Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year
A nurse is conducting a class for new mothers about infants and nutrition. One of the women asks, "What is the best nutrition for my 3-month-old infant?" Which response by the nurse would be most appropriate? "Human milk is the best nutrition for your child" "Experts recommend soy milk as the preferred food.". "Iron fortified formula is necessary for the infant's growth" "Rice cereal is the best because allergy risk is low. "
"Human milk is the best nutrition for your child"
A nurse on a home visit is providing safety tips to a family of a 1-week-old infant. Which of the following statements by the parents indicates the need for further teaching? "We will place our infant in a rear-facing car seat in the back seat of the car." "We will position our infant on his side for sleeping." "We will swaddle our son to keep him quiet and warm to sleep." "We will give our son a pacifier before placing him in his crib."
"We will position our infant on his side for sleeping."
The infant weighs 7 lb 4 oz (3,300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? 14 lb 8 oz (6.6 kg) 21 lb 12 oz (9.9 kg) 25 lb (11.3 kg) 28 lb 4 oz (12.8 kg)
21 lb 12 oz (9.9 kg)
The nurse establishes the following plan of care based on the nursing diagnosis: Caregiver role strain related to infant crying throughout night as manifested by parents stating, "We are exhausted." Which nursing interventions are included in the plan of care? Select all that apply. Establish a quieting ritual for infant before bed. During night awakening, keep interactions minimal. Add rice cereal to the evening bottle to prevent hunger and awakening. At bedtime, ensure the child is in a deep sleep then place in crib. Having one parent awake at a time with infant
Established a quieting ritual for infant before bed During night awakening keep interactions minimal Having one parent awake at a time with infant
The nurse is visiting a mother who has a 3-month-old infant who has been hospitalized for cardiac problems. Which nursing diagnosis should the nurse use to guide care for this family at this time? health-seeking behaviors related to adjusting to parenthood risk for impaired parenting related to hospitalization of infant disturbed maternal sleep pattern related to infant's feeding schedule deficient knowledge related to normal infant growth and development
Risk for impaired parenting related to hospitalization of infant
Estimating illness in an infant is difficult. To help an infant's parents do this, which of the following would you instruct them to use? Take her temperature about once a week. Call if she spits up any formula. Use her interest in eating as a good gauge. Call if the infant's stools are yellow.
Use her interest in eating as a good gauge.
The best way for an infant's parent to help the child complete the developmental task of the first year is to: expose the infant to many caregivers to help the infant learn variability. talk to the infant at a special time each day. respond to the infant consistently. keep the infant stimulated with many toys.
respond to the infant consistently.
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: the child weighs less than expected for age. the child weighs more than expected for age. the child weighs the expected amount for age. the weight assessment is blatantly inaccurate.
the child weighs less than expected for age.
The mother of a 16-month-old infant comes into the clinic and asks the nurse, "When will my baby play with toys by moving them from one hand to the other?" The nurse's response is based on knowledge that transferring objects from one hand to the other is normally accomplished by what age? 17 weeks 20 weeks 28 weeks 36 weeks 48 weeks
28 weeks
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? Uses only the left hand to grasp Picks up small objects using entire hand Crawls with stomach down Cannot pull self to standing
Uses only the left hand to grasp
The nurse is concerned that a 9-month-old baby is gaining too much weight. What should the nurse instruct the parents to help control the baby's weight gain? Use skim milk for feedings. Provide whole-grain cereal for one feeding. Provide one bottle a day of diluted gelatin mix. Feed the baby a serving of pudding once a day.
Provide whole-grain cereal for one feeding.
The nurse is conducting a physical examination of a 8-month-old infant. Which observation may be cause for concern about the infant's neurologic development? The infant displays an asymmetric tonic neck reflex (fencing reflex). The infant grasps a finger when it is placed in the palm. The infant's toes hyperextend when the bottom of the foot is stroked. The anterior fontanel (fontanelle) is open and easily palpated.
The infant displays an asymmetric tonic neck reflex (fencing reflex).
The mother of a 3-month-old infant expresses concern that her infant's head is misshapen. Which would be the most appropriate question by the nurse? "Do you use "tummy time" with the infant?" "Is the infant rolling over yet?" "Have you thought of using a helmet?" "Does the infant sleep on its side?"
"Do you use "tummy time" with the infant?"
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? "I can expect my infant to be able to raise the head up when on the stomach within the next month." "I can expect my infant to become clingy around strangers within the next month." "I can expect my infant to be able to hold a rattle within the next month." "I can expect my infant to laugh out loud within the next month."
"I can expect my infant to be able to raise the head up when on the stomach within the next month."
A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond? "The baby can sleep in your room in an infant crib, but not in an adult bed." "Sure, you can do whatever you want, it is your baby." "Sure you can, but make sure you use a soft mattress for support." "Bed sharing is okay, just make sure the infant is between two people."
"The baby can sleep in your room in an infant crib, but not in an adult bed."
During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? "Babies can't tell the difference between people at that age." "Maybe she just knows your voice better than your mother's." "You may be right, since infants can sense their mother's smell as early as 7 days old." "I'm not sure a 4-week-old has developed a sense of smell yet."
"You may be right, since infants can sense their mother's smell as early as 7 days old."
The nurse enters her client's room and finds the infant on a pillow with a bottle propped up while the mother is dressing. What statement should the nurse make? "Look how cute she is." "Are you almost ready to be discharged?" "You should always hold your baby for feedings instead of propping the bottles." "Is she almost done feeding?"
"You should always hold your baby for feedings instead of propping the bottles."
A parent takes the 4-month-old infant to the health care provider. The parent asks what type of baby cereal to provide now that the infant is starting solid foods. How should the nurse respond? "You should buy wheat cereal." "You should buy oat cereal." "You should buy rice cereal." "You should buy barley cereal."
"You should buy rice cereal."
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? 10 lb 8 oz (4760 g) 13 lb (5900 g) 15 lb 4 oz (6920 g) 19 lb 8 oz (8825 g)
19 lb 8 oz (8825 g)
In working with infants, the nurse would expect the posterior fontanel to be closed in an infant who is which age? 3 months 1 month 3 weeks 6 weeks
3 months
A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially? Check the expiration date on the car seat. Have the car seat installed by a professional. Clean all fabric that touches the infant. Inspect the car seat for any cracks or damage.
Check the expiration date on the car seat.
The nurse is assessing Julie, a 3-month-old infant. Which developmental milestone would the nurse expect? Julie can hold her head erect and steady. Julie can grasp a toy at will. Julie can sit by herself. Julie loves to play "pat-a-cake".
Julie can hold her head erect and steady.
During an assessment, the nurse determines that a 3-month-old infant has a Moro reflex. What does this finding indicate to the nurse? It usually lasts until 9 months. It will persist until the age of 1 year. Most 3-month-old infants still have a Moro reflex. If present at 3 months of age, a neurologic exam is needed.
Most 3-month-old infants still have a Moro reflex.
The nurse is teaching a parenting class to a group of first-time mothers. She recommends which of the following as positive caregiver-infant interactions? Select all that apply. Mother offers adequate types and amounts of food for the infant. Mother holds the infant in an appropriate position while feeding. Mother always maintains a quiet environment while holding the infant. Mother burps the baby during and after feeding. Mother provides age-appropriate toys for the infant.
Mother offers adequate types and amounts of food for the infant. Mother holds the infant in an appropriate position while feeding. Mother burps the baby during and after feeding. Mother provides age-appropriate toys for the infant.
A nurse is instructing the mother of a newborn about bathing and skin care. When discussing bathing, the nurse includes which of the following besides hygiene as an important reason for bathing? Promoting parental bonding Preventing infection Providing moisturization Stimulating circulation
Promoting parental bonding
In providing anticipatory guidance related to choking hazards for infants, what should the nurse include in the teaching? Select all that apply. Propping a bottle Raw carrots Shape sorter Plastic bags Stuffed animals
Propping a bottle raw carrots plastic bags
A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? Lock all cabinets that contain cleaning supplies. Keep all pots and pans in lower cabinets. Give warm bottles of formula to the baby. Restrain the baby in a car seat.
Restrain the baby in a car seat
The nurse is visiting a mother who has a 3-month-old infant. Which anticipatory guidance information should the nurse provide to the mother at this time? The child will have a fear of strangers. The child will experience many moody periods. The child will expect things to be done a certain way. The child should be able to turn over onto the back at age 4 months.
The child should be able to turn over onto the back at age 4 months.
A new parent asks the nurse what she should look for when the baby starts to teethe. What should the nurse explain to the parent? The child's gum line will be tender. The child will have a high temperature. The child will not play or eat for 2 days. The child will be constipated for 2 days.
The child's gum line will be tender
The nurse in a community clinic is caring for a 6-month-old infant and parent. Which nursing intervention is priority? monitoring the infant's weight and height encouraging a more frequent feeding schedule obtaining the infant's current feeding pattern recommending higher-calorie solid foods
monitoring the infant's weight and height
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." "I can feed our baby popcorn." "I can feed our baby raisins." "I can feed our baby lollipops."
"I can feed our baby Cheerios."
A client who is breastfeeding asks the nurse if she can give the newborn a pacifier. Which nursing response is most appropriate? "I know a lot of people who breastfed and also gave their newborns a pacifier." "This decision should be made by you and your partner based on your personal preferences." "I will request the lactation consultant come talk to you about pacifier usage while breastfeeding." "It is recommended to wait until breastfeeding is well-established before introducing a pacifier."
"It is recommended to wait until breastfeeding is well-established before introducing a pacifier."
The nurse is completing an infant history on a 5-month-old and documents the following symptoms. Which will the nurse attribute to teething? Select all that apply. Drooling and biting Increased sucking on hands Irritability and awakening from sleep Refusing to eat Fever and diarrhea
Drooling and biting Increased sucking on hands Irritability and awakening from sleep Refusing to eat
A 3-month-old infant has a Moro reflex. Which statement is most true of this reflex? A Moro reflex normally lasts until 9 months. It is not important how long the reflex persists, only that it is present at birth. A Moro reflex present at 3 months of age requires referral for a neurologic examination. Infant may retain the Moro reflex at 3 month old; it fades between 2 and 4 months.
Infant may retain the Moro reflex at 3 month old; it fades between 2 and 4 months.
The nurse is assessing a 4-month-old infant during a scheduled visit. Which findings might suggest a developmental problem? The child does not babble. The child does not make sounds in response to voices. The child does not make high pitched noises. The child does not say dada or mama.
The child does not make sounds in response to voices.
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: should have disappeared. should be pronounced and easy to elicit. is expected to appear within 1 month. is a protective reflex and retained for life.
should have disappeared.
The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months? 27.5 in (70 cm) 29 in (74 cm) 30.5 in (77.5 cm) 32 in (81 cm)
27.5 in (70 cm)
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond? The infant's gumline will be tender. The infant will not play or eat for 2 days. The infant will be constipated for 2 days. The infant's temperature may go as high as 102°F (38.9°C).
The infant's gumline will be tender
An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated? The next visit would be in 1 month. The next visit would be at 6 months. The next visit would be in 3 months. The next visit would be at 9 months.
The next visit would be at 6 months
A 6-month-old girl weighs 14.7 pounds (6.7 kg) during a scheduled check-up. Her birth weight was 8 pounds (3600 g). What is the priority nursing intervention? talking about solid food consumption discouraging daily fruit juice intake increasing the number of breast-feedings discussing the child's feeding patterns
discussing the child's feeding patterns
Which measures should receive priority in the care plan for an infant client who has sensitive skin? Use scented wipes with stool Use baby power with each change Change diapers frequently Use only cloth diapers
Change diapers frequently
The nurse is assessing a 6-month-old infant in the clinic. Which characteristic represents normal language development for this age? Cooing Laughing out loud Babbling Producing noises when spoken to
Babbling
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? four teeth six to 12 teeth 14 to 18 teeth 24 teeth
six to 12 teeth
At which age would the nurse expect to find the beginning of object permanence? 1 month 6 months 9 months 12 months
6 months
A nurse is providing health promotion education to a family of an infant at the family birth center. The nurse knows the parents need more education when they state which response? "I will switch to whole milk when my infant is around 6 months of age." "I will introduce soft foods for my infant around 6 months of age." "I will give my infant a drinking cup gradually around 6 months." "I will introduce new foods one at a time."
"I will switch to whole milk when my infant is around 6 months of age."
The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred? "I'll start with baby oatmeal cereal mixed with low-fat milk." "The cereal should be a fairly thin consistency at first." "I can puree the meat that we are eating to give to my baby." "Once he gets used to the cereal, then we'll try giving him a cup."
"The cereal should be a fairly thin consistency at first."
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? as soon as the first tooth erupts by 12 months of age when weaning is complete as soon as the infant begins to eat fruit
As soon as the first tooth erupts
The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent? Infants need a daily bath Soap lubricates and oils an infant's skin Bath time provides an opportunity for play Never use soap on an infant's hair
Bath time provides an opportunity for play
The English-speaking nurse is assessing a 12-month-old child with an English-speaking father and a Spanish-speaking mother. The child does not use words like "drink" "dog" or "ball." What is the nurse's priority intervention? performing a developmental evaluation of the child encouraging the parents to speak only one language to the child asking the mother if the child uses Spanish words for those items referring the child to a developmental specialist to rule out developmental delay
asking the mother if the child uses Spanish words fo those items
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone? develop a fear of strangers be able to turn over onto the back insist on things being done the infant's way have many "blue" or moody periods
be able to turn over onto the back
A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her? "Be sure to wash the infant's face, hands, and diaper area daily." "Be sure to give the baby a complete bath every day." "Be sure to oil the scalp with mineral oil and leave it on overnight before bathing the infant the next day." "Be sure to brush the scalp with a soft toothbrush during the bath to prevent seborrhea."
"Be sure to wash the infant's face, hands, and diaper area daily."
The nurse is reinforcing teaching with a group of caregivers related to the nutritional needs of the infant. One caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse? "Milk will not fully provide the child's needs for iron, which is found in solid foods." "By this age the child becomes interested in trying new skills." "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex." "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods."
"Milk will not fully provide the child's needs for iron, which is found in solid foods."
After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur? "I will place my infant on the back to sleep every night." "I have a crib in my room so that I can breastfeed my baby." "My husband gave the baby a special bear that I will place in the crib." "By keeping the room at a neutral temperature, I do not have to use blankets."
"My husband gave the baby a special bear that I will place in the crib."
A nurse is teaching first-time parents about bathing their infant. The nurse instructs the parents to wait until which day to give the baby a tub bath? 7-10 days after birth 14 days after birth. 7 days after birth 3 days after birth
7-10 days after birth
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend? a rear-facing booster seat a forward-facing convertible booster a rear-facing 5-point harness restraint a forward-facing 5-point harness restraint
A rear-facing 5-point harness restraint
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? The infant says "da-da" when looking at her father The infant squeals with pleasure The infant coos, babbles, and gurgles The infant imitates her father's cough
The infant says "da-da" when looking at her father
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? Health seeking behaviors related to adjusting to parenthood Ineffective role performance related to new responsibilities Social isolation related to lack of adequate social support Deficient knowledge related to normal infant growth and development
Deficient knowledge related to normal infant growth and development
What action shows an example of Erik Erikson's developmental task for the infant? The infant cries and the caregiver picks the child up. The infant cries when they have a wet diaper. The infant smiles as people walk past the crib. The infant plays the game peek-a-boo.
The infant cries and the caregiver picks the child up
The mother of a 3-month-old baby is concerned because the child is not able to sit independently. How should the nurse respond to this mother's concern? Most babies sit steadily at 3 months. Most babies sit steadily at 4 months. Most babies do not sit steadily until 8 months. Sitting ability and the age of first tooth eruption are correlated.
Most babies do not sit steadily until 8 months.
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? Most infants sit steadily at 3 months; this infant is slightly delayed. Most infants do not sit steadily until 8 months; this infant is normal. Sitting ability and the age of first tooth eruption are correlated. Most infants sit steadily at 4 months; this infant is normal.
Most infants do not sit steadily until 8 months; this infant is normal.
In observing an infant who is 6 months of age, which fine motor skill would the infant have most recently attained? The infant can hold a bottle. The infant can hold a cup. The infant has a strong grasp reflex. The infant has developed the pincer grasp.
The infant can hold a bottle.