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.
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. "Avoid immunizing your child with the meningococcal vaccine."
This statement is incorrect. Children with sickle cell anemia are at increased risk of infections, including meningococcal disease. Immunization with the meningococcal vaccine is recommended to help prevent this serious infection.
B. "Restrict the time your child spends playing outdoors."
While it's important for children with sickle cell anemia to avoid extreme temperatures and stay hydrated to prevent triggering a vaso-occlusive crisis, completely restricting outdoor playtime may not be necessary. It's essential to encourage appropriate hydration and dress warmly in cold weather but allowing outdoor play in moderation can be beneficial for physical activity and socialization.
C. "Increase your child's intake of oral fluids."
This is a correct statement. Adequate hydration is crucial for children with sickle cell anemia to help prevent vaso-occlusive crises and maintain overall health. Increasing oral fluid intake, particularly water, can help prevent dehydration and promote circulation of sickle-shaped red blood cells.
D. "Provide your child with a high-protein diet."
This is also a correct statement. A diet rich in high-quality protein can help support healthy growth and development in children with sickle cell anemia. Protein is important for building and repairing tissues, including red blood cells. However, it's essential to ensure a balanced diet that includes a variety of nutrients, not just protein.
Correct Answer is B
Explanation
A. Give the infant liquids using a small spoon with a long handle.
Give the infant liquids using a small spoon with a long handle.While feeding is essential, the method described is not specific to postoperative care after cleft palate repair.Feedings are resumed by bottle, breast/chest, or cup per surgeon preference; some surgeons prescribe the use of an Asepto syringe for feeding or a soft cup such as a soft-tipped sippy cup.
B. Apply elbow restraints to the infant.
Apply elbow restraints to the infant is correct.Elbow restraints would be used to prevent the infant from injuring or traumatizing the surgical site.
C. Gently check the infant's suture line using a padded tongue depressor.
It's important to assess the surgical site for signs of infection or bleeding, but using a padded tongue depressor may not be the most appropriate method. The nurse should follow the surgeon's orders regarding wound care and assessment techniques, which may include visual inspection without manipulation.
D. Place the infant in a supine position.
Placing the infant in a supine position is generally recommended after cleft palate repair surgery to minimize strain on the surgical site and promote healing. However, it's essential to ensure proper positioning to prevent aspiration and maintain airway patency.
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