Deck 33: Cognitive Alterations

Question 1

Which of the following developmental tests do nurses and others use most often?

A) Wechsler Preschool and Primary Scale of Intelligence
B) Bayley Scales of Infant Development
C) Denver Developmental Screening Test II
D) Vineland Adaptive Behavior Scales

Answer 1

Denver Developmental Screening Test II

Question 2

The two most prevalent syndromes associated with mental retardation (MR) are Down syndrome and which of the following?

A) Marfan's
B) autism
C) fragile X
D) pickwickian

Answer 2

fragile X

Question 3

Which of the following would the nurse share then answering parents' questions about the cause of mental retardation?

A) Heredity is the main cause of mental retardation in the newborn and infant.
B) There are many causes; sometimes there is a single cause and sometimes there is more than one cause.
C) Mental retardation begins in utero with fetal development gone wrong.
D) Virus infection in utero is the main cause of mental retardation.

Answer 3

There are many causes; sometimes there is a single cause and sometimes there is more than one cause.

Question 4

A parent of a newborn who has mental retardation asks the nurse to explain what the pediatrician meant then he said, "The brain of the newborn has anatomic plasticity." Which of the following statements by the nurse would best explain anatomic plasticity?

A) "This means nerve cells in certain brain areas can assume functions of a different area, or signals can be rerouted around a nonfunctioning area."
B) "The brain is in a bony cage that, like hard plastic, will not give, and so parents must use caution to protect the head at all times."
C) "The brain is heartier than previously thought and has a harder surface on the outer layer of the brain."
D) "This is referring to the pliability of plastic, which is soft, and to the electric conductivity of plastic, which transmits signals rapidly."

Question 5

Which of the following classifications applies to the majority of children with mental retardation?

A) mild
B) moderate
C) severe
D) profound

Question 6

Children who have an identified neurological condition causing their mental retardation, have minimal capacity for functioning, require a highly structured setting, have delays in all developmental areas, and display basic emotional responses, are classified in which of the following groups?

A) mild
B) moderate
C) severe
D) profound

Question 7

Standardized tests are one of several factors used to make the diagnosis of mental retardation. The Stanford-Binet is a standardized test of intelligence quotient. At what measurement on this test (corroborated by other tests as needed) is a child classified as mentally retarded?

A) below 70
B) 80 or less
C) 90 or below
D) below 100

Question 8

When a child scores low enough on the Stanford-Binet to be classified as mentally retarded, the test is repeated. A mother, whose child is asked to repeat the test at a later date, asks the nurse why her child has to go through this test a second time. Which of the following is the nurse's best response?

A) "We want to reduce the chance of human error and make certain we have interrater reliability in the scoring."
B) "Test-retest provides a chance for the rater to test the child's recall of information presented during the first test."
C) "A repeat test helps us give you a more accurate score, because many factors, such as mood or sleep, can influence the score."
D) "Your child scored low, and we want to give the child a second chance to prove that he has a normal intelligence quotient."

Question 9

You are the nurse caring for a newborn infant who has a cleft lip and cleft palate and shows signs of mental retardation. Which of the following actions on your part would best support the parents?

A) Model love and acceptance of the infant, and convey how precious the infant is.
B) Answer all questions, and give additional information with absolute honesty no matter how difficult it may be for the parents to accept.
C) Immediately give the parents the number of the support group for parents with children who are mentally retarded.
D) Call the chaplain, and ask the chaplain to talk with the parents.

Question 10

You are the nurse working with parents and their newborns on a postpartum unit there the newborns room with the mother. The parents of one of the babies learns that their newborn has mental retardation. You notice these parents going through the stage of denial and then demonstrating anxiety. You realize that this anxiety:

A) must be reduced as soon as possible and you need to calm the family immediately
B) serves a purpose in alerting the family that something is amiss and in generating needed energy to deal with the situation
C) will keep the family from completing the stages of adjusting to the child having mental retardation
D) is related to the loss of their dream of a perfect child and how other people will be disappointed in them

Question 11

Parents of a child who is mentally retarded ask the nurse in the pediatrician's office to help them make a judgment about placement. They ask the nurse what he would do if he were in their place. Which of the following is the nurse's best response?

A) List all the reasons for and against placement based on the parents' own assessment of the child.
B) Tell the parents what you would do if the child were yours and give your rationale.
C) Provide information about all options: placement, day care, special schools, home care, and respite care options.
D) Refer the parents to the physician and the social worker.

Question 12

Which of the following factors is known to directly increase the incidence of Down syndrome (DS)?

A) alcohol and drug use
B) vitamin deficiencies
C) age of mother
D) age of father

Question 13

You are caring for a neonate who has Down syndrome. Which of the following orders would be most helpful to obtain from the pediatrician if the order has not already been written?

A) echocardiogram
B) magnetic resonance imaging (MRI) scan
C) electromyelogram
D) computed tomography (CAT) scan

Question 14

The nurse assessing a newborn will recognize which of the following signs and symptoms as common features of Down syndrome?

A) wide space between the big and second toe
B) X-shaped double crease across the palm of the hand
C) large nose and raised nasal bridge
D) a small tongue in a large mouth

Question 15

A definitive diagnosis of Down syndrome is based on:

A) facial features
B) family history
C) physical findings
D) karyotyping

Question 16

The parents ask the nurse to tell them if there is a cure for Down syndrome. The nurse will explain that:

A) this condition can be cured by extensive plastic surgery
B) there is no cure or specific medical treatment for Down syndrome
C) there is a new chromosomal reduction method available in Europe
D) mental retardation can be greatly reduced by teaching and training

Question 17

Which of the following areas should the nurse caring for a child with Down syndrome focus on?

A) increasing socialization of the family and the child
B) building self-esteem and hygiene skills in the child
C) screening for anomalies, teaching of parents, and prevention of respiratory infection and accidents
D) training the child in areas such as speech, walking, toilet training, hygiene, and socialization

Question 18

The nurse, working with parents who are doing long-term planning for the care of their child with Down syndrome, will share with the parents that the life expectancy for a child with Down syndrome is:

A) 30 years
B) 37 years
C) 46 years
D) 50-58 years

Question 19

The nurse is assessing a child who has autism. Which of the following behaviors would the nurse most likely find in the assessment?

A) solitary play, repeated seemingly meaningless activities, bizarre body movements, obsessive about physical environment, and little speech
B) quietly engaged in parallel play with others, hugging everyone at times, and getting excited about seeing familiar people
C) hallucinations, hearing voices, hurting others, and tearing up toys
D) showing a wide range of emotions, labile, and aggressive

Question 20

The nurse working with a child who has autism will keep in mind that the typical response of a child with autism who is subjected to mild or moderate pain is best represented by which of the following statements?

A) beating the head against the wall and screaming loudly for the caregivers to help
B) impassivity to mild or moderate pain and sometimes loud howling in response to insignificant injuries
C) holding the head in the hands while sitting and facing away from others, usually in the corner of the room
D) barking, guttural responses, and facial tics while banging on various surfaces

Question 21

Parents are describing for the nurse the sleeping patterns of their child with autism. Which of the following statements would match the typical sleep pattern of a child with autism?

A) He sleeps all the time with very little waking time.
B) He sleeps soundly at night for 10 to 12 hours.
C) He sleeps very little and is up at night and always on the go.
D) He is a light sleeper but sleeps all night if the room is very quiet and dark.

Question 22

Which of the following interventions is generally considered the most important in autism?

A) early and intensive educational services
B) starting the child in 1st grade close to 7 years old
C) hiring a school tutor to help the child keep up with homework
D) having siblings spend a great deal of time with the child with autism

Question 23

Which of the following types of instructional environments do children with autism do best in?

A) small groups working together to complete task assignments
B) individual computer work in individual computer cubicles
C) classroom settings such as the open classroom without walls
D) highly structured with as much one-on-one instruction as possible

Question 24

Which of the following elements is included in the comprehensive educational curriculum known as Treatment and Education of Autistic and Communication Handicapped Children (TEACCH)?

A) inclusion in the regular classroom, room helpers to work with the child with autism, and special talking texts
B) caregiver and professional collaboration, individualized treatment based on assessment, and highly structured holistic teaching
C) a complete package of instruction for day-to-day teaching with lesson plans, games, tests, fun activities, and various types of music
D) a variation of the Stevenson method of teaching children with learning disabilities

Question 25

The incidence of mental retardation in the school-aged population is ____________________% in school-aged children.

Question 26

Which of the following assessment findings would the nurse anticipate finding in the child with Down syndrome? Select all that apply.

A) small space between the big and second toe
B) a high arched palate
C) a small tongue in a large mouth
D) square hands with a simian line

Question 27

Which of the following assessment findings would the nurse anticipate finding in the child with fragile X syndrome? Select all that apply.

A) large ears
B) rough, dry skin
C) slim body weight
D) large testes