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Wongs Nursing Care of Infants 8th Edition Hockenberry Wilson Test Bank

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Wongs Nursing Care of Infants 8th Edition Hockenberry Wilson Test Bank

ISBN-13: 978-0323039635

ISBN-10: 0323039634

 

Description

Wongs Nursing Care of Infants 8th Edition Hockenberry Wilson Test Bank

ISBN-13: 978-0323039635

ISBN-10: 0323039634

 

 

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Hockenberry & Wilson: Wong’s Nursing Care of Infants and Children,

8th Edition

 

Chapter 24: The Child with Cognitive, Sensory, or Communication Impairment

 

Test Bank

 

MULTIPLE CHOICE

 

  1. The American Association on Intellectual and Developmental Disabilities (formerly the American Association on Mental Retardation, or AAMR) classifies MR based on:
1. Age of onset
2. Subaverage intelligence
3. Adaptive skill domains
4. Causative factors for MR

 

 

ANS:   3

 

  Feedback
1 Age of onset before 18 years is part of the former criteria.
2 Low IQ alone is not the sole criterion for MR.
3 The AAMR has categorized MR into adaptive skill domains. The child must demonstrate functional impairment in at least two of the following adaptive skill domains: communication, self-care, home living, social skills, use of community resources, self-direction, health and safety, functional academics, leisure, and work.
4 Etiology is not part of the classification

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 990

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. Secondary prevention activities for MR include:
1. Genetic counseling
2. Avoidance of prenatal rubella infection
3. Preschool education and counseling services
4. Newborn screening for treatable inborn errors of metabolism

 

 

ANS:   4

 

  Feedback
1 These are examples of primary prevention strategies designed to preclude the occurrence of disorders that can cause MR.
2 These are examples of primary prevention strategies designed to preclude the occurrence of disorders that can cause MR.
3 Preschool education and counseling services are examples of tertiary prevention. These are designed to include early identification of conditions and provision of appropriate therapies and rehabilitation services.
4 Secondary prevention involves activities that are designed to identify the condition early and initiate treatment to avert cerebral damage. Inborn errors of metabolism such as hypothyroidism, PKU, and galactosemia can cause MR.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 991

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. What is a primary goal in caring for the child with mental retardation?
1. Developing vocational skills
2. Promoting optimum development
3. Finding appropriate out-of-home care
4. Helping child and family adjust to future care

 

 

ANS:   2

 

  Feedback
1 Vocational skills are only one goal. The focus must also be on the family and other aspects of development.
2 The goal for children with MR is the promotion of optimum social, physical, cognitive, and adaptive development as individuals within a family and community.
3 Out-of-home care is considered as part of the child’s development.
4 Optimum development includes adjustment for both family and child.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 991

OBJ:    Integrated process: Nursing Process: Planning

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. One of the techniques that have been especially useful for learners having mental retardation is called fading. Which of the following best describes this technique?
1. Positive reinforcement when tasks or behaviors are mastered
2. Repeated verbal explanations until tasks are faded into child’s development
3. Negative reinforcement for specific tasks or behaviors that need to be faded out
4. Gradually fading out the assistance given to the child so that the child becomes more independent

 

 

ANS:   4

 

  Feedback
1 This is part of behavior modification. An essential component is ignoring undesirable behaviors.
2 Verbal explanations are not as effective as demonstration and physical guidance.
3 Consistent negative reinforcement is helpful, but positive reinforcement that focuses on skill attainment should be incorporated.
4 Fading is physically taking the child through each sequence of the desired activity and gradually fading out the physical assistance so that the child becomes more independent.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 993

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. The parents of a child with cognitive impairment ask the nurse for guidance with discipline. The nurse’s recommendation should be based on knowledge that:
1. Discipline is ineffective with cognitively impaired children.
2. Cognitively impaired children do not require discipline.
3. Behavior modification is an excellent form of discipline.
4. Physical punishment is the most appropriate form of discipline.

 

 

ANS:   3

 

  Feedback
1 Limit setting must be clear and simple.
2 Limit setting must be clear and simple.
3 Discipline must begin early. Limit-setting measures must be simple, consistent, and appropriate for the child’s mental age. Behavior modification, especially reinforcement of desired behavior and use of time-out procedures, is an appropriate form of behavior control.
4 Aversive strategies should be avoided in disciplining the child.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 994

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. Appropriate interventions to facilitate social development of the child with cognitive impairment include which of the following?
1. Provide age-appropriate toys and play activities.
2. Avoid exposure to strangers who may not understand cognitive development.
3. Provide peer experiences, such as infant stimulation and preschool programs.
4. Emphasize mastery of physical skills because they are delayed more often than verbal skills.

 

 

ANS:   3

 

  Feedback
1 This is important, but peer interactions will facilitate social development.
2 Parents should expose the child to individuals who do not know the child. This enables the child to practice social skills.
3 The acquisition of social skills is a complex task. Initially an infant stimulation program should be used. Children of all ages need peer relationships. Parents should enroll the child in preschool. When older, they should have peer experiences similar to those of other children such as group outings, Boy and Girl Scouts, and Special Olympics
4 Verbal skills are delayed more than physical skills.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 994

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. The nurse is discussing sexuality with the parents of an adolescent girl who has moderate cognitive impairment. Which of the following should the nurse consider when dealing with this issue?
1. Sterilization is recommended for any adolescent with cognitive impairment.
2. Sexual drive and interest are very limited in individuals with cognitive impairment.
3. Individuals with cognitive impairment need a well-defined, concrete code of sexual conduct.
4. Sexual intercourse rarely occurs unless the individual with cognitive impairment is sexually abused.

 

 

ANS:   3

 

  Feedback
1 Permanent contraception by sterilization presents moral and ethical issues and may have psychologic effects on the adolescent. It may be prohibited in some states.
2 The adolescent needs to have practical sexual information regarding physical development and contraception. Cognitively impaired individuals may desire to marry and have families. The adolescent needs to be protected from individuals who may make intimate advances.
3 Adolescents with moderate cognitive impairment may be easily persuaded and lack judgment. A well-defined, concrete code of conduct with specific instructions for handling certain situations should be defined for the adolescent.
4 The adolescent needs to have practical sexual information regarding physical development and contraception. Cognitively impaired individuals may desire to marry and have families. The adolescent needs to be protected from individuals who may make intimate advances.

 

 

DIF:    Cognitive Level: Application             REF:    p. 995

OBJ:    Integrated process: Teaching/Learning

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. 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 recommend:
1. Doing a task analysis first
2. Not expecting this task to be learned
3. Spoon-feeding child until child tries to do it alone
4. Feeding finger foods so spoon-feeding is unnecessary

 

 

ANS:   1

 

  Feedback
1 Successful teaching begins with a task analysis. The endpoint (self-feeding, toilet training, etc.) is broken down into the component steps. The child is then guided to master the individual steps in sequence.
2 Depending on the child’s functional level, this should be an achievable goal.
3 The child requires demonstration and then guided training for each component of the self-feeding.
4 This eliminates some of the intermediate steps that are necessary to using a fork and spoon. For socialization purposes, it is desirable that a child use feeding implements.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 996

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. These findings are most suggestive of which of the following?
1. Microcephaly
2. Cerebral palsy
3. Down syndrome
4. Fragile X syndrome

 

 

ANS:   3

 

  Feedback
1 The infant with microcephaly has a small head.
2 Cerebral palsy is a diagnosis not usually made at birth. No characteristic physical signs are present.
3 These are characteristics associated with Down syndrome.
4 The infant with fragile X syndrome has increased head circumference; long, wide, and/or protruding ears; long, narrow face with prominent jaw; hypotonia; and high arched palate.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1000

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. 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 “he’s like a rag doll. He doesn’t cuddle up to me like my other babies did.” The nurse’s best interpretation of this lack of clinging or molding is which of the following?
1. Sign of detachment and rejection
2. Indicative of maternal deprivation
3. A physical characteristic of Down syndrome
4. Suggestive of autism associated with Down syndrome

 

 

ANS:   3

 

  Feedback
1 This is characteristic of Down syndrome, not detachment.
2 There is no evidence of maternal deprivation.
3 Infants with Down syndrome have hypotonicity of muscles and hyperextensibility of joints, which complicate positioning. The limp, flaccid extremities resemble the posture of a rag doll. Holding the infant is difficult and cumbersome, and parents may feel that they are inadequate.
4 Autism is not associated with Down syndrome, and it would not be evident at 2 weeks of age.

 

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1003

OBJ:    Integrated process: Teaching/Learning

TOP:    Area of client needs: Physiologic Integrity/Reduction of Risk Potential

 

  1. Many of the physical characteristics of Down syndrome present challenges to caregivers. Care of the child should include which of the following?
1. Delay feeding solid foods until the tongue thrust has stopped.
2. Modify diet as necessary to minimize the diarrhea that often occurs.
3. Provide calories appropriate to child’s mental age.
4. Use a cool-mist vaporizer to keep mucous membranes moist and secretions liquefied.

 

 

ANS:   4

 

  Feedback
1 The child has a protruding tongue, which makes feeding difficult. The parents must persist with feeding while the child continues the physiologic response of the tongue thrust.
2 The child is predisposed to constipation.
3 Calories should be appropriate to the child’s weight and growth needs, not mental age.
4 The constant stuffy nose forces the child to breathe by mouth, drying the mucous membranes and increasing the susceptibility to upper respiratory tract infections. A cool-mist vaporizer will keep the mucous membranes moist and liquefy secretions. Respiratory infections combined with cardiac anomalies are the primary cause of death in the first years.

 

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1001

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Physiologic Integrity/Reduction of Risk Potential

 

  1. Fragile X syndrome is which of the following?
1. Chromosomal defect affecting only females
2. Second most common genetic cause of mental retardation
3. Most common cause of uninherited mental retardation
4. Chromosomal defect that follows the pattern of X-linked recessive disorders

 

 

ANS:   2

 

  Feedback
1 Fragile X primarily affects males.
2 Fragile X syndrome is the most common inherited cause of mental retardation and the second most common genetic cause of mental retardation after Down syndrome.
3 Fragile X is inherited.
4 Fragile X follows the pattern of X-linked dominant inheritance with reduced penetrance.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1004

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development

 

  1. The nurse should suspect a hearing impairment in an infant who demonstrates a lack of which of the following behaviors?
1. Babbling by age 12 months
2. Eye contact when being spoken to
3. Startle or blink reflex to sound
4. Gesturing to indicate wants after age 15 months

 

 

ANS:   1

 

  Feedback
1 The absence of babbling or inflections in voice by age 7 months is an indication of hearing difficulties.
2 Lack of eye contact is not indicative of a hearing loss.
3 An infant with a hearing impairment might react to a loud noise but not respond to the spoken word.
4 The child with hearing impairment uses gestures rather than vocalizations to express desires at this age.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1007

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. 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. Which of the following is the most appropriate nursing action?
1. Ignore the sound.
2. Suggest he reinsert the hearing aid.
3. Ask him to reverse the hearing aids in his ears.
4. Suggest he raise the volume of the hearing aid.

 

 

ANS:   2

 

  Feedback
1 This would be annoying to others.
2 The whistling sound is acoustic feedback. The nurse should have the child remove the hearing aid and reinsert it, making sure no hair is caught between the ear mold and the ear canal.
3 The hearing aids are molded specifically for each ear.
4 This would be annoying to others.

 

 

DIF:    Cognitive Level: Analysis                  REF:    p. 1008

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. Which of the following facilitates lip reading by the hearing-impaired child?
1. Speak at an even rate.
2. Avoid using facial expressions.
3. Exaggerate pronunciation of words.
4. Repeat in exactly the same way if child does not understand.

 

 

ANS:   1

 

  Feedback
1 The child should be helped to learn and understand how to read lips by speaking at an even rate.
2 These interfere with the child’s comprehension of the spoken word.
3 These interfere with the child’s comprehension of the spoken word.
4 These interfere with the child’s comprehension of the spoken word.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1008

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. Which of the following is defined as reduced visual acuity in one eye despite appropriate optical correction?
1. Myopia
2. Hyperopia
3. Amblyopia
4. Astigmatism

 

 

ANS:   3

 

  Feedback
1 Myopia, or nearsightedness, refers to the ability to see objects clearly at close range but not a distance.
2 Hyperopia, or farsightedness, is the ability to see objects at a distance but not at close range.
3 Amblyopia, or lazy eye, is reduced visual acuity in one eye. Amblyopia is usually due to one eye not receiving sufficient stimulation. The resulting poor vision in the affected eye can be avoided with the treatment of the primary visual defect such as strabismus.
4 Astigmatism is unequal curvatures in refractive apparatus.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1012

OBJ:    Integrated process: Nursing Process: Problem Identification

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which of the following?
1. Place cool compress on eye during transport to ED.
2. Irrigate eye copiously with a sterile saline solution.
3. Remove object with lightly moistened gauze pad.
4. Apply a Fox shield to affected eye and any type of patch to the other eye.

 

 

ANS:   4

 

  Feedback
1 These interventions may cause more damage to the eye.
2 These interventions may cause more damage to the eye.
3 These interventions may cause more damage to the eye.
4 The nurse’s role in a penetrating eye injury is to prevent further injury to the eye. A Fox shield (if available) should be applied to the injured eye, and a regular eye patch to the other eye to prevent bilateral movement.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1011

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Physiologic Integrity/Reduction of Risk Potential

 

  1. A father calls the emergency department nurse saying that his daughter’s 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 of the following before the child is transported?
1. Keep eyes closed.
2. Apply cold compresses.
3. Irrigate eyes copiously with tap water for 20 minutes.
4. Prepare a normal saline solution (salt and water) and irrigate eyes for 20 minutes.

 

 

ANS:   3

 

  Feedback
1 This may allow the detergent to do further harm to the eyes during transport.
2 This may allow the detergent to do further harm to the eyes during transport.
3 The first action is to flush the eyes with clean tap water. This will rinse the detergent from the eyes.
4 Normal saline is not necessary. The delay can allow the detergent to cause continued injury to the eyes.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1011

OBJ:    Integrated process: Nursing Process: Intervention

TOP:    Area of client needs: Physiologic Integrity/Reduction of Risk Potential

 

  1. A 5-year-old has bilateral eye patches in place after surgery yesterday morning. Today he can be out of bed. Which of the following is the most important nursing intervention?
1. Speak to him when entering the room.
2. Allow him to assist in feeding himself.
3. Orient him to his immediate surroundings.
4. Reassure him and allow his parents to stay with him.

 

 

ANS:   3

 

  Feedback
1 This is a component of nursing care that is expected with all clients, unless contraindicated.
2 Unless additional impairments are present, his meal tray should be set up and he should be able to feed himself.
3 Safety is the priority concern. Since he can now be out of bed, it is imperative that he knows about his physical surroundings.
4 This is an essential part of nursing care for all children.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1015

OBJ:    Integrated process: Nursing Process: Implementation

TOP:    Area of client needs: Physiologic Integrity/Reduction of Risk Potential

 

  1. Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which of the following areas with onset before age 3 years?
1. Parallel play
2. Gross motor development
3. Ability to maintain eye contact
4. Growth below the 5th percentile

 

 

ANS:   3

 

  Feedback
1 This is play typical of toddlers and is usually not affected.
2 Social, not gross motor, development is affected by autism.
3 One hallmark of ASD is the inability of children with the disorder to maintain eye contact with another person.
4 Physical growth and development are not usually affected.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1020

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. Included in the nursing care of a child with ASD is:
1. Assign multiple staff to care for child.
2. Communicate with child at developmental level.
3. Provide a wide variety of foods for the child to try.
4. Place in semiprivate room with roommate of similar age.

 

 

ANS:   2

 

  Feedback
1 Consistent caregivers are essential for children with ASD. The same staff members should care for child as much as possible.
2 Children with ASD require individualized care. The nurse needs to communicate with the child at the child’s developmental level.
3 Children with ASD do not adapt to changing situations. The same foods should be provided to allow the child to adjust.
4 A private room is desirable for children with ASD. Stimulation is minimized.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1021

OBJ:    Integrated process: Nursing Process: Assessment

TOP:    Area of client needs: Health Promotion and Maintenance/Prevention and Early Detection of Disease

 

  1. Suggestions for parents regarding stuttering in children should include which of the following?
1. Offer rewards for proper speech.
2. Encourage child to take it easy and go slowly when stuttering.
3. Help the child by supplying word when he or she is experiencing a block.
4. Give child plenty of time and the impression that you are not in a hurry.

 

 

ANS:   4

 

  Feedback
1 Promising rewards for proper speech places additional pressure on the child.
2 This draws attention to the dysfluency.
3 The child needs to complete a sentence and thought without being interrupted.
4 Hesitancy and dysfluency should be considered a normal part of speech development. An important approach is to allow the child plenty of time to speak.

 

 

DIF:    Cognitive Level: Comprehension      REF:    p. 1022

OBJ:    Integrated process: Teaching/Learning

TOP:    Area of client needs: Health Promotion and Maintenance/Growth and Development