Deck 37: Impact of Cognitive or Sensory Impairment on the Child and Family

Question 1

When should a child diagnosed 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.

Answer 1

As young as possible.

Question 2

Which action best facilitates lipreading 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

Answer 2

Speaking at an even rate

Question 3

Which intervention is focused on facilitating socialization of the cognitively impaired child?

A) Provide age-appropriate toys and play activities.
B) Provide peer experiences such as Special Olympics 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.

Answer 3

Provide peer experiences such as Special Olympics when older.

Question 4

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

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

Question 5

A father calls the emergency department nurse saying that his child's eyes burn after getting some dishwasher detergent in them.What should the nurse recommend before the child is transported to the emergency department?

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 6

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 7

A parent asks the nurse why a developmental assessment is being conducted for a child during a routine well-child visit.The nurse answers based on what knowledge about such routine developmental assessments?

A) Not necessary unless the parents request them.
B) The best method for early detection of cognitive disorders.
C) Frightening to parents and children and should be avoided.
D) Valuable in measuring intelligence in children.

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:

A) microcephaly.
B) Down syndrome.
C) cerebral palsy.
D) fragile X syndrome.

Question 9

Which action is contraindicated when a child diagnosed with Down syndrome is hospitalized?

A) Determine the child's vocabulary for specific body functions.
B) Assess the child's hearing and visual capabilities.
C) Encourage parents to leave the child alone at night.
D) Have meals served at the child's usual mealtimes.

Question 10

Prevention of hearing impairment in children is a major goal for the nurse.How can this be best achieved?

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 11

Which statement accurately describes fragile X syndrome?

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

Question 12

The school nurse is caring.What emergency treatment is appropriate for a child with a penetrating eye injury?

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 the eye copiously with a sterile saline solution.

Question 13

What term is used to identify the most common type of hearing loss,which results from interference of transmission of sound to the middle ear?

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

Question 14

The nurse is talking with a 10 year old who wears bilateral hearing aids.The left hearing aid is making an annoying whistling sound that the child cannot hear.What is the most appropriate nursing action to address this issue?

A) Ignore the sound.
B) Ask the child to reverse the hearing aids.
C) Suggest that the child reinsert the hearing aid.
D) Suggest that the child raise the volume of the hearing aid.

Question 15

A 9 year old diagnosed 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 what knowledge?

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.

Question 16

Which is the most common congenital anomaly associated with Down syndrome?

A) Hypospadias
B) Pyloric stenosis
C) Septal defects
D) Congenital hip dysplasia

Question 17

What is 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 18

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 19

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 20

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 21

The nurse assesses a toddler for excessive tearing and corneal haziness to confirm which medical diagnosis?

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

Question 22

A nurse is preparing a teaching session for parents on the prevention of childhood hearing loss.The nurse identify what as being the most common cause of hearing impairment in children?

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

Question 23

The teaching plan for the parents of a 3-year-old child with amblyopia should include which 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 24

The nurse is discussing sexuality with the parents of an adolescent 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 25

What should the nurse keep in mind when planning to communicate with a child who is diagnosed with an autism spectrum disorder (ASD)?

A) The child has normal verbal communication.
B) The child is expected to use sign language.
C) The child may exhibit monotone speech and echolalia.
D) The child is not listening if he/she is not looking at the nurse.

Question 26

A nurse is providing a parent information regarding autism spectrum disorder (ASD).Which statement made by the parent indicates understanding of the teaching?

A) "Autism is characterized by periods of remission and exacerbation."
B) "The onset of autism usually occurs before toddler stage."
C) "Children with autism have imitation and gesturing skills."
D) "Autism can be treated effectively with medication."

Question 27

An adolescent male visits his primary care provider complaining of difficulty with his vision.When the nurse asks the adolescent to explain what visual deficits he/she is experiencing,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

Question 28

A parent whose child has been diagnosed with a cognitive deficit should be counseled about what fact related to intellectual impairment?

A) Is usually due to a genetic defect.
B) Is likely caused by a variety of factors.
C) Is rarely due to first-trimester events.
D) Is usually caused by parental intellectual impairment.

Question 29

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 the 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 30

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

A) Restrict helmet use to those who wear eyeglasses or contact lenses.
B) Discourage the use of goggles with helmets.
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 31

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) Use color examples to describe something to a child who has been blind since birth.
E) Identify noises for the child.

Question 32

A child with autism is hospitalized with asthma.The nurse should plan care so that the:

A) parents' expectations are met.
B) child's routine habits and preferences are maintained.
C) child is supported through the autistic crisis.
D) parents need not be at the hospital.

Question 33

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 34

What intervention should the nurse implement when noting gross bleeding in a child's eye after being hit in the eye?

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

Question 35

Which assessment findings help confirm a diagnosis of 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 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 nurse is instructing a nursing assistant on techniques to facilitate lipreading 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 38

Which statement by a parent about a child's 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."