A nurse is assessing a 6-month-old infant. Which observation best demonstrates cephalocaudal growth?

Infant can hold head steady before rolling over

Infant can pick up small objects with thumb and forefinger

Infant can sit independently

Infant can crawl using arms and legs simultaneously

Answer and Explanation

The Correct Answer is A

A. Infant can hold head steady before rolling over is correct because cephalocaudal growth and development occur from head to toe. Control of the head and neck muscles develops first, followed by control of the trunk and then the lower extremities. Being able to hold the head steady is an early milestone that clearly demonstrates cephalocaudal progression.

B. Infant can pick up small objects with thumb and forefinger is incorrect because this describes development of the pincer grasp, which reflects fine motor development and typically occurs later (around 9–12 months). It does not specifically demonstrate cephalocaudal progression.

C. Infant can sit independently is incorrect because sitting requires trunk and core muscle control, which develops after head control. While related to cephalocaudal development, it is not the best example because it occurs later in the sequence.

D. Infant can crawl using arms and legs simultaneously is incorrect because crawling involves coordinated use of both upper and lower extremities, which occurs later in infancy and reflects overall motor coordination rather than early head-to-toe development.

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Correct Answer is B

Explanation

A. Closed fontanel and high-pitched cry is incorrect because a closed fontanel is normal at this age only if ossification is occurring, and a high-pitched cry may indicate pain or neurologic irritation but is not the most specific sign of increased ICP.

B. Bulging fontanel and dilated scalp veins is correct because increased intracranial pressure (ICP) in infants often presents with a bulging, tense fontanel due to accumulation of cerebrospinal fluid, and prominent scalp veins result from increased venous pressure. These are hallmark early signs of hydrocephalus and warrant prompt attention.

C. Constant low-pitched cry and restlessness is incorrect because while irritability and restlessness may accompany increased ICP, a low-pitched cry is not a classic indicator, and these signs are nonspecific.

D. Depressed fontanel and decreased blood pressure is incorrect because a depressed fontanel usually indicates dehydration, not increased ICP, and hypotension is a late and less reliable sign of increased ICP in infants.

A. Teaching the family about long-term management of asthma B. Avoiding using any latex product C. Administering medication for long-term desensitization D. Using only nonallergenic latex products

Correct Answer is B

Explanation

A. Teaching the family about long-term management of asthma is incorrect because asthma management is not directly related to latex allergy, although children with latex allergy may have an increased risk of atopy. The focus should be on latex avoidance.

B. Avoiding using any latex product is correct. Children with spina bifida are at high risk for latex allergy due to frequent surgical procedures and exposure to latex-containing medical products. Complete avoidance of latex in medical equipment, gloves, toys, and household items is the most important preventive intervention to reduce the risk of anaphylaxis or allergic reactions.

C. Administering medication for long-term desensitization is incorrect because there is currently no safe or standard desensitization therapy for latex allergy. Management focuses on prevention and avoidance.

D. Using only nonallergenic latex products is partially misleading. There is no guarantee that “nonallergenic” latex products are completely safe; therefore, latex-free alternatives should be used instead of relying on “nonallergenic” labels.

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