Unit G

The nursing student is preparing a presentation which will illustrate the various stages of growth and development starting with a newborn. Which example should the student point out will best illustrate cephalocaudal growth pattern?

Controlling the head and neck before being able to control the arms and legs

Family stress theory

Crisis interventions are used by nurses to help families cope with challenging events.

First rule of thumb?

DO NO HARM!

A mother calls the clinic every couple of weeks concerned that her infant is not developing appropriately. What would be an appropriate nursing diagnosis for the nurse to assign to this client?

Deficient knowledge related to normal infant growth and development

A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks?

Developmental

Therapeutic care/atraumatic care

Encompasses the prevention, treatment, diagnosis or palatation of chronic/acute conditions.

An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health?

Ensure that the child brushes his teeth after each meal and snacks.

A nurse is performing a routine physical examination of a 5-year-old girl. Which of the following should the nurse note as developmentally inappropriate for this child?

Evidence of early breast development

Family system theory

Family is a system that continually interacts with its members and environments. Nurses can intervene to help cope with change.

Tertiary level of prevention

Focuses on clients with defect/disability that is permanent and irreversible. Involves minimizing the effects of long term effects by interventions directed at preventing complications and deterioration.

Secondary level of prevention

Focuses on persons who are experiencing health problems/illnesses and are at risk for developing complications.

A 2-month-old boy has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?

He needs to try a different formula to assess for sensitivity.

The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development?

Her vocabulary is between 10 and 15 words.

Family theory

How members respond to events in/outside of the family.

A first-time parent asks the nurse what toys would be appropriate for her son's second birthday next month. What recommendations would be nurse make?

Play lawn mower

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

Poor articulation

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant?

Use the crib for sleeping only, not for play activities.

What is atraumatic care?

Therapeutic care by persons in therapeutic environments and through the use of interventions that eliminate/minimize the psychologic and physiologic distress experienced by children and their families in the health care settings.

According to Erikson, normal adolescent behavior includes trying on new roles and possibly even rebelling. What is the purpose of this behavior in adolescents?

To establish a sense of identity

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply.

"Do not refer to medicines as candy." "Do not allow your child to approach strange dogs." "Have your child hold hands with a grown-up in parking lots." "Role-model bicycle safety by wearing a helmet too."

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

"Do you participate in any sports?"

A nurse is providing health promotion education to a family of an 11-month-old infant who is eating "finger foods." The nurse knows the parents understand the risk of infant choking when they state which response below?

"I can feed our baby Cheerios."

A nurse is discussing safety measures with the parents of a toddler. What would the nurse emphasize to address the most frequent type of accident in toddlers?

"Keep all cleaning products and drugs out of the reach of your child."

The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother?

"This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."

The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern?

"This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech."

The mother of a 4-year-old tells the nurse that she is frustrated because all she seems to do lately is fight with the child over what the child wants to eat and wear. The mother says that she sometimes wants to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this mother?

"Use the time-out technique for discipline."

Conformity is vital to school-age children.

True

Suicide is so common in adolescents it ranks as the third leading cause of death in the 10- to 24-year-old age group.

True

The best way for a parent to handle a temper tantrum by a toddler is to calmly express disapproval and then ignore it.

True

During a health maintenance visit, a 15-year-old girl mentions that she is not happy with being overweight. Which approach is best for the nurse to take?

"What specifically have you been noticing?"

The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize?

"You're following expected patterns of growth."

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

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

During a well-child visit, a mother tells the nurse that she uses timeout to discipline her 2 year old. The nurse determines that the mother understands the concept of timeout when the mother states that she keeps the toddler in time out for _______.

2 minutes

At what age is measuring occipital head circumference in a child discontinued?

24 months

Community

A group of individuals with shared characteristics who interact with each other.

The nurse is leading a discussion in a health class at the high school on adolescent relationships. The nurse determines the session is successful when the students correctly choose which type of relationship as involving a member of the opposite sex?

A heterosexual relationship

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

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

Primary level of prevention

True prevention, person is not sick yet. Focuses on health promotions of disease/injury.

An 8-month-old hospitalized with bronchiolitis is crying in the crib because it is time for a feeding. The parent caring for the child has left the room to eat lunch. If the needs of the child are not met, what phase of the developmental stage will not be achieved according to Erikson?

Trust

The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?

Undressing himself

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.

"Household"

Being used more frequently to describe family units because of emotional/political nature of newer definitions of family.

What are some leading causes of death in peds?

Cardiovascular, obesity, chronic lung disease, depression, violence, substance abuse, nutritional deficiency, HIV/AIDS

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

Cooperative play

A nurse is taking a health history on a new family at the pediatric clinic. Which information is the priority information to gather for a complete history database?

Immunization record

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

Industry

Community care

Looks at the general health of the community or specific populations and develops health initiatives based on their needs.

Developmental theory

Nurses provide anticipatory guidance to prepare families for transition to the next developmental stage.

A parent with a 2-year-old invites a friend with a toddler over for a play date when they notice their children are not really interacting while playing. The children are playing side-by-side when one toddler gets up and grabs a toy car out of the hands of the other toddler which results in both toddlers crying. To prevent this from occuring again, which intervention should the parents make?

Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.

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.

Pieces of apples Orange slices Cheese Yogurt

If the infant is following a normal pattern of dentition, the child would most likely have how many teeth by the age of 14 months?

Six to 12 teeth

To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?

Take the apical pulse.

A nurse is preparing an educational seminar about the moral and spiritual development of preschoolers. When describing this topic, which information would the nurse include?

Tendency to do good out of self-interest

The 18-month-old has most likely attained which gross motor skill?

The ability to walk independently.

The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?

The first tooth usually erupts between 6 to 8 months.

What position is the infant placed in for "tummy time"?

The infant is placed on the floor on their tummy.

The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments?

The infant will most likely present with developmental skills consistent with a 6-month-old infant.

When testing the deep tendon reflexes of a child, a four-point grading scale is used. What would a 1+ result mean for a reflex tested?

The reflex is diminished.

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

adolescents

A nurse is preparing a teaching plan for the parents of a newborn. When explaining the neurologic development, how should the nurse point out that this occurs?

center-to-outside

When assessing a 4-year-old, the nurse understands that the client is developing a conscience when the client performs which action?

tattles on a sibling

While assessing an adolescent, a nurse would assess which behavior as indicating the use of formal thought processes?

uses abstract thought while engaging in conversations