A nurse is assessing a 7-month-old infant who has Down syndrome. Which of the following developmental milestones should the nurse expect?
Uses a spoon
Crawls short distances
Speaks five to eight words
Stands with assistance
The Correct Answer is B
Choice A rationale:
A 7-month-old infant with Down syndrome is less likely to use a spoon.
Choice B rationale:
Crawling short distances is a developmental milestone that can be expected at this age.
Choice C rationale:
Speaking five to eight words is not an appropriate milestone for a 7-month-old infant.
Choice D rationale:
Standing with assistance usually occurs around 9-12 months, which might be delayed in infants with Down syndrome.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
Exhibiting grief response behaviors may indicate the client is processing emotions related to the assault but may not necessarily indicate effectiveness of the plan of care.
Choice B rationale:
Stating a desire for revenge suggests unresolved anger and is not indicative of effective coping or progress.
Choice C rationale:
A sign of effectiveness in the plan of care for a client who has experienced sexual assault is the client's willingness to seek guidance and support in making important life decisions. This indicates a sense of trust in the nurse and a desire to move forward in a positive way.
Choice D rationale:
Demonstrating an increase in regressive behavior might indicate emotional distress but does not necessarily indicate effectiveness of the plan of care.
Correct Answer is A
Explanation
Choice A rationale:
Clustering nursing care activities minimizes disruptions to the client, reduces fatigue, and allows for periods of rest in between interventions.
Choice B rationale:
Hyperoxygenating the client before suctioning helps maintain adequate oxygenation and prevents hypoxia during the suctioning procedure.
Choice C rationale:
Keeping the room well lit is not necessary for a client on mechanical ventilation and can actually disturb their rest.
Choice D rationale:
Maintaining a specific PaCO2 level might be important for some clients, but this is not a general action applicable to all mechanically ventilated clients.
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