The nurse is performing a physical assessment on a 6-month-old baby. Which finding should the nurse understand as abnormal for this child?

The child has the beginning signs of tooth eruption.

The child is able to track and follow objects.

The child’s anterior fontanel is open.

The child’s posterior fontanel is open.

Answer and Explanation

The Correct Answer is D

A. The child has the beginning signs of tooth eruption:

Teething usually begins around 4-7 months of age, so the beginning signs of tooth eruption (teething) are typical at six months.

B. The child is able to track and follow objects:

By six months, most infants can track and follow objects with their eyes, which is a normal developmental milestone for this age.

C. The child’s anterior fontanel is open:

The anterior fontanelle, the soft spot at the top of the baby's head, remains open until around 18-24 months of age, so its presence at six months is expected and considered normal.

D. The child’s posterior fontanel is open.

By six months of age, the posterior fontanelle, the soft spot located at the back of the baby's head, typically closes or is significantly smaller than it was at birth. The posterior fontanelle usually closes between 2 to 4 months of age in most infants. If it remains noticeably open by six months, it might warrant further evaluation as it could be indicative of a developmental or medical issue.

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Correct Answer is B

Explanation

A. Sore throat:

A sore throat is a common symptom of various respiratory tract infections, including acute epiglottitis. However, examining the throat with a tongue depressor is unlikely to directly precipitate a sore throat in this context.

B. Complete obstruction:

Examining the child's throat with a tongue depressor in acute epiglottitis can potentially trigger spasm or swelling of the already inflamed epiglottis, leading to a rapid and complete obstruction of the airway. This is a critical concern and is why healthcare providers approach suspected cases of epiglottitis with great caution.

C. Inspiratory stridor:

Inspiratory stridor (high-pitched sound during inhalation) is a common symptom of upper airway obstruction, including in conditions like acute epiglottitis. It may be present without manipulation, but using a tongue depressor in the throat could exacerbate this symptom.

D. Respiratory tract infection:

Acute epiglottitis is indeed a type of respiratory tract infection. However, examining the throat with a tongue depressor is not likely to directly precipitate a respiratory tract infection.

A. The mother opens the capsule and some medication spills on the fingers. B. The child takes a dose before having an afternoon snack. C. The child chews an enteric form of the medication. D. The father tells the child that diarrhea is expected with this medication.

Correct Answer is B

Explanation

A. The mother opens the capsule and some medication spills on the fingers:

Pancreatic enzymes are usually taken intact, and their contents are meant to be sprinkled on soft food, not opened and spilled. This observation suggests a misunderstanding of the proper administration.

B. The child takes a dose before having an afternoon snack.

In cystic fibrosis, pancreatic enzyme replacement therapy is commonly used to help digest and absorb nutrients. The enzymes are typically taken with meals and snacks to aid in the digestion of food.

C. The child chews an enteric form of the medication:

Pancreatic enzymes are usually enteric-coated to protect them from stomach acid, and they are not meant to be chewed. Chewing can reduce their effectiveness. This observation indicates a need for clarification on administration.

D. The father tells the child that diarrhea is expected with this medication:

While gastrointestinal side effects can occur with pancreatic enzyme use, persistent diarrhea may indicate a dosage issue or other problems. It's important to address this with the healthcare provider. The statement suggests a potential misunderstanding or need for clarification.

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The nurse is performing a physical assessment on a 6-month-old baby. Which finding should the nurse understand as abnormal for this child?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is assessing a child with acute epiglottitis. Examining the child’s throat by using a tongue depressor might precipitate which symptom or condition?

Correct Answer is B

Explanation

The nurse is evaluating teaching provided to a school-age child and parents about the use of pancreatic enzymes for cystic fibrosis. Which observation indicates that teaching has been effective?

Correct Answer is B

Explanation

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