15-20

The nurse is assessing a 3-year-old. What is the expected weight gain for this age child? a. 2 times the birth weight b. 2.5 times the birth weight c. 3 times the birth weight d. 4 times the birth weight

d. 4 times the birth weight (The expected weight of a -year-old toddler is four times the birth weight.)

What does the nurse consider as an appropriate snack for a 2-year-old child? a. Hot dog sections b. Grapes c. Popcorn d. Applesauce

d. Applesauce (Applesauce is a healthy and safe snack food for the toddler. The toddler is at risk for choking on foods such as grapes, hot dogs, and popcorn.)

The nurse explains that when a mother tells her 4-year-old child that balls should be played with outside and not inside the house, the child is likely to obey the rule because she:

does not want to be punished.

The nurse encourages a Puerto Rican family to bring food to a child because he is not eating the food served on his hospital tray. The nurse would expect the child to eat:

dried beans mixed with rice.

The nurse recognizes that when the toddler claims everything in the environment as "mine," it is an example of the toddler trait of ____________________.

egocentrism (Toddlers are egocentric in that they perceive their world only as it applies to them, such as MY mommy, MY dog, MY car, MY house, MY street. As they mature and have more experience with the world, they come to a more realistic viewpoint.)

To entertain a 5-year-old child, the nurse would suggest the developmentally appropriate choice of a:

model airport with toy planes.

When demonstrating a bath procedure to parents of Vietnamese origin, the nurse should avoid:

touching the child's head.

When a small group of preschool-age children were playing house, each child was pretending to be a particular family member. The nurse recognizes this as which type of play?

cooperative

The nurse assessing a 2-year-old is satisfied to see that the present weight of the child is _____________ the birth weight.

triple (The birth weight has usually tripled by the time the child is 2 years of age.)

When the 8-year-old child comes to the school nurse with his central incisor in his hand and reports he knocked his tooth out on the water fountain, the nurse should:

wash off the tooth and place it in a container of milk.

An assessment of a child's nutritional status reveals the child is alert, with shiny hair, firm gums, firm mucous membranes, and regular elimination. This child's nutritional status would be described as:

well nourished.

The nurse calculates the basal metabolic index (BMI) on an 8-year-old child who is 48 inches tall (1.2 meters) and weighs 100 pounds (45.4 kg) to be:

32.4.

What will the nurse advise a parent to do when introducing solid foods?

Introduce each new food 4 to 7 days apart.

Parents of a 6-month-old infant ask the nurse why it is necessary to offer iron-rich formula to their child. What is the correct response?

The infant has exhausted maternal iron stores.

The nurse suggests what approach(es) for introducing a toddler to new foods? Select all that apply.

a. Serve one food at a time. b. Avoid showing personal likes or dislikes. c. Offer foods in small amounts, less than a teaspoon. e. Serve food warm.

At a well-baby visit, parents of a 6-month-old ask when to take the infant for the first dental visit. The nurse's best response would be:

"A dental visit by 1 year of age is recommended by the American Academy of Pediatric Dentistry."

At what age does an infants birth weight triple?

1 year

The mother of a 7-month-old states, "The baby is eating food now. Should I give him regular milk, too?" The nurse would respond:

"Continue breast milk or iron-fortified formula until 1 year of age."

What is the earliest age at which the infant should be able to walk independently?

12 to 15 months

An infant's birth weight is 7 pounds, 8 ounces. The nurse can project the weight at 6 months to be _____ pounds.

15

A mother asks the nurse how much food should be offered to her 2-year-old. The nurse responds that a good rule of thumb for serving size would be _____ tablespoons.

2

When does the posterior fontanelle close?

2 to 3 months

The parent of a 3-month-old infant asks the nurse, At what age do infants usually begin drinking from a cup? What is the nurses most accurate response?

5 months

The mother of a 7-month-old reports that the first lower central incisor has erupted. She asks the nurse, "How many teeth will he have by his first birthday?" The nurse would explain that by 1 year of age, the infant usually has _____ teeth.

6

The nurse planning anticipatory guidance for the caregiver of a preschool-age child would explain that permanent teeth begin erupting about the age of _____ years.

6

The nurse recognizes Piaget's concrete operational thinking when a:

7-year-old says, "I am sick because I have germs in my chest."

What is the earliest age at which an infant is able to sit steadily alone?

8 months

When planning an activity for a 3-year-old, the nurse bases the plan on the average attention span of _____ minutes.

ANS: 15

____________ is a preschoolers idea that the world and all of its contents are created by people.

ANS: Artificialism Artificialism is the belief that all things in the world have been created by people.

Put the stages of separation anxiety in order from first to last. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Detachment b. Regression c. Despair d. Protest

ANS: D, C, A, B The preschool child may feel abandoned by the parents and continues to be subject to separation anxiety. Separation anxiety is manifested by the stages of protest, despair, detachment, and regression.

____________________ _________ is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there. .

ANS: Symbolic functioning Symbolic functioning is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there

The gradual transfer of behavioral control from the parent to the child is accomplished through _________________.

ANS: discipline Through discipline the parent gradually gives up behavior self-control to the child.

Play that is designed to retrain muscles or improve eye-hand coordination is considered ____________________ play.

ANS: therapeutic Therapeutic play, whether at home or in a clinic or rehab center, is designed to retrain muscles, strengthen muscles, or improve eye-hand coordination

The nurse advises the parents of a 6-year-old child to try and ensure at least ______ hours of sleep daily for the child.

ANS: 11 The 6-year-old school-age child needs at least 11 hours of sleep.

The nurse is aware that by the age of _____, the first permanent teeth erupt.

ANS: 6 At the age of 6, the first permanent teeth erupt: the 6-year molars.

Which is an example of associative play? a. Two children playing house, one playing the role of the dad and the other playing the mom b. Two children playing in a sand box, one building a wall and the other digging a hole c. Two children playing with sports-associated items, one with a football and the other with a bat d. Two children playing with a coloring book, one coloring pictures and the other looking at pictures

ANS: A Associative play allows the preschoolers to use their enlarged vocabulary in play with other children to carry on conversations and describe scenarios for each to play.

A school-age child becomes frustrated with a school assignment and says, "I can't do this!" What is the most developmentally supportive response from the parent? a. Ask, "What is it that is so difficult?" b. Allow the child to quit the effort. c. Call in older siblings to help. d. Finish the project for them.

ANS: A Helping the child focus on the problem that is keeping him from mastery can limit frustration. Quitting or having someone else finish is detrimental to the development of industry.

A mother reports that she has a new job and her 12-year-old child is home alone for a time after school. Which statement made by the parent alerts the nurse to a potentially unsafe situation for this child? a. "I told him that he could invite a few friends after school." b. "I put a list of emergency numbers next to the telephone." c. "Last week we made a first aid kit together." d. "There is a neighbor available in case of an emergency."

ANS: A Latchkey children are subject to a higher rate of accidents. Permitting school-age children and their friends to be home alone in an unsupervised environment is an unsafe situation.

The parents of a 4-year-old boy are concerned because they have noticed him frequently touching his penis. What knowledge would act as the basis for the nurses response? a. This behavior indicates a normal curiosity about sexuality. b. Masturbation suggests the boy has an excessive fear of castration. c. It is usually a result of discomfort from a penile rash or irritation. d. The behavior is abnormal and the child should be referred for counseling.

ANS: A Masturbation at this age is common and indicates that the preschooler has a normal curiosity about sexuality.

A father is concerned about how long his preschool-age child will continue sucking his thumb. What is the most helpful response from the nurse? a. Most children will stop thumb-sucking naturally by school age. b. Over-the-counter treatments that give a bad taste can be placed on the thumb to discourage the practice. c. Consistently touching the childs fingers whenever he sucks his thumb is most effective. d. Thumb-sucking is detrimental to the eruption of the childs teeth and must be stopped as soon as possible.

ANS: A Most children give up the habit of thumb-sucking by the time they reach school.

What tasks would be appropriate to expect of a 5-year-old? a. Setting the table with paper plates b. Washing the dirty knives c. Carrying glasses from the table to the sink d. Scrubbing out the sink with cleanser

ANS: A Parents must consider developmental level and safety when asking the 5-year-old child to help with chores.

What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6-year-old boy? a. Handheld video game b. MP3 player c. Adventure book d. Jigsaw puzzle

ANS: A The 6-year-old child can perform numerous feats that require muscle coordination. At this age, the handheld video game will offer competition without overexertion.

A 9-year-old boy is often cranky and irritable, and his school performance has declined. What is the most probable factor causing this behavior? a. He sleeps only 6 to 7 hours a night. b. He eats eggs every day. c. He has a new dog. d. He plays about 1 to 3 hours each evening.

ANS: A The 9-year-old child requires about 10 hours of sleep per night.

The parents of an 8-year-old child tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurse's most helpful response to explain nightmares? a. They are a normal extension of the child's fear of mutilation. b. They are an abnormal response to repressed feelings. c. They are a common result of latent sexuality. d. They are a side effect of overactivity and stimulation.

ANS: A The nightmares experienced by an 8-year-old child are an extension of their characteristic fear of mutilation.

What is the most appropriate intervention when dealing with occasional aggression in a 4-year-old child? a. Have the child take a time-out in the corner for 4 minutes. b. Spank the child at the time of the incident. c. Take away television privileges for the day. d. Send the child to his room for 30 minutes.

ANS: A Time-out periods, usually lasting 1 minute per year of age, with the child sitting in a chair or corner, are considered an effective disciplinary technique.

The school nurse is planning sex education classes for school-age children. What should the nurse be sure to do? a. Use simple terms. b. Avoid slang or "street" words and concepts. c. Keep topics on biological aspects of sexual development. d. Limit questions to keep content clear.

ANS: A Using simple terms is essential but slang and street terms need to be clarified. Apply age-specific information across broad aspects of biological, social, and current attitudes.

Which bedtime preparation rituals are the most appropriate for the nurse to suggest? (Select all that apply.) a. Telling a story b. Placing a favorite toy in bed c. Placing a glass of water at the bedside d. Turning on a night light e. Playing energetically

ANS: A, B, C, D All options are soothing bedtime rituals except energetic playing, which would be stimulating and counterproductive to sleep.

What basic "feeling" words should the nurse use in attempting to help a 7-year-old girl express her feelings about being in a new school? (Select all that apply.) a. Mad b. Glad c. Sad d. Scared e. Jealous

ANS: A, B, C, D The words "mad," "glad," "sad," and "scared" are basic feeling words that can prompt a young child to better express his or her feelings.

What does including play in the plan of care for a 5-year-old allow the child to do? (Select all that apply.) a. Exercise his imagination b. Assume a role and act it out c. Offers an emotional outlet d. Avoid magical thinking e. Interact with other children

ANS: A, B, C, E Benefits of play for the preschooler include exercising imagination, assuming a role and acting it out, offering an emotional outlet, and interaction with other children. Play employs the use of magical thinking.

The nurse points out what advantage(s) of a nursery school or preschool experience? (Select all that apply.) a. Increasing self-confidence b. Fostering group cooperation c. Detecting adjustment problems d. Attainment of toilet training skills e. Playing experiences with other children

ANS: A, B, C, E Nursery school increases self-confidence, group cooperation, social skills, and cooperative play. Objective observations by a nursery school instructor can detect early adjustment problems. The child is usually toilet trained prior to the start of preschool.

The school nurse is preparing an educational program for new teachers regarding school-age children. What information is accurate for the nurse to include? (Select all that apply.) a. Participation in group activity increases b. Egocentricity prevails c. Thinking is logical d. Preference is toward family interaction e. Understand cause and effect

ANS: A, C, E Piaget refers to the thought processes of the school-age period as concrete operations. Concrete operations involve logical thinking and an understanding of cause and effect. The egocentric view of the preschool child is replaced by the ability to understand the point of view of another person. Between 6 and 12 years of age, children prefer friends of their own sex and usually prefer the company of their friends to that of their brothers and sisters.

What developmental milestone(s) assist the 5-year-old boy toward developing his sexual identity? (Select all that apply.) a. Begins to be less focused on his mother b. Ignores both parents totally c. Regresses to a more infantile level d. Forms a romantic attachment to the mother e. Identifies with the parent of the same sex

ANS: A, D, E Children of this age become less focused on the mother as the central person and begin to identify with the parent of the same sex, forming a romantic attachment to the parent of the opposite sex. This little boy might say, Im going to marry my mother. A little girl might say, Im going to marry my daddy.

The parent of a 3 -year-old child tells the nurse, My daughter points instead of speaking whenever she wants me to get something for her, but she understands me when I ask her to do something. Based on the parents comment, what does the nurse suspect? a. Age-appropriate language development b. An expressive language delay c. A receptive language delay d. A potential hearing deficit

ANS: B An expressive language delay is suspected when the child understands spoken language but is not talking

A parent is concerned about her childrens reaction should their grandmother die. What understanding will guide the nurses response? a. Children are unlikely to notice their grandmothers absence if no one reminds them. b. Young children often understand that other people die, but do not equate it with themselves. c. The childrens response will depend entirely on whether they have been acquainted with death before this. d. Children can understand the concept of a higher being much like adults can.

ANS: B Between 3 and 4 years of age, the child becomes curious about death and dying. They may realize that others die, but they do not relate death to themselves.

The nurse is assessing a school-age child. What will the nurse expect in regard to physical development of this child? a. Growth of 3 to 6 inches per year b. Gain of 5 to 7 pounds per year c. Increase of head circumference by 1 inch per year d. A visual acuity of 20/20 by 9 years of age

ANS: B During the school-age period, the average weight gain per year is generally 5.5 to 7 pounds.

What is the nurses best advice to a parent about a preschoolers imaginary friend? a. Having imaginary friends is a sign that the child has low self-esteem. b. It is common for preschoolers to have imaginary friends. c. Preschoolers invent an imaginary friend when they feel overwhelmed. d. The best approach to dealing with an imaginary friend is to ignore them.

ANS: B Imaginary friends are common and normal during the preschool period and serve many purposes, such as relief from loneliness, mastery of fears, and acting as a scapegoat.

The nurse is advising parents of a 10-year-old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Erikson's theory? a. Constant variety of activities b. Successful performance in Little League c. Feeling healthy and strong d. Having a girlfriend

ANS: B The child who is successful in activities will feel positively about himself or herself.

When asked about her activities, a 10-year-old girl responded, "I like school. I play the flute in the school band, and I take tennis lessons." What does the nurse know these activities will help this child develop? a. Initiative b. Industry c. Identity d. Intimacy

ANS: B The school-age period is referred to by Erikson as the stage of industry. Successful participation in activities facilitates the child's sense of industry.

The pediatric nurse is presenting school-age children with information on safety issues to follow when going home alone. What guidelines should they be educated to follow? (Select all that apply.) a. Ask for identification before letting someone in the house. b. Never accept rides with strangers. c. Keep doors locked. d. Do not enter house if door is ajar. e. Walk to and from school with friends.

ANS: B, C, D, E Strangers should never be allowed in the house. Children should be instructed never to accept rides with strangers, to keep doors locked, not to enter the house if the door is ajar, and to walk to and from school with friends.

A 10-year-old child with disabilities is begging her parents for a dog. When at the pediatric clinic, the parents inquire about possible benefits pet ownership may provide to their child. What benefits of pet ownership should the nurse indicate? (Select all that apply.) a. Decrease the need for physical therapy b. Lower blood pressure c. Improve communication d. Foster trust e. Ease path to socialization

ANS: B, C, D, E Studies have documented the positive influence of pet ownership on improving the medical and psychological outcome after illness or surgery. Disabled children especially benefit from interacting with pets. The interaction with animals can lower blood pressure and heart rate, reduce loneliness and feelings of isolation, improve communication, foster trust, and motivate participation in physical therapy. Pets allow the ill child who feels separated from other people to feel companionship and acceptance. Shy children often find pet ownership eases the path to socialization with others who initiate contact because of the pet.

Which major developmental tasks will the nurse expect a child to accomplish by the end of the preschool years? (Select all that apply.) a. Development of parallel play b. Acceptance of separation c. Increased communication skills d. Consistent appetite e. Control of bodily functions

ANS: B, C, E The major tasks of the preschool child include preparation to enter school, development of a cooperative type of play, control of body functions, acceptance of separation, and increase in communication skills, memory, and attention span. Appetite remains inconsistent.

A preschool-age child is asked, Why do trees have leaves? Which response would be an example of animism? a. So I can have shade over my sandbox. b. Because God made them that way. c. To hide behind when they are scared. d. For the squirrels to play in.

ANS: C Animism describes the tendency of preschool children to attribute human characteristics to nonhuman objects.

The nurse is educating a group of preschool parents about the importance of safety. Which statement by a parent indicates the need for further education? a. I continue to provide a great deal of indirect supervision for my child. b. My stairway is always free of clutter. c. I only leave my child in the car for brief moments. d. Medications are kept in a locked cabinet.

ANS: C Children must not play in or around the car or be left alone, even for a brief moment, in the car. Preschool children still require a good deal of indirect supervision to protect them from dangers that arise from their immature judgment or social environment. Stairways should be free of clutter and medications kept out of reach.

What intervention might the nurse suggest as helpful for the child with enuresis? a. Applying an electric pad that gently shocks the child b. Waking the child several times during the night to urinate c. Decreasing fluid intake after the evening meal d. Increasing dietary fiber intake

ANS: C If a child is experiencing enuresis, liquids after dinner should be limited and the child should routinely void before going to bed.

What should the nurse suggest as the most appropriate toy choice for a 3-year-old? a. A board game b. A small pet, such as a goldfish c. A large construction set d. Push-pull toys .

ANS: C Large construction sets are suitable toys for the preschool-age child

The parent of a 4 -year-old child tells the nurse, Bedtime is difficult. I cant get my son to go to bed at night. The nurse and the childs mother discuss options. What intervention is the most appropriate choice? a. Allow the child to put himself to bed when he is tired. b. Let the child read in his room until he falls asleep. c. Establish a bedtime routine and use it consistently. d. Tire him out with physical activity before bedtime.

ANS: C Parents should engage the child in quiet activities before bedtime and establish a ritual that signals readiness for bedtime.

The nurse is discussing preschoolers sexual curiosity with the parent. What statement by the mother leads the nurse to determine that the mother understands the information? a. Make up funny words for body parts. b. Distract the child with a toy if they ask about sex. c. Answer their questions when they ask. d. Tell them to ask you again when they are 6 year old.

ANS: C Parents should provide sex education at the time the child asks about sex.

Parents ask the pediatric nurse how school life might influence their growing child. What area of development will the nurse indicate that school affects the least? a. Moral development b. Social development c. Physical development d. Cognitive development

ANS: C Physical development is the least affected by school life. Moral development occurs as they have experience with, and understand, rules and fairness in the school setting. Schools have a profound influence on the socialization of children, who bring to school what they have learned and experienced in the home. Success in school requires an integration of cognitive, receptive, and expressive (language) skills.

What is best for the nurse to suggest to the parents of an overweight 9-year-old child to help prevent obesity? a. Use whole milk as a between-meal snack because it is more filling than skim milk. b. Feed the child before family meal times to monitor intake more closely. c. Encourage the child to engage in physical activity for at least an hour a day. d. Remove all sweets and junk food from the house.

ANS: C Regular physical activity reduces weight.

Which stage of cognitive development is a 9-year-old child in according to Piaget? a. Formal operations b. Preoperational c. Concrete operations d. Sensorimotor

ANS: C School-age children are in the concrete operations stage of cognitive development.

A 3-year-old child, while playing with his favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. What behavior will the nurse anticipate from this child? a. Will play well with the other child b. Will give the toy up and then not play anymore c. Will become angry and a physical response might ensue d. Will ignore the toy and go on to something else

ANS: C The 3-year-old child is egocentric and likely will become angry when others attempt to take his or her possessions.

How does the nurse characterize the play of 5-year-old children? a. Enjoying rough and tumble play b. Playing well-organized games c. Following rules d. Preferring inside activities

ANS: C The 5-year-old wants to play by the rules but cannot accept losing. The rules may be very strict or change as the game progresses.

A parent asked the nurse, "At what age are children capable of assuming more responsibility for personal belongings?" What is the nurse's best response based on knowledge of growth and development? a. 6 years b. 7 years c. 9 years d. 12 years

ANS: C The 9-year-old child is dependable and assumes more responsibility for personal belongings.

What fear is unique to the preschool period? a. Water b. Animals c. Bodily harm d. Death .

ANS: C The fear of bodily harm, particularly the loss of body parts, is unique to this stage

What type of play is most appropriate when planning care for a child with moderate intellectual deficiency? a. Exercise leg and arm muscles. b. Be educationally oriented to make up for lost time. c. Be adjusted to mental age rather than chronological age. d. Involve contact sports and aggressive physical activity with other children. .

ANS: C The nurse must consider the childs mental age rather than her chronological age when selecting toys for play

Which statement best describes the 3-year-old child? a. Boisterous, tattles on others b. Aggressive, shows off c. Helpful, wants to assist with chores d. Talkative, inquisitive about the environment

ANS: C Three-year-old children are helpful and can assist in simple household chores.

The school nurse is preserving a tooth that was knocked out on the school playground. What will the nurse be especially careful to do? a. Wrap the tooth loosely in a clean cloth. b. Rinse the tooth with alcohol. c. Handle the tooth only by the crown. d. Place the tooth in a warm environment.

ANS: C When a permanent tooth is avulsed, the tooth should be picked up by the crown to prevent any further damage to the root and placed in milk until the child can be examined by a dentist.

A parent confides in the school nurse that her 8-year-old twins argue and bicker constantly. What is the best response by the nurse? a. Express alarm at the constant aggression. b. Voice concern and investigate referral for counseling. c. Inquire about what punitive action the parents have taken to stop it. d. Offer reassurance that such behavior is normal for 8-year-olds.

ANS: D Argumentative and competitive behavior is normal in 8-year-olds.

What will children who are unable to express themselves with words often do? a. Become reclusive and introspective b. Develop other methods of verbal communication c. Engage in more creative play d. Have tantrums and act out

ANS: D Children with delayed communication skills will frequently have tantrums and act out when they are unable to make their needs known.

What should the nurse keep in mind when planning to teach a class on nutrition to fourth-grade students? a. School-age children can concentrate on only one aspect of a situation. b. School-age children can think abstractly. c. School-age children are egocentric in their thinking. d. School-age children think logically and concretely.

ANS: D Piaget refers to the thought process of this period as concrete operations, which involves logical thinking and an understanding of cause and effect.

A seventh-grade girl tells the school nurse that her art teacher, a woman, is her hero. What is the most appropriate interpretation of the girl's comment? a. The student may be exploring her career options. b. The comment is cause for concern about sexual abuse. c. The child may have difficulty interacting with her peers. d. Hero worship is a normal phenomenon.

ANS: D School-age children tend to admire their teachers and adult companions. For the 11- to 12-year-old, hero worship is a normal phenomenon.

What statement by an 11-year-old child leads the nurse to determine he has moved from the mind-set of egocentrism? a. "I am a member of the best Cub Scout group in the world." b. "I must do my homework before I can play." c. "My dad can do anything!" d. "I'm sorry. I bet that hurt your feelings."

ANS: D The ability to see another's point of view indicates moving away from egocentrism into a more altruistic mind-set.

A mother is concerned because her 9-year-old boy has developed the habit of twitching his eyes and flipping his hair while communicating with anyone. What is the best nursing response to this parent? a. "This may indicate that he needs eyeglasses." b. "Children sometimes do these things for attention." c. "This behavior suggests low self-esteem." d. "Tics appear when a child is under stress."

ANS: D The child cannot help such actions and should not be scolded for them because they are mainly a result of tension.

A 4-year-old child insists he has more money with a nickel than his father has with a dime. What is this perception, as described in Piagets theory? a. Egocentrism b. Artificialism c. Animism d. Intuition

ANS: D The intuitive stage, as described by Piaget, is prelogical thinking that is based on the outside appearance of objects. A nickel is larger than a dime and therefore more valuable.

A parent states, "My 7-year-old really wants a dog. His 10-year-old brother has allergies to animal dander. I don't know what to do." What type of pet should the nurse suggest as the best choice? a. A small breed of dog because the large dogs produce more allergens. b. An older unneutered dog that produces fewer allergens than a younger one. c. A cat because it requires less care and is less allergenic. d. A poodle, which does not shed, making it a good choice for people with allergies

ANS: D The poodle does not have a shed cycle and so it may be the least offensive pet for the allergic child.

What type of relationships are the preferred social interactions for the school-age child? a. Heterosexual interest groups b. Association with one "best friend" c. Rigidly organized groups with complex rules d. Same-sex peer groups

ANS: D The preferred social interaction of the school-age child is in same-sex peer groups or cliques.

A 4-year-old child tells the nurse she will not eat peas because they are green. Of what is this an example? a. Egocentrism b. Artificialism c. Animism d. Centering

ANS: D The tendency to concentrate on a single outstanding characteristic of an object while excluding other features is known as centering.

The nurse discusses preparation for school with the parents of a 6-year-old girl who will soon be starting first grade. What statement by the girl's father leads the nurse to determine that the parents understood the information? a. "We should put a stop to her thumb-sucking." b. "We'll have a talk about what school is like." c. "We will let her walk to the bus stop by herself." d. "We'll have her meet some children who will be in her class."

ANS: D To prepare a child for school, parents can arrange for the child to meet other children who will be entering school with her.

Parents of a 5-year-old child tell the nurse they are concerned about their childs speech development by stating, No one can understand him but us. What clinical classification of speech disorder does the nurse suspect? a. Global language delay b. Expressive language delay c. Language loss d. Articulation disorder

ANS: D When parents are the only people to understand their preschool child, an articulation disorder is suspected.

What would the nurse expect a 4-month-old to be able to accomplish?

Lift head and shoulders.

A parent is concerned because her infant has a diaper rash. What is the best action the nurse would advise the parent to implement?

Apply a protective ointment on the area.

A parent brings a 6-month-old infant to the pediatric clinic for her well-baby examination. Her birth weight was 8 pounds, 2 ounces. What will the nurse weighing the infant today would expect her weight to be?

At least 16 pounds

Put the developmental milestones in order from first achieved to last achieved. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Jumps with both feet b. Holds a cup by the handle c. Social smile d. Babbles e. Understands "no"

C, D, E, A, B (Social smile: 2 months Babbles: 3 months Understands "no": 9 months Jumps with both feet: 24 months Holds a cup by the handle: 36 month)

The nurse is assessing development in a 9-month-old infant. What would the nurse expect to observe?

Creeping along the floor

A new mother is voicing concern she is breastfeeding her newborn too frequently. How often does the nurse instruct this mother she should expect her newborn to feed?

Every 2 to 3 hours

A mother is concerned because her 10-month-old is lethargic. What is the best action the nurse can advise this mother to implement?

Handle the infant slowly and gently.

What is an abnormal finding in an evaluation of growth and development for a 6-month-old infant?

Head lag present

What statement made by a parent indicates correct understanding of infant feeding?

I give the baby any new foods before he takes his bottle.

Which statement indicates the mother of an 8-month-old understands infant sleep patterns?

I put the pacifier in the crib so that she can find it when she wakes up.

The nurse discusses child-proofing the home for safety with the mother of a 9-month-old. Which statement made by the mother would indicate an unsafe behavior?

In the car, she rides in a front-facing car seat.

The nurse is talking with a parent about tooth eruption. What teeth will the nurse explain are the first deciduous teeth to erupt?

Lower central incisors

A mother tells the nurse, "My 11-month-old son is not as active as my other children were at this age. He is the youngest of four and the older children love to dote on him." Which factor is influencing this child's language development?

Ordinal position

The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately?

Respiratory rate of 60 breaths per minute

What is the most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old?

Play with push-pull toys.

_________________________ is when toddlers increase their sense of security by making compulsive routines of simple tasks.

Ritualism (Ritualism is when toddlers increase their sense of security by making compulsive routines of simple tasks.)

A mother calls the pediatricians office because her infant is colicky. What is the most helpful measure the nurse can suggest to the mother?

Rock the fussy infant slowly and gently.

The nurse observes a 10-month-old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed?

The pincer grasp

How might the nurse demonstrate the parachute reflex with an infant?

Thrusting the infant downward into the crib

The mother of an infant born prematurely tells the nurse, The baby is irritable. She cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe her? What is the most appropriate recommendation to help this parent?

Wrap the infant snugly when you hold them.

The nurse observes that a 2-year-old is able to use a spoon steadily at mealtime. The nurse recognizes that being able to self feed is important to the toddler in developing:

a sense of independence.

The nurse is planning to explain the use of time-outs to the parent of a 3-year-old. How many minutes will the nurse indicate is appropriate for a child of this age? a. 3 b. 6 c. 10 d. 15

a. 3 (Timing for time-out is usually based on 1 minute per year of age.)

What guideline should an adult follow when speaking to a toddler? a. Be at eye level with the child. b. Hold by the shoulders to keep the child's attention. c. Seat the child to focus on conversation. d. Speak in a firm strong voice.

a. Be at eye level with the child. (Being at eye level is helpful to hold the child's attention and is especially important when the child is frightened.)

A 16-month-old child is attending a well-child visit at a pediatric clinic. Which assessment would indicate the biggest cause for concern? a. Does not walk independently b. Prefers finger feeding c. Limited to single words d. Is unable to climb steps

a. Does not walk independently (A child should be walking independently by 16 months old. It is normal for a child this age to prefer finger feeding and to be limited to single words. Many children do not climb steps until 24 months of age.)

The pediatric nurse reminds a group of parents that children differ from adults in what way(s)? Select all that apply.

a. Higher metabolic rate b. Greater surface area in relation to their weight c. Less mature organ systems e. Continuously changing growth and development pattern

Parents tell the nurse they are frustrated with their toddler's recent behavior and refusal to agree with anything they ask of them. What does the nurse explain as the term for when a toddler tests their own power? a. Negativism b. Dawdling c. Tantrums d. Food fads

a. Negativism (By refusing to eat, dress, sleep, or anything else by saying "No," toddlers test their own power to control. Because toddlers are also egocentric, they come to believe that their negativism is absolute. This is especially true if the adults give into it.)

When selecting a potty chair, the parents are encouraged to select one that has which characteristic(s)? (Select all that apply.) a. Small enough for the child's feet to touch floor b. Sturdy and stable c. Supportive of child's back and arms d. Made of plastic or fiberglass e. Capable of being taken apart easily

a. Small enough for the child's feet to touch floor b. Sturdy and stable c. Supportive of child's back and arms (Potty chairs should be small and sturdy and supportive of the child's back and arms. The composition is not important as long as it is stable.)

Parents of a toddler are discussing the emotion of fear with the pediatric nurse. What information can the nurse offer regarding fear and the toddler? (Select all that apply.) a. Stress increases fear. b. Rituals help deal with fear. c. Teasing the child can decrease fear. d. Once fear is learned it is difficult to eliminate. e. Adults should openly share their fears.

a. Stress increases fear. b. Rituals help deal with fear. d. Once fear is learned it is difficult to eliminate. (Once a fear has been learned, it is more difficult to eliminate. Clinging to favorite possessions and repetitive rituals are self-consoling behaviors for the toddler, particularly at bedtime and during separation from parents. Stress increases fear of separation. Adults should attempt to control their own fears in the presence of young children. Respect and understanding should always be accorded to children who are afraid. Making fun of the fear or shaming the child in front of others is detrimental to self-esteem.)

What would the nurse assessing growth and development of a 2-year-old child expect to find? a. The child jumps with both feet. b. Twenty deciduous teeth have erupted. c. The child can hop on one foot. d. The child has a vocabulary of 900 words.

a. The child jumps with both feet. (The 2-year-old can jump with both feet. The remaining achievements occur after 2 years of age.)

Why does day care for the toddler differ from that of the preschooler? a. Toddlers have a shorter attention span. b. Toddlers need more group play. c. Toddlers are less prone to environmental dangers. d. Toddlers require less outdoor space.

a. Toddlers have a shorter attention span. (Toddlers have a shorter attention span than preschoolers and are prone to investigate other opportunities in the environment that may put them in harm's way. Toddlers are more interested in parallel play.)

The nurse points out which physiological change(s) in the toddler that serve(s)as protection against disease? (Select all that apply.) a. Toughening of the skin b. Increased capillary response for thermoregulation c. Stabilization of body temperature d. Elevation in white blood cell count e. Enlarged adenoids and tonsils

a. Toughening of the skin b. Increased capillary response for thermoregulation c. Stabilization of body temperature e. Enlarged adenoids and tonsils (With the exception of an increased white blood cell (WBC) count, which is always pathological, the other options are all maturing changes that equip the toddler to better fight disease.)

The toddler is in Erikson's stage of _______________versus_______________.

autonomy; shame and doubt (The toddler is in Erikson's stage of autonomy versus shame and doubt, which is based on a continuum of trust established during infancy)

The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." What is the most appropriate response by the nurse? a. "Has your daughter been sick recently?" b. "How much milk does she drink in a day?" c. "Has she become a fussy eater, too?" d. "Have you tried offering her finger foods?"

b. "How much milk does she drink in a day?" (Milk should be limited to 24 ounces a day. Too few solid foods can lead to dietary deficiencies of iron.)

How many hours should toddlers be able to stay dry for the nurse to suggest they are ready to begin bladder training? a. 1 b. 2 c. 3 d. 4

b. 2 (If the toddler is mature enough to retain urine for 2 hours, bladder training can be effective.)

A parent remarks, "My 18-month-old daughter carries her blanket around everywhere. Is this normal?" What is the best explanation a nurse who has an understanding of toddler development might give? a. She carries her blanket because she is ritualistic. b. Carrying her favorite blanket is self-consoling behavior. c. This behavior can be discouraged by offering new toys to the child. d. This could be indicative of emotional distress.

b. Carrying her favorite blanket is self-consoling behavior. (Favorite possessions and repetitive rituals are self-consoling behaviors for the toddler.)

What is the most appropriate toy for the nurse to select for a normal 2-year-old child? a. Bicycle with training wheels b. Dump truck c. Wind-up toy d. Building block set

b. Dump truck (The 2-year-old enjoys playing with objects that can be pushed or pulled.)

The nurse suggests offering which food(s) to support the toddler's desire to self-feed? (Select all that apply.) a. Pureed foods b. Finger foods c. Foods served cold d. Foods in colorful dishes e. Foods that are varied and colorful

b. Finger foods d. Foods in colorful dishes e. Foods that are varied and colorful (Finger foods that are varied and colorful and served in colorful dishes at a moderate temperature are all attractive. Foods can be chopped into small pieces but not pureed.)

What is the best advice the nurse can offer a parent concerned because her 2-year-old is very active and does not eat much? a. Insist that the child eat one food on the plate. b. Help the child wind down with a quiet activity before mealtime. c. Maintain a consistent eating schedule for the family. d. Serve the meal with a variety of interesting plates, cups, and utensils.

b. Help the child wind down with a quiet activity before mealtime. (Quiet time before meals provides an opportunity for the active toddler to wind down.)

What instruction would the nurse include when planning anticipatory guidance for parents of a toddler? a. Adhere to a rigid schedule because the toddler is ritualistic. b. Limit-setting should include praise. c. Shoes should fit snugly at the toe and arch. d. Dress the toddler in pants with a zipper so that he or she can learn to zip and unzip clothes.

b. Limit-setting should include praise. (Limit-setting should include praise as well as disapproval for undesired behavior.)

The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. What type of play is this? a. Solitary b. Parallel c. Associative d. Cooperative

b. Parallel (Toddlers engage in parallel play. Children play next to, but not with, each other.)

On a home visit, the nurse notes that the parents require teaching intervention to protect the 15-month-old child who lives there. What observation would lead the nurse to this conclusion? a. The fireplace has a screen. b. The dining room table has a tablecloth on it. c. There are paintings on the wall. d. The kitchen floor is clean but not shiny.

b. The dining room table has a tablecloth on it. (A tablecloth presents a safety hazard because the curious toddler will reach up and pull on it. The toddler could be injured if items on the table are moved when the tablecloth is pulled.)

The nurse suggests to the parents of an obese 10-year-old that they use the Portion Plate for Kids placemat. How does this tool help with selection of portion sizes? Select all that apply.

b. Tips on healthy food choices e. Familiar objects such as a deck of cards to measure servings

What would be an expected finding when assessing language development in a 2-year-old? a. A 900-word vocabulary b. Use of two-word sentences c. Use of pronouns and prepositions d. 100% of speech is understandable

b. Use of two-word sentences (The 2-year-old should be using two-word sentences.)

A mother reports that she and her husband have had one child together, but both have children from previous marriages living in their home. The nurse will base the care planning on the fact this family type is a(n) _____ family.

blended

The nurse explains that with the completion of myelination, the toddler will have the neuromuscular maturity to attain _______________ or _______________ control.

bowel, bladder (With the mature myelin, the toddler is able to translate neural impulses and respond in a significant manner. With myelination, the toddler can now translate the feeling of a full bladder or bowel and respond by defecating or urinating at will—hopefully in the bathroom.)

The nurse is discussing toilet training with parents. What behavior by the child would identify toilet training readiness? a. Willing to sit on the potty for 15 to 20 minutes b. Dry in the daytime for 4-hour periods c. Able to communicate that he or she is wet d. Curious about bathroom activities

c. Able to communicate that he or she is wet (Children are ready for toilet training when they can communicate in some fashion that they are wet or need to urinate or defecate.)

What could the nurse recommend to a child's mother to encourage a toddler to practice independence? a. Offer a variety of items to choose from to stimulate his mind. b. Allow the child to determine his own daily routine. c. Offer him a choice between two items. d. Set the routine herself, but discuss with her toddler how he or she would have done it differently.

c. Offer him a choice between two items. (The toddler can be allowed to make choices as the situation warrants, but the number of choices should be limited because too many confuse the toddler.)

Which healthy snack food(s) would the school nurse suggest to a group of adolescents? Select all that apply.

c. Raw vegetables d. Cheese

Which finding would concern the nurse assessing vital signs on a 2-year-old? a. Temperature of 37.1° C (98.8° F) b. Pulse at 100 beats/min c. Respirations of 36 breaths/min d. Blood pressure of 90/60 mm Hg

c. Respirations of 36 breaths/min (In the toddler period, the respiratory rate decreases to 25 breaths/min.)

How would the nurse advise a parent who states, "I never know how much food to feed my child"? a. Serving sizes should not exceed 1 teaspoon of each type of food. b. Food quantities must be carefully measured to avoid overfeeding. c. Use 1 tablespoon of each food for each year of age as a guideline. d. A toddler should eat three balanced meals. Snacks are not necessary.

c. Use 1 tablespoon of each food for each year of age as a guideline. (A tablespoon of each type of food for each year of age is a good guideline to follow when determining serving sizes.)

Which behavior reported by a parent of an 18-month-old toddler would the nurse report to the pediatrician as a cause for concern? a. Has temper tantrums b. Feeds self sloppily c. Walks by holding onto furniture d. Speaks in short sentences

c. Walks by holding onto furniture (By 18 months, a toddler should have been walking alone for several months. The toddler who walks holding onto furniture should be evaluated by a developmental specialist.)

When the nurse notes that an infant can lift her head before she can sit, the nurse is assessing _____ development.

cephalocaudal

To meet Erikson's developmental task of industry, the nurse caring for a 7-year-old would choose an activity such as:

completing a 50-piece jigsaw puzzle.

When the nurse asks the 10-year-old Native American if he is ready to go to therapy, he does not answer immediately. The nurse assesses this as:

considering the answer in silence

A unique organization of characteristics that determines an individual's pattern of behavior is known as:

personality.

The nurse assessing patterns of growth in a child would investigate further if:

previous weight was in the 75th percentile, and present weight is in the 25th percentile.

When the previously potty-trained 3-year-old wets the bed after admission to the hospital, the nurse assesses this event is caused by a____________________ related to the new environment.

regression (Regression occurs when a situation causes the person to go back to a less mature manner of coping. Faced with the new situation, in this case a hospital admission, the toddler reverts to an earlier coping mechanism in which potty training has no part. The same regression frequently appears when a new infant is introduced to the family circle, or when a traumatic event such as a death or divorce affects the family)

The nurse has discussed with the mother introducing solid foods to the 6-month-old infant. The nurse determines that the mother understands the information when she states the first food she will give to the infant is:

rice cereal.