Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay?

“My child has a vocabulary of approximately 20 words.”

“My child is still thumb sucking.”

“My child seems to be quite wary of strangers.”

“My child is able to stand but is not yet taking steps independently.”

Answer and Explanation

The Correct Answer is D

A. “My child has a vocabulary of approximately 20 words.”

This statement indicates language development, and an 18-month-old with a vocabulary of approximately 20 words is within the expected range. It's a positive indicator of language acquisition.

B. “My child is still thumb sucking.”

Thumb sucking is a common self-soothing behavior in infants and toddlers. While it's a normal behavior, it typically decreases with age. Thumb sucking alone may not necessarily be a cause for concern unless it persists significantly and interferes with other aspects of development.

C. “My child seems to be quite wary of strangers.”

Stranger anxiety is a normal developmental stage, and many children exhibit wariness or fear of unfamiliar people around the age of 18 months. It is considered a typical response and not necessarily indicative of developmental delay.

D. “My child is able to stand but is not yet taking steps independently.”

At 18 months, most children are expected to be walking independently. The inability to take independent steps might be a concern for gross motor skill development. While some variation is normal, a delay in achieving this milestone might prompt further evaluation to rule out any underlying developmental issues.

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Correct Answer is B

Explanation

A. Tetracycline:

Tetracycline antibiotics, such as doxycycline or minocycline, can be effective against the bacteria that cause impetigo. However, their use in children, especially younger ones, might be limited due to concerns about potential effects on developing teeth and bones. Therefore, they are not the first-line choice for pediatric impetigo.

B. Penicillin:

Penicillin or other antibiotics in the penicillin family, such as dicloxacillin or amoxicillin, are commonly used to treat impetigo caused by Streptococcus pyogenes. Penicillin-based antibiotics are effective against certain strains of the bacteria responsible for impetigo. They are often a preferred choice for pediatric impetigo.

C. Metronidazole:

Metronidazole is an antibiotic with activity against anaerobic bacteria and certain parasites. However, it is not typically used to treat impetigo caused by Staphylococcus aureus or Streptococcus pyogenes.

D. Lindane:

Lindane is an anti-parasitic medication used for conditions like scabies or lice. It is not effective against the bacteria that cause impetigo. Lindane is not an appropriate treatment for impetigo, and its use is limited due to potential neurotoxicity.

A. “We will keep our household hot water heater at 130 degrees.” B. “We will place poisonous substances in a high cupboard.” C. “We will place a gate at the top and bottom of stairways.” D. “We will put plastic fillers in all electrical plugs.” E. “We will turn handles of pans on the stove toward the back of the stove.”

Correct Answer is ["B","C","D","E"]

Explanation

A. “We will keep our household hot water heater at 130 degrees.”

The recommended setting for a hot water heater is typically 120 degrees Fahrenheit to prevent scalds. Setting it at 130 degrees may still pose a risk of burns to young children.

B. “We will place poisonous substances in a high cupboard.”

Placing poisonous substances out of reach in a high cupboard is a safety measure to prevent children from accessing potentially harmful substances.

C. “We will place a gate at the top and bottom of stairways.”

Using safety gates at the top and bottom of stairways is an effective way to prevent young children from falling down stairs.

D. “We will put plastic fillers in all electrical plugs.”

Placing plastic fillers in electrical plugs helps prevent children from inserting objects into outlets, reducing the risk of electric shock.

E. “We will turn handles of pans on the stove toward the back of the stove.”

Turning handles of pans on the stove toward the back is a safety measure to prevent young children from reaching up and pulling hot items off the stove.

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Which statement by the mother of an 18-month-old would lead the nurse to believe that the child should be referred for further evaluation for developmental delay?

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