Ch 12 Intro Newborn through To
Which statement made by a pregnant woman indicates the need for further teaching about necessary interventions to reduce the risk of sudden infant death syndrome (SIDS)? 1 "I should quit smoking during pregnancy." 2 "I should place soft toys near my baby during sleep." 3 "I should place my baby on her back while sleeping." 4 "I should cover my baby with small and lightweight sheets."
"I should place soft toys near my baby during sleep." Soft toys and pillows increase the risk of SIDS because they may hinder breathing and increase the risk of respiratory distress. Smoking during pregnancy will result in respiratory problems in the newborn, which increases the risk of SIDS. Therefore, the mother should quit smoking during pregnancy. Placing the baby on her back to sleep is the safest position and should be modeled by the nurses in the hospital. Overheating the baby with blankets will increase the risk of SIDS. Therefore, the parent should cover the baby with small and lightweight sheets.
The nurse is interacting with the parent of a 6-month-old infant and suspects that the neonate is at risk of intestinal bleeding. Which statement made by the parent supports the nurse's conclusion? 1 "I give cow's milk to my child every other day." 2 "I give boiled vegetables to my child every day." 3 "I give iron-fortified cereal to my child once a day." 4 "I give 20 ounces of formula to my child every day."
1 "I give cow's milk to my child every other day." Cow's milk increases the risk of intestinal bleeding and the incidence of allergies in a child who is younger than 12 months. The digestive system of a 6-month-old child will be able to digest boiled vegetables. Therefore, the infant will not have risk of intestinal bleeding. A 6-month-old child will have a well-developed gastrointestinal system to digest cereals. Therefore, an iron-fortified cereal diet is appropriate and does not cause intestinal bleeding. It is appropriate to provide 20 ounces of formula every day.
The birth weight of an infant is 2.7 kg. What would be the approximate projected weight of the infant at 1 year of age? Record your answer using one decimal place.______ kg
The projected weight of the infant at 1 year of age is three times the birth weight. The birth weight of the infant is 2.7 kg. Therefore, the approximate projected weight of the infant at 1 year will be 2.7 x 3 = 8.1 kg.
At what age is a baby expected to turn from the abdomen to the back? 1 2 to 4 months 2 4 to 6 months 3 6 to 8 months 4 8 to 10 months
2 4 to 6 months At 5 months of age, infants are expected to be able to turn from their abdomens to their backs. Infants can turn to their sides at 2 to 4 months of age. Infants can sit alone without support at 6 to 8 months of age. Infants can crawl on the floor using their arms at 8 to 10 months of age.
In evaluating the gross-motor development of a 5-month-old infant, which action would the nurse expect the infant to do? 1 Roll from abdomen to back. 2 Move from prone to sitting unassisted. 3 Sit upright without support. 4 Turn completely over.
1 Roll from abdomen to back.
What is the appropriate age for parents to discuss sexual intercourse, reproduction, and sexually transmitted infections with their child? 1 8 years of age 2 10 years of age 3 13 years of age 4 15 years of age
When a child reaches the age of 10, parents should begin talking about the upcoming pubertal changes that the child will experience. These discussions include introductory information topics related to menstruation, sexual intercourse, reproduction, and sexually transmitted infections (STIs). An 8-year-old child may not be mature enough to understand sex education. Though 13- and 15-year-old children can understand these discussions, 10 years of age is more appropriate, because this is the time when pubertal changes begin to take place in children.
A breastfeeding infant whose birth weight was 3000 grams now weighs 2700 grams after a week. The concerned mother asks the nurse about the infant's weight loss. What is the nurse's best response? 1 "Weight loss during this period is normal for an infant." 2 "The infant is dehydrated and needs fluid replenishment." 3 "Weight loss is due to the infant's increased motor activity." 4 "You should stop breastfeeding immediately."
1 "Weight loss during this period is normal for an infant." It is normal for an infant to lose 10% of the body weight in the first week after birth, due to defecation, urination, and lesser fluid intake than that of placental intake. The neonate does not need any fluid replenishment because the mother's milk is the primary source of food and fluids. The infant's motor activity is limited, so it is an unlikely cause of the weight loss. An infant who is regularly breastfed is unlikely to lose weight due to the breast milk.
A nurse observes that a child is able to hold onto objects properly. What is the probable age of the child? 1 1 to 2 years 2 3 to 4 years 3 5 to 6 years 4 7 to 8 years
1 1 to 2 years A child who is 1 to 2 years old may be able to hold objects properly. At 3 to 4 years of age, a child can stack a tower of small blocks. At 5 to 6 years of age, a child may be able to differentiate objects according to color. At 7 to 8 years of age, a child is likely to develop the cognitive ability to place objects in order, according to their increasing or decreasing size.
Which condition in a newborn requires immediate intervention? 1 Absence of reflexes 2 Presence of molding 3 Cyanosis of hands and feet 4 Soft and protuberant abdomen
1 Absence of reflexes Normal newborn reflexes include blinking in response to bright lights, startling in response to sudden loud noises, and sucking, rooting, grasping, yawning, coughing, sneezing, and hiccoughing. Assessment of these reflexes is vital, because the newborn depends largely on reflexes for survival and in response to the environment. If the newborn has an absence of reflexes, immediate interventions must be taken. Molding, or overlapping of the soft skull bones, allows the fetal head to adjust to various diameters of the maternal pelvis and is a common occurrence. This is a normal phenomenon in infants. Normal physical characteristics include cyanosis of the hands and feet for the first 24 hours, and a soft, protuberant abdomen.
When nurses are communicating with adolescents, what should they do? 1 Be alert for clues to their emotional state. 2 Ask closed-ended questions to get straight answers. 3 Avoid looking for meaning behind the adolescents' words or actions. 4 Avoid discussing sensitive issues such as sex and drugs.
1 Be alert for clues to their emotional state. Adolescents are searching for their identities and trying to become emotionally independent from parents while still maintaining family ties. Depression, substance abuse, and violence are all real concerns during this period; thus, the nurse must be aware of an adolescent's emotional state.
The nurse finds that a 5-year-old hospitalized child sucks his thumb. What should the nurse tell the parent regarding this? 1 It is a normal coping mechanism for stress. 2 The child needs to be evaluated by a pediatrician. 3 The child should be scolded whenever he does so. 4 The child seems to suck his thumb out of hunger
1 It is a normal coping mechanism for stress. During times of stress children tend to regress to an earlier developmental stage. Children may start to wet the bed, suck their thumbs, or ask the parents to feed, dress, or hold them. This is a normal coping mechanism for stress, which can be caused by illness and hospitalization. It usually disappears as the stress subsides. The child does not need pediatric consultation as it is not pathological. The child should not be scolded because this is a normal coping mechanism. Thumb-sucking does not indicate that the child is hungry.
The nurse is assessing four newborns in a neonatal care unit. Which neonate does the nurse identify as having abnormal physical characteristics? 1 Neonate 1 2 Neonate 2 3 Neonate 3 4 Neonate 4
1 Neonate 1 The average weight of a newborn is 6 to 9 lbs and they measure 19 to 21 inches. Therefore, Neonate 1 with a birth weight of 5 lbs and a length of 18 inches is considered to have abnormal physical characteristics. Neonate 2 has a normal weight of 6 lbs, as well as a normal length of 19 inches. Neonate 3 has a weight of 7 lbs and a length of 20 inches, which are normal values. Neonate 4 with a weight of 8 lbs and a length of 21 inches is also considered normal.
In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. What are they? 1 Nutrition, stress, and mother's age 2 Prematurity, stress, and mother's age 3 Nutrition, mother's age, and fetal infections 4 Fetal infections, prematurity, and placenta previa
1 Nutrition, stress, and mother's age The woman's diet before and during pregnancy has a significant effect on fetal development. The mother's age may contribute to a risk for chromosomal defects (older mothers) or the lack of prenatal care (adolescent mothers); pregnancy is often accompanied by stress because of all of the developmental changes, and it is important to know whether the mother has an effective support system.
A 12-year-old patient is showing signs of depression after being a victim of bullying at school. Which program would be appropriate to improve the child's situation? 1 Peer mediation program 2 Sleep intervention program 3 Classroom-based curricular program 4 Target-hardening and zero-tolerance policies
1 Peer mediation program Peer mediation programs are aimed at resolving conflicts among students; these programs can reduce the incidence of bullying-related depression, as it enhances self-confidence. Though sleep interventions may be needed for a student, these interventions are not aimed at improving sociability. A classroom-based curricular program is limited to fostering the relationship between students and teachers. Though target-hardening and zero-tolerance policies tackle school violence, this option is more appropriate for strengthening the security of the school's premises and does not directly help improve sociability.
At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which option should the nurse recommend? 1 Provide nutritious snacks. 2 Offer rewards for eating at mealtimes. 3 Avoid giving snacks so the toddler is hungry at mealtime. 4 Firmly explain to the mother why eating at mealtime is important.
1 Provide nutritious snacks. Toddlers do not grow as quickly as they do during infancy and thus eat smaller meals; nutritious snacks can help to ensure that they gain the nutrients they need. The old standbys of enough sleep and adequate nutritional intake also help keep excessive stress at bay. Although nursing students learn about the body's energy needs in anatomy and physiology classes, somehow they tend to forget that glucose is necessary for brain cells to work. Skipping breakfast or lunch, or surviving on junk food puts the brain at a disadvantage
The mother of a 4-year-old patient reports that her child has reverted to bed-wetting and thumb sucking. Which statements by the mother help the nurse understand the reason for the child's condition? Select all that apply. 1 "We moved to a new home recently." 2 "We had a second child last month." 3 "We brought a new pet into our house." 4 "We employed a new caregiver for our child." 5 "We changed the paint of the walls in our home."
1 "We moved to a new home recently." 2 "We had a second child last month." 4 "We employed a new caregiver for our child." A reversion to bed-wetting and thumb-sucking indicates stress in the preschool-age patient. Relocating to a new home can cause stress, because the child may miss his or her friends or relatives from the old environment. The birth of a new sibling can also induce stress in preschoolers, because they think that parents give the new baby more attention. Finally, changes in caregiving arrangements can induce stress in preschoolers, because they have to adapt to new caregiving patterns. Getting a pet can relieve the child from stress. Home renovations or changing the paint color of the walls are unlikely to significantly disturb the child and, therefore, are not likely factors related to the child's bed-wetting or thumb sucking.
The nurse is preparing a teaching plan about eating disorders in adolescents. Which statements about bulimia should the nurse include when teaching to adolescents? Select all that apply. 1 An individual with bulimia may engage in binge eating. 2 An individual with bulimia does not engage in exercise. 3 An individual with bulimia may induce vomiting. 4 If untreated, bulimia may lead to significant morbidity and mortality. 5 An individual with bulimia may refuse to take laxatives.
1 An individual with bulimia may engage in binge eating. 3 An individual with bulimia may induce vomiting. 4 If untreated, bulimia may lead to significant morbidity and mortality. Bulimia is an eating disorder, mostly found in adolescent girls. The adolescent may pursue a thin body image and may indulge in spurts of binge eating. Following an episode of binge eating, the individual usually induces vomiting to get rid of the extra calories ingested. If left untreated, it can lead to significant mortality and morbidity. Individuals with anorexia nervosa may exercise compulsively to work off food that was eaten. These individuals also tend to abuse laxatives to prevent absorption of food.
The nurse is caring for a 14-year-old boy after surgical repair for a tibia fracture. The mother of the adolescent tells the nurse about his careless attitude and his arrogance at home. She also complains that he argues with his siblings. What points should the nurse keep in mind while communicating with this boy? Select all that apply. 1 Ask open-ended questions. 2 Avoid discussing sex and drugs. 3 Avoid talking about his girlfriend and friends. 4 Look for the meanings behind his words or actions. 5 Be alert to clues concerning his emotional state.
1 Ask open-ended questions. 4 Look for the meanings behind his words or actions. 5 Be alert to clues concerning his emotional state. The nurse needs to ask open-ended questions with adolescents. Open-ended questions can provide more information. The nurse should look for the meanings behind words because adolescents may not reveal everything. The nurse should be alert for clues to their emotional state, as they do not express emotions openly. Matters such as sex, drugs, friends, and girlfriends should be openly discussed. It opens the channels for further discussion.
The nurse is assessing a 2-year-old child in a wellness clinic. Which food items should the nurse suggest that the parent avoid giving the toddler to ensure proper nutrition? Select all that apply. 1 Junk food 2 Whole milk 3 Solid foods 4 Low-fat milk 5 Finger foods
1 Junk food 2 Whole milk Toddlers may have a food "jag," which means they sometimes desire only food of a particular type. The nurse should tell the parent to avoid junk food because it does not provide adequate nutrition. Whole milk after age 2 also should be avoided because it is high in fat, and the 2-year-old is consuming alternate sources of fat in the diet. A solid diet that contains vegetables and cereals is encouraged because toddlers can obtain the needed nutrients from these food items. Low-fat milk is high in proteins and has a moderate amount of healthy fat, both of which are required for growth, and therefore is recommended. Toddlers like to eat finger foods because they can feed themselves.
A school health nurse is teaching a group of parents on how to promote the health of school-age children. What are the instructions that the nurse should provide? Select all that apply. 1 School-age children should be educated and encouraged to plan, select, and prepare healthy meals. 2 School-age children do not require a consistent bedtime. 3 School-age children should be educated on the hazards of smoking. 4 School-age children should be provided with healthy and nutritious snacks. 5 School-age children should be given age-appropriate immunizations
1 School-age children should be educated and encouraged to plan, select, and prepare healthy meals. 3 School-age children should be educated on the hazards of smoking. 4 School-age children should be provided with healthy and nutritious snacks. 5 School-age children should be given age-appropriate immunizations School-age children should be educated about and encouraged to plan, select, and prepare healthy meals. This helps them learn about healthy meal planning. Antismoking efforts, initiated by parents and schools, must begin before adolescence. The school-age period is not a time of rapid physical growth. Rather, growth is slow and steady compared to that of infancy and adolescence. Snacks should be healthy and nutritious, not high in calories, and chosen according to the food guide pyramid. The children should also be adequately immunized to protect them from infections. Adequate sleep time is important for optimal growth and development. Therefore, the parents need to set a consistent bedtime and promote a regular bedtime routine.
The nurse has assisted a patient in delivering a newborn. What interventions should the nurse implement immediately to prevent complications in the newborn? Select all that apply. 1 Wash hands before touching the baby. 2 Teach the patient about the advantages of breastfeeding. 3 Remove secretions from the airway through a suction or bulb syringe. 4 Cover the baby with a warm blanket and place under a radiant warmer. 5 Provide immunizations to the newborn as per the institution's policy.
1 Wash hands before touching the baby. 3 Remove secretions from the airway through a suction or bulb syringe. 4 Cover the baby with a warm blanket and place under a radiant warmer. The newborn is susceptible to infection. Therefore, the nurse should wash his or her hands before touching the baby. The family members and visitors should be instructed to wash their hands before touching the baby. The nurse should ensure a patent airway by removing secretions from the airway through a suction or bulb syringe. Newborns are susceptible to heat loss; hypothermia can increase the oxygen demands. Therefore, the nurse should keep the baby warm by wrapping the baby in a blanket and placing the baby under a radiant warmer. Teaching the patient about breastfeeding is important but is not an immediate intervention. Immunizations are given once the baby is stabilized. The key term for this question is immediately. Teaching the patient about breastfeeding and providing immunizations are not incorrect, but they are not immediate priorities. Watch carefully for questions that ask you to prioritize which interventions are needed immediately.
The mother of a newborn infant who was birthed vaginally asks the nurse, "Is something wrong because it seems my baby's head is not the proper shape?" Which is the nurse's best response? 1 "Place a soft pillow under your baby's head." 2 "It will be a more rounded shape within few days." 3 "You should get an x-ray of your child's head to provide more insight." 4 "You should immediately report this to the primary health care provider."
2 "It will be a more rounded shape within few days." Molding is a phenomenon of the overlapping of soft skull bones while adjusting to the size of the vagina during birth. This condition resolves within a few days as bones readjust to their original size. Using a soft pillow is a risk factor of sudden infant death syndrome. The infant does not require an x-ray examination to determine the defect. The infant has molding of the head due to vaginal delivery, which is a normal finding. Therefore, the infant does not require immediate attention of the primary health care provider.
While assessing the vital signs of a 4-year-old patient, the nurse finds that the child is expressing fear. What would be the appropriate nursing action in this situation? 1 Measuring vital signs in the child as quickly as possible 2 Allow the child to touch or play with the stethoscope and other simple equipment 3 Postponing the measurement of vital signs to the next day 4 Teaching the parent how to measure vital signs in the child
2 Allow the child to touch or play with the stethoscope and other simple equipment Preschoolers generally cooperate when taking their vital signs if they are allowed to help the nurse measure the vital signs of parents or are offered the nurse's equipment to use. Therefore, the nurse should offer the stethoscope or other simple equipment to the child to reduce fear. Measuring the vital signs increases the risk of error. Postponing measuring the vital signs may result in harmful outcomes. Parents do not have enough knowledge to take vital signs. Even if the procedure is demonstrated, parents may not be able to measure vital signs appropriately, which may lead to inaccurate results.
The mother of an infant complains to the nurse that the infant has experienced an allergic reaction. Which of the mother's actions might have caused an allergic response in the infant? 1 Breastfeeding her infant 2 Feeding the infant whole cow's milk 3 Feeding the infant breastmilk from a bottle 4 Feeding the infant iron-fortified formulas
2 Feeding the infant whole cow's milk The composition of whole cow's milk may cause intestinal bleeding or anemia, or trigger an allergic reaction in infants under 12 months of age. Breast milk contains essential nutrients for infants, whether it comes from breast or bottle. It is safe and preferred for infants to consume breast milk. Fruit-flavored drinks, as well as sodas, should be avoided, because they do not provide nutrients. However, these beverages are unlikely to cause allergic reactions. Iron-fortified formulas are acceptable alternatives to breast milk but are not associated with allergic reactions.
You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was bad. Which is the most correct interpretation of his comment? 1 His response is indicative of extreme stress. 2 His response is representative of his cognitive development. 3 His response is suggestive of excessive discipline at home. 4 His response is indicative of his developing a sense of inferiority.
2 His response is representative of his cognitive development. Preschoolers exhibit egocentric thought, meaning that they truly believe that their thinking is shared by others and that they can control their environment by their thoughts.
A mother of an adolescent complains that her child's school performance has declined and the child has been isolating herself over the past few days. The mother also suspects that the child has also been engaging in substance abuse. After assessing the child, the nurse finds that the child is experiencing depression and has suicidal thoughts. What would be the most appropriate intervention in this situation? 1 Educate the adolescent using interactive media. 2 Make an immediate referral to a mental health professional. 3 Educate the adolescent on the side effects of substance abuse. 4 Counsel the parents on the degrading health of the adolescent
2 Make an immediate referral to a mental health professional. Declined school performance, self-imposed isolation, and depression are the warning signs of suicidal tendencies. Therefore, the adolescent should be immediately referred to a mental health professional to prevent the degrading mental health and risk of suicide. Educating the adolescent on the side effects of substance abuse, and educating the parents on the health of the adolescent would not make a significant difference, unless treated methodologically.
Which type of psychosocial behavior is most common in school-age children? 1 Limited interest in sexual education 2 Preference for playing with same sex peers 3 Avoiding involvement in group activities 4 Defining the self based on external characters
2 Preference for playing with same sex peers School-age children tend to consider the opposite sex negatively. Therefore, they tend to develop friends of the same sex. School-age children tend to have a high interest in sexual education. School-age children will develop socialization so they prefer group activities to solitary play activities. Unlike toddlers, school-age children do not define themselves based on external characters.
The nurse is assessing a 6-month-old infant and anticipates that the infant has impaired motor development. Which finding helped the nurse to reach this conclusion? 1 The infant is unable to crawl. 2 The infant is unable to sit without support. 3 The infant is unable to pull him or herself up to stand. 4 The infant is unable to walk even by holding the furniture.
2 The infant is unable to sit without support. A 6-month-old will be able to sit without support from others. The inability to sit without support indicates that the infant has impaired gross-motor development. The ability to crawl develops from 8 to 10 months of age, not at 6 months of age. Therefore, an inability to crawl does not indicate that the infant has impaired development. The ability to pull up oneself to a standing position develops at 8 to 10 months of age, not at 6 months of age. Therefore, the inability of the infant to pull himself or herself to stand up still does not indicate that the 6-month-old infant has impaired motor development. The ability to walk by holding the furniture develops at 10 to 12 months of age, not at 6 months of age. Therefore, an inability to walk even by holding the furniture does not indicate that the 6-month-old infant has impaired motor development.
Which characteristic is commonly observed in a 5-year-old child? 1 Binge eating 2 Trying new foods 3 Finicky eating habits 4 Desire to eat one food
2 Trying new foods Trying different new foods is a characteristic feature observed in 5-year-old children. Binge eating is a common eating disorder seen in adolescents. Finicky eating habits and the desire to eat one food repeatedly are most commonly seen in 4-year-old children.
A school health nurse is teaching a group of adolescents about prevention of health risks. Which are important health risks in this age group that the nurse should address? Select all that apply. 1 Stunted growth 2 Suicide 3 Falls and injuries 4 Pregnancy 5 Sexually transmitted diseases
2 Suicide 4 Pregnancy 5 Sexually transmitted diseases Suicide is an important health risk in adolescence. An adolescent may attempt suicide due to depression and social isolation. Adolescent pregnancy continues to be a major social challenge for our nation. The United States has the highest rate of teenage pregnancy and childbearing annually compared to other industrialized nations (Hockenberry and Wilson, 2015). . The sexual behavior of adolescents contributes to morbidity and mortality due to sexually transmitted diseases. Stunted growth is not typically a problem faced during adolescence. Falls and injuries are seen more in younger children, not adolescents.
A mother complains about her 4-year-old child being a picky eater. What is the appropriate response by the nurse? 1 "Children of this age group generally dislike solid foods, and prefer liquids." 2 "Children of this age group must always be encouraged to eat new foods." 3 "Children of this age group are typically selective eaters." 4 "Children of this age group exhibit these picky eating behaviors when malnourished."
3 "Children of this age group are typically selective eaters." Children that are 4 years of age are finicky eaters, and start to try new foods as they approach and reach 5 years of age. It is not typical for 4-year-old children to prefer liquids to solid foods. Encouraging a 4-year-old child to try new foods may be counterproductive. In the case of malnourishment, the child's interest in any type of food would grow.
A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching? 1 "I can start giving her whole milk at about 12 months." 2 "I should continue to breastfeed for another 6 months." 3 "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." 4 "I can start giving her solid food now."
3 "I've started giving her plenty of fruit juice as a way to increase her vitamin intake." Breast milk or formula is recommended at this time; fruit juice is not considered a nutritive addition.
A parent tells the nurse, "My 2-year-old child does not do what I tell him." What should the nurse suggest to the parent? 1 "Encourage the toddler's independence." 2 "Ask the toddler to follow your instructions." 3 "Limit the opportunities for a 'no' answer." 4 "Wait until the toddler looks for instructions."
3 "Limit the opportunities for a 'no' answer." Toddlers may have behavioral problems as they start to act and think independently. In such conditions, parents can deal with the negativism by limiting the opportunities for a "no" answer and, at the same time, indirectly giving the instruction. The parent should encourage the toddler's independence. However, encouraging independence without limiting the opportunities is unlikely to produce effective behavioral results. Asking the toddler to follow the instructions is unlikely to be successful and would further worsen the situation. Toddlers are unlikely to look for instructions, because they tend to act independently.
At which age should a child be able to perform fine-motor skills such as transferring objects from hand to hand? 1 2 to 4 months 2 4 to 6 months 3 6 to 8 months 4 8 to 10 months
3 6 to 8 months At the age of 6 to 8 months, infants start to perform fine-motor skills such as transferring objects from hand to hand, banging objects together, and pulling strings to obtain an object. At the age of 2 to 4 months the infant can hold a rattle for short periods, look at and play with fingers, and bring objects from hand to mouth. At the age of 4 to 6 months the infant is able to grasp objects at will and can drop them to pick up another objects; however, children at this age are not expected to be able to transfer objects from hand to hand. At the age of 8 to 10 months the infant is able to pick up small objects and shows hand preference.
When does the anterior fontanel close? 1 Between 1 to 6 months 2 Between 6 to 12 months 3 Between 12 to 18 months 4 Between 18 to 24 months
3 Between 12 to 18 months The anterior fontanel is diamond-shaped and has frontal and parietal bones surrounding it. The anterior fontanel is usually palpable in infants and closes by 12-18 months. Before 12 months, the skull bones and sutures are too tender to ossify and close. By 18 months of age, the skull bones usually ossify and are too late for a fontanel to close after that. The posterior fontanel closes by the end of the second or third month.
The nurse observes that an adolescent has a severe concern about weight gain and distorted body image. The mother of the adolescent tells the nurse "My daughter performs vigorous exercises, induces vomiting after binge eating, and uses laxatives regularly." Which disease does the nurse anticipate in the patient? 1 Scoliosis 2 Amblyopia 3 Bulimia nervosa 4 Anorexia nervosa
3 Bulimia nervosa An adolescent with bulimia nervosa is characterized by fanatical concern about body weight, and performs measures to prevent weight gain after binge eating. Therefore, the adolescent with bulimia nervosa performs vigorous exercise, induces vomiting after eating, and uses laxatives regularly. Scoliosis is a spinal disorder and is not associated with binge eating. Amblyopia is associated with vision loss, not with body weight. In order to maintain a thin body image, an adolescent with anorexia nervosa starves and performs frenetic exercise patterns.
You are working in an adolescent health center when a 15-year-old patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care? 1 Contact her parents to alert them to her need for birth control. 2 Refer her to a primary health care provider to obtain a prescription for birth control. 3 Conduct a thorough sexual history and a careful examination of the genitalia. 4 Ask her to have her partner come to the clinic for STI testing.
3 Conduct a thorough sexual history and a careful examination of the genitalia. Adolescent pregnancy and STIs are concerns that should be addressed by the nurse to support health care.
A parent of a 2-year-old child complains, "My child has not been eating properly for the last few days." Which of the parent's actions does the nurse suspect to be causing the child to not eat? 1 Giving the child finger foods 2 Giving the child snacks between meals 3 Giving the child 3 pints of milk per day 4 Giving the child 2 ounces of breads and grains per day
3 Giving the child 3 pints of milk per day Giving children more than a quart of milk per day usually decreases the appetite for solid foods. Therefore, it is advisable to limit the milk intake to 2 to 3 cups per day. Giving finger foods to toddlers allows them to eat by themselves and satisfy their needs for independence and control. Toddlers often develop a desire to eat one food repeatedly. Therefore, giving toddlers snacks between meals is beneficial and does not cause decreased appetite. A diet consisting of breads and grains is essential for child growth, but would likely not be responsible for a decreased appetite.
Which intervention made by a parent indicates the need for further teaching about the proper use of car seats for infants? 1 Placing the baby in the car seat in the center seat 2 Placing the baby in the car seat with the seat belt on 3 Placing the baby in the car seat in the passenger seat 4 Placing the baby in the car seat in the rear-facing position
3 Placing the baby in the car seat in the passenger seat The car seat for infants should not be in the passenger seat because the head of the baby will be close to the dashboard and will increase the risk of injury. The car seat should be in the rear seat or center seat of the car. The seat belt of the car seat should be secured. Placing the car seat in rear-facing position is correct for infants.
Children in which age group are in the industry-versus-inferiority stage of Erikson's psychosocial development? 1 Toddlers 2 Adolescent 3 School-age children 4 Preschoolers
3 School-age children School-age children tend to develop an independent attitude and try to behave like adults. Therefore, school-age children are in the industry-versus-inferiority stage of Erikson's psychosocial development. Toddlers are in the autonomy stage of Erikson's psychosocial development as they develop autonomous behavior. Adolescents use cliquish behavior and may be intolerant of differences. They may have close peer relationships or remain socially isolated. Therefore, adolescents are in identity-versus-confusion stage of Erickson's psychosocial development. Preschoolers tend to learn new things and take the initiative. Therefore, preschoolers are in the initiative-versus-guilt stage of Erickson's psychosocial development.
The nurse is teaching a group of school-age children about the safety and prevention of accidents. Which statements made by an 11-year-old child indicate an understanding of safety principles? Select all that apply. 1 I used to wear a bike helmet when I was a little kid. 2 I do not need a life jacket on a boat because I can swim. 3 I make sure that I always wear a helmet while riding a bike. 4 I remind my dad to check the batteries in the smoke detectors. 5 I know how to swim, but I still wear a flotation device on a boat.
3 I make sure that I always wear a helmet while riding a bike. 4 I remind my dad to check the batteries in the smoke detectors. 5 I know how to swim, but I still wear a flotation device on a boat. School-age children are prone to injury and accidents. Head injuries can be avoided by wearing helmets when riding a bike. Smoke detectors can detect fire and raise an alarm. Smoke detectors should always be functioning properly. A personal flotation device should be worn when riding in a boat even if everyone knows how to swim. Life jackets should be worn by everybody when on a boat regardless of whether they know how to swim. People of all ages should wear a helmet, regardless of age, when riding a bike.
A mother reports that her baby is crying more even after feedings. The nurse instructs the mother about how to care for the infant during these times. Which statement made by the parent indicates effective learning? 1 "I will feed the baby soft foods." 2 "I will continue to feed the baby until the crying stops." 3 "I will change the baby's diaper whenever the baby cries." 4 "I will try to understand the baby's cry patterns for necessary action."
4 "I will try to understand the baby's cry patterns for necessary action." Crying is the only means of communication for a baby. This is the primary method by which a baby provides cues for the parents. A nurse teaching a parent about the cry patterns of a baby helps the parent take necessary action. Feeding soft foods to the baby may not stop the crying, because the problem might be something unrelated to feeding. Likewise, while it's possible that the infant has a wet diaper, but that may not be the only reason for the crying. Babies consume a small range of food, consisting mostly of mother's milk or fortified foods. If a baby is overfed, it leads to further discomfort.
A mother expresses concern that her 5-year-old child frequently talks about a fairy who plays with her. What should be the nurse's response? 1 "Consider a psychological evaluation for your child." 2 "Don't allow your child to watch more than 30 minutes of television per day." 3 "Explain to your child in a soothing manner that the fairy is not real." 4 "It is very normal for a 5-year-old child to have imaginary playmates."
4 "It is very normal for a 5-year-old child to have imaginary playmates."
A mother of a 2-year-old child tells the nurse, "I am worried that my child is not eating properly and is not gaining weight." Which advice given by the nurse to the mother will be beneficial for the child? 1 "You should provide beverages and snacks between meals." 2 "You should provide full meals three times a day to your child." 3 "You should provide low-fat milk to your child between meals." 4 "You should provide nutritious finger foods to your child between meals."
4 "You should provide nutritious finger foods to your child between meals." Toddlers tend to develop independence and like to play but not eat. Therefore, the nurse should instruct the parents to provide finger foods because it helps the active child consume adequate nutrition. Providing beverages and snacks between meals will reduce the child's hunger. The child will need to eat smaller meals more often rather than a full meal three times a day. The number of milk servings should be 2 or 3 cups a day in a toddler and the milk should be whole milk.
At what age can an infant normally place objects into containers? 1 4 to 6 months 2 6 to 8 months 3 8 to 10 months 4 10 to 12 months
4 10 to 12 months At 10 to 12 months, an infant can place objects into containers. At 4 to 6 months, an infant can grasp an object at will and drop it to pick up another object. At 6 to 8 months, an infant can transfer objects from one hand to the other. At 8 to 10 months, an infant can effectively use the pincer grasp.
The nurse works in a well-baby clinic. Which baby should the nurse expect to have no head lag? 1 A 1-month-old baby 2 A 2-month-old baby 3 A 3-month-old baby 4 A 4-month-old baby
4 A 4-month-old baby As the baby grows, gross motor skills are developed. A 4-month-old baby is usually able to hold the head up and has no head lag. Babies less than 4 months of age may not be developed enough to hold their heads up.
The nurse is assessing the developmental milestones for babies in a clinic. Which baby would be expected to crawl on the floor using his or her arms? 1 A baby who is 2 to 4months old 2 A baby who is 4 to 6 months old 3 A baby who is 6 to 8 months old 4 A baby who is 8 to 10 months old
4 A baby who is 8 to 10 months old At 5 months of age, an infant may be able to turn him or herself from the abdomen to the back. An infant who is 2 to 4 months old can turn to the sides. An infant who is 6 to 8 months old can sit alone without support. An infant who is 8 to 10 months old can crawl on the floor using his or her arms.
The nurse is assessing motor skills in four school-age children. Which child does the nurse identify as having impaired gross-motor skills? 1 Child A 2 Child B 3 Child C 4 Child D
4 Child D School-age children generally become more graceful during this period because the strength of their large-muscle coordination doubles and improves. Therefore, child D, who is unable to jump, run, throw, and catch balls while playing has impaired gross-motor skills. Fine-motor skills improve as children gain control over their fingers and wrists. Therefore, the inability to hold pencils, crayons, scissors, and rulers indicates impaired fine-motor skills in children A, B, and C.
Which statement is most descriptive of the psychosocial development of school-age children? 1 Boys and girls play equally with each other. 2 Peer influence is not yet an important factor to the child. 3 They like to play games with rigid rules. 4 Children frequently have best friends.
4 Children frequently have best friends. Peer relationships become very important to school-age children, and they usually develop close friendships.
Which approach would be best for the nurse to use with a hospitalized toddler? 1 Always give several choices. 2 Set few limits to allow for open expression. 3 Use noninvasive methods when possible. 4 Gain cooperation before attempting treatment.
4 Gain cooperation before attempting treatment. Toddlers are learning to become independent and frequently display negative behavior if an effort to gain their trust is not provided initially. Providing too many choices does not support their efforts to gain control.
Which factor can contribute to the potential weight loss of a 7-month-old child? 1 Cessation of mother's milk 2 Inclusion of fortified milk in the child's diet 3 Dehydration pertaining to adaptation to new foods 4 Inclusion of fruit juices instead of whole fruits in the diet
4 Inclusion of fruit juices instead of whole fruits in the diet The use of fruit juices and non-nutritive drinks does not provide sufficient calories during the second 6 months of life. On the contrary, solid foods like whole fruits, vegetables, and meat provide additional sources of nutrients. Stopping the mother's milk completely would not affect the body weight, because other dietary supplements are available to properly nourish the child. Fortified milk supplements are used as alternatives to breast milk in order to provide adequate nutrition to infants. Frequent dehydration most often occurs in severe pathological conditions and usually does not occur with the introduction to new foods.
A woman is unable to breast feed her 7-month-old infant. What alternative does the nurse recommend? 1 Soda 2 Fruit juice 3 Cow's milk 4 Iron-fortified formula
4 Iron-fortified formula Iron-fortified formula contains nucleotides and long-chain fatty acids that improve memory function and augment brain function. Therefore, iron-fortified formula is used as an alternative to breast milk. Sodas, fruit juices, and other non-nutritive fluids should be avoided, because they do not add adequate calorific value to the diet. Cow's milk is also a primary alternative to mother's milk, but it contains no folate, iron, or vitamin B 12, which are important for infant growth. Whole cow's milk can also cause allergies some infants.
While assessing a preschooler, the nurse anticipates a risk for amblyopia. Which finding in the child supports the nurse's suspicion? 1 Obesity 2 Anorexia nervosa 3 Sleep disturbances 4 Non-binocular vision
4 Non-binocular vision The presence of nonbinocular vision, or strabismus, indicates a risk foramblyopia, which can result in blindness. Childhood obesity is a common problem in children, which may increase the risk for hypertension, diabetes, and coronary artery disease. However, it is not associated with amblyopia. Anorexia nervosa is a common eating disorder seen in adolescence and is associated with binge eating. It does not increase the risk for amblyopia. Sleep disturbances occur due to drug withdrawal and are also warning signs of suicidal tendencies in adolescents. However, sleep disturbances are not associated with amblyopia.
Which action does the nurse expect a 4-month-old infant to perform? 1 Using a pincer grasp 2 Banging objects together 3 Placing object into a container 4 Placing objects from hand to mouth
4 Placing objects from hand to mouth The 4-month-old child will be able to hold a bottle and transfer it from hand to mouth. The ability to use a pincer grasp or holding an item with finger and thumb develops at 8 to 10 months of age. The ability to bang objects together develops at 6 to 8 months of age. The ability to place objects into a container develops at the age of 10 to 12 months.
Twhe school nurse is counseling an obese 10-year-old child. What factor would be important to consider when planning an intervention to support the child's health? 1 Concentrate on the child only, not the family, because it is the child's responsibility. 2 Consider the use of medications to suppress the appetite. 3 First, plan for weight loss through dieting and then add activity as tolerated. 4 Plan food intake to allow for growth.
4 Plan food intake to allow for growth. Although growth slows down during the school-age years, it is still important that appropriate nutrients be provided to promote growth. Children need adequate caloric intake along with activity for gross-motor development. Dieting might not provide the intake necessary.
Which developmental milestone would an infant begin to demonstrate at the age of 7 to 9 months? 1 Smiling responsively 2 Differentiating a stranger 3 Linking visual to auditory stimuli 4 Realizing things exist even when unseen
4 Realizing things exist even when unseen By the age of 7 to 9 months, infants begin to realize that things still exist even when they can no longer be seen. This understanding is called object permanence and is a vital developmental milestone. At the age of 2 to 3 months infants begin to smile responsively rather than reflexively. Some infants as young as 3.5 months will be able to link visual and auditory stimuli. By the age of 8 months infants will be able to differentiate a stranger from a familiar person and respond differently with both.
While working in the high-school clinic, one of the students tells you that she is worried about her friend who has started to refuse to participate in group activities, no longer cares about how she looks at school, and is not going to all of her classes. What does your assessment of these symptoms indicate? 1 She has just broken up with her boyfriend and time will heal all. 2 You will need to observe her over time to see if symptoms persist. 3 School may be too difficult for her right now. 4 She may be contemplating suicide.
4 She may be contemplating suicide. Depression is a major health concern for adolescents and can be triggered by many factors; the symptoms that are listed indicate the patient may be considering suicide.
While assessing a baby, the nurse concludes that the baby has achieved the developmental milestone appropriate for 10 to 12 months of age. Which of the baby's actions supports the nurse's conclusion? 1 The baby turns from side to back. 2 The baby sits alone without support. 3 The baby pulls self to standing or sitting position. 4 The baby holds the pencil and makes a mark on paper.
4 The baby holds the pencil and makes a mark on paper. An infant would reach the developmental milestone of holding a crayon or pencil and making a mark on a piece of paper at 10 to 12 months of age. Turning from the side to the back is a developmental milestone that can be achieved at 2 to 4 months of age. At 6 to 8 months of age, an infant would achieve the developmental milestone of sitting alone without support. At 8 to 10 months of age, an infant is able to pull him or herself to a standing or seated position.
What can the nurse infer from the image? 10366551215 1 The infant is exhibiting lanugo. 2 The infant is exhibiting molding. 3 The infant is exhibiting startle reflex. 4 The infant is exhibiting tonic neck reflex
4 The infant is exhibiting tonic neck reflex The infant depicted in the figure is exhibiting tonic neck reflex. When the infant's head is turned to one side, the arm and leg on that side should extend while the opposite arm and leg should flex. Lanugo is present on the skin of the back. Because the infant is lying dorsally, lanugo cannot be observed in this position. In molding, the bones readjust within a few days, producing a rounded appearance to the neonate's head. Molding cannot be interpreted from the figure. Moro reflex is the other name for startle reflex. The Moro, or startle, reflex is characterized by the infant being startled in response to sudden loud noises. Because the infant does not appear startled, the nurse cannot conclude that the infant is showing the startle reflex.
A nurse is teaching a parent about preventing sudden infant death syndrome (SIDS). Which action made by the parent indicates effective learning? 1 The parent sleeps or shares a bed with the infant 2 The parent wraps the infant in layers of blankets 3 The parent places stuffed animals in the infant's crib 4 The parent positions the infant on the infant's back while sleeping
4 The parent positions the infant on the infant's back while sleeping According to the recommendations of the American Academy of Pediatrics, the infant should be positioned on his or her back while sleeping. This position keeps the airway patent and decreases the risk of sudden infant death syndrome (SIDS). Sleeping or sharing a bed with the infant may cause accidental suffocation in the infant, leading to SIDS. Wrapping an infant in layers of blankets may cause hyperthermia, as well as SIDS. Making the infant sleep with stuffed animals may cause suffocation and increase the risk of SIDS.
