A mother brings a 23-month-old child for a well-child check. She apologizes, stating, “It’s my allergies, not a cold, that is causing me to sniffle so much.” The mother reports that the toddler seems “slower at doing things” than her older children did. The nurse notices that the child sits in the mother’s lap without fear or hesitation and responds to the mother’s questions, but fails to look at the mother’s face when being spoken to. These behaviors are supportive of what additional assessment?

Indications of physical abuse of the child by the caregiver.

Evidence of cocaine abuse by the caregiver affecting the child.

Autistic behaviors demonstrated by the child.

Attention deficit hyperactive disorder (ADHD) characteristics demonstrated by the child.

Answer and Explanation

The Correct Answer is C

Choice A reason: Lack of eye contact and developmental delay don’t directly indicate physical abuse, which typically shows fear or physical signs. Autistic behaviors like poor eye contact are more likely, making this incorrect, as the toddler’s behaviors align better with autism in the well-child assessment.

Choice B reason: Cocaine abuse by the caregiver might affect development but isn’t linked to specific behaviors like poor eye contact. Autistic traits better explain the toddler’s symptoms, making this speculative and incorrect compared to the nurse’s assessment of developmental concerns in the child.

Choice C reason: Poor eye contact and slower development at 23 months suggest autistic behaviors, common in autism spectrum disorder. This aligns with pediatric developmental screening, making it the correct additional assessment for the nurse to consider based on the toddler’s observed behaviors during the check.

Choice D reason: ADHD typically presents later with hyperactivity and inattention, not poor eye contact or developmental delay at 23 months. Autistic behaviors are more fitting, making this incorrect, as the toddler’s symptoms align better with autism than ADHD in the well-child evaluation.

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Correct Answer is C

Explanation

Choice A reason: Infant sebaceous and sweat glands are not fully functional, developing postnatally. The skin’s role in temperature regulation is accurate, making this incorrect, as it misstates infant integumentary function in the instructor’s presentation to student nurses on the system’s role.

Choice B reason: The integumentary system is present at birth, though maturing over time, not absent until after birth. Temperature regulation is a key function, making this incorrect, as it exaggerates the system’s developmental timeline in the instructor’s presentation on the integumentary system.

Choice C reason: The skin, the body’s largest organ, regulates temperature through sweating and vasodilation, a primary integumentary function. This aligns with physiological principles, making it the most accurate statement for the instructor to present to student nurses about the integumentary system’s role.

Choice D reason: Oxygen distribution is a respiratory and circulatory function, not integumentary. The skin’s temperature regulation is correct, making this incorrect, as it misattributes a role to the integumentary system in the instructor’s presentation to student nurses on its physiological functions.

A. Look for the baby to start running a fever and develop a stuffy nose and that will indicate his teeth are coming in. B. If the baby does not have any teeth come in by next month, the mother needs to bring him back for x-rays. C. Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption. D. A baby’s first teeth should erupt by 8 to 10 months of age and are the two lower front teeth.

Correct Answer is C

Explanation

Choice A reason: Fever and stuffy nose are not reliable indicators of teething and may signal illness. Genetic variation explains delayed eruption in an 8-month-old, making this misleading and incorrect for addressing the mother’s anxiety about her baby’s lack of teeth in the phone consultation.

Choice B reason: Requiring x-rays if no teeth erupt by 9 months is premature, as teeth can appear up to 12 months normally. Genetic factors reassure without unnecessary tests, making this alarmist and incorrect for responding to the mother’s dentition concerns about her 8-month-old baby.

Choice C reason: Tooth eruption varies genetically, with some babies teething later (up to 12 months) without issue. This explanation reassures the mother about her 8-month-old’s delayed dentition, aligning with pediatric dental norms, making it the correct information to alleviate her anxiety effectively.

Choice D reason: Stating teeth should erupt by 8-10 months is inaccurate, as normal eruption can occur up to 12 months. Genetic variability better addresses the mother’s concern, making this incorrect, as it risks heightening anxiety with a rigid timeline for the baby’s tooth eruption.

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Naxlex Comprehensive Predictor Exams

The nurse instructor is reviewing the integumentary system during a presentation to a group of student nurses. Which statement made by the instructor is the most accurate regarding the integumentary system?

Correct Answer is C

Explanation

A first-time mother calls the pediatrician’s office to ask the nurse about her baby’s tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby’s dentition?

Correct Answer is C

Explanation

During a well-child checkup, a child shares being embarrassed when she is seen with her 7-year-old sister who wears an arm prosthesis after the limb was amputated. Which statement by the nurse most appropriately addresses the child’s concerns?

The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?

The nurse is discussing types of treatment used when working with children who have orthopedic disorders. Which form of treatment covers the lower part of the body, usually from the waist down, and either one or both legs while leaving the feet open?

The nurse is collecting data on a 4-month-old child brought to the clinic by the caregiver. The nurse observes the child’s mouth and notes a white coating that looks like milk curds. Which of the following questions would be most important for the nurse to ask the caregiver?

The nurse is discussing the ears and hearing in a child with a group of peers. Which statement is most accurate related to this topic?

The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation?