Chapter 25: Growth and Development of the Newborn and Infant Prep U
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? "Maturation refers to the child's increases in body size." "Development refers to the increase in skills the child demonstrates as they grow and age." "Both growth and development are influenced by heredity." "Increases in body size are referred to as growth."
"Maturation refers to the child's increases in body size."
When performing neurological reflexes on the infant, which primitive reflex will be present longest? Step Babinski Moro Rooting
Babinski
What action shows an example of Erik Erikson's developmental task for the infant? The infant cries when he or she has a wet diaper. The infant plays the game peek-a-boo. The infant cries and the caregiver picks the child up. The infant smiles as people walk past the crib.
The infant cries and the caregiver picks the child up.
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? The anterior fontanel (fontanelle) is open and easily palpated. His toes hyperextend when the bottom of the foot is stroked. The infant displays an asymmetric tonic neck reflex (fencing reflex). The infant grasps a finger when it is placed in his palm.
The infant displays an asymmetric tonic neck reflex (fencing reflex).
The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply. The infant is unable string together 2 word sentences. The infant seems disinterested in the surrounding environment. The infant does not pay attention to noises behind him. The infant babbles. The infant has frequent episodes of crossed eyes.
The infant does not pay attention to noises behind him. The infant has frequent episodes of crossed eyes. The infant seems disinterested in the surrounding environment.
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond? The infant will be constipated for 2 days. The infant's gumline will be tender. The infant's temperature may go as high as 102°F (38.9°C). The infant will not play or eat for 2 days.
The infant's gumline will be tender.
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? when weaning is complete as soon as the infant begins to eat fruit by 12 months of age as soon as the first tooth erupts
as soon as the first tooth erupts
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 weight assessment is blatantly inaccurate. the child weighs more than expected for age. the child weighs the expected amount for age. the child weighs less than expected for age.
the child weighs less than expected for age.
Parents of a newborn ask the nurse how to select a daycare facility that will limit the spread of germs for their newborn. Which response by the nurse is most useful? "Ask parents of current children at the facility how often their children are sick to get an estimate of exposure." "Ask staff if they perform regular handwashing between child interactions and diaper changes." "Check if the facility allows older children to enter the newborn room, this can place your newborn at high risk." "Ask the staff if they clean toys with a bleach cleaner at the end of each day."
"Ask staff if they perform regular handwashing between child interactions and diaper changes."
A first-time mother, who is breastfeeding, phones the clinic nurse because she is concerned about her 3-month-old infant's stools. Which statement by the mother would alert the nurse to further assess the situation? "My infant has not had a bowel movement in almost 8 hours." "The stools are loose and seedy." "My infant grunts and squirms when having a bowel movement." "The stools are foamy and smell terrible."
"The stools are foamy and smell terrible."
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate? "Grunting is normal with infant stool formation." "We will need to collect a stool specimen for analysis." "Is he in pain?" "What does his stool look like?"
"What does his stool look like?"
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? 19 lb 8 oz (8825 g) 13 lb (5900 g) 15 lb 4 oz (6920 g) 10 lb 8 oz (4760 g)
19 lb 8 oz (8825 g)
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? 28 lb 4 oz (12.8 kg) 21 lb 12 oz (9.9 kg) 25 lb (11.3 kg) 14 lb 8 oz (6.6 kg)
21 lb 12 oz (9.9 kg)
What is the correct amount of wet diapers a mature infant should produce each day? An infant should have 1 to 2 wet diapers/day. An infant should have 6 to 8 wet diapers/day. An infant should have 3 to 5 wet diapers/day. An infant should have 9 to 10 wet diapers/day.
An infant should have 6 to 8 wet diapers/day.
The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent? Bath time provides an opportunity for play Never use soap on an infant's hair Infants need a daily bath Soap lubricates and oils an infant's skin
Bath time provides an opportunity for play
The nurse is providing education to the woman about foods commonly associated with allergies in infants and young children. What items should be included in this list? Select all that apply. Strawberries Peanut butter Cow's milk Soy products Egg substitutes
Cow's milk Peanut butter Strawberries
The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated? Document the findings as normal. Review the birth records of the infant to see if there were any other anomalies. Notify the infant's physician. Measure the infant's head circumference.
Document the findings as normal.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants? Takes in new information at a rapid rate and asks "why" and "how". Insists they can "do it" and the next moment they revert to being dependent. Grows and develops skills more rapidly than at any other time in their life. Has an increased attention span and can be interested in an activity for a long length of time.
Grows and develops skills more rapidly than at any other time in their life.
The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula? Iron Calcium Vitamin E Vitamin D
Iron
An infant is breastfed. When assessing the stools, which findings would be typical? Harder stools than those of bottle-fed infants A strong odor Less constipation than bottle-fed infants Fewer stools than bottle-fed infants
Less constipation than bottle-fed infants
The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client? Child Baby Newborn Infant
Newborn
The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client? Infant Child Newborn Baby
Newborn
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? 1 upper tooth 1 to 2 lower teeth No teeth 1 to 3 natal teeth
No teeth
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? Turning a doorknob Building a tower of four cubes Walking independently Sitting independently
Sitting independently
Which milestone would the nurse expect an infant to accomplish by 8 months of age? Being able to sit from a standing position Pulling self to a standing position Creeping on all fours Sitting without support
Sitting without support
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. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. The infant can be expected to display developmental skills consistent with a 8-month-old infant. The infant will likely show the skills of an infant with the adjusted age of 7 month.
The infant will most likely present with developmental skills consistent with a 6-month-old infant.
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? If she is safe, they lie her down and leave. The child has a regular, scheduled bedtime. They sing to her before she goes to sleep. They put her to bed when she falls asleep.
They put her to bed when she falls asleep.
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life? Fear Trust Love Feel anger
Trust
The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term? Assessing the parents' care and feeding skills Educating the parents about when colic stops Watching how the parents respond to the child Urging the baby's mother to take time for herself away from the child
Urging the baby's mother to take time for herself away from the child
A mother calls the clinic nurse asking for recommendations on comfort measures for her infant who is teething. What recommendation should the nurse make? Select all that apply. acetaminophen small chunks of ice teething rings hard candy hand cream
teething rings acetaminophen
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? "Sure, you can do whatever you want, it is your baby." "Sure, you can, make sure you use a soft mattress for support." "Bed sharing is okay, just make sure the infant is between two people." "Baby can sleep in your room in an infant crib, but not in an adult bed."
"Baby can sleep in your room in an infant crib, but not in an adult bed."
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." "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods." "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex." "By this age the child becomes interested in trying new skills."
"Milk will not fully provide the child's needs for iron, which is found in solid foods."
The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what state the infant is in by what the mother says, and that it's fine to try and feed the infant? "She has been a chatterbox and smiles just like her brother." "She is still sleeping; I guess she is worn out." "She is so quiet today; that is not like her." "She has been crying every time someone picks her up."
"She has been a chatterbox and smiles just like her brother."
A mother asks the nurse where the microwave is so that she can warm up breast milk to feed her baby. What is the best response by the nurse? "You should only give fresh breast milk to an infant." "Breast milk can be given cold, so there is no need to heat it." "Make sure that you test the milk on your wrist before feeding." "You should warm the milk under warm water instead."
"You should warm the milk under warm water instead."
The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed? Upper central gumline Lower lateral gumline Upper lateral gumline Lower central gumline
Lower central gumline
A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?
Most 3-month-old infants still have a Moro reflex.
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? Respond promptly when the infant cries. Read age-appropriate books to the infant daily. Appropriately enunciate words when speaking to the infant. Praise the infant when a new milestone is reached.
Respond promptly when the infant cries.
A nurse is educating a client being discharged with her newborn baby. What is the highestpriority item that must be included in the teaching plan? Give warm bottles of formula to the baby. Lock all cabinets that contain cleaning supplies. Restrain the baby in a car seat. Keep all pots and pans in lower cabinets.
Restrain the baby in a car seat.
Which milestone would the nurse expect an infant to accomplish by 8 months of age? Sitting without support Being able to sit from a standing position Pulling self to a standing position Creeping on all fours
Sitting without support
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 coos, babbles, and gurgles The infant says "da-da" when looking at her father The infant squeals with pleasure The infant imitates her father's cough
The infant says "da-da" when looking at her father
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. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. The infant will likely show the skills of an infant with the adjusted age of 7 month. The infant can be expected to display developmental skills consistent with a 8-month-old infant.
The infant will most likely present with developmental skills consistent with a 6-month-old infant.
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? Let the baby cry during the night and she will eventually fall back to sleep. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. Use the crib for sleeping only, not for play activities. Put the baby to bed at various times of the evening.
Use the crib for sleeping only, not for play activities.
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: smiling at herself in the mirror. looking for a toy in her crib at the last place she saw it. shaking a rattle to enjoy the sound. pushing a spoon from her high chair tray to the floor.
looking for a toy in her crib at the last place she saw it.
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: is a protective reflex and retained for life. should be pronounced and easy to elicit. is expected to appear within 1 month. should have disappeared.
should have disappeared.
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? the development of a 3-month-old the growth of a 5-month-old the development of a 10-week-old the growth of a 2-month-old
the development of a 3-month-old
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? the growth of a 2-month-old the growth of a 5-month-old the development of a 3-month-old the development of a 10-week-old
the development of a 3-month-old
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? Running a mild fever or vomiting Frequent loose stools Choosing soft foods over hard foods Increased biting and sucking
Increased biting and sucking
Two parents who have financial issues ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents? "You should just buy a new crib to be on the safe side." "You can use any crib that you want." "You can use the crib, but there are guidelines to follow." "No, you cannot use a borrowed crib."
"You can use the crib, but there are guidelines to follow."
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the bestresponse by the nurse? "Delays are normal when a child is premature." "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." "You should talk with the doctor about getting your son tested." "All children mature and develop at different rates so it is unwise to compare them in this way."
"Delays are normal when a child is premature."
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? "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 infant can tell their mother from another woman's smell." "Babies really 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."
The nurse is evaluating if nutrition counseling for new mothers has been effective. Which comments by the mothers indicate the need for more instruction? Select all that apply. "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth." "I can start giving my baby small snack like cheerios around 8 months of age." "As long as I wait for at least 3 days to introduce new foods I should be able to determine if my child has any food allergies." "It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." "My mother said that I shouldn't introduce rice cereal as the first solid food, but I'm confident that is best."
"It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth."
A nurse is preparing to administer vaccines to a 4-month-old infant. Which vaccines will the nurse administer? Select all that apply. diphtheria, tetanus, and pertussis inactivated poliomyelitis Haemophilus B pneumococcal varicella
Haemophilus B inactivated poliomyelitis diphtheria, tetanus, and pertussis pneumococcal
The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance." "We should get some rest in about 1 month when the newborn starts sleeping through the night."
"I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance."
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? "By keeping the room at a neutral temperature, I do not have to use blankets." "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."
"My husband gave the baby a special bear that I will place in the crib."
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? Encourage the infant to latch on properly Maintain adequate diet and fluid intake Maintain a feed-on-demand approach Apply warm compresses to the breast
Maintain a feed-on-demand approach
The nurse goes in to check on a new mother to see how breastfeeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse? "Maybe you should watch the breastfeeding video again." "You will never get him to eat all unwrapped like that." "That is not how you get him to eat." "You are doing a wonderful job attempting to wake the baby."
"You are doing a wonderful job attempting to wake the baby."
The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off A mother tells her husband to be sure to place the newborn on his back when putting the baby in the bassinet A mother places the baby comforter her grandmother made over the newborn's body A mother places her newborn on its side after falling asleep A mother states all of her children like sleeping on their abdomen and this newborn likes it too
A mother places her newborn on its side after falling asleep A mother states all of her children like sleeping on their abdomen and this newborn likes it too A mother places the baby comforter her grandmother made over the newborn's body A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? Cannot pull self to standing Crawls with stomach down Picks up small objects using entire hand Uses only the left hand to grasp
Uses only the left hand to grasp
The nurse is teaching the parents of a 6-month-old infant about proper dental care. Which action will the nurse indicate as most likely to cause dental caries in this infant? Putting the infant to bed with a bottle of milk or juice Brushing the infant's teeth with fluoride-free toothpaste Using a cloth instead of a brush for cleaning the infant's teeth Not cleaning the infant's gums after eating meals or snacks
Putting the infant to bed with a bottle of milk or juice
A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours and seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. What should be the primary nursing diagnosis in this situation? Risk for aspiration related to feeding the infant an inappropriate food Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food Readiness for enhanced nutrition, related to the age of the infant
Risk for aspiration related to feeding the infant an inappropriate food
