Nokea
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.
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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.
A newborn assessment shows a separated sagittal suture, oblique palpebral fissures, a depressed nasal bridge, a protruding tongue, and transverse palmar creases. These findings are most suggestive of which condition?
- A. Microcephaly
- B. Cerebral palsy
- C. Down syndrome
- D. Fragile X syndrome
Correct Answer: C
Rationale: These physical characteristics, including a separated sagittal suture and protruding tongue, are hallmark signs of Down syndrome. Microcephaly involves a small head, cerebral palsy lacks specific physical signs at birth, and fragile X syndrome presents different features like a long face and large ears.
What technique facilitates lip reading by a hearing-impaired child?
- A. Speak at an even rate.
- B. Avoid using facial expressions.
- C. Exaggerate pronunciation of words.
- D. Repeat in exactly the same way if child does not understand.
Correct Answer: A
Rationale: Speaking at an even rate aids lip reading by allowing the child to follow lip movements clearly. Avoiding facial expressions, exaggerating pronunciation, or repeating identically can distort visual cues and hinder understanding.
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.
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.