An eight-month-old infant with Down syndrome is being seen in the clinic. His mother tells the nurse that he is difficult to hold, that "He's like a rag doll. He does not cuddle up to me like my other babies did." The nurse's best interpretation of this lack of clinging or molding is which of the following?
Sign of detachment and rejection.
Sign of maternal deprivation.
Suggestive of autism associated with Down syndrome
Result of the physical characteristics of Down syndrome.
The Correct Answer is D
A. Detachment and rejection are psychosocial interpretations that require deeper behavioral assessment and are not appropriate assumptions based on physical presentation alone.
B. Maternal deprivation refers to a lack of emotional bonding or nurturing, which is not evidenced here and is not the cause of the floppiness described.
C. While autism can co-occur with Down syndrome, the description given is more characteristic of hypotonia, not autism-specific behavior.
D. Infants with Down syndrome commonly have generalized hypotonia (low muscle tone), which causes them to feel “floppy” or like a rag doll when held. This is a well-known physical trait of the condition and not a sign of emotional or developmental issues at this stage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This statement reflects a proper understanding of the peak flow meter’s purpose — it can help detect early changes in airway function before symptoms are felt, allowing for early intervention and improved asthma control.
B. This reflects a misunderstanding of the correct technique — the meter should be reset to zero before each use, and the child should use a full, fast breath to blow into the meter.
C. While daily monitoring is helpful, the peak flow meter does not prevent asthma attacks — this statement reflects false reassurance and misunderstanding.
D. Peak flow should be measured with a single, forceful breath, not multiple breaths — this indicates incorrect use of the device.
Correct Answer is C
Explanation
A. Digoxin is used to strengthen cardiac contractions and treat heart failure, but it does not maintain ductal patency.
B. Ibuprofen is a prostaglandin inhibitor, and would actually cause closure of the PDA, which is contraindicated in transposition of the great vessels.
C. Prostaglandin E (such as alprostadil) is administered to keep the ductus arteriosus open, allowing mixing of oxygenated and deoxygenated blood to improve oxygenation until surgical correction is performed.
D. Indomethacin is also a prostaglandin inhibitor used to close a PDA, not keep it open.
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