Developmental delay

1. A mother tells the nurse that the pediatrician has expressed concern that her 4-year child exhibits
developmental delays. The mother expressed readiness to place her child in a preschool program for
related children. The nurse should:
a. Praise the mother for her acceptance and encourage her plan
b. Advise in mother to have the pediatrician help choose an appropriate program
c. Ask the mother for more specific information related to the developmental delays
d. Tell the mother that this is probably a premature action because developmental delay often
disappears.

2. When observing a newborn with Down Syndrome, the nurse should be aware that a common
defect associated with this condition is:
a. Deafness
b. Hydrocephaly
c. Muscular hypertonicity
d. Congenital heart defect

3. Which of the following interventions would best help a child with cerebral palsy achieve the goal
of improved self care ability:
a. Provide the child with a protective helmet
b. Provide age-and condition appropriate utensils
c. Administer medications as ordered
d. Provide for adequate rest period

4. The most common conservative treatment for cerebral palsy is:

a. Traction
b. Orthopedic surgery
c. Recreational therapy
d. Physical therapy

5. The American Association of Mental Deficiency’s definition of mental retardation stresses:

a. No responsiveness to contact
b. Deficit in adaptive behavior along with intellectual impairment
c. Cognitive impairment occurring after age 22 years
d. IQ level must be below 50

6. Which of the following is the term applied to a severe physical or mental disability that occurs
before age 22 years and likely will result in substantial limitation of function?
a. Developmental
b. Handicap
c.Chronic illness
d. Disability

7. A child with diminished sensation in the legs because of cerebral palsy should be taught special
safety precautions, including:
a. Testing the temperature of water in any water related activity
b. Setting the clock two times during the night to change position
c. Tightening straps & buckles more than usual on braces when ambulating
d. Locking down at the lower extremities when crutch walking to determine proper
positioning of the legs
8. Becky Steven, aged 7 years, is newly diagnosed as mildly retarded with an IQ of 65. Becky is the
youngest of three children, unable to articulate well, & functions at a 3 years old level. Becky's
parents have recently separated. The best predictor of Mrs. Becky's coping behavior in regard to
Becky's problem would be:
a. The state of the Steven's marital relationship
b. Becky's birth order in the family
c. Becky's gender
d. Becky's developmental level

9. Mrs. Stevens is attempting to deal with Becky's diagnosis, minimize its impact on the family, &
resolve her own marital problems. Progression of a stressful situation to a crisis situation
commonly involves all of the following variables except:
a. Available support system
b. Perception of the event
c. Past coping behaviors
d. Sibling's reaction to the diagnosis

10. Which of the following congenital anomalies are commonly associated with Down's Syndrome?
a. VSD
b. Cystic fibrosis
c. Club foot
d. Cleft lip

11. Why are children with Down's syndrome more prone to the development of URI?
a. Hypertonicity of chest muscle
b. A decreased anteroposterior diameter of the nasopharynx, which
contributes to insufficient drainage
c. Increased mucus production
d. Immature defense mechanism

12. A mother has recently been informed that her child has Down’s syndrome. You will be assigned
to care for the child at shift change. Which of the following characteristics is not associated with
Down’s syndrome?
a. Simian crease
b. Brachycephaly
c. Oily skin
d. Hypotonicity

13. After talking with the parents of a child with Down Syndrome, which of the following would
the nurse identify as an appropriate goal of care of the child?
a) encouraging self-care skills in the child
b) teaching the child something new each day
c) encouraging more lenient behavior limits for the child
d) achieving age-appropriate social skills

14. When assessing the development of a 15 month old child with cerebral palsy, which of the
following milestones would the nurse expect a toddler of this age to have achieved?
a) walking up steps
b) using a spoon
c) copying a circle
d) putting a block in cup

15. Which assessment finding would lead the nurse to suspect Down syndrome in a newborn?
a) prominent scalp veins and high-pitched cry
b) single palmar crease and hypotonia
c) flat maxillary area and short papebral tissues
d) microcephaly, persistent postnatal growth lag

16. A child has spastic cerebral palsy. Which is characteristic of a child with this condition?
a. The child is mentally retarded.
b. The child's muscles are underdeveloped.
c. The child will jerk away from your touch.
d. Children with cerebral palsy need to lie flat when eating

17. Cerebral palsy refers to a group of neuromuscular disorders resulting from prenatal,
perinatal, or postnatal central nervous system damage. Which neonate has the highest risk of
developing cerebral palsy?
a. A neonate born at 28 weeks' gestation
b. A neonate of a mother with diabetes
c. A neonate with an Apgar score of 8/9
d. A full-term neonate weighing 8 lb (3.6 kg)

18. A nurse is caring for a child with cerebral palsy. Her primary goal during therapy is to:
a. place the child in an environment with other children who have similar disabilities.
b. protect the child from situations in which he might feel different from other children.
c. provide the child with opportunities for optimal development.
d. provide opportunities for dealing with mental retardation

19. A mother refuses to accept the fact that her infant with Down syndrome (trisomy 21) is
developmentally delayed. The mother is using which defense mechanism?
a. Rationalization
b. Projection
c. Denial
d. Repression

Most children with Down’s syndrome:

A Require institutional care (False)
B Require special schooling (True)
C Have associated epilepsy (False)
D Cannot be trained to live independently (True)
E Develop autistic symptoms (False)

The following statements on Down's syndrome are correct:

A the overall risk of having a child with Down's syndrome, irrespective of maternal age, is 1 in 650 live
births. (True)
B the risk of having another baby with trisomy 21 after the birth of a child with Down's syndrome is the
same as that seen in the general population. (False)
C Down's syndrome is due to a 14;21 translocation in 30% of cases. (False)
D hyperthyroidism is commonly found in children with Down's syndrome. (False)
E 30% of children with Down's syndrome have congenital cardiac defects. (True)

Cognitive Disability:
A child identified with developmental delay is evaluated and found to have an intelligence
quotient (IQ) of 55. What is the definition of mental retardation?
Mental retardation is defined as deviations below the population intellectual functioning, measured by
an IQ, more than two standard mean on standardized intelligence tests. Mental retardation is usually
associated with functional deficits in areas such as self-care, communication, or social interactions. Mild
retardation is defined as an IQ of 50–70, and moderate-severe retardation is defined as an IQ less than
50.

What is the best predictor of a child’s subsequent cognitive performance?

Language and speech development are the best indicators of future intelligence.