Deck 19: Impact of Cognitive or Sensory Impairment on the Child and Family

Question 1

The most common type of hearing loss, which results from interference of transmission of sound to the middle ear, is called:

A)Conductive.
B)Sensorineural.
C)Mixed conductive-sensorineural.
D)Central auditory imperceptive.

Answer 1

Conductive.

Question 2

What is one of the major physical characteristics of the child with Down syndrome?

A)Excessive height
B)Spots on the palms
C)Inflexibility of the joints
D)Hypotonic musculature

Answer 2

Hypotonic musculature

Question 3

The nurse is assessing a neonate who was born 1 hour ago to healthy, white parents in their early 40s. Which of the following findings would be most suggestive of Down syndrome?

A)Hypertonia
B)Low-set ears
C)Inner epicanthal folds
D)Long, thin fingers and toes

Answer 3

Inner epicanthal folds

Question 4

Appropriate interventions to facilitate socialization of the cognitively impaired child include which of the following?

A)Provide age-appropriate toys and play activities.
B)Provide peer experiences, such as scouting, when older.
C)Avoid exposure to strangers who may not understand cognitive development.
D)Emphasize mastery of physical skills, because they are delayed more often than verbal skills.

Question 5

When should children with cognitive impairment be referred for stimulation and educational programs?

A)As young as possible
B)As soon as they have the ability to communicate in some way
C)At age 3 years, when schools are required to provide services
D)At age 5 or 6 years, when schools are required to provide services

Question 6

Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third grade for part of the school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join. The nurse's recommendation should be based on which of the following?

A)Programs like Cub Scouts are inappropriate for children who are mentally retarded.
B)Children with Down syndrome have the same need for socialization as other children.
C)Children with Down syndrome socialize better with children who have similar disabilities.
D)Parents of children with Down syndrome encourage programs, such as scouting, because they deny that their children have disabilities.

Question 7

Many of the physical characteristics of Down syndrome present nursing problems. Care of the child should include which of the following?

A)Delay feeding solid foods until the tongue thrust has stopped.
B)Modify diet as necessary to minimize the diarrhea that often occurs.
C)Provide calories appropriate to child's age.
D)Use a cool-mist vaporizer to keep mucous membranes moist.

Question 8

A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which of the following?

A)Microcephaly
B)Down syndrome
C)Cerebral palsy
D)Fragile X syndrome

Question 9

The child with Down syndrome should be evaluated for which of the following before participating in some sports?

A)Hyperflexibility
B)Cutis marmorata
C)Atlantoaxial instability
D)Speckling of iris (Brushfield's spots)

Question 10

When caring for a newborn with Down syndrome, the nurse should be aware that the most common congenital anomaly associated with Down syndrome is which of the following?

A)Hypospadias
B)Pyloric stenosis
C)Congenital heart disease
D)Congenital hip dysplasia

Question 11

Fragile X syndrome is which of the following?

A)Chromosomal defect affecting only females
B)Chromosomal defect that follows the pattern of X-linked recessive disorders
C)Second most common genetic cause of mental retardation
D)Most common cause of noninherited mental retardation

Question 12

Which of the following is an implanted ear prosthesis for children with sensorineural hearing loss?

A)Hearing aid
B)Cochlear implant
C)Auditory implant
D)Amplification device

Question 13

Which of the following should be the major consideration when selecting toys for a child who is mentally retarded?

A)Safety
B)Age-appropriateness
C)Ability to provide exercise
D)Ability to teach useful skills

Question 14

When a child with mild mental retardation reaches the end of adolescence, which of the following characteristics would be expected?

A)Achieves a mental age of 5 to 6 years
B)Achieves a mental age of 8 to 12 years
C)Unable to progress in functional reading or arithmetic
D)Acquires practical skills and useful reading and arithmetic to an eighth-grade level

Question 15

The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which of the following should the nurse consider when dealing with this issue?

A)Sterilization is recommended for any adolescent with cognitive impairment.
B)Sexual drive/interest is very limited in individuals with cognitive impairment.
C)Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
D)Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.

Question 16

A young child who has an intelligence quotient of 45 would be described as which of the following?

A)Within the lower limits of the range of normal intelligence
B)Mildly retarded but educable
C)Moderately retarded but trainable
D)Severely retarded and completely dependent on others for care

Question 17

The nurse should suspect a hearing impairment in an infant who demonstrates which of the following behaviors?

A)Absence of the Moro reflex
B)Absence of babbling by age 7 months
C)Lack of eye contact when being spoken to
D)Lack of gesturing to indicate wants after age 15 months

Question 18

The nurse is talking with a 10-year-old boy who wears bilateral hearing aids. The left hearing aid is making an annoying whistling sound that the child cannot hear. Which of the following is the most appropriate nursing action?

A)Ignore the sound.
B)Ask him to reverse the hearing aids in his ears.
C)Suggest he reinsert the hearing aid.
D)Suggest he raise the volume of the hearing aid.

Question 19

Distortion of sound and problems in discrimination are characteristic of what type of hearing loss?

A)Conductive
B)Sensorineural
C)Mixed conductive-sensorineural
D)Central auditory imperceptive

Question 20

Hearing is expressed in decibels (dB), or units of loudness. Which of the following is, in decibels, the softest sound a normal ear can hear?

A)0
B)10
C)40 to 50
D)100

Question 21

Which of the following terms refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting them on the retina?

A)Myopia
B)Amblyopia
C)Cataract
D)Glaucoma

Question 22

Which of the following terms refers to the ability to see objects clearly at close range but not at a distance?

A)Myopia
B)Amblyopia
C)Cataract
D)Glaucoma

Question 23

When assessing the eyes of a neonate, the nurse observes opacity of the lens. This is a symptom of which of the following?

A)Blindness
B)Glaucoma
C)Cataracts
D)Retinoblastoma

Question 24

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which of the following?

A)Apply a regular eye patch.
B)Apply a Fox shield to affected eye and any type of patch to the other eye.
C)Apply ice until the physician is seen.
D)Irrigate eye copiously with a sterile saline solution.

Question 25

A father calls the emergency department nurse saying that his daughter's eyes burn after getting some dishwasher detergent in them. The nurse recommends that the child be seen in the emergency department or by an ophthalmologist. The nurse also should recommend which of the following before the child is transported?

A)Keep eyes closed.
B)Apply cold compresses.
C)Irrigate eyes copiously with tap water for 20 minutes.
D)Prepare a normal saline solution (salt and water) and irrigate eyes for 20 minutes.

Question 26

Prevention of hearing impairment in children is a major goal for the nurse. This can be achieved through which of the following?

A)Involvement in immunization clinics for children
B)Assessing a newborn for hearing loss
C)Answering parents' questions about hearing aids
D)Participating in hearing screening in the community

Question 27

Which of the following facilitates lip reading by the hearing-impaired child?

A)Speak at an even rate.
B)Exaggerate pronunciation of words.
C)Avoid using facial expressions.
D)Repeat in exactly the same way if child does not understand.

Question 28

An adolescent gets hit in the eye during a fight. The school nurse, using a flashlight, notes the presence of gross hyphema (hemorrhage into anterior chamber). The nurse should:

A)Apply a Fox shield.
B)Instruct the adolescent to apply ice for 24 hours.
C)Have adolescent rest with eye closed and ice applied.
D)Notify parents that adolescent needs to see an ophthalmologist.

Question 29

A nurse would suspect possible visual impairment in a child who displays which of the following?

A)Excessive rubbing of the eyes
B)Rapid lateral movement of the eyes
C)Delay in speech development
D)Disinterest in casual conversation with peers

Question 30

Which of the following is the most common clinical manifestation of retinoblastoma?

A)Glaucoma
B)Amblyopia
C)Cat's eye reflex
D)Sunken eye socket

Question 31

The most common cause of hearing impairment in children is which of the following?

A)Auditory nerve damage
B)Congenital ear defects
C)Congenital rubella
D)Chronic otitis media