Which of the following findings is considered normal during a physical examination of a 3-year-old child?
Presence of Babinski reflex.
Ability to hop on one foot.
Using three-word sentences.
Absence of stranger anxiety.
The Correct Answer is C
This question assesses knowledge of pediatric growth and development milestones for a toddler transitioning into the preschool stage. Application of physical, cognitive, and language development standards for a thirty-six-month-old child is required to distinguish normal findings from abnormal neurological or developmental delays.
Choice A rationale
The Babinski reflex, where the big toe dorsiflexes, should disappear by twenty-four months of age as the corticospinal tract matures. Its presence at age three is abnormal and suggests a central nervous system lesion or delayed neurological development.
Choice B rationale
Hopping on one foot is a gross motor skill usually mastered at age four. While some three-year-olds may attempt it, it is not the standard developmental expectation for this age group, who are more adept at riding tricycles.
Choice C rationale
By age three, children typically have a vocabulary of about nine hundred words and use three-word to four-word sentences. This linguistic milestone reflects normal cognitive and social development, allowing the child to communicate basic needs and observations effectively.
Choice D rationale
The absence of stranger anxiety is not a standard physical or developmental finding at this age. While it peaks earlier, children at age three still demonstrate clear preferences for primary caregivers and may show wariness toward unfamiliar individuals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Psychosocial development in infancy centers on the reliability of the external environment. Knowledge of Erikson's developmental stages is necessary to understand how early caregiver interactions establish the foundational emotional security required for all subsequent stages of human growth.
Choice A rationale
Consistency in feeding, comforting, and hygiene allows the infant to perceive the world as predictable and safe. When basic needs are met promptly, the infant develops a sense of hope and trust in their primary caregivers.
Choice B rationale
Exposing infants to too many different caregivers can lead to inconsistent responses to their cues. This lack of a stable, primary attachment figure may hinder the development of a secure base and contribute to future mistrust.
Choice C rationale
Infants are developmentally unable to explore environments alone safely. While autonomy is important in the toddler stage, the infancy stage requires the presence of a supportive caregiver to provide safety and satisfy physiological and emotional needs.
Choice D rationale
Self-soothing is a skill that develops later; forcing independence too early can lead to feelings of abandonment. Promptly responding to an infant's distress is scientifically proven to build the neural pathways associated with emotional regulation and trust.
Correct Answer is A
Explanation
This question addresses pediatric respiratory management and oxygen therapy protocols. Knowledge of the American Heart Association 2020 guidelines is required to identify the target oxygen saturation levels that balance tissue oxygenation while avoiding the physiological risks of hyperoxia or hypoxia.
Choice A rationale
The guidelines recommend maintaining oxygen saturation at 94 percent or higher. This level ensures adequate arterial oxygen content for systemic delivery while minimizing the risks of lung injury or oxidative stress associated with excessive supplemental oxygen administration in children.
Choice B rationale
A saturation of 90 percent is generally considered hypoxic for a stable pediatric patient. Lower levels can trigger pulmonary vasoconstriction and impair metabolic processes, potentially leading to cellular dysfunction or cardiovascular instability if the underlying cause of hypoxia is not corrected.
Choice C rationale
While 99 percent is within normal limits, the guidelines emphasize titrating oxygen to maintain at least 94 percent. Aiming for 99 percent often involves unnecessary high-flow oxygen, which can cause hyperoxic tissue damage and suppress the natural respiratory drive.
Choice D rationale
An SpO2 of 85 percent indicates significant hypoxemia and requires immediate intervention. Normal ranges are typically 95 to 100 percent. Prolonged levels at 85 percent result in anaerobic metabolism, lactic acidosis, and potential end-organ damage due to insufficient oxygen supply.
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