Chapter 54 The Child With an Intellectual Disability or Developmental Disability

Chapter 54  The Child With an Intellectual Disability or Developmental Disability

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. A parent whose child has been diagnosed with a cognitive deficit should be counseled that

intellectual impairment
a. is usually due to a genetic defect.
b. may be caused by a variety of factors.
c. is rarely due to first trimester events.
d. is usually caused by parental intellectual impairment.

ANS: B
There are a multitude of causes for intellectual impairment. In most cases, a specific cause has
not been identified. Only a small percentage of children with intellectual impairment are
affected by a genetic defect. One third of children with intellectual impairment are affected by
first trimester events. Intellectual impairment can be transmitted to a child only if the parent
has a genetic disorder.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 1338 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

2. A parent asks the nurse why a developmental assessment is being conducted for a child during

a routine well-child visit. The nurse answers based on the knowledge that routine
developmental assessments during well-child visits are
a. not necessary unless the parents request them.
b. the best method for early detection of cognitive disorders.
c. frightening to parents and children and should be avoided.
d. valuable in measuring intelligence in children.

ANS: B
Early detection of cognitive disorders can be facilitated through assessment of development at
each well-child examination. Developmental assessment is a component of all well-child
examinations. Developmental assessments are not as frightening when the parent and child are
educated about the purpose of the assessment. Developmental assessments are not intended to
measure intelligence.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 1340 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

3. The father of a child recently diagnosed with developmental delay is very rude and hostile

toward the nurses. This father was cooperative during the child’s evaluation a month ago.
What is the best explanation for this change in parental behavior?
a. The father is exhibiting symptoms of a psychiatric illness.
b. The father may be abusing the child.
c. The father is resentful of the time he is missing from work for this appointment.
d. The father is experiencing a symptom of grief.

ANS: D
After a child is diagnosed with a developmental delay, families typically experience a cycle of
grieving that is repeated when developmental milestones are not met. One cannot determine
that a parent is exhibiting symptoms of a psychiatric illness on the basis of a single situation.
The scenario does not give any information to suggest child abuse. Although the father may
have difficulty balancing his work schedule with medical appointments for his child, a more
likely explanation for his behavior change is that he is grieving the loss of a normal child.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 1342 | Nursing Care Plan OBJ: Nursing Process: Assessment
MSC: Client Needs: Psychosocial Integrity

4. The most appropriate nursing diagnosis for a child with a cognitive dysfunction is

a. impaired social interaction.
b. deficient knowledge.
c. risk for injury.
d. ineffective coping.

ANS: C
The nurse needs to know that limited cognitive abilities to anticipate danger lead to risk for
injury. Safety is a priority for all children with cognitive dysfunction. Impaired social
interaction is indeed a concern for the child with a cognitive disorder but does not address the
limited ability to anticipate danger. Because of the child’s cognitive deficit, knowledge will
not be retained and will not decrease the risk for injury. Ineffective individual coping does not
address the limited ability to anticipate danger.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 1341 | Safety Alert Box OBJ: Nursing Process: Diagnosis
MSC: Client Needs: Health Promotion and Maintenance

5. Anticipatory guidance for the family of a preadolescent with a cognitive dysfunction should

include information about
a. institutional placement.
b. sexual development.
c. sterilization.
d. appropriate clothing.

ANS: B
Preadolescents who have a cognitive dysfunction may have normal sexual development
without the emotional and cognitive abilities to deal with it. It is important to assist the family
and child through this developmental stage. The child may or may not need institutional
placement at some point. Sterilization is not an appropriate intervention when a child has a
cognitive dysfunction. By the time a child reaches preadolescence, the family should have
received counseling on age-appropriate clothing.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 1342 | Nursing Care Plan OBJ: Nursing Process: Planning
MSC: Client Needs: Health Promotion and Maintenance