Test 4: Toddler/Preschool - Growth/Development
The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?
"By the age of 6 most children can print some letters and maybe their first name."
According to Piaget, children in the sensorimotor stage of cognitive development have
* A limited concept of time * have imaginary playmates * are very egocentric.
Behaviors that reflect the perioperational stage according to Piaget
* Understanding instructions literally * imitating others' behaviors
Age appropriate milestones: Age 5
* draw a person with a body and at least 6 body parts * copy triangles * dress and undress herself * learning to tie shoes
Parallel play
* occurs when children play with similar toys, beside each other, but are not influenced by other children's play activities * characteristic of toddlers
If the child is gaining weight at an expected rate, a child who weighs 36 pounds (16.3 kg) at 3 years of age would weigh what amount at age 5?
44 lbs. (20 kg)
Each year the toddler gains
5 to 10 lbs
The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse?
"The preschooler is developing a conscience."
After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching?
"When my 3-year-old asks 'Why?' all the time, this is completely normal."
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations?
"You need to adhere to various routines."
Communication through words and gestures is typical of a __ year old
1
Head circumference equals chest circumference at
12 months
A mother comes to the clinic with her 4-year-old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the client has a normal vocabulary for age. The nurse is aware that language for a 4-year-old consists of at least approximately how many words?
1500 words
A mother asks the nurse, "Now that Jimmy is 14-months-old and drinking from a cup, how much milk should he be getting each day?"Which amount would the nurse recommend?
16 ounces
The anterior fontanel closes at
18-24 months
Which of the following immunizations would you plan to administer at a preschool health maintenance visit?
DTaP
The mother of a 2-year-old tells you she is constantly scolding him for having wet pants. She says her son was trained at 12 months, but since he started to walk, he wets all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group?
Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior.
A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe?
Imitative play
Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify what task as the task of the preschooler?
Initiative
Developmental task of the preschool period
Initiative versus guilt
The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?
Magical thinking Thoughts are all-powerful
A nurse is assisting the parents of 2-year-old who is having temper tantrums. Which of the following would the nurse encourage the parents to do once temper tantrums have started?
Move objects out of the way or move the child to prevent injury
A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?
Opening drawers in the room, pulling out supplies, and examining them
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget?
Preoperational thought
Which gross motor skill would the 4-year-old child have most recently attained?
The child can hop on one foot.
The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development?
The child does not use the names of familiar objects.
A 15-month-old boy has been brought to the clinic because he is pale and listless. Iron deficiency anemia is suspected. The nurse interviews the mother about the child's diet. Which of the following would the nurse identify as possible contributing factor?
The child drinks 4 cups of milk per day
Transduction is
The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?
The nurse of a preschool child is helping parents develop a healthy meal plan for their child. What nutritional requirements for this age group should the nurse consider?
The typical preschooler requires about 85 kcal/kg of body weight. The 3- to 5-year-old requires 500 to 800 mg calcium and 10 mg iron daily. The 3-year-old should consume 19 mg dietary fiber daily, while the 4- to 8-year-old requires 25 mg dietary fiber per day
The nurse is watching toddlers at play. Which normal behavior would the nurse observe?
Toddlers engage in parallel play.
Fear of mutilation is significant during the preschool age.
True
.Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases A child nearly 3 years of age should speak in three- to four-word sentences.
The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention?
Wake the child up nightly 30 to 45 minutes after going to sleep.
Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium?
White beans
The first deciduous teeth that the preschool age child normally looses are the
central incisors
Toward the end of the preschool age, most children begin loosing their deciduous teeth and permanent teeth begin to erupt. Which of the following teeth are usually the first to come out?
central incisors
Centration is
focusing on one aspect of a situation while neglecting others
Coorination of secondary schema is seen in
infants at age 10 months
Primary circular reaction is seen in
infants of 3 months
The four leading causes of unintentional injury in early childhood include
motor vehicle/traffic accidents, drowning, fires, and burn injury and unintentional suffocation
Cooperative play
occurs during a leader-follower relationship (seen in toddlers)
Associative play
occurs when children are playing together in a group without organization or leadership.
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:
parallel play
Tertiary circular reaction is seen in
toddlers between 12 and 15 months
Solitary play
when a child plays alone, absorbed in the activity and uninterested in the play of other children (Seen in infants )
The parents of a toddler ask the nurse about disciplining their son. What would be most helpful for the nurse to suggest? Select all that apply.
• "It's better to praise correct behavior than to punish wrong behavior."
A nurse is talking with the mother of a 2 ½ -year-old who is starting toilet training. The nurse determines that the child is the stage of toilet learning when the mother states which of the following? Select all that apply.
• 'He says he wants to wear "big-boy" pants" • "He can pull his pants up and down by himself."
A nurse is providing anticipatory guidance to parents of a 3-year-old about nutrition and finger foods. Which of the following would be most appropriate for the nurse to suggest? Select all that apply
• Diced fruit • Shredded cheese • Cereal
The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply.
• Extending breastfeeding into toddlerhood is believed to be beneficial to the child. • Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. • The toddler requires an average intake of 500 mg calcium per day.
** The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.
• Plans activities and makes up games • Initiates activities with others • Acts out roles of other people
Pointing to named body parts is characteristic of a ___ year old
2
The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to:
allow her to experiment with Play-Doh.
Animism is
attributing life-like qualities to inanimate objects.
In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will:
be able to use each language as a separate system.
16 temporary teeth: Development milestone for what age?
2 years olf
The average preschool-age child will grow how many inches per year?
2.5 to 3 inches
The preschool age grows about _____ inches each year.
2.5 to 3 inches
Understanding concepts such as on, under, or in is typical of a __ year old
3
The toddler grows about how many inches in height per year?
3 inches
If a toddler is following a normal pattern of growth, which of the following weights would be most likely for a 3-year-old toddler who weighed 21 lbs. at the age of 12 months?
37 lbs.
The preschool age child gains about ____ pounds each year.
4 to 5 lbs each year
The nurse is preparing a safety program for the parents of children ranging in age from 1 to 4 years. Which of the following would the nurse include as the leading cause of death in this age group?
Automobile accidents
Developmental task of the toddler
Autonomy
The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue?
Before answering questions, find out what the child thinks about the subject.
The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which food would the nurse recommend?
Cooked lentils
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following?
Deferred imitation
A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which nursing diagnosis is most applicable for his family?
Deficient knowledge of normal preschool development
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old?
He should speak in two-word sentences ("Me go").
A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master?
Initiative vs. guilt
A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is:
Physical growth slows.
The mother of a toddler boy half-jokingly states: "I am so tired of hearing 'NO!' I wish he would stop!" What suggestions will the nurse offer to reduce toddler negativism? Select all that apply.
• Avoid "yes" and "no" questions. • Offer simple choices: "Blue shirt or red one?" • Make statements: "It is time for lunch." • Avoid ending a request with "Okay?" • Use humor to make "no" funny: "Do cows bark?"
The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? Select all that apply.
• Counting 10 or more objects • Correctly naming at least four colors • Understanding the concept of time • Knowing everyday objects
Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds
• Johnny is growing slowly in height but rapidly in weight. • Johnny may be at risk for overweight or obesity. • Johnny's height and weight should be plotted on a growth chart.
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.
• Plans activities and makes up games • Initiates activities with others • Acts out roles of other people
A nurse is presenting a class on toilet training to a group of parents with toddlers. Which information would the nurse include in the class? Select all that apply.
• Putting the child on the potty chair at regular intervals during the day • Using training pants that slide down easily and quickly • Praising the child when he or she urinates or defecates
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply.
• Sweet potatoes • Spinach • Carrots
The nurse determines that a 20-month old is in Piaget's sensorimotor stage of cognitive development. Which of the following would support this assessment? Select all that apply
• The child has an imaginary playmate • The child has a limited concept of time. • The child demonstrates egocentricity.
A nurse is instructing a young mother on how to ensure a safe bath time for her 4-year-old son. Which of the following are important suggestions for the nurse to give to the mother? (Select all that apply.)
• Turn down the temperature of the water heater to under 120°F • Do not leave the child unsupervised in the bath tub • Assist the child in cleaning under fingernails and around ears
A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" What foods would be appropriate for the nurse to suggest? Select all that apply.
• Yogurt • Cheese • Pieces of apples • Orange slices
