In planning care for a child diagnosed with autistic spectrum disorder, which would be a realistic client outcome?
1. The client will communicate all needs verbally by discharge.
2. The client will participate with peers in a team sport by day four.
3. The client will establish trust with at least one caregiver by day five.
4. The client will perform most self-care tasks independently.
3
Rationale: The most realistic client outcome for a child diagnosed with autistic spectrum disorder is for the client to establish trust with at least one caregiver. Trust should be evidenced by facial responsiveness and eye contact. This outcome relates to the nursing diagnosis impaired social interaction.
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The mother brings her five-month-old infant to the clinic for a well-child visit. The mother tells the nurse that the baby's father had febrile seizures when he was an infant
The mother says she is concerned her baby will have a febrile seizure and wants to know what she should do to prevent it. The nurse explains: Standard Text: Select all that apply. 1. That the baby has no more risk of febrile seizures than any other baby. 2. When the infant has a fever, the mother should give the baby dose-appropriate aspirin. 3. That the baby should be sponged with cold water. 4. The mother should increase the child's fluid intake. 5. That after the tepid bath, the child should be patted dry.
Which of the following best describes how schools can determine what their school health education priorities should include? (Select all that apply.)
a. Provide opportunities for students to practice decision-making skills b. Choose priorities according to which behaviors lead to avoidable problems c. Make priorities consistent with the six topics identified by Healthy People 2020 d. Determine priorities by the education and expertise of the local school nurse e. Select priorities according to parent and student interests f. Decide on priorities based on whatever funding sources are willing to fund
The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which of the following statements would indicate that the boy is having nightmares instead of night terrors?
A) "It usually happens about an hour after he falls asleep." B) "He will tell us about what happened in his dream." C) "He is completely unaware that we are there." D) "When we try to comfort him, he screams even more."
In an interview with a patient who is visually impaired, it is important for the nurse to
a. speak loudly and distinctly. b. touch the patient frequently to emphasize the nurse's presence. c. use a tone of voice, volume, and inflection appropriate to the message. d. use simple phrases and closed questions.