Chapter 37. Genetics and
Dysmorphology
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 is a multitude of causes for intellectual impairment. In nearly half of the cases, a specific
cause has not been identified. Only 5% 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.
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 frightening when the parent and child
are educated about the purpose of the assessment and are not intended to measure
intelligence.
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 childs 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 in the anger stage of the grief process.
ANS: D
After a child is diagnosed with a developmental delay, the family may feel grief. The grief
process begins with a stage of disbelief and denial and then progresses to anger. It is not
possible to 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.
4. An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a
limited ability to anticipate danger 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. Impaired social interaction is indeed a concern for the child with a cognitive disorder
Dysmorphology
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 is a multitude of causes for intellectual impairment. In nearly half of the cases, a specific
cause has not been identified. Only 5% 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.
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 frightening when the parent and child
are educated about the purpose of the assessment and are not intended to measure
intelligence.
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 childs 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 in the anger stage of the grief process.
ANS: D
After a child is diagnosed with a developmental delay, the family may feel grief. The grief
process begins with a stage of disbelief and denial and then progresses to anger. It is not
possible to 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.
4. An appropriate nursing diagnosis for a child with a cognitive dysfunction who has a
limited ability to anticipate danger 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. Impaired social interaction is indeed a concern for the child with a cognitive disorder
