A nurse is providing care for an 18-month-old toddler in the primary care provider's office. The primary care provider has finished performing the autism screening assessment (M-CHAT-R/F) on the child and noted a negative screening. Which of the following is true regarding this result?
The child has autism spectrum disorder. The child should be referred to an early intervention program.
The child may still have autism spectrum disorder. The child should be screened again at 24 months old.
The child does not have autism spectrum disorder and further assessment is not warranted.
The child may or may not have autism spectrum disorder. The child needs to be rescreened with the correct tool for the age of the child.
The Correct Answer is B
A. The child has autism spectrum disorder. The child should be referred to an early intervention program: A negative M-CHAT-R/F screening does not indicate a diagnosis of autism spectrum disorder. Referral to early intervention is reserved for children who screen positive or show concerning developmental delays.
B. The child may still have autism spectrum disorder. The child should be screened again at 24 months old: The M-CHAT-R/F is a screening tool, not a diagnostic test. Children can develop or exhibit signs of autism after 18 months, so rescreening at 24 months is recommended to identify late-emerging symptoms. This approach ensures ongoing monitoring of developmental progress.
C. The child does not have autism spectrum disorder and further assessment is not warranted: A negative screen reduces concern but does not rule out autism. Symptoms may emerge later, and continued developmental surveillance is necessary. No single screening can definitively exclude the disorder.
D. The child may or may not have autism spectrum disorder. The child needs to be rescreened with the correct tool for the age of the child: The M-CHAT-R/F is age-appropriate for 16–30 months. Since the child is 18 months old, the correct tool was used, so repeating with a different tool is not necessary. Monitoring at subsequent ages is appropriate.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Dismiss suspicions since the nurse is not able to assist victims of human trafficking: Ignoring potential signs of human trafficking can place the adolescent at continued risk and fails to meet the nurse’s ethical and legal responsibilities to protect vulnerable patients.
B. Avoid conversations or questions that may upset the adolescent or the accompanying person: Avoiding inquiry prevents the nurse from gathering critical information to identify and protect the adolescent from harm. Sensitive, trauma-informed questioning is essential.
C. Contact the appropriate hospital and law enforcement resources and follow organizational protocols: Following institutional protocols and notifying designated authorities ensures the adolescent receives protection, proper assessment, and support services, while maintaining safety and legal compliance.
D. Confront the person accompanying the adolescent: Direct confrontation can escalate danger, compromise the adolescent’s safety, and interfere with investigation. Professional protocols and law enforcement involvement are safer and more effective.
Correct Answer is A
Explanation
A. Prevention of opportunistic infections: Clients with HIV are at increased risk for opportunistic infections due to immune system compromise. Safety education prioritizes infection prevention strategies such as hand hygiene, food safety, avoiding exposure to pathogens, and adhering to antiretroviral therapy to maintain immune function.
B. Avoiding sunlight exposure: While some medications may increase photosensitivity, sunlight avoidance is not a primary safety focus for clients with HIV. Education is more critically directed toward infection risk reduction and immune protection.
C. Techniques for managing medication side effects: Managing side effects is an important aspect of treatment adherence, but it is not the primary focus of safety education. Safety teaching centers on reducing infection exposure and recognizing early signs of illness.
D. Engagement in high-contact sports: High-contact sports are not specifically contraindicated for all clients with HIV. Safety education emphasizes individualized activity guidance rather than universal restriction, with infection prevention remaining the priority focus.
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