A nurse is performing a developmental assessment on a 4-year-old client. What assessment finding would warrant further investigation?
The client has urinary and bowel continence.
The client is unable to tie their shoes.
The client introduces their "friend" who is not visible to the nurse.
The client speaks in 2-3 word sentences.
The Correct Answer is D
Rationale:
A. Urinary and bowel continence is expected by age 4, so this does not warrant further investigation.
B. Tying shoes is a skill typically developed later, around 5-6 years of age, so not being able to do so at age 4 is not concerning.
C. Having an imaginary friend is common in children around this age and is not a cause for concern.
D. Speaking in 2-3 word sentences is typical for a younger child, around 2 years of age. By age 4, a child should be able to speak in more complex sentences, so this finding warrants further investigation.
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Correct Answer is C
Explanation
Rationale:
A. Reduced intellectual processing is not typically associated with hyperthyroidism; it is more commonly associated with hypothyroidism.
B. Slow, lethargic movements are more indicative of hypothyroidism rather than hyperthyroidism.
C. Recent weight loss is a common symptom of hyperthyroidism due to increased metabolic rate and appetite changes.
D. A swollen, protuberant abdomen is not a typical symptom of hyperthyroidism. It is more associated with other conditions such as hypothyroidism or gastrointestinal issues.
Correct Answer is B
Explanation
Rationale:
A. Changing routines frequently might confuse the child rather than stimulate initiative.
B. Rewarding the child for showing initiative positively reinforces the behavior and encourages further development.
C. Allowing the child to make choices about playmates can foster independence but may not directly stimulate initiative.
D. Setting appropriate limits is important for a child's development, but not setting any limits can lead to behavioral issues rather than promoting initiative.