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 B
Explanation
Choice A rationale
Acrocyanosis is a common and typically benign condition in newborns, characterized by bluish discoloration of the hands and feet. It is not an immediate priority.
Choice B rationale
Respiratory distress is the priority assessment for a newborn immediately following a cesarean delivery. Ensuring the newborn has a patent airway and is breathing effectively is crucial for their survival and immediate well-being.
Choice C rationale
Hypothermia is a concern for newborns, but respiratory distress takes precedence as an immediate life-threatening condition.
Choice D rationale
Accidental lacerations can occur during a cesarean delivery, but they are usually not life-threatening and can be addressed after ensuring the newborn's respiratory status is stable. .
Correct Answer is C
Explanation
Choice A rationale
The absence of creases on the plantar surface is typical of a preterm infant, not a term infant. Term infants usually have some creases.
Choice B rationale
Abundant lanugo is more common in preterm infants, while term infants may have some but not extensive lanugo.
Choice C rationale
A flexed position at rest is expected in a term neonate, as it indicates good muscle tone and neuromuscular development.
Choice D rationale
The pinna of the ear remaining folded is more indicative of a preterm infant, as term infants typically have fully formed and firmer ear cartilage.