ATI Practice Women & Newborn Health ATI -Form A, Form B,

ATI Practice Women & Newborn Health ATI -Form A, Form B, & Form C 2022 □ A nurse in the pediatrician's office is checking the Babinski reflex in a 3-month-old infant. The nurse determines that the infant's response is normal if which of the following findings is noted? A The infant turns to the side that is touched. B The fingers curl tightly and the toes curl forward. C The toes flare and the big toe is dorsiflexed. Correct D There is extension of the extremities on the side to which the head is turned, with flexion on the opposite side. □ Rationale: To elicit the Babinski reflex, the nurse strokes the lateral sole of the foot from the heel to across the base of the toes. In the expected response, the toes flare and the big toe dorsiflexes. The Babinski reflex disappears at 12 months of age. Turning to the side that is touched is the expected response when the rooting reflex is elicited. Tight curling of the fingers and forward curling of the toes is the expected response when the grasp reflex (palmar and plantar) is elicited. Extension of the extremities on the side to which the head is turned with flexion on the opposite side is the expected response when the tonic neck reflex is elicited. □ □ Test-Taking Strategy: Knowledge regarding the method of testing and the expected response of the Babinski reflex is needed to answer this question. Recalling that to elicit Babinski reflex the nurse would stroke the lateral sole of the foot will direct you to the correct option. Review the procedure for testing this reflex in an infant and the expected response if you had difficulty with this question. □ □ Reference: McKinney, E., James, S., Murray, S., & Ashwill, J. (2009). Maternal-child nursing (3rd ed., p. 516). St. Louis: Elsevier. □ □ Level of Cognitive Ability: Analyzing □ □ Client Needs: Health Promotion and Maintenance □ □ Integrated Process: Nursing Process/Assessment