Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
Chapter 21:
1. The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the
American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?
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.
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,Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
DIF: Cognitive Level: Understanding REF: p. 824
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. Secondary prevention for cognitive impairment includes what activity?
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: Understanding REF: p. 826
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
3. What is a primary goal in caring for a child with cognitive impairment?
a. Developing vocational skills
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,Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
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 part of the child’s development. Optimum development includes adjustment for both the
family and child.
DIF: Cognitive Level: Understanding REF: p. 828 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
4. One of the techniques that has been especially useful for learners having cognitive impairment is called
fading. What description best explains this technique?
a. Positive reinforcement when tasks or behaviors are mastered
b. Repeated verbal explanations until tasks are faded into the child’s development
c. Negative reinforcement for specific tasks or behaviors that need to be faded out
d. Gradually reduces the assistance given to the child so the child becomes more independent
ANS: D
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, Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
Fading is physically taking the child through each sequence of the desired activity and gradually fading out
the physical assistance so 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: Analyzing REF: p. 827 TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
5. The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What
should the nurse’s recommendation be based on?
a. Discipline is ineffective with cognitively impaired children.
b. Cognitively impaired children do not require discipline.
c. Behavior modification is an excellent form of discipline.
d. Physical punishment is the most appropriate form of discipline.
ANS: C
Discipline must begin early. Limit-setting measures must be clear, 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. Aversive strategies should be
avoided in disciplining the child.
DIF: Cognitive Level: Applying REF: p. 827
4/32
or Communication Impairment questions with
answers
Chapter 21:
1. The American Association on Intellectual and Developmental Disabilities (AAIDD), formerly the
American Association on Cognitive Impairment, classifies cognitive impairment based on what parameter?
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.
1/32
,Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
DIF: Cognitive Level: Understanding REF: p. 824
TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
2. Secondary prevention for cognitive impairment includes what activity?
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: Understanding REF: p. 826
TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
3. What is a primary goal in caring for a child with cognitive impairment?
a. Developing vocational skills
2/32
,Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
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 part of the child’s development. Optimum development includes adjustment for both the
family and child.
DIF: Cognitive Level: Understanding REF: p. 828 TOP: Nursing Process: Planning
MSC: Client Needs: Psychosocial Integrity
4. One of the techniques that has been especially useful for learners having cognitive impairment is called
fading. What description best explains this technique?
a. Positive reinforcement when tasks or behaviors are mastered
b. Repeated verbal explanations until tasks are faded into the child’s development
c. Negative reinforcement for specific tasks or behaviors that need to be faded out
d. Gradually reduces the assistance given to the child so the child becomes more independent
ANS: D
3/32
, Nurs exam – The Child with Cognitive, Sensory,
or Communication Impairment questions with
answers
Fading is physically taking the child through each sequence of the desired activity and gradually fading out
the physical assistance so 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: Analyzing REF: p. 827 TOP: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance
5. The parents of a child with cognitive impairment ask the nurse for guidance with discipline. What
should the nurse’s recommendation be based on?
a. Discipline is ineffective with cognitively impaired children.
b. Cognitively impaired children do not require discipline.
c. Behavior modification is an excellent form of discipline.
d. Physical punishment is the most appropriate form of discipline.
ANS: C
Discipline must begin early. Limit-setting measures must be clear, 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. Aversive strategies should be
avoided in disciplining the child.
DIF: Cognitive Level: Applying REF: p. 827
4/32
