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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Imitating adult behavior to be nice does not explain the child’s withdrawal and concern when the father is away. Fear of loss better accounts for these anxiety-driven behaviors post-accident, making this less fitting and incorrect for the child’s emotional response to the traumatic event.
Choice B reason: The child’s withdrawal and concern when the father is away suggest fear of losing him after the accident, a common reaction in young children. This aligns with pediatric psychology evidence on trauma response, making it the correct factor explaining the child’s behavior in this context.
Choice C reason: Fear of personal injury is less likely than fear of losing the father, given the child’s focus on the father’s absence. Withdrawal reflects attachment anxiety, not self-protection, making this less accurate and incorrect compared to the loss-related emotional response observed in the child.
Choice D reason: Believing he caused the accident is possible but less supported without evidence of guilt statements. Fear of loss better explains the child’s withdrawal and concern for the father’s absence, making this speculative and incorrect for the primary behavioral factor affecting the 5-year-old.
Correct Answer is C
Explanation
Choice A reason: Little League may be too physically demanding for an 8-year-old with muscular dystrophy, risking fatigue or injury. An art class supports engagement without exertion, making this impractical and incorrect compared to the nurse’s suggestion for a low-physical activity suitable for the child.
Choice B reason: Sedentary family activities limit social and creative stimulation, potentially isolating the child with muscular dystrophy. An art class encourages participation, making this overly restrictive and incorrect compared to the nurse’s recommendation for an engaging, low-exertion activity for the 8-year-old.
Choice C reason: An art class allows the 8-year-old with muscular dystrophy to engage socially and creatively without physical exertion, supporting well-being. This aligns with pediatric chronic illness activity planning, making it the correct suggestion for the caregivers to promote the child’s participation and development.
Choice D reason: Homeschooling may reduce social interaction, increasing feelings of difference for the child with muscular dystrophy. An art class fosters inclusion, making this isolating and incorrect compared to the nurse’s suggestion for an activity that supports social engagement without physical demands.
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