The parent of a preschool-aged client expresses concern that the ...

[JGIBBSON]

The parent of a preschool-aged client expresses concern that the client cannot ride a tricycle. Which action by the nurse is the most appropriate?
 
  1. Reassure the father that this is normal.
  2. Refer the child to the health care provider.
  3. Perform further growth and development assessments.
  4. Ask the father about any siblings and at what age they rode a tricycle.

Question 2

The mother of a 5-month-old infant calls the pediatric clinic to report tremors in the infant's extremities and chin. Which action by the nurse is the most appropriate?
 
  1. Reassure the mother that these tremors are a normal part of the infant's development.
  2. Give the mother the first available appointment to see the health care provider.
  3. Contact the health care provider to see if an electroencephalogra m (EEG) should be ordered.
  4. Ask the mother to keep a diary of the tremors and schedule an appointment for next week.

[tmlewis4706]

Answer to Question 1

Correct Answer: 3

The nurse should perform further growth and development assessments, as gross and fine motor development undergo rapid development during the toddler years (ages 1-3). A preschool-aged child (ages 3-5) should be able to pedal a tricycle, a major accomplishment typically mastered at the end of the toddler years. While the child may not be developmentally delayed, simply reassuring the father that this is normal without further assessment is not an appropriate action by the nurse. By first performing further growth and developmental assessments the nurse is better informed as to the need and urgency of a referral to the health care provider. Before gathering information about other children in the family and their developmental milestones, this child should be thoroughly assessed.

Answer to Question 2

Correct Answer: 1

Tremors of the extremities or chin of an infant are normal and reflect immature myelinization. This will disappear by 1 year of age as the nervous system continues to develop and myelinization of the efferent pathways matures. It is not necessary for the infant to be seen on an urgent basis; this is a normal phase of development. It is not necessary to consult the health care provider to discuss possible EEG as this is not indicative of seizure activity, but rather the result of an immature but normal nervous system. It is not necessary for the mother to record these tremors or see the health care provider since this is normal for a child of this age.

[JGIBBSON]

Excellent

[xthemafja]

TYSM