Ch. 20 Evolve Quiz

Which is a sign of visual impairment in an infant?

No reaction to light An infant or child who has no reaction to light is likely visually impaired. Excessive rubbing of eyes is a sign of visual impairment in children, not infants. Rapid lateral movement of the eyes is not associated with visual impairment. Lack of binocularity after, not before, 4 months of age is associated with amblyopia and requires further investigation.

Which term is appropriate when describing reduced visual acuity in one eye despite appropriate optical correction?

Amblyopia The definition of amblyopia is the reduction of visual acuity in one eye despite appropriate optical correction. Myopia is nearsightedness, the ability to see objects up close but not clearly at a distance. Hyperopia is farsightedness, the ability to clearly see distant objects but not close ones. Astigmatism is an alteration in vision caused by unequal curvature in the eye's refractive apparatus.

Which nursing recommendation is appropriate for the parents of a cognitively impaired child asking for guidance with discipline?

Behavior modification is an excellent form of discipline. Positive behaviors and desirable actions should be reinforced with cognitively impaired children. Behavior modification with positive reinforcement is effective in children with cognitive impairment. Discipline is essential in assisting the child in developing boundaries. Most children with cognitive impairment will not be able to understand the reason for the physical punishment, and the behavior will not change. Physical punishment is not an acceptable form of discipline.

Which finding is appropriate when identifying cognitive impairment in children?

Delayed developmental milestones Delayed achievement of developmental milestones is a major clue to the presence of cognitive impairment in children. Children with Down syndrome or fragile X syndrome have dysmorphic features that make cognitive impairment easier to recognize. Abnormal eye contact, gross motor delay, decreased alertness to voice or movement, language difficulties, and feeding difficulties are all early behavioral signs of cognitive impairment.

Which statement is appropriate regarding X-linked dominant patterns with reduced penetrance?

Female carriers may exhibit learning disabilities In an X-linked dominant pattern, a female carrier with normal intelligence might exhibit some learning disabilities and psychological disorders. This is called X-linked dominant pattern with reduced penetrance. In an X-linked dominant pattern with reduced penetrance, a male carrier might have learning disabilities and psychological disorders. Sons of the affected male are not affected by the disorder in an X-linked dominant pattern if the father is a carrier of the faulty gene, because sons only inherit the Y chromosome from the father. Males with the full mutation will exhibit intellectual disabilities in an X-linked dominant pattern because they have only one X chromosome.

Which clinical manifestations are appropriate for myopia in children? Select all that apply.

Headache Dizziness Clumsiness Eye rubbing Clinical manifestations of myopia in children include headaches, dizziness, clumsiness, and eye-rubbing. Amblyopia, or "lazy eye," is not associated with myopia.

Which clinical symptoms are appropriate with spinal cord compression from atlantoaxial instability? Select all that apply.

Loss of motor skills Persistent neck pain Changes in sensation Loss of bladder control Children with Down syndrome who suffer atlantoaxial instability are at risk for spinal cord compression. Signs of spinal cord compression include persistent neck pain, changes in sensation, loss of motor skills, and loss of bladder or bowel control. Back pain is not a common symptom of spinal cord compression.

Which patient has fragile X syndrome?

Patient with long, wide ears, prominent jaw, macroorchidism Long, wide, or protruding ears; a long face with a prominent jaw; and large testes (macroorchidism) are typical characteristics of males with fragile X syndrome. The presence of small ears, a hypoplastic mandible, and cryptorchidism are characteristics of males with Down syndrome. Microdontia is a characteristic feature of patients with Down syndrome. Self-biting is observed in both Down syndrome and fragile X syndrome. Patients with hearing impairments appear to be dreamy and "in their own world." Hyperopia, or farsightedness, is not a clinical manifestation observed in patients with fragile X syndrome. Cracked skin and short feet are clinical manifestations seen in patients with Down syndrome.

Which type of sensory impairment is appropriate for a 4-year-old child who has difficulty processing linguistic information through audition with or without a hearing aid?

Profound A child who has difficulty processing linguistic information through audition with or without a hearing aid has a profound sensory impairment. A slight sensory impairment is defined as difficulty hearing faint or distant speech. A moderate sensory impairment is defined as hearing sufficient to enable successful processing of linguistic information through audition. A moderately severe impairment is defined as hearing sufficient to enable successful processing of linguistic information through audition.

Which skill is appropriate when discussing the importance of a young child to hear sounds?

Speech development The ability to hear sounds is essential for the development of speech. The child who cannot hear sounds will have difficulty with communication, social development, and behavior, but the ability to hear sounds is especially important because it is essential for speech development.

Which clinical manifestations are appropriate for Down syndrome? Select all that apply.

Flat nasal bridge Separated saggital suture High arched, narrow palate The most common clinical manifestations of Down syndrome include a separated sagittal suture; small nose; high, arched, narrow palate; wide space between the big and second toes; plantar crease between the big and second toes; hyperflexibility and muscle weakness; neck skin excess and laxity; depressed nasal bridge; and oblique palpebral fissures. Early-onset dementia occurs in one third of those with Down syndrome. Hypoplastic mandible, rather than hyperplastic mandible, is a clinical manifestation of Down syndrome.

Which condition is appropriate for the child who has difficulty in reading, performs poorly in school, and complains of frequent headaches?

Myopia A child with myopia has frequent headaches and has difficulty in reading. The child is able to see objects at a close range but not at a distance. Hyperopia is diagnosed when the ability to see close objects is affected. Cataract is identified when a child is unable to see objects clearly. The perception of halos around objects and eye redness indicate glaucoma.