PDQ CH18

31. The nurse is talking to the parent of a 13-month-old child. The mother states, "My child does not make noises like 'da' or 'na' like my sister's baby, who is only 9 months old." Which statement by the nurse would be most appropriate to make?

"I am going to request a referral to a hearing specialist."

16. Hearing is expressed in decibels (dB), or units of loudness. Which is the softest sound a normal ear can hear?

0 dB

32. A nurse is preparing to perform a dressing change on a 6-year-old child with mild cognitive impairment (CI) who sustained a minor burn. Which strategy should the nurse use to prepare the child for this procedure?

Demonstrate a dressing change on a doll.

36. Trisomy 13, trisomy 18, and trisomy 21 have which in common?

Diagnosis can be made early, based on physical characteristics.

10. A newborn assessment shows separated sagittal suture, oblique palpebral fissures, depressed nasal bridge, protruding tongue, and transverse palmar creases. Of what are these findings most suggestive?

Down syndrome

25. A nurse should suspect possible visual impairment in a child who displays which characteristic?

Excessive rubbing of the eyes

2. Which assessment findings indicate to the nurse a child has Down syndrome? (Select all that apply.)

High arched narrow palate Protruding tongue Transverse palmar crease

9. What is one of the major physical characteristics of the child with Down syndrome?

Hypotonic musculature

6. The nurse is discussing sexuality with the parents of an adolescent girl with moderate cognitive impairment. Which should the nurse consider when dealing with this issue?

Individuals with cognitive impairment need a well-defined, concrete code of

28. 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 action before the child is transported?

Irrigate eyes copiously with tap water for 20 minutes.

1. Autism is a complex developmental disorder. The diagnostic criteria for autism include delayed or abnormal functioning in which areas with onset before age 3 years? (Select all that apply.)

Language as used in social communication Symbolic or imaginative play Social interaction

34. A child with autism spectrum disorder (ASD) is admitted to the hospital with pneumonia. The nurse should plan which priority intervention when caring for the child?

Maintain a structured routine and keep stimulation to a minimum.

23. Which term refers to the ability to see objects clearly at close range but not at a distance?

Myopia

29. An adolescent gets hit in the eye during a fight. The school nurse, using a flashlight, notes the presence of gross hyphema (hemorrhage into anterior chamber). What is the priority nursing action?

Notify parents that the adolescent needs to see an ophthalmologist

5. What are appropriate interventions to facilitate socialization of the cognitively impaired child?

Provide peer experiences, such as scouting, when older.

14. A school nurse is performing hearing screening on school children. The nurse recognizes that distortion of sound and problems in discrimination are characteristic of which type of hearing loss?

Sensorineural

20. A nurse is caring for a hearing-impaired child who lip reads. The nurse should plan which intervention to facilitate lipreading?

Speak at an even rate.

3. A nurse is instructing a nursing assistant on techniques to facilitate lipreading with a hearing-impaired child who lip reads. Which techniques should the nurse include? (Select all that apply.)

Speak at eye level. Use facial expressions while speaking. Keep sentences short.

18. 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 is the most appropriate nursing action?

Suggest he reinsert the hearing aid.

13. A child has just been diagnosed with fragile X syndrome. What is fragile X syndrome?

The second most common genetic cause of cognitive impairment

35. Which genetic term refers to the transfer of all or part of a chromosome to a different chromosome after chromosome breakage?

Translocation

12. Many of the physical characteristics of Down syndrome present nursing problems. Care of the child should include which intervention?

Use a cool-mist vaporizer to keep mucous membranes moist.

8. Mark, a 9-year-old with Down syndrome, is mainstreamed into a regular third-grade class for part of the school day. His mother asks the school nurse about programs, such as Cub Scouts, that he might join. The nurse's recommendation should be based on which statement?

Children with Down syndrome have the same need for socialization as other children.

21. A nurse is preparing a teaching session for parents on prevention of childhood hearing loss. What is the most common cause of hearing impairment in children?

Chronic otitis media

15. A school nurse is performing hearing screening on school children. The nurse recognizes that the most common type of hearing loss resulting from interference of transmission of sound to the middle ear is characteristic of which type of hearing loss?

Conductive

33. Parents of a child with Down syndrome ask the nurse about techniques for introducing solid food to their 8-month-old child's diet. The nurse should give the parents which priority instruction?

A small but long, straight-handled spoon should be used to push the food toward the back and side of the mouth.

7. When caring for a newborn with Down syndrome, what should the nurse be aware is the most common congenital anomaly associated with Down syndrome?

Congenital heart disease

17. The nurse should suspect a hearing impairment in an infant who demonstrates which behavior?

Absence of babbling by age 7 months

2. When a child with mild cognitive impairment reaches the end of adolescence, which characteristic should be expected?

Achieves a mental age of 8 to 12 years

27. The school nurse is caring for a child with a penetrating eye injury. Emergency treatment includes which intervention?

Apply a Fox shield to affected eye and any type of patch to the other eye.

3. When should children with cognitive impairment be referred for stimulation and educational programs?

As young as possible

11. The child with Down syndrome should be evaluated for which condition before participating in some Sports?

Atlantoaxial instability

22. Prevention of hearing impairment in children is a major goal for the nurse. This can be achieved through which intervention?

Being involved in immunization clinics for children

24. Which of the following terms refers to opacity of the crystalline lens that prevents light rays from entering the eye and refracting on the retina?

Cataract

26. When assessing the eyes of a neonate, the nurse observes opacity of the lens. This represents which impairment?

Cataracts

30. Which of the following is the most common clinical manifestation of retinoblastoma?

Cat's eye reflex

19. Which is an implanted ear prosthesis for children with sensorineural hearing loss?

b. Cochlear implant

1. A young child has an intelligence quotient (IQ) of 45. The nurse should document this finding as:

moderate cognitive impairment but trainable.

4. Which should be the major consideration when selecting toys for a child who is cognitively impaired?

safety