Ch. 3- Growth and Development of the Newborn and Infant PrepU
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? A. no teeth B. 1 upper tooth C. 1 to 2 lower teeth D. 1 to 3 natal teeth
A. no teeth Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? A. frequent loose stools B. increased biting and sucking C. choosing soft foods over hard foods D. running a mild fever or vomiting
B. increased biting and sucking The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on.
The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which finding(s) is normal for this infant? Select all that apply. A. respiratory rate 28 breaths/min B. heart rate 101 beats/min C. infant has moderate head lag D. infant walks independently E. temperature 100.6°F (38.1°C)
A. respiratory rate 28 breaths/min B. heart rate 101 beats/min D. infant walks independently - The respiratory rate slows from an average of 30 to 60 breaths/min in the newborn to about 20 to 30 breaths/min in the 12-month-old infant. - As the cardiovascular system matures, the average pulse rate decreases from 120 to 140 beats/min in the newborn to about 100 beats/min in the 12-month-old infant. - Walking independently often occurs at 12 months of age. - Head lag should not be present in a 12-month-old infant (usually not present by 4 months of age). - A temperature of 100.6°F (38.1°C) is abnormal and could indicate an infection.
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: A. should have disappeared. B. should be pronounced and easy to elicit. C. is a protective reflex and retained for life. D. is expected to appear within 1 month.
A. should have disappeared. This primitive (not protective) reflex should be present at birth and disappear around age 4 months.
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: A. pushing a spoon from her high chair tray to the floor. B. looking for a toy in her crib at the last place she saw it. C. shaking a rattle to enjoy the sound. D. smiling at herself in the mirror.
B. looking for a toy in her crib at the last place she saw it. Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant's behaviors show use of her senses and motor activity but do not illustrate object permanence.
The nurse is providing education to the woman about foods commonly associated with allergies in infants and young children. What items should be included in this list? Select all that apply. A. egg substitutes B. soy products C. cow's milk D. strawberries E. peanut butter
C. cow's milk D. strawberries E. peanut butter In infants and children, certain foods are associated with allergies. These foods include cow's milk, egg whites, peanut butter and strawberries. Soy products and egg substitutes are not among those foods associated with allergies in children.
What feeding practice used by the parents of an 8-month-old should the nurse discourage? A. Including the infant at family meals in her high chair. B. Giving the child soft table food and finger foods. C. Continuing to offer foods the child rejects. D. Placing all liquids given the child in a "no spill" sippy cup.
D. Placing all liquids given the child in a "no spill" sippy cup. - No-spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times when avoiding spills is a must. - The other feeding practices are age appropriate and safe. - Soft table food and finger foods promote accepting new textures and self-feeding. - Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.
After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur? A. "I will place my infant on the back to sleep every night." B. "By keeping the room at a neutral temperature, I do not have to use blankets." C. "I have a crib in my room so that I can breastfeed my baby." D. "My husband gave the baby a special bear that I will place in the crib."
D. "My husband gave the baby a special bear that I will place in the crib." The nurse should reinforce that stuffed animals, blankets, pillows, and soft mattresses are suffocation hazards for infants.
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? A. Read age-appropriate books to the infant daily. B. Appropriately enunciate words when speaking to the infant. C. Praise the infant when a new milestone is reached. D. Respond promptly when the infant cries.
D. Respond promptly when the infant cries. The developmental task of the infant year, according to Erikson, is to gain a sense of trust. This can be accomplished by promptly meeting the infant's needs during the first year of life. If the infant does not learn to trust, mistrust will develop. Praising will help meet the future developmental tasks of the child. Reading books and appropriately enunciating words will aid in the infant's language development.
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? A. Sitting independently B. Turning a doorknob C. Building a tower of four cubes D. Walking independently
A. Sitting independently - Infants typically sit independently, without support, by age 8 months. - Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. - Building a tower of three or four blocks is a milestone of an 18-month-old. - Turning a doorknob is a milestone of a 24-month-old.
Which assessment findings if noted in a 4-month-old infant would the nurse recognize as normal growth and development? A. holds head up when prone, bears partial weight on legs, reflexes are fading B. uses palmer grasp, starts to make vowel sounds, reaches out C. follows object past midline with eyes, keeps hands fisted, rolls over D. rolls over, grasp reflex fading, cooing sound
A. holds head up when prone, bears partial weight on legs, reflexes are fading At 4 months of age, the infant should be able to hold the head up when prone and bear partial weight on the legs; newborn reflexes are beginning to fade. The nurse should recognize these changes as normal growth and development.
The nurse is assessing a 6-month-old infant in the clinic. Which characteristic represents normal language development for this age? A. Laughing out loud B. Cooing C. Babbling D. Producing noises when spoken to
C. Babbling Cooing begins in the first 4 weeks of life, productions of noises when spoken to and laughing out loud are seen later than 6 months of age. Infants begin to babble around 6 months of age.
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life? A. Love B. Feel anger C. Trust D. Fear
C. Trust Erikson identifies various developmental stages which all children accomplish as they grow and develop into adults. The primary psychosocial developmental task for the infant is learning to trust. This task creates the foundation for the developmental tasks of the next stages of the child's life. If the infant does not receive food, love, attention, and comfort, the infant learns to mistrust the environment and those who are responsible for caring for the child. Learning to feel anger, love, and fear come at later times in development.
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? A. 13 lb (5900 g) B. 15 lb 4 oz (6920 g) C. 10 lb 8 oz (4760 g) D. 19 lb 8 oz (8825 g)
D. 19 lb 8 oz (8825 g) - The average newborn weighs 7.5 lb (3400 g). The average newborn loses 10% of birth weight over the first week of life but regains it in about 10 to 14 days. Most infants double their birth weight by 4 to 6 months of age and triple their birth weight by the time they are 1 year old. - If the newborn weighed 6 lb 8 oz (2,950 g) at birth and tripled that weight at 12 months, the infant should weigh 19 lb 8 oz (6.5 lb × 3 = 19.5 lb) or 8825 g.
A mother asks the nurse where the microwave is so that she can warm up breast milk to feed her baby. What is the best response by the nurse? A. "You should warm the milk under warm water instead." B. "Breast milk can be given cold, so there is no need to heat it." C. "You should only give fresh breast milk to an infant." D. "Make sure that you test the milk on your wrist before feeding."
A. "You should warm the milk under warm water instead." A microwave can heat unevenly and cause burns and therefore should never be used to heat breast milk or formula for an infant. In addition, it can change the immune properties of the breast milk.
The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply. A. "I try to eat healthy in front of my daughter so she will hopefully pick up good eating habits." B. "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." C. "Food is so expensive. I can't afford for my child to leave any food on the plate." D. "I have tried at least 10 times with every green vegetable and I can't get my son to like them." E. "I plan on encouraging my son to cook with me when he is old enough so that he will enjoy a variety of foods and learn how to cook too."
B. "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." C. "Food is so expensive. I can't afford for my child to leave any food on the plate." D. "I have tried at least 10 times with every green vegetable and I can't get my son to like them." Encouraging children to eat everything on their plate can lead to overeating and obesity. Children may need to be exposed to new food at least 20 times before determining if they like it or not. Letting a child eat whatever he wants does not lead to good choices as the child matures.
The infant weighs 7 lb 4 oz (3,300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? A. 14 lb 8 oz (6.6 kg) B. 21 lb 12 oz (9.9 kg) C. 25 lb (11.3 kg) D. 28 lb 4 oz (12.8 kg)
B. 21 lb 12 oz (9.9 kg) The average weight of a newborn is 7.5 lb (3400 g). The infant gains about 30 g each day. By 1 year of age, the infant has tripled the birth weight and has grown 10 to 12 in (25 to 30 cm). 7.25 lb × 3 = 21.75 lb or 21 lb 12 oz (9.9 kg)
The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective? A. The parent spanks the child while taking the child into another room away from the dog B. The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog C. The parent allows the child to continue pulling at the dog and states, "If the dog bites her she will learn." D. The parent places the child in time-out and explains the reason for the time-out
B. The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog Providing a safe environment, redirection away from undesirable behaviors, and saying "no" in appropriate instances are effective forms of discipline for an infant's developmental level. Infants are at an increased risk for injury from spanking and do not understand the reason for the spanking. Infants do not understand time-outs or the reason for this type of discipline.
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? A. If she is safe, they lie her down and leave. B. They sing to her before she goes to sleep. C. They put her to bed when she falls asleep. D. The child has a regular, scheduled bedtime.
C. They put her to bed when she falls asleep. If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: A. the child weighs more than expected for age. B. the child weighs the expected amount for age. C. the child weighs less than expected for age. D. the weight assessment is blatantly inaccurate.
C. the child weighs less than expected for age. Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11250 g). The child is underweight for age.
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? A. the development of a 10-week-old B. the growth of a 2-month-old C. the development of a 3-month-old D. the growth of a 5-month-old
C. the development of a 3-month-old The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? A. "Increases in body size are referred to as growth." B. "Development refers to the increase in skills the child demonstrates as they grow and age." C. "Both growth and development are influenced by heredity." D. "Maturation refers to the child's increases in body size."
D. "Maturation refers to the child's increases in body size." - Maturation refers to an increase in functionality of various body systems or developmental skills. - Growth refers to an increase in physical size. - Development is the sequential process by which infants and children gain various skills and functions. - Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement.
When performing neurological reflexes on the infant, which primitive reflex will be present longest? A. step B. rooting C. Moro D. Babinski
D. Babinski Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. Except for the Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life, giving way to protective reflexes.
Which milestone would the nurse expect an infant to accomplish by 8 months of age? A. Pulling self to a standing position B. Creeping on all fours C. Being able to sit from a standing position D. Sitting without support
D. Sitting without support - Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. - They are able to creep at 9 months and pull to a standing position by 10 months. - At 12 months the infant is able to sit from a standing position and is learning to walk.
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn? A. Bathing is a time for bonding with the parents. B. Bathing can prevent infection. C. Bathing is a great time to apply lotion. D. Bathing helps moisten the skin.
A. Bathing is a time for bonding with the parents. The parents can use bath time for bonding with their newborn. This can be done with talking, cooing, and singing. Bath time should be slow-paced and nonstressful. Newborns prefer interacting with parents over toys and they love to watch people's faces. Bathing can help prevent infection, but it is a secondary response. Using soaps on the skin tends to dry the skin, not moisten it. After bathing, lotion can be applied. It is soothing to the baby and keeps the skin softened.
The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months? A. 30.5 in (77.5 cm) B. 27.5 in (70 cm) C. 29 in (74 cm) D. 32 in (81 cm)
B. 27.5 in (70 cm) - Infants gain about 0.5 to 1 in (1.25 to 2.5 cm) in length for each of the first 6 months of life. Therefore, a 21.5-in (54.6-cm) infant adding 6 in (15 cm) of growth would be 27.5 in (70 cm). - Infants grow the fastest during the first 6 months of life and slow down the second 6 months. - By 12 months of age, the infant's length has increased by 50%, making this infant 32 in (81 cm) at 1 year old.
While evaluating the development of a 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated? A. Hand regard B. Binocular vision C. Object permanence D. Depth perception
C. Object permanence - By 10 months, an infant looks under a towel or around a corner for a concealed object (beginning of object permanence, or become aware an object out of sight still exists). - Hand regard, which is typically demonstrated by 3-month-olds, is a phenomenon that involves the infant holding his hands in front of his face and studying them. - Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when they follow moving objects with their eyes. - Depth perception allows 7-month-olds to transfer toys from hand to hand.
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? A. The irregularity of the infant's respirations are concerning; I will notify the physician. B. An infant at this age should have regular respirations. C. The respirations of a 1-month-old infant are normally irregular and periodically pause. D. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.
C. The respirations of a 1-month-old infant are normally irregular and periodically pause. The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.
At what age would it be okay to introduce carrots to an infant's diet? A. Solid food can be introduced at 4 to 6 months of age. B. Solid food can be introduced whenever the child seems ready. C. Solid food can be introduced at 7 to 9 months of age. D. Solid food can be introduced after 9 months of age.
A. Solid food can be introduced at 4 to 6 months of age. The tongue extrusion reflex is present until the infant is 4 to 6 months of age. After this reflex disappears then solid food may be introduced. The infant's ability to swallow solid foods is not completely functional until this age nor are the enzymes present which are needed to process foods. The infant must be ready to handle spoon-feeding. By 7 months onward, the baby should be eating solid foods regularly and drinking from a cup in addition to breast or bottle feeds.
The nurse is assessing the 18-month-old infant. The nurse notes the anterior fontanel (fontanelle) has closed. What initial action by the nurse is indicated? A. Notify the infant's health care provider. B. Document the findings as normal. C. Measure the infant's head circumference. D. Review the birth records of the infant to see if there were any other anomalies.
B. Document the findings as normal. The anterior fontanel (fontanelle) most often closes between 12 and 24 months of age. The closure of the fontanel (fontanelle) at 18 months of age does not signal any health issues for the infant.
What is the correct amount of wet diapers a mature infant should produce each day? A. An infant should have 1 to 2 wet diapers/day. B. An infant should have 3 to 5 wet diapers/day. C. An infant should have 9 to 10 wet diapers/day. D. An infant should have 6 to 8 wet diapers/day.
D. An infant should have 6 to 8 wet diapers/day. Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 ml/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day. The infant should have an intake of between 140 to 160 ml/kg/day to be well hydrated and nourished. This amount of intake will produce the 6 to 8 diapers/day.
The infant measured 20 in (50 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months? A. 30 to 32 in (76 to 81 cm) B. 36 to 38 in (91 to 96 cm) C. 26 to 28 in (66 to 71 cm) D. 40 to 42 in (102 to 107 cm)
A. 30 to 32 in (76 to 81 cm) - The average newborn is 20 in (50 cm) in length. The infant grows more quickly in length during the first 6 months of life than the last 6 months of their first year. - By 12 months the infant's length has increased 50%. That would mean a 20-in (50-cm) infant would have grown approximately 10 in (25 cm) in 1 year, making the normal length be 30 to 32 in (76 to 81 cm).
During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? A. "Babies can't tell the difference between people at that age." B. "Maybe she just knows your voice better than your mother's." C. "You may be right, since infants can sense their mother's smell as early as 7 days old." D. "I'm not sure a 4-week-old has developed a sense of smell yet."
C. "You may be right, since infants can sense their mother's smell as early as 7 days old." The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell.
The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted? A. "Does he place toys into a box or container and take them out?" B. "Is he able to hold a pencil and scribble on paper?" C. "Does he move a toy back and forth from one hand to the other when you give it to him?" D. "Is he able to drink with a cup by himself?"
C. "Does he move a toy back and forth from one hand to the other when you give it to him?" Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.
The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? A. Natal teeth noted in the mouth that are loose B. The neck is short, thick and mobile C. Gluteal folds are present and symmetrical D. The newborn startles to loud sounds
A. Natal teeth noted in the mouth that are loose The presence of 1 or 2 teeth at birth (natal teeth) is a finding that may be benign or may point to other congenital abnormalities. The neck should be short, thick and mobile. The gluteal folds should be symmetrical. It is normal for the newborn to startle to loud sounds.
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? A. "I can expect my infant to be able to raise the head up when on the stomach within the next month." B. "I can expect my infant to be able to hold a rattle within the next month." C. "I can expect my infant to become clingy around strangers within the next month." D. "I can expect my infant to laugh out loud within the next month."
A. "I can expect my infant to be able to raise the head up when on the stomach within the next month." - It is expected that a 3-month-old infant can raise the head to 45 degrees while laying on the stomach. - Becoming clingy around strangers occurs in the infant around 6 to 8 months of age. - The infant can begin to hold a rattle around 5 months of age. - At 4 to 5 months, the infant will typically begin to laugh out loud.
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? A. Use the crib for sleeping only, not for play activities. B. Put the baby to bed at various times of the evening. C. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. D. Let the baby cry during the night and she will eventually fall back to sleep.
A. Use the crib for sleeping only, not for play activities. - A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. - Using the crib for sleeping only helps the child associate the bed with sleep. - Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. - While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.
The nurse enters a client's room to find the new mother crying softly. The client states, "I had my heart set on breastfeeding but my infant was born with a cleft lip. My dreams of breastfeeding are destroyed." Which response by the nurse is appropriate? A. "You can use a supplemental nursing system to get a similar experience." B. "You may still breastfeed your infant. I will show you appropriate techniques to use." C. "You should speak with a lactation consultant before making a decision on which feeding method to use." D. "I am so sorry your infant has a cleft lip. Bottle feeding will be easiest for you and your infant."
B. "You may still breastfeed your infant. I will show you appropriate techniques to use." - The nurse should be therapeutic and reassure the mother that breastfeeding may still be an option. Infants with cleft lips may still successfully breastfeed once appropriate techniques are learned and implemented. - A supplemental nursing system is used to provide supplemental milk to breastfeeding babies. - Telling the client to speak with a lactation consultant does not address the client's current concern.
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? A. as soon as the infant begins to eat fruit B. as soon as the first tooth erupts C. when weaning is complete D. by 12 months of age
B. as soon as the first tooth erupts Before tooth eruption occurs, parents should clean the infant's gums after feeding with a damp wash cloth. After the first tooth erupts, parents can use a soft bristle tooth brush. Dental hygiene should be part of the infant's everyday care. The American and Canadian Dental Associations recommend the first dental checkup to occur around 1 year of age. Infants should not go to bed with bottles or sippy cups to prevent dental caries.
The nurse is evaluating the effectiveness of nutrition counseling for new mothers. Which comments by the mothers indicate the need for more instruction? Select all that apply. A. "I can start giving my baby a small snack like cheerios around 8 months of age." B. "As long as I wait for at least 3 days to introduce new foods I should be able to determine if my child has any food allergies." C. "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth." D. "It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." E. "My mother said that I shouldn't introduce rice cereal as the first solid food, but I'm confident that is best."
C. "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth." D. "It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." - Either home-made pureed or pre-packaged baby food is acceptable, but neither should have any spices (eg, salt, cinnamon) added to it. - No-spill sippy cups actually allow juice to be in constant contact with the teeth because they are much like bottles in that the child must suck on them to get a drink.
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the bestresponse by the nurse? A. "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." B. "You should talk with the doctor about getting your son tested." C. "Delays are normal when a child is premature." D. "All children mature and develop at different rates so it is unwise to compare them in this way."
C. "Delays are normal when a child is premature." When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse.
The nurse goes in to check on a new mother to see how breastfeeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse? A. "That is not how you get him to eat." B. "You will never get him to eat all unwrapped like that." C. "You are doing a wonderful job attempting to wake the baby." D. "Maybe you should watch the breastfeeding video again."
C. "You are doing a wonderful job attempting to wake the baby." The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.
The parents of a 4-day-old infant report concern about his weight loss. What is the bestresponse by the nurse? A. "Babies will begin to rapidly regain weight and will double birth weight around 4 to 6 months of age." B. "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks." C. "Babies may lose up to 10% of their body weight in the first month of life." D. "Weight loss after birth is normal."
B. "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks." The question asks for the best response which typically informs or instructs the client on a situation in which they are concerned. The average newborn weighs 7 lb 8 oz (3,400 g) at birth. Newborns lose up to 10% of their body weight over the first week of life. The average newborn then gains about 30 g per day and regains his or her birth weight by 10 to 14 days of age. Most infants double their birth weight by 4 to 6 months of age and triple their birth weight by the time they are 1 year old.
The student nurse is reviewing the chart of a newborn. The document indicates the newborn is in the quiet alert state. Which is the best description of this sleep phase? A. The newborn's eyes are open and he is smacking his lips. B. The infant is awake but appears drowsy. C. The infant's eyes are partially open and there are small movements in the extremities. D. The newborn's eyes are open and no body movements are noted.
D. The newborn's eyes are open and no body movements are noted. The normal newborn moves through 6 stages of consciousness. The quite alert state is when the infant's eyes are open but the body is calm. Open eyes accompanied by body movements is characteristic of the active alert state.
A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond? A. "Sure, you can do whatever you want, it is your baby." B. "Sure you can, but make sure you use a soft mattress for support." C. "The baby can sleep in your room in an infant crib, but not in an adult bed." D. "Bed sharing is okay, just make sure the infant is between two people."
C. "The baby can sleep in your room in an infant crib, but not in an adult bed." According to the 2016 recommendation by the American Academy of Pediatrics, infants should sleep in the same bedroom as the parents, but on a separate firm surface, such as a crib or bassinet, and never on a couch, armchair or adult bed, to decrease the risks of sleep-related deaths.
The nurse is educating a new parent regarding nutritional needs for the newborn. Which statement is accurate and should be taught regarding the nutritional needs of a newborn? A. Growth during newborn stage is slow, so fewer calories are needed then when the infant is older. B. Cow's milk is similar to breast milk in terms of calories and nutrients and is appropriate for the newborn. C. Formula is designed to provide similar amounts of calories as breast milk would provide. D. Newborns require additional water to supplement their diet if they are only formula feeding.
C. Formula is designed to provide similar amounts of calories as breast milk would provide. Infant formula is designed to mimic the same nutritional value as breast milk. Cow's milk is not appropriate for newborns as a source of nutrition. Water is not needed for formula-fed or breastfed infants. Infants are growing the most during the early months and need more calories, not less.
The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments? A. The infant will likely show the skills of an infant with the adjusted age of 7 months. B. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. C. The infant can be expected to display developmental skills consistent with a 8-month-old infant. D. The infant will most likely present with developmental skills consistent with a 6-month-old infant.
D. The infant will most likely present with developmental skills consistent with a 6-month-old infant. When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks (or 2 months) premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that: A. most newborns need to eat about 4 times per day. B. demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night. C. the best feeding schedule offers food every 4 to 6 hours. D. the newborn's stomach can hold between 0.5 oz and 1 oz.
D. the newborn's stomach can hold between 0.5 oz and 1 oz. The capacity of the normal newborn's stomach is between 0.5 oz and 1 oz. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1.5 to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.
The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3600 g) and was 20 in (50.8 cm) in length. Which finding is consistent with the normal infant growth and development? A. weight of 18 lb (8200 g) and length of 28 in (71.1 cm) B. weight of 14 lb (6400 g) and length of 24 in (61.0 cm) C. weight of 20 lb (9100 g) and length of 30 in (76.2 cm) D. weight of 16 lb (7300 g) and length of 26 in (66.0 cm)
D. weight of 16 lb (7300 g) and length of 26 in (66.0 cm) - The average newborn weighs 7.5 lb (3400 kg) at birth. Most infants double their birth weight at 4 to 5 months and will triple by the time they are 1 year old. - If this infant was 8 lb (3600 kg) at birth, then it is most likely now 16 lb (7300 g). The average newborn is 20 in (50 cm) long at birth. They grow more quickly in length over the first 6 months, than during the second 6 months. - By 12 months of age, the infant's length has increase by 50%. At 1 year, this infant will most likely be 30 in (76.2 cm) in length; however, since most of the growth occurs in the first 6 months, it is possible for the infant to grow an additional 6 in (15 cm) during that time.
The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. A. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." B. "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." C. "We should get some rest in about 1 month when the newborn starts sleeping through the night." D. "My newborn can see up-close things, like our faces, better than things at a distance." E. "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth."
A. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." D. "My newborn can see up-close things, like our faces, better than things at a distance." E. "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." Newborn stools will become yellowish in color after the first few days of life. Newborns typically lose 5% to 10% of their birthweight the first few days of life, and begin to gain weight after this period. Newborns have better up-close vision and begin to recognize human faces during their newborn stage. Most infants will not sleep through the night until about 3 months of age. There is no evidence that rice cereal keeps a newborn from waking and the practice of feeding rice cereal to newborns is discouraged by physicians as the newborn needs formula or breast milk specifically.
