CHILD 5 - G+D PRESCHOOLER
The mother of a preschool-age child is discussing normal development with the pediatric nurse. The nurse explains the developmental milestone of initiative. Which statement by the mother might be an example of this developmental milestone? a) "He tries to sweep up cereal his brother spilled but cries when he can't do it well." b) "He broke my favorite plate but blamed it on some friend he called Paul, but we don't know anyone named Paul." 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."
A
The nurse is caring for a preschool child in the hospital with severe developmental delays. The parents have 3 other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highest priority in regard to the parents at this time? a) Risk for caregiver role strain b) Readiness for enhanced parenting c) Imbalanced nutrition, less than body requirements d) Interrupted family processes
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 have been talking about enrolling in a morning preschool program since this is our only child." b) "We think it is important to have play dates with our friend's preschool children." c) "Our child attends a wonderful preschool 3 times per week." d) "My parents are the only babysitters our child has ever had. I think contact with mostly adults is important for this age." e) "I am very concerned that our child is acting too much like some of the other children at our day care."
A, B, C
Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds a) Johnny's height and weight should be plotted on a growth chart. b) Johnny may be at risk for overweight or obesity. c) Johnny is growing slowly in height but rapidly in weight. d) Johnny is following a normal pattern of growth for the preschool years.
A, B, C
The parents of a 5-year-old tell the student nurse, "Our daughter takes after her father's lack of athletic ability. We have worked with her but she can't seem to throw a ball at all when we are playing with her." Which responses by the student are not appropriate? Select all that apply. a) "I am sure she will catch on as she plays with more children and when she starts taking physical education classes at school. b) "Athletic ability is often hereditary, so it is good you are aware of her lack of athleticism while she is young." c) "Enrolling your daughter in a preschool softball or baseball program might help her athletic and motor skills." d) "I know how annoying that has to be. Neither my brother nor I have any athletic ability and neither do our parents." e) "It may not be athletic ability. Most preschoolers are able to throw a ball by the age of 5 years. Have you discussed this with your pediatrician?"
A, B, C, D
A mother describes her 4-year-old girl's eating habits as "picky" and goes on to describe using wheedling, coaxing, and threatening measures to get her to eat. The nurse determines the child is growing normally. What interventions will be suggested? Select all that apply. a) Focus on quality, not quantity. b) Offer a variety of healthy foods including those liked and refused. c) Allow the child to decide how much she will eat. d) Approach mealtime matter-of-factly. e) Ignore the pickiness. f) Offer only nutritious between-meal snacks.
A, B, C, D, E, F
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 using a night light in the child's room." b) "Keep the door closed and the lights off so that your child can fall asleep faster." c) "Avoid having your child watch frightening shows on TV before bedtime." d) "Set up some familiar bedtime rituals for your child." e) "Try reading a favorite story before bedtime."
A, C, D, E
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply. a) When discussing improper behavior, call the behavior "bad" or "naughty," not the child. b) Spank with an open hand only and never with an object. c) Books and stories can help preschoolers master proper behavior. d) A time-out of about 8 minutes would be appropriate for intentional misbehavior. e) Anticipate situations likely to cause misbehavior and redirect the child to another activity.
A, C, E
A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity? a) Draw a picture first for the child to see how to do it. b) Make a model for the child to follow so it will be easy to copy. c) Support whatever the child paints. d) Tell the child that it will be fun but that he or she should not make a mess.
C
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 she must follow directions or she will be hurt. b) Explain that she must behave because the technician is busy. c) Help her pretend the x-ray machine is a camera. d) Tell her a radiograph is a picture of the dark inside her body.
C
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 what stage as identified by Piaget? a) Coordination of secondary schema b) Tertiary circular reaction c) Preoperational thought d) Primary circular reaction
C
The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which response by the nurse would be most appropriate? a) "Some children this age cannot hold a pencil or crayon well enough to write legibly." b) "Usually by the age of 6, most children can write numbers up to nine, but no letters." c) "By the age of 6 most children can print some letters and maybe their first name." d) "It is not unusual for children of this age to be writing their first name in cursive."
C
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
A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond? a) "Where did you get that funny name?" b) "I don't see anyone." c) "Are you kidding me?" d) "Tell me about Boo-ga-loo."
D
Which gross motor skill would the 4-year-old child have most recently attained? a) The child can button his/her clothes. b) The child can tie his/her shoelaces. c) The child can cut his/her food. d) The child can hop on one foot.
D
A 4-year-old child is drawing with crayons. Which creation by the child would most be reflective of the anticipated skill level of this age? a) The child is able to proficiently draw several letters of the alphabet. b) The child is able to draw shapes such as circles and squares. c) The child draws random lines on the paper and reports it is a person. d) The child draws a person with 6 body parts.
B
The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best? a) "Remind him that kindergarten will be a lot of fun and he'll make new friends." b) "Kindergarten is a big step for a child. Be patient with him." c) "Be aware that he may have difficulty adjusting being away from home 5 days a week." d) "Talk to your son's new teacher and schedule a tour with him."
D
Question: Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order. 1 Warn the child there will be a time-out if the behavior does not stop. 2 Remove the preschooler to a boring spot. 3 Parent knows the misbehavior was intentional. 4 Set a timer for no more than 4 minutes. 5 If the child gets up, replace the child and restart the time.
3, 1, 2, 4, 5
A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be? a) Preschool b) School age c) Adolescence d) Toddler
A
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 comes and wakes us up after she awakens." b) "She screams and thrashes when we try to touch her." c) "She is scared after she wakes up." d) "She has a hard time going back to sleep."
B
Which project or game would you anticipate that a preschooler would most enjoy while hospitalized? a) Playing an electronic, hand-held game b) Dressing in her mother's coat to play house c) Planting flower bulbs that she can watch grow next spring d) Turning out the lights to play hide and seek
B
The parents of a 5-year-old tell the nurse that it "seems like our child is afraid of everything from fireworks to butterflies." What actions should the nurse take? Select all that apply. a) Advise the parents to help the child understand that the fears are irrational. b) Suggest to the parents to talk with their child about his fears. c) Work with the parents and child to devise strategies to help deal with the fears. d) Ask the parents if they can identify anything that may be causing their child be be fearful. e) Encourage the parents to just ignore the fears since this is common behavior with the preschool-aged child.
B, C, D
Which assessment findings of the speech of a 5-year-old child warrant further follow-up? Select all that apply. a) The child is able to articulate his full name. b) The child has a vocabulary of an estimated 1,200 words. c) The child is unable to provide his address when asked. d) The child is able to count to 15 without prompting. e) It is difficult for people outside of the household to understand his conversation.
B, C, E
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) Fast food eaten once a month b) Food used as reward or punishment c) Mealtimes organized and regular d) Expectations to eat everything on plate e) Television on during meals f) A father who is overweight
B, D, E, F
Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify what task as the task of the preschooler? a) Industry b) Autonomy c) Initiative d) Trust
C
A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage? a) Giving the child opportunity to speak and finish her ideas b) Enunciating clearly and slowing down parental speech c) Looking at the child while she is speaking d) Asking the girl to slow down and to think before she talks
D
A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond? a) "You should answer his questions by whatever feels most comfortable to you." b) "I would suggest getting books with pictures to help explain the differences between male and female genitalia." c) "That is a difficult subject to address. I'm not sure what is the best way to answer that question." d) "It's best to answer his questions using accurate anatomical names and keep your answers simple."
D
A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group? a) Vocabulary b) Gross motor skills c) Fine motor skills d) Imagination
D
A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? a) Solitary play b) Parallel play c) Group play d) Imitative play
D
In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a) mix the two languages in the same sentence. b) avoid asking questions. c) be prone to stuttering. d) be able to use each language as a separate system.
D
If the child is gaining weight at an expected rate, a child who weighs 36 pounds (16.3 kg) at 3 years of age would weigh what amount at age 5? a) 44 lbs. (20 kg) b) 38 lbs. (17.2 kg) c) 50 lbs. (22.7 kg) d) 58 lbs. (26.3 kg)
A
The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to: a) allow her to experiment with Play-Doh. b) provide her with clothes that snap rather than button. c) help her learn how to follow rules. d) teach her street-crossing safety.
A
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) "I usually have him in time-out for about 10 minutes." b) "He is allowed out of time-out when he is calm." c) "The time-out doesn't just have to be in his room." d) "I put him in time-out when the problem occurs."
A
In working with the preschool-age child, the nurse recognizes what action as characteristic of a preschooler? a) The child takes in new information at a rapid rate and asks "why" and "how." b) The child has an increased attention span and can be interested in an activity for a long length of time. c) The child grows and develops skills more rapidly than at any other time in her life. d) The child insists she can "do it," and the next moment reverts to being dependent.
A
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) "Attributing life-like qualities to inanimate objects is quite normal at this age." b) "Do you think your daughter is hallucinating? c) "Your daughter is demonstrating animism which is common." d) "Is there a family history of mental illness?"
A
A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is: a) Physical growth slows. b) Cognitive growth slows. c) Personality growth slows. d) Physical growth accelerates.
A
According to Erikson, the task for the preschool child to develop: a) Initiative b) Trust c) Autonomy d) Industry
A
A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master? a) Initiative vs. guilt b) Trust vs. mistrust c) Industry vs. inferiority d) Autonomy vs. shame
A
A family from India has recently moved to the United States. Their 5-year-old often visits the school nurse after lunch complaining of a "stomachache". The lunch staff tell the nurse that the child eats very little for lunch. What is the best action by the nurse? a) Meet with the child and parents and discuss if cultural food preferences may be hindering the amount being eaten at lunch. b) Speak to the child and parents to discuss the repercussions of visiting the nurse so frequently. c) Explain to the child that the reason for the stomachache is that not enough is being eaten during lunch. d) Talk with the child and encourage that lunches be brought from home so that nutrient needs are met.
A
The mother of a 4-year-old tells the nurse that she is frustrated because all she seems to do lately is fight with the child over what the child wants to eat and wear. The mother says that she sometimes wants to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this mother? a) "Use the time-out technique for discipline." b) "Spank lightly to get the child's attention." c) "It's not normal to feel that way." d) "Take some toys away when the child acts like that."
A
What would be most effective in helping promote initiative and nutritional health for a preschooler? a) Encouraging the child to cut up small pieces of apple for a snack b) Giving the child a high carbohydrate snack after preschool c) Praising the child for cleaning his large plate of food d) Allowing the child to spread soft cheese on crackers
D
Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment. a) True b) False
B
The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium? a) Peach b) Apple c) Orange d) Banana
C
The developmental task of preschoolers is to achieve a sense of a) accomplishment versus inefficiency. b) cognition versus attitude. c) autonomy versus shame and doubt. d) initiative versus guilt.
D
A mother reports to the nurse that her 4-year-old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother? a) "Preschoolers' imitating is a healthy behavior. It is part of their imagination and normal growth and development." b) "I can imagine that it would be very irritating." c) "This is not normal behavior. I am going to get the doctor's advice." d) "I am sure there are ways to get your daughter to stop imitating you."
A
During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents? a) "Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here." b) "I think we need to plan how to discipline your child when acting out this way." c) "We don't allow children of this age to throw tantrums so you will need to manage your child's behavior." d) "I am concerned that your child may have a developmental delay since most children of this age don't throw temper tantrums."
A
Fear of mutilation is significant during the preschool age. a) True b) False
A
The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond? a) "Tell me about your child's exposure to tobacco smoke." b) "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?" c) "Tobacco smoke is linked with an increased number of ear infections." d) "You should stop smoking around your child."
A
When assessing a preschool-aged child, which activity is most closest associated with the primary psychosocial task of this age group? a) Attempting to dress himself b) Making friends with other children of the same age group c) Trying not to cry when upset d) Self-soothing when upset
A
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) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior. b) 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. c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents. d) The thought of losing his father was scary, and the child is trying to show his father how much he loves him.
B
A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. What would be the best response for the nurse to give the child? a) "Oh no! I have a crocodile in my room. Please don't bite me!" b) "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile." c) "What happened to my client? Did you eat her?" d) "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you."
B
A school nurse has completed an educational program for parents of the preschool children. Which statement by a participant indicates a need for further education? a) "I'm glad to know that it's okay that my 5-year-old is learning to skate." b) "My 5-year-old son still needs me to dress and undress him." c) "I need to work with my 4-year-old, she should be able to cut paper with scissors on her own." d) "My 3-year-old is doing fine, he can hop on one foot already."
B
Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue? a) Planning for the child to get 12 hours of sleep daily b) Allowing the preschooler to fall asleep wherever and whenever the child is tired enough c) Eliminating caffeine sources beginning late afternoon d) Providing a nightlight e) Taking the TV set out of the child's room
B
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) "This is probably a good time to talk about safety and who can touch him." b) "I will need to find an appropriate punishment for him if this continues." c) "I have heard that both boys and girls often touch themselves at this age." d) "I should teach him certain rules about this activity."
B
The mother of a 4-year-old child is concerned that she caught him masturbating in the bath tub. Which is the most appropriate response by the nurse? a) "You will need to speak with the doctor about that behavior since I cannot address sexual issues in a child." b) "Masturbation is a normal part of preschool development." c) "If you catch your child masturbating, you should immediately make them stop." d) "Masturbation is not a normal behavior for a child of that age."
B
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) Falls when bending over to touch toes. c) Pedals tricycle without assistance. d) Unscrews a bolt on a toy.
B
The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which statement is most accurate regarding the gross motor skills of a 4-year-old? a) The child can throw and catch a ball. b) The child can hop on one foot. c) The child can walk backwards with heel to toe. d) The child can jump rope.
B
The nurse is doing teaching with a group of caregivers of preschool children on various topics. The topic of sexual development is discussed. Which statement made by the caregivers indicates an understanding of the sexual development of the preschool-age child? a) "I will tell my daughter that she will have time to explore her body as she gets older." b) "I feel better knowing that what she is doing is normal." c) "I will encourage my son to ask his father any questions that are sexual in nature." d) "When I find my son masturbating, I will tell him that is unacceptable."
B
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 dramatic play? a) Children are playing apart from others without being part of a group. b) Children are acting out a troubling situation. c) Children are playing in an organized group with each other. d) Children are observing without participating.
B
The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement by the mother indicates a need for further teaching? a) "The balls of her feet should reach both pedals while sitting." b) "She can ride on the street if I am riding with her." c) "She should always ride on the sidewalk." d) "Pedal back brakes are better for her age group."
B
The parents of a 6-year-old tell the school nurse that they are worried that their child will fall behind other children academically because they are not able to afford expensive toys like computer games and handheld electronic devices. Which are acceptable responses by the nurse? Select all that apply. a) "There are rental agencies that rent these type of devices. Would that be a possibility financially?" b) "Do you play with your child and provide means of play through things like dolls, puzzles, crayons,and Play-Doh? These are the types of toys suggested for preschoolers." c) "Could you possibly save a little money each paycheck in order to be able to purchase such items." d) "All of these expensive toys that are advertised and purchased by some people are not necessary for preschoolers. Simple toys like chalk and Legos are great." e) "I understand how this can be frustrating, but rest assured this does not place your child at a disadvantage academically."
B, D, E
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 nursing diagnosis is most applicable for his family? a) Compromised family coping related to abnormal behavior of child b) Disturbed thought processes related to deep-set psychological need c) Deficient knowledge of normal preschool development d) Social isolation related to unwillingness to relate except through imaginary friend
C
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) Reading a book b) Singing a song he learned at preschool c) Opening drawers in the room, pulling out supplies, and examining them d) Rough-housing with his father
C
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: a) preschoolers having a harder time sharing than toddlers. b) regression. c) testing and identification of group role. d) playing in an even-number group of children (four).
C
Teaching a group of caregivers about the topic of nutrition, one caregiver tells the group, "I use desserts as a reward for good behavior." A person in the group asks the nurse what she thinks about that idea. Which statement by the nurse would be the most appropriate? Using dessert as a reward for good behavior may cause the child to a) learn to choose sweets over nutritious food. b) cause the child to be overweight. c) only behave on days when dessert is something she likes. d) learn to use food to manipulate others' behavior.
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."
C
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) "You should watch this type of behavior closely since most children this age tell the truth." b) "You should punish your son because no child should be telling lies at this age." c) "Your son may have a friend named Andrew, but it could be an imaginary friend." d) "You need to show your child the broken tool since at this age they must see something in order to understand."
C
The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate? a) "Is there a reason you are concerned about your child's height?" b) "Your son is slightly below the normal height for his age group but may still grow to be a normal height in the coming year." c) "Both your son's height and rate of growth are within normal limits for his age." d) "Your son is slightly below the normal height for his age but he had demonstrated a normal growth rate this year."
C
The nurse is caring for a child who is described as being an inquisitive learner, loves to learn new things, and feels a sense of accomplishment when succeeding in activities. The nurse understands that this child is in which of Erikson's stages of development? a) Autonomy versus shame and doubt b) Industry versus inferiority c) Initiative versus guilt d) Trust versus mistrust
C
The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? a) "The school requires processed foods and high sugar foods be avoided." b) "The school has a looser environment, which is a good match for his temperament." c) "The school is quite structured and advocates corporal punishment." d) "There is a very low student-teacher ratio, and they do a lot of hands-on projects."
C
The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation? a) Absence of dental caries b) Presence of 20 deciduous teeth c) Presence of 10 deciduous teeth d) Presence of 19 deciduous teeth
C
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) 0.5 to 1 inch (1.27 to 2.54 cm) b) 3.5 to 4 inches (8.89 to 10.16 cm) c) 2.5 to 3 inches (6.35 to 7.62 cm) d) 1 to 2 inches (2.54 to 5.07 cm)
C
The nurse is observing a playgroup of children of all ages. The preschoolers in the group would most likely be doing which activity? a) Painting pictures in the art corner of the room. b) Playing a board game. c) Pretending to be mommies and daddies in the playhouse. d) Watching a movie with other children their age.
C
The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching? a) "We need to continually remind her about safety rules." b) "She still needs a booster seat in the car." c) "We need to tell her that her vitamins are candy." d) "We need to know the basics of CPR and first aid."
C
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize: a) enrolling the child in swimming lessons. b) adults learning infant/child cardiopulmonary resuscitation (CPR). c) using and renewing sunscreen regularly. d) having the child wear a personal flotation device whenever near or on the water.
D
The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond? a) "I wouldn't be too concerned since he seems fine during my assessment." b) "I am sure he will become more proficient in these activities soon." c) "Maybe practicing these activities with him would help him improve these motor skills." d) "Your child is not expected to be able to perform those activities at 3 years of age."
D
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) "The frequency of these wetting episodes may be consistent with a low-grade urinary tract infection." b) "Discipline should be applied after these times." c) "Consider restricting your daughter's fluid intake." d) "At this age it is helpful to remind children to go to the bathroom."
D
The mother of a 5-year-old kindergarten student tells the school nurse she is concerned that her son doesn't seem to be able to pronounce words correctly that begin with the letters "th" and "r." What is the best response by the nurse? a) "Language development is critical at this age. I will notify our language specialist so this can be dealt with as soon as possible." b) "Are you sure about this because I haven't noticed this. Maybe he just does this to get a response from you when he is at home." c) "I will ask your child's teacher if he is speaking this way during class. It may be an attention seeking effort on his part." d) "It is very common for children 6 years and younger to have difficulty with these sounds, but I will let our speech therapist know so it can be monitored."
D
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education? a) "It is okay for my four-year-old to still play in his sandbox." b) "My four-year-old will be getting a tricycle for his birthday. I'm glad it's a good gift for her." c) "I will add some crayons, chalk and finger paints to my three-year-old's birthday gifts." d) "I am so glad I can get rid of all of those bath toys because they take up so much room."
D
The nurse is assessing a 4-year-old child. The child tells the nurse about her friend, Nancy, who lives in her room at home. The mother tells the nurse that Nancy is not a real person. The nurse would use which term when documenting this assessment finding? a) Preoperational thought b) Animism c) Magical thinking d) Imaginary friend
D
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 enjoys eggs and fortified cereal for breakfast." b) "He eats a well-balanced diet." c) "He does not like spinach, but he does like chicken and beef." d) "He loves milk and drinks it every time he is thirsty."
D
The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which statement is most accurate regarding the fine motor skills of a 3-year-old? a) The child can print a few letters. b) The child can use scissors. c) The child can tie his shoelaces. d) The child can button his clothes.
D
The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child? a) "Our child gets into food jags where she will only eat one food all day long." b) "My husband is insistent that our 5-year-old not eat any snacks so he will eat he all of his meals at mealtime." c) "My 4-year-old eats as much as my adolescent does every day." d) "My child is so picky and eats the same thing every day for days on end!"
D
The nurse is discussing the topic of nutrition with a group of caregivers of preschoolers. Which statement by the caregivers is most accurate regarding nutrition in the preschooler? a) "My child is growing so rapidly, she needs to eat three big meals a day." b) "It is important for me to give my child calcium so his muscles will grow." c) "It is hard for me to get my child to drink the 4 cups of milk he needs each day." d) "If I give snacks throughout the day, my child can meet her nutritional requirements."
D
The nurse is organizing an indoor play area for preschoolers. What play materials are least important? a) Cut, paste, drawing, and painting materials b) Dress-up clothes and hats and puppets c) CD player with music and musical instruments d) Electronic teaching toys e) Balls, blocks, and puzzles
D
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 independently and are side-by-side. c) Children are playing apart from others without being part of a group. d) Children are playing in an organized group with each other.
D
The nurse is speaking to a parent of a 4-year-old. The parent states that she has trouble getting her child to go to bed at night. Which is the best response by the nurse? a) "Children need dark to sleep. It's important not to use a nightlight even if your child is afraid of the dark." b) "It's okay to let your child fall asleep while watching television in their room. This often helps if your child is afraid of the dark." c) "Sometimes your child needs to burn off excess energy before bed. I would suggest allowing them to run around house for 10 to 15 minutes before bedtime." d) "It's just as important to establish a morning wake-up time as it is as establishing a bedtime. Children tend to do better when they have a normal routine to follow."
D
When planning how to respond to a child about telling stories, you would base your statement on the fact that: a) a preschooler is in an insecure period. b) preschoolers have a limited vocabulary. c) a 3-year-old knows the word two but not the concept 2. d) imagination in a 3-year-old is at its peak.
D
While the nurse is talking with a 6-year-old who has been a client of the clinic since birth, the child begins to tell the nurse that he is the star of a popular children's television program. What is the nurse's best response? a) "What makes you think you are the star of the show?" b) "You are only 6 years old so I don't think you are the star of that show quite yet." c) "I don't think your mother would like you telling people that." d) "I bet you like that show a lot. Which character is your favorite?"
D
