A nurse is planning to collect data from an 11-month-old infant who has failure to thrive. Which of the following findings should the nurse expect?
Weight above the 10th percentile
Makes eye contact with others
Poor muscle tone
Stranger anxiety
The Correct Answer is C
A. Weight above the 10th percentile would not be expected in an infant with failure to thrive. Infants with failure to thrive typically exhibit weight below the 5th percentile due to insufficient caloric intake or absorption.
B. Making eye contact with others is a normal developmental milestone at 11 months and would not be expected to be impaired in a child with failure to thrive.
C. Poor muscle tone is a common finding in infants with failure to thrive, as malnutrition and inadequate nourishment can affect the development of muscle strength and coordination.
D. Stranger anxiety is a typical developmental stage at 11 months, but it is not associated with failure to thrive. Infants with failure to thrive may exhibit developmental delays, but stranger anxiety is not a primary concern.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Wiping from the outer corner of the eye to the inner canthus is incorrect because this can introduce bacteria from the outer part of the eye into the inner part, which could exacerbate the infection. The proper technique is to wipe from the inner canthus to the outer canthus to prevent contamination.
B. Cleaning the eye with a moist cloth is appropriate for conjunctivitis as it helps remove secretions and crusts that accumulate. Using a clean, moist cloth minimizes irritation to the eye.
C. Keeping the eye covered with a compress is not recommended unless directed by a provider. Compresses could increase irritation or harbor bacteria if not kept clean.
D. Applying eye ointment in the morning is not optimal because ointment should generally be applied at night to prevent blurred vision during the day. The nurse should advise applying it as prescribed by the healthcare provider.
Correct Answer is C
Explanation
A. Children with autism may have difficulty with social interactions and sensory processing. Placing them in a semiprivate room could cause distress due to the lack of control over the environment and may increase anxiety.
B. Maintaining eye contact with a child with autism, especially when agitated, may increase stress and exacerbate agitation. Many children with autism avoid eye contact and may find it uncomfortable.
C. Children with autism can be very sensitive to sensory input, including physical touch. Minimizing physical contact helps reduce sensory overload and the child’s anxiety.
D. While providing comforting stimuli can be beneficial, leaving the television on at night may disturb the child’s sleep or increase sensory overload, especially if they are sensitive to sounds or visual stimuli.
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