Exam 1 Growth and Development - Textbook Questions

The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as:

normal for this stage of growth and development - *negativism*

The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health?

"Clean your baby's gums, then new teeth, with a washcloth."

Ms. Shaw brings in her 11-year-old daughter for a well-child check-up. The school-ager says to the nurse, "I look different from my friends. I do not wear bras and my friends are already wearing bras." What would be an appropriate response to this school-ager?

"During late school-age years, girls begin to develop their secondary sexual characteristics on an *individual basis*.You are fine and it is normal to be concerned about being different, but you will develop normally over the next few years."

The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. What is the nurse's best response?

"Infants need to be fed and cleaned; if you are sure those needs are met, just let her cry."

The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse?

"The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

Johnny is a 9-year-old whose mother and father both work during the day. He returns home after school. How should the parents prepare Johnny for this experience? What safety rules would be included in the education for Johnny?

- have a key to the house - know the rules of the house, how to reach parents and a neighbor, and how to call 911 - access to a specified snack that does not require using the stove - parents must inform Johnny whether he can play outside or if he must stay inside and complete homework - talk about fire safety - firearm safety must be discussed Discuss with Johnny's parents the possibility of after-school programs

The nurse is providing teaching about accidental poisoning to the family of a 3-year-old. The nurse understands that a child of this age is at increased risk of accidental ingestion due to which sensory alteration?

A less discriminating sense of taste.

A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse?

Assess the child's usual intake pattern at home.

The mother of an 11-month-old boy who was born at 24 weeks' gestation is concerned about his size and motor skills. What information should the nurse provide?

Assessment of a premature infant's growth and development should be based on the adjusted age rather than the chronologic age. An 11-month-old who was born at 24 weeks' gestation (4 months early) should exhibit the growth and development of a 7-month-old infant.

Develop a plan for educating the parent of a 34-month-old who has been resistant to toilet teaching. Include assessments the nurse will make as well as the plan for teaching.

Assessments: Does the child walk? Know when the diaper is wet/dirty.Have a word for toileting. Take off his pants himself. Teaching: Have the child sit on the potty for 5 minutes after each meal. Give the child a small reward for sitting on the potty and/or for actually voiding or defecating.

A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response?

Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.

What has the most influence in deterring an adolescent from beginning to drink alcohol?

Drinking habits of peers

In developing a weight-loss plan for an adolescent, which would the nurse include? (Select all that apply.)

Eat slowly and place the fork down between each bite. Have the family exercise together. Refer to an adolescent weight-loss program. Keep a food and exercise diary.

What is the best advice about nutrition for the toddler?

Encourage *cup drinking* and give water between meals and snacks.

The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response?

Hesitancy and dysfluency are normal during this period of development.

If you determine that the infant in the question above is experiencing normal spitting up associated with his developmental age, develop a brief teaching plan to review with the mother.

Increase the frequency and decrease the volume of feedings; make sure the infant burps at least two or three times per feeding; keep the infant upright for 20 to 30 minutes after feeding; avoid placing the infant in an infant seat after feeding. If vomiting increases or becomes projectile or if the infant is failing to gain weight, notify the primary care provider.

To gain cooperation from a toddler, what is the best approach by the nurse?

Kneel in front of the toddler while he or she is on the mother's lap.

The mother of two sons, ages 6 and 9, states they want to play on the same baseball team. As the school nurse, what advice would you give their mother?

Levels of coordination and concentration differ, so the boys need to be on different teams.

Sally's mother is asking the nurse for advice about purchasing a two-wheeled bike for her 7-year-old. What guidance should the nurse offer this parent?

Mother needs to assess whether or not Sally is physically ready to ride a two-wheeled bike. *Safety* is also a major concern - coordination is limited, as is the ability to assess and react to dangers of a situation. *Rules* should be made and discussed with Sally about where Sally can ride the bike and the use of the safety equipment. Mother should teach by *role-modeling* - wear safety equipment when she rides her bike.

The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother?

Place the child in time-out for 4 minutes. - 1 min per age in years

The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words without any consistency. What is the nurse's best response to this information?

Receptive language normally develops earlier than expressive language.

Which activities will promote weight loss in an obese school-age child? (Choose all that apply.)

Role modeling by family Becoming active in sports Involving child in meal planning and grocery shopping

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior?

Separation anxiety is normal at this age; the infant recognizes parents as separate beings.

Which is associated with early adolescence? (Select all that apply.)

Still at times wants to be dependent upon parents Is influenced by peers and values memberships in cliques

Construct a 3-day menu for a picky 4-year-old. Include three daily meals and two snacks.

The 3-day menu should include a balanced diet, of foods preschoolers like, based on the young child food pyramid.

Construct a 3-day menu for a 2-year-old, one that is realistic and will provide the nutrients needed.

The 3-day menu should include a balanced diet, of foods toddlers like, based on the young child food pyramid

An infant's mother thinks there may be something wrong with him because "he spits up so much." What further information should the nurse obtain?

The nurse would need to determine the frequency, consistency, characteristics, and volume of emesis; the volume and frequency of feeding; the adequacy of burping; and growth parameters.

Jane tells the school nurse that she might be homosexual. What additional information would the nurse obtain?

The nurse would need to find out *why* Jane feels that she might be homosexual. The nurse needs to be sensitive, nonjudgmental, and supportive to what Jane is saying.

Alicia's parents are worried because all of Alicia's friends wear heavy makeup and have multiple piercings and hair colors. What advice would the nurse give Alicia's parents?

The parents should get to know Alicia's friends as individuals before they judge them. Their appearance might not reflect what their values are.

Develop a home and car safety plan for the 12-month-old infant.

The safety plan should include information on car seat safety, poisoning prevention and treatment, child safety locks and gates, water safety, and avoidance of "choke" foods.

A 2-year-old is having a temper tantrum. What advice should the nurse give the mother?

The tantrum should be ignored as long as the toddler is safe.

Teach a preschool class about bicycle and street safety. Be certain to design the content at an appropriate developmental level.

The teaching plan should be based on a preschooler's developmental level of understanding and include items such as not talking to strangers, always wearing a helmet with trike/bike riding, always holding hands with a grown-up to cross the street, not playing with matches, etc.

Develop a teaching plan about safety to present to a toddler-age preschool class.

The teaching plan should be based on a toddler's developmental level of understanding.

A mother brings her 9-month-old boy to the clinic for a well-child check-up. She has questions about feeding, speech, and walking. Develop a teaching plan of anticipatory guidance for the 9-month-old infant.

The teaching plan should include appropriate information related to progression of feeding and self-feeding skills, language development, and motor skills appropriate for the 9-month-old infant.

The parents of Joe, a 14-year-old, talk to the school nurse about Joe's behavior at home. He is moody, fights with his younger siblings, only wants to be on his computer, and does not want to go on the family vacation. What advice would the nurse give the parents?

These behaviors can be typical of an adolescent at this age. To what degree Joe is performing these behaviors needs to be determined. Joe might be doing some of those behaviors because of more serious underlying problems. The parents should have an open discussion withJoe, talking with him about how they perceive his behaviors

Which of the following are reasons that stealing occurs in school-age children? (Choose all that apply.)

To escape punishment Lack of sense of property Strong desire to own something

When giving parents guidance for the adolescent years, the nurse would advise the parents to: (Select all that apply.)

accept the adolescent as a unique individual listen and try to be open to the adolescent's views respect the adolescent's privacy provide unconditional love

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by:

developing a sense of worth and competence.

During a sports physical examination, Susan, a 16-year-old, tells her health care provider that she is overweight. What additional information would the nurse obtain?

more information about why Susan feels she is overweight and her weight and height to plot on growth charts and obtain her BMI

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as:

normal for this stage of growth and development - imagination helps child cope with stressors