Deck 55: The Child with a Sensory Alteration

Question 1

An adolescent goes to the primary care provider complaining of difficulty with vision.When the nurse asks the adolescent to explain the visual deficits,the adolescent states,"I am having difficulty seeing distant objects; they are less clear than things that are close." What disorder does the nurse suspect the adolescent has?

A) Hyphema
B) Astigmatism
C) Amblyopia
D) Myopia

Answer 1

Myopia

Question 2

A child just returned from cataract eye surgery.What is the most significant nursing intervention to prevent increasing intraocular pressure in this child?

A) Monitor for hypertension.
B) Prevent coughing and vomiting.
C) Lower the head of the bed slightly.
D) Avoid use of steroids after the surgery.

Answer 2

Prevent coughing and vomiting.

Question 3

Teaching parents about the use and application of an eye patch to treat strabismus should include which instruction?

A) Check under the patch four times a day.
B) Apply the patch directly to the face.
C) Sometimes patching alone will straighten the eye.
D) Negotiate the number of hours per day that the patch is to be worn.

Answer 3

Apply the patch directly to the face.

Question 4

Parents of a 4-year-old child are concerned because the child continues to stutter.What nursing intervention is correct?

A) Remind the parents that stuttering is normal in children younger than 10 years.
B) Facilitate a speech evaluation performed if the stuttering continues beyond age 5 years.
C) Reinforce the fact that this common speech defect requires no treatment.
D) Tell the parents that speech problems are most treatable during the child's teen years.

Question 5

The teaching plan for a 7-year-old boy with color deficiency should include what instruction?

A) Buy only one color of clothing to ensure the child's ability to match items himself.
B) Patching the weaker eye will improve his color vision.
C) Teach him an alternate way to distinguish between the colors of traffic signals.
D) Botulism toxin drops must be administered every 2 months to improve color vision.

Question 6

The nurse should know that the results of untreated amblyopia ("lazy eye")in the child may include which of the following?

A) Impaired depth perception
B) Strabismus
C) Color deficiency
D) Ptosis

Question 7

The correct position for the postoperative child who has had a cataract removed from the right eye is the ________ position.

A) supine
B) prone
C) knee-chest
D) right lateral Sims

Question 8

Initial care of the child with a chemical burn to the eye(s)is focused on which of the following?

A) Irrigation of the affected eye(s)
B) Application of topical steroids
C) Administration of an analgesic
D) Administration of medication to constrict the pupils

Question 9

A 13-year-old adolescent is suspected to have a visual deficit and is scheduled for further evaluation.The teen asks the nurse to tell "the truth" about the tests.What is the nurse's best response?

A) "Don't worry about anything. We're here to take good care of you."
B) "Ask your parents. They have talked with the physicians."
C) "Most of the vision tests are painless and noninvasive."
D) "Trust the doctors. They know what is best for you."

Question 10

The teaching plan for the parents of a 3-year-old child with amblyopia ("lazy eye")should include what instruction?

A) Apply a patch to the child's eyeglass lenses.
B) Apply a patch only during waking hours.
C) Apply a patch over the "bad" eye to strengthen it.
D) Cover the "good" eye completely with a patch.

Question 11

The nurse is caring for a 2-year-old child who has a history of meningitis as an infant.The child is not speaking and does not turn the head to the sound of a rattle.Which type of hearing loss in a child may have resulted from a previous infection with meningitis?

A) Conductive
B) Sensorineural
C) Central
D) Mixed

Question 12

A 10-year-old patient is talking to the nurse about wanting to try contact lenses instead of wearing glasses.The child states that the other children at school call her "four-eyes." Contact lenses should be prescribed for a child who is

A) at least 12 years of age.
B) able to read all the written information and instructions.
C) able to independently care for the lenses in a responsible manner.
D) confident that she really wants contact lenses.

Question 13

Which statement by a parent indicates understanding of instructions on the care of a child with conjunctivitis?

A) "I should treat my other children with these eye drops to prevent spread of the disease."
B) "My child must remain home from school until she has received 72 hours of antibiotic drops."
C) "I should avoid touching the tip of the ointment tube to my child's eye."
D) "My child may go back to wearing her contact lenses 24 hours after treatment has started."

Question 14

On the second postoperative day of an eye surgery,the child has puffy eyes,increased tearing,and fever.What is the most applicable nursing diagnosis?

A) Risk for Infection related to surgical procedure
B) Infection related to surgical procedure
C) Disturbed Sensory Perception (Visual) related to surgical procedure
D) Acute Pain related to recent surgical intervention

Question 15

A 2-year-old has excessive tearing and corneal haziness.The nurse knows that these symptoms may indicate which of the following?

A) Viral conjunctivitis
B) Paralytic strabismus
C) Congenital cataract
D) Infantile glaucoma

Question 16

Which statement best describes how a cataract affects a child's vision?

A) It increases intraocular pressure.
B) It alters the ability to distinguish among colors.
C) It causes double vision.
D) It prevents a clear image from forming on the retina.

Question 17

What manifestation in a 5-month-old child could indicate visual problems?

A) Lack of binocularity
B) Visual acuity of 20/50
C) Strabismus
D) Hyperopia

Question 18

Which teaching guideline helps prevent eye injuries during sports and play activities?

A) Restrict helmet use to those who wear eye glasses or contact lenses.
B) Discourage the use of goggles with helmets so the child can see better.
C) Wear eye protection when participating in high-risk sports such as paintball.
D) Wear a face mask when playing any sport or playing roughly.

Question 19

Which statement by a parent about conjunctivitis indicates that further teaching is needed?

A) "I'll have separate towels and washcloths for each family member."
B) "I'll notify my doctor if the eye gets redder or the drainage increases."
C) "When the eye drainage improves, we'll stop giving the antibiotic ointment."
D) "After taking the antibiotic for 24 hours, my child can return to school."

Question 20

A 5-year-old diagnosed with chlamydial conjunctivitis should be carefully assessed for which of the following?

A) Sexual abuse
B) Immune deficiency
C) Congenital cataract
D) Secondary glaucoma

Question 21

Which interventions should the nurse plan when caring for a child with a visual impairment? (Select all that apply.)

A) Touch the child upon entering the room before speaking.
B) Keep items in the room in the same location.
C) Describe the placement of the eating utensils on the meal tray.
D) Face the child when speaking.
E) Identify noises for the child.

Question 22

A nurse is providing anticipatory guidance to parents of a 2 1/2-year-old.What instruction is best to help the child's language development?

A) Have the child's hearing tested at 3 years.
B) Use clear speech and avoid baby talk.
C) Speak with different voice inflections.
D) Insist the child listen when you are talking.

Question 23

Which interventions should the nurse plan when caring for a child with a hearing loss? (Select all that apply.)

A) Speak loudly.
B) Speak slowly.
C) Have the child's full attention.
D) Use visual aids.
E) Eliminate background noise.

Question 24

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

A) Taping the eye shut
B) Patching the affected eye with any reasonable item
C) Applying ice until the physician is seen
D) Irrigating the eye copiously with a sterile saline solution

Question 25

A parent brings an 18-month-old to the pediatrician for a routine well-child visit and reports the child has been babbling and cooing since 6 months of age but is not yet saying any words.Which response by the nurse is the most appropriate?

A) "Don't worry, your child should catch up soon."
B) "The doctor will want to refer your child to an audiologist and speech pathologist."
C) "This is normal speech development for an 18-month-old child."
D) "Your child has an expressive language disorder and needs further evaluation."

Question 26

A nurse suspects possible visual impairment in a child who displays which problem?

A) Excessive tearing 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 27

A patient who has a hyphema is at risk for developing which condition?

A) Glaucoma
B) Strabismus
C) Diplopia
D) Astigmatism

Question 28

The nurse is preparing new parents for discharge home with their well newborn.The nurse explains that the newborn cannot be discharged until the mandatory hearing screening is performed.

Question 29

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

A) Absence of intelligible speech by 12 months
B) Cessation of babbling at age 7 months
C) Lack of eye contact when being spoken to
D) Lack of gesturing to indicate wants after age 15 months

Question 30

Discharge planning for an 8-year-old child with a patched eye after a large corneal abrasion should include which instruction?

A) Removing the patch after 8 hours for instillation of antibiotic ointment
B) Gently massaging the affected eye to prevent edema
C) Keeping the patch in place for 24 hours
D) Returning after 7 days of patching for reassessment

Question 31

Adequate hearing depends on intact auditory structures and quality of sound.Failure to hear at 40 to 69 dB would be categorized as a __________ hearing loss.

Question 32

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.