A 4-month old infant who has a congenital heart defect develops heart failure and is exhibiting marked dyspnea at rest . The nurse is aware this finding can be attributed to:

Correct Answer: C

Rationale: The nurse would first assess for an irregular heart rate and rhythm. In a 4-month old infant with a congenital heart defect experiencing marked dyspnea at rest, the sudden onset of cyanosis (blue coloration) and increased respiratory rate can indicate worsening heart failure and potential arrhythmias. Assessing for any abnormal heart rhythms is a priority to determine if immediate intervention is required to stabilize the infant's condition and prevent further deterioration.

Correct Answer: B

Rationale: Autism screening is recommended between 18 and 24 months.

Correct Answer: C

Rationale: Behavioral insomnia involves resistance to bedtime routines.

Correct Answer: A

Rationale: Older age is generally considered a poor prognostic factor, but not necessarily worse than other listed options.

Correct Answer: D

Rationale: Heavy meals close to bedtime disrupt sleep.