Chapter 25: Growth and Development of the Newborn and Infant

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother? "Giving a bottle of milk when the infant goes to bed can lead to obesity." "You could occasionally give your baby a bottle of water at bedtime." "Giving your baby a pacifier at bedtime will satisfy the need to suck." "Bottles given at bedtime can cause erosion of the enamel on the teeth."

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

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 best response by the nurse? "All children mature and develop at different rates so it is unwise to compare them in this way." "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." "You should talk with the doctor about getting your son tested." "Delays are normal when a child is premature."

"Delays are normal when a child is premature."

The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? "Both growth and development are influenced by heredity." "Development refers to the increase in skills the child demonstrates as they grow and age." "Maturation refers to the child's increases in body size." "Increases in body size are referred to as growth."

"Maturation refers to the child's increases in body size."

The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate? "What does his stool look like?" "Grunting is normal with infant stool formation." "We will need to collect a stool specimen for analysis." "Is he in pain?"

"What does his stool look like?"

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. Maybe she just knows your voice better than your mother's." b. "You may be right, since infants can sense their mother's smell as early as 7 days old." c. "I'm not sure a 4-week-old infant can tell their mother from another woman's smell." d. "Babies really can't tell the difference between people at that age."

"You may be right, since infants can sense their mother's smell as early as 7 days old."

The nurse is caring for a parent following the birth of the newborn. The new parent asks the nurse, "When is the best time for me to start bonding with my baby?" Which response by the nurse is appropriate? "Interaction has the best effect on bonding when the newborn is in a quiet sleep state." "You should interact with your newborn when the eyes are open wide and bright." "When newborns begin to cry, they are in need of parental interaction." "Newborns prefer to have verbal interaction as they enter a drowsy state."

"You should interact with your newborn when the eyes are open wide and bright."

The parent of 1-week-old infant voices concerns about the infant's weight loss since birth. At birth the infant weighed 7 lb (3.2 kg); the infant currently weighs 6 lb 5 oz (2.9 kg). Which response by the nurse is most appropriate? "Your infant has lost a bit more than the normal amount." "All infants lose a substantial amount of weight after birth." "Your infant's weight loss is within the expected range." "Your infant has lost too much weight and may need to be hospitalized."

"Your infant's weight loss is within the expected range."

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? 19 lb 8 oz (8825 g) 10 lb 8 oz (4760 g) 13 lb (5900 g) 15 lb 4 oz (6920 g)

19 lb 8 oz (8825 g)

The infant weighs 7 lb 4 oz (3300 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? 28 lb 4 oz (12.8 kg) 14 lb 8 oz (6.6 kg) 21 lb 12 oz (9.9 kg) 25 lb (11.3 kg)

21 lb 12 oz (9.9 kg)

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit? 20 lb (9.1 kg) and 28 inches (70 cm) 16 lb (7.2 kg) and 26 inches (65 cm) 28 pounds (12.7 kg) and 32 inches (80 cm) 24 pounds (10.8 kg) and 30 inches (75 cm)

24 pounds (10.8 kg) and 30 inches (75 cm)

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? Pots and pans from the kitchen cupboard Brightly colored stacking toy A yellow rubber duck for the bath A push-pull toy

A yellow rubber duck for the bath

What is the correct amount of wet diapers a mature infant should produce each day? An infant should have 1 to 2 wet diapers/day. An infant should have 6 to 8 wet diapers/day. An infant should have 9 to 10 wet diapers/day. An infant should have 3 to 5 wet diapers/day.

An infant should have 6 to 8 wet diapers/day.

The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula? Iron Calcium Vitamin D Vitamin E

Iron

An infant is breastfed. When assessing the stools, which findings would be typical? Fewer stools than bottle-fed infants A strong odor Harder stools than those of bottle-fed infants Less constipation than bottle-fed infants

Less constipation than bottle-fed infants

The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? Gluteal folds are present and symmetrical The neck is short, thick and mobile The newborn startles to loud sounds Natal teeth noted in the mouth that are loose

Natal teeth noted in the mouth that are loose

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? Respond promptly when the infant cries. Read age-appropriate books to the infant daily. Praise the infant when a new milestone is reached. Appropriately enunciate words when speaking to the infant.

Respond promptly when the infant cries.

The parents of a 10-month-old infant ask the nurse for recommendations for television programs for their infant. What will the nurse recommend? Cartoons should be avoided due to violence. Screen time is not recommended for infants of this age. Programs with simple language can help to promote language development. Bright colors and music will be most engaging for an infant this age.

Screen time is not recommended for infants of this age.

A parent has a 3-year-old child and a 4-month-old infant who both have gastroenteritis. The 3-year-old child is well enough to be cared for at home, but the 4-month-old infant requires hospitalization. How does the nurse explain the difference between these outcomes to the family? The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration. The 3-year-old child has a milder case of the illness, and the 4-month-old infant has a more severe case. The 3-year-old child is taking solid foods they can be fed at home, but the 4-month-old infant requires greater nutritional support. The 4-month-old infant has not yet had all of their vaccinations and is more prone to severe illness.

The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration.

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? The infant can be expected to display developmental skills consistent with a 8-month-old infant. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. The infant will most likely present with developmental skills consistent with a 6-month-old infant. The infant will likely show the skills of an infant with the adjusted age of 7 months.

The infant will most likely present with developmental skills consistent with a 6-month-old infant.

The parent of a 1-month-old infant voices concern about the infant's respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide? The irregularity of the infant's respirations is concerning; I will notify the health care provider. The respirations of a 1-month-old infant are normally irregular and periodically pause. An infant at this age should have regular respirations. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.

The respirations of a 1-month-old infant are normally irregular and periodically pause.

The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what state the infant is in by what the mother says, and that it's fine to try and feed the infant? a. "She is still sleeping; I guess she is worn out." b. "She has been a chatterbox and smiles just like her brother." c. "She has been crying every time someone picks her up." d. "She is so quiet today; that is not like her."

b. "She has been a chatterbox and smiles just like her brother."

What information would the nurse include when teaching the parents of an infant about colic? a. The infant will need future follow-up for a "nervous" bowel. b. Colic symptoms will probably fade at 3 months of age. c. Formula intake should be doubled to keep the infant from losing weight. d. Symptoms will decrease if the infant is laid on the back after feedings.

b. Colic symptoms will probably fade at 3 months of age.

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? a. Lock all cabinets that contain cleaning supplies. b. Restrain the baby in a car seat. c. Keep all pots and pans in lower cabinets. d. Give warm bottles of formula to the baby.

b. Restrain the baby in a car seat.

At the 6-month-old well-child visit, the parent is concerned that the child is unsteady and often falls over when sitting. What will the nurse advise the parent about this? a. The child is progressing well on other milestones so there's no cause for worry. b. The child should be provided with a baby seat to support the sitting position. c. The child's stability will progress to independent sitting over the upcoming months. d. The child should have a referral for a neuromuscular assessment.

c. The child's stability will progress to independent sitting over the upcoming months.

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. Put the baby to bed at various times of the evening. b. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. c. Use the crib for sleeping only, not for play activities. d. Let the baby cry during the night and she will eventually fall back to sleep.

c. Use the crib for sleeping only, not for play activities.

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. They sing to her before she goes to sleep. b. If she is safe, they lie her down and leave. c. The child has a regular, scheduled bedtime. d. They put her to bed when she falls asleep.

d. They put her to bed when she falls asleep.

The nurse is teaching the parents of a 6-month-old infant about proper dental care. Which action will the nurse indicate as most likely to cause dental caries in this infant? a. brushing the infant's teeth with fluoride-free toothpaste b. using a cloth instead of a brush for cleaning the infant's teeth c. not cleaning the infant's gums after eating meals or snacks d. putting the infant to bed with a bottle of milk or juice

d. putting the infant to bed with a bottle of milk or juice

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? choosing soft foods over hard foods frequent loose stools increased biting and sucking running a mild fever or vomiting

increased biting and sucking

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: looking for a toy in her crib at the last place she saw it. smiling at herself in the mirror. pushing a spoon from her high chair tray to the floor. shaking a rattle to enjoy the sound.

looking for a toy in her crib at the last place she saw it.

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: should have disappeared. should be pronounced and easy to elicit. is expected to appear within 1 month. is a protective reflex and retained for life.

should have disappeared.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? sitting independently building a tower of four cubes walking independently turning a doorknob

sitting independently

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? the development of a 3-month-old the growth of a 2-month-old the growth of a 5-month-old the development of a 10-week-old

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 nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that: the best feeding schedule offers food every 4 to 6 hours. the newborn's stomach can hold between 0.5 oz and 1 oz. most newborns need to eat about 4 times per day. demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.

the newborn's stomach can hold between 0.5 oz and 1 oz.

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? weight of 20 lb (9100 g) and length of 30 in (76.2 cm) weight of 16 lb (7300 g) and length of 26 in (66.0 cm) weight of 14 lb (6400 g) and length of 24 in (61.0 cm) weight of 18 lb (8200 g) and length of 28 in (71.1 cm)

weight of 16 lb (7300 g) and length of 26 in (66.0 cm)