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A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

“You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome."

“Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress."

"It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development.”

“Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies."

Answer and Explanation

The Correct Answer is C

A. "You should focus solely on cognitive development at home, as professional interventions are not effective for children with fragile X syndrome." This is incorrect. Professional interventions, including speech therapy, occupational therapy, and behavioral therapy, are essential for supporting cognitive and social development in children with fragile X syndrome.

B. "Since your child has cognitive delays, you should avoid social activities that could overwhelm them and hinder their progress." Avoiding social activities can actually be harmful, as children with fragile X syndrome benefit from structured social interactions and support. Instead of avoidance, individualized strategies should be used to help the child participate comfortably.

C. "It's important to work with a multidisciplinary team to address your child's cognitive delays and support their development." This is correct. A multidisciplinary team, including special education teachers, therapists, and healthcare providers, helps ensure the child receives individualized support in cognitive, social, and communication skills.

D. "Cognitive delays in children with fragile X syndrome typically resolve on their own, so there is no need for specialized educational plans or therapies." Cognitive delays in fragile X syndrome do not resolve on their own. Early intervention and specialized education plans (e.g., IEPs) are crucial in maximizing the child’s potential.

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Correct Answer is B

Explanation

A. Cough, edema, and increased work of breathing. While these symptoms can indicate worsening heart failure, cough and edema are less prominent signs in infants compared to respiratory distress and feeding difficulties.

B. Tachypnea and diaphoresis with feeding, poor weight gain, and irritability. This is correct. Infants with worsening heart failure often struggle with feeding due to increased energy demands and difficulty breathing. Tachypnea (rapid breathing) and diaphoresis (excessive sweating) during feeding are classic early signs. Poor weight gain results from inadequate caloric intake, and irritability may be due to fatigue and hypoxia.

C. Abdominal pain, poor appetite, and cough. Abdominal pain is difficult to assess in infants, and poor appetite alone is not a definitive sign of heart failure. Cough may occur but is not a primary indicator of worsening heart failure in infants.

D. Bradycardia, rapid weight gain, and irritability. Bradycardia is not a common sign of worsening heart failure in infants; tachycardia (fast heart rate) is more typical. Rapid weight gain could suggest fluid retention but is not as reliable a sign as feeding difficulties and respiratory distress.

A. Uses one finger to repetitively spin a wheel on a toy truck B. 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 C. No attempt to communicate verbally D. Makes repetitive noises that change pitch but do not seem to be associated with trying to communicate E. Parent picks up toddler and gives them a hug and a kiss on the cheek. Toddler does not respond or cuddle them back F. Does not respond when asked to point to a body part or show the nurse the toy they are playing with

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

Explanation

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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A nurse is reinforcing teaching to the parents of a 6-year-old child who has fragile X-syndrome and is manifesting cognitive delays. Which of the following statements concerning coordination of care should the nurse reinforce?

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Naxlex Comprehensive Predictor Exams

A nurse is providing care for an infant who has heart failure and is being discharged from the hospital. When reinforcing discharge education, which of the following clinical manifestations should the nurse ensure caregivers are able to identify as signs of worsening heart failure?

Correct Answer is B

Explanation

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

Explanation

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