During a well-child visit, a parent asks why their 7-month-old has started to reach for objects with one hand before picking up smaller items with the fingers. Which explanation should the nurse give?
"Your baby is demonstrating proximal-to-distal development, gaining control from the center outward"
Your baby should use both hands equally at this age"
"This is a sign of delayed fine motor development"
"Your baby is skipping developmental milestones"
The Correct Answer is A
A. Infant motor development follows a proximal-to-distal pattern, meaning control develops from the center of the body outward. At 7 months, infants first gain control of shoulders and arms, allowing them to reach with the whole hand. Later, fine motor skills like the pincer grasp (using thumb and forefinger) develop around 9–12 months, enabling the child to pick up small objects. This progression is typical and expected.
B. At 7 months, infants are still developing bilateral coordination. It is normal for a baby to favor one hand or alternate hands inconsistently. Expecting equal use of both hands at this stage reflects a misunderstanding of normal motor development.
C. Fine motor skills, such as using the thumb and forefinger to grasp small objects, emerge later. Reaching with the whole hand at 7 months is part of normal development. Labeling it as delayed is incorrect and may cause unnecessary concern.
D. The infant is following the typical developmental sequence, progressing from gross motor to fine motor control. Reaching with one hand before using the pincer grasp does not indicate skipped milestones. Developmental milestones are achieved in a predictable order, and this behavior is within normal limits.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Differentiation refers to cells or structures becoming specialized, whereas development encompasses functional changes and skill acquisition. While differentiation occurs, the scenario emphasizes both physical growth and skill acquisition, making this pairing incomplete.
B. Growth refers to quantitative increases, such as weight and height, and maturation refers to qualitative functional changes over time. While maturation is implied, the scenario specifically highlights skill improvement and the ability to perform complex tasks, which aligns more directly with differentiation.
C. Growth is represented by the child’s appropriate weight gain, a quantitative change. Differentiation is reflected in the improved coordination, problem-solving skills, and ability to perform complex tasks like tying shoelaces. These changes indicate that the child’s structures and functions are becoming more specialized, matching the definition of differentiation.
D. Development focuses on functional abilities and skill acquisition, and maturation refers to functional competency over time. While relevant, this combination does not explicitly include the quantitative growth aspect (weight gain), which is a key part of the scenario.
Correct Answer is ["A","C","D","E"]
Explanation
A. Grunting is an expiratory sound produced when a newborn partially closes the glottis during exhalation. This helps maintain positive airway pressure, keeps alveoli open, and improves oxygenation. Persistent grunting indicates the newborn is working hard to breathe and is a classic early sign of respiratory distress.
B. Increased appetite is not a symptom of respiratory distress. In fact, newborns experiencing distress often have difficulty feeding or show poor coordination of sucking and swallowing because breathing requires increased effort. Feeding difficulties, rather than increased appetite, may accompany respiratory compromise.
C. Stridor is a high-pitched sound heard during inspiration, typically caused by upper airway obstruction. It may result from conditions such as laryngomalacia, vocal cord paralysis, or airway edema. Stridor is a red flag for respiratory compromise and requires prompt assessment and monitoring.
D. Retractions occur when a newborn uses accessory muscles to breathe, pulling the skin inward around the sternum, ribs, or clavicles. This indicates increased work of breathing and reduced lung compliance. Retractions are a reliable physical sign of significant respiratory distress.
E. Nasal flaring occurs when the nostrils widen during inspiration to increase airflow. It is one of the earliest visible signs of respiratory distress and signals that the newborn is compensating for hypoxia or increased airway resistance.
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