b. "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 addressing a group of parents whose children are suspected of having autism spectrum disorder (ASD).Which statement by the parents indicates that additional teaching is necessary? a. "The essential features of autism are typically noticed by 3 years of age." b. "We should notice deficits in our children by the age of 5." c. "A feature of ASD is the inability to understand nonverbal behavior." d. "A child with ASD should will not engage in imaginative play.

b. "We should notice deficits in our children by the age of 5." 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 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? a. "Your child will comprehend nonverbal cues." b. "Your child will most likely continue to struggle with communication skills." c. "Your child will function normally with social interaction." d. "Your child will most likely function independently."

b. "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.

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? a. 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 b. Allowing the patient to stay next to his mother with the teddy bear and speaking to him calmly and concisely c. Engaging as little as possible with the patient, so as not to upset him more, and keeping to the task at hand d. Telling the mother that her son is too old to play with teddy bears

b. 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 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? a. Making sure the job is an easy one b. Helping the patient find a position that will allow them to use their strongest talents c. Partnering the patient with someone else at work so that they can keep an eye on them at all times d. None, as those with ASD generally cannot work because the disorder is too debilitating to allow them to be productive community members

b. Helping the patient find a position that will allow them to use their strongest talents 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.

Rigid and obsessive behavior seen in children with autism spectrum disorder. Manifests as head banging, twirling in circles, biting themselves, and flapping hands/arms. a. Echolalia b. Sterotypy c. Stimulants d. Hyperkinesis

b. Sterotypy

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? a. "ASD is caused by problems in the parietal and frontal lobes of your child's brain." b. "ASD is caused by trauma that happened at birth." c. "ASD is most likely caused due a problem with the neurons in the frontal and temporal lobes of your child's brain." d. "ASD is caused by arrested development of the brain in the uterus."

c. "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 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? a. "I will monitor my child closely with any new medications." b. "I will note if my child has any increase in negative behaviors from medication." c. "I will give my child aspirin to help with the symptoms of ASD." d. "I will watch to see if my child has any suicidal thoughts.

c. "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.

The nurse is discussing clinical manifestations with a group of parents of children who have been diagnosed with autism spectrum disorder (ASD). Which statement by a parent should lead the nurse to question the diagnosis of their child? a. "My child is not able to react to social cues." b. "My child engages in repetitive behaviors." c. "My child understands the language of older children." d. "My child displays self-destructive behavior."

c. "My child understands the language of older children." 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 performing discharge teaching for a child who is diagnosed with autism spectrum disorder (ASD) with the child's parents. Which statement by the parents indicates that the teaching was successful? a. "We will remind our child that he will never be normal." b. "We will avoid all childhood vaccinations until our child reaches adulthood." c. "We will repeat treatments performed at the clinic and hospital at home." d. "We will feed our child a diet that is rich in gluten.

c. "We will repeat treatments performed at the clinic and hospital at home." The nurse would encourage repetition of treatments for the 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 educate the patient not to consume foods rich in gluten.