Chapter 18: Impact of Cognitive or Sensory Impairment on the Child and Family Hockenberry: Wong’s Essentials of Pediatric Nursing, 10th Edition ALL ANSWERS 100% SOLVED 2022/2023 EDITION RATED GRADE A+

1. A young child has an intelligence quotient (IQ) of 45. The nurse should document this finding as: a. within the lower limits of the range of normal intelligence. b. mild cognitive impairment but educable. c. moderate cognitive impairment but trainable. d. severe cognitive impairment and completely dependent on others for care. ANS: C Moderate cognitive impairment IQs range between 35 and 55. The lower limit of normal intelligence is approximately 70. Individuals with IQs of 50 to 70 are considered to have mild cognitive impairment but educable. An IQ of 20 to 40 results in severe cognitive impairment. DIF: Cognitive Level: Understand REF: p. 530 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Psychosocial Integrity 2. When a child with mild cognitive impairment reaches the end of adolescence, which characteristic should be expected? a. Achieves a mental age of 5 to 6 years b. Achieves a mental age of 8 to 12 years c. Unable to progress in functional reading or arithmetic d. Acquires practical skills and useful reading and arithmetic to an eighth-grade level ANS: B By the end of adolescence, the child with mild cognitive impairment can acquire practical skills and useful reading and arithmetic to a third- to sixth-grade level. A mental age of 8 to 12 years is obtainable, and the child can be guided toward social conformity. The achievement of a mental age of 5 to 6 years and being unable to progress in functional reading or arithmetic are characteristics of children with moderate cognitive impairment. Acquiring practical skills and useful reading and arithmetic to an eighth-grade level is not descriptive of cognitive impairment. DIF: Cognitive Level: Understand REF: p. 530 TOP: Integrated Process: Nursing Process: Assessment MSC: Area of Client Needs: Psychosocial Integrity 3. When should children with cognitive impairment be referred for stimulation and educational programs? a. As young as possible b. As soon as they have the ability to communicate in some way c. At age 3 years, when schools are required to provide services d. At age 5 or 6 years, when schools are required to provide services ANS: A NURSINGTB.COM WONGS ESSENTIALS OF PEDIATRIC NURSING 10TH EDITION HOCKENBERRY TEST BANK NURSINGTB.COM The child’s education should begin as soon as possible. Considerable evidence exists that early intervention programs for children with disabilities are valuable for cognitively impaired children. The early intervention may facilitate the child’s development of communication skills. States are encouraged to provide early intervention programs from birth under Public Law 101-476, the Individuals with Disabilities Education Act. DIF: Cognitive Level: Apply REF: p. 530 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Psychosocial Integrity 4. Which should be the major consideration when selecting toys for a child who is cognitively impaired? a. Safety b. Age appropriateness c. Ability to provide exercise d. Ability to teach useful skills ANS: A Safety is the primary concern in selecting recreational and exercise activities for all children. This is especially true for children who are cognitively impaired. Age appropriateness, the ability to provide exercise, and the ability to teach useful skills should all be considered in the selection of toys, but safety is of paramount importance. DIF: Cognitive Level: Understand REF: p. 531 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Safe and Effective Care Environment: Safety and Infection Control 5. What are appropriate interventions to facilitate socialization of the cognitively impaired child? a. Provide age-appropriate toys and play activities. b. Provide peer experiences, such as scouting, when older. c. Avoid exposure to strangers who may not understand cognitive development. d. Emphasize mastery of physical skills because they are delayed more often than verbal skills. ANS: B The acquisition of social skills is a complex task. 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. It is important to provide age-appropriate toys and play activities, but peer interactions will facilitate social development. Parents should expose the child to strangers so that the child can practice social skills. Verbal skills are delayed more than physical skills. DIF: Cognitive Level: Apply REF: p. 533 TOP: Integrated Process: Nursing Process: Implementation MSC: Area of Client Needs: Psychosocial Integrity 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? a. Sterilization is recommended for any adolescent with cognitive impairment. b. Sexual drive and interest are limited in individuals with cognitive impairment. c. Individuals with cognitive impairment need a well-defined, concrete code of NURSINGTB.COM WONGS ESSENTIALS