A nurse is caring for a child who has retinoblastoma that has potentially metastasized to the brain. Which of the following diagnostic tests should the nurse anticipate for determining if metastasis of the brain has occurred?

A. "Speaking a different language at home shouldn't affect learning how letters sound.": Learning a second language can temporarily affect letter recognition and phonemic awareness in the new language. Dismissing the parent’s observation may create unnecessary concern and does not address the normal process of bilingual language acquisition.

B. "Children who are learning a new language sometimes have difficulty learning new letters.": Bilingual children may experience temporary delays in recognizing letters or sounds in a second language due to limited exposure and differences in phonetics. This response normalizes the experience and reassures the parent while encouraging continued support in both languages.

C. "It's great that you're teaching them another language at this age.": While promoting bilingualism is positive, this statement does not address the parent’s concern regarding letter recognition difficulties in English. It lacks guidance on supporting literacy development.

D. "You should have them evaluated by our speech team.": Referral is unnecessary at this stage unless there are broader concerns such as speech delays or communication disorders. Difficulty recognizing letters in a second language is often a normal part of bilingual learning.

A. "An infant's lymph nodes may be large and tender at 2 months of age.": While lymph nodes can be slightly enlarged in infants, tenderness or significant enlargement at 2 months may indicate infection or another underlying condition and is not considered a normal finding.

B. "Infants should be able to hold their head steady without support by 3 months of age.": Most infants develop good head control by 4 months, not 3 months. Expecting full head steadiness at 3 months is premature and reflects misunderstanding of typical developmental milestones.

C. "Facial drooping during assessment is a normal finding and does not require further action.": Facial drooping is abnormal at any age and may indicate neurologic compromise, such as cranial nerve VII palsy. It warrants immediate evaluation rather than being considered normal.

D. "Inspection and palpation should be used to evaluate the skull, eyes, ears, nose, mouth, throat, and neck structures.": This statement correctly describes the comprehensive approach to pediatric head and neck assessment. Both inspection and palpation are essential for identifying abnormalities in structure, symmetry, and function.