A nurse is collecting data from a 3-year-old child during a well-child visit.
Which of the following findings should alert the nurse to a possible developmental delay?
The child speaks in three-word sentences
The child copies a circle with a crayon
The child rides a tricycle using pedals
The child has frequent temper tantrums
The Correct Answer is D
The child has frequent temper tantrums. This is because temper tantrums are not a normal part of a 3-year-old child’s development and can indicate emotional or behavioral problems. According to the height and weight chart for children, a 3-year-old child should be able to do the following:
• Speak in three-word sentences
• Copy a circle with a crayon
• Ride a tricycle using pedals
Therefore, choices A, B and C are wrong because they are expected developmental milestones for a 3-year-old child.
A nurse should collect data from the child and the parents to determine the cause and frequency of the temper tantrums and provide appropriate interventions and referrals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Grilled cheese sandwich with tomato soup.This food choice indicates an understanding of the teaching because it is low in purines, which are chemicals that break down into uric acid and can trigger gout attacks.
Some additional information for the response are:
• Choice A.Liver and onions with mashed potatoes is wrong because liver is an organ meat that is high in purines and should be avoided by people with gout.
• Choice C.Roast beef with green beans and rice is wrong because roast beef is a red meat that is high in purines and should be limited by people with gout.
• Choice D.Sardines on whole wheat crackers with cheese is wrong because sardines are a type of oily fish that is high in purines and should be avoided by people with gout.
• A low-purine diet for gout management should include fruits, vegetables, whole grains, legumes, nuts, and low-fat dairy products.It should also limit sugar, alcohol, and meat consumption.
Correct Answer is C
Explanation
Hold the newborn in a semi-upright position during feeding.This prevents the formula from flowing back into the baby’s ears and causing infections.It also helps the baby swallow less air and reduces the risk of choking.
Choice A is wrong because warming the formula in a microwave oven can create hot spots that can burn the baby’s mouth.The formula should be warmed by running it under warm tap water or placing it in a bowl of warm water.
Choice B is wrong because discarding any unused formula after 2 hours at room temperature is too long.Bacteria can grow rapidly in warm milk that is left sitting out and unused.The formula should be discarded after one hour at room temperature or within 24 hours if refrigerated.
Choice D is wrong because burping the newborn after finishing each ounce of formula is not necessary.Burping can interrupt the feeding and make the baby lose interest in finishing the bottle.The baby should be burped only when they show signs of discomfort or after finishing the feeding.
Normal ranges for formula intake vary depending on the baby’s age, weight and appetite.In general, newborn babies need around 150 to 200 ml per kilo of their weight a day until they’re 6 months old.The baby should be fed when they show signs of hunger, such as rooting, sucking or crying, and not forced to finish the bottle if they are full.
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