The expressive and receptive language development of a 5-year-old girl is severely impaired. The child also displays severe psychomotor retardation, poorly coordinated gait and trunk movements, and stereotypic hand movements. What other associated features would lead the PMHNP to suspect a diagnosis of Rett syndrome rather than autism spectrum disorder in this patient?
Lack of social engagement
Lack of imaginative play
Deceleration of head growth at around age 6 months
Lack of eye contact
The Correct Answer is C
Choice A reason: Lack of social engagement is common in autism spectrum disorder and is not specific for Rett syndrome.
Choice B reason: Lack of imaginative play is also a feature of autism spectrum disorder, making it nonspecific for Rett syndrome.
Choice C reason: This is the correct answer. A hallmark of Rett syndrome is deceleration of head growth beginning around 6 months of age. This feature, in combination with severe psychomotor impairment and stereotypic hand movements, helps differentiate Rett syndrome from autism.
Choice D reason: Lack of eye contact is common in autism spectrum disorder and is not a distinguishing feature of Rett syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Although structural imaging may show small variations in multiple regions, reduced thalamic volume alone is not consistently observed or diagnostic in ADHD.
Choice B reason: EEG findings in ADHD typically show increased, not decreased, slow-wave activity (especially theta waves), reflecting cortical underarousal. Therefore, this option is inaccurate.
Choice C reason: Reduced total brain volume is a consistent biological finding in ADHD. Neuroimaging studies show that children and adults with ADHD tend to have smaller total brain volume, particularly in the prefrontal cortex, basal ganglia, and cerebellum. These differences reflect delayed cortical maturation and reduced neural connectivity, which underlie impaired executive functioning, attention control, and impulse regulation.
Choice D reason: ADHD is associated with delayed cortical maturation rather than early maturation. The developmental lag particularly affects the prefrontal regions involved in planning, inhibition, and working memory.
Correct Answer is B
Explanation
Choice A reason: Severe dehydration can cause dizziness and weakness, but the presence of confusion and nausea in a type 1 diabetic patient raises concern for metabolic disturbance rather than isolated dehydration.
Choice B reason: Diabetic ketoacidosis (DKA) is characterized by hyperglycemia, ketonemia, dehydration, nausea, vomiting, weakness, and altered mental status. Patients with type 1 diabetes, particularly those with eating disorders, are at increased risk due to insulin omission or inadequate intake.
Choice C reason: Acute renal failure can present with nausea, confusion, and weakness, but there is no information suggesting a sudden change in kidney function or laboratory evidence in this scenario.
Choice D reason: Myocardial toxicity is unlikely in this presentation; while electrolyte disturbances may affect the heart, the immediate constellation of symptoms in a type 1 diabetic points more toward DKA.
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