A nurse at an inpatient facility is planning care for a child who has autism spectrum disorder. Which of the following interventions should the nurse include in the plan of care?
Keep staff visits with the child brief.
Vary daily routines when providing care for the child.
Place the child in a semiprivate room.
Keep the television on in the child's room for background noise.
The Correct Answer is A
A. This is the correct intervention. Children with autism spectrum disorder may have difficulty with social interactions and may become overwhelmed by prolonged or intense interactions. Keeping staff visits brief allows for positive interactions while minimizing potential stress for the child.
B. Children with autism spectrum disorder often thrive on routines and predictability.
Varying daily routines can be distressing and may lead to increased anxiety.
C. Placing the child in a semi-private room may expose them to additional stimuli and potential social interactions, which can be overwhelming for a child with an autism spectrum disorder. A private room may provide a quieter and more controlled environment.
D. Background noise, such as from a television, can be overstimulating for a child with autism spectrum disorder. It is generally recommended to provide a quiet environment to help the child feel more comfortable and at ease.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Absent nuchal rigidity is a positive sign in the context of managing bacterial
meningitis, but it alone does not determine when droplet precautions can be discontinued.
B. This is the correct answer. A negative cerebrospinal fluid (CSF) culture indicates that the bacterial infection has been effectively treated. Once the CSF culture is negative, the child is no longer considered contagious and can be removed from droplet precautions.
C. The initiation of antibiotics is an important step in treating bacterial meningitis, but the passage of time alone does not indicate when precautions can be discontinued. The
effectiveness of treatment is better determined by laboratory and clinical indicators.
D. The temperature is an important clinical parameter, but a temperature below 37.4° C (99.3° F) alone does not determine when droplet precautions can be discontinued. The decision is based on the resolution of the infectious process, as indicated by negative cultures.
Correct Answer is C
Explanation
A. Placing the child in the Trendelenburg position is not necessary for tracheostomy care. In fact, this position is generally not recommended for routine tracheostomy care.
B. Sterile technique, not clean technique, should be used when changing the tracheostomy tube to reduce the risk of infection.
C. This is the correct action. Having the child flex his head can help prevent tension on the tracheostomy ties and ensure a secure and comfortable fit.
D. Full-strength hydrogen peroxide is too harsh and can cause irritation to the skin around the stoma. It is recommended to use normal saline or a mild soap and water solution for cleaning.
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