During a well-baby checkup, a mother is concerned because her 2-month-old infant cannot hold her head up when she is pulled to a sitting position. Which response by the nurse is appropriate?
a. Head control is usually achieved by 4 months of age.
b. You shouldn't be trying to pull your baby up like that until she is older.
c. Head control should be achieved by this time.
d. This inability indicates possible nerve damage to the neck muscles.
Question 2While performing a well-child assessment on a 5 year old, the nurse notes the presence of palpable, bilateral, cervical, and inguinal lymph nodes. They are approximately 0.5 cm in size, round, mobile, and nontender. The nurse suspects that this child:
a. Has chronic allergies.
b. May have an infection.
c. Is exhibiting a normal finding for a well child of this age.
d. Should be referred for additional evaluation.
Question 3The physician reports that a patient with a neck tumor has a tracheal shift. The nurse is aware that this means that the patient's trachea is:
a. Pulled to the affected side.
b. Pushed to the unaffected side.
c. Pulled downward.
d. Pulled downward in a rhythmic pattern.
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