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A child diagnosed with autism is hospitalized in an inpatient mental health unit. When developing the plan of care for this child, which of the following would the nurse most likely include?
- A. Ensuring that a variety of caregivers are available for the child
- B. Providing a consistent, structured environment with predictable routines
- C. Allowing the child frequent visits off the unit to provide stimulation
- D. Sending the child to the time out area if the child repeats phrases continually
Correct Answer: B
Rationale: Children with autism thrive in consistent, structured environments with predictable routines, as these reduce anxiety and support behavioral stability. Option A is counterproductive, as multiple caregivers can disrupt consistency. Option C may overstimulate the child, and option D is inappropriate for managing repetitive behaviors typical of autism.
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The nurse is caring for a 3½-year-old child with autism who has been hospitalized. The child rocks continuously without any danger present to the child?s safety. Which intervention by the nurse would be most appropriate?
- A. Continue to monitor the child?s behaviors.
- B. Hold the child until the child stops rocking.
- C. Ignore the child?s rocking behavior.
- D. Place the child in a time out area until the rocking stops.
Correct Answer: C
Rationale: Rocking is a common self-soothing behavior in children with autism and is not harmful in this context. Ignoring the behavior (option C) is most appropriate, as it avoids reinforcing or escalating the behavior while ensuring safety. Option A is passive and less specific. Options B and D could distress the child and are inappropriate for non-harmful behaviors.
A group of nursing students is reviewing information about disruptive behavior disorders. The students demonstrate understanding of the topic when they identify which of the following as an externalizing disorder?
- A. Anxiety
- B. Depression
- C. Schizophrenia
- D. Conduct disorder
Correct Answer: D
Rationale: Conduct disorder is an externalizing disorder characterized by behaviors like aggression and rule-breaking, which are outwardly directed. Anxiety (option A), depression (option B), and schizophrenia (option C) are internalizing or psychotic disorders, not externalizing.
The nurse is giving a presentation comparing and contrasting autism disorder and Asperger syndrome. Which of the following would the nurse include as differentiating Asperger syndrome from autism disorder?
- A. Children typically do not engage in stereotypic behavior.
- B. They display age-appropriate intelligence.
- C. The children often reverse pronouns when speaking.
- D. They appear aloof and indifferent to others.
Correct Answer: B
Rationale: Asperger syndrome is distinguished from autism by the presence of age-appropriate intelligence and language development, though social challenges persist. Option A is incorrect, as stereotypic behaviors may still occur in Asperger?s. Option C is more typical of autism, not Asperger?s. Option D applies to both conditions and does not differentiate them.
The nurse is counseling a family whose 4-year-old child has mild mental retardation. The nurse is working with the family on realistic long-term goals. Which of the following would be most appropriate?
- A. Locating suitable residential placement for the child
- B. Finding a foster home for the child
- C. Achieving independent functioning of the child as an adult
- D. Preventing the onset of psychiatric disorders in the child
Correct Answer: C
Rationale: For a child with mild mental retardation, realistic long-term goals focus on maximizing independence to the extent possible. Mild mental retardation typically allows individuals to achieve some level of independent functioning as adults, such as living in supported environments or performing simple jobs with guidance. Options A and B (residential placement or foster home) are premature and not necessarily appropriate for mild cases, as they imply more severe disability. Option D is less feasible, as psychiatric disorders may not be preventable due to the complexity of mental health conditions.
The nurse is preparing to initiate a behavioral treatment program for a child with encopresis. Which of the following would the nurse most likely implement first?
- A. Administration of mineral oil
- B. Bowel Cleansing
- C. Low-fiber diet
- D. Toilet sitting after each meal
Correct Answer: B
Rationale: For encopresis, the first step is typically bowel cleansing to address any fecal impaction, which can contribute to involuntary soiling. Mineral oil (option A) or toilet sitting (option D) may follow, and a low-fiber diet (option C) is counterproductive, as high fiber is preferred.