A nurse is collecting data from a 3-month-old infant. Which of the following is an expected developmental finding?
Rolls from back to side
Able to hold a rattle
Holds arms out to be picked up
Displays fear toward strangers
The Correct Answer is B
A. Rolling from back to side typically occurs around 4 to 5 months of age.
B. At 3 months, an infant is expected to be able to hold a rattle.
C. Holding arms out to be picked up usually develops around 7 to 9 months of age.
D. Fear toward strangers, known as stranger anxiety, typically begins around 6 to 8 months of age.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is "\"{\\\"xRanges\\\":[163.4270782470703,203.4270782470703],\\\"yRanges\\\":[122.35760498046875,162.35760498046875]}\""
Explanation
The recommended placement for a small pediatric pulse oximeter probe is around the great toe, the outer palm or the foot. This placement is non-invasive and should not cause discomfort to the child. The nurse should the apply a snuggly fitting sock to hod the sensor in place.
Correct Answer is B
Explanation
A. Polyuria is not typically associated with sepsis; it may be seen in other conditions such as diabetes. In sepsis, urine output is often decreased due to impaired kidney function and shock.
B. Disorientation is a sign of sepsis, indicating that the infection may have spread to the bloodstream and is affecting the central nervous system. Altered mental status is a critical indicator of severe infection.
C. Hyperactive bowel sounds are not associated with sepsis. In sepsis, bowel sounds may actually be decreased due to decreased perfusion to the gastrointestinal tract.
D. Hypoglycemia can occur in sepsis, but it is not as specific an indicator as disorientation. Monitoring blood glucose levels is important, but disorientation provides a clearer sign of systemic infection.
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