During a well-child visit, a nurse notes that a toddler has recently started speaking in short sentences, but gross motor skills such as running have shown little change. Which principle does this BEST illustrate?

Directional trends

Developmental pace

Sensitive periods

Sequential trends

Answer and Explanation

The Correct Answer is B

A. Directional trends describe the general patterns of growth, such as cephalocaudal (head-to-toe) or proximodistal (center-to-periphery) development. The scenario focuses on differences in the rate of skill acquisition, not the direction of development.

B. Developmental pace refers to the rate at which different skills or abilities emerge, which can vary among domains. In this scenario, the toddler’s language skills are advancing rapidly, while gross motor skills like running show little change, illustrating that different areas of development progress at different rates.

C. Sensitive periods refer to specific windows of time during which a child is particularly responsive to certain types of learning or stimuli, such as language acquisition. The scenario does not specify a critical timing for development, but rather differences in progression across skills, so sensitive periods are not the primary principle illustrated.

D. Sequential trends refer to the orderly and predictable progression of developmental milestones, such as crawling before walking. While the toddler is developing language, the scenario emphasizes rate differences, not the order in which skills emerge.

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Correct Answer is B

Explanation

A. Genetic testing for CFTR mutations is incorrect as the primary diagnostic tool. While genetic testing can identify specific CF mutations and is useful for screening or confirming atypical cases, it is not considered the first-line gold standard for diagnosis.

B. Sweat chloride test is correct. The sweat chloride test measures the concentration of chloride in sweat, which is abnormally elevated in individuals with cystic fibrosis due to defective CFTR channels. A chloride concentration ≥60 mmol/L on two separate occasions confirms the diagnosis. It remains the gold standard diagnostic test for CF in children.

C. Chest x-ray is incorrect because it is not diagnostic for CF. Although chest x-rays may show structural lung changes such as hyperinflation or bronchiectasis in advanced disease, they cannot confirm CF on their own.

D. Pulmonary function tests (PFTs) are incorrect for initial diagnosis in young children. PFTs assess lung function and disease progression but are not reliable for confirming CF, especially in a 3-year-old who may not be able to perform the maneuvers required.

A. Increasing the child's intake of high-fat foods to address malnutrition B. Administering inhaled corticosteroids to reduce airway inflammation C. Initiating chest physiotherapy (CPT) to promote airway clearance and reduce mucus build-up D. Encouraging increased fluid intake to help with hydration and thin mucus

Correct Answer is C

Explanation

A. Nutrition is important in CF because malabsorption is common, but addressing malnutrition is not the immediate priority when the child is experiencing respiratory compromise. Nutritional interventions are secondary to airway management.

B. Inhaled corticosteroids can help reduce chronic airway inflammation, but they do not remove existing mucus or immediately improve airflow. They are part of long-term management rather than urgent treatment during an exacerbation.

C. CPT is the cornerstone of CF management, particularly during exacerbations. Techniques such as percussion, postural drainage, and vibration help mobilize thick mucus, improve airway clearance, enhance oxygenation, and reduce the risk of infection and further lung damage. Immediate airway clearance is critical for symptom relief and prevention of respiratory complications.

D. Adequate hydration can support mucus thinning but is not sufficient alone to manage an acute pulmonary exacerbation. It is adjunctive, supporting other interventions like CPT and medications.

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During a well-child visit, a nurse notes that a toddler has recently started speaking in short sentences, but gross motor skills such as running have shown little change. Which principle does this BEST illustrate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

Correct Answer is C

Explanation

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