CH 17 peds ?'s

Which type of play is most typical of the preschool period? a. Solitary b. Parallel c. Associative d. Team

C (Associative play is group play in similar or identical activities but without rigid organization or rules. Solitary play is that of infants. Parallel play is that of toddlers. School-age children play in teams.)

A 4-year-old child tells the nurse, "I got sick because I broke my sister's toy." The nurse knows that this is an example of which of the following? A. Lying B. Animism C. Expressing remorse D. Transductive reasoning

D. Transductive reasoning

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? a) "He is allowed out of time-out when he is calm." b) "I put him in time-out when the problem occurs." c) "The time-out doesn't just have to be in his room." d) "I usually have him in time-out for about 10 minutes."

d) "I usually have him in time-out for about 10 minutes."

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as 1. Problematic; the child is old enough to begin to have a basis in reality. 2. Normal, because the child is hospitalized and out of her routine. 3. Normal for this stage of growth and development. 4. Problematic, as it interferes with needed nursing care.

3. Normal for this stage of growth and development.

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? 1. Allow the child unlimited access to the sippy cup to ensure adequate hydration. 2. Encourage sweets for the extra caloric content. 3. Teach the mother about nutritional needs of the preschooler. 4. Assess the child's usual intake pattern at home.

4. Assess the child's usual intake pattern at home.

During the preschool period, the emphasis of injury prevention should be placed on: a. Constant vigilance and protection. b. Punishment for unsafe behaviors. c. Education for safety and potential hazards. d. Limitation of physical activities.

C (Education for safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers. Constant vigilance and protection is not practical at this age since preschoolers are becoming more independent. Punishment may make children scared of trying new things. Limitation of physical activities is not appropriate.)

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of: A. identity. B. intimacy. C. initiative. D. industry.

C (initiative)

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to which of the following? a) The fact that preschoolers have a harder time sharing than toddlers b) Playing in an even-number group of children (four) c) Testing and identification of group role d) Regression

c) Testing and identification of group role

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? 1. If spanking is not working, then time-out is not likely to be helpful either. 2. Place the child in time-out for 4 minutes. 3. Use time-out only if removing privileges is unsuccessful. 4. The child should stay in time-out until crying ceases.

2. Place the child in time-out for 4 minutes.

The causative agent for erythema infectiosum (fifth disease) is: A.parvovirus B19 B. human herpes virus type 6. C. human herpes virus types 1 and 2. D. group A β-hemolytic streptococci.

A

Which common childhood communicable disease may cause harm fetus? a. Erythema infectiosum b. Roseola c. Rubeola d. Rubella

A

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad." The nurse's best interpretation of this comment is that it is: a. A sign of stress. b. Common at this age. c. Suggestive of maladaptation. d. Suggestive of excessive discipline at home.

B (Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think that they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age show stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.)

A normal characteristic of the language development of a preschool-age child is: a. Lisp. b. Stammering. c. Echolalia. d. Repetition without meaning.

B (Stammering and stuttering are normal dysfluencies in preschool-age children. Lisps are not a normal characteristic of language development. Echolalia and repetition are traits of toddlers' language.)

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is: A. unsafe play that should be discouraged. B. creative play that should be encouraged. C. suggestive of limited family resources. D. suggestive of limited adult supervision.

B (creative play that should be encouraged.)

A 4-year-old child tells the nurse that she does not want another blood sample drawn because "I need all my insides, and I don't want anyone taking them out." Which is the nurse's best interpretation of this? a. Child is being overly dramatic. b. Child has a disturbed body image. c. Preschoolers have poorly defined body boundaries. d. Preschoolers normally have a good understanding of their bodies.

C (Preschoolers have little understanding of body boundaries, which leads to fears of mutilation. The child is not capable of being dramatic at 4 years of age. She truly has fear. Body image is just developing in the school-age child. Preschoolers do not have good understanding of their bodies.)

When caring for a preschool age child, the nurse should incorporate knowledge that body image has developed to include: A. a well-defined body boundary. B. knowledge about his or her internal anatomy. C. fear of intrusive procedures. D. anxiety and fear of separation.

C (fear of intrusive procedures.)

The parents of a 4-year-old girl are worried because she has an imaginary playmate. The nurse's BEST response is to tell the parents: A. a psychosocial evaluation is indicated. B. an evaluation of possible parent-child conflict is indicated. C. having imaginary playmates is normal and useful at this age. D. having imaginary playmates is abnormal after about age 2 years.

C (having imaginary playmates is normal and useful at this age.)

By what age would the nurse expect that most children could understand prepositional phrases such as "under," "on top of," "beside," and "in back of"? a. 18 months b. 24 months c. 3 years d. 4 years

D (At 4 years, children can understand directional phrases. Children 18 to 24 months and 3 years of age are too young.)

Which characteristic best describes the language of a 3-year-old child? a. Asks meanings of words b. Follows directional commands c. Can describe an object according to its composition d. Talks incessantly, regardless of whether anyone is listening

D (Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly, regardless of whether anyone is listening. A 4- to 5-year-old asks lots of questions and can follow simple directional commands. A 6-year-old can describe an object according to its composition.)

A 4-year-old female child is afraid of dogs. What should the nurse recommend to her parents to help her with this fear? A. Keep her away from dogs B. Buy her a stuffed dog toy C. Force her to touch a dog briefly D. Let her watch other children play with a dog

D (Let her watch other children play with a dog)

In terms of fine motor development, what could the 3-year-old child be expected to do? a. Tie shoelaces. b. Use scissors or a pencil very well. c. Draw a person with seven to nine parts. d. Copy (draw) a circle.

D (Three-year-olds are able to accomplish the fine motor skill of drawing a circle. Tying shoelaces, using scissors or a pencil very well, and drawing a person with multiple parts are fine motor skills of 5-year-old children.)

Which accomplishment would the nurse expect of a healthy 3-year-old child? a. Jump rope b. Ride a two-wheel bicycle c. Skip on alternate feet d. Balance on one foot for a few seconds

D (Three-year-olds are able to accomplish the gross motor skill of balancing on one foot. Jumping rope, riding a two-wheel bike, and skipping on alternate feet are gross motor skills of 5-year-old children.)

The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency? a) "He loves milk and drinks it every time he is thirsty." b) "He does not like spinach, but he does like chicken and beef." c) "He eats a well-balanced diet." d) "He enjoys eggs and fortified cereal for breakfast."

a) "He loves milk and drinks it every time he is thirsty."

The nurse's BEST approach for effective communication with a preschool age child is through: A. speech. B. play. C. drawing. D. actions.

B (play)

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? 1. Hesitancy and dysfluency are normal during this period of development. 2. Reading to the child will help model appropriate speech. 3. Expressive language concerns warrant a developmental evaluation. 4. The mother should ask her child's physician for a speech therapy evaluation.

1. Hesitancy and dysfluency are normal during this period of development.

Preschoolers' fears can best be dealt with by which intervention? a. Actively involving them in finding practical methods to deal with the frightening experience b. Forcing them to confront the frightening object or experience in the presence of their parents c. Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are d. Ridiculing their fears so they understand that there is no need to be afraid

A (Actively involving the child in finding practical methods to deal with the frightening experience is the best way to deal with fears. Forcing a child to confront fears may make the child more afraid. Preconceptual thought prevents logical understanding. Ridiculing fears does not make them go away.)

In terms of cognitive development, the 5-year-old child would be expected to: a. Use magical thinking. b. Think abstractly. c. Understand conservation of matter. d. Be able to comprehend another person's perspective.

A (Magical thinking is believing that thoughts can cause events. Abstract thought does not develop until school-age years. The concept of conservation is the cognitive task of school-age children ages 5 to 7 years. Five-year-olds cannot understand another's perspective.)

The nurse preparing a nutritional teaching plan for the parents of a preschool child should include which information? A. The quality of the food consumed is more important than the quantity. B. Nutrition requirements for preschoolers are very different from requirements for toddlers. C. Requirement for calories per unit of body weight increases slightly during the preschool period. D. Average daily intake of preschoolers should be about 3000 calories.

A (The quality of the food consumed is more important than the quantity.)

A useful skill that the nurse should expect a 5-year-old child to be able to master is to: a. Tie shoelaces. b. Use a knife to cut meat. c. Hammer a nail. d. Make change from a quarter.

A (Tying shoelaces is a fine motor task typical of 5-year-olds. Using a knife to cut meat is a fine motor task of a 7-year-old. Hammering a nail and making change from a quarter are fine motor tasks of an 8- to 9-year-old.)

The nurse is assessing a preschool age child who is stuttering when answering the nurse's questions. The nurse should offer alternate methods of responding to the stuttering when observing the parent: A. completing the child's sentences. B. listening attentively. C. encouraging the child to speak slowly. D. helping the child relax.

A (completing the child's sentences.)

Which play patterns does a 3-year-old child typically display (select all that apply)? a. Imaginary play b. Parallel play c. Cooperative play d. Structured play e. Associative play

A, B, C, E (Children between ages 3 and 5 years enjoy parallel and associative play. Children learn to share and cooperate as they play in small groups. Play is often imitative, dramatic, and creative. Imaginary friends are common around age 3 years. Structured play is typical of school-age children.)

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age group? (Select all that apply.) A. Falls B. Drowning C. Poisoning D. Sports injuries E. Tricycle and bicycle accidents

A, B, C, E (Falls Drowning Poisoning Tricycle and bicycle accidents)

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child (select all that apply)? a. Plastic telephone b. Hand puppets c. Jigsaw puzzle (100 pieces) d. Farm animals and equipment e. Jump rope

A, B, D (To promote imaginative play for a 3-year-old child, the nurse should provide: dress-up clothes, dolls and dollhouses, housekeeping toys, play-store toys, telephones, farm animals and equipment, village sets, trains, trucks, cars, planes, hand puppets, and medical kits. A 100-piece jigsaw puzzle and a jump rope would be appropriate for a young, school-age child but not a 3-year-old child.)

The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.) A. large blocks B. alphabet flash cards C. 100-piece puzzles D. dolls E. hand puppets

A, B, D, E (large blocks alphabet flash cards dolls hand puppets)

The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurse's best response is: a. "They will be here soon." b. "They will come after dinner." c. "Let me show you on the clock when 6 PM is." d. "I will tell you every time I see you how much longer it will be."

B (A 4-year-old understands time in relation to events such as meals. Children perceive "soon" as a very short time. The nurse may lose the child's trust if his parents do not return in the time he perceives as "soon." Children cannot read or use a clock for practical purposes until age 7 years. This answer assumes that the child understands the concept of hours and minutes, which is not developed until age 5 or 6 years.)

The parent of a 4-year-old son tells the nurse that the child believes "monsters and the boogeyman" are in his bedroom at night. The nurse's best suggestion for coping with this problem is to: a. Insist that the child sleep with his parents until the fearful phase passes. b. Suggest involving the child to find a practical solution such as a night-light. c. Help the child understand that these fears are illogical. d. Tell the child frequently that monsters and the boogeyman do not exist.

B (A night-light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with parents or telling the child that these creatures do not exist will not get rid of the fears. A 4-year-old is in the preconceptual age and cannot understand logical thought.)

In terms of language and cognitive development, a 4-year-old child would be expected to: a. Think in abstract terms. b. Follow simple commands. c. Understand conservation of matter. d. Comprehend another person's perspective.

B (Children ages 3 to 4 years can give and follow simple commands. Children cannot think abstractly at age 4 years. Conservation of matter is a developmental task of the school-age child. A 4-year-old child cannot comprehend another's perspective.)

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits (select all that apply)? a. Think in abstract terms. b. Follow directional commands. c. Understand conservation of matter. d. Use sentences of eight words. e. Tell exaggerated stories.

B, E (Children ages 3 to 4 years can give and follow simple commands and tell exaggerated stories. Children cannot think abstractly at age 4 years. Conservation of matter is a developmental task of the school-age child. Five-year-old children use sentences with eight words with all parts of speech.)

Imaginary playmates are beneficial to the preschool child because they: a. Take the place of social interactions. b. Take the place of pets and other toys. c. Become friends in times of loneliness. d. Accomplish what the child has already successfully accomplished.

C (One purpose of an imaginary friend is to be a friend in time of loneliness. Imaginary friends do not take the place of social interactions but may encourage conversation. Imaginary friends do not take the place of pets or toys. They accomplish what the child is still attempting, not what has already been accomplished.)

The nurse is giving anticipatory guidance to the parent of a 5-year-old. In this guidance, it is MOST important to: A. prepare the parent for increased aggression. B. encourage the parent to offer the child choices. C. inform the parent to expect a more tranquil period at this age. D. advise parents that this is the age when stuttering may develop.

C (inform the parent to expect a more tranquil period at this age.)

A nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which of the following is the most appropriate activity for this child? A) Large picture books B) A radio C) Crayons and coloring book D) A sports video

C. In the preschooler, play is simple and imaginative and includes activities such as crayons and coloring books, puppets, felt and magnetic boards, and Play-Doh. Large picture books are most appropriate for the infant. A radio and a sports video are most appropriate for the adolescent.

The nurse would expect that most children would be using sentences of six to eight words by age: A. 18 months. B. 24 months. C. 3 years. D. 5 years.

D (5 years.)

The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated? a) "At this age it is helpful to remind children to go to the bathroom." b) "Consider restricting your daughter's fluid intake." c) "The frequency of these wetting episodes may be consistent with a low-grade urinary tract infection." d) "Discipline should be applied after these times."

a) "At this age it is helpful to remind children to go to the bathroom."

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply. a) "Try reading a favorite story before bedtime." b) "Set up some familiar bedtime rituals for your child." c) "Try using a night light in the child's room." d) "Keep the door closed and the lights off so that your child can fall asleep faster." e) "Avoid having your child watch frightening shows on TV before bedtime."

a) "Try reading a favorite story before bedtime." b) "Set up some familiar bedtime rituals for your child." c) "Try using a night light in the child's room." e) "Avoid having your child watch frightening shows on TV before bedtime."

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply. a) A father who is overweight b) Expectations to eat everything on plate c) Fast food eaten once a month d) Mealtimes organized and regular e) Television on during meals f) Food used as reward or punishment

a) A father who is overweight b) Expectations to eat everything on plate e) Television on during meals f) Food used as reward or punishment

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a) be able to use each language as a separate system. b) be prone to stuttering. c) mix the two languages in the same sentence. d) avoid asking questions.

a) be able to use each language as a separate system.

The developmental task of preschoolers is to achieve a sense of a) initiative versus guilt. b) accomplishment versus inefficiency. c) autonomy versus shame and doubt. d) cognition versus attitude.

a) initiative versus guilt.

The mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone? a) "He broke my favorite plate but blamed it on some friend he called Paul, but we don't know anyone named Paul." b) "He tries to sweep up cereal his brother spilled but cries when he can't do it well." c) "He refuses to hold my hand while we are crossing the street." d) "When I leave him with a babysitter he gets upset, but she says he still does what she asks him to do."

b) "He tries to sweep up cereal his brother spilled but cries when he can't do it well."

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares? a) "She is scared after she wakes up." b) "She screams and thrashes when we try to touch her." c) "She comes and wakes us up after she awakens." d) "She has a hard time going back to sleep."

b) "She screams and thrashes when we try to touch her."

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play? a) Children are playing together in an activity without organization. b) Children are playing in an organized group with each other. c) Children are playing independently and are side-by-side. d) Children are playing apart from others without being part of a group.

b) Children are playing in an organized group with each other.

Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify which of the following as the task of the preschooler? a) Industry b) Initiative c) Trust d) Autonomy

b) Initiative

A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best? a) "Do you think your daughter is hallucinating? b) "Is there a family history of mental illness?" c) "Attributing life-like qualities to inanimate objects is quite normal at this age." d) "Your daughter is demonstrating animism which is common."

c) "Attributing life-like qualities to inanimate objects is quite normal at this age."

Which of the following would be most effective in helping promote initiative and nutritional health for a preschooler? a) Praising the child for cleaning his large plate of food b) Encouraging the child to cut up small pieces of apple for a snack c) Allowing the child to spread soft cheese on crackers d) Giving the child a high carbohydrate snack after preschool

c) Allowing the child to spread soft cheese on crackers

The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer? a) Encourage the parent to consider allowing the child to sleep with her b) Encourage the parent to leave on the television in the child's room c) Encourage the mother to check for monsters under the bed in the presence of the child d) Encourage the parent to allow a small night light

d) Encourage the parent to allow a small night light

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of: a) beginning empathy. b) magical thinking. c) animism. d) transduction.

d) transduction.

The nurse is organizing an indoor play area for preschoolers. What play materials are least important? a) Dress-up clothes and hats and puppets b) Balls, blocks, and puzzles c) Cut, paste, drawing, and painting materials d) CD player with music and musical instruments e) Electronic teaching toys

e) Electronic teaching toys

In providing anticipatory guidance to parents whose child will soon be entering kindergarten, which is a critical factor in preparing a child for kindergarten entry? a. The child's ability to sit still b. The child's sense of learned helplessness c. The parent's interactions and responsiveness to the child d. Attending a preschool program

C (Interactions between the parent and child are an important factor in the development of academic competence. Parental encouragement and support maximize a child's potential. The child's ability to sit still is important to learning; however, parental responsiveness and involvement are more important factors. Learned helplessness is the result of a child feeling that he or she has no effect on the environment and that his or her actions do not matter. Parents who are actively involved in a supportive learning environment will demonstrate a more positive approach to learning. Preschool and day care programs can supplement the developmental opportunities provided by parents at home, but they are not critical in preparing a child for entering kindergarten.)

The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be a) "Your son may have a friend named Andrew, but it could be an imaginary friend." b) "You should watch this type of behavior closely since most children this age tell the truth." c) "You need to show your child the broken tool since at this age they must see something in order to understand." d) "You should punish your son because no child should be telling lies at this age."

a) "Your son may have a friend named Andrew, but it could be an imaginary friend."

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply. a) Many car seats are installed improperly, making them unsafe. b) The back seat remains the safest place for children to ride. c) Children who weigh less than 40 pounds should use a car seat with harness and top tether. d) Booster seats should be used with both a shoulder and lap belt.

a) Many car seats are installed improperly, making them unsafe. b) The back seat remains the safest place for children to ride. c) Children who weigh less than 40 pounds should use a car seat with harness and top tether. d) Booster seats should be used with both a shoulder and lap belt.

The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old? a) The child can hop on one foot. b) The child can walk backwards with heel to toe. c) The child can jump rope. d) The child can throw and catch a ball.

a) The child can hop on one foot.

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify? a) Dental caries b) Obesity c) Iron deficiency d) Interference with growth

c) Iron deficiency

A 4-year-old female child sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This is MOST likely described as: A. a nightmare. B. night terror. C. seizure activity. D. sleep apnea.

B

What is descriptive of the preschooler's understanding of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms like "yesterday" appropriately

B (In a preschooler's understanding, time has a relation with events such as, "We'll go outside after lunch." Preschoolers develop an abstract sense of time at age 3 years. Children can tell time on a clock at age 7 years. Children do not fully understand use of time-oriented words until age 6 years.)

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make? a. Punish children so this behavior stops. b. Neither condone nor condemn the curiosity. c. Allow children unrestricted permission to satisfy this curiosity. d. Get counseling for this unusual and dangerous behavior.

B (Three-year-olds become aware of anatomic differences and are concerned about how the other "works." Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. Encouraging the children to ask questions of the parents and redirecting their activity are more appropriate than giving permission. Exploration is age-appropriate and not dangerous behavior.)

When preparing parents to teach their preschool child about human sexuality, the nurse should emphasize that: A. a parent's words may have a greater influence on the child's understanding than the parent's actions. B. parents should determine exactly what the child wants to know before answering a question about sex. C. parents should avoid using correct anatomic terms because they are confusing to the preschooler. D. parents should allow children to satisfy their sexual curiosity by playing "doctor."

B (parents should determine exactly what the child wants to know before answering a question about sex.)

During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. His birthday is close to the cutoff date, and he has not attended preschool. The nurse's BEST recommendation is to: A. start kindergarten. B. perform developmental screening. C. observe a kindergarten class. D. postpone kindergarten and go to preschool.

B (perform developmental screening.)

A 4-year-old boy has been having increasingly more frequent angry outbursts in preschool. He is very aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. The MOST appropriate intervention is to: A. explain that this is normal in preschoolers, especially boys. B. refer the child for professional help. C. talk to the preschool teacher to obtain validation for the behavior the parent reports. D. encourage the parent to try more consistent and firm discipline.

B (refer the child for professional help.)

The nurse is guiding parents in selecting a day care facility for their child. When making the selection, it is especially important to consider: a. Structured learning environment. b. Socioeconomic status of children. c. Cultural similarities of children. d. Teachers knowledgeable about development.

D (A teacher knowledgeable about development will structure activities for learning. A structured learning environment is not necessary at this age. Socioeconomic status is not the most important factor in selecting a preschool. Preschool is about expanding experiences with others; cultural similarities are not necessary.)

A 4 year old is going to finger paint for the first time. Which of the following is the best action for the adult supervisor of this activity? a) Make a model for the child to follow so it will be easy to copy. b) Support whatever the child paints. c) Tell the child that it will be fun but that he or she should not make a mess. d) Draw a picture first for the child to see how to do it.

b) Support whatever the child paints.

A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing? a) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident. b) The thought of losing his father was scary, and the child is trying to show his father how much he loves him. c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents. d) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior.

a) The boy wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so he believes he caused the accident.

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching? a) "I have heard that both boys and girls often touch themselves at this age." b) "I will need to find an appropriate punishment for him if this continues." c) "This is probably a good time to talk about safety and who can touch him." d) "I should teach him certain rules about this activity."

b) "I will need to find an appropriate punishment for him if this continues."

Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age how many additional words do most children use? a) 3,000 words b) 2,000 words c) 1,500 words d) 1,000 words

b) 2,000 words

The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination? a) 1 to 2 inches (2.54 to 5.07 cm) b) 2.5 to 3 inches (6.35 to 7.62 cm) c) 3.5 to 4 inches (8.89 to 10.16 cm) d) 0.5 to 1 inch (1.27 to 2.54 cm)

b) 2.5 to 3 inches (6.35 to 7.62 cm)

A 4-year-old is hospitalized with a urinary tract infection. Based on what you know of her cognitive development, which approach would be best to prepare her for a radiograph? a) Tell her a radiograph is a picture of the dark inside her body. b) Help her pretend the x-ray machine is a camera. c) Explain that she must behave because the technician is busy. d) Tell her she must follow directions or she will be hurt.

b) Help her pretend the x-ray machine is a camera.

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson? a) Rough-housing with his father b) Opening drawers in the room, pulling out supplies, and examining them c) Reading a book d) Singing a song he learned at preschool

b) Opening drawers in the room, pulling out supplies, and examining them

The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation? a) Presence of 20 deciduous teeth b) Presence of 10 deciduous teeth c) Absence of dental caries d) Presence of 19 deciduous teeth

b) Presence of 10 deciduous teeth

Which of the following actions by a preschooler would suggest that his thinking is inconsistent with normal preschooler growth and development? a) Refusal to go to bed without his friend b) Refusal to play with "real" children c) Insistence that his imaginary friend watch television with him d) Insistence that this imaginary friend have dinner with the family

b) Refusal to play with "real" children

A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family? a) Social isolation related to unwillingness to relate except through imaginary friend b) Compromised family coping related to abnormal behavior of child c) Deficient knowledge of normal preschool development d) Disturbed thought processes related to deep-set psychological need

c) Deficient knowledge of normal preschool development

A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group? a) Gross motor skills b) Vocabulary c) Imagination d) Fine motor skills

c) Imagination

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3 year old is in which of the following stages as identified by Piaget? a) Tertiary circular reaction b) Primary circular reaction c) Preoperational thought d) Coordination of secondary schema

c) Preoperational thought

When planning how to respond to a child about telling stories, you would base your statement on the fact that a) preschoolers have a limited vocabulary. b) a 3-year-old knows the word two but not the concept 2. c) imagination in a 3-year-old is at its peak. d) a preschooler is in an insecure period.

c) imagination in a 3-year-old is at its peak.