Deck 19: 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

A school nurse is performing hearing screening on school children.The nurse recognizes that the most common type of hearing loss resulting from interference of transmission of sound to the middle ear is characteristic of which type of hearing loss?

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

Answer 2

Conductive

Question 3

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 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.

Answer 3

Suggest he reinsert the hearing aid.

Question 4

Mark,a 9-year-old with Down syndrome,is mainstreamed into a regular third-grade class 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 statement?

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 5

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

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

Question 6

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

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 7

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 8

A school nurse is performing hearing screening on school children.The nurse recognizes that distortion of sound and problems in discrimination are characteristic of which type of hearing loss?

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

Question 9

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

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

Question 10

A child has just been diagnosed with fragile X syndrome.The nurse recognizes that fragile X syndrome is:

A)a chromosomal defect affecting females only.
B)a chromosomal defect that follows the pattern of X-linked recessive disorders.
C)the second most common genetic cause of mental retardation.
D)the most common cause of noninherited mental retardation.

Question 11

Which should be the major consideration when selecting toys for a child who is cognitively impaired?

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

Question 12

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

Question 13

A young child has an intelligence quotient (IQ)of 45.The nurse should document this finding as:

A)within the lower limits of the range of normal intelligence.
B)mild cognitive impairment but educable.
C)moderate cognitive impairment but trainable.
D)severe cognitive impairment and completely dependent on others for care.

Question 14

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 15

When a child with mild cognitive impairment reaches the end of adolescence,which characteristic should 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 16

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

A)Sterilization is recommended for any adolescent with cognitive impairment.
B)Sexual drive and interest are 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 17

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

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

Question 18

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

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

Question 19

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 20

A nurse is caring for a hearing-impaired child who lip reads.The nurse should plan which intervention to facilitate lip reading?

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 21

A child with autism spectrum disorder (ASD)is admitted to the hospital with pneumonia.The nurse should plan which priority intervention when caring for the child?

A)Maintain a structured routine and keep stimulation to a minimum.
B)Place child in a room with a roommate of the same age.
C)Maintain frequent touch and eye contact with the child.
D)Take the child frequently to the playroom to play with other children.

Question 22

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

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 23

Which expected appearance will the nurse explain to parents of an infant returning from surgery after an enucleation was performed to treat retinoblastoma? (Select all that apply.)

A)A lot of drainage will come from the affected socket.
B)The face may be edematous or ecchymotic.
C)The eyelids will be sutured shut for the first week.
D)There will be an eye pad dressing taped over the surgical site.
E)The implanted sphere is covered with conjunctiva and resembles the lining of the mouth.

Question 24

When assessing the eyes of a neonate,the nurse observes opacity of the lens.This represents which impairment?

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

Question 25

A nurse should suspect possible visual impairment in a child who displays which characteristic?

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 the ability to see objects clearly at close range but not at a distance?

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

Question 27

A nurse is preparing a teaching session for parents on prevention of childhood hearing loss.The nurse should include that the most common cause of hearing impairment in children is:

A)auditory nerve damage.
B)congenital ear defects.
C)congenital rubella.
D)chronic otitis media.

Question 28

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

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 29

Parents of a child with Down syndrome ask the nurse about techniques for introducing solid food to their 8-month-old child's diet.The nurse should give the parents which priority instruction?

A)It is too early to add solids; the parents should wait for 2 to 3 months.
B)A small but long, straight-handled spoon should be used to push the food toward the back and side of the mouth.
C)If the child thrusts the food out, the feeding should be stopped.
D)Solids should be offered only three times a day.

Question 30

A nurse is instructing a nursing assistant on techniques to facilitate lip reading with a hearing-impaired child who lip reads.Which techniques should the nurse include? (Select all that apply.)

A)Speak at eye level.
B)Stand at a distance from the child.
C)Speak words in a loud tone.
D)Use facial expressions while speaking.
E)Keep sentences short.

Question 31

Which assessment findings indicate to the nurse a child has Down syndrome? (Select all that apply.)

A)High arched narrow palate
B)Protruding tongue
C)Long, slender fingers
D)Transverse palmar crease
E)Hypertonic muscle tone

Question 32

Which of the following terms 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 33

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 34

A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI)who sustained a minor burn.Which strategy should the nurse use to prepare the child for this procedure?

A)Verbally explain what will be done.
B)Have the child watch a video on dressing changes.
C)Demonstrate a dressing change on a doll.
D)Explain the importance of keeping the burn area clean.

Question 35

Autism is a complex developmental disorder.The diagnostic criteria for autism include delayed or abnormal functioning in which areas with onset before age 3 years? (Select 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 36

The nurse is talking to the parent of a 13-month-old child.The mother states,"My child does not make noises like 'da' or 'na' like my sister's baby,who is only 9 months old." Which statement by the nurse would be most appropriate to make?

A)"I am going to request a referral to a hearing specialist."
B)"You should not compare your child to your sister's child."
C)"I think your child is fine, but we will check again in 3 months."
D)"You should ask other parents what noises their children made at this age."

Question 37

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 action 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 38

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