During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action?
a. Teach parents appropriate exercises.
b. Recheck head control at next visit.
c. Refer child for further evaluation.
d. Refer child for further evaluation if anterior fontanel is still open.
ANS: C
Significant head lag after age 6 months strongly indicates cerebral injury and is referred for further evaluation. Reduction of head lag is part of normal development. Exercises will not be effective. The lack of achievement of this developmental milestone must be evaluated.
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