Evolve HESI Peds

Which term should the nurse use when describing the physical growth that occurs during the toddler years? 1 Linear 2 Steplike 3 Sporadic 4 Unpredictable

2 The physical growth of a toddler-age client is steplike. The growth pattern is not linear, sporadic, or unpredictable.

Which tasks related to dressing should the nurse expect the 2-year-old child to accomplish? Select all that apply. 1 Putting on socks 2 Pulling shoes off 3 Fastening coats and jackets 4 Extending the arm to place clothing 5 Placing the shoe on the correct foot

1, 2, 4 By the age of 2 years the nurse would expect the toddler-age client to put on socks, pull off shoes, and extend the arm to assist with the placement of clothing. The nurse would not expect the child to fasten coats and jackets or to place a shoe on the correct foot.

How is stage 2 of Kohlberg's theory different from stage 1? 1 Stage 2 is a premoral stage. 2 Stage 2 is focused on avoiding punishments. 3 Stage 2 is based on a child obeying his or her parent's rules. 4 Stage 2 is about recognizing another's point of view.

4 During stage 2 of Kohlberg's theory, a child learns that there can be more than one point of view. Both stages 1 and 2 are premoral stages that are associated with limited cognitive thinking. Both stages involve a child wanting to avoid punishment and showing obedience to a parent's rules.

At what age should a nurse instruct a parent that his or her child will have finicky eating habits? 1 One year old 2 Two years old 3 Four years old 4 Five years old

3 Four-year-old children have finicky eating habits. Toddlers (one- and two-year-old children) often develop the desire to eat one food repeatedly. Five-year-olds are more interested in trying new foods.

Which growth and developmental assessments should the nurse include when conducting a health maintenance visit for a 15-month-old toddler? Select all that apply. 1 Length 2 Weight 3 Body mass index 4 Head circumference 5 Developmental screening

1, 2, 4 Growth and developmental assessments that the nurse should perform for a 15-month-old toddler include length, weight, and head circumference. Body mass index is not assessed until 24-months of age. A developmental surveillance, not screening, is appropriate for a 15-month-old toddler.

Which nursing actions are accurate when measuring a head circumference for an infant? Select all that apply. 1 Using a cloth tape for accuracy 2 Obtaining one measurement per visit 3 Documenting the information in the progress notes 4 Using paper tape marked with tenths of a centimeter 5 Placing the tape slightly above the eyebrows and pinna of the ears

4, 5 Nursing actions that are accurate when measuring a head circumference for an infant include using paper tape parked in tenths of a centimeter (to facilitate plotting information on growth chart) and placing the tape slightly above the eyebrows and the pinna of the ears (the largest circumference of the head is the target measurement). The use of cloth tape is not recommended because it may stretch providing an inaccurate measurement; paper or metal tape should be used. The nurse should take several measurements at each visit for accuracy. The head circumference is plotted on the growth chart; the information is not documented in the progress notes.

The nurse is performing physical assessments for children in a daycare center. Which children should require a head circumference in order to monitor growth patterns? Select all that apply. 1 A 6-month-old infant who is breastfed 2 A 15-month-old toddler who has asthma 3 A 3-year-old child whose birthday was the day prior 4 A 5-year-old who will attend kindergarten in the fall 5 An 8-year-old child who will begin playing soccer next week

1, 2, 3 The nurse includes a head circumference in the physical assessment from birth to 36 months of age; therefore, the 6-month-old infant, the 15-month-old toddler, and the 3-year-old child whose birthday was the day prior will all have their head circumferences measured during the assessment. The 5-year-old and the 8-year-old will not have their head circumferences measured during the assessment process.

Which statement is true about toddlers? 1 Toddlers grow about 4.2 cm each year. 2 Toddlers develop a sense of autonomy. 3 Toddlers are aware of the danger of water. 4 Toddlers gain approximately 2 to 4 pounds (0.9 to 1.8 kg) each year

2 According to Erikson, a sense of autonomy emerges during toddlerhood. Children strive for independence by using their developing muscles to do everything for themselves and becoming the master of their bodily functions. The average toddler grows 6.2 cm per year. Toddlers' lack of awareness regarding the danger of water and their newly developed walking skills make drowning a major cause of accidental death in this age group. Toddlers gain approximately 5 to 7 pounds (2.3 to 3.2 kg) each year.

The nurse is teaching the parents of a 3-year-old client about fine motor skills, particularly the progression of drawing during this stage of development. Which order of progression stated by the client's parent would indicate understanding of the progression of drawing for the preschool-age child? 1. Shape stage 2. Design stage 3. Pattern stage 4. Pictorial stage 5. Scribble stage

5, 3, 1, 2, 4 Preschool drawing goes through several stages from the beginning to the end during this stage of development. The first stage is the scribble stage, the second is the pattern stage, the third is the shape stage, the fourth is the design stage, and the fifth stage is the pictorial stage.

Which vaccine may cause intussusception in children? 1 Rotavirus 2 Hepatitis 3 Measles, mumps, and rubella 4 Diphtheria, tetanus, and pertussis

1 Rotavirus vaccines very rarely cause intussusception, a form of bowel obstruction in which the bowel telescopes in on itself. Hepatitis vaccines can cause anaphylactic reactions. The measles, mumps, and rubella vaccine may cause thrombocytopenia. The diphtheria, tetanus, and pertussis vaccine carries a small risk of causing acute encephalopathy, convulsions, and a shock-like state.

What pain scale is used to measure the intensity of pain in preschoolers? 1 FACES scale 2 Visual analogue scale 3 Numerical rating scale 4 Verbal descriptor scale

1 The FACES scale is used to measure the intensity of pain in a preschooler. The scale consists of six cartoon faces ranging from a smiling face ("no hurt") to increasingly less happy faces to a final sad and tearful face ("hurts worst"). The visual analogue scale, numerical rating scale, and verbal descriptor scale can be used in young children and adults.

A nurse counsels the parents of a five-year-old child. Which of these concepts would the nurse include in the discussion? Select all that apply. 1 Animism 2 Egocentrism 3 Logical reasoning 4 Concrete thinking 5 Object permanence

1, 2 The nurse will explain the concepts of egocentrism and animism to the parents of a five-year-old child. Logical reasoning is associated with individuals who are 11 years and older. Concrete thinking is associated with children from the ages of 7 to 11 years old. Object permanence is observed in children between birth and two years old.

When does the anterior fontanel of an infant close? 1 At 4 to 10 months 2 At 8 to 12 months 3 At 12 to 18 months 4 At 18 to 26 months

3 The anterior fontanel usually closes between 12 and 18 months.

Which major gross motor development skills would the nurse expect to see demonstrated during a teaching session with parents of a 12-month old client who is entering the toddler stage of development? 1 Walking alone 2 Drawing a stick figure person 3 Showing interest in cooperative play 4 Beginning to develop object permanence

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Which factors influence vocabulary, speech, and comprehension in preschoolers? Select all that apply. 1 Environment 2 Health status 3 Temperament 4 Cognitive ability 5 Physical development

1, 4 Environment and cognitive ability influence vocabulary, speech, and comprehension in preschoolers. Health status and physical development influence a child's school readiness. Temperament influences a child's social development and interactions.

What gross motor skill is observed in children between 8 and 10 months old? 1 The child can creep on his or her hands and knees. 2 The child has predominant inborn reflexes. 3 The child can sit alone without any kind of support. 4 The child can bear his or her weight on forearms when prone.

1 A child between 8 and 10 months old can creep on his or her hands and knees. A child between birth and 1 month old has predominant inborn reflexes. A child between 6 and 8 months old can sit alone without support. A child between 2 and 4 months old can bear his or her weight on his or her forearms when in the prone position.

How many words in the vocabulary of a 3-year-old client would indicate the need for further assessment by the nurse? 1. 500 words 2. 900 words 3. 1500 words 4. 2100 words

1 A vocabulary of 500 words at the age of 3 would indicate the need for the nurse to further assess the client's language development. Nine hundred words are expected and would not require further investigation by the nurse. Fifteen hundred words is expected by the age of 4 and 2100 words is expected by 5 years of age; therefore, these findings would not indicate the need for further assessment by the nurse.

Which period of Piaget's theory describes the idea of object permanence? 1 Sensorimotor period 2 Preoperational period 3 Formal operations period 4 Concrete operations period

1 There are four periods of Piaget's theory of cognitive development. The first period is the sensorimotor period; this period describes object permanence. During the ages of birth to 2 years old, the child understands that objects continue to exist even when they are not visible. The second period is the preoperational period, which is observed in children between the ages of 2 and 7 years. During this time, children learn to think about the use of symbols and have mental images. The third period is the concrete operations period, which is observed between the ages of 7 and 11 years. During this period, the child thinks about an action before performing it. The formal operations period is the fourth period, which is observed in children from the ages of 11 years old throughout adulthood. During this period, there is a prevalence of egocentric thought

In what ways can a nurse promote medication adherence in children? Select all that apply. 1 By mixing oral medications with food or juice 2 By communicating with parents to ensure active participation 3 By selecting a convenient route of dosage and dosing schedule 4 By measuring liquid formulations with a calibrated spoon or syringe 5 By refraining from readministering the drug if the child spills it or spits it out

1, 2, 3, 4 Oral medications may be mixed with food or fruit juice to improve their palatability. Communication with parents helps to ensures conscientious and skilled participation. The most convenient dosage form and dosing schedule should be selected to help ensure easy administration. Liquid formulations should be measured with the use of a calibrated spoon or syringe to help prevent inappropriate dosing. If the child spits out or spills the drug, the amount of drug spilled should be readministered.

According to the Piaget's theory, which behavior does a nine-year-old child show? 1 Logical reasoning 2 Concrete thinking 3 Object permanence 4 Imaginary audience

2 A child of nine years of age will exhibit concrete thinking. Logical reasoning is observed in individuals starting from the age of 11. Object permanence is observed in children between birth and two years old. The idea of being constantly observed by an imaginary audience is observed in individuals starting from the age of 11.

According to Freud's theory, in what order do the stages of child development occur? 1. Anal 2. Oral 3. Genital 4. Oedipal 5. Latency

2, 1, 4, 5, 3 Freud's theory sets forth five stages of child development. The oral stage (stage 1) spans the period from birth to 12 to 18 months. The anal stage (stage 2) occurs between the ages of 18 months and 3 years. The Oedipal stage (stage 3) occurs between 3 and 6 years of age. The latency stage (stage 4) occurs between the ages of 6 and 12 years. Finally, the genital stage (stage 5) lasts from puberty through adulthood.

What developmental skills does a preschooler exhibit? Select all that apply. 1 Personal identity 2 Specific reasoning 3 Increased curiosity 4 Magical thinking 5 Understanding of others

2, 3, 4 Preschoolers begin to engage in specific and become curious. Preschoolers' thinking is often described as magical thinking. Between the ages of 12 and 36 months, toddlers start thinking of the self as separate from the mother. School-age children around the age of 12 years start concentrating on more than one aspect of a situation. They also start understanding different points of view.

Which gross motor behaviors should the nurse assess for when conducting a health maintenance visit for a 4-year-old client? Select all that apply. 1 Skating 2 Skipping 3 Jumping rope 4 Catching a ball 5 Hopping on one foot

2, 4, 5 Gross motor behaviors the nurse would expect for a 4-year-old client include skipping, catching a ball, and hopping on one foot. Skating and jumping rope are expected for a 5-, not 4-year-old client.

Which of these skills should be present in a six to eight month old child? 1 The child pulls himself or herself to stand or sit. 2 The child is able to pick small objects. 3 The child can sit alone without support. 4 The child can place objects into containers.

3 A child of six to eight months of age should be able to sit alone without support. A child after 8 months of age should be able to pick up small objects, place objects in containers, and pull himself or herself up to stand or sit.

If hearing loss is detected early, proper intervention can help a child achieve normal language development. What is the latest age that hearing loss should be detected to ensure that a child achieves normal language development? Record your answer using a whole number. ______________ months

3 If a healthcare provider detects hearing loss before the child is three months old and an intervention is initiated within six months, the child can achieve normal language development.

According to Piaget's theory of cognitive development, what is the correct order of a child's activities? 1. The child develops egocentrism and animism. 2. The child is able to describe a process without actually doing it. 3. The child develops action pattern for dealing with the environment. 4. The child demonstrates feelings and behaviors characterized by self-consciousness.

3, 1, 2, 4 During the first period (the sensorimotor stage), a child develops an action pattern for dealing with the environment. During the second period (known as the preoperational stage), a child develops egocentrism in that they see objects and persons from only his or her point of view. During this stage, children also demonstrate animism, in which they personify objects. During the next stage (concrete operations stage), a child is able to describe a process without actually doing it. During the last period (formal operations stage), a child demonstrates feelings and behavior characterized by self-consciousness.

A nursing instructor asks a nursing student about Kohlberg's theory. Which stages does a nurse include under the first level of the theory? Select all that apply. 1 Good boy-nice girl orientation 2 Society-maintaining orientation 3 Instrument relativist orientation 4 Universal ethical principle orientation 5 Punishment and obedience orientation

3, 5 The first level of Kohlberg's theory is preconventional reasoning, which includes the instrument relativist orientation stage and punishment and obedience orientation stage in the first level. Good boy-nice girl orientation stage and society-maintaining orientation stage are covered under the conventional reasoning level. Universal ethical principle orientation stage is a part of postconventional reasoning.

Which developmental milestone related to feeding does a nurse anticipate for a 36-month-old client? Select all that apply. 1 Using a straw to drink 2 Drinking well from a cup 3 Chewing with the mouth closed during meals 4 Beginning to use a fork by holding it in the fist 5 Spilling small amounts of food when using a spoon

4, 5 The nurse would anticipate the 36-month-old toddler to use a fork by holding it in the fist and spilling small amounts of food when using a spoon. The nurse would anticipate the 24-month-old toddler to use a straw to drink liquids. The 15-month-old toddler is expected to drink well from a cup. Chewing with the mouth closed during meals is an expectation for the 24-month-old toddler.

What gross motor skill is found in children between two to four months of age? 1 The child can creep on its hands and knees. 2 The child has predominant inborn reflexes. 3 The child can sit alone without any kind of support. 4 The child can bear weight on forearms when prone.

4 A child between two and four months of age is able to bear his or her weight on the forearms when in the prone position. A child between eight and 10 months of age can creep on their hands and knees. A child between birth and one month has predominant inborn reflexes. A child between six and eight months of age can sit alone without support.

What stage of Kohlberg's theory of moral development defines "right" by the decision of the conscience? 1 Social contract orientation 2 Society-maintaining orientation 3 Instrumental relativist orientation 4 Universal ethical principle orientation

4 Kohlberg's theory of moral development consists of six stages. Universal ethical principle orientation is the sixth stage. It defines "right" by the decision of the conscience in accordance with self-chosen ethical principles. Social contract orientation is the fifth stage of Kohlberg's theory. During this stage, an individual follows societal law but recognizes the possibility of changing the law to improve society. Society-maintaining orientation stage is the fourth stage. Individuals expand their focus from a relationship with others to societal concerns during this stage. Instrumental relativist orientation is the second stage. In this stage, the child recognizes that there is more than one right view.

A nurse educates the mother of a preschooler about potential physical changes in the child. Which statement made by the mother needs correction? 1 "My child will gain about 7 lbs (3.18 kg) per year." 2 "My child will grow 2.5 to 3 inches (6.2 to 7.5 cm) per year." 3 "Large and fine muscle coordination will improve in my child." 4 "My child will appear more slender due to elongation of the legs."

1 Preschoolers gain about 5 lbs (2.3 kg), not 7 lbs (3.18 kg), per year. The average increase in the height of preschoolers per year is 2.5 to 3 inches (6.2 to 7.5 cm). Large and fine muscle coordination improves in preschoolers. Preschoolers appear more slender due to elongation of the legs.

What situation would the nurse instruct the parents may possibly predispose a preschooler to feeling guilty? 1 The caregiver's responses are too harsh. 2 The individual is unable to establish companionship. 3 The parents try to control the child and limit choices. 4 The parents fail to establish a sense of trust in the child.

1 Preschoolers often develop a feeling of guilt if the caregiver's responses are too harsh. If a young adult is not able to establish companionship and intimacy, isolation results due to rejection and disappointment. The toddler develops his or her autonomy by making choices. Controlling the child and limiting choices can predispose a child to a sense of shame and doubt. If parents fail to establish a sense of trust with an infant, it can lead to a feeling of mistrust in the infant.

The nurse is preparing to assess several clients at a pediatric clinic. Which client would require a developmental screening versus developmental surveillance during a scheduled health maintenance visit? 1 A 9-month-old infant 2 A 2-week-old newborn 3 A 15-month-old toddler 4 A 4-year-old preschooler

1 The nurse would conduct a developmental screening for the 9-month-old infant during a scheduled health maintenance visit. The 2-week-old newborn, the 15-month-old toddler, and the 4-year-old preschooler would all require developmental surveillance during a health maintenance visit.

The nurse is preparing to administer a vaccine to a child. Which conditions, if present, would allow for the safe administration of the vaccine? Select all that apply. 1 Current antimicrobial therapy 2 Mild to moderate local reactions 3 Anaphylactic reaction to vaccines 4 Recent exposure to infectious diseases 5 Moderate to severe illness with or without fever

1, 2, 4 A vaccine can be safely administered even if the child is on any antimicrobial therapy or develops a mild to moderate local reaction. Recent exposure to an infectious disease is not a contraindication. A vaccine is contraindicated if the child has moderate to severe illness with or without fever or develops an anaphylactic reaction.

The nurse assesses and reports a disproportionate head-to-chest ratio for a 6-month-old infant. Which information should the nurse prepare to share with the infant's parents as the most likely cause of this assessment data? 1 "Your infant most likely has an altered chest shape." 2 "Your infant is likely experiencing abnormal head growth." 3 "Your infant will most likely be diagnosed with brain cancer." 4 "Your infant most likely had inaccurate measurements during the last visit."

2 A disproportionate head-to-chest ratio during infancy is most likely caused by abnormal head growth. While an altered chest shape may cause the disproportionate measurements, this is not the most likely cause. Telling the parents that their infant will most likely be diagnosed with brain cancer is inaccurate and not therapeutic. The data obtained to determine the disproportionate measures was obtained during the current visit; previous measurements will not be taken into account in this circumstance.

What is the similarity between stages 5 and 6 of Kohlberg's theory? 1 Both stages explain the basic rights of an individual. 2 Both stages emphasize the democratic process. 3 Both stages are associated with postconventional reasoning. 4 Both stages stress the importance of following laws without question.

3 Postconventional reasoning is associated with stages 5 and 6 of Kohlberg's theory. Stage 5 explains the basic rights of an individual, whereas stage 6 defines "right" by the decision of conscience in accordance with self-chosen ethical principles. Stage 5 emphasizes the democratic process, whereas stage 6 does not. Stage 5 stresses the importance of following laws without question, whereas an individual in stage 6 may not follow a law if it seems unjust.

Which fine motor skill should the nurse anticipate when assessing a 15-month-old client during a health maintenance visit? 1 Kneeling without support 2 Standing without support 3 Creeping up stairs without assistance 4 Holding cubes in one hand without assistance

4 Holding cubes in one hand without assistance is a fine motor skill the nurse should anticipate when assessing a 15-month-old client during a health maintenance visit. Kneeling, standing, and creeping up stairs without support are all gross, not fine, motor skills.

Which parental statement indicates the need for more education related to fine motor skill development for a toddler-age client who is 24 months of age? 1 "My child should be able to turn a door knob." 2 "My child should align 2 or 3 cubes like a train." 3 "My child should imitate vertical strokes when drawing." 4 "My child should turn more than 1 page of a book at a time."

4 A 24-month-old toddler-age child should be able to turn 1 page of a book at a time. This parental statement indicates the need for further education regarding fine motor skills. The parental statements related to turning a door knob, aligning 2 or 3 cubes like a train, and imitating vertical strokes when drawing all indicate correct understanding of fine motor skills at 24 months of age.

Which nursing action is appropriate when assessing a pediatric client's arm circumference? 1 Using specialized calipers for the measurements 2 Having cloth tape available to measure the midpoint 3 Recording the average of one measurement using two sites 4 Measuring vertically along the posterior aspect of the upper arm

4 Arm circumference is an indirect measurement of muscle mass. The appropriate nursing action is to measure vertically along the posterior aspect of the upper arm to the acromial process and to the olecranon process. Specialized calipers are used to assess skinfold measurements. The nurse should record the average of at least two measurements at the same site.

At what age is a toddler-age client physiologically and psychologically prepared for toilet training? 1 13 months 2 16 months 3 19 months 4 22 months

4 The 22-month-old toddler-age client is both physiologically and psychologically prepared for toilet training. The 13-month-old, the 16-month old, and the 19-month old are not yet physiologically and psychologically prepared for toilet training.

After assessing a preschooler, a nurse concludes that a child has high physical skills for his or her age. Which finding in the child supports the nurse's conclusion? 1 The child can jump rope. 2 The child can skip on alternate feet. 3 The child can walk up and down steps with ease. 4 The child is able to hold a pencil adeptly and print letters and words.

4 The ability to hold a pencil adeptly and print letters and words is a characteristic of six-year-old children (school-age). A preschooler who exhibits this ability has physical skills greater than their age. Preschoolers can jump rope, skip on alternate feet, and walk up and down steps with ease.

What is the required average daily intake of calories in preschoolers? 1) 400 2) 700 3) 1,000 4) 1,800

4 The average daily intake of calories required in preschoolers is 1800 calories. Four hundred, 700, and 1,000 would be too low

Which actions demonstrate fine motor skills? Select all that apply. 1 Crawling 2 Creeping 3 Sitting erect 4 Holding a rattle 5 Picking up objects 6 Holding a baby bottle

4, 5, 6 Holding a rattle, picking up objects, and holding a baby bottle are demonstrations of fine-motor skills. Gross-motor skills include crawling, creeping, and sitting erect.

Which statement correctly describes the initiative versus guilt stage? 1 Individuals like to pretend and try out new roles. 2 Individuals are more accomplished in some basic self-care activities. 3 Individuals show marked preoccupation with appearance and body image. 4 Individuals are eager to apply themselves to learning socially productive skills and tools

1 During the initiative versus guilt stage, a child likes to pretend and try out new roles. A child is more accomplished in some basic self-care activities during the autonomy versus sense of shame and doubt stage. During the identity versus role confusion stage, an individual shows marked preoccupation with appearance and body image. During the industry versus inferiority stage, a child is eager to apply himself or herself to learning socially productive skills and tools.

Which statement would the nurse state is true for toddlers? 1 The incidence of poisoning is very common in toddlers. 2 An 18-month-old child uses approximately up to 300 words. 3 The average toddler gains 2 to 3 pounds (0.9 to 1.4 kg) each year. 4 Toddlers prefer to engage in parallel play rather than in solitary play.

1 Poisonings occur frequently because children of around 2 years of age place objects or substances in their mouths to learn about them. The 18-month-old child uses approximately 10 words. A toddler gains approximately 5 to 7 pounds (2.3 to 3.2 kg) each year. The toddler begins to engage in parallel play during toddlerhood but also engages in solitary play.

What is the similarity between the preoperational period and the formal operations period of Piaget's theory? 1 Both periods involve the concept of an imaginary audience judging an individual's decisions. 2 Both periods demonstrate animism in a child. 3 Both periods explain the idea of egocentric thought in an individual. 4 Both periods occur at the beginning of an individual's cognitive development.

3 The preoperational period and formal operations period explain egocentric thought. The preoperational period describes egocentrism in a child between the ages of 2 and 7; the formal operations period explains egocentrism in an individual from the age of 11 through adulthood. During the formal operations period, an individual believes that his or her actions and appearance are constantly being scrutinized by an imaginary audience. The preoperational period is associated with a child believing in animism. The preoperational period marks the beginning of cognitive development; the formal operations period marks the end of cognitive development.

At what age does a child start to crawl? 1. 3 months 2. 5 months 3. 7 months 4. 9 months

4 At the age of 9 months, a child starts to crawl along the floor and can pull himself or herself to a standing or sitting position. At the age of 3 months, a child can lift his or her head and chest and is able to sit erect with support. At the age of 5 months, a child can support much of his or her own weight when pulled to stand. At the age of 7 months, a child can sit alone without support, can bear his or her full weight on his or her feet, and can hold on to furniture.

Which findings in a four-year-old indicates an appropriate development of socialization skills? Select all that apply. 1 The child tends to be selfish and impatient. 2 The child takes pride in his or her accomplishments. 3 The child tells family tales to others with no restraint. 4 The child is eager to do things correctly and please others. 5 The child tries to follow rules during an associative play, but cheats to avoid losing

1, 2, 3 Four-year-old children tend to be selfish and impatient, and they take pride in accomplishments. They may tell family tales to others with no restraint. A five-year-old child may be eager to do things correctly and please others. A five-year-old tries to follow rules during associative play, but may cheat to avoid losing.

The nurse is providing care to a preschool-age client of Asian descent during a scheduled health maintenance visit. The family speaks fluent English. Which assessment strategies should the nurse implement with the child and family based on the current data? Select all that apply. 1 Using open-ended questions 2 Avoiding prolonged eye contact 3 Phrasing questions in a neutral manner 4 Asking all questions directly to the interpreter 5 Asking several questions for time management purposes

1, 2, 3 Open-ended questions should be used as frequently as possible during a health history interview. This is especially important for a family of Asian descent who tend to answer "yes" or anticipate the answer the nurse wants to hear. Direct or prolonged eye contact is often seen as a sign of disrespect when assessing a family of Asian descent. Phrasing questions in a neutral manner decreases the risk of the family anticipating the answer the nurse wants to hear, which often occurs for clients of Asian descent. Since the family speaks fluent English, there is no need to engage the services of an interpreter unless the family requests it. If an interpreter was used, the nurse would direct the questions directly to the family. One question should be asked at a time during the assessment process.

The nurse is planning care for a 2-month-old infant who is diagnosed with bronchopulmonary dysplasia (BPD). Which activities may inhibit the infant's ability to learn through sensorimotor experiences? Select all that apply. 1 Oxygen therapy by tent 2 Frequent arterial blood gases (ABG) 3 Overinvolvement of the parent in care 4 Multiple caregivers during hospitalization 5 Contact isolation due to respiratory syncytial virus (RSV)

1, 2, 5 A chronic illness experienced by an infant can inhibit the ability to learn through sensorimotor experiences. This often occurs with an increased exposure to painful experiences (frequent ABGs) rather than pleasurable ones and through limited contact with the environment from restricted movement (oxygen therapy by tent) or confinement (contact isolation for RSV). Overinvolvement of the parent in care may inhibit the infant from beginning to develop a sense of separateness from his or her parent. Multiple caregivers during hospitalization may impact the infant's ability to bond or attach to his or her parent.

During which health maintenance visit for a toddler-age client should the nurse assess the ability to throw a ball overhand without losing balance? 1. 12 months 2. 18 months 3. 24 months 4. 30 months

2 A toddler-age client should be able to throw a ball overhand without losing balance by 18 months of age [1] [2]. Twelve months is too young to throw a ball without losing balance. Twenty-four months and 30 months are later than when the nurse anticipates this skill to occur.

Which is a developmental milestone related to feeding that the nurse anticipates for a 15-month-old client? 1 Using a straw to drink 2 Drinking well from a cup 3 Chewing food with mouth closed 4 Spilling small amounts of food when using a spoon

2 The nurse would anticipate that a 15-month-old toddler can drink well from a cup. The use of a straw to drink liquids and chewing food with the mouth closed is an expectation for the 24-month-old toddler. Spilling small amounts of food when using a spoon is an expectation for a 36-month-old toddler.

Which immunization should the nurse provide parental education on during the health maintenance visit for a 4-year-old client? 1 Hepatitis B # 3 2 Inactive poliovirus # 3 3 Measles, mumps, and rubella # 1 4 Haemophilus influenza type B # 2

2 The nurse would prepare education for the parents of a 4-year-old child for the inactive poliovirus # 3 as this is administered to children between 4 to 6 years of age. Hepatitis B # 3 is administered to children between 6 and 18 months of age. The first measles, mumps, and rubella vaccine is administered to children between 12 and 15 months of age. The second haemophilus influenza type B is administered to children 6 months after the first vaccine, which is administered at 12 months of age.

The nurse is conducting a health assessment for a school-age child who is new to the pediatric practice. Which questions should the nurse ask the child and parents related to growth? Select all that apply. 1 "What grade are you currently attending?" 2 "At what age did your child cut his or her first tooth?" 3 "Do you have a best friend at your new school?" 4 "What was your child's approximate length at 1 year of age?" 5 "What was your child's approximate weight at 6 months, 1, 2, and 5 years of age?"

2, 4, 5 All of these questions are appropriate when conducting an assessment for a child who is new to the pediatric practice to collect information regarding the child's history. The questions that are appropriate to assess growth include: asking the parents when the child cut his or her first tooth; asking the parents the child's approximate length at 1 year of age; and asking the parents the child's approximate weight at 6 months, 1, 2, and 5 years of age. Asking the child what grade he or she is in and if he or she has a best friend is more appropriate when collecting information about the child's development.

Which assessment finding should the nurse identify as a physical readiness cue for a toddler-age client related to toilet training? 1 Having regular bowel movements 2 Willing to invest the time needed 3 Telling a parent that the diaper is wet 4 Expressing a willingness to please parents

1 A toddler-age client who has regular bowel movements is exhibiting a physical readiness for toilet training. Willingness to invest the time needed indicates parental readiness, not a physical readiness by the toddler, to begin toilet training. Telling a parent that the diaper is wet indicates a mental readiness by the toddler-age client for toilet training. Expressing a willingness to please parents indicates the toddler is psychologically ready for toilet training.

Which data collected during a developmental assessment for a 5-year-old client would indicate the need for further intervention? 1 Names coins correctly 2 Has a vocabulary of 1500 words 3 Ties shoe laces independently 4 Has hand dominance established

2 The nurse would expect that the 5-year-old client would have a vocabulary of 2100, not 1500, words; therefore, this finding would indicate the need for further intervention by the nurse. It is expected the that 5-year-old client will be able to name coins correctly, tie shoe laces independently, and have established hand dominance; therefore, this data does not indicate the need for further intervention.

Which statement by the parent of a toddler-age client indicates correct understanding of language development? 1 "My child knows more words than he understands." 2 "My child understands more words than he can speak." 3 "My child won't be able to speak in phrases until preschool." 4 "My child should be able to begin reading simple books soon."

2 The toddler-age child understands more than he can speak. This statement indicates correct understanding. The toddler-age child would not be able to speak more words than he can understand. The toddler-age child should be able to speak in phrases during this stage of development. The child will not be able to read simple books until late preschool or early school-age.

How many words should the nurse expect the 3-year-old child to acquire each day? 1. 2 to 3 2. 5 to 6 3. 8 to 10 4. 11 to 13

2. 5-6 words The nurse would expect the 3-year-old toddler-age child to acquire 5 to 6 new words each day. Two to 3 new words, 8 to 10 new words, and 11 to 13 new words are not expected parameters for language development.

How should a nurse control the negative behavior of a toddler? 1 By allowing for more openness 2 By using invasive methods 3 By limiting his or her opportunities to say no 4 By giving the toddler choices

3 The nurse reduces the likelihood of a toddler engaging in negative behavior by reducing the child's opportunities to give "no" responses. The nurse should avoid too much openness with the toddler. The nurse should not use invasive methods to control negative behavior because this may cause fear. The nurse should not give the toddler choices. For example, the nurse should not ask, "Do you want to take the medicine?" Instead, the nurse should say, "It's time to take the medicine."

Which theory states that a child's growth pattern is related to gene activity? 1 Gesell's theory 2 Piaget's theory 3 Erikson's theory 4 Havinghurst's theory

1 Gesell's theory of development states that each child's pattern of growth is unique and that this pattern is directed by gene activity. Piaget's theory of cognitive development comprises four periods related to age: sensorimotor, preoperational, concrete operations, and formal operations. Erikson's theory of psychosocial development states that an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Havinghurst's theory of stage crisis is based on developmental tasks. This theory incorporates three primary sources for developmental tasks: tasks that surface because of physical maturation, tasks that evolve from personal values, and tasks that are a result of pressures from society.

Which data should the nurse anticipate when conducting a developmental assessment for a 5-year-old client? Select all that apply. 1 Names coins correctly 2 Has a vocabulary of 1500 words 3 Participates in parallel play 4 Ties shoe laces independently 5 Has hand dominance established

1, 4, 5 When conducting a developmental assessment for a 5-year-old client, the nurse anticipates the client to be able to name coins correctly, tie shoe laces independently, and have established hand dominance. A vocabulary of 1500 words would indicate a language delay; the 5-year-old client is expected to have a vocabulary of 2100 words. Participation is associative, not parallel play, and is expected by 5 years of age.

According to Piaget's theory, which of these statements about the period of concrete operations is true? 1 A child develops a scheme for dealing with the environment. 2 A child is able to describe a process without actually doing it. 3 A child has the capacity to reason with respect to possibilities. 4 A child believes that everyone experiences the world exactly as he or she does.

2 According to Piaget's theory, a child is able to describe a process without actually carrying it out in the concrete operations period. A child develops a scheme for dealing with the environment during the sensorimotor period. A child gains the capacity to reason with respect to possibilities during the formal operations period. A child believes that everyone experiences the world exactly as he or she does during the preoperational period.

A nurse prepares a chart comparing the language development of four preschoolers. Which child may have developed advanced language skills? 1 Preschooler A: age 3; uses complete sentences of three or four words 2 Preschooler B: age 4; knows the names of the days of the week and months of the year 3 Preschooler C: age 5; uses sentences of six to eight words, with all parts of speech 4 Preschooler D: age 4; use sentences of four or five words

2 Children learn the names of days of week and months by the age of five years, not four years. Therefore preschooler B has developed advanced language skills. Three-year-old children use complete sentences of three or four words. Four-year-old children use sentences of four or five words. Five-year-old children use sentences of six to eight words, with all parts of speech.

Which statement is true regarding the physical development of a preschooler? 1 Children gain about 3 lbs (1.36 kg) per year. 2 Preschoolers grow 6.2 to 7.5 cm per year. 3 Preschoolers grow three times their length at around 4 years. 4 The average weight of the child at four years is 32 lbs (14.51 kg).

2 Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers gain about 5 lbs (2.26 kg) per year. They also grow double their length at around 4 years old. The average weight of a 4 year old is 37 lbs (16.78 kg).

For which pediatric client should the nurse use the Age and Stages Questionnaire (ASQ) as a developmental screening tool during a health maintenance assessment? 1 A 2-week old newborn client 2 A 15-month-old toddler client 3 A 6-year-old school-age client 4 A 14-year-old adolescent client

2 The ASQ developmental screening tool is appropriate to use for pediatric clients from 1 month to 4.5 years of age. The nurse would use this screening tool for the 15-month-old toddler. The other clients are not within the age range for the use of the ASQ screening tool.

Which statement about language development in preschoolers is correct? 1 Preschoolers find words such as "die" and "dye" confusing. 2 Preschoolers realize that words have arbitrary rather than absolute meanings. 3 Preschoolers become aware of the rules for linking words into phrases and sentences. 4 Preschoolers accept language as a means of representing the world in a subjective manner.

1 Preschooler children find phonetically similar words such as "die" and "dye" confusing. School-aged children realize that words have arbitrary rather than absolute meanings. School-aged children become aware of the rules for linking words into phrases and sentences; they also accept language as a means of representing the world in a subjective manner.

A nursing instructor asks a nursing student about the level "conventional reasoning" in Lawrence Kohlberg's theory of moral development. Which statements made by the student indicate the need of further teaching? Select all that apply. 1 "A child recognizes that there is more than one correct view." 2 "Individuals expand their focus from a relationship with others to societal concerns." 3 "An individual seeks the approval of and maintains the expectations of one's immediate group." 4 "A child's response to a moral dilemma is in terms of absolute obedience to authority and rules." 5 "An individual follows societal law but recognizes the possibility of changing the law to improve society."

1 "A child recognizes that there is more than one correct view." 4 "A child's response to a moral dilemma is in terms of absolute obedience to authority and rules." 5 "An individual follows societal law but recognizes the possibility of changing the law to improve society." During the preconventional reasoning level, a child recognizes that there is more than one correct view. During the postconventional reasoning level, individuals follow societal law, but recognize the possibility of changing the law to improve society. During the preconventional reasoning stage, a child's response to a moral dilemma is in terms of absolute obedience to authority and rules. During the conventional reasoning level, individuals expand their focus from a relationship with others to societal concerns. During the conventional reasoning level, an individual wants to win the approval and maintain the expectations of one's immediate group.

A nurse is educating a group of mothers about the nutritional needs of toddlers. Which of these statements made by a mother indicate the need for further teaching? Select all that apply. 1 "I need to give more than 24 ounces of milk per day." 2 "I should provide more calories from fats than proteins." 3 "I should refrain from giving grapes, nuts, and raw vegetables." 4 "I should give foods rich in calcium and phosphorus for healthy bone growth." 5 "I should try to give small, frequent meals consisting of breakfast, lunch, and dinner."

1, 2 Toddlers who consume more than 24 ounces of milk daily in place of other foods may develop milk anemia, because milk is a poor source of iron. A toddler needs more protein than fats in the diet. Certain foods, such as nuts, grapes, and raw vegetables, as well as hot dogs, candy, and popcorn, have been implicated in choking deaths and should be avoided. Calcium and phosphorus are important for healthy bone growth. Small frequent meals consisting of breakfast, lunch, and dinner with three interspersed high nutrient-dense snacks help improve nutritional intake.

Which physical growth parameters should the nurse anticipate when assessing an 18-month-old client during a scheduled health maintenance visit? Select all that apply. 1 Physiologic anorexia 2 Growth needs decreased 3 Anterior fontanelle remains open 4 Primary dentation of sixteen teeth 5 Chest circumference exceeds head circumference

1, 2 When conducting a physical assessment for an 18-month-old client during a scheduled health maintenance visit, the nurse anticipates physiologic anorexia [1] [2] and a decrease in growth needs. The nurse expects the anterior fontanelle to be closed, not open. Primary dentation of sixteen teeth and a chest circumference that exceeds head circumference is not a physical growth parameter the nurse anticipates until the child is 24 months of age.

According to Piaget's theory, which of these statements would a nurse say to a mother about her four-year-old child? Select all that apply. 1 "The child will only be able to consider his or her own point of view." 2 "The child will consider that inanimate objects may be alive." 3 "The child will think about an action before performing it." 4 "The child will believe that his or her actions are scrutinized." 5 "The child will be able to order things according to length."

1, 2 According to Piaget's theory, a four-year-old child will see others only from his or her point of view. In addition, the child will consider inanimate objects as living. Between the ages of 4 and 11 years, the child thinks about an action before performing it physically. Between the age of 11 years throughout adulthood, a child believes that his or her actions and appearance are constantly scrutinized. The child has an "imaginary audience." This is the period of formal operations. Between the ages of 4 and 11 years, a child is able to correctly order or sort objects by length or weight.

A nurse is educating the parents of a preschooler about the importance of play in the development of their child. Which statements should the nurse include for adequate teaching? Select all that apply. 1 "Playing helps the child to socialize with others." 2 "Pretend play allows children to learn to understand others." 3 "Playing helps the child to release frustration." 4 "If the child fantasizes about imaginary playmates, introduce him or her to reality." 5 "The child should completely avoid television, video games, and computer programs."

1, 2, 3 A child should be encouraged to play because this activity helps the child to socialize with others, learn to understand other points of view, develop skills in solving social problems, and release frustration. Imaginary playmates are a sign of health and allow the child to distinguish between reality and fantasy; this type of play should not be discouraged. Television, video games, and computer programs also support development and the learning of basic skills.

When teaching the parents of a toddler-age client about normal growth and development, which statements should the nurse include in the teaching session regarding learning through the senses? Select all that apply. 1 "The toddler often puts new objects in the mouth." 2 "The toddler may inspect a new toy by turning it over." 3 "The toddler will touch a new object only once during exploration." 4 "The toddler will shake a new toy when it is first introduced to the play area." 5 "The toddler rarely uses the sense of smell to learn about something new introduced within the environment."

1, 2, 4 The toddler learns through his or her senses by placing new objects in the mouth, inspecting new items by turning them over, and shaking a new toy when it is first introduced to the play area. The toddler will touch a new object several times when learning about it. The toddler will use the sense of smell in order to learn.

Which fine motor skills should the nurse assess for during a health maintenance visit for a toddler-age client? Select all that apply. 1 Throwing a ball 2 Grasping small objects 3 Walking up and down steps 4 Standing on one foot for several seconds 5 Placing a round object in the correctly shaped hole

1, 2, 5 The toddler-age client continues to develop fine motor skills [1] [2], including throwing a ball, grasping small objects, and placing a round object in the correctly shaped hole. Walking up and down steps and standing on one foot for several seconds is also expected during the toddler stage of development; however, these are gross, not fine, motor skills.

Which questions should the nurse include when conducting a health history interview with the parents of a 4-year-old client to assess fine motor skills? Select all that apply. 1 "Is your child able to use scissors?" 2 "Is your child able to ride a tricycle?" 3 "Is your child able to tie shoe laces?" 4 "Is your child able to climb stairs using alternate feet?" 5 "Is your child able to build a tower using 9 or 10 blocks?"

1, 3 Fine motor skills expected at 4 years of age include using scissors and being able to tie shoe laces; therefore, these questions are appropriate during the health history interview. Riding a tricycle is a gross motor behavior that is expected by 3 years of age. Climbing steps using alternate feet is a gross, not fine, motor skill that is expected by 4 years of age. Building a tower using 9 or 10 blocks is a fine motor skill expected by age 3, not age 4.

Which precautions should the nurse follow to minimize medication errors in children? Select all that apply. 1 Report all medication errors 2 Receive verbal orders over the telephone 3 Use authoritative resources such as drug handbooks 4 Communicate with the parents or caregivers 5 Confirming information about the client every time a dose is given

1, 3, 4, 5 Using authoritative resources such as drug handbooks and confirming information about the client every time a dose is given helps to minimize medication errors. Communicating with the parents and caregivers would also help to decrease any medication errors. Reporting any medication errors helps to identify the cause of such errors. Receiving verbal orders over the telephone is not recommended because there may be a bad connection and important information may be lost.

The nurse is providing care to a bilingual preschool-age child. Which should the nurse take into consideration regarding the child's language development? Select all that apply. 1 Disabilities will manifest in both languages. 2 The language spoken in the home will be less developed. 3 The child will only be able to read in one of the languages. 4 Milestones are reached at the same stage for both languages. 5 Bilingual children often act as medical interpreters for their families.

1, 4 When planning care for a bilingual preschool-age child, the nurse should consider that language disabilities will manifest in both languages and that milestones for both languages will be reached during the same time frame. There is no evidence that the language spoken in the home will be less developed. A bilingual child will be able to read in both languages. Bilingual children should not act as medical interpreters for their family members.

Which activities will the nurse suggest to the parents of a preschool-age child to enhance fine motor skills? Select all that apply. 1 Using scissors 2 Riding a bicycle 3 Throwing a ball 4 Tying shoe laces 5 Playing with clay

1, 4, 5 The nurse should suggest using scissors, tying shoe laces, and playing with clay as activities that are appropriate for a preschool-age client to enhance fine motor skills. Riding a bicycle and throwing a ball are age-appropriate activities to enhance gross, not fine, motor skills for the preschool-age client.

A nursing instructor asks a nurse to convert a 104 °F temperature into degrees Celsius. What temperature does the nurse record? Record your answer using a whole number ___________________ °C

40 To convert Fahrenheit to Celsius, subtract 32 from the Fahrenheit reading and multiply the result by 5/9. oC = (F - 32) × 5/9 oC = (104 °F - 32) × 5/9 oC= 40 oF