Question

A nurse is assessing a 10-month-old infant. Which of the following findings should the nurse report to the provider?

Answer 1

Correct Answers:

The infant does not sit steadily without support.

Rationale :

👶At 10 months, sitting without support is a crucial gross motor milestone.

⚠️Inability to sit steadily can indicate a neuromuscular or musculoskeletal delay.

📈This milestone reflects core strength and neurological development, necessary for future motor progress.

🧠Missing this skill at 10 months may point to conditions like hypotonia or cerebral palsy and requires prompt evaluation.

📌Core Message

A delay in sitting without support at 10 months signals a possible gross motor developmental issue that must be assessed.

Answer 2

Correct Answers:

Place the child in an upright position

Rationale :

🪑An upright position helps maintain airway patency in a child with suspected epiglottitis.

🚫Attempting to visualize the throat can trigger laryngospasm and complete airway obstruction.

📞The nurse must avoid invasive procedures and prioritize airway protection.

🛑Suspected epiglottitis requires emergency intervention, and positioning the child to breathe easily is the first step.

📌Core Message

Proper positioning to protect the airway is critical in managing suspected epiglottitis—avoid throat manipulation.

Answer 3

Correct Answers:

Call for help, then check for a pulse

Rationale :

📢In an unresponsive child, the priority is to activate emergency response and assess for circulation.

🩺Pulse check determines whether to begin chest compressions or rescue breaths.

📱Prompt help ensures advanced life support can be provided while assessments continue.

❣️Skipping pulse check could delay appropriate intervention, especially since respiratory arrest precedes cardiac arrest in children.

📌Core Message

The nurse must first call for help and assess pulse to guide proper resuscitative action in an unresponsive child.

Answer 4

Correct Answers:

The toddler cannot stand upright without support.

Rationale :

🧍By 15 months, the ability to stand independently is a key gross motor milestone.

📉Failure to do so may suggest a neuromuscular or developmental delay.

📋This skill is foundational for ambulation and motor coordination, which should be progressing at this stage.

🖊️Identifying this delay early allows for intervention and referrals to support optimal development.

📌Core Message

The inability to stand unsupported at 15 months may indicate a developmental delay and should be reported.

Answer 5

Correct Answers:

Daytime symptoms occur more than twice a week.
Minor limitations with normal activity

Rationale :

🌬️Mild persistent asthma is marked by daytime symptoms more than twice weekly, but not daily.

🏃There are minor activity limitations, yet the child can usually function well.

📊A PEF of ≥80% is more typical in intermittent asthma, not mild persistent.

🌙Nighttime symptoms in mild persistent asthma occur more than twice per month, not just twice.

📌Core Message

Mild persistent asthma involves frequent daytime symptoms and minor limitations, distinguishing it from intermittent asthma.

Answer 6

Correct Answers:

Negative behaviors characterized by the need for autonomy

Rationale :

🙅Toddlers display negativism—resisting commands—as they assert autonomy.

🔄This behavior reflects Erikson's autonomy vs. shame and doubt stage.

🧒After surgery, toddlers may react with increased resistance due to loss of control.

💢Understanding this helps the nurse support the child with choices and reassurance.

📌Core Message

Negativism in toddlers is a normal expression of their drive for autonomy, especially after stressful events.

Answer 7

Correct Answers:

Active psychiatric disorder

Rationale :

🧠An active psychiatric condition such as depression or bipolar disorder is the greatest predictor of suicide risk.

📉Mental illnesses often involve hopelessness, isolation, or impulsivity, which increase risk.

📋Other factors may contribute, but mental health disorders are the strongest and most direct indicators.

📞Early psychiatric intervention is crucial for reducing suicide attempts and mortality.

📌Core Message

An active psychiatric disorder is the most significant risk factor for adolescent suicide.

Answer 8

Correct Answers:

Frequent swallowing

Rationale :

👅Frequent swallowing is an early and subtle sign of post-tonsillectomy bleeding.

💉This may occur as the child swallows trickling blood, which isn't always visible.

🩸Bleeding can become life-threatening if not caught early, especially near the airway.

🩺Observing swallowing patterns enables timely detection and intervention.

📌Core Message

Frequent swallowing after tonsillectomy is a classic early indicator of hemorrhage and must be reported immediately.

Answer 9

Correct Answers:

Iron deficiency anemia

Rationale :

🥛Drinking large amounts of milk can cause iron deficiency anemia by displacing iron-rich foods.

🍽️Milk is low in iron and reduces appetite for solid foods with essential nutrients.

🧃It also interferes with iron absorption, compounding the deficiency.

📉This can lead to problems in growth, immunity, and cognitive development.

📌Core Message

Too much milk in toddlers can lead to iron deficiency anemia by decreasing intake and absorption of iron.

Answer 10

Correct Answers:

Uses a unidextrous grasp

Rationale :

🖐️At 7 months, infants should use both hands or begin to transfer objects between hands.

🛑A persistent unidextrous grasp can indicate a neurological or motor development issue.

🔍This may be an early sign of hemiparesis or cerebral palsy.

⏰Early detection allows for timely therapy and neurological evaluation.

📌Core Message

A unidextrous grasp at 7 months may signal a motor or neurologic delay and requires further evaluation.

1 :
A nurse is assessing a 10-month-old infant. Which of the following findings should the nurse report to the provider?

2 :
A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?

4 :
A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?

5 :
A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)

6 :
A nurse is assessing the psychosocial development of a toddler following a tonsillectomy. Which of the following findings is a manifestation of this following?

7 :
A nurse is collecting data from an adolescent. Which of the following should the nurse identify as the greatest risk for suicide?

8 :
A nurse is monitoring a child for manifestations of hemorrhage following a tonsillectomy. Which of the following findings is a manifestation of this postoperative complication?

9 :
A parent tells a nurse that her toddler drinks a quart of milk a day and has a poor appetite for solid foods. The nurse should explain that the toddler is at risk for which of the following disorders?

10 :
A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?

1 : A nurse is assessing a 10-month-old infant. Which of the following findings should the nurse report to the provider?

2 : A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?

4 : A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?

5 : A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)

6 : A nurse is assessing the psychosocial development of a toddler following a tonsillectomy. Which of the following findings is a manifestation of this following?

7 : A nurse is collecting data from an adolescent. Which of the following should the nurse identify as the greatest risk for suicide?

8 : A nurse is monitoring a child for manifestations of hemorrhage following a tonsillectomy. Which of the following findings is a manifestation of this postoperative complication?

9 : A parent tells a nurse that her toddler drinks a quart of milk a day and has a poor appetite for solid foods. The nurse should explain that the toddler is at risk for which of the following disorders?

10 : A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?

1 :
A nurse is assessing a 10-month-old infant. Which of the following findings should the nurse report to the provider?

2 :
A nurse is planning care for a child who has suspected epiglottitis. Which of the following actions should the nurse take?

4 :
A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?

5 :
A nurse is caring for a school-age child who has mild persistent asthma. Which of the following is an expected finding? (Select all that apply.)

6 :
A nurse is assessing the psychosocial development of a toddler following a tonsillectomy. Which of the following findings is a manifestation of this following?

7 :
A nurse is collecting data from an adolescent. Which of the following should the nurse identify as the greatest risk for suicide?

8 :
A nurse is monitoring a child for manifestations of hemorrhage following a tonsillectomy. Which of the following findings is a manifestation of this postoperative complication?

9 :
A parent tells a nurse that her toddler drinks a quart of milk a day and has a poor appetite for solid foods. The nurse should explain that the toddler is at risk for which of the following disorders?

10 :
A nurse in a clinic is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?