Peds CH3 PrepU
The infant weighs 6 lbs. 8 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of four months? a) 16 lbs. b) 13 lbs. c) 15 lbs. 4 oz. d) 10 lbs. 8 oz.
B) 13 lbs. Most infants double their birthweight by 4 months of age and triple their birthweight by the time they are 1 year old.
Martha asks the nurse if her 2-month-old could have baby bananas yet. The nurse would respond and educate Martha on the nutrition stages of infants by which of these responses? a) "In two months you can try bananas if you think she is ready." b) "When did you feed your other child bananas? c) "Sure, if you feel she is ready to have bananas." d) "In one month you can try bananas if you think she is ready."
A) "In two months you can try bananas if you think she is ready." The nurse should choose this response because no solid foods are recommended for infants until 3 months of age. The age of 4 to 6 months is the age recommended to introduce solid foods. The other responses are the incorrect age or are letting the parent decide the appropriate answer.
Which of the following would you include when teaching the parents of an infant about colic? a) Colic symptoms will probably fade at 3 months of age. b) Symptoms will decrease if she is laid on her back after feedings. c) Their child will need future follow-up for a "nervous" bowel. d) Formula intake should be doubled to keep her from losing weight.
A) Colic symptoms will probably fade at 3 months of age.
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Turning a doorknob b) Building a tower of four cubes c) Sitting independently d) Walking independently
C) Sitting independently Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old. (less)
The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1? a) Uses speech-like rhythm when talking with an adult b) Uses multisyllabic babbling c) Understands "no" and other simple commands d) Squeals and makes pleasure sound
Understands "no" and other simple commands At age 1, most babies understand the word "no" and other simple commands. Children at this age also learn one or two other words. Babies squeal, make pleasure sounds, and use multisyllabic babbling at age 6 months. Using speech-like rhythm when talking with an adult usually occurs between ages 9 to 12 months
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a) Pushing a spoon from her high chair tray to the floor b) Looking for a toy in her crib at the last place she saw it c) Shaking a rattle to enjoy the sound d) Smiling at herself in the mirror
B) Looking for a toy in her crib at the last place she saw it Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant behaviors show use of her senses and motor activity but do not illustrate object permanence.
The best way for an infant's father to help his child complete the developmental task of the first year is to a) talk to her at a special time each day. b) keep her stimulated with many toys. c) expose her to many caregivers to help her learn variability. d) respond to her consistently.
D) Respond to her consistently. A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust.
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a) The growth of a 5-month-old b) The development of a 10-week-old c) The growth of a 2-month-old d) The development of a 3-month-old
D) The development of a 3-month-old The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.
A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how? a) "Bed sharing has positive effects on babies, let me get you information." b) "Sure, you can, make sure you use a soft mattress for support." c) "Bed sharing is okay, just make sure the infant is between two people." d) "Sure, you can do whatever you want, it is your baby."
A) Bed sharing has positive effects on babies, let me get you information." The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? a) 1 to 3 natal teeth b) 1 to 2 lower teeth c) 1 upper tooth d) No teeth
D) No teeth Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.
The infant in the exam room has the following signs and symptoms. Which ones will the nurse attribute to teething? (Select all that apply.) a) Drooling and biting b) Refusing to eat c) Irritability and awakening from sleep d) Increased sucking on hands e) Fever and diarrhea
Drooling and biting Refusing to eat Irritability and awakening from sleep Increased sucking on hands
The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern? a) Head size has increased 5 in (12 cm) since birth. b) The child weighs 10 lb 2 oz (4.6 kg). c) The child measures 21 in (53 cm) in length. d) The child exhibits palmar grasp reflex.
A) Head size has increased 5 in (12 cm) since birth. The child's head size is large for his adjusted age of 4 months, which would be cause for concern. Normal growth would be 3.6 in (9 cm). At 10 lb, 2 oz (12 cm), the child is the right weight for a 4-month-old adjusted age. Palmar grasp reflex disappears between 4 and 6 months adjusted age, so this would not be a concern yet. The child is of average weight for a 4-month-old adjusted age.
The nurse goes in to check on Lilly and how breast-feeding is going with her new son. The nurse observes the infant is on her lap with the blanket unwrapped, and Lilly is washing his face, and gently stroking the baby. Lily has had trouble breast-feeding the last few times. What is the appropriate response from her nurse? a) "Lilly, you are doing a wonderful job attempting to waken the baby." b) "Lilly, you will never get him to eat all unwrapped like that." c) "Lilly, maybe you should watch the breast-feeding video again." d) "Lilly, that is not how you get him to eat."
A) Lilly, you are doing a wonderful job attempting to waken the baby." The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breast-fed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment
The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively? a) Maintain adequate diet and fluid intake b) Apply warm compresses to the breast c) Maintain a feed-on-demand approach d) Encourage the infant to latch on properly
A) Maintain a feed-on-demand approach The best way to ensure effective feeding is by maintaining a feed-on-demand approach rather than a set schedule. Applying warm compresses to the breast helps engorgement. Encouraging the infant to latch on properly helps prevent sore nipples. Maintaining proper diet and fluid intake for the mother helps ensure an adequate milk supply.
Which of the following milestones would you expect an infant to accomplish by 8 months of age? a) Sitting without support b) Being able to sit from a standing position c) Creeping on all fours d) Pulling self to a standing position
A) Sitting without support Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines: a) The child weighs less than expected for age. b) The weight assessment is blatantly inaccurate. c) The child weighs more than expected for age. d) The child weighs the expected amount for age.
A) The child weighs less than expected for age. Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) They put her to bed when she falls asleep. b) The child has a regular, scheduled bedtime. c) They sing to her before she goes to sleep. d) If she is safe, they lie her down and leave.
A) They put her to bed when she falls asleep. If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices
The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be: a) "You could give your baby a bottle of water at bedtime occasionally." b) "Bottles given at bedtime can cause erosion of the enamel on the teeth." c) "Giving your baby a pacifier at bedtime will satisfy the need to suck." d) "Giving a bottle of milk when the infant goes to bed can lead to obesity."
B) Bottles given at bedtime can cause erosion of the enamel on the teeth." The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable (D) and a pacifier will satisfy the sucking need (C), the most appropriate response is B. Giving a bottle at bedtime is not a factor that leads to obesity.
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? a) Choosing soft foods over hard foods b) Increased biting and sucking c) Running a mild fever or vomiting d) Frequent loose stools
B) Increased biting and sucking The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on
Anticipatory guidance for an infant for the 4th month should include the fact that she probably will a) insist on things being done her way. b) be able to turn over onto the back. c) develop a fear of strangers. d) have many "blue" or moody periods.
B) be able to turn over onto the back. Infants typically turn over front to back at 4 months, enlarging the area of the house that needs to be childproofed.
Julie is an 18-year-old new mother. When the nurse discharges the mom and infant, she notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? a) "With the car seat in front, you can keep an eye on your baby." b) "You should never put the car seat in the front." c) "Let me go over car seat safety with you, so you can install your car seat properly." d) "I see you have a car seat, that is great."
C) "Let me go over car seat safety with you, so you can install your car seat properly." The nurse should notice this is not the proper place for a car seat. The car seat should be rear facing and in the center of the back seat of the car. The nurse would review car seat safety with Julie and have Julie install the seat properly. The nurse should provide written materials if available. The other responses are not appropriate and do not ensure that proper installation will occur and that infant safety will be maintained
A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her? a) Be sure to give the baby a complete bath every day b) Be sure to oil the scalp with mineral oil and leave it on overnight before bathing the infant the next day c) Be sure to wash the infant's face, hands, and diaper area daily d) Be sure to brush the scalp with a soft toothbrush during the bath to prevent seborrhea
C) Be sure to wash the infant's face, hands, and diaper area daily Except in very hot weather, an infant does not need a bath every day. If a parent is tired and would not enjoy bath time or if some days are just too rushed, a complete bath can be omitted, with only the infant's face, hands, and diaper area washed. Some infants do need their head and scalp washed frequently (every day or every other day) to prevent seborrhea, a scaly scalp condition often called cradle cap. If seborrhea lesions do develop, they adhere to the scalp in yellow, crusty patches. The skin beneath them may be slightly erythematous. The patches can be softened by oiling the scalp with mineral oil or petroleum jelly and leaving it on overnight. The crusts can then be removed by shampooing the hair the next morning. A soft toothbrush or fine-toothed comb can be used to help remove them
The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a) Actively urge the child to eat new foods b) Let the child eat only the foods she prefers c) Serve new foods several times d) Provide small portions that must be eaten
C) Serve new foods several times When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns
In working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant. a) The child has an increased attention span and can be interested in an activity for a long length of time b) The child takes in new information at a rapid rate and asks "why" and "how" c) The child grows and develops skills more rapidly than at any other time in their life d) The child insists they can "do it," the next moment they revert to being dependent
C) The child grows and develops skills more rapidly than at any other time in their life The infant grows and develops skills more rapidly than he or she ever will again. The toddler insists they can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother: a) most newborns need to eat about 4 times per day. b) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night. c) the newborn's stomach can hold between one-half to 1 ounce. d) the best feeding schedule offers food every 4 to 6 hours.
C) the newborn's stomach can hold between one-half to 1 ounce. The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1½ to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night
The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months? a) 25 lbs. b) 28 lbs. 4 oz. c) 14 lbs. 8 oz. d) 21 lbs. 12 oz.
D) 21 lbs. 12 oz. By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.
What is the correct amount of urine diapers a mature infant should have each day? a) An infant should have 1 to 2 wet diapers/day. b) An infant should have 9 to 10 wet diapers/day. c) An infant should have 3 to 5 wet diapers/day. d) An infant should have 6 to 8 wet diapers/day.
D) An infant should have 6 to 8 wet diapers/day. Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300ml/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day.
A newborn infant requires skin care that includes bathing. Besides hygiene, what are other reasons for bathing an infant? a) Bathing helps moisten the skin. b) Bathing can prevent infection. c) Bathing is a great time to apply lotion. d) Bathing is a time for bonding with the parents.
D) Bathing is a time for bonding with the parents. The parents can use bath time for bonding with their infant. This can be done with talking, cooing, and singing. Bath time should be paced and non-stressful.
