A nurse is caring for a client who has autism spectrum disorder. Which of the following findings should the nurse expect?
Expressive affect
Ambivalence
Echolalia
Associative looseness
The Correct Answer is C
A. Expressive affect: Individuals with autism spectrum disorder (ASD) often have difficulty expressing their emotions in a typical manner. They may display a restricted range of facial expressions or have difficulty conveying emotions through facial expressions and gestures. However, "expressive affect" typically refers to the appropriate display of emotions, which may not be characteristic of ASD.
B. Ambivalence: Ambivalence refers to conflicting feelings or attitudes about a situation or person. While individuals with ASD may experience a range of emotions, including ambivalence, it is not a specific characteristic associated with the disorder. Ambivalence is a common human experience and may occur in individuals with or without ASD.
C. Echolalia: Echolalia is a common communication characteristic observed in individuals with ASD. It involves the repetition or echoing of words or phrases spoken by others. This behavior may occur immediately after hearing the words or phrases (immediate echolalia) or may be delayed. Echolalia can serve various functions, including communication, self-regulation, or expression of anxiety.
D. Associative looseness: Associative looseness is a thought disorder characterized by a lack of logical connection between thoughts and ideas. It is typically associated with conditions such as schizophrenia rather than ASD. Individuals with ASD may exhibit difficulties with social communication, including challenges in maintaining conversations or understanding social cues, but this is different from the disorganized thinking observed in associative looseness.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Assist the client to the correct room: This option addresses the immediate safety concern by guiding the client back to their own room, reducing distress for both the client and the other resident. It promotes dignity and minimizes the risk of agitation or further disruptive behavior.
B. Place the client in restraints: Restraints should only be used as a last resort for safety when all other measures have been exhausted and when there's an immediate risk of harm to the client or others. Restraints can be physically and psychologically harmful to individuals with Alzheimer's disease and should not be used unless absolutely necessary.
C. Reorient the client to time and place: Reorientation may not be effective for clients with advanced Alzheimer's disease, as their cognitive impairments may limit their ability to understand or retain this information. Additionally, reorientation may not address the immediate safety concern posed by the client's behavior.
D. Move the client to a room at the end of the hall: While this option may be considered in some situations to minimize disruption to other residents, it does not address the underlying issue of the client's confusion or wandering behavior. Additionally, moving the client may cause further distress and confusion.
Correct Answer is D
Explanation
A. Suppression: Suppression involves consciously pushing down or ignoring thoughts, feelings, or memories that are perceived as unacceptable or distressing. In this scenario, the client is not consciously trying to push down or ignore their behavior; instead, they are explaining their actions using a defense mechanism.
B. Reaction-formation: Reaction-formation occurs when an individual expresses feelings or behaviors that are the opposite of their true feelings or desires. In this case, the client's statement does not involve expressing the opposite of their true feelings. Instead, they are rationalizing their behavior.
C. Compensation: Compensation involves attempting to overcome feelings of inadequacy or failure in one area by excelling in another area. The client's statement does not suggest that they are compensating for anything; rather, they are explaining their behavior through a defense mechanism.
D. Rationalization: Rationalization involves providing logical or socially acceptable reasons for behavior that are not the true reasons. In this scenario, the client is rationalizing their behavior by attributing it to external factors, such as their boss's influence, rather than acknowledging their own responsibility for their actions. This defense mechanism allows the client to avoid facing the underlying issue of alcohol abuse by providing a seemingly reasonable explanation for their behavior.
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