Autism Spectrum Disorder and Down Syndrome (18 Questions)

1. Mme Gagnon brings her 18-month-old son, Léo, to the clinic for a routine check-up. She expresses concern, stating: "My neighbor's son is the same age and is already saying 10 words, but Léo doesn't speak yet. He just sits in the corner and spins the wheels of his toy truck for hours."

Question:
During your assessment of Léo, which specific observation would be considered a significant "red flag" for Autism Spectrum Disorder requiring further evaluation? *
2. Émile, a 6-year-old with Autism Spectrum Disorder, is admitted to the pediatric unit for a scheduled tonsillectomy. Upon admission, he becomes extremely agitated, screaming and flapping his hands. His mother explains, "He is terrified because this is not his bedroom."

Question:
What is the most appropriate nursing intervention to reduce Émile’s distress? *
3. You are attempting to administer medication to Lucas, a 5-year-old with Autism. When you ask him, "Lucas, do you want to take your juice now?" he responds by saying, "Lucas, do you want to take your juice now?" in the exact same tone.

Question:
How should the nurse interpret this communication? *
4. Sophie, a 9-year-old with severe Autism, is in the emergency department waiting room for a laceration on her arm. The waiting room is crowded, noisy, and the fluorescent lights are flickering. Sophie begins to bang her head rhythmically against the wall and moan.

Question:
What is the priority nursing action? *
5. Marc, 7 years old, is non-verbal and has Autism. He is 4 hours post-operative from an appendectomy. He is rocking back and forth in bed and grimacing, but he does not cry or point to his stomach. His heart rate is 110 bpm. The order reads: "Morphine IV PRN for pain."

Question:
Which assessment tool or method is best to determine if Marc requires analgesia? *
6. Mme Roy consults the nurse because her 4-year-old son Thomas (ASD) will only eat beige foods (chicken nuggets, crackers, plain pasta) and refuses to touch anything with a "slimey" texture like fruit or yogurt. She is worried about his nutrition.

Question:
What is the most appropriate initial nursing advice? *
7. Hugo, a 12-year-old with Autism, has been prescribed Risperidone by the psychiatrist to manage severe aggression and self-injury. The parents ask, "What side effects should we watch out for?"

Question:
Which potential adverse effect requires careful monitoring with this medication? *
8. Mme Tremblay breaks down crying during a clinic visit for her 10-year-old son with severe ASD. She says, "I haven't slept through the night in 10 years. He wanders if I don't lock the doors. My husband and I are fighting constantly. I just can't do this anymore."

Question:
What is the priority nursing intervention for the family? *
9. You are performing a physical assessment on Baby Bouchard, born 2 hours ago. The physician suspects Trisomy 21 (Down Syndrome). The baby is resting quietly in the bassinet.

Question:
Which cluster of physical findings would the nurse identify as consistent with this diagnosis? *
10. Clara, a 2-month-old infant with Down Syndrome, visits the clinic for a weight check. The mother reports, "She takes a very long time to finish her bottle, and she gets sweaty on her forehead when she drinks." You note that Clara has not gained weight since the last visit.

Question:
Based on the diagnosis of Down Syndrome, which underlying condition does the nurse suspect? *
11. Hugo, a 12-year-old with Down Syndrome, tells the school nurse he wants to join the gymnastics team and do somersaults and trampolining.

Question:
Before clearing Hugo for these specific activities, what medical screening is essential? *
12. Mme Lefebvre asks why her 3-year-old son with Down Syndrome seems to get pneumonia and ear infections "every single winter," whereas her other children do not.

Question:
What is the best physiological explanation the nurse can provide? *
13. Liam, a 6-year-old admitted for dehydration secondary to gastroenteritis, has Autism Spectrum Disorder. During the admission interview, his parents explicitly stated, "He has a severe sensory aversion to green foods. If he sees anything green on his plate, he will scream and refuse to eat anything at all." It is lunchtime, and the dietary aide brings a tray containing grilled chicken, mashed potatoes, and steamed broccoli.

Question:
What is the nurse’s priority action before presenting the tray to Liam? *
14.1 Émile, an 8-year-old with Autism, is admitted for observation after a minor fall. His parents inform you that his strict home routine involves lights out and falling asleep exactly at 19:30. Any disruption to this routine causes severe meltdowns and insomnia. You review his medication administration record (MAR) and notice the physician has prescribed: "Melatonin 3 mg PO daily at 20:00."

Question:
What is the most appropriate nursing action? *
14.2 Following the adjustment of the medication time, Émile receives his first dose of Melatonin in the hospital. The next morning, you are performing your assessment.

Question:
Which specific side effect of Melatonin should the nurse monitor for, which could impact Émile’s safety during the day? *
15. Sophie, a 5-year-old with severe Autism, is being admitted for pneumonia. She is non-verbal and visibly terrified. Her father asks, "Can she sleep with her giant Squishmallow plushie? It’s the only thing that calms her down, but I know hospitals are strict about germs."

Question:
How should the nurse respond to support Sophie’s mental health? *
16. Marc, a 10-year-old with Autism, becomes overwhelmed by the noise of the IV pump alarm. He starts rocking violently and banging his forehead repeatedly against the metal side rail of the hospital bed.

Question:
What is the priority nursing intervention to ensure physical safety? *
17. You need to obtain a set of vital signs (blood pressure and temperature) from Lucas, a 7-year-old with Autism. He is verbal but processes information slowly.

Question:
Which communication strategy is most effective for obtaining his cooperation? *