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A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

“You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome."

“Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress."

"It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development.”

“Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies."

Answer and Explanation

The Correct Answer is C

A. "You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome." This is incorrect. Professional interventions, including speech therapy, occupational therapy, and behavioral therapy, are essential for supporting cognitive and social development in children with fragile X syndrome.

B. "Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress." Avoiding social activities can actually be harmful, as children with fragile X syndrome benefit from structured social interactions and support. Instead of avoidance, individualized strategies should be used to help the child participate comfortably.

C. "It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development." This is correct. A multidisciplinary team, including special education teachers, therapists, and healthcare providers, helps ensure the child receives individualized support in cognitive, social, and communication skills.

D. "Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies." Cognitive delays in fragile X syndrome do not resolve on their own. Early intervention and specialized education plans (e.g., IEPs) are crucial in maximizing the child’s potential.

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Correct Answer is B

Explanation

A. "Since ADHD is genetic, we need to know if other family members have been diagnosed to determine if your child has it." While ADHD has a genetic component, a family history alone is not sufficient to diagnose the condition. A proper diagnosis requires a comprehensive evaluation, not just genetic predisposition.

B. "Your child will need a comprehensive evaluation, based on specific criteria including a detailed history and behavior assessment." ADHD diagnosis is based on clinical criteria from the DSM-5, which includes a thorough history, observation of symptoms in multiple settings, and standardized behavior assessments. This ensures an accurate and well-supported diagnosis.

C. "If your child shows symptoms of ADHD at home but not at school, they can still be diagnosed with ADHD." ADHD symptoms must be present in at least two different settings, such as home and school, to meet diagnostic criteria. If symptoms are only seen in one setting, another cause may be responsible for the child’s behavior.

D. "ADHD can be confirmed with a blood test, so we should schedule one for your child." There is no laboratory test, imaging, or biomarker that can diagnose ADHD. Diagnosis is based on behavioral criteria and clinical evaluation rather than medical testing.

A. A 3-year-old toddler who aspirated several sunflower seeds and continues to cough with an O2 saturation of 91%. B. A 6 year old child admitted with asthma exacerbation who used a rescue inhaler 16 hours ago. C. A 15-year-old adolescent who had a laparoscopic appendectomy 30 hours ago, rates their pain a 3 on a scale of 1 to 10, and is preparing for discharge this morning. D. An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hours and ate 90% of their meals.

Correct Answer is A

Explanation

A. A 3-year-old toddler who aspirated several sunflower seeds and continues to cough with an O₂ saturation of 91%. This child is the highest priority due to the risk of airway obstruction. Persistent coughing and decreased oxygen saturation suggest partial obstruction, which could worsen. Immediate assessment and intervention are necessary to prevent respiratory distress or complete airway blockage.

B. A 6-year-old child admitted with asthma exacerbation who used a rescue inhaler 16 hours ago. While asthma exacerbations can be serious, this child is currently stable since there is no indication of respiratory distress or worsening symptoms requiring immediate intervention.

C. A 15-year-old adolescent who had a laparoscopic appendectomy 30 hours ago, rates their pain a 3 on a scale of 1 to 10, and is preparing for discharge this morning. This client is stable, with mild pain and no reported complications. They do not require immediate attention.

D. An 18-month-old admitted for dehydration 2 days ago who has had six wet diapers in the last 24 hours and ate 90% of their meals. This child's hydration status appears to be improving, with adequate urine output and good oral intake, making them a lower priority compared to a child with respiratory compromise.

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A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

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