new fam prep u exam 4

A mother calls the pediatric nurse practitioner about her 7-year-old daughter's dental hygiene. The daughter has had three cavities. She does not know what to do and asks the nurse for guidance. How should the nurse respond?

"Are you able to supervise her brushing?"

The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment?

"Do you participate in any sports?"

Which statement by a school-aged child demonstrates Erikson's psychosocial stage of industry versus inferiority?

"I have friends and I succeed" versus "I have no friends and am incapable."

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?

"I usually have him in time-out for about 10 minutes."

The nurse is teaching a group of school-age children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching?

"I will grow an average of 2.5 in (6.5 cm) per year."

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?

"I will need to find an appropriate punishment for him if this continues."

The nurse is observing several children interacting during a community health event. Which observed behavior would be indicative of a 4-year-old child?

"Look! I am a nurse, and I am helping people feel better!"

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by a caregiver best indicates a common aspect of the diet and nutrition of the preschool child?

"My child is so picky and eats the same thing every day for days on end!"

During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?

"Play helps children to develop cognitively, socially, physically, and emotionally."

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?

"Tell me about Boo-ga-loo."

The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond?

"Tell me about the circumstances when this occurs."

The nurse is caring for a school-aged child in the primary care setting. The parent of the child asks how often the child should see the dentist. Which is the best response made by the nurse?

"The child should see a dentist twice a year."

The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse?

"The preschool-age child is developing a conscience."

During an annual visit of a 6-year-old boy, the nurse observes dental caries on two of the child's primary teeth. Which response by the parents suggests more education is needed regarding the importance of primary teeth?

"These are only his baby teeth so we are not worried."

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior?

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior."

The nurse is discussing the latchkey child with a group of working caregivers. Which of the following statements made by the caregivers indicates an understanding of an important responsibility of the caregiver of the latchkey child?

"We have a list of phone numbers of our family and neighbor by the phone."

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?

"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

The nurse is speaking with the parent of a 4-year-old child. Which statement by the parent would suggest a need for further investigation?

"When we go to the park, my child never wants to play with the other children."

A parent brings a 6-year-old to the clinic and informs the nurse that the child is tired all the time, even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse?

"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."

The mother and her 8-year-old daughter come to the clinic for a well-child visit. The mother asks the nurse, "About how much sleep should my daughter be getting?" The nurse responds by saying:

10-12 hours.

The nurse is evaluating the diet of a 9-year-old boy who is fairly active. The nurse determines that the child's nutritional intake is adequate based on the understanding that this child needs how many calories per day?

2000

The nurse is conducting a well-child examination of a 5-year-old girl who was 40 inches tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler?

43 inches

The nurse is collecting data on a 7-year-old child who weighed 7 lb 2 oz (3.2 kg) at birth. If the child is following a normal pattern of weight gain, the nurse would anticipate the child would weigh approximately:

50 pounds.

A nurse is obtaining a weight on a 7-year-old who weighed 8 pounds at birth. How much does the nurse anticipate that he should weigh now?

56 pounds

The nurse is interacting with preschool-aged children in a day care center. Which situation(s), if observed by the nurse, would alert the nurse to further assess the child for a developmental concern? Select all that apply.

A child points to a snack and looks at the care provider to indicate wanting the snack. A child states, "I cold" when wanting a blanket to cover up with during story time.

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise?

A feeling of inferiority

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?

A sense of competence, mastery, and worth

A parent tells the nurse that the 6-year-old child has been biting his fingernails since beginning first grade. After analysis, the cause is determined to be increased stress. What advice would the nurse give the parent regarding this behavior?

Allow some time every day for the child to talk about new experiences

A 3-year-old is hospitalized unexpectedly and is frightened about the experience. What action could the nurse take to minimize the anxiety the child is experiencing?

Allow the child to handle the equipment before it is used on the child.

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?

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough

The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue?

Before answering questions, find out what the child thinks about the subject.

A mother of a 4-year-old boy brings a local toy store's advertisement to the nurse, seeking advice on selection of appropriate toys for her son. Which toy would the nurse recognize as being inappropriate for him?

Building blocks

A 5-year-old child is overheard by her parents calling her dog a "fat boo-boo butt" and they are concerned. What advice would the nurse provide for them regarding this behavior?

Calmly correct the child, telling her not to say those words again.

The pattern of growth in which the child is able to control the head and neck before the arms and legs is known as which of the following?

Cephalocaudal

A nurse is assigned to care for a 7-year-old child. The child wants to show the nurse a collection of baseball cards. The nurse understands that the collection of objects is common in this age group and is known as what type of thinking?

Classification

The nurse is caring for a hospitalized 10-year-old client. Which nursing action is most appropriate?

Consistently reinforce the child's self-worth.

The nurse is teaching the parents of a 9-year-old girl about the socialization that is occurring in their child through school contacts. Which information would the nurse include in her teaching plan?

Continuous peer relationships provide the most important social interaction for school-age children.

The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play?

Cooperative play

A mother who is vegan, when asked about the nutritional intake of her 18-month-old, tells the nurse not to worry because she is providing plenty of protein to her daughter. "And," she says, "I avoid giving her fats." Which of the following would be the most appropriate response for nurse to give this mother?

Correct response: "Your child needs fat in the diet at this age, as it is needed for myelination of spinal nerves."

A 7-year-old is told that she will have to have her tonsils out during school break. Though disappointed, the child understands the problems with missing school. What type of behavior is the child displaying?

Decentration

A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client?

Delayed growth and development related to frequent illness

A nurse recognizes that a pregnant homeless woman has challenges that other pregnant women may not. What problems should the nurse anticipate that the homeless pregnant patient will have? Select all that apply.

Delivery of low birth weight infants Lack of prenatal care Poor nourishment

A parent tells the nurse about being frustrated because the preschool-aged child screams every time the parent attempts to buckle the child's seat belt. What advice should the nurse give this parent?

Do not start the car until seat belts are in place.

The nurse is organizing an indoor play area for preschool-age children. Which play materials are least important?

Electronic teaching toys

The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local day care. What information would the nurse include in this education session? Select all that apply.

Encourage children to select their own clothing to wear each day. Parents will need to supervise tooth-brushing and be responsible for flossing. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing.

What teaching points would a nurse provide for families of school-aged children to help prevent substance abuse? Select all that apply.

Encourage decision-making and discuss family values. Set firm rules regarding alcohol and other drug usage and discuss consequences associated with breaking the rules. Give the child "what if" examples to situations they may face.

A nurse is working with a family that has two children who were identified as overweight based on screening. Which of the following strategies would be important for the nurse to include in assisting the family? Select all that apply.

Encouraging moderate exercise for 60 minutes/day Involving the entire family in the program Emphasizing that the family not skip meals

Children ages 8 to 9 years of age are playing games together. Everyone takes turns and has an opportunity to play and share equally. This describes which of the following perspectives?

Fairness

A homeless parent brings a child with a severe earache to the clinic. What can the nurse do to establish a therapeutic relationship so that the parent feels respected?

Focus on positive factors in the caregiver's relationship with the child.

The terms "growth" and "development" often are used interchangeably. To which of the following does "development" refer?

He learns to throw a ball overhand.

A nurse observes a 3-year-old child playing with an older sibling. In which type of play would the nurse expect to see the siblings engaged?

Imitative play

An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step?

Industry

A 10-year-old girl is excited when she receives the "most improved player" award on her softball team. Although she was not the strongest player on the team, she always tried to perform at her best level and never gave up on practicing her skills. What stage of psychosocial development according to Erik Erikson is this child demonstrating?

Industry versus inferiority

Which would be a nutritional goal for a preschool client?

Introduce new food gradually and include variety.

The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?

Magical thinking

A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior?

Make time each day to spend with the child individually.

A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed?

My son should can let his friend ride as a passenger on his bicycle as long as they both wear helmets."

The nurse is playing with the 8-month-old infant. The nurse hides the toy to assess cognitive function of the infant. The infant tries to find the toy. The nurse is assessing which characteristic of Piaget's stages of cognitive development?

Object permanence

The mother of a 10-year-old daughter is concerned that her child is becoming overweight. Her weight plots in the 95th percentile in the growth chart. Which action would the nurse recommend to the mother to address her concerns?

Offer to go walking every day after school with her for 30 minutes.

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?

Opening drawers in the room, pulling out supplies, and examining

A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family?

Parental anxiety related to lack of understanding of childhood development

A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group?

Participating in a craft project

When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction?

Peer relationships

A nurse is speaking with a 7-year-old boy in the hospital. The boy asks the nurse, "Where is the westroom? I need to use the westroom." The nurse recognizes that this developmental problem is which of the following?

Poor articulation

What activities would a nurse recommend to the families of school-aged children to promote attainment of Erikson's developmental stage of industry vs. inferiority? Select all that apply.

Praising the child for their academic efforts Participating on the school soccer team Allowing the child to assist her teacher in straightening up the classroom

While preforming a preoperative assessment on a 3-year-old client, a nurse should be aware of what type of cognitive thought process by the child?

Preoperational - The child will want to play with the equipment.

While making a visit to the home of a family with a school-age child, the nurse observes a hunting rifle leaning against the wall in the dining room. Which nursing diagnosis should the nurse use to guide interventions for the family at this time?

Risk for injury

The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?

Selected: a sense of security as children gain independence

The nurse is caring for a 9-year-old patient in the hospital. Which project should the nurse provide to help this child achieve the developmental task of industry?

Sew a purse that will take one afternoon.

What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother?

Specific program goals to be accomplished should be available.

A community health nurse is giving a lecture to parents of children home alone in the afternoons ("latchkey" children). What advice should the nurse include? Select all that apply.

Teach the child to keep the house key hidden. Let the child know if you are going to be delayed. Plan a telephone contact on the child's arrival home.

Which gross motor skill would the 4-year-old child have most recently attained?

The child can hop on one foot.

A nurse in the clinic observes a school-age child pushing another child. The parent is watching without disciplining the child and tells the nurse, "He just does what he wants to and doesn't listen to anything I say." What can the nurse inform that parent about the development of self-confidence in the child? Select all that apply.

The child needs positive attention to develop self-confidence. The child needs clear expectations to develop self-confidence. The child needs consistent rules to develop self-confidence.

A 9-year-old boy is admitted into the hospital with a broken femur. What is important for the nurse to consider when caring for this child?

The child should be prepared for procedures and should be allowed to view and handle equipment that is going to be used when appropriate.

The nurse caring for a hospitalized 8-year-old child recognizes that the child has developed an understanding of reversibility. Which of the following relates to the development of this understanding?

The child understands that his or her illness is probably only temporary.

The nurse is supervising lunch time for children on a pediatric ward. Which observation is considered abnormal for this age group?

The child uses his fingers and refuses to use a fork.

A nurse is evaluating a 5-year-old client in the clinic. Which finding would indicate to the nurse that the client is not meeting Erikson's stages of psychosocial development?

The client asks permission to play.

When caring for a child with a cognitive impairment, what is a primary factor for the nurse to consider regarding the approach for interaction with the child?

The developmental stage is based on developmental tasks achieved.

A nurse is caring for a hospitalized child with divorced parents. What intervention is important for the nurse to provide when caring for this child?

The nurse should have clear information about who the custodial parent is and adhere to his or her wishes.

In teaching caregivers of preschool children, the nurse would reinforce that which activity would be most important for this age group?

The preschool child should be properly restrained when riding in a vehicle.

The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. What is an appropriate response to this concern?

Treat the action in a matter-of-fact manner, emphasizing safety.

A seasoned pediatric nurse realizes that a hospitalized child's need for identity is strongest in which of the following groups?

adolescents

A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted?

appropriate social development

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage?

asking the girl to slow down and to think before she talks

During their school-aged years, children understand concepts best if they can see the concept illustrated. This type of thinking is termed:

concrete thought.

Which immunization would the nurse expect to administer at a preschool health maintenance visit?

diphtheria, pertussis, and tetanus (DTaP) booster

Which nurse best fosters a school-aged child's adaptation to hospitalization? The nurse who:

explains procedures and shows the child equipment that will be used on them.

The nurse and a client are discussing the client's preschool child. The client states, "When I tell my child it's time for bed, he/she screams and cries for almost an hour each night before going to sleep." The client and the nurse decide that the next course of action is:

follow a routine and set a bedtime.

A trend with growth and development of the infant is that development is proximodistal. This means:

growth progresses from gross motor movements to fine motor movements.

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:

having the child wear a personal flotation device whenever near or on the water.

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?

imagination

When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that:

imagination in a 3-year-old is at its peak.

industry versus inferiority

industry versus inferiority.

The most important safety precaution for parents to teach preschoolers is:

not to ride in a car with strangers.

The nurse plans an activity for a chronically ill hospitalized child. Which activity is the best choice to provide stimulation for the child?

painting a picture

A mother tells the nurse she is having difficulty getting her 6-year-old to do chores. Based on the child's developmental level, what activity would be best for the nurse to recommend to the mother?

putting books on shelf

When assessing the growth and development of a 4-year-old, which would the nurse note as being appropriate?

tells a fantasy story about a bear and a car

If a preschooler sees you pour his liquid medicine from a tall, thin glass into a short, wide one, he will probably reason that:

the amount of medicine is less (the glass is not as full).

A 2-year-old with pneumonia has recently been hospitalized. When the lunch tray arrives to the floor, the nurse caring for the patient sets up the tray and allows the child to self-feed with a spoon despite the mess. What is the nurse's best reason for these actions?

to foster autonomy

The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening?

viewing her baby sister's illness as her fault