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 B

Explanation

A. The client is experiencing anisognosia: Anisognosia, a lack of awareness of one's own illness, is common in various psychiatric disorders, particularly in psychotic disorders like schizophrenia. While it is concerning, it does not typically require immediate reporting.

B. The client is experiencing command hallucinations: Command hallucinations, where the client hears voices telling them to take harmful actions, pose a direct safety risk. These should be immediately reported to the provider for further evaluation and intervention.

C. The client is exhibiting concrete thinking: Concrete thinking is common in individuals with certain psychiatric conditions, such as schizophrenia or intellectual disabilities. While it limits abstract thought, it is not an immediate cause for alarm.

D. The client is exhibiting a blunted affect: A blunted affect, or reduced emotional expression, is a common symptom in various mental health disorders. It is important for diagnosis and treatment planning but is not an immediate emergency or urgent situation.

A. Assign the client to a different caregiver each shift. B. Teach the client assertive techniques. C. Refute the client's perception of visual hallucinations D. Reinforce the client's orientation with a calendar.

Correct Answer is D

Explanation

A. Assign the client to a different caregiver each shift: This is not ideal for a client with acute delirium. Consistency in caregivers is important to reduce confusion and help the client feel more secure in a familiar environment.

B. Teach the client assertive techniques: Assertiveness training is more appropriate for clients with anxiety or communication difficulties, not for those with acute delirium. In delirium, the priority is managing cognitive function and safety.

C. Refute the client's perception of visual hallucinations: Refuting hallucinations can cause frustration and worsen the client's confusion. It’s better to acknowledge the hallucinations calmly without validating them, offering reassurance instead of confrontation.

D. Reinforce the client's orientation with a calendar: This is an appropriate intervention. Using a calendar, clock, and other orientation tools helps reinforce reality and can reduce confusion in clients with delirium, aiding in their cognitive stabilization.

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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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