Peds 12

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The quality of the food consumed is more important than the quantity T or F

T

What factors should the nurse include in the teaching plan regarding the physical growth of a preschooler?

Physical growth of a preschooler slows and stabilizes. The average child gains about 2.3 kg (5 pounds) per year and increases in height by about 6.5 to 9 cm (2.5 to 3.5 inches) per year

How could the nurse guide a mother on family-centered care during the preschool years?

The nurse could inform the mother to expect a tranquil period at 5 years of age; help the mother prepare him for entrance into school; ensure the child is up-to-date on immunizations; suggest that unemployed parental caregivers consider their own activities when the child begins school; and suggest swimming lessons or other activities for the child

Piaget's preoperational phase consists of which two phases?

The preconceptual phase (ages 2 to 4 years) The phase of intuitive thought (ages 4 to 7 years)

What does the nurse identify as the most important aspect of a preschool or daycare program?

The social climate, type of guidance, and attitude toward the children that is fostered by the teacher or leader rather than whether structured learning is imposed

Which observation is associated with nightmares as opposed to sleep terrors? a. Child has no memory of the event or dream like state. b. Has a hard time returning to sleep following the event. c. Thrashing type behaviors continue when the child awakens. d. Is not comforted by traditional methods of contact.

b. Has a hard time returning to sleep following the event.

A 4-year-old child is seen playing with his father while waiting in the clinic area for a well checkup visit. The nurse observing the interaction notes that this behavior as being an example of? a. Imaginative play b. Mutual play c. Dramatic play d. Avoidance play

b. Mutual play

The best approach for effective communication with a preschooler is through a. speech. b. play. c. drawing. d. actions.

b. play.

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of a. identity. b. intimacy. c. initiative. d. industry.

c. initiative.

Identify the two rules that govern answering a child's questions about sex or other sensitive issues

determine what the child knows and thinks be honest with responses

The most critical period for speech development occurs between ___ and ___ years of age

2, 4

The preschool years range from ___ to ___ years of age

3, 5

What sleep problems that might concern parents typically occur in the preschool age group?

An inability to fall asleep, bedtime fears, waking during the night, nightmares, prolonging bedtime through rituals

During preschool, the separation-individuation process is completed T or F

F

Identify three functions served by imaginary playmates

They become friends for the child in times of loneliness They accomplish what the child is still attempting They experience what the child wants to forget or remember

Development of the ___ is strongly linked to spiritual development

conscience

What are some of the preschool child's most common fears?

fear of the dark, being left alone, animals, ghosts, sexual matters, objects or persons associated with pain

What is the most important factor in terms of the overall evaluation of a nursery school or daycare center?

personal observation

___ in the preschool child is a normal part of sexual curiosity and exploration

masturbation

Preschoolers are forming strong attachments to the ___ parent while identifying with the ___ parent

opposite-sex, same-sex

According to Piaget, ___ becomes the child's way of understanding, adjusting to, and working out life's experiences

play

Protein requirements increase with age, and the recommended intake for preschoolers is ___ to ___ g/day

13, 19

An average child can be expected to have a vocabulary of more than ___ words by the age of 6 years

2100

By ___ years of age, the child skips on alternate feet, jumps rope, and begins to skate and swim

5

In children over 2 years of age, intake of fiber, fruits, and vegetables should equal the child's age plus ___ g/day

5

According to Erikson, the chief psychosocial task of the preschool period is acquiring a sense of ___. Conflict arises when preschoolers experience ___

initiative, guilt

Identify why preschool years are a prime time for sleep disturbances

As toddlers and preschoolers cope with autonomy, separation, and object permanence, they begin to have more sleep problems. Some have trouble going to sleep, especially after so much activity and stimulation during the day. Others may develop bedtime fears, wake during the night, or have nightmares or sleep terrors. Still others may prolong the inevitable through elaborate rituals

Describe the type of play most apparent during the preschool years

Associative play is defined as group play in similar or identical activities but without rigid organization or rules

Why is preschool age an appropriate time to begin sex education?

At about age 3 years, children are aware of anatomic differences between the sexes and are concerned with how the anatomy of the opposite sex works. They are really concerned about eliminative functions. This leads to physical exploration and questions to obtain more information

Preschoolers' thinking is often magical. What does this mean?

Because of their egocentrism and transductive reasoning, preschoolers believe their thoughts are all-powerful

Why are young children especially vulnerable to stress?

Because of their limited capacity to cope

What is the best way to help children overcome their fears?

By actively involving them in finding practical methods to deal with the frightening experience

Contrast language development in 3- to 4-year-old children with language development in 4- to 5-year-old children

Children aged 3 to 4 years can speak in sentences of three or four words. Their speech is telegraphic. They ask questions and use plurals and past-tense verbs. They can name familiar objects. Children aged 4 to 5 years use sentences of four to five words. They can repeat a question until they receive an answer

What should parents be informed of regarding the intake of carbonated beverages in young children?

Carbonated beverages are known to contribute to dental caries, and they also provide nonnutritive calories that may displace or preclude the intake of nutrients necessary for growth

Describe how preschoolers use causality and give an example

Causality resembles logical thought. Preschoolers explain a concept as they have heard it described by others, but their understanding is limited. The concept of time is an example of causality

What types of toys, playthings, and activities could be recommended to foster a 5-year-old's development in dramatic play?

Dress-up clothes, dolls, housekeeping toys, dollhouses, play-store toys, telephones, toy farm animals and equipment, trains, trucks, cars, planes, hand puppets, and doctor and nurse kits

Identify three developmental milestones that a 5-year-old should have accomplished in language development

Has a vocabulary of 2100 words; uses six- to eight-word sentences; names coins and names four or more colors; describes drawing; knows days of the week and names of months; can follow three commands in succession

Why are bandages critical to the preschooler who has just had abdominal surgery?

Intrusive experiences are frightening, especially those that disrupt the integrity of the skin, such as injections and surgery. They fear that if their skin is "broken," all of their blood and "insides" can leak out. Therefore bandages are critical to "keep everything from coming out"

What types of toys, playthings, and activities could be recommended to foster a 5-year-old's development in physical play?

Jumping, running, climbing, swimming, skiing, skating, tricycles, scooter trucks, wagons, gym and sports equipment, sandboxes, wading pools, and winter sleds

List three opportunities that nursery schools and daycare centers provide for children

Learning group cooperation; adjusting to various sociocultural differences; coping with frustration, dissatisfaction, and anger

List the four steps parents should take in assessing a preschool

Meet the director Meet some of the caregivers or teachers Systematically evaluate the facility in comparison with others Observe the program in action

Differentiate between nightmares and sleep terrors

Nightmares are scary dreams that take place during rapid eye movement (REM) sleep and are followed by full awakening. After the nightmare is over, the child wakes and cries. Night terrors are a partial arousal from very deep non-REM sleep. The child screams and thrashes during the terror and then is calm

Identify four ways parents should prepare children for preschool

Present the idea of school as exciting and pleasurable Talk to the child about the activities that he or she will participate in at school Introduce the child to the teacher and familiarize him or her with the school Provide the school with detailed information about the child's home environment, such as familiar routines and food preferences

Identify the five factors that differentiate "problematic" aggression from "normal" aggression

Quantity (number of occurrences) Severity (interference with function) Distribution (different manifestations) Onset (sudden change in behavior) Duration (at least 4 weeks)

How often should routine dental care by a dentist be provided to preschoolers?

Routine dental care should be well established during preschool years and is recommended at 6- to 12-month intervals, depending on the family history, the child's dental development, and the presence or absence of dental caries

Identify three developmental milestones that a 5-year-old should have accomplished in gross motor development

Skips and hops on alternate feet; throws and catches ball well; jumps rope; skates with good balance; walks backward with heel to toe; jumps from height of 12 inches and lands on toes; balances on alternate feet with eyes closed

The Denver Articulation Screening Examination is an excellent tool for assessing a child's articulation skills T or F

T

Although preschoolers' fine motor control is improved, they still require assistance and supervision with brushing, and flossing should be performed by parents T or F

T

During the preschool years, the emphasis in injury prevention is placed on education for safety and potential hazards to prevent injury T or F

T

During the preschool years, vocabulary increases dramatically T or F

T

In preschoolers' minds, calling them bad means they are bad persons T or F

T

Preschoolers increasingly use language without comprehending the meaning of words, particularly concepts of right and left, causality, and time T or F

T

A variety of health problems among adults is thought to be influenced by eating patterns established in the preschool years. What goal would you encourage parents to achieve related to the intake of fat in this age group?

The American Academy of Pediatrics Committee on Nutrition recommends that by 5 years old, fatty acid consumption should be less than 10% of caloric intake. Parents should provide foods with less saturated fat (e.g., low-fat milk) and consider including soy-enriched foods

Thom has had an imaginary friend, named "Boy," since he turned 3 years old. His mother is beginning to wonder whether "Boy" will be with Thom forever. What information should the nurse give Thom's mother regarding imaginary friends?

The nurse could inform Thom's mother that imaginary friends typically show up at around 3 years of age and stop when the child enters school. Firstborn and only children are more likely to have an imaginary friend. It might help to inform Thom's mother that imaginary friends serve three purposes: they become friends in times of loneliness, they accomplish what the child is still attempting, and they experience what the child wants to forget or remember. Reassure Thom's mother that his fantasy is a sign of health that helps him differentiate between make-believe and reality

Identify three developmental milestones that a 5-year-old should have accomplished in fine motor development

Ties shoelaces; uses scissors well; copies a diamond and triangle; prints a few letters, numbers, or words

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age group? Select all that apply. a. Falls b. Drowning c. Poisoning d. Sports injuries e. Tricycle and bicycle accidents

a. Falls b. Drowning c. Poisoning e. Tricycle and bicycle accidents

Parents are concerned about the behavior of their preschool child as he is exhibiting aggressive behavior in interactions with other children. Which information would be relevant in determining if the behavior represents an abnormal pattern? Select all that apply. a. How many times this type of behavior has occurred in recent weeks? b. Does the behavior seem to be escalating? c. How long has this behavior been going on? d. Do you think that the behavior is warranted considering the situation that has occurred?

a. How many times this type of behavior has occurred in recent weeks? b. Does the behavior seem to be escalating?

Which is descriptive of the nutritional requirements of preschool children? a. The quality of the food consumed is more important than the quantity. b. Nutritional requirements for preschoolers are different from requirements for toddlers. c. The requirement for calories per unit of body weight increases slightly during the preschool period. d. The average daily intake of preschoolers should be about 3000 calories.

a. The quality of the food consumed is more important than the quantity.

There are no absolute indicators for school readiness, but the child's social maturation, especially ___ is as important as his or her academic readiness

attention span

When preparing parents to teach their preschool child about human sexuality, what should the nurse emphasize? a. A parent's words may have a greater influence on the child's understanding than the parent's actions. b. Parents should determine exactly what the child wants to know before answering a question about sexuality. c. Parents should avoid using correct anatomic terms because they are confusing to the preschooler. d. Parents should encourage preschoolers to satisfy their sexual curiosity by playing "doctor."

b. Parents should determine exactly what the child wants to know before answering a question about sexuality.

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is a. unsafe play that should be discouraged. b. creative play that should be encouraged. c. suggestive of limited family resources. d. suggestive of limited adult supervision.

b. creative play that should be encouraged.

A 4½-year-old boy has been having increasingly frequent angry outbursts in preschool for approximately 8 to 10 weeks. In addition, he is aggressive toward the other children and teachers. His parents ask the nurse for advice. The most appropriate nursing intervention is to a. explain that this is normal in preschoolers, especially boys. b. refer the child for counseling. c. talk to the preschool teacher to obtain validation for the behavior the parent reports. d. encourage the parent to try more consistent and firm discipline.

b. refer the child for counseling.

Kimberly, age 4 years, sometimes wakes her parents up at night, screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This most likely scenario is a. nightmares. b. sleep terrors. c. seizure activity. d. sleep apnea.

b. sleep terrors.

The nurse is giving anticipatory guidance to the parent of a 5-year-old. What is the most appropriate information to include? a. Prepare the parent for increased aggression. b. Encourage the parent to offer the child choices. c. Inform the parent that he or she can expect a more tranquil period at this age. d. Advise the parent that this is the age when stuttering may develop.

c. Inform the parent that he or she can expect a more tranquil period at this age.

The preschooler's body image has developed to include a. a well-defined body boundary. b. knowledge about his or her internal anatomy. c. fear of intrusive procedures. d. fear of looking different from his or her friends.

c. fear of intrusive procedures.

The two rules used to provide sensitive information to a preschooler focus on a. describing the information in a succinct way and answering any questions. b. ask the child if he/she understands what you have told them and then clarify any additional questions. c. find out what they know and think and then be honest. d. use the opportunity to provide minimal information and keep the level of interaction simple.

c. find out what they know and think and then be honest.

The parents of a 4½-year-old girl are worried because she has an imaginary playmate. Based on the nurse's knowledge of the preschooler, the most appropriate response is a. a psychosocial evaluation is indicated. b. an evaluation of possible parent-child conflict is indicated. c. having imaginary playmates is normal and useful at this age. d. having imaginary playmates is abnormal after age 2 years.

c. having imaginary playmates is normal and useful at this age.

During a well-child visit, the father of a 4-year-old child tells the nurse that he is not certain if his child is ready for kindergarten. The child's birthday is close to the cutoff date, and the child has not attended preschool. The most appropriate recommendation by the nurse is to a. encourage the father to have the child start kindergarten. b. recommend to the father that he postpone kindergarten and send the child to preschool. c. refer the child for developmental screening and make a recommendation based on the results. d. have the father observe a kindergarten class and then decide if his child would enjoy the experience.

c. refer the child for developmental screening and make a recommendation based on the results.

By what age would the nurse expect most children to use sentences of four or five words? a. 18 months b. 24 months c. 3 years d. 4½ years

d. 4½ years

Ashley, age 4½ years, is afraid of dogs. What should the nurse recommend to her parents to help her with this fear? a. Keep her away from dogs. b. Buy her a stuffed dog toy. c. Force her to touch a dog briefly. d. Let her watch other children play with a dog.

d. Let her watch other children play with a dog.

Excessive consumption of ___ has been associated with adverse health effects, such as dental caries and gastrointestinal symptoms

fruit juices

One of the tasks related to the preschool period is ___ for school and scholastic learning

readiness

The rate of physical growth ___ and ___ during the preschool years

slows, stabilizes

The failure to master sensorimotor integrations results in ___ during the preschool years. Is this finding more frequent in boys or girls?

stuttering, boys


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