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    Hesi rn pediatric and women health (wgu) proctored exam

    A nurse is assessing a toddler. Which of the following findings should the nurse report to the provider?

    Explanation & Rationale

    Choice A reason: A positive Babinski reflex beyond infancy is abnormal. Normally, the Babinski reflex disappears by 12 to 18 months of age as the nervous system matures. Persistence of this reflex at 24 months or older indicates possible neurological dysfunction, such as upper motor neuron lesion or developmental delay. This finding should be reported to the provider for further evaluation. Choice B reason: The Moro reflex is a primitive reflex that disappears by about 4 months of age. Its absence in a toddler is expected and normal. Therefore, this finding does not need to be reported. Choice C reason: Referring to self by name is an appropriate developmental milestone for toddlers around 24 months. It reflects growing language and self-awareness. This is an expected finding and does not require provider notification. Choice D reason: Pointing to common objects when asked is a normal developmental milestone for toddlers. It demonstrates receptive language development and cognitive ability. This is expected and does not indicate any abnormality.

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