The nurse is discussing discipline issues with a group of caregivers of preschool-aged children who have a cognitive impairment. One father tells the group that after he tells his child to stop doing something, the child just continues. Parents in the group make the following statements. Which statement indicates an understanding of disciplining the cognitively impaired child?
“We hold a family meeting to explain to our other children that she gets away with things they will not get away with because of her impairment.”
“We always take away a privilege our child has been looking forward to, such as going to a movie next weekend.”
“My wife and I just ignore the behavior and if there is a mess, clean up the mess. He doesn’t understand that he has an impairment.”
“We wait until a behavior happens a second time and immediately put our child in time-out.”
The Correct Answer is D
Choice A reason: Explaining differential treatment to siblings fosters resentment and doesn’t teach the impaired child. Time-out after repetition reinforces boundaries, making this unhelpful and incorrect compared to a direct discipline strategy addressing the cognitively impaired preschooler’s continued behavior effectively.
Choice B reason: Taking away privileges like movies is too abstract for a cognitively impaired preschooler to connect to behavior. Immediate time-out is clearer, making this ineffective and incorrect compared to a concrete, immediate consequence tailored to the child’s cognitive limitations in discipline.
Choice C reason: Ignoring behavior and cleaning up avoids teaching consequences, reinforcing unwanted actions in a cognitively impaired child. Time-out provides structure, making this counterproductive and incorrect compared to a strategy that directly addresses and corrects the preschooler’s behavior with appropriate discipline.
Choice D reason: Waiting for a second occurrence and using immediate time-out provides clear, consistent consequences, suitable for a cognitively impaired preschooler’s understanding. This aligns with pediatric behavioral strategies, making it the correct statement reflecting effective discipline for the child’s continued behavior issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Discussing anxiety and depression is relevant but premature without addressing the immediate issue of the child being alone and scared after school. After-school programs provide supervision and safety, making this less urgent and incorrect compared to resolving the primary concern of unsupervised time for the child.
Choice B reason: Preventing drug and alcohol use is important but not the priority for a 10-year-old scared and alone after school. After-school programs address immediate safety and social needs, making this secondary and incorrect compared to tackling the child’s current unsupervised and fearful situation at home.
Choice C reason: Emergency contact numbers are useful but do not resolve the ongoing issue of the child being alone and scared daily. After-school programs offer structured supervision, directly addressing the primary concern, making this less critical and incorrect for the nurse’s priority action for this family.
Choice D reason: Providing a list of after-school programs addresses the child’s fear and isolation by offering supervised, engaging activities, reducing unsupervised time at home. This prioritizes safety and emotional well-being, aligning with pediatric nursing goals for supporting relocated families, making it the correct action to assist them.
Correct Answer is D
Explanation
Choice A reason: Slightly crooked teeth may complicate oral hygiene but are not a primary cause of cavities, which depend more on brushing and diet. Malocclusions affect chewing efficiency, making this less accurate and incorrect compared to the functional impact of misaligned teeth noted during the assessment.
Choice B reason: Malocclusions do not directly cause infections or tooth loss unless severe and untreated. Slight cross-over primarily impacts chewing and jaw function, not infection risk, making this exaggerated and incorrect for the primary reason to seek orthodontic consultation for the teenager’s teeth.
Choice C reason: Social impacts like dating or hiring are speculative and not the primary clinical concern for slight malocclusions. Chewing and jaw efficiency are direct functional issues, making this psychosocial focus less relevant and incorrect for the orthodontic referral rationale in this clinical scenario.
Choice D reason: Slight malocclusions, like crossed front teeth, can impair chewing and jaw function, leading to inefficient mastication or strain. This functional concern justifies orthodontic evaluation, aligning with dental health principles, making it the correct reason to recommend seeing an orthodontist for the teenager.
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