The nurse is examining a 10-month-old boy who was born 10 weeks early. Which finding is cause for concern?

The child exhibits plantar grasp reflex.

The child has doubled his birth weight.

No primary teeth have erupted yet.

The child's head circumference is 49.53 cm.

Answer and Explanation

The Correct Answer is C

A. The child exhibits plantar grasp reflex: The presence of the plantar grasp reflex at 10 months

is appropriate and not cause for concern. This reflex typically diminishes by around 9 months but can persist slightly longer in premature infants.

B. The child has doubled his birth weight: Doubling birth weight by around 6 months is a normal developmental milestone, and achieving this by 10 months is appropriate, indicating healthy growth.

C. No primary teeth have erupted yet: The absence of primary teeth by 10 months, especially in a preterm infant, may indicate a delay in dental development and should prompt further evaluation by a healthcare provider.

D. The child's head circumference is 49.53 cm: The head circumference of 49.53 cm falls within the typical range for a 10-month-old infant and is not inherently concerning.

Nursing Test Bank

Quiz #1: RN Exams Pharmacology Exams Quiz #2: RN Exams Medical-Surgical Exams Quiz #3: RN Exams Fundamentals Exams Quiz #4: RN Exams Maternal-Newborn Exams Quiz #5: RN Exams Anatomy and Physiology Exams Quiz #6: RN Exams Obstetrics and Pediatrics Exams Quiz #7: RN Exams Fluid and Electrolytes Exams Quiz #8: RN Exams Community Health Exams Quiz #9: RN Exams Promoting Health across the lifespan Exams Quiz #10: RN Exams Multidimensional care Exams

Get 100+ Naxlex Exit Exams for $79 Try Naxlex NCLEX-RN (14 Day Free-Trial)

Naxlex Comprehensive Predictor Exams

Quiz #1: Naxlex RN Comprehensive online practice 2019 B with NGN Quiz #2: Naxlex RN Comprehensive Predictor 2023 Quiz #3: Naxlex RN Comprehensive Predictor 2023 Exit Exam A Quiz #4: Naxlex HESI Exit LPN Exam Quiz #5: Naxlex PN Comprehensive Predictor PN 2020 Quiz #6: Naxlex VATI PN Comprehensive Predictor 2020 Quiz #8: Naxlex PN Comprehensive Predictor 2023 - Exam 1 Quiz #10: Naxlex HESI PN Exit exam Quiz #11: Naxlex HESI PN EXIT Exam 2

Free Nursing Study Resources

Correct Answer is C,A,D,B

Explanation

Correct Answer:C, A, D, B.

C. Inspection:The initial step in an abdominal assessment is to inspect the abdomen visually. This allows the nurse to observe for any abnormalities in skin color, shape, and

movement without causing discomfort or altering findings that could be affected by palpation or auscultation.

A. Auscultation:Following inspection, auscultation is performed before any palpation. This is because palpation can stimulate bowel sounds, which may alter the nurse's ability to accurately assess the bowel activity and vascular sounds.

D. Superficial palpation:After auscultation, superficial palpation is done to detect tenderness, distension, or superficial masses. It is gentle and less likely to cause discomfort or alter deeper structures.

B. Deep palpation: The final step is deep palpation, which is used to examine the organs and structures that are deeper within the abdominal cavity. It is performed last to prevent any potential discomfort or alteration in the patient's condition that could interfere with the earlier steps of the assessment.

A. Describing the tongue extrusion reflex B. Explaining how to prepare table meats C. Advising about increased caloric needs D. Discussing the type of sippy cup to use

Correct Answer is C

Explanation

A. Describing the tongue extrusion reflex: The tongue extrusion reflex is typically present in

infants up to around 4 to 6 months of age and diminishes as they begin to eat solid foods. At 7 months, this reflex is likely no longer prominent.

B. Explaining how to prepare table meats: While introducing solid foods is important around 6 months of age, meats are often introduced later in infancy due to their texture and potential

allergenicity. At 7 months, infants may still be primarily consuming pureed or mashed foods.

C. Advising about increased caloric needs: At 7 months, infants are transitioning to a more varied diet that includes solid foods alongside breast milk or formula. Guidance on meeting their

increasing nutritional needs is crucial at this stage.

D. Discussing the type of sippy cup to usE. Sippy cups are typically introduced closer to the end of the first year or during the transition to weaning from the bottle. While it's important to

discuss appropriate feeding utensils, addressing increased caloric needs is a more immediate concern for a 7-month-old infant.

View Question and Answer

Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.

Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today

The nurse is examining a 10-month-old boy who was born 10 weeks early. Which finding is cause for concern?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to perform an abdominal assessment on a child. Identify the sequence the nurse should follow. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

Correct Answer is C,A,D,B

Explanation

The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is most appropriate for this child?

Correct Answer is C

Explanation

The nurse performing a health history on a child asks the parents if their child has experienced increased appetite or thirst. What body system is the nurse assessing with this question?

For which children would the nurse conduct an immediate comprehensive health history?

The nurse is teaching the student nurse the sequence for performing the assessment techniques during a physical examination. What is the appropriate order?

Which would be least effective in gaining the cooperation of a toddler during a physical examination?

A nurse is assessing a toddler at a well-child visit. At what point in the physical examination should the nurse examine the child's tympanic membrane?

The nurse is providing teaching for the mother of an infant who receives all of his nutrition through a nasogastric feeding tube. The nurse is reviewing interventions to promote growth and development. Which response from the mother indicates a need for further teaching?

The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says. The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?