The nurse is performing a physical assessment of a 3-year-old girl. What finding would be a concern for the nurse?
The toddler's anterior fontanel is not fully closed.
The toddler gained 3 in in height since last year.
The toddler gained 4 lb in weight since last year.
The circumference of the child's head increased 1 in since last year.
The Correct Answer is A
A. The toddler's anterior fontanel is not fully closeD. The closure of the anterior fontanel typically occurs by around 18 months of age. If the fontanel is still open at 3 years old, it may indicate a delay in normal development and could be a cause for concern. The nurse should further assess this finding and consider follow-up with the healthcare provider.
B. The toddler gained 3 in in height since last year: Growth in height is expected during early childhood, and a gain of 3 inches over a year is within the normal range for a 3-year-old.
C. The toddler gained 4 lb in weight since last year: Weight gain is also expected during early childhood, and a gain of 4 pounds over a year is within the normal range for a 3-year-old.
D. The circumference of the child's head increased 1 in since last year: Head circumference typically increases during early childhood as the brain grows, and a 1-inch increase over a year is within the normal range for a 3-year-old.
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Related Questions
Correct Answer is C
Explanation
A. Transduction - Transduction refers to the process of reasoning from one specific instance to another without necessarily understanding the broader concept. The girl's statement about the sky and her throat does not demonstrate this mental process.
B. Centration - Centration involves focusing on only one aspect of a situation while ignoring others. The girl's statement may involve a degree of focus, but it's more indicative of a broader imaginative process.
C. Magical thinking - Magical thinking involves attributing human emotions or characteristics to inanimate objects or natural phenomena. The girl's belief that the sky is crying because it's sad about her throat hurting reflects this type of thinking.
D. Animism - Animism is a belief system that attributes life or consciousness to natural objects or phenomena. While the girl's statement involves anthropomorphizing the sky, it specifically
involves emotions rather than attributing life itself to the sky. Therefore, magical thinking is a more accurate description.
Correct Answer is A
Explanation
A. "This is a primitive reflex known as the palmar grasp.": The palmar grasp reflex is a primitive reflex observed in newborns where they automatically grasp onto objects (or fingers) that touch
their palms. This reflex typically disappears by around 6 months of age.
B. "This is a protective reflex known as rooting.": Rooting is a reflex where newborns turn their head and open their mouth in response to cheek or mouth stimulation, facilitating breastfeeding. It is not related to grasping objects with the hands.
C. "This is a primitive reflex known as the plantar grasp.": The plantar grasp reflex is similar to the palmar grasp but occurs when pressure is applied to the sole of the foot. It is unrelated to grasping objects with the hands.
D. "This is a protective reflex known as the Moro reflex.": The Moro reflex, also known as the startle reflex, involves the newborn's arms and legs extending and then flexing in response to a sudden movement or loud noise. It is not related to grasping objects with the hands.
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