Pediatric 1.0
The parent of a 16-month-old toddler asks, "What is the best way to keep our son from getting into our medicines at home?" the nurse's best response is a. "all medicines should be locked securely away." b. "the medicines should be placed in cabinets." c. "the child just needs to be taught not to touch medicines." d. "medicines should not be kept in the homes of small children."
a. "all medicines should be locked securely away." The major reason for poisoning in thehome is improper storage. Toddlers can climb, unlatch cabinets, and obtain access to high-security places. For medications, only a locked cabinet is safe. Toddlers can climb by using furniture. High places are not a deterrent to an exploring toddler. Toddlers are not able to generalize as dangerous all thedifferent forms of medications that may be available in thehome. It is not feasible to not keep medicines in thehomes of small children. Many parents require medications for chronic illnesses. Parents must be taught safe storage for their home and when they visit other homes.
Preschoolers' fears can best be dealt with by which intervention? a. Actively involving them in finding practical methods to deal with the frightening experience b. Forcing them to confront the frightening object or experience in the presence of their parents c. Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are d. Ridiculing their fears so that they understand that there is no need to be afraid
a. Actively involving them in finding practical methods to deal with the frightening experience Actively involving them in finding practical methods to deal with the frightening experience is the best way to deal with fears. Forcing a child to confront fears may make the child more afraid. Preconceptual thought prevents logical understanding. Ridiculing fears does not make them go away.
A nurse is teaching a parent about administration of iron supplements to a 7-month-old infant. Which would the nurse include in the teaching session? (Select all that apply.) a. Administer the iron supplement with a dropper toward the side and to the back of the mouth. b. Administer the iron supplement with feedings. c. Your infant's stools may look tarry green. d. Your infant may have some diarrhea initially. e. Follow the iron supplement with 4 ounces of juice.
a. Administer the iron supplement with a dropper toward the side and to the back of the mouth. c. Your infant's stools may look tarry green Liquid iron supplements may stain the teeth; therefore, administer them with a dropper toward the back of the mouth (side). Ideally, iron supplements should be administered between meals for greater absorption. Avoid administration of liquid iron supplements with whole cow's milk or milk products because they bind free iron and prevent absorption. Educate parents that iron supplements will turn stools black or tarry green. Iron supplements may cause transient constipation, not diarrhea. In older children, follow liquid iron supplement with a citrus fruit or juice drink (no more than 3 to 4 oz).
A 16 months old child falls down a few stairs, then gets up and "scolds" the stairs as if they caused him to fall. This is an example of which of the following? a. Animism b. Ritualism c. Irreversibility d. Delayed cognitive development
a. Animism Animism is the attribution of lifelike qualities to inanimate objects. By scolding the stairs, the toddler is attributing human characteristics to them. Ritualism is the need to maintain the sameness and reliability. It provides a sense of comfort to the toddler. Irreversibility is the inability to reverse or undo actions initiated physically. Steven is acting in an age-appropriate manner.
Which accurately describes the speech of the preschool child? a. Dysfluency in speech patterns is normal. b. Sentence structure and grammatic usage are limited. c. By age 5 years, child can be expected to have a vocabulary of about 1000 words. d. Rate of vocabulary acquisition keeps pace with thedegree of comprehension of speech.
a. Dysfluency in speech patterns is normal. Dysfluency includes stuttering and stammering, a normal characteristic of language development. Children speak in sentences of three or four words at age 3 to 4 years and eight words by age 5 years. At 5 years, children have a vocabulary of 2100 words. Children often gain vocabulary beyond degree of comprehension.
Which gross motor milestones would the nurse assess in an 18-month-old child? (Select all that apply.) a. Jumps in place with both feet b. Takes a few steps on tiptoe c. Throws ball overhand without falling d. Pulls and pushes toys e. Stands on one foot momentarily
a. Jumps in place with both feet c. Throws ball overhand without falling d. Pulls and pushes toys An 18-month-old child can jump in place with both feet, throw a ball overhand without falling, and pull and push toys. Taking a few steps on tiptoe and standing on one foot momentarily is not acquired until 30 months of age.
Marasmus is seen in children 6 months to 2 years in underdeveloped countries. Which symptoms would the nurse expect for this condition? a. Loose, wrinkled skin b. Edematous skin c. Depigmentation of the skin d. Dermatoses
a. Loose, wrinkled skin Marasmus is characterized by gradual wasting and atrophy of body tissues, especially of subcutaneous fat. thechild appears to be very old, with loose and wrinkled skin, unlike thechild with kwashiorkor, who appears more rounded from theedema. Fat metabolism is less impaired than in kwashiorkor; thus, deficiency of fat-soluble vitamins is usually minimal or absent. In general, theclinical manifestations of marasmus are similar to those seen in kwashiorkor with thefollowing exceptions: With marasmus, there is no edema from hypoalbuminemia or sodium retention, which contributes to a severely emaciated appearance; no dermatoses caused by vitamin deficiencies; little or no depigmentation of hair or skin; moderately normal fat metabolism and lipid absorption; and a smaller head size and slower recovery after treatment.
While conducting an educational class, which risk factors would the nurse include as increasing an infant's risk of a sudden infant death syndrome incident? (Select all that apply.) a. Maternal smoking b. Co-sleeping c. Vaccinations d. Prone sleeping e. Recent viral illness
a. Maternal smoking b. Co-sleeping d. Prone sleeping Certain groups of infants are at increased risk for SIDS: low birth weight, low Apgar scores, recent viral illness, and male sex. Breastfed infants and infants of average or above average weight are not at higher risk for SIDS.
The parents of a 4-month-old infant tell the nurse that they are heating the baby's formula in a microwave oven. Which would the nurse recommend? a. Never heat a bottle in a microwave oven. b. Heat only 10 ounces or more. c. Always leave bottle top uncovered to allow heat to escape. d. Shake bottle vigorously for at least 30 seconds after heating.
a. Never heat a bottle in a microwave oven. Bottles cannot be heated safely in microwave ovens even if safe guidelines are followed and regardless of theamount to be heated due to uneven heating and possible burns.
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. How would the nurse interpret this finding? a. Normal finding b. Finding requiring a referral c. Abnormal finding d. Normal finding, but requires rechecking in 1 month
a. Normal finding This is a normal finding. the anterior fontanel closes between ages 12 and 18 months. No further intervention is required.
Which would the nurse recommend as a substitute formula for an infant with a cow's milk allergy? a. Nutramigen b. Goat's milk c. Similac d. Enfami
a. Nutramigen Treatment of CMA is elimination of cow's milk-based formula and all other dairy products. For infants fed cow's milk formula, this primarily involves changing the formula to a casein hydrolysate milk formula (Pregestimil, Nutramigen, or Alimentum). Goat's milk (raw) is not an acceptable substitute because it cross-reacts with cow's milk protein, is deficient in folic acid, has a high sodium and protein content, and is unsuitable as the only source of calories. Cow's milk protein is contained in both Enfamil and Similac.
A nurse is teaching parents methods to reduce lead levels in their home. Which would the nurse include in the teaching? (Select all that apply.) a. Plant bushes around the outside of the house. b. Ensure your child eats regular meals. c. Use hot water from the tap when boiling vegetables. d. Food can be stored in ceramic in the refrigerator. e. Ensure that your child's diet contains sufficient iron and calcium
a. Plant bushes around the outside of the house. b. Ensure your child eats regular meals. e. Ensure that your child's diet contains sufficient iron and calcium. Methods to reduce lead levels in homes include: planting bushes around theoutside of thehouse if soil is contaminated with lead, so children cannot play there; ensuring that children eat regular meals because more lead is absorbed on an empty stomach; and ensuring that children's diets contain sufficient iron and calcium. Cold water should only be used for drinking, cooking, and reconstituting powder infant formula. Hot water dissolves lead more quickly than cold water and thus contains higher levels of lead. Do not use pottery or ceramic ware that was inadequately fired or is meant for decorative use for food storage or service.
Which toys would a nurse provide to promote imaginative play for a 3-year-old hospitalized child? (Select all that apply.) a. Plastic telephone b. Hand puppets c. Jigsaw puzzle (100 pieces) d. Farm animals and equipment e. Jump rope
a. Plastic telephone b. Hand puppets d. Farm animals and equipment To promote imaginative play for a 3-year-old child, thenurse should provide: dress-up clothes, dolls, housekeeping toys, dollhouses, play-store toys, telephones, farm animals and equipment, village sets, trains, trucks, cars, planes, hand puppets, or medical kits. A 100-piece jigsaw puzzle and a jump rope would be appropriate for a young, school-age child but not a 3-year-old child.
Which is an appropriate play activity for a 7-month-old infant to encourage visual stimulation? a. Playing peek-a-boo b. Playing pat-a-cake c. Imitating animal sounds d. Showing how to clap hands
a. Playing peek-a-boo Because object permanence is a new achievement, peek-a-boo is an excellent activity to practice this new skill for visual stimulation. Pat-a-cake and showing how to clap hands will help with kinetic stimulation. Imitating animal sounds will help with auditory stimulation
Which is common characteristics of those who sexually abuse children? (Select all that apply.) a. Pressure victim into secrecy b. Are usually unemployed and unmarried c. Typically a man whom the victim knows d. Have many victims that are each abused once only e. Typically have a prior criminal record
a. Pressure victim into secrecy c. Typically a man whom the victim knows Sex offenders may pressure the victim into secrecy regarding the activity as a "secret between us" that other people may take away if they find out. the offender may be anyone, including family members and persons from any level of society. Sex offenders are usually trusted acquaintances of the victims and victims' families. Many victims are abused many times over a long period.
Which action is taken by the nurse when a parent of an infant with colic verbalizes, "All this baby does is scream at me; it is a constant worry." a. Provide methods for coping to the mother. b. Encourage parent not to worry so much. c. Assess parent for other signs of inadequate parenting. d. Reassure parent that colic rarely lasts past age 9 months
a. Provide methods for coping to the mother Colic is multifactorial, and no single treatment is effective for all infants. the parent is verbalizing concern and worry. the nurse should allow the parent to put these feelings into words. An empathic, gentle, and reassuring attitude, in addition to suggestions about remedies, will help alleviate the parent's anxieties. the nurse should reassure the parent that he or she is not doing anything wrong. Colic is multifactorial. the infant with colic is experiencing spasmodic pain that is manifested by loud crying, in some cases up to 3 hours each day. Telling the parent that it will eventually go away does not help him or her through the current situation
In terms of gross motor development, which would the nurse expect a 5-month-old infant to do? (Select all that apply.) a. Roll from abdomen to back. b. Put feet in mouth when supine. c. Roll from back to abdomen. d. Sit erect without support. e. Move from prone to sitting position. f. Adjust posture to reach an object.
a. Roll from abdomen to back. b. Put feet in mouth when supine. Rolling from abdomen and to back and placing the feet in the mouth when supine are developmentally appropriate for a 5-month-old infant. the ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually achieved by 8 months. the10-month-old infant can usually move from a prone to a sitting position. the8-month-old infant adjusts posture to reach an object.
A nurse is teaching a parent about introduction of solid foods into an infant's diet. Which would the nurse include in the teaching session? (Select all that apply.) a. Solid food introduction can be started at 4 to 6 months of age. b. Iron fortified cereal is introduced first. c. Begin the introduction of solid foods by mixing with formula in the bottle. d. Introduce egg white in small quantities (1 tsp) at 6 months. e. Introduce one food at a time, usually at intervals of 4 to 7 days.
a. Solid food introduction can be started at 4 to 6 months of age. b. Iron fortified cereal is introduced first. e. Introduce one food at a time, usually at intervals of 4 to 7 days. Rice cereal, because of its low allergenic potential, is thefirst solid food introduced to an infant at 4 to 6 months of age. Introduce one food at a time, usually at intervals of 4 to 7 days, to identify food allergies. Introduce egg white in small quantities (1 tsp) toward theend of thefirst year to detect an allergy. Solid food introduction should be started at 4 to 6 months of age. Never introduce foods by mixing them with theformula in a bottle.
Parents are concerned that their child is showing aggressive behaviors. Which suggestion would the nurse make to the parents? a. Supervise television viewing. b. Ignore the behavior. c. Punish the child for the behavior. d. Accept the behavior if the child is male.
a. Supervise television viewing. Television is also a significant source for modeling at this impressionable age. Research indicates there is a direct correlation between media exposure, both violent and educational media, and preschoolers exhibiting physical and relational aggression (Ostrov, Gentile, and Crick, 2006). Therefore, parents should be encouraged to supervise television viewing. the behavior should not be ignored because it can escalate to hyperaggression. the child should not be punished because it may reinforce the behavior if the child is seeking attention. For example, children who are ignored by a parent until they hit a sibling or the parent learn that this act garners attention. the behavior should not be accepted from a male child; this is using a "double standard" and aggression should not be equated with masculinity
Which findings would the nurse expect when assessing a child with kwashiorkor disease? a. Thin wasted extremities with a prominent abdomen b. Constipation c. Elevated hemoglobin d. High levels of protein
a. Thin wasted extremities with a prominent abdomen The child with kwashiorkor has thin, wasted extremities and a prominent abdomen from edema (ascites). Diarrhea (persistent diarrhea malnutrition syndrome) not constipation commonly occurs from a lowered resistance to infection and further complicates theelectrolyte imbalance. Anemia and protein deficiency are common findings in malnourished children with kwashiorkor.
A parent of an 18-month-old boy tells the nurse that he has rapid mood swings, and if he is scolded, he shows anger and then immediately wants to be held. the nurse's best interpretation of this behavior is included in which statement? a. This is normal behavior for his age. b. This is unusual behavior for his age. c. He is not effectively coping with stress. d. He is showing he is not getting enough attention
a. This is normal behavior for his age. Toddlers use distinct behaviors in the quest for autonomy. They express their will with continued negativity and the use of the word "no." Children at this age also have rapid mood swings. the nurse should reassure the parents that their child is engaged in expected behavior for an 18- month-old. Having a rapid mood swing is an expected behavior for a toddler.
Which is a useful skill that the nurse would expect a 5-year-old child to be able to master? a. Tie shoelaces b. Use knife to cut meat c. Hammer a nail d. Make change out of a quarter
a. Tie shoelaces Tying shoelaces is a fine motor task of 5-year-olds. Using a knife to cut meat is a fine motor task of a 7-year-old. Hammering a nail and making change out of a quarter are fine motor and cognitive tasks of an 8- to 9-year-old.
Which is the leading cause of death during the toddler period? a. Unintentional injuries b. Infectious diseases c. Congenital disorders d. Childhood diseases
a. Unintentional injuries Injuries are the single most common cause of death in children ages 1 through 4 years. This represents the highest rate of death from injuries of any childhood age group except adolescence. Infectious diseases and childhood diseases are less common causes of deaths in this age group. Congenital disorders are the second leading cause of death in this age group.
To prevent plagiocephaly, the nurse would teach parents to a. place infant prone for 30 to 60 minutes per day. b. buy a soft mattress. c. allow infant to nap in the car safety seat. d. have infant sleep with the parents.
a. place infant prone for 30 to 60 minutes per day. Prevention of positional plagiocephaly may begin shortly after birth by implementing prone positioning or "tummy time" for approximately 30 to 60 minutes per day when the infant is awake. Soft mattresses or sleeping with parents (co-sleeping) are not recommended because they put the infant at a higher risk for a sudden infant death incident. To prevent plagiocephaly, prolonged placement in car safety seats should be avoided.
The nurse is talking to a parent of an infant with severe atopic dermatitis (eczema) and would suggest which of the following to the parent? (Select all that apply.) a. "You can use warm wet compresses to relieve discomfort." b. "You will need to keep your infant's fingernails and toenails cut short." c. "You should bathe your baby in a bubble bath two times a day." d. "You will need to prevent your baby from scratching the area by using a mild antihistamine." e. "You can try a fabric softener in the laundry to avoid rough cloth." f. "You should apply an emollient to the skin immediately after a bath."
b. "You will need to keep your infant's fingernails and toenails cut short." d. "You will need to prevent your baby from scratching the area by using a mild antihistamine." f. "You should apply an emollient to the skin immediately after a bath." The eczematous lesions of atopic dermatitis are intensely pruritic. Scratching can lead to new lesions and secondary infection; an antihistamine can be used. Keeping the skin hydrated is a goal of treating atopic dermatitis. Applying an emollient immediately after a bath helps to trap moisture and prevent moisture loss. Cool wet compresses should be used for relief. Bubble baths and harsh soaps should be avoided, as is bathing excessively, since this leads to drying. Fabric softener should be avoided because of the irritant effects of some of its components.
The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. the nurse would expect the infant to now weigh approximately how many pounds? a. 10 b. 15 c. 20 d. 25
b. 15 Birth weight doubles at about age 5 to 6 months. At 6 months, a child who weighed 7 pounds at birth would weigh approximately 15 pounds; 10 pounds is too little. the infant would have gone from the50th percentile at birth to below the5th percentile; 20 to 25 pounds is too much. the infant would have tripled the birth weight at 6 months.
1. A parent asks the nurse "when will my infant start to teethe?" the nurse responds that the earliest age at which an infant begins teething with eruption of lower central incisors is _____ months. a. 4 b. 6 c. 8 d. 12
b. 6 Teething usually begins at age 6 months with theeruption of thelower central incisors; 4 months is too early for teething. By age 8 months, theinfant has theupper and lower central incisors. At age 12 months, theinfant has six to eight deciduous teeth.
Which is descriptive of the preschooler's understanding of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms like "yesterday" appropriately
b. Associates time with events In a preschooler's understanding, time has a relation with events such as "We'll go outside after lunch." Preschoolers develop an abstract sense of time at age 3 years. Children can tell time on a clock at age 7 years. Children do not fully understand use of time-oriented words until age 6 years
A 4-year-old child who is hospitalized with a bacterial infection tells the nurse that he is sick because he was "bad." Which is the nurse's best interpretation of this comment? a. Sign of stress b. Common at this age c. Suggestive of maladaptation d. Suggestive of excessive discipline at home
b. Common at this age Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think they are directly responsible for events, making them feel guilty for things outside their control. Children of this age show stress by regressing developmentally or acting out. Maladaptation is unlikely. Telling the nurse that he is sick because he was "bad" does not imply excessive discipline at home.
Which is a clinical manifestation of acetaminophen poisoning? a. Hyperpyrexia b. Hepatotoxicity c. Hyperactivity d. Drooling and inability to clear secretions
b. Hepatotoxicity Hepatic involvement is thethird stage of acetaminophen poisoning. Hyperpyrexia is a severe elevation in body temperature and is not related to acetaminophen poisoning. Acetaminophen does not cause burning pain in stomach or pose an airway threat.
In terms of language and cognitive development, a 4-year-old child would be expected to have which traits? (Select all that apply.) a. Think in abstract terms. b. Less egocentrism developed. c. Understand conservation of matter. d. Use sentences of eight words. e. Understands time better. f. Comprehend another person's perspective.
b. Less egocentrism developed. e. Understands time better. Children ages 3 to 4 years can give and follow simple commands and tell exaggerated stories. Children cannot think abstractly at age 4 years. Conservation of matter is a developmental task of theschool-age child. Five-year-old children use sentences with eight words with all parts of speech. A 4-year-old child cannot comprehend another's perspective.
Which prescribed antidote would the nurse prepare to administer for a child who has acetaminophen poisoning? a. Naloxone (Narcan) b. N-acetylcysteine (Mucomyst) c. Flumazenil (Romazicon) d. Digoxin immune Fab (Digibind)
b. N-acetylcysteine (Mucomyst) Antidotes available to treat toxin ingestion include N-acetylcysteine for acetaminophen poisoning, naloxone for opioid overdose, flumazenil (Romazicon) for benzodiazepine (diazepam [Valium], midazolam [Versed]) overdose, and digoxin immune Fab (Digibind) for digoxin toxicity.
Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which recommendation would the nurse make? a. Punish children so this behavior stops. b. Neither condone nor condemn the curiosity. c. Allow children unrestricted permission to satisfy this curiosity. d. Get counseling for this unusual and dangerous behavior.
b. Neither condone nor condemn the curiosity. Three-year-olds become aware of anatomic differences and are concerned about how the other "works." Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. Encouraging the children to ask questions of the parents and redirecting their activity are more appropriate than giving permission. Exploration is age appropriate and not dangerous behavior.
Which is the most effective way to clean a toddler's teeth? a. Child to brush regularly with a toothpaste of his or her choice b. Parent to stabilize thechin with one hand and brush with theother c. Parent to brush the mandibular occlusive surfaces, leaving the rest for the child d. Parent to brush the front labial surfaces, leaving the rest for the child
b. Parent to stabilize the chin with one hand and brush with the other For young children, the most effective cleaning of teeth is by the parents. Different positions can be used if the child's back is to the adult. the adult should use one hand to stabilize the chin and the other to brush the child's teeth. the child can participate in brushing, but for a thorough cleaning, adult intervention is necessary.
Which are characteristic of physical development of a 30-month-old child? (Select all that apply.) a. Birth weight has doubled. b. Primary dentition is complete. c. Voluntary control of urethral sphincter. d. Anterior fontanel is open. e. Left or right hand dominance is established.
b. Primary dentition is complete. c. Voluntary control of urethral sphincter. Usually by age 30 months, the primary dentition of 20 teeth is completed, and the child has sphincter control in preparation for bowel and bladder control. Birth weight doubles at approximately ages 5 to 6 months. the anterior fontanel closes at age 12 to 18 months. Birth length is doubled around age 4. Left- or right-handedness is not established until about age 5.
Which is descriptive of a toddler's cognitive development at age 20 months? a. Searches for an object only if he or she sees it being hidden b. Realizes that "out of sight" is not out of reach c. Puts objects into a container but cannot take them out d. Understands the passage of time, such as "just a minute" and "in an hour"
b. Realizes that "out of sight" is not out of reach At this age, the child is in the final sensorimotor stage. Children will now search for an object in several potential places, even though they saw only the original hiding place. Children have a more developed sense of objective permanence. They will search for objects even if they have not seen them hidden. When a child puts objects into a container but cannot take them out, this is indicative of tertiary circular reactions. An embryonic sense of time exists, although the children may behave appropriately to time-oriented phrases; their sense of timing is exaggerated.
Which play item would the nurse bring from the playroom to a hospitalized toddler in isolation? a. Small plastic Lego b. Set of large plastic building blocks c. Brightly colored balloon d. Coloring book and crayons
b. Set of large plastic building blocks Play objects for toddlers must still be chosen with an awareness of danger from small parts. Large, sturdy toys without sharp edges or removable parts are safest. Large plastic blocks are appropriate for a toddler in isolation. Small plastic toys such as Lego can cause choking or can be aspirated. Balloons can cause significant harm if swallowed or aspirated. Coloring book and crayons would be too advanced for a toddler.
A 3-month-old infant presents to the Emergency Department with subdural and retinal hemorrhages but no external signs of trauma, and dies shortly after arriving. What would the nurse suspect? a. Plant poisoning b. Shaken-baby syndrome c. Sudden infant death syndrome (SIDS) d. Congenital neurologic problem
b. Shaken-baby syndrome Shaken-baby syndrome causes internal bleeding but may have no external signs. Unintentional injury would not cause these injuries. SIDS and congenital neurologic problems would not appear this way.
Which intervention would the nurse implement during the time a child is receiving calcium EDTA chelation therapy? a. Calorie counts b. Strict intake and output c. Telemetry monitoring d. Glucose monitoring
b. Strict intake and output Because calcium disodium edetate (EDTA) and lead are toxic to the kidneys, a nurse should keep strict records of intake and output to monitor renal functioning. Adequate hydration is essential during therapy because the chelates are excreted via the kidneys. Calorie counts, telemetry, or contact isolation would not be nursing interventions appropriate for a child undergoing chelation therapy.
Which are the clinical manifestations the nurse expects to assess in an infant with cow's milk allergy? (Select all that apply.) a. Eczema b. Vomiting c. Rhinitis d. Abdominal pain e. Moist skin
b. Vomiting c. Rhinitis d. Abdominal pain An infant with cow's milk allergy will possibly have vomiting, rhinitis, and abdominal pain. the mucous membranes may be pale due to anemia from blood lost in the GI tract, and the skin will be itchy with the possibility of atopic dermatitis.
Which statement is correct about toilet training? a. Bladder training is usually accomplished before bowel training. b. Wanting to please the parent helps motivate the child to use the toilet. c. Watching older siblings use the toilet confuses the child. d. Children must be forced to sit on the toilet when first learning.
b. Wanting to please the parent helps motivate the child to use the toilet. Voluntary control of the anal and urethral sphincters is achieved sometime after the child is walking. the child must be able to recognize the urge to let go and to hold on. the child must want to please parent by holding on rather than pleasing self by letting go. Bowel training precedes bladder training. Watching older siblings provides role modeling and facilitates imitation for the toddler. the child should be introduced to the potty chair or toilet in a nonthreatening manner
The clinic is lending a federally approved car seat to an infant's family. the nurse would explain that the safest place to put the car seat is a. front facing in back seat. b. rear facing in back seat. c. front facing in front seat with air bag on passenger side. d. rear facing in front seat if an air bag is on thepassenger side.
b. rear facing in back seat. The rear-facing car seat provides thebest protection for an infant's disproportionately heavy head and weak neck. themiddle of theback seat is thesafest position for thechild. theinfant must be rear facing to protect thehead and neck in theevent of an accident. Severe injuries and deaths in children have occurred from air bags deploying on impact in thefront passenger seat.
The parent of a 2-week-old infant, exclusively breastfed, asks the nurse if fluoride supplements are needed. Which is the nurse's best response? a. "She needs to begin taking them now." b. "They are not needed if you drink fluoridated water." c. "She may need to begin taking them at age 6 months." d. "She can have infant cereal mixed with fluoridated water instead of supplements."
c. "She may need to begin taking them at age 6 months." Fluoride supplementation is recommended by theAmerican Academy of Pediatrics beginning at age 6 months if thechild is not drinking adequate amounts of fluoridated water (0.3 ppm). theamount of water that is ingested and theamount of fluoride in thewater are taken into account when supplementation is being considered.
Which statement by a parent indicates an understanding of a home apnea monitor? a. "We can adjust the monitor to eliminate false alarms." b. "We should sleep in the same bed as our monitored infant." c. "We will always look at the baby first if the alarm sounds. d. "We will place the monitor in the crib with our infant."
c. "We will always look at the baby first if the alarm sounds. The parents should check the monitor several times a day to be sure the alarm is working and that it can be heard from room to room. the parents should not adjust the monitor to eliminate false alarms. Adjustments could compromise the monitor's effectiveness. the monitor should be placed on a firm surface away from the crib and drapes. the parents should not sleep in the same bed as the monitored infant.
By which age would the nurse expect an infant to be able to sit down from a standing position? a. 6 months b. 8 months c. 12 months d. 15 months
c. 12 months A 12-month-old infant should be able to sit down from a standing position without assistance.
The nurse would teach parents that which age is safe to give infants whole milk instead of commercial infant formula? a. 6 months b. 9 months c. 12 months d. 18 months
c. 12 months The American Academy of Pediatrics does not recommend theuse of cow's milk for children younger than 12 months. At 6 and 9 months, theinfant should be receiving commercial infant formula or breast milk. At age 18 months, milk and formula are supplemented with solid foods, water, and some fruit juices.
At which age does an infant start to recognize familiar faces and objects, such as a feeding bottle? a. 1 month b. 2 months c. 3 months d. 4 months
c. 3 months The child can recognize familiar objects at approximately age 3 months. For the first 2 months of life, infants watch and observe their surroundings. the4-month-old infant is able to anticipate feeding after seeing the bottle.
At which age can most infants sit steadily unsupported? a. 4 months b. 6 months c. 8 months d. 10 months
c. 8 months Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months, an infant can sit with support. At age 6 months, the infant will maintain a sitting position if propped. By 10 months, the infant can maneuver from a prone to a sitting position.
A nurse is conducting a teaching session for parents of infants. the nurse explains that which behavior indicates that an infant has developed object permanence? a. Recognizes familiar face, such as mother b. Recognizes familiar object, such as bottle c. Actively searches for a hidden object d. Secures objects by pulling on a string
c. Actively searches for a hidden object During the first 6 months of life, infants believe that objects exist only as long as they can see them. When infants search for an object that is out of sight, this signals the attainment of object permanence, whereby an infant knows an object exists even when it is not visible. Between ages 8 and 12 weeks, infants begin to respond differentially to the mother. They cry, smile, vocalize, and show distinct preference for the mother. This preference is one of the stages that influences the attachment process but is too early for object permanence. Recognizing familiar objects is an important transition for the infant, but it does not signal object permanence. the ability to understand cause and effect is part of secondary schemata development.
Which play is most typical of the preschool period? a. Solitary b. Parallel c. Associative d. Team
c. Associative Associative play is group play in similar or identical activities but without rigid organization or rules. Solitary play is that of infants. Parallel play is that of toddlers. School-age children play in teams.
Why are imaginary playmates beneficial to the preschool child? a. Take the place of social interactions b. Take the place of pets and other toys c. Become friends in times of loneliness d. Accomplish what the child has already successfully accomplished
c. Become friends in times of loneliness One purpose of an imaginary friend is to be a friend in time of loneliness. Imaginary friends do not take the place of social interaction, but may encourage conversation. Imaginary friends do not take the place of pets or toys. Imaginary friends accomplish what the child is still attempting.
A nurse is assessing a 12-month-old infant. Which statement best describes the infant's physical development a nurse would expect to find? a. Anterior fontanel closes by age 6 to 10 months. b. Binocularity is well established by age 8 months. c. Birth weight triples by age 1 year. d. Maternal iron stores persist during the first 12 months of life.
c. Birth weight triples by age 1 year. Growth is very rapid during thefirst year of life. thebirth weight has approximately doubled by age 5 to 6 months and triples by age 1 year. theanterior fontanel closes at age 12 to 18 months. Binocularity is not established until age 15 months. Maternal iron stores are usually depleted by age 6 months.
The nurse counsels the parents of an infant that which vitamin can cause a toxic reaction at a low dose? a. Niacin b. B6 c. D d. C
c. D Hypervitaminosis of vitamin D presents the greatest problem because this fat-soluble vitamin is stored in the body. Vitamin D is the most likely of all vitamins to cause toxic reactions in relatively small overdoses. the water-soluble vitamins, primarily niacin, B6, and C, can also cause toxicity but not at the low dose that occurs with vitamin D
Developmentally, which would most children at age 12 months be able to do? a. Use a spoon adeptly b. Relinquish the bottle voluntarily c. Eat the same food as the rest of the family d. Reject all solid food in preference to the bottle
c. Eat the same food as the rest of the family By age 12 months, most children are eating the same food that is prepared for the rest of the family. Using a spoon usually is not mastered until age 18 months. the parents should be engaged in weaning a child from a bottle if that is the source of liquid. Toddlers should be encouraged to drink from a cup at the first birthday and be weaned from the bottle totally by 14 months. the child should be weaned from a milk- or formula-based diet to a balanced diet that includes iron-rich sources of food.
Which injury prevention efforts are emphasized during the preschool period? a. Constant vigilance and protection b. Punishment for unsafe behaviors c. Education for safety and potential hazards d. Limitation of physical activities
c. Education for safety and potential hazards Education for safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers. Constant vigilance and protection is not practical at this age because preschoolers are becoming more independent. Punishment may make children scared of trying new things. Limitation of physical activities is not appropriate.
Which is the most frequent source of acute childhood lead poisoning? a. Folk remedies b. Unglazed lead pottery c. Lead-based paint d. Lead tainted ash
c. Lead-based paint Lead-based paint in houses built before 1978 is the most frequent source of lead poisoning. Some folk remedies and unglazed pottery may contain lead, but they are not the most frequent source. Cigarette butts and ashes do not contain lead.
Which snack would the nurse recommend parents offer to their slightly overweight preschool child? a. Carbonated beverage b. 10% fruit juice c. Low fat milk d. Whole milk
c. Low fat milk Milk and dairy products are excellent sources of calcium and vitamin D (fortified). Low-fat milk may be substituted, so the quantity of milk may remain the same while limiting fat intake overall. Parents should be educated regarding non-nutritious fruit drinks, which usually contain less than 10% fruit juice yet are often advertised as healthy and nutritious; sugar content is dramatically increased and often precludes an adequate intake of milk by the child. In young children, intake of carbonated beverages that are acidic or that contain high amounts of sugar is also known to contribute to dental caries. Low fat milk should be substituted for whole milk if the child is slightly overweight.
Which would the nurse suggest to the parents of an infant who has a prolonged need for middle-of-the-night feedings? a. Decrease daytime feedings. b. Allow child to go to sleep with a bottle. c. Offer last feeding as late as possible at night. d. Put infant to bed after asleep from rocking.
c. Offer last feeding as late as possible at night. To manage an infant who has a prolonged need for middle-of-the-night feedings parents should be taught to offer last feeding as late as possible at night. Parent should increase daytime feeding intervals to 4 hours or more (may need to be done gradually), offer no bottles in bed, put to bed awake and when child is crying, check at progressively longer intervals each night; reassure child but do not hold, rock, take to parent's bed, or give bottle or pacifier.
A 4-year-old child tells the nurse that she does not want another blood sample drawn because "I need all my insides, and I don't want anyone taking them out." Which is the nurse's best interpretation of this? a. Child is being overly dramatic. b. Child has a disturbed body image. c. Preschoolers have poorly defined body boundaries. d. Preschoolers normally have a good understanding of their bodies.
c. Preschoolers have poorly defined body boundaries. Preschoolers have little understanding of body boundaries, which leads to fears of mutilation. the child is not capable of being dramatic at 4 years of age. She truly has fear. Body image is just developing in the school-age child. Preschoolers do not have good understanding of their bodies.
Which would the nurse include in the instructions for seborrhea dermatitis (cradle cap)? a. Shampoo every three days with a mild soap. b. The hair should be shampooed with a medicated shampoo. c. Shampoo every day with a mild soap or antiseborrheic shampoo. d. The loosened crusts should not be removed with a fine-toothed comb.
c. Shampoo every day with a mild soap or antiseborrheic shampoo. When seborrheic lesions are present, the treatment is directed at removing the crusts. Parents are taught the appropriate procedure to clean the scalp. Shampooing should be done daily with a mild soap or commercial baby shampoo; medicated shampoos are not necessary, but an antiseborrheic shampoo containing sulfur and salicylic acid may be used. Shampoo is applied to the scalp and allowed to remain on the scalp until the crusts soften. Then the scalp is thoroughly rinsed. A finetooth comb or a soft facial brush helps remove the loosened crusts from the strands of hair after shampooing.
A toddler's parent asks the nurse for suggestions on dealing with temper tantrums. Which is the most appropriate recommendation? a. Punish the child. b. Leave the child alone until the tantrum is over. c. Stay calm and ignore the behavior. d. Explain to child that this is wrong.
c. Stay calm and ignore the behavior. The parent should be told that the best way to deal with temper tantrums is to ignore the behaviors, provided that the actions are not dangerous to the child. Tantrums are common in toddlers as the child becomes more independent and overwhelmed by increasingly complex tasks. the parents and caregivers need to have consistent and developmentally appropriate expectations. Punishment and explanations will not be beneficial. the parent's presence is necessary both for safety and to provide a feeling of control and security to the child when the tantrum is over.
According to Piaget, which describes magical thinking common in preschool age children? a. Events have cause and effect. b. God is like an imaginary friend. c. Thoughts are all-powerful. d. If the skin is broken, the child's insides will come out.
c. Thoughts are all-powerful. Because of their egocentrism and transductive reasoning, preschoolers believe that thoughts are all-powerful. Cause-and-effect implies logical thought, not magical thinking. Thinking God is like an imaginary friend is an example of concrete thinking in a preschooler's spiritual development. Thinking that if the skin is broken, the child's insides will come out is an example of concrete thinking in development of body image.
Rickets is caused by a deficiency in a. vitamin A. b. vitamin C. c. vitamin D. d. folic acid.
c. vitamin D. Fat-soluble vitamin D and calcium are necessary in adequate amounts to prevent thedevelopment of rickets. No correlation exists between vitamins A, C, folic acid, or iron and rickets.
The parents of a newborn say that their toddler is aggressive toward the infant and has commented the infant should "go back in mommy's tummy". Which is the nurse's best reply? a. "Let's see if we can figure out why he hates the new baby." b. "That's a strong statement to come from such a small boy." c. "Let's refer him to counseling to work this hatred out. It's not a normal response." d. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this.
d. "That is a normal response to the birth of a sibling. Let's look at ways to deal with this." The arrival of a new infant represents a crisis for even the best-prepared toddlers. They do not hate or resent the infant; rather, they hate the changes that this additional sibling produces, especially the separation from mother during the birth. This is a normal response.
By which age would the nurse expect that most children could obey prepositional phrases such as "under," "on top of," "beside," and "behind"? a. 18 months b. 24 months c. 3 years d. 4 years
d. 4 years At 4 years, children can understand directional phrases. Children at 18 months, 24 months, and 3 years are too young.
At which blood level is chelation therapy for lead poisoning initiated in a child? a. 10 to 14 g/dl b. 15 to 19 g/dl c. 20 to 44 g/dl d. 45 g/dl
d. 45 g/dl Chelation therapy is initiated if the child's blood level is greater than or equal to 45 g/dl. At 10 to 14 g/dl, the family should have lead-poisoning education and follow-up level. At 15 to 19 g/dl, the family should have lead-poisoning education and follow-up level but if it persists, initiate environmental investigation. At 20 to 44 g/dl environmental investigation and lead hazard control are necessary.
The psychosocial developmental tasks of toddlerhood include which characteristic? a. Development of a conscience b. Recognition of sex differences c. Ability to get along with age-mates d. Ability to delay gratification
d. Ability to delay gratification If the need for basic trust has been satisfied, then toddlers can give up dependence for control, independence, and autonomy. One of the tasks that the toddler is concerned with is the ability to delay gratification. Development of a conscience occurs during the preschool years. the recognition of sex differences occurs during the preschool years. the ability to get along with age-mates develops during the preschool and school-age years.
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is often prone (face down) while awake. Which knowledge would the nurse's response should be based? a. Unacceptable because of the risk of sudden infant death syndrome (SIDS) b. Unacceptable because it does not encourage achievement of developmental milestones c. Acceptable to encourage fine motor development d. Acceptable to encourage head control and turning over
d. Acceptable to encourage head control and turning over These parents are implementing theguidelines to reduce therisk of SIDS. Infants should sleep on their backs and then be placed on their abdomens when awake to enhance development of milestones such as head control. theface-down position while awake and on theback for sleep are acceptable because they reduce risk of SIDS and allow achievement of developmental milestones. These position changes encourage gross motor, not fine motor, development.
Which intervention would the nurse implement when feeding a 12-month-old infant with failure to thrive? a. Provide stimulation during feeding. b. Avoid being persistent during feeding time. c. Limit feeding time to 10 minutes. d. Assess difficulties encountered during feeding.
d. Assess difficulties encountered during feeding. The nurse preparing to feed an infant with failure to thrive should maintain a face-to-face posture with theinfant when possible. Encourage eye contact and remain with theinfant throughout themeal. Stimulation is not recommended; a quiet, unstimulating atmosphere should be maintained. Persistence during feeding may need to be implemented. Calm perseverance through 10 to 15 minutes of food refusal will eventually diminish negative behavior. Although forced feeding is avoided, "strictly encouraged" feeding is essential. the length of the feeding should be established (usually 30 minutes); limiting the feeding to 10 minutes would make the infant feel rushed
Which would the nurse expect of a healthy 3-year-old child? a. Jump rope b. Ride a two-wheel bicycle c. Skip on alternate feet d. Balance on one foot for a few seconds
d. Balance on one foot for a few seconds Three-year-olds are able to accomplish this gross motor skill. Jumping rope, riding a two-wheel bicycle, and skipping on alternate feet are gross motor skills of 5-year-olds.
The nurse who is caring for a preschool aged child who aspirated a small amount of paint thinner knows which condition(s) may be diagnosed? a. Hepatic dysfunction b. Dehydration secondary to vomiting c. Esophageal stricture and shock d. Bronchitis and chemical pneumonia
d. Bronchitis and chemical pneumonia Paint thinner is a hydrocarbon. the immediate danger is aspiration. Acetaminophen overdose, not hydrocarbons, causes hepatic dysfunction. Dehydration is not the primary danger. Esophageal stricture is a late or chronic issue of hydrocarbon ingestion.
The nurse recommends to parents that peanuts are not a good snack food for toddlers. Which is the nurse's rationale for this action? a. Low in nutritive value b. High in sodium c. Cannot be entirely digested d. Can be easily aspirated
d. Can be easily aspirated Foreign-body aspiration is common during the second year of life. Although they chew well, this age child may have difficulty with large pieces of food, such as meat and whole hot dogs, and with hard foods, such as nuts or dried beans. Peanuts have many beneficial nutrients, but should be avoided because of the risk of aspiration in this age group. the sodium level may be a concern, but the risk of aspiration is more important. Many foods pass through the gastrointestinal tract incompletely undigested. This is not necessarily detrimental to the child.
In terms of fine motor development, which would the3-year-old child be expected to do? a. Lace shoes and tie shoelaces with a bow. b. Use scissors to cut pictures, and print a few numbers. c. Draw a person with seven parts and correctly identify the parts. d. Draw a circle and name what has been drawn.
d. Draw a circle and name what has been drawn. Three-year-olds are able to accomplish this fine motor skill. Being able to lace shoes and tie shoelaces with a bow, use scissors to cut pictures, and print a few numbers, or draw a person with seven parts and correctly identify the parts are fine motor skills of 4- or 5-year-olds.
The nurse suspects that a child has ingested some type of poison. Which clinical manifestation would be most suggestive that the poison was a corrosive product? a. Tinnitus b. Disorientation c. Stupor, lethargy, coma d. Edema of lips, tongue, pharynx
d. Edema of lips, tongue, pharynx Edema of lips, tongue, and pharynx indicates a corrosive ingestion. Tinnitus is indicative of aspirin ingestion. Corrosives do not act on thecentral nervous system (CNS).
Which is an important nursing responsibility when dealing with a family experiencing the loss of an infant from sudden infant death syndrome (SIDS)? a. Explain how SIDS could have been predicted and prevented. b. Interview parents in depth concerning the circumstances surrounding the child's death. c. Discourage parents from making a last visit with the infant. d. Ensure arrangements are made for a follow-up home visit to parents as soon as possible after the child's death.
d. Ensure arrangements are made for a follow-up home visit to parents as soon as possible after the child's death. A competent, qualified professional should visit the family at home as soon as possible after the death and provide the family with printed information about SIDS. An explanation of how SIDS could have been predicted and prevented is inappropriate. SIDS cannot be prevented or predicted. Discussions about the cause will only increase parental guilt. the parents should be asked only factual questions to determine the cause of death. Parents should be allowed and encouraged to make a last visit with their child.
Which vitamin is recommended for all women of childbearing age to reduce the risk of neural tube defects? a. A b. C c. Niacin d. Folic acid
d. Folic acid The vitamin supplement that is recommended for all women of childbearing age is a daily dose of 0.4 mg of folic acid. Folic acid taken before conception and during pregnancy can reduce therisk of neural tube defects by 70%. No correlation exists between vitamins A, C, or folic acid and neural tube defects.
Which is an appropriate action when an infant becomes apneic? a. Shake vigorously b. Roll head side to side c. Hold by feet upside down with head supported d. Gently stimulate trunk by patting or rubbing
d. Gently stimulate trunk by patting or rubbing If the infant is apneic, the infant's trunk should be gently stimulated by patting or rubbing. If the infant is prone, turn onto the back. the infant should not be shaken vigorously, the head rolled side to side, or held by the feet upside down with the head supported. These can cause injury.
Which is probably the most important criterion on which to base the decision to report suspected child abuse? a. Inappropriate parental concern for the degree of injury b. Absence of parents for questioning about child's injuries c. Inappropriate response of child d. Incompatibility between the history and injury observed
d. Incompatibility between the history and injury observed Conflicting stories about the "accident" are the most indicative red flags of abuse. Inappropriate response of caregiver or child may be present, but is subjective. Parents should be questioned at some point during the investigation.
Parents tell the nurse that their 6-month-old son often sleeps with them. They seem unconcerned about this. the nurse's response would be based on which statement? a. Separation from parents should be completed by this age. b. Daytime attention should be increased. c. This is a common and accepted practice, especially in some cultural groups. d. Infants should not sleep in an adult bed due to therisk of suffocation.
d. Infants should not sleep in an adult bed due to the risk of suffocation. Co-sleeping, or sharing the family bed, in which the parents allow the children to sleep with them, is a common and accepted practice in many cultures. Parents should evaluate the options available and avoid conditions that place the infant at risk. Population-based studies are currently under way; no evidence at this time supports or condemns the practice for safety reasons. Cosleeping is a cultural practice. One year is the age at which children are just beginning to individuate. Increased daytime activity may help decrease sleep problems in general, but cosleeping is a culturally determined phenomenon.
The practitioner has ordered activated charcoal for a young child who ingested a large amount of acetylsalicylic acid at home. the nurse administers charcoal in which way? a. Administer through a nasogastric tube because the child will not drink it because of the taste. b. Mix in food such as mashed potatoes. c. Give half of the solution, and then give the other half in 1 hour. d. Mix with water to form a slurry.
d. Mix with water to form a slurry. Although the activated charcoal can be mixed with a flavorful beverage, it will be black and resemble mud. When it is served in an opaque container, the child does not have any preconceived ideas about its being distasteful. the nasogastric tube should be used only in children without a gag reflex. the ability to see the charcoal solution may affect the child's desire to drink it. the child should be encouraged to drink the solution all at once.
A parent asks the nurse about negativism in toddlers. Which is the most appropriate recommendation? a. Punish the child. b. Provide more attention. c. Ignore the child who says "no." d. Reduce the opportunities for a "no" answer.
d. Reduce the opportunities for a "no" answer. The nurse should suggest to the parent that questions be phrased with realistic choices rather than yes or no answers. This provides the toddler with a sense of control and reduces the opportunity for negativism. Negativism is not an indication of stubbornness or insolence and should not be punished. the negativism is not a function of attention; the child is testing limits to gain an understanding of the world. the toddler is too young to be asked to not always say "no."
A father tells the nurse that his daughter wants the same plate and cup used at every meal, even if they go to a restaurant. Which would the nurse explain to the father? a. This behavior is abnormal b. Used as a way to exert unhealthy control c. Regression is common at this age d. Ritualism is common at this age
d. Ritualism is common at this age The child is exhibiting the ritualism that is characteristic at this age. Ritualism is the need to maintain sameness and reliability. It provides a sense of comfort to the toddler. It will dictate certain principles in feeding practices, including rejecting a favorite food because it is served in a different container. Ritualism is not indicative of a child who has unreasonable expectations, but rather normal development. Toddlers use ritualistic behaviors to maintain necessary structure in their lives. This is not regression, which is a retreat from a present pattern of functioning.
What is a late symptom of acute acetylsalicylic acid poisoning? a. Chemical pneumonitis b. Hepatic damage c. Retractions and grunting d. Seizures
d. Seizures Hyperactivity, fever, confusion, seizures, renal and respiratory failure are late symptoms of acute acetylsalicylic poisoning.
Which factor predisposes toddlers to frequent infections? a. Respirations are abdominal. b. Pulse and respiratory rates are slower than those in infancy. c. Defense mechanisms are less efficient than those during infancy. d. Short, straight internal ear canal and large lymph tissue.
d. Short, straight internal ear canal and large lymph tissue. Toddlers continue to have the short, straight internal ear canal of infants. the lymphoid tissue of the tonsils and adenoids continues to be relatively large. These two anatomic conditions combine to predispose the toddler to frequent infections. the abdominal respirations and lowered pulse and respiratory rate of toddlers do not affect their susceptibility to infection. the defense mechanisms are more efficient compared with those of infancy.
Which characteristic best describes the language of a 3-year-old child? a. Asks meanings of words b. Follows directional commands c. Describes an object according to its composition d. Talks incessantly regardless of whether anyone is listening
d. Talks incessantly regardless of whether anyone is listening Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly regardless of whether anyone is listening. A 4- to 5-year-old asks lots of questions and can follow simple directional commands. A 6-year-old can describe an object according to its composition.
A nurse is planning care for a 17-month-old child. According to Piaget, which stage would the nurse expect the child to be in cognitively? a. Trust b. Preoperational c. Secondary circular reaction d. Tertiary circular reaction
d. Tertiary circular reaction The 17-month-old child is in the fifth stage of the sensorimotor phase, tertiary circular reactions. the child uses active experimentation to achieve previously unattainable goals. Trust is Erikson's first stage. Preoperational is the stage of cognitive development usually present in older toddlers and preschoolers. Secondary circular reactions last from about ages 4 to 8 months.
The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stools. the nurse's explanation of this is based on which statement? a. Child should not be given fibrous foods until digestive tract matures at age 4 years. b. Child should not be given any solid foods until this digestive problem is resolved. c. This is abnormal and requires further investigation. d. This is normal because of the immaturity of digestive processes at this age.
d. This is normal because of the immaturity of digestive processes at this age. The immaturity of the digestive tract is evident in the appearance of the stools. Solid foods are passed incompletely broken down in the feces. An excess quantity of fiber predisposes the child to large, bulky stools. This is normal for the child and is a normal part of the maturational process; no further investigation is necessary.
Children on vegan diets are at risk for a deficiency of which substance? a. Fat b. Protein c. Vitamin C d. Vitamin B12
d. Vitamin B12 Children on vegetarian diets, especially vegan diets are at risk for vitamin B12 deficiency, so it must be ensured that an adequate source of this vitamin is consumed through either supplements or fortified foods. Fats, proteins and vitamin C can be obtained from a variety of fruits, vegetables, legumes, and nuts.
Which characteristic best describes the gross motor skills of a 24-month-old child? a. Skips and can hop in place on one-foot b. Rides tricycle and broad jumps c. Jumps with both feet and stands on one foot momentarily d. Walks up and down stairs and runs with a wide stance
d. Walks up and down stairs and runs with a wide stance The 24-month-old child can go up and down stairs alone with two feet on each step and runs with a wide stance. Skipping and hopping on one foot are achieved by 4-year-old children. Jumping with both feet and standing on one foot momentarily are achieved by 30-month-old children. Tricycle riding and broad jumping are achieved at age 3.