Wong's Nursing Care of Infants and Children 9th Edition by Marilyn J. Hockenberry, David Wilson
Wong's Nursing Care of Infants and Children 9th Edition by Marilyn J. Hockenberry, David Wilson
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Chapter 24: The Child with Cognitive, Sensory, or Communication Impairment
Complete Chapter Questions With Answers
Sample Questions Are Posted Below
MULTIPLE CHOICE
| a. | age of onset. |
| b. | subaverage intelligence. |
| c. | adaptive skill domains. |
| d. | causative factors for cognitive impairment. |
ANS: C
The AAIDD has categorized cognitive impairment 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. Age of onset before 18 years is part of the former criteria. Low intelligence quotient (IQ) alone is not the sole criterion for cognitive impairment. Etiology is not part of the classification.
DIF: Cognitive Level: Comprehension REF: p. 909
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
| a. | genetic counseling. |
| b. | avoidance of prenatal rubella infection. |
| c. | preschool education and counseling services. |
| d. | newborn screening for treatable inborn errors of metabolism. |
ANS: D
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, phenylketonuria, and galactosemia can cause cognitive impairment. Genetic counseling and avoidance of prenatal rubella infections are examples of primary prevention strategies to preclude the occurrence of disorders that can cause cognitive impairment. 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.
DIF: Cognitive Level: Comprehension REF: p. 910
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
| a. | Developing vocational skills |
| b. | Promoting optimum development |
| c. | Finding appropriate out-of-home care |
| d. | Helping child and family adjust to future care |
ANS: B
The goal for children with cognitive impairment is the promotion of optimum social, physical, cognitive, and adaptive development as individuals within a family and community. Vocational skills are only one part of that goal. The focus must also be on the family and other aspects of development. Out-of-home care is considered as part of the child’s development. Optimum development includes adjustment for both family and child.
DIF: Cognitive Level: Comprehension REF: p. 912 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
| a. | Positive reinforcement when tasks or behaviors are mastered |
| b. | Repeated verbal explanations until tasks are faded into child’s development |
| c. | Negative reinforcement for specific tasks or behaviors that need to be faded out |
| d. | Gradually fading out the assistance given to the child so that the child becomes more independent |
ANS: D
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. Positive reinforcement when tasks or behaviors are mastered is part of behavior modification. An essential component is ignoring undesirable behaviors. Verbal explanations are not as effective as demonstration and physical guidance. Consistent negative reinforcement is helpful, but positive reinforcement that focuses on skill attainment should be incorporated.
DIF: Cognitive Level: Comprehension REF: p. 911
TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity
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