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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

A. "Seal nonwashable items in a plastic bag for 2 days."

This instruction is incorrect. Items that cannot be laundered may be dry-cleaned or sealed in a plastic bag for two weeks

B. "Soak hair brushes in boiling water for 10 minutes."This is correct. According to CDC, combs and brushes should be soaked in hot water (at least 130 degrees fahrenheit) to help avoid re-infestation.

C. "Apply permethrin 1 percent cream rinse every day for 5 days."

This instruction is incorrect. Permethrin 1 percent cream rinse is a medication used to treat head lice infestations, but it is typically applied only once and then rinsed out after a specified period of time (usually 10 minutes). Repeated daily application for five days is not recommended and may lead to unnecessary exposure to the medication.

D. "After washing bed linens, place them in a dryer on a cool setting for 30 minutes."

This instruction is incorrect. To effectively kill lice and nits on bed linens, they should be washed in hot water (at least 130°F or 54°C) and then dried on a hot setting in the dryer. A cool setting may not be sufficient to kill lice and nits.

A. Iron deficiency anemia B. Vitamin A toxicity C. Impaired carbohydrate metabolism D. Lactose intolerance

Correct Answer is A

Explanation

A. Iron deficiency anemia: Whole milk is a poor source of iron, and excessive consumption of whole milk can displace iron-rich foods from the diet. Therefore, a toddler who consumes a large amount of whole milk and has a poor appetite is at risk for iron deficiency anemia due to inadequate iron intake. Iron deficiency anemia is characterized by low levels of iron in the body, leading to decreased production of red blood cells and impaired oxygen transport.

B. Vitamin A toxicity: While excessive intake of vitamin A can lead to toxicity, it is unlikely to occur from consuming whole milk alone. Vitamin A toxicity is more commonly associated with excessive intake of vitamin A supplements or foods that are rich in preformed vitamin A, such as liver. Therefore, vitamin A toxicity is not a significant risk for a toddler who drinks whole milk.

C. Impaired carbohydrate metabolism: There is no direct relationship between whole milk consumption and impaired carbohydrate metabolism. Impaired carbohydrate metabolism is typically associated with conditions such as diabetes mellitus or metabolic syndrome, rather than dietary factors like milk consumption.

D. Lactose intolerance: Lactose intolerance is the inability to digest lactose, the sugar found in milk and dairy products, due to a deficiency of the enzyme lactase. While excessive consumption of whole milk may exacerbate symptoms in a child with lactose intolerance, it is not a risk factor for developing lactose intolerance itself. Lactose intolerance is more commonly observed in individuals of certain ethnic backgrounds or those with a genetic predisposition.

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