A nurse is teaching a group of new parents about infant reflexes.

Which of the following statements should the nurse include in the teaching? (Select all that apply.)

“The Moro reflex is also called the startle reflex because it occurs when the baby is startled by something.”

“The Moro reflex helps the baby develop their sense of balance and coordination.”

“The Moro reflex involves extending and flexing the arms and legs in response to a sudden movement.”

“The Moro reflex can be used to assess the integrity of the baby’s nervous system.”

“The Moro reflex can be triggered by changing the baby’s position or temperature.”

Answer and Explanation

Correct Answer : A,C,D

The Moro reflex, or startle reflex, is an involuntary response to a sudden loss of support or a loud noise that involves spreading and curling the arms and legs.

The Moro reflex involves three distinct components: spreading out the arms (abduction), pulling the arms in (adduction), and crying (usually). The baby may also extend and flex their legs.

The Moro reflex can be used to assess the integrity of the baby’s nervous system, as it reflects the development and function of the brain stem. Absence, asymmetry, or persistence of the Moro reflex may indicate neurological problems.

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Correct Answer is A

Explanation

This is a normal reflex that is present in newborns and disappears by 4 to 6 months of age.It is also known as the fencing reflex because the infant assumes a position similar to a fencer when the head is turned to one side.

A. The infant’s arms and legs flex and then extend B. The infant’s toes curl downward when the sole of the foot is touched C. The infant’s arms abduct at the elbows and the fingers spread to form a C shape D. The infant makes stepping movements when held upright with feet touching a flat surface

Correct Answer is C

Explanation

This is part of theMoro reflex, also called the startle reflex, which is normally present in infants up to about 4 to 6 months old.The reflex is triggered by a loud sound, a sudden movement, or a change in temperature, and causes the baby to throw back his or her head, extend his or her arms and legs, and then pull them back in.

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A nurse is teaching a group of new parents about infant reflexes. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is observing an infant who is lying on his back. The nurse notices that when the infant’s head is turned to the right, his right arm and leg extend, while his left arm and leg flex. The nurse recognizes this as which of the following reflexes?

Correct Answer is A

Explanation

A nurse is performing a neurological assessment on a 4-month-old infant. The nurse gently drops the infant’s head backward while supporting the body. The nurse expects to see which of the following responses as part of a normal reflex?

Correct Answer is C

Explanation

A nurse is observing a newborn’s reactions to different stimuli. The nurse touches the corner of the newborn’s mouth with a finger and sees that the newborn turns her head toward that side and starts to suck. The nurse recognizes this as:

A nurse is teaching a group of new parents about infant reflexes. Which of the following statements should the nurse include in the teaching? (Select all that apply.)

A nurse is caring for a 2-month-old infant who has a positive Moro reflex. Which of the following actions should the nurse take to elicit this reflex? (Select all that apply.)

A nurse is evaluating an infant’s neuromuscular development by testing different reflexes. The nurse strokes the outer edge of the sole of the infant’s foot up toward the toes and observes that the infant’s toes fan upward and out. The nurse documents this as:

A nurse is teaching a group of parents about infant reflexes. Which of the following statements by a parent indicates an understanding of the teaching?

A nurse is evaluating a client who has a suspected stroke. The nurse asks the client to stick out his tongue and observes that it deviates to the left side. Which of the following cranial nerves is most likely affected?

A nurse is teaching a group of new parents about infant reflexes.

Which of the following statements should the nurse include in the teaching? (Select all that apply.)