A nurse is assessing a 4-month-old infant on a pediatric unit.
Which of the following findings should the nurse expect?
Uses thumb and index fingers in a pincer grasp.
Closed posterior fontanel.
Lateral incisors.
Sitting steadily without support.
The Correct Answer is B
Choice A rationale
A pincer grasp, using the thumb and index finger to pick up small objects, typically develops around 9 to 12 months of age, not at 4 months.
Choice B rationale
The posterior fontanel typically closes by the age of 2 to 3 months, so a 4-month-old infant would be expected to have a closed posterior fontanel. This finding is consistent with normal development.
Choice C rationale
Lateral incisors, the teeth on either side of the front teeth, typically erupt around 9 to 13 months of age, not at 4 months.
Choice D rationale
Sitting steadily without support generally occurs closer to 6 to 8 months of age, so it would not be expected in a 4-month-old infant.
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Correct Answer is A
Explanation
Choice A rationale
Storing a firearm in a top drawer is unsafe, even if it is out of the child’s immediate reach. Firearms should be securely locked in a location inaccessible to children.
Choice B rationale
Locking cleaning products under the sink is a safe practice to prevent accidental poisoning, demonstrating correct safety precautions.
Choice C rationale
Placing safety covers on electrical outlets is a safe practice to prevent electrical shocks, indicating proper home safety measures.
Choice D rationale
Installing safety gates at the top and bottom of stairs is a recommended safety measure to prevent falls, showcasing awareness of proper childproofing.
Correct Answer is C
Explanation
Choice A rationale
Encouraging play exercises in the evening can lead to overstimulation, which can make it harder for the toddler to fall asleep. Physical activity should generally be done earlier in the day to help with sleep later on.
Choice B rationale
Turning off the room light can create a dark environment conducive to sleep, but it doesn’t address the need for a calming routine, which is essential for young children’s sleep. Some children also feel safer with a nightlight.
Choice C rationale
Providing bedtime rituals can help signal to the toddler that it is time to wind down and sleep. Consistent rituals, such as reading a story or singing a lullaby, provide a sense of security and comfort.
Choice D rationale
Explaining the source of the toddler’s fears may be beyond the cognitive ability of a toddler and does not directly promote sleep. It’s better to provide comfort and reassurance through routine.