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Q&A 2026/2027 | A+ Graded | Exam Prep |
Comprehensive Exam Guide 2026&2027
1. Which nursing approach best supports person-centered care for an adult with an
intellectual or developmental disability (IDD)?
A. Making decisions for the individual to prevent mistakes
B. Using the same care plan for individuals with similar diagnoses
C. Incorporating the individual's preferences, strengths, communication style, and goals into care
D. Limiting participation in decisions when caregivers are available
Answer: C
Person-centered care recognizes the individual as an active participant in care and
incorporates preferences, abilities, communication needs, and personal goals.
2. A nurse is assessing a person with profound intellectual disability who cannot verbally
describe pain. Which assessment strategy is most appropriate?
A. Use an individualized behavioral pain assessment and observe changes from baseline
B. Assume absence of verbal complaints indicates absence of pain
C. Ask the caregiver to determine whether pain is present without further assessment
D. Administer analgesia whenever the individual becomes quiet
Answer: A
Individuals with limited verbal communication may express pain through behavioral or
physiological changes. Comparing current behavior with the person's baseline improves
assessment accuracy.
3. Which finding should most strongly prompt a nurse to investigate possible dysphagia in
a person with developmental disability?
A. Preference for eating independently
B. Slow walking speed
C. Frequent requests for additional fluids
D. Coughing during meals accompanied by a wet or gurgling voice
Answer: D
,Coughing during eating and a wet or gurgling vocal quality are important indicators of
possible aspiration or impaired swallowing and require further evaluation.
4. A nurse notices that a client with IDD has suddenly become withdrawn and less
communicative than usual. What should the nurse do first?
A. Document the behavior as a new baseline
B. Assess for an underlying physical or psychological cause
C. Recommend psychiatric hospitalization
D. Restrict activities until the behavior resolves
Answer: B
A sudden behavioral change may be an important indicator of pain, infection, medication
effects, injury, or another health problem. The underlying cause should be assessed before
labeling the behavior.
5. Which principle is central to supporting self-determination in developmental disabilities
nursing?
A. Allowing the individual to make informed choices whenever possible
B. Giving caregivers complete authority over decisions
C. Avoiding discussion of risks with the individual
D. Requiring staff approval for routine personal choices
Answer: A
Self-determination involves supporting the individual's right and ability to make choices while
providing appropriate information and assistance.
6. A client with IDD begins displaying aggressive behavior that is unusual for the
individual. Which action is most appropriate initially?
A. Apply a restrictive intervention immediately
B. Ignore the behavior
C. Assess for medical, environmental, communication, and psychosocial triggers
D. Permanently remove the client from community activities
Answer: C
Unexpected behavior may communicate unmet needs or illness. Assessment of possible
triggers should precede restrictive interventions whenever safety permits.
7. Which communication technique is most appropriate when explaining a new medication
to a person with an intellectual disability?
,A. Use complex medical terminology to ensure accuracy
B. Speak only with the caregiver
C. Provide the written drug monograph without explanation
D. Use plain language, appropriate pacing, and communication supports
Answer: D
Accessible communication promotes understanding and participation. The nurse should adapt
language and communication methods to the person's needs.
8. A nurse is developing goals with a person who has IDD. Which goal best demonstrates
person-centered planning?
A. The client will follow all staff instructions without objection
B. The client will identify and work toward a personally meaningful activity
C. The client will remain in the residential setting during all free time
D. The client will accept the standard facility routine
Answer: B
Person-centered goals are meaningful to the individual and focus on participation,
preferences, independence, and quality of life.
9. Which condition is particularly important to consider when assessing unexplained
changes in behavior in a person with IDD?
A. Underlying pain or illness
B. Staff preference
C. Facility scheduling
D. The individual's age alone
Answer: A
Pain and illness may present as behavioral changes when communication is limited, making
medical assessment essential.
10. A client with IDD repeatedly refuses a prescribed treatment but appears to understand
the information provided. What is the nurse's priority?
A. Threaten discharge from services
B. Ask another client to persuade the individual
C. Explore the reason for refusal and assess decision-making capacity
D. Administer the treatment without consent
Answer: C
, Refusal should be explored respectfully. When the individual can make the relevant decision,
the nurse must respect autonomy while ensuring informed decision-making.
11. Which factor most increases the risk of health disparities among people with IDD?
A. Universal access to preventive care
B. Communication barriers and reduced access to appropriate healthcare
C. Consistent transportation availability
D. Strong continuity of primary care
Answer: B
Communication barriers, inaccessible services, transportation difficulties, and limited provider
knowledge can contribute to healthcare disparities.
12. A nurse is preparing a client with IDD for a diagnostic procedure. Which intervention
is most appropriate?
A. Avoid explaining the procedure to prevent anxiety
B. Ask the caregiver to answer every question
C. Use unfamiliar terminology to maintain professionalism
D. Explain the procedure using accessible language and individualized preparation
Answer: D
Preparation should be adapted to the person's communication and cognitive needs and
should promote understanding and participation.
13. Which finding is most concerning in an adult with developmental disability who takes
multiple medications?
A. The client prefers medications with food
B. The client takes medications at the same time daily
C. New sedation, unsteady gait, and increased falls after a medication change
D. The client uses a pill organizer
Answer: C
New sedation, gait instability, and falls after a medication change may indicate adverse
effects or excessive medication burden and require prompt evaluation.
14. What is the primary purpose of medication reconciliation?
A. To identify discrepancies between the medications the person should be taking and those
actually being taken
B. To reduce every medication to one daily dose