Deck 42: Impact of Cognitive or Sensory Impairment on the Child and Family

Question 1

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

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

Answer 1

Congenital heart disease.

Question 2

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 knowing that:

A)Programs such as Cub Scouts are inappropriate for children who are cognitively impaired.
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.

Answer 2

Children with Down syndrome have the same need for socialization as other children.

Question 3

The major consideration when selecting toys for a child who is cognitively impaired is:

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

Answer 3

Safety.

Question 4

Appropriate interventions to facilitate socialization of the cognitively impaired child include to:

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

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

A)Being involved 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 6

When a child with mild cognitive impairment reaches the end of adolescence,what characteristic 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 7

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 8

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.

Question 9

Which term 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 10

Many of the physical characteristics of Down syndrome present nursing problems. Care of the child should include:

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

Question 11

An implanted ear prosthesis for children with sensorineural hearing loss is a(n):

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

Question 12

A young child who has an intelligence quotient (IQ) of 45 would be described as:

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

Question 13

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. The most appropriate nursing action is to:

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

Question 14

The child with Down syndrome should be evaluated for what characteristic before participating in some sports?

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

Question 15

What facilitates lip reading by the hearing-impaired child?

A)Speaking at an even rate
B)Exaggerating pronunciation of words
C)Avoiding using facial expressions
D)Repeating in exactly the same way if child does not understand

Question 16

The nurse should suspect a hearing impairment in an infant who demonstrates which behavior?

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 17

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:

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

Question 18

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 19

Fragile X syndrome is:

A)A chromosome defect affecting only females.
B)A chromosome defect that follows the pattern of X-linked recessive disorders.
C)The second most common genetic cause of cognitive impairment.
D)The most common cause of noninherited cognitive impairment.

Question 20

Hearing is expressed in decibels,or units of loudness. In decibels the softest sound a normal ear can hear is:

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

Question 21

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. What should the nurse recommend before the child is transported?

A)Keep the 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 22

Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which area(s) with onset before age 3 years? Choose all that apply.

A)Language as used in social communication
B)Parallel play
C)Gross motor development
D)Growth below the 5th percentile for height and weight
E)Symbolic or imaginative play
F) Social interaction

Question 23

The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes:

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

Question 24

The most common clinical manifestation of retinoblastoma is:

A)Glaucoma.
B)Amblyopia.
C)White eye reflex.
D)Sunken eye socket.

Question 25

A nurse would suspect possible visual impairment in a child who displays:

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

Question 26

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

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

Question 27

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.