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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. Pinpoint pupils are a characteristic sign of opioid overdose, not inhalation of gasoline.
B. Correct. Ataxia (lack of coordination) can be a neurological symptom associated with inhalation of gasoline or other volatile substances. These substances can affect the central nervous system and lead to impaired coordination.
C. Hyperactive reflexes are not a typical finding associated with inhalation of gasoline.

This is more characteristic of conditions like hyperthyroidism or certain neurological disorders.
D. Hypothermia is not a typical finding associated with inhalation of gasoline. It is more likely to cause symptoms related to the central nervous system and respiratory system.

A. Dark brown blood noted in emesis B. Axillary temperature 38° C (100° F) C. Child reports pain level of 5 on the FACES scale D. Frequent swallowing

Correct Answer is D

Explanation

A. Dark brown blood in emesis is expected postoperatively due to swallowed blood and does not require immediate intervention.
B. A mild fever (38°C or 100°F) can occur postoperatively and is not an emergency.
C. Pain is expected after a tonsillectomy and should be managed but does not require immediate intervention.
D. Frequent swallowing may indicate active bleeding from the surgical site, which requires immediate assessment and intervention.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse in an emergency department is assessing an adolescent who reports inhalation of gasoline. Which of the following findings should the nurse expect?

Correct Answer is B

Explanation

A nurse is caring for a child in the PACU following a tonsillectomy. Which of the following findings requires immediate intervention by the nurse?

Correct Answer is D

Explanation

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