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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Children with Down syndrome typically exhibit short stature, not excessive height.
B. While children with Down syndrome may have a single transverse palmar crease, not "spots on the palms," this is not the most defining physical feature.
C. One of the hallmark physical characteristics of Down syndrome is hypotonia (low muscle tone). It often leads to delayed motor development, poor head control, and floppy posture in infancy.
D. Children with Down syndrome are more likely to have hyperflexible joints due to ligamentous laxity, not inflexibility.

A. weight gain B. hyperactivity C. pink mucous membranes D. poor nutritional intake

Correct Answer is D

Explanation

A. Weight gain is typically a sign of adequate nutrition and growth, not a concern for a cardiac defect.
B. Hyperactivity is not characteristic of infants, especially at 1 month of age, and is not a common sign of a cardiac issue in this age group.
C. Pink mucous membranes indicate adequate oxygenation, which does not suggest a cardiac defect.
D. Poor nutritional intake in an infant may signal an underlying cardiac defect, particularly if accompanied by fatigue with feeding, diaphoresis, or failure to thrive. Infants with congenital heart defects often have difficulty feeding due to increased energy expenditure and reduced oxygenation, making this a key red flag.

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Naxlex Comprehensive Predictor Exams

While teaching anticipatory guidance to a young couple with a child with Down syndrome, the nurse explains that one major physical characteristic of the child with Down syndrome is:

Correct Answer is C

Explanation

The following is found during the assessment of a 1-month-old infant. Which of the following would lead the nurse to suspect a cardiac defect?

Correct Answer is D

Explanation

A nurse is providing education to a school-age child who has a new diagnosis of asthma. Which of the following statements should the nurse include in the teaching?

The nurse is caring for a child with Kawasaki disease (KD). A student nurse on the unit asks if there are medications to treat this disease. The nurse's response to the student nurse is:

A child with a history of strep throat presents with fever, shortness of breath, abdominal pain, and a very painful and swollen shoulder joint. Based on this history and presentation, what medical condition should be suspected?

A nurse is caring for an 8-year-old child who has acute rheumatic fever. Which of the following assessments is the nurse's priority immediately after admission?

A nurse cares for a 4-year-old child with croup who wets the bed overnight. When the parents visit the next day, the nurse explains the situation, and one of the parents says, "She never wets the bed at home. I am so embarrassed." Which of the following responses should the nurse make?

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The nurse assesses a child with coarctation of the aorta. Which common clinical manifestation is the nurse likely to observe?

A nurse is caring for an infant diagnosed with Tetralogy of Fallot. The infant suddenly becomes cyanotic, and his oxygen saturation reading drops to 60% Choose the interventions the nurse should perform. (Select All that Apply.)