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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.
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The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes what intervention?
- A. Place a cool compress on eye during transport to the emergency department.
- B. Irrigate the eye copiously with a sterile saline solution.
- C. Remove the object with a lightly moistened gauze pad.
- D. Apply a Fox shield to the affected eye and any type of patch to the other eye.
Correct Answer: D
Rationale: Applying a Fox shield to the injured eye and a patch to the other eye prevents further injury by minimizing movement. Cool compresses, irrigation, or removing the object risk additional damage to the eye.
What description applies to fragile X syndrome?
- A. Chromosomal defect affecting only females
- B. Second most common genetic cause of cognitive impairment
- C. Most common cause of uninherited cognitive impairment
- D. Chromosomal defect that follows the pattern of X-linked recessive disorders
Correct Answer: B
Rationale: Fragile X syndrome is the second most common genetic cause of cognitive impairment after Down syndrome and the most common inherited cause, primarily affecting males via X-linked dominant inheritance with reduced penetrance. It is not limited to females, not uninherited, and not recessive.
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 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.
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.