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 D
Explanation
A. Papillae: Papillae are small, nipple-like projections on the surface of the tongue that contain taste buds and help with the texture of food. They do not connect the tongue to the floor of the mouth.
B. Uvula: The uvula is the small, fleshy extension at the back of the soft palate that hangs above the throat. It plays a role in speech and swallowing but is not connected to the tongue.
C. Palate: The palate forms the roof of the mouth and separates the oral cavity from the nasal cavity. It includes both the hard palate (anterior) and soft palate (posterior), but it does not connect the tongue to the floor of the mouth.
D. Frenulum: The frenulum is a thin fold of tissue that connects the underside of the tongue to the floor of the mouth. This structure helps stabilize the tongue and allows for proper movement during speech and swallowing.
Correct Answer is D
Explanation
A. Nystagmus in extreme superior gaze: A few beats of nystagmus in extreme lateral gaze may be normal, but sustained nystagmus, especially in superior gaze, suggests neurological impairment such as vestibular dysfunction or multiple sclerosis.
B. Slight amount of lid lag when moving the eyes from a superior to an inferior position: Lid lag, where the upper eyelid lags behind the downward movement of the eye, is often associated with hyperthyroidism (e.g., Graves' disease). It is not a normal finding in the diagnostic positions test.
C. Convergence of the eyes: Convergence is assessed when a person focuses on a near object, such as during an accommodation test. The diagnostic positions test evaluates extraocular muscle function and cranial nerves III, IV, and VI, focusing on coordinated movement rather than convergence.
D. Parallel/synchronized movement of both eyes: The normal finding in the diagnostic positions test is smooth, coordinated movement of both eyes in all six cardinal directions without lagging, misalignment, or significant nystagmus. This indicates intact extraocular muscles and proper cranial nerve function.
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