ATI LPN
Wong's Essentials of Pediatric Nursing 11th Edition Test Bank
Chapter 18 : Impact of Cognitive or Sensory Impairment on the Child and Family Questions
Question 1 of 5
A newborn assessment shows a separated sagittal suture, oblique palpebral fissures, a depressed nasal bridge, a protruding tongue, and transverse palmar creases. These findings are most suggestive of which condition?
Correct Answer: C
Rationale: These physical characteristics, including a separated sagittal suture and protruding tongue, are hallmark signs of Down syndrome. Microcephaly involves a small head, cerebral palsy lacks specific physical signs at birth, and fragile X syndrome presents different features like a long face and large ears.
Question 2 of 5
A 2-week-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that hes like a rag doll. He doesnt cuddle up to me like my other babies did. What is the nurses best interpretation of this lack of clinging or molding?
Correct Answer: C
Rationale: Hypotonicity and hyperextensibility in Down syndrome cause a rag doll-like posture, making holding difficult. This is a physical characteristic, not detachment, maternal deprivation, or autism, which is not typically associated with Down syndrome at this age.
Question 3 of 5
Many of the clinical features of Down syndrome present challenges to caregivers. Based on these features, what intervention should the nurse include in the childs care?
Correct Answer: D
Rationale: A cool-mist vaporizer helps keep mucous membranes moist, reducing the risk of respiratory infections due to mouth breathing from a stuffy nose, a common issue in Down syndrome. Limiting feeding ignores the need to persist through tongue thrust, constipation is more common than diarrhea, and calories should match physical growth needs, not mental age.
Question 4 of 5
What description applies to fragile X syndrome?
Correct Answer: B
Rationale: Fragile X syndrome is the second most common genetic cause of cognitive impairment after Down syndrome and the most common inherited cause, primarily affecting males via X-linked dominant inheritance with reduced penetrance. It is not limited to females, not uninherited, and not recessive.
Question 5 of 5
The nurse should suspect a hearing impairment in an infant who fails to demonstrate which behavior?
Correct Answer: A
Rationale: Absence of babbling by 7 months, and certainly by 12 months, suggests hearing impairment, as it indicates a lack of auditory input for language development. Eye contact and gesturing are not directly tied to hearing, and a startle reflex may occur with loud noises despite hearing issues.