Nokea
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.
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What condition is defined as reduced visual acuity in one eye despite appropriate optical correction?
- A. Myopia
- B. Hyperopia
- C. Amblyopia
- D. Astigmatism
Correct Answer: C
Rationale: Amblyopia, or lazy eye, is reduced visual acuity in one eye despite correction, often due to insufficient visual stimulation. Myopia is nearsightedness, hyperopia is farsightedness, and astigmatism involves unequal refractive curvatures, none of which define amblyopia.
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.
The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?
- A. Age of onset
- B. Subaverage intelligence
- C. Adaptive skill domains
- D. Causative factors for cognitive impairment
Correct Answer: C
Rationale: The AAIDD classifies cognitive impairment based on functional impairment in at least two adaptive skill domains, such as communication, self-care, or social skills. Age of onset before 18 is a criterion but not the basis for classification. Subaverage intelligence alone is insufficient, and etiology is not part of the classification system.
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.
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.