NURS 301 - PEDS Test 2: Chapters 21 - 31. Questions and Answers. Rationales Provided.
CH. 21
1. The American Association on Intellectual and
... [Show More] 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.
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.
3. What is a primary goal in caring for a child with cognitive impairment?
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 part of the childs development. Optimum
development includes adjustment for both the family and child.
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 childs 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
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.
5. The parents of a child with cognitive impairment ask the nurse for guidance with discipline.
What should the nurses 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 childs 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.
6. What intervention is most appropriate to facilitate social development of a child with a
cognitive impairment?
a. Provide age-appropriate toys and play activities.
b. Avoid exposure to strangers who may not understand cognitive development.
c. Provide peer experiences, such as infant stimulation and preschool programs.
d. Emphasize mastery of physical skills because they are delayed more often than verbal skills.
ANS: C
The acquisition of social skills is a complex task. Initially, an infant stimulation program should
be used. 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. Providing age-appropriate toys and play
activities is important, but peer interactions facilitate social development. Parents should expose
the child to individuals who do not know the child. This enables the child to practice social skills.
Verbal skills are delayed more often than physical skills. [Show Less]