Nokea
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.
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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.
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 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.
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 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.