Nokea
A father calls the emergency department nurse saying that his daughters 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 the eyes closed.
- B. Apply cold compresses.
- C. Irrigate the eyes copiously with tap water for 20 minutes.
- D. Prepare a normal saline solution (salt and water) and irrigate the eyes for 20 minutes.
Correct Answer: C
Rationale: Irrigating the eyes with tap water for 20 minutes immediately flushes out the detergent, minimizing damage. Keeping eyes closed or applying compresses risks further harm, and preparing saline delays critical irrigation.
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The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?
- A. Age of onset
- B. Subaverage intelligence
- C. Adaptive skill domains
- D. Causative factors for cognitive impairment
Correct Answer: C
Rationale: The AAIDD classifies cognitive impairment based on functional impairment in at least two adaptive skill domains, such as communication, self-care, or social skills. Age of onset before 18 is a criterion but not the basis for classification. Subaverage intelligence alone is insufficient, and etiology is not part of the classification system.
The nurse is discussing sexuality with the parents of an adolescent girl who has a moderate cognitive impairment. What factor 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 very 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.
Correct Answer: C
Rationale: A concrete code of sexual conduct helps adolescents with cognitive impairment navigate social situations safely due to their susceptibility to persuasion and limited judgment. Sterilization is ethically complex and not universally recommended, sexual drive is not necessarily limited, and intercourse can occur without abuse, necessitating education.
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. Parallel play
- B. Gross motor development
- C. Ability to maintain eye contact
- D. Growth below the fifth percentile
Correct Answer: C
Rationale: A hallmark of autism spectrum disorders is the inability to maintain eye contact, reflecting impaired social interaction, with onset before age 3. Parallel play and gross motor development are typically unaffected, and physical growth is not a diagnostic criterion.
The nurse should suspect a hearing impairment in an infant who fails to demonstrate which behavior?
- A. Babbling by age 12 months
- B. Eye contact when being spoken to
- C. Startle or blink reflex to sound
- D. Gesturing to indicate wants after age 15 months
Correct Answer: A
Rationale: Absence of babbling by 7 months, and certainly by 12 months, suggests hearing impairment, as it indicates a lack of auditory input for language development. Eye contact and gesturing are not directly tied to hearing, and a startle reflex may occur with loud noises despite hearing issues.
The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What should the nurses recommendation be based on?
- A. Discipline is ineffective with cognitively impaired children.
- B. Cognitively impaired children do not require discipline.
- C. Behavior modification is an excellent form of discipline.
- D. Physical punishment is the most appropriate form of discipline.
Correct Answer: C
Rationale: Behavior modification, using clear, simple, and consistent limits with reinforcement of desired behaviors, is effective for children with cognitive impairment. Discipline is necessary and effective when tailored to mental age, and physical punishment is inappropriate.