The nurse is assessing an 18-month-old patient at a well-child visit. What findings would suggest a developmental delay?

Says two-word sentences.

Uses pincer grasp to eat Cheerio’s.

Removes shoes and socks.

Prefers to use the right hand.

Answer and Explanation

The Correct Answer is D

Choice A reason: Saying two-word sentences is an expected developmental milestone for an 18-month-old child. At this age, children should begin combining two words to form simple sentences, such as "more juice" or "mama go." This indicates normal language development.

Choice B reason: Using a pincer grasp to eat Cheerio’s is a typical fine motor skill for an 18-month-old child. The ability to pick up small objects between the thumb and forefinger demonstrates proper development of fine motor skills and hand-eye coordination.

Choice C reason: Removing shoes and socks is a common developmental milestone for an 18-month-old child. This task shows growing independence and the ability to perform basic self-care activities, which is a sign of normal development.

Choice D reason: Preferring to use the right hand may suggest a developmental delay because children typically do not show a strong hand preference (left or right) until around the age of 2 to 3 years. Early hand dominance can be a sign of an underlying issue, such as asymmetry in muscle strength or neurological development. It is important to assess further if a child shows a strong preference for one hand at this early age.

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Correct Answer is A

Explanation

Choice A reason: Pathologic jaundice is an abnormal condition that typically appears within the first 24 hours of life. It often indicates an underlying health problem and requires prompt medical evaluation and intervention.

Choice B reason: Both pathologic and physiologic jaundice are not treated with exchange transfusions of maternal O-negative blood. Exchange transfusions are only considered in severe cases of jaundice, typically for pathologic jaundice when other treatments are ineffective.

Choice C reason: Physiologic jaundice is a common and usually harmless condition that occurs in many newborns, peaking around the second or third day of life. It does not result in kernicterus, a rare but severe form of brain damage caused by very high levels of bilirubin. Pathologic jaundice, if untreated, may lead to kernicterus.

Choice D reason: Physiologic jaundice generally does not require transfer to the neonatal intensive care unit. It is usually managed with simple interventions, such as phototherapy, and often resolves on its own as the newborn's liver matures and becomes more efficient at processing bilirubin.

A. The child will have intellectual delays. B. Cerebral palsy is a genetic disorder. C. The child will have a shortened lifespan. D. This is a non-progressive disorder.

Correct Answer is D

Explanation

Choice A reason: While some children with cerebral palsy may have intellectual delays, it is not accurate to generalize this condition as affecting all children with cerebral palsy. The extent of intellectual involvement can vary widely. Therefore, stating this as a definite teaching point may not be appropriate for every child.

Choice B reason: Cerebral palsy is not typically considered a genetic disorder. It is most commonly caused by damage to the developing brain either during pregnancy, childbirth, or shortly after birth. Factors that contribute to cerebral palsy can include infections, lack of oxygen, and traumatic injuries, but it is not primarily a genetic condition.

Choice C reason: While cerebral palsy can impact a child's overall health and development, stating that it will shorten the child's lifespan is not necessarily true. Many individuals with cerebral palsy live into adulthood, and lifespan can vary widely depending on the severity of the condition and the presence of associated health issues.

Choice D reason: Cerebral palsy is accurately described as a non-progressive disorder. This means that while the symptoms of cerebral palsy can change over time (due to growth, development, and other factors), the underlying brain injury does not worsen. Understanding that cerebral palsy is non-progressive can help parents focus on managing symptoms and improving their child's quality of life.

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The nurse is assessing an 18-month-old patient at a well-child visit. What findings would suggest a developmental delay?

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