A nurse is assessing a one-month-old infant.
Which of the following findings should the nurse report to the provider?
Inability to sit without support.
Inability to raise head when in prone position.
Inability to bring an object to mouth.
Inability to pick up an object with fingers.
Correct Answer : B,C,D
Choice A rationale
At one month of age, infants are not expected to sit without support. Therefore, an inability to do so would not be a cause for concern at this age.
Choice B rationale
By one month, infants should be able to briefly raise their head when placed in a prone (on their stomach) position. If an infant is unable to do this, it could indicate a potential developmental delay or muscle weakness.
Choice C rationale
At one month, infants typically have not yet developed the coordination to bring an object to their mouth. Therefore, an inability to do so at this age would not be a cause for concern.
Choice D rationale
By one month, infants are not expected to have the fine motor skills necessary to pick up an object with their fingers. Therefore, an inability to do so would not be a cause for concern at this age.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
An 18-month-old who has a high fever, coughs hard, and has a runny nose requires urgent care. High fever in a child can be a sign of a serious infection or other medical condition. The hard coughing could indicate a respiratory issue such as bronchitis or pneumonia, which can be serious in young children. The runny nose is another symptom of a possible respiratory infection.
Choice B rationale
A one-year-old who has a slight fever, a rash, and green secretions may not require urgent care but should still be seen by a healthcare provider. A slight fever can be a sign of a minor infection, which may resolve on its own or with over-the-counter remedies. However, a rash
and green secretions could indicate a bacterial infection, which may require antibiotic treatment.
Correct Answer is C
Explanation
Choice A rationale
While it’s true that early recognition of symptoms can help in managing respiratory infections, this is not the primary reason why infants are at increased risk. Infants can be more susceptible to respiratory infections due to physiological factors rather than caregiver awareness.
Choice B rationale
Infants do have smaller airways compared to adults, which can allow for a larger number of organisms to enter. However, the size of the airways is not the main factor that increases the risk of respiratory infections in infants. Other factors, such as the maturity of the immune system and the ability to clear the airways, play a more significant role.
Choice C rationale
Infants’ airways are indeed narrow and can obstruct more easily, trapping organisms. This is one of the main reasons why infants are at an increased risk for respiratory infections. The narrow airways in infants can lead to increased resistance and decreased airflow, making it easier for organisms to invade and cause infections.
Choice D rationale
While it’s true that infants have faster respiratory rates than adults, this does not necessarily increase their risk for respiratory infections. A faster respiratory rate does not inhibit an infant’s ability to cough effectively. In fact, coughing is a protective reflex that can help clear the airways of mucus and foreign particles.
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