Deck 42: Cognitive and Sensory Impairment

Question 1

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

Answer 1

Sensorineural

Question 2

The child 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 spots)

Answer 2

Atlantoaxial instability

Question 3

Which of the following facilitates lip-reading by the hearing-impaired child?

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

Answer 3

Speaking at an even rate

Question 4

A young child who has an intelligence quotient (IQ)of 45 is which of the following?

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 5

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 6

When caring for a newborn with Down syndrome,the nurse should be aware that the most common congenital anomaly is which one of the following?

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

Question 7

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 8

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

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

Question 9

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

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 10

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.What is the most appropriate nursing action?

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 11

Mark,a 9-year-old with Down syndrome,is mainstreamed into a regular Grade 3 class for part of the school day.His mother asks the school nurse about programs such as Cub Scouts that he might join.What knowledge should the nurse's recommendation be based upon?

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 want access to programs such as Scouts because they deny that their children have disabilities.

Question 12

What is the most common type of hearing loss that results from interference of transmission of sound to the middle ear?

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

Question 13

Which of the following activities is an appropriate intervention to facilitate socialization for a cognitively impaired child?

A) Providing age-appropriate toys and play activities
B) Providing peer experiences such as Guides or 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 14

When a child with mild cognitive impairment reaches the end of adolescence,which level of skill development is expected?

A) Achieves a mental age of 3 to 7 years
B) Achieves a mental age of 8 to 12 years
C) Unable to progress in functional reading or arithmetic
D) Acquires practical skills, useful reading, and arithmetic to an eighth-grade level

Question 15

Which of the following should be included in the care of a child with Down syndrome?

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 the child's age.
D) Use a cool-mist vaporizer to keep mucous membranes moist.

Question 16

A newborn assessment shows separated sagittal suture,oblique palpebral fissures,depressed nasal bridge,protruding tongue,and transverse palmar creases.What are these findings most suggestive of?

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

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

What is 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 19

Which one of the following is an implanted ear prosthesis for children with sensorineural hearing loss?

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

Question 20

Preventing hearing impairment in children is a major goal for a nurse.What is one way that this can be achieved?

A) Be involved in immunization clinics for children.
B) Assess a newborn for hearing loss.
C) Answer parents' questions about hearing aids.
D) Participate in hearing screening in the community.

Question 21

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 22

What is the most common clinical manifestation of retinoblastoma?

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

Question 23

An adolescent gets hit in the eye during a fight.The school nurse,using a flashlight,notes the presence of a gross hyphema (hemorrhage into anterior chamber).What should the nurse do?

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

Question 24

A nurse suspects possible visual impairment in a child who displays which one of the following?

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 25

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

A) Symbolic or imaginative play
B) Parallel play
C) Gross motor development
D) Growth below the 5th percentile for height and weight

Question 26

The school nurse is caring for a child with a penetrating eye injury.Which one of the following is included in emergency treatment?

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

Question 27

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 the parents do before transporting the child?

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.