A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following findings should the nurse not report to the provider?
The infant does not exhibit fear of strangers.
The infant does not roll over from his abdomen to his back.
The infant does not pick up objects from the floor with his fingers.
The infant does not sit on the floor unsupported.
None
None
The Correct Answer is B
A. The infant does not exhibit fear of strangers.
The infant does not exhibit fear of strangers is not a finding that the nurse should report to the provider, as this is a normal social behavior for a 6-month-old infant. Infants usually develop stranger anxiety between 8 and 12 months of age, when they become more aware of their surroundings and attachment figures.
B. The infant does not roll over from his abdomen to his back.
By 6 months of age, most infants can roll over in both directions— from their abdomen to their back and vice versa. The inability to roll over from abdomen to back may indicate a delay in gross motor skills development. This finding should be reported to the healthcare provider for further evaluation.
C. The infant does not pick up objects from the floor with his fingers.
By 6 months of age, infants typically begin to develop the ability to grasp and pick up objects using their fingers. This milestone is part of fine motor skills development. The inability to pick up objects from the floor with fingers may indicate a delay in fine motor skills and should be reported to the provider for further assessment.
D. The infant does not sit on the floor unsupported.
By 6 months of age, infants typically begin to develop the ability to sit unsupported for short periods. While some variability exists in when infants achieve this milestone, the inability to sit unsupported at 6 months may indicate a delay in gross motor skills development. This finding should be reported to the provider for further evaluation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Steatorrhea: Steatorrhea refers to the presence of fat in the stool, which can indicate malabsorption or digestive issues, but it is not a typical symptom of a urinary tract infection (UTI). Therefore, it is not relevant to consider steatorrhea in the context of a UTI.
B. Jaundice: Jaundice is characterized by yellowing of the skin and eyes due to elevated levels of bilirubin in the blood. It is typically associated with liver or gallbladder problems and is not a common symptom of a UTI. Therefore, it is not relevant to consider jaundice in the context of a UTI.
C. Incontinence: Incontinence, or the inability to control urination, can be a symptom of a UTI in toddlers. UTIs can cause irritation of the bladder, leading to urgency, frequency, and in some cases, incontinence. Therefore, incontinence is a relevant finding to consider in the context of a UTI.
D. Rebound tenderness: Rebound tenderness is a sign of peritoneal irritation and is typically associated with conditions affecting the abdomen, such as appendicitis or peritonitis. It is not a typical symptom of a UTI. Therefore, it is not relevant to consider rebound tenderness in the context of a UTI.
Correct Answer is D
Explanation
A. "You should give your child aspirin if they report pain at the site."
This statement is incorrect. Aspirin is a blood-thinning medication that can increase the risk of bleeding, which is particularly concerning after a cardiac catheterization procedure. It is not recommended to administer aspirin unless specifically instructed by the healthcare provider.
B. "You can remove the pressure dressing 8 hours after the procedure."
This statement is incorrect. The pressure dressing applied after a cardiac catheterization procedure is typically left in place for a specific period of time, as determined by the healthcare provider. The dressing helps prevent bleeding at the insertion site. It is essential to follow the healthcare provider's instructions regarding the timing of dressing removal.
C. "Your child can soak in the bathtub 24 hours after the procedure."
This statement is incorrect. Immersing the insertion site in water, such as soaking in a bathtub, should be avoided for a certain period after a cardiac catheterization procedure to reduce the risk of infection. The healthcare provider will provide specific instructions on when it is safe for the child to bathe or shower.
D. "Your child should avoid strenuous physical activities for several days."
This statement is correct. After a cardiac catheterization procedure, it is typically recommended to avoid strenuous physical activities for a specified period to allow the insertion site to heal properly and reduce the risk of complications such as bleeding or hematoma formation.
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