A nurse is assessing an 8-month-old infant for cerebral palsy. Which of the following findings is a manifestation of the condition?

Can always track an object with eyes

Needs support with pillow props for sitting

Uses a pincer grasp to pick up a toy

Smiles when a parent appears

Answer and Explanation

The Correct Answer is B

A. Can always track an object with eyes:

The ability to track an object with the eyes typically develops in infants around 2 to 3 months of age. This developmental milestone is not specific to cerebral palsy and is generally expected in healthy infants.

B. Needs support with pillow props for sitting

Explanation:

Cerebral palsy (CP) is a group of permanent movement disorders that appear in early childhood. It is caused by abnormal development or damage to the parts of the brain that control movement, balance, and posture. The symptoms of cerebral palsy can vary widely, but they are generally related to motor function and coordination.

The manifestation of needing support with pillow props for sitting is consistent with the motor impairments often seen in cerebral palsy. Children with cerebral palsy may have difficulties with muscle control and coordination, which can affect their ability to sit independently. The need for external support to maintain a sitting position is indicative of motor developmental delays or challenges associated with cerebral palsy.

C. Uses a pincer grasp to pick up a toy:

The pincer grasp, where a child uses the thumb and index finger to pick up small objects, usually develops around 9 to 12 months of age. This developmental milestone is not directly associated with cerebral palsy and is part of normal infant development.

D. Smiles when a parent appears:

Smiling in response to familiar faces, including parents, is a social and emotional developmental milestone that typically occurs around 2 to 3 months of age. While cerebral palsy can affect motor function, it does not directly impact an infant's ability to express emotions like smiling.

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Correct Answer is D

Explanation

A. Allow for adjustment of rules to correlate with the child's behavior.Rules should be consistent and predictable for children with ASD. Frequently changing or “adjusting” rules to match variable behavior increases confusion and anxiety and reduces opportunities to learn expected behaviors.

B. Allow for imaginative play with peers without supervision.
Many children with ASD need structured, supervised social interactions and support to learn play skills, take turns, and interpret social cues. Unsupervised imaginative play may lead to misunderstanding, frustration, or safety issues.

C. Provide a flexible schedule that adjusts to the child's interests.
While incorporating a child’s interests into activities is useful, children with ASD generally do best with a structured, predictable schedule. Sudden flexibility or frequent schedule changes can be disorienting. Best practice: keep a consistent routine but incorporate preferred interests within that structure.

D. Establish a reward system for positive behavior.A reward system (token economy, sticker charts, immediate specific praise) provides clear, consistent, and concrete reinforcement for targeted behaviors. This increases motivation, helps teach expected behaviors, and can be faded gradually as behaviors become routine.

A. Place a pillow under the child's head. B. Clear the area of hazards. C. Position the child side-lying D. Loosen restrictive clothing

Correct Answer is C

Explanation

A. Place a pillow under the child's head.

Explanation: While providing comfort is important, the priority in this scenario is to ensure the child's safety. Placing a pillow under the head can be considered after addressing immediate safety concerns.

B. Clear the area of hazards.

Explanation: Correct Choice. Ensuring the area is clear of hazards is the nurse's priority. During a seizure, the child can experience uncontrolled movements, and having hazards around can lead to injuries. Clearing the area helps prevent harm. But priority is to position the child side lying.

C. Position the child side-lying.

Explanation: Correct Choice. Placing the child in a side-lying position helps prevent choking and aspiration due to vomiting during the seizure. It also minimizes the risk of airway obstruction and helps manage secretions.

D. Loosen restrictive clothing.

Explanation: While loosening restrictive clothing can facilitate breathing, the priority in this situation is addressing safety concerns related to the seizure and vomiting. Ensuring a clear and safe environment takes precedence.

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