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The mother of a young child with cognitive impairment asks for suggestions about how to teach her child to use a spoon for eating. The nurse should make which recommendation?
- A. Do a task analysis first.
- B. Do not expect this task to be learned.
- C. Continue to spoon feed the child until the child tries to do it alone.
- D. Offer only finger foods so spoon feeding is unnecessary.
Correct Answer: A
Rationale: Task analysis breaks down self-feeding into manageable steps, guiding the child to master each component. Expecting the task to be unlearnable is defeatist, continued spoon-feeding delays independence, and finger foods avoid necessary socialization skills.
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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.
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.
What is a primary goal in caring for a child with cognitive impairment?
- A. Developing vocational skills
- B. Promoting optimum development
- C. Finding appropriate out-of-home care
- D. Helping child and family adjust to future care
Correct Answer: B
Rationale: The primary goal is to promote optimum social, physical, cognitive, and adaptive development within the family and community. Vocational skills are a component, not the primary focus. Out-of-home care and future care adjustments are secondary to fostering overall development.
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.
A 5-year-old child has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. What nursing intervention is most important at this time?
- A. Speak to him when entering the room.
- B. Allow him to assist in feeding himself.
- C. Orient him to his immediate surroundings.
- D. Reassure him and allow his parents to stay with him.
Correct Answer: C
Rationale: Orienting the child to his surroundings is critical for safety, as bilateral eye patches impair vision and he is now mobile. Speaking on entry, assisting with feeding, and parental presence are important but secondary to ensuring a safe environment.