The nurse holds an infant upright and allows his feet to brush the surface of the examination table. Which of the following is the normal reflex response to this stimulation?
A.
Draws legs up tight against the lower abdomen
B.
Extends legs straight against the pressure
C.
Makes stepping actions with both feet
D.
Toes curl in then fan outward symmetrically
ANS: C
The stepping reflex occurs when the infant is held upright and his or her feet brush a horizontal surface distal to the feet. Drawing the legs up tight against the lower abdomen would be an abnormal response. Extending the legs against pressure is a positive magnet reflex. Curling the toes in, then fanning them outward, is a positive Babinski reflex.
You might also like to view...
An outsider's viewpoint of a specific culture or culture group is referred to as:
a. emic knowledge. b. etic knowledge. c. lay or folk knowledge. d. worldview knowledge.
Health promotion should continue across the lifespan. Therefore, it is important for the nurse to understand when to initiate health promotion. When in the lifespan should health promotion begin?
A) Adolescence B) School age C) Preschool D) Before birth
What is a correct statement regarding a nurse who acts beyond the scope of practice?
a. Demonstrates what a good nurse he or she can be b. Provides enriched services to patients who would not otherwise receive them c. May make other nurses angry because of the increased expectations created d. May be disciplined by the board of nurs-ing
The nurse is preparing a teaching plan for an older patient who is taking multiple medications. Which principles should the nurse keep in mind during the planning phase?
1. The patient should use only one pharmacy to fill prescriptions. 2. The patient should keep a list of all medications for easy accessibility. 3. Polypharmacy is a common cause of medication errors in older patients. 4. Polypharmacy is unique to older patients and is the most common cause of medication errors. 5. The patient should be aware of each prescribed medication, the dose, and possible side effects.