In a fully developed term infant, at age 6 weeks the nurse practitioner should expect the triangular-shaped posterior fontanel to be:

closed.

open.

pulsatile.

open and pulsatile.

Answer and Explanation

The Correct Answer is A

Rationale:
A. The posterior fontanel, which is triangular in shape, typically closes by 6–8 weeks of age in a full-term infant. Closure at this age is considered normal and indicates appropriate cranial development.
B. While some posterior fontanels may remain slightly open beyond 6 weeks, persistent patency is uncommon and may warrant evaluation.
C. A pulsatile posterior fontanel is more characteristic of the anterior fontanel in a normal infant and is not typical for the posterior fontanel.
D. An open and pulsatile posterior fontanel at 6 weeks is unusual and may suggest delayed closure or underlying pathology.

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Correct Answer is B

Explanation

Rationale:
A. Routine follow-up is inappropriate because an absent red reflex can indicate serious ocular pathology, such as congenital cataract, retinoblastoma, or other intraocular abnormalities. Waiting until the next routine exam could delay critical diagnosis and treatment.
B. Referral to a pediatric ophthalmologist is the correct action. Early evaluation is essential to preserve vision and rule out life-threatening conditions. Pediatric ophthalmologists can perform a thorough dilated eye exam and additional imaging if needed.
C. Delaying immunizations and ordering a CT scan is not the standard initial step; imaging may be indicated later depending on ophthalmologic findings, but urgent ophthalmology referral takes priority.
D. Referral to a pediatric neurologist is not indicated at this stage, as the absent red reflex points primarily to an ocular rather than neurologic issue.

A. an inhaled bronchodilator. B. an over-the-counter antihistamine. C. a cough suppressant. D. supportive care.

Correct Answer is D

Explanation

Rationale:
A. Inhaled bronchodilators have limited efficacy in mild bronchiolitis and are not routinely recommended for initial treatment.
B. Over-the-counter antihistamines are not effective for bronchiolitis in infants.
C. Cough suppressants are not recommended in infants due to potential side effects and lack of proven benefit.
D. Supportive care is the mainstay of treatment for mild bronchiolitis, including ensuring adequate hydration, monitoring oxygenation, and providing comfort measures. Most cases are self-limited and resolve without pharmacologic intervention.

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In a fully developed term infant, at age 6 weeks the nurse practitioner should expect the triangular-shaped posterior fontanel to be:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

During the ophthalmic exam in an infant, the nurse practitioner notices an absent red reflex. The remaining examination findings are within normal limits. The nurse practitioner should:

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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