Question 1

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

Accepted Answer

Excessive tearing and corneal haziness are indicative of glaucoma.Because the child is younger than 3 years of age,it would be classified as "infantile." Discharge is noted with conjunctivitis.Corneal haziness is not a symptom of conjunctivitis.Paralytic strabismus is caused by weakness or paralysis of one or more of the extraocular muscles.Neither tearing nor corneal haziness is a symptom of paralytic strabismus.Congenital cataract will present as an opacity,but not excessive tearing.

Question 2

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?

Accepted Answer

Chronic otitis media is the most common cause of hearing impairment in children.It is essential that appropriate measures be instituted to treat existing infections and prevent recurrences.Auditory nerve damage,congenital ear defects,and congenital rubella are rarer causes of hearing impairment.

Question 3

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

Accepted Answer

Treatment for amblyopia (lazy eye)requires that the "good" eye is patched to force the child to use the "bad" eye,thus strengthening the muscles.The patch should always be applied directly to the child's face,not to eyeglasses.The patch should be left in place even when the child is sleeping.Covering the "bad" eye will not contribute to strengthening it.The "good" eye should be patched.

Question 4

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?

Accepted Answer

Adolescents with moderate cognitive impairment may be easily persuaded and lack judgment.A well-defined,concrete code of conduct with specific instructions for handling certain situations should be laid out for the adolescent.Permanent contraception by sterilization presents moral and ethical issues and may have psychologic effects on the adolescent.It may be prohibited in some states.The adolescent needs to have practical sexual information regarding physical development and contraception.Cognitively impaired individuals may desire to marry and have families.The adolescent needs to be protected from individuals who may make intimate advances.

Question 5

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

Accepted Answer

Children with autism have abnormalities in the production of speech,such as a monotone voice or echolalia,or inappropriate volume,pitch,rate,rhythm,or intonation.The child has impaired verbal communication and abnormalities in the production of speech.Some autistic children may use sign language,but it is not assumed.Children with autism often are reluctant to initiate direct eye contact.

Question 6

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

Accepted Answer

The onset of ASD is now frequently diagnosed in toddlers because of their atypical development is being recognized early.Autism does not have periods of remission and exacerbation.Autistic children lack imitative skills.Medications are of limited use in children with autism.

Question 7

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?

Accepted Answer

Myopic patients have the ability to see near objects more clearly than those at a distance; it is caused by the image focusing beyond the retina.Hyphema includes hemorrhage in the anterior chamber and is not a refractive disorder.Astigmatism is caused by an abnormal curvature of the cornea or lens.Amblyopia is a problem of reduced visual acuity not correctable by refraction.

Question 8

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

Accepted Answer

There are a multitude of causes for intellectual impairment.In most cases,a specific cause has not been identified.Only a small percentage of children with intellectual impairment are affected by a genetic defect.One third of children with intellectual impairment are affected by first-trimester events.Intellectual impairment can be transmitted to a child only if the parent has a genetic disorder.

Question 9

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?

Accepted Answer

Providing a structured routine for the child to follow is key in the management of ASD.Decreasing stimulation by using a private room,avoiding extraneous auditory and visual distractions,and encouraging the parents to bring in possessions the child is attached to may lessen the disruptiveness of hospitalization.Because physical contact often upsets these children,minimum holding and eye contact may be necessary to avoid behavioral outbursts.Children with ASD need to be introduced slowly to new situations,with visits with staff caregivers kept short whenever possible.The playroom would be too overwhelming with new people and situations and should not be a priority of care.

Question 10

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

Accepted Answer

High risk sports such as paintball can cause penetrating eye injuries.Eye protection should be worn.All children who participate in sports should be protected by the appropriate headgear.Goggles and helmets can and should be used concurrently.A face mask does not prevent damage to the child's head.

Question 11

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

Accepted Answer

Keep all items in the room in the same location and order.Describing how many steps away something is or the placement of eating utensils on a tray are both useful tactics.Identify noises for the child because children who are visually impaired or blind often have difficulty establishing the source of a noise.Never touch the child without identifying yourself and explaining what you plan to do.When describing objects or the environment to a child who is blind or visually impaired use familiar terms.If the child has been blind since birth,color has no meaning.

Question 12

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

Accepted Answer

Children with autism are often unable to tolerate even slight changes in routine.The child's routine habits and preferences are important to maintain.Focus of care is on the child's needs rather than on the parent's desires.Autism is a lifelong condition.The presence of the parents is almost always required when an autistic child is hospitalized.

Question 13

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?

Accepted Answer

Children with CI have a marked deficit in their ability to discriminate between two or more stimuli because of difficulty in recognizing the relevance of specific cues.However,these children can learn to discriminate if the cues are presented in an exaggerated,concrete form and if all extraneous stimuli are eliminated.Therefore,demonstration is preferable to verbal explanation,and learning should be directed toward mastering a skill rather than understanding the scientific principles underlying a procedure.Watching a video would require the use of both visual and auditory stimulation and might produce overload in the child with mild CI.Explaining the importance of keeping the burn area clean would be too abstract for the child.

Question 14

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

Accepted Answer

The parents should be notified that the adolescent must see an ophthalmologist as soon as possible.Applying a Fox shield,instructing the adolescent to apply ice for 24 hours,and having the adolescent rest with the eye closed and heat applied may cause further damage.

Question 15

Which assessment findings help confirm a diagnosis of Down syndrome? (Select all that apply.)

Accepted Answer

The assessment findings of Down syndrome include high-arched,narrow palate; protruding tongue; and transverse palmar creases.The fingers are stubby and the muscle tone is hypotonic,not hypertonic.

Question 16

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?

Accepted Answer

By 11 months of age,a child should be making well-formed syllables such as "da" or "na" and should be referred to a specialist if not."You should not compare your child to your sister's child," "I think your child is fine,but we will check again in 3 months," and "You should ask other parents what noises their children made at this age" are not appropriate statements to make to the parent.

Question 17

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.)

Accepted Answer

To facilitate lipreading for a hearing-impaired child who can lip-read,the speaker should be at eye level,facing the child directly or at a 45-degree angle.Facial expressions should be used to assist in conveying messages,and the sentences should be kept short.The speaker should stand close to the child,not at a distance.Using a loud tone while speaking will not facilitate lipreading.

Question 18

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

Accepted Answer

The antibiotic should be continued for the full prescription.Maintaining separate towels and washcloths will prevent the other family members from acquiring the infection.If the infection proliferates,the physician should be contacted.The child should be kept home from school or day care until the child receives the antibiotic for 24 hours.

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