A nurse is caring for a toddler in a pediatric clinic.

Exhibits

Click to highlight the findings that require immediate follow-up. To deselect a finding click on the finding again.

Screenings

13-month visit

Gross Motor: Can stand up and walk independently, attempts to scoot upstairs on hands and knees

Fine motor: Picks at cereal out of a snack cup with two fingers. Transfers food from one hand to the other and feeds self with small bites in a fist. Uses one finger to repetitively spin a wheel on a toy truck.

Nutrition: Drinks from a cup when parent holds it but does not pick up the cup or try to hold it. Likes fruit like blueberries and peaches, but spits out vegetables.

Language: No attempt to communicate verbally. Makes repetitive noises that change pitch but do not seem to be associated with trying to communicate. Behavioral: Parent picks up toddler and gives them a hug and a kiss on the cheek. Toddler does not respond or cuddle them back. Does not respond when asked to point to a body part or show the nurse the toy they are playing with.

Uses one finger to repetitively spin a wheel on a toy truck

Drinks from a cup when parent holds it but does not pick up the cup or try to hold it. Likes fruit like blueberries and peaches, but spits out vegetables

No attempt to communicate verbally

Makes repetitive noises that change pitch but do not seem to be associated with trying to communicate

Parent picks up toddler and gives them a hug and a kiss on the cheek. Toddler does not respond or cuddle them back

Does not respond when asked to point to a body part or show the nurse the toy they are playing with

Answer and Explanation

The Correct Answer is ["A","B","C","D","E","F"]

Language Delay: "No attempt to communicate verbally. Makes repetitive noises that change pitch but do not seem to be associated with trying to communicate." By 12–13 months, toddlers typically say 1–2 words, attempt to mimic sounds, and use gestures (e.g., pointing, waving) to communicate. The lack of verbal communication and repetitive vocalizations without meaning raise concerns about delayed expressive language development, which is an early sign of ASD or speech delay

Lack of Social Reciprocity: "Parent picks up toddler and gives them a hug and a kiss on the cheek. Toddler does not respond or cuddle them back." By this age, toddlers typically enjoy physical affection, seek comfort, and show attachment to caregivers. A lack of reciprocal affection or engagement may indicate social communication deficits, which are hallmark features of ASD.

Nutrition: Likes fruit like blueberries and peaches, but spits out vegetables." Food preferences at this age are common, and rejecting vegetables alone is not necessarily concerning. However, extreme food selectivity (avoiding entire food groups, refusing textures) can be a sign of sensory processing issues, which are more common in ASD.

Fine Motor: "Drinks from a cup when parent holds it but does not pick up the cup or try to hold it." By 12–13 months, toddlers typically attempt to hold and drink from a cup independently.Delayed self-feeding skills may indicate fine motor delays or lack of interest in independent eating, which can be seen in neurodevelopmental disorders like ASD.

Lack of Joint Attention: "Does not respond when asked to point to a body part or show the nurse the toy they are playing with." At 12–13 months, toddlers should be able to follow simple commands and engage in joint attention (e.g., pointing to objects, responding to names). Failure to follow basic commands or lack of engagement with others is a red flag for delayed receptive language development or social communication deficits.Lack of joint attention is one of the earliest indicators of ASD and warrants immediate follow-up.

"Uses one finger to repetitively spin a wheel on a toy truck". This behavior is another important red flag for autism spectrum disorder (ASD) and requires immediate follow-up. This child’s repetitive spinning of a wheel using one finger suggests fixated, repetitive behaviors, which are hallmark features of ASD.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. "Tetralogy of Fallot is a group of four heart defects that impact circulation of blood in your child's body. These are pulmonary stenosis, ventricular septal defect, right ventricular hypertrophy, and an overriding aorta." This is the correct definition of Tetralogy of Fallot. The four defects result in decreased oxygenation of blood, leading to cyanosis and other circulatory problems that require medical intervention.

B. "Tetralogy of Fallot is a heart defect that impacts circulation in your child's body due to the atypical placement of the aorta." While an overriding aorta is one of the four defects in Tetralogy of Fallot, it is not the sole cause of circulatory problems. The condition results from a combination of four structural abnormalities, not just aortic malposition.

C. "Tetralogy of Fallot is a group of heart defects that impact the circulation of blood in your child's body. These are aortic stenosis, atrial septal defect, and left ventricular hypertrophy." This statement describes different congenital heart defects but does not accurately define Tetralogy of Fallot. Aortic stenosis and atrial septal defects are not components of this condition.

D. "Tetralogy of Fallot is a heart defect that impacts circulation in your child's body due to an opening in the wall between the ventricles, causing mixing of oxygenated and deoxygenated blood." While a ventricular septal defect (VSD) is one of the four components, it is not the only issue affecting circulation. The combination of all four defects contributes to the condition's severity.

A. Mood changes B. Swollen knees C. Frequent falls D. Dental caries

Correct Answer is B

Explanation

A. Mood changes. While mood changes can occur due to various health conditions, they are not a direct indicator of a bleeding disorder. Bleeding disorders typically present with physical symptoms like easy bruising or joint swelling.

B. Swollen knees. Joint swelling (hemarthrosis) is a key sign of bleeding disorders such as hemophilia. In children with a bleeding disorder, even minor trauma can cause bleeding into the joints, leading to pain, stiffness, and swelling, particularly in weight-bearing joints like the knees and ankles.

C. Frequent falls. While frequent falls may result in bruising, they are not a direct indicator of a bleeding disorder. However, children with a bleeding disorder may bruise excessively or experience prolonged bleeding after minor falls.

D. Dental caries. Dental caries (tooth decay) is not a symptom of a bleeding disorder but rather results from poor oral hygiene, dietary factors, or bacterial infection. Bleeding disorders may cause prolonged bleeding after dental procedures, but they do not directly cause cavities.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting in the care of an infant diagnosed with tetralogy of Fallot. The infant's caregiver asks the nurse to explain this diagnosis. Which of the following is an accurate statement about this condition?

Correct Answer is A

Explanation

A nurse is collecting data while caring for a school-age child. Which of the following findings may indicate an undiagnosed bleeding disorder?

Correct Answer is B

Explanation

A nurse is reinforcing teaching to a group of parents about potential causes of autism spectrum disorder (ASD). Which of the following statements should the nurse reinforce?

A nurse is assisting in the care of a toddler whose caregivers have questions about allergies. Which of the following should the nurse identify as the most common allergic reaction in children?

A nurse is providing education to a 12-year-old child who has been newly diagnosed with celiac disease. Which of the following statements by the client indicates a need for further teaching?

A nurse is assisting in the care of a 6-year-old client who has nephrotic syndrome. Which of the following adverse effects of corticosteroids should the nurse recognize as having the potential to impact the child's psychosocial development? (Select All that Apply.)

A nurse is assisting in the care of an infant in a pediatric clinic Exhibits For each potential finding, click to specify if the finding is common with the diagnosis. There must be at least 1 selection in every row. There does not need to be a selection in every column.

A nurse is reinforcing teaching to the parents of a 2-month-old infant who has Down Syndrome. Which of the following statements addressing cognitive ability should the nurse reinforce?

A nurse is caring for a 13-year-old adolescent in the pediatric emergency room who has a suspected head injury. Which of the following actions should the nurse take first?