Nokea
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.
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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.
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.
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 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.
One of the techniques that has been especially useful for learners having cognitive impairment is called fading. What description best explains this technique?
- A. Positive reinforcement when tasks or behaviors are mastered
- B. Repeated verbal explanations until tasks are faded into the childs development
- C. Negative reinforcement for specific tasks or behaviors that need to be faded out
- D. Gradually reduces the assistance given to the child so the child becomes more independent
Correct Answer: D
Rationale: Fading involves guiding the child through a task and gradually reducing assistance to promote independence. Positive reinforcement supports behavior modification, verbal explanations are less effective, and negative reinforcement is not the primary focus of fading.