The parents of a child with a neurologic disorder and severe intellectual disability are concerned about the child's frequent emotional changes and anger.
How might the nurse interpret these changes in emotion?
The child is not functioning at the expected level for a child with a severe intellectual disability and needs further assessment.
The child may be having temper tantrums which will likely turn into self-injurious behaviors if the parents do not intervene.
The child requires behavioral interventions to prevent hurting self and others.
The child may be frustrated and unable to appropriately express needs.
The Correct Answer is D
Choice A rationale
Intellectual disability involves significant limitations in both intellectual functioning and adaptive behavior. When a child functions within the parameters of a severe neurologic deficit, emotional lability is often a manifestation of the underlying pathology rather than a lack of expected progress. Assessing the child further is always appropriate in clinical practice, but it does not provide the immediate interpretation of why the emotional changes are occurring in relation to the specific disability presented.
Choice B rationale
Temper tantrums are common in pediatric development, but labeling these specific emotional shifts as tantrums that will inevitably lead to self-injurious behavior is a leap in clinical logic. While some children with severe intellectual disabilities may develop self-harming habits as a form of sensory input or communication, it is not a guaranteed progression for every child experiencing anger. Interpreting the behavior as a precursor to self-injury ignores the more likely immediate cause of the emotional distress.
Choice C rationale
Behavioral interventions are certainly a component of a comprehensive care plan for children with neurologic disorders. However, the nurse’s primary role in interpreting these changes is to identify the root cause of the distress before jumping to restrictive or preventative interventions. Focusing solely on preventing harm to others or self misses the opportunity to understand the internal experience of the child, who may be experiencing significant neurological discomfort or environmental overstimulation that triggers the anger.
Choice D rationale
Children with severe intellectual disabilities often lack the cognitive and linguistic skills required to communicate complex internal states, such as pain, hunger, or frustration. Emotional outbursts and anger frequently serve as a substitute for verbal communication when a child is unable to navigate their environment or express specific needs. The nurse must recognize that these behaviors are functional attempts at interaction. Frustration arises when the child’s internal desires are not met by the external support system.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Early term is defined as an infant born between 37 weeks 0 days and 38 weeks 6 days of gestation. The neonate in this scenario was born at 35 weeks and 4 days, which falls significantly below the threshold for early term. Infants in the early term category have different developmental milestones and lower risks for respiratory distress compared to those born earlier, making this classification scientifically inaccurate for a neonate born at 35 weeks and 4 days.
Choice B rationale
Post term refers to a pregnancy that extends beyond 42 weeks 0 days of gestation. This classification is associated with risks such as placental insufficiency and meconium aspiration syndrome. Given that this infant was born at 35 weeks and 4 days, they are significantly far from the post-term range. Scientific classification systems strictly reserve the post-term label for those exceeding the 42-week mark, as the physiological challenges of post-maturity differ greatly from those of prematurity.
Choice C rationale
Preterm is a broad category that encompasses any infant born before 37 weeks 0 days of gestation. While this infant is technically preterm, the most specific and clinically accurate sub-category for an infant born at 35 weeks and 4 days is late preterm. In clinical practice, providing the most precise sub-classification is essential for determining the specific level of monitoring required, as preterm can refer to infants born anywhere from 20 to 36 weeks and 6 days.
Choice D rationale
Late preterm is the specific scientific definition for infants born between 34 weeks 0 days and 36 weeks 6 days of gestation. This neonate was born at 35 weeks and 4 days, placing them directly within this critical window. Late preterm infants often appear physically similar to full-term infants but remain physiologically immature, facing higher risks for respiratory distress, temperature instability, hypoglycemia, and hyperbilirubinemia. Accurate classification ensures that healthcare providers implement the appropriate specialized surveillance protocols.
Correct Answer is C
Explanation
Choice A rationale
Allowing a child to cry alone, often referred to as the cry it out method, is not recommended for neonates or infants immediately after birth. Scientific evidence suggests that prompt responses to an infant's distress signals are essential for developing a secure attachment and building foundational trust. Ignoring a newborn's cries can lead to increased cortisol levels and psychological stress, which negatively impacts the delicate neurological development and emotional bond between the mother and the infant.
Choice B rationale
Newborns require constant closeness and physical contact to regulate their physiological systems, such as heart rate, temperature, and breathing. Suggesting that a mother needs time alone to avoid overwhelming the child is scientifically inaccurate in the context of healthy bonding. Isolation during the immediate postpartum period can lead to maternal detachment or postpartum depression. The biological expectation of a newborn is continuous proximity to the caregiver to ensure survival and optimal emotional health through sensory stimulation.
Choice C rationale
Reciprocal interactions like holding, skin to skin contact, and gentle vocalization stimulate the release of oxytocin in both the mother and the newborn. Oxytocin is a hormone critical for social bonding and maternal behavior. These sensory inputs facilitate the transition to extrauterine life for the infant and help the mother develop confidence in her caregiving abilities. Engaging in these behaviors strengthens the neurobiological pathways associated with attachment, ensuring the infant feels safe and supported.
Choice D rationale
Giving an infant space to allow for natural biological development is a concept that does not apply to the neonatal period. Human infants are born neurologically immature and are biologically programmed to seek out and remain in close proximity to their primary caregiver. Proximity seeking is a survival mechanism. Physical separation can disrupt the development of the internal working model of relationships. Natural development occurs through social interaction and physical touch rather than through physical or emotional distance.
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