Chapter 17 Care of the Preschooler

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

ANS: A

A nurse is caring for a 4-year-old child that will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement? A. Allow the child to play with a procedure doll. B. Not discuss the procedure in front of the child. C. Distract the child with games and candy. D. Take the child to the playroom for coloring.

ANS: A

A parent brings the 4-year-old child for a check-up. Which finding would concern the nurse? A. Resting pulse rate of 120 B. Ectomorphic body type C. No increase in appetite compared with that in toddler years D. Weight gain of 5 lb (2.27 kg) in the past year

ANS: A

The nurse is assessing a 5-year-old child. Which assessment finding would be documented as abnormal? A. Inability to state address. B. Inability to count to 20. C. Can recall a part of a story. D. Can explain how an item is used.

ANS: A

The nurse is teaching the preschooler's parents injury prevention. Which method would the nurse advise for the parents as the best way to enforce injury prevention? A. Repetition and reinforcement B. Safety rules C. Adequate supervision D. Constant vigilance E. Repetition, modeling, and reinforcement

ANS: A

The parent of a four year-old child has expressed concern that the child is wetting her bed several times each week. What should the nurse teach the parent? A. Bed wetting is not an unexpected behavior at this age B. The child's fluid intake should be limited after 3:00 p.m. C. The parents should try to dialogue with the child about possible causes and solutions D. The parents should provide incentives for keeping the bed dry

ANS: A

When assessing a child and his parents during a well-child visit, the nurse determines that the child is experiencing night terrors. Which of the following would the nurse be most likely to suggest to assist the parents in dealing with this issue.? A. Allowing the episode to take its course B. Waking the child up during the episode C. Allowing the child roam about without supervision D. Talking to the child while the episode is occurring

ANS: A

During an admission assessment the nurse is discussing the developmental level of the child with the parents. Which comments by the parents demonstrate a good understanding of developmental expectations of the preschool-aged child? Select all that apply. A. "We think it is important to have play dates with our friend's preschool children." B. "Our child attends a wonderful preschool 3 times per week." C. "I am very concerned that our child is acting too much like some of the other children at our day care." D. "My parents are the only babysitters our child has ever had. I think contact with mostly adults is important for this age." E. "We have been talking about enrolling in a morning preschool program since this is our only child."

ANS: A, B, E

The home health nurse, who is visiting the home of a 4-year-old, prepares a nursing care plan with the nursing diagnosis of "At risk for injury related to the parents insufficient knowledge of safety practices for preschooler." Which nursing interventions should the nurse include in the plan of care? Select all that apply. A. Teach the parents to use a forward-facing car seat with harness and top tether. B. Teach the parents to only smoke in a vehicle with the child if a window is open. C. Teach the parents that the preschooler should use an approved bicycle helmet when riding a bicycle at any time. D. Teach the parents that they should wash the hands of the preschooler to ensure that proper hand washing has occurred. E. Teach the parents that medications can be kept in unlocked cabinets if childproof caps are used.

ANS: A, C

The parents of a preschool-aged child are investigating child care centers to enroll the child. What would the nurse review with the parents prior to them making a decision? Select all that apply. A. Ask about the child-staff ratio. B. Ask about the center's payment plan. C. Find out if parents can visit at any time. D. Find out how long the center has been in operation. E. Ask about the center's licenses and compliance with regulations.

ANS: A, C, D, E

A young client arrives at the clinic with a rash on the trunk and flexor surfaces of the extremities. The parent informs the nurse that the rash started a day before on the exterior surfaces of the extremities; 2 days before, the child had a really bad rash on the face. The health care provider diagnoses the child with erythema infectiosum. The nurse tells the parent that this is also known as: A. enterovirus. B. fifth disease. C. rosacea. D. pityriasis rosea.

ANS: B

What would be most effective in helping promote initiative and nutritional health for a preschooler? A. Giving the child a high carbohydrate snack after preschool B. Allowing the child to spread soft cheese on crackers C. Encouraging the child to cut up small pieces of apple for a snack D. Praising the child for cleaning his large plate of food

ANS: B

Which type of play would the nurse use to prepare a preschooler for upcoming surgery to reduce the stress of the event? A. Associative play B. Dramatic play C. Onlooker play D. Cooperative play

ANS: B

Which would be a nutritional goal for a preschool client? A. Eat everything on the plate. B. Introduce new food gradually and include variety. C. Reduce messiness and spills. D. Let the child eat only what the child wants.

ANS: B

The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local daycare. What information would the nurse include in this education session? Select all that apply. A. Preschoolers are capable of taking a bath independently. B. Encourage children to select their own clothing to wear each day. C. Parents will need to supervise tooth-brushing and be responsible for flossing. D. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing. E. Preschoolers only need to wear bicycle helmets if they are going on long rides.

ANS: B, C, D

During a well-child checkup, the mother of a 5-year-old girl reports her daughter seems much smaller than her 2 older children did at this same age. A review of the medical record reveals that the child is 44 inches tall and weighs 42 pounds. What information should be included in the response by the nurse? A. "Your daughter is within normal limits for her weight but she is slightly shorter in stature than other children her age." B. "Your daughter is within the acceptable range for her height but she is significantly smaller in weight for her age." C. "Your daughter is slightly taller than other children her age but her weight is normal" D. "The weight of your daughter at this time is with normal limits for her age but she is moderately taller than other children her age."

ANS: C

The nurse has completed an education program on normal communication abilities in the preschool child. Which statement by a participant indicates a need for further education? A. "It is normal that my 4-year-old asks so many questions." B. "I'm glad to know that is normal that my 4-year-old cannot count to 10 yet." C. "I'm concerned that my 5-year-old can only count to 20." D. "I'm concerned that my 5-year-old cannot say his name and address."

ANS: C

The nurse is assessing a 4-year-old child. Which assessment finding would the nurse identify as being of the highest concern? A. Hops on one foot. B. Copies capital letters. C. Stands on one foot for about 3 seconds. D. Draws a person with 4 body parts.

ANS: C

The nurse is assessing a 3-year-old child. Which assessment finding would the nurse identify as abnormal? A. Builds a tower of 10 cubes. B. Pedals tricycle without assistance. C. Unscrews a bolt-on a toy. D. Falls when bending over to touch toes.

ANS: D

The parent of a 5-year-old child calls the doctor's office to seek advice about proper nutrition for her child. Which statement by the mother indicates that further teaching is needed? A. "I give her three meals a day and some snacks in between if she gets hungry." B. "We offer her the same foods we are eating, just in smaller portions." C. "She loves fruit, so I give her 1 cup each day." D. "Since she doesn't like vegetables, we no longer serve them to her."

ANS: D