A mother brings her 2-month-old daughter in for an examination and says, "My daughter rolled over against the wall, and now I have noticed that she has this spot that is soft on the top of her head. Is something terribly wrong?" How should the nurse respond?
"Perhaps that could be a result of your dietary intake during pregnancy."
"That 'soft spot' may be an indication of cretinism or congenital hypothyroidism."
"That 'soft spot is normal, and actually allows for growth of the brain during the first year of your baby's life."
"Your baby may have craniosynostosis, a disease of the sutures of the skull."
The Correct Answer is C
A. "Perhaps that could be a result of your dietary intake during pregnancy": This statement does not address the mother's concerns about the soft spot and shifts the focus away from the immediate issue. The soft spot, or fontanelle, is a normal anatomical feature and is not related to maternal dietary intake during pregnancy.
B. "That 'soft spot' may be an indication of cretinism or congenital hypothyroidism": This statement is misleading. While developmental delays can be associated with congenital hypothyroidism, the presence of a soft spot on a 2-month-old’s head is a normal finding, not a direct indication of a metabolic disorder.
C. "That 'soft spot' is normal, and actually allows for growth of the brain during the first year of your baby's life": This response provides accurate information about the anterior fontanelle, which is a normal feature in infants. The fontanelle allows for skull growth as the brain expands during the early months of life. It typically closes by 12-18 months of age.
D. "Your baby may have craniosynostosis, a disease of the sutures of the skull": This statement could cause unnecessary alarm for the mother. Craniosynostosis is a condition where one or more of the sutures in a baby’s skull fuse prematurely, but it would typically present with other signs such as an abnormal head shape. A soft spot on its own does not indicate this condition.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Ethmoid: The ethmoid sinuses are located between the eyes and are not typically accessible for palpation during a physical examination. Instead, tenderness in this area is assessed through inspection and indirect methods rather than direct palpation.
B. Maxillary: The maxillary sinuses are located in the cheeks and are accessible for palpation. The nurse can assess for tenderness or swelling in this area, which can indicate sinusitis or infection. Palpating the maxillary sinuses is a standard part of the examination for patients with cold and sinus pain.
C. Mastoid: The mastoid process is located behind the ear and contains air cells, but it is not directly involved in sinus pain associated with cold symptoms. While mastoid tenderness may indicate a different type of infection (such as mastoiditis), it is not part of the sinus assessment.
D. Sphenoid: The sphenoid sinuses are located deep within the skull, behind the nasal cavity, and are not accessible for palpation during a physical examination. Any issues with the sphenoid sinuses would typically be assessed through imaging studies rather than physical palpation.
Correct Answer is A
Explanation
A. Macular degeneration: The loss of central vision while maintaining peripheral vision is characteristic of macular degeneration, a common age-related condition that affects the macula, the central part of the retina responsible for sharp and detailed vision. Patients with this condition often struggle with tasks that require fine visual acuity, such as reading or recognizing faces.
B. Increased intraocular pressure or glaucoma: Glaucoma typically causes peripheral vision loss rather than central vision loss. Patients may not notice changes in their vision until the disease has progressed significantly, making this option less likely given the patient's symptoms.
C. Vision that is normal for someone her age: While age-related changes in vision are common, the specific symptoms described—difficulty reading, sewing, and recognizing faces—indicate a significant problem rather than a normal aging process. Conditions like macular degeneration should be considered when central vision loss is present.
D. The beginning stages of cataract formation: Cataracts generally cause blurred vision, glare, and difficulty with night vision. They typically affect overall vision rather than causing specific central vision loss while preserving peripheral vision. Therefore, while cataracts are common in older adults, they do not align with the symptoms described in this case.
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