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Which observation is expected when the nurse is assessing the gestational age of a neonate born at term?

A.

No creases on the plantar surface of the foot.

B.

Abundant lanugo covering most of the body.

C.

Flexed position at rest.

D.

Pinna of the ear that remains folded.

Answer and Explanation

The Correct Answer is C

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.


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Correct Answer is C

Explanation

Choice A rationale

The Industry vs. Inferiority stage, according to Erikson, occurs from age 6 to puberty, where children focus on learning, developing skills, and striving for competence. A 20-month-old

child is not yet in this stage.

Choice B rationale

The Trust vs. Mistrust stage is the earliest stage in Erikson's theory, occurring from birth to about 18 months. While a 20-month-old child has recently transitioned out of this stage, it

is not the stage applicable to their current developmental phase.

Choice C rationale

The Autonomy vs. Shame and Doubt stage occurs from approximately 18 months to 3 years. At 20 months, children are striving for independence, making choices, and developing a

sense of self-control, which is characteristic of this stage.

Choice D rationale

The Initiative vs. Guilt stage occurs from ages 3 to 6 years, where children begin to assert power and control through directing play and other social interactions. A 20-month-old child

is not in this stage yet.

Correct Answer is B

Explanation

Choice A rationale

Constructing a model airplane may require smaller parts and more intricate work, not ideal for a 4-year-old child.

Choice B rationale

Putting together a large-piece puzzle is suitable for fine motor skills development and can be done while in isolation.

Choice C rationale

Playing in the hallway would expose the child to other areas and people, defeating the purpose of airborne precautions.

Choice D rationale

Watching a video game in the playroom is not feasible as it would require leaving the isolation area.

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