A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?

Increased intracranial pressure

Dehydration

Overhydration

These are normal findings

Answer and Explanation

The Correct Answer is D

A. Increased intracranial pressurE. Pulsation and bulging of the fontanel may be signs of

increased intracranial pressure in infants. However, it is important to differentiate between normal fontanel characteristics and abnormal signs of elevated intracranial pressure. In this case, the pulsation and bulging are likely normal responses to crying and changes in intracranial pressure during the newborn period.

B. Dehydration: Dehydration typically presents with sunken fontanels rather than pulsation and bulging. Dehydration is a serious condition that requires prompt assessment and intervention, but it is not indicated by the findings described in the scenario.

C. Overhydration: Overhydration is not typically associated with pulsation and bulging of the fontanel. Overhydration may lead to fluid overload and edema but does not directly affect fontanel characteristics.

D. These are normal findings: Pulsation and brief bulging of the fontanel in response to crying are considered normal findings in newborns. Fontanels allow for the flexibility of the skull bones during childbirth and provide space for brain growth during infancy. Pulsation and bulging may occur temporarily during crying or changes in intracranial pressure and are not necessarily

indicative of pathology.

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Correct Answer is D

Explanation

A. Change the routine of the preschooler often to stimulate initiativE. While providing variety and new experiences is important for stimulating a child's curiosity and creativity, abruptly changing routines too often can disrupt the child's sense of security and stability. Consistency in routines helps preschoolers feel secure and understand expectations.

B. Do not set limits on the preschooler's behavior as this results in low self-esteem: Setting appropriate limits and boundaries is essential for preschoolers to develop a sense of security and learn socially acceptable behavior. However, overly strict or rigid limits can stifle initiative and creativity. It's important for parents to strike a balance between setting limits and allowing for exploration and initiative.

C. As a parent, decide how and with whom the child will play: Encouraging preschoolers to

make their own choices about play activities and playmates fosters independence and initiative. Parents should provide opportunities for free play and exploration within safe boundaries,

allowing the child to make decisions and learn from their experiences.

D. Reward the child for initiative in order to build self-esteem: Positive reinforcement for initiative-taking behavior encourages preschoolers to explore their environment, try new

activities, and develop confidence in their abilities. By praising and acknowledging their efforts, parents can help build their child's self-esteem and motivation to take on new challenges.

A. "Do you participate in any sports?" B. "Do you play any instruments?" C. "Do you like to do puzzles?" D. "Do you like to construct models?"

Correct Answer is A

Explanation

A. "Do you participate in any sports?": This question directly addresses gross motor skills by inquiring about physical activities that involve large muscle groups and coordination, such as sports.

B. "Do you play any instruments?": While playing musical instruments may involve some coordination and motor skills, it primarily assesses fine motor skills rather than gross motor skills.

C. "Do you like to do puzzles?": Puzzles primarily assess cognitive skills rather than gross motor skills.

D. "Do you like to construct models?": Constructing models also primarily assesses fine motor skills and cognitive abilities rather than gross motor skills.

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A nurse is assessing the fontanels of a crying newborn and notes that the posterior fontanel pulsates and briefly bulges. What do these findings indicate?

Nursing Test Bank

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