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Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should the nurse include in the childs care?
- A. Encourage parents to limit feeding attempts because of the tongue thrust.
- B. Modify the diet as necessary to minimize the diarrhea that often occurs.
- C. Provide calories appropriate to the childs mental age.
- D. Use a cool-mist vaporizer to keep the mucous membranes moist and secretions liquefied.
Correct Answer: D
Rationale: A cool-mist vaporizer helps keep mucous membranes moist, reducing the risk of respiratory infections due to mouth breathing from a stuffy nose, a common issue in Down syndrome. Limiting feeding ignores the need to persist through tongue thrust, constipation is more common than diarrhea, and calories should match physical growth needs, not mental age.
You may also like to solve these questions
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.
What intervention is most appropriate to facilitate social development of a child with a cognitive impairment?
- A. Provide age-appropriate toys and play activities.
- B. Avoid exposure to strangers who may not understand cognitive development.
- C. Provide peer experiences, such as infant stimulation and preschool programs.
- D. Emphasize mastery of physical skills because they are delayed more often than verbal skills.
Correct Answer: C
Rationale: Peer experiences, such as infant stimulation and preschool programs, foster social development by providing opportunities for interaction. Age-appropriate toys support play but not socialization, avoiding strangers limits social growth, and verbal skills are often more delayed than physical skills.
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.
A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that hes like a rag doll. He doesnt cuddle up to me like my other babies did. What is the nurses best interpretation of this lack of clinging or molding?
- A. Sign of detachment and rejection
- B. Indicative of maternal deprivation
- C. A physical characteristic of Down syndrome
- D. Suggestive of autism associated with Down syndrome
Correct Answer: C
Rationale: Hypotonicity and hyperextensibility in Down syndrome cause a rag doll-like posture, making holding difficult. This is a physical characteristic, not detachment, maternal deprivation, or autism, which is not typically associated with Down syndrome at this age.