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While Assessing a 7-Month-Old Infant,the Nurse Makes a Loud Noise

Question 25

Multiple Choice

While assessing a 7-month-old infant,the nurse makes a loud noise and notes abduction and flexion of the arms and legs;fanning of the fingers,and curling of the index finger and thumb in a "C" position;and the infant bringing in its arms and legs toward its body.What does the nurse know about this response?


A) This could indicate brachial nerve palsy.
B) This is an expected startle response at this age.
C) This reflex should have disappeared between 1 and 4 months of age.
D) It is normal as long as movements are symmetrical bilaterally.

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