Nokea
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.
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The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes what intervention?
- A. Place a cool compress on eye during transport to the emergency department.
- B. Irrigate the eye copiously with a sterile saline solution.
- C. Remove the object with a lightly moistened gauze pad.
- D. Apply a Fox shield to the affected eye and any type of patch to the other eye.
Correct Answer: D
Rationale: Applying a Fox shield to the injured eye and a patch to the other eye prevents further injury by minimizing movement. Cool compresses, irrigation, or removing the object risk additional damage to the eye.
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 intervention is the most appropriate nursing action?
- A. Ignore the sound.
- B. Suggest he reinsert the hearing aid.
- C. Ask him to reverse the hearing aids in his ears.
- D. Suggest he raise the volume of the hearing aid.
Correct Answer: B
Rationale: The whistling sound is acoustic feedback, often caused by improper fit or hair in the ear canal. Reinserting the hearing aid correctly resolves this. Ignoring the sound is disruptive, reversing aids is incorrect due to ear-specific molds, and raising the volume worsens feedback.
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.
Secondary prevention for cognitive impairment includes what activity?
- A. Genetic counseling
- B. Avoidance of prenatal rubella infection
- C. Preschool education and counseling services
- D. Newborn screening for treatable inborn errors of metabolism
Correct Answer: D
Rationale: Secondary prevention focuses on early identification and treatment to prevent cerebral damage, such as newborn screening for inborn errors of metabolism like hypothyroidism or phenylketonuria. Genetic counseling and rubella prevention are primary prevention, while preschool education is tertiary prevention.
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.