A nurse is planning care for a school-aged child who has autism spectrum disorder and is nonverbal. Which of the following interventions should the nurse include in the plan of care?

Provide positive reinforcement when the child uses eye contact.

Administer haloperidol to the child as prescribed.

Administer tranquilizing medications if the child becomes frustrated.

Instruct the child's guardian on the use of implosion therapy.

Answer and Explanation

The Correct Answer is A

A. Provide positive reinforcement when the child uses eye contact: Positive reinforcement is an effective strategy for children with autism, especially for improving communication behaviors like eye contact. It encourages social interaction in a non-overwhelming way.
B. Administer haloperidol to the child as prescribed: Haloperidol is an antipsychotic used for certain symptoms in ASD, but its use should be carefully monitored. Medication is not the first line for addressing communication challenges in children with ASD.
C. Administer tranquilizing medications if the child becomes frustrated: Using tranquilizing medications as a first response is inappropriate. Non-pharmacological approaches, like behavior modification, should be prioritized to manage frustration and other symptoms.
D. Instruct the child's guardian on the use of implosion therapy: Implosion therapy, which involves exposing the child to anxiety-provoking situations, is not appropriate for children with ASD. It can increase distress and is not suitable for managing the child's needs.

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Correct Answer is A

Explanation

A. Stay with the client for 15 min following meals: Staying with the client for 15 minutes after meals is a common practice to ensure that they do not engage in behaviors like purging or hiding food. It provides supervision and support to prevent the client from engaging in harmful activities.

B. Weigh the client every day for the first week of acute care: Weighing the client daily is not typically recommended, as it may increase anxiety and focus on weight. Weighing may be done periodically, but the frequency should be tailored to the client’s needs and the treatment.

C. Schedule the client for a daily exercise program: Exercise may be restricted or minimized in clients with anorexia nervosa, especially in the acute phase of treatment, as excessive exercise can worsen the condition and interfere with recovery.

D. Discuss food-related topics with the client during meals: Discussing food-related topics during meals may increase anxiety or pressure related to food. The focus during meals should be on providing a supportive, non-judgmental environment that encourages normal eating patterns.

A. Fatigue B. Hand tremors C. Rapid speech D. Seizures

Correct Answer is A

Explanation

A. Fatigue: Fatigue is a common symptom of cocaine withdrawal, as the body adjusts to the absence of the stimulant. Clients often feel extremely tired or lethargic during this phase. Depressive symptoms that accompany withdrawal can also contribute to feelings of exhaustion.

B. Hand tremors: Hand tremors are more often seen with alcohol withdrawal or neurological disorders. While tremors can occur in some cases, they are not a typical manifestation of cocaine withdrawal. The focus is more on mood and energy changes.

C. Rapid speech: Rapid speech is a sign of cocaine intoxication, not withdrawal. During withdrawal, clients tend to experience slowed speech and cognitive dulling, not the heightened energy associated with the drug.

D. Seizures: Seizures are more related to cocaine overdose or intoxication, not withdrawal. Withdrawal typically involves mood changes and fatigue rather than physical manifestations like seizures.

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A nurse is planning care for a school-aged child who has autism spectrum disorder and is nonverbal. Which of the following interventions should the nurse include in the plan of care?

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