Growth and Development of the Newborn and Infant

colic

Inconsolable crying that lasts 3 hours or longer per day and for which there is no physical cause. Cause of colic is thought to be problems in the gastrointestinal or neurologic system (probably system immaturity), temperament, or parenting style of the mother or father.

The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which ability should appear at this age? 1 Uses two or three words with meaning 2 Cruises around furniture 3 Feeds self with spoon (but spills) 4 Sits from standing position

2 At 10 months, this ability appears and is practiced often in preparation for later independent walking. NOT 1.3.4. All the rest of the skills take an additional 2 months to develop and appear around age 1 year

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the parent's first child. What should be the priority nursing intervention? 1 Recommend the parent offer smaller and more frequent feedings. 2 Offer assurance that spitting up is normal. 3 Observe the parent during feeding and burping the infant. 4 Describe the capacity of a 5-week-old infant's stomach.

3 Assessing the parent's feeding and burping technique is the first nursing action needed. The parent may be overfeeding or inadequately burping the child. NOT 1 Recommending smaller and more frequent feedings would be determined by the assessment. 2.4. Assuring the parent that some spitting up is normal and describing the capacity of the infant's stomach is helpful information but not the priority

The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? 1 Shifts a toy to his left hand and reaches for another. 2 Picks up an object using his thumb and fingertips. 3 Puts down a little ball to pick up a stuffed toy. 4 Enjoys hitting a plastic bowl with a large spoon.

3 At 6 months of age, the child is able to put down one toy to pick up another. NOT 1 He will be able to shift a toy to his left hand to reach for another with his right hand by 7 months. 2.4 He will pick up an object with his thumb and fingertips at 8 months, and he will enjoy hitting a plastic bowl with a large spoon at 9 months.

A 12-month-old seen at a walk-in clinic weighed 8 lb 4 oz (3.75 kg) at birth. Weight now is 20 lb 8 oz (9.3 kg). The nurse determines: 1 The weight assessment is blatantly inaccurate. 2 The child weighs more than expected for age. 3 The child weighs less than expected for age. 4 The child weighs the expected amount for age.

3 Birth weight should triple by 12 months. The child should weigh near 24 lb 12 oz (11.25 kg). The child is underweight for age.

At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about: A. 1 in larger than the chest. B. ½ in smaller than the chest. C. equal in size to the chest. D. 2 in larger than the chest.

A. The head is about 1 inch (2.5 cm) larger than the chest and will grow rapidly during the first 6 months. Chest circumference is not routinely measured after the newborn period.

The term "gross motor skills" refers to ...

Refers to those that use the large muscles (e.g., head control, rolling, sitting, and walking) Gross motor skills develop in a cephalocaudal fashion (from the head to the tail) In other words, the baby learns to lift the head before learning to roll over and sit

Object permanence

Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though the infant cannot see it. Occurs somewhere between 4 and 7 months

Newborn stomach capacity: How often do newborns eat:

The capacity of the normal newborn's stomach is between 0.5 oz and 1 oz. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1.5 to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.

cephalocaudal development

The pattern of growth in which areas near the head develop earlier than areas farther from the head

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply. 1 "Food is so expensive. I can't afford for my child to leave any food on the plate." 2 "I have tried at least 10 times with every green vegetable and I can't get my son to like them." 3 "I try to eat healthy in front of my daughter so she will hopefully pick up good eating habits." 4 "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." 5 "I plan on encouraging my son to cook with me when he is old enough so that he will enjoy a variety of foods and learn how to cook too."

1 Encouraging children to eat everything on their plate can lead to overeating and obesity. 2 Children may need to be exposed to new food at least 20 times before determining if they like it or not. 4 Letting a child eat whatever he wants does not lead to good choices as the child matures.

The nurse is assessing development of a 4-month-old infant during a well-child visit. Which observation needs further investigation? 1 The infant responds to the parent when the infant sees him or her but not at other times when the parent is near. 2 The infant shows interest in looking at near or high-contrast objects. 3 The infant turns the head in the direction of a squeak toy. 4 The infant makes babbling sounds, coos, and smiles.

1 If the infant does not respond to the parent's voice, it could indicate hearing loss. Infants recognize parents' voices from 1 month of age. NOT 2.3.4. It is normal for the infant to turn the head in the direction of a squeak toy, to focus visually on near or high-contrast objects, and to make babbling sounds but no words by this age. Infants develop a social smile at 2 months.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? 1 Sitting independently 2 Walking independently 3 Building a tower of four cubes 4 Turning a doorknob

1 Infants typically sit independently, without support, by age 8 months. NOT 2 Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. 3 Building a tower of three or four blocks is a milestone of an 18-month-old. 4 Turning a doorknob is a milestone of a 24-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? 1 The growth of a 2-month-old 2 The development of a 10-week-old 3 The development of a 3-month-old 4 The growth of a 5-month-old

1 The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.

The parents of a 4-day-old infant report concern about the infant's weight loss. What is the best response by the nurse? 1 "Babies may lose up to 10% of their body weight in the first month of life." 2 "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks." 3 "Weight loss after birth is normal." 4 "Babies will begin to rapidly regain weight and will double birth weight around 6 months of age."

2 The average newborn weighs 7 lb 8 oz (3,400 g) at birth. Newborns lose up to 10% of their body weight over the first week of life. The average newborn then gains about 30 g per day and regains his or her birthweight by 10 to 14 days of age. Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old

The nurse in a community clinic is assessing a 2-month-old infant. The parent asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 2 months of age? 1 The infant transfers objects from one hand to the other. 2 The infant stays seated in the tripod position. 3 The infant raises head and chest while on stomach. 4 The infant laughs aloud and responds to name.

3 Infants have gained some neck control and can independently raise head and chest by 2 months of age. NOT 1 Transferring objects from one hand to another is expected at 7 months of age. 4 Laughing aloud and responding to his or her name is expected between 4 to 5 months of age. 2 Sitting in the tripod position is not expected until 6 months of age.

A young breastfeeding parent calls the telephone nurse because the parent is concerned about the 3-month-old's stools. Which information indicates a possible problem? 1 "The infant hasn't had a stool for 3 days." 2 "The infant grunts and squirms when filling the diaper." 3 "The stools are foamy and smell terrible." 4 "The infant's stools are loose and seedy."

3 This may indicate a digestive problem or illness. The health care provider or nurse practitioner should be contacted. NOT 1.2.4. All the other statements describe normal stooling

The nurse is helping the parent of a 5-month-old infant understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? 1 A push-pull toy 2 Pots and pans from the kitchen cupboard 3 Brightly colored stacking toy 4 A yellow rubber duck for the bath

4 The rubber duck is most appropriate. It is safe, visually stimulating while bobbing on the water, and adds pleasure to bath time. NOT 1 A push-pull toy promotes skill for a walking infant. 2 Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered (4-7 months). 3 A 5-month-old does not have the fine motor coordination to use stacking toys

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? A 27.5 in (70 cm) B 29 in (74 cm) C 30.5 in (77.5 cm) D 32 in (81 cm)

A. Infants gain about 0.5 to 1 in (1.25 to 2.5 cm) in length for each of the first 6 months of life. Therefore, a 21.5-in (54.6-cm) infant adding 6 in (15 cm) of growth would be 27.5 in (70 cm). Infants grow the fastest during the first 6 months of life and slow down the second 6 months. NOT D. By 12 months of age, the infant's length has increased by 50%, making this infant 32 in (81 cm) at 1 year old.

Fine motor development includes

Fine motor development includes the maturation of hand and finger use. Fine motor skills develop in a proximodistal fashion (from the center to the periphery). In other words, the infant first bats with the whole hand, eventually progressing to gross grasping, before being capable of fine fingertip grasping

The nurse is conducting a physical examination of a 5-month-old infant. Which observation may be cause for concern about the infant's neurologic development? 1 The toes hyperextend when the bottom of the foot is stroked. 2 The anterior fontanel is open and easily palpated. 3 The infant displays an asymmetric tonic neck reflex (fencing reflex). 4 The infant grasps a finger when it is placed in the palm.

The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age

A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond? 1 The infant's gumline will be tender. 2 The infant will not play or eat for 2 days. 3 The infant will be constipated for 2 days. 4 The infant's temperature may go as high as 102°F (38.9°C).

1 Infants experience discomfort as the tooth emerges through the periodontal membrane and from inflammation. When teething, some infants become irritable, have excessive drooling, and like to bite on hard surfaces. To relieve discomfort, the parent can apply ice to the gums or use an over-the-counter topical anesthetic for infants. Some infants will refuse to eat or have poor sleeping due to the pain in the gums. There is not a definitive time frame for this to occur, and it does not happen in all infants. Fever, diarrhea, and vomiting are signs of illness, not teething.

Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures. Moro, Step, Plantar, Root, Babinski

1 The step reflex will disappear at 4 to 8 weeks 2 The root reflex at 3 months 3 The Moro reflex at 4 months 4 The plantar reflex at 9 months 5 The Babinski reflex by 12 months.

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: 1 suggest more awake tummy time for the child. 2 refer the infant for developmental and/or neurologic evaluation. 3 consider this a normal response for the age. 4 conclude the earlier assessments carried out fatigued the infant.

2 There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. NOT 1.3.4. All other nursing actions indicate failure to recognize the problem.

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: 1 is expected to appear within 1 month. 2 should have disappeared. 3 is a protective reflex and retained for life. 4 should be pronounced and easy to elicit

2 This primitive (not protective) reflex should be present at birth and disappear around age 4 months

The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? 1 running a mild fever or vomiting 2 choosing soft foods over hard foods 3 increased biting and sucking 4 frequent loose stools

3 The nurse would advise the mother to watch for increased biting and sucking. NOT 1.4. Mild fever, vomiting, and diarrhea are signs of infection. 2 The child would more likely seek out hard foods or objects to bite on

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone? 1 develop a fear of strangers 2 be able to turn over onto the back 3 insist on things being done the infant's way 4 have many "blue" or moody periods

2 At four months of age, the infant is able to lift the head and look around. The infant can roll from prone to supine. When being pulled up, the head leads. The 4-month-old infant can make simple vowel sounds, laugh aloud, and vocalize in response to voices. NOT 1 A fear of strangers does not occur until the child is older 4 a 4-month-old infant has not developed emotionally to have "moody" periods and is dependent on parental care

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? 1 The infant says "da-da" when looking at her father 2 The infant squeals with pleasure 3 The infant coos, babbles, and gurgles 4 The infant imitates her father's cough

1 By 9 months, an infant usually speaks a first word: "da-da" or "ba-ba." The other answers refer to earlier milestones in language development. NOT 2 In response to a nodding, smiling face, or a friendly tone of voice, a 3-month-old infant will squeal with pleasure or laugh out loud. 3 By 4 months, infants are very "talkative," cooing, babbling, and gurgling when spoken to. 4 At 6 months, infants learn the art of imitating. They may imitate a parent's cough, for example, or say "Oh!" as a way of attracting attention.

What feeding practice used by the parents of an 8-month-old should the nurse discourage? 1 Placing all liquids given the child in a "no spill" sippy cup 2 Including the infant at family meals in the high chair 3 Continuing to offer foods the child rejects 4 Giving the child soft table food and finger foods

1 No spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times avoiding spills is essential. The other feeding practices are age appropriate and safe. NOT 4 Soft table and finger foods promote accepting new textures and self-feeding. 3 Reoffering rejected food allows the child to accept it when ready. 2 Including the infant at the family table provides for modeling of eating behaviors and socialization

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? 1 They sing to her before she goes to sleep. 2 They put her to bed when she falls asleep. 3 If she is safe, they lie her down and leave. 4 The child has a regular, scheduled bedtime.

2 If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. NOT 1.3.4. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices

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? 1 "You will never get him to eat all unwrapped like that." 2 "You are doing a wonderful job attempting to wake the baby." 3 "That is not how you get him to eat." 4 "Maybe you should watch the breastfeeding video again."

2 The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. NOT 1.3.4. The other responses do not emotionally support the mom or contribute to a positive learning environment.

The nurse is examining an 8-month-old child for appropriate development during a regular check-up. Which observation points to a developmental risk? 1 Crawls with stomach down 2 Picks up small objects using entire hand 3 Cannot pull self to standing 4 Uses only the left hand to grasp

4 Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. NOT 2 Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. 1.3. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks

A parent is discussing the 10-month-old child with the nurse. Which comment indicates a need for teaching? 1 "I wipe my child's teeth every day with a fresh washcloth." 2 "We have safety gates at the top and bottom of our stairs." 3 "My child gets a few sips of apple juice each day from a regular cup, not a sippy cup." 4 "My child loves being in the walker and 'zips' around the house."

4 Walkers are safety hazards and not recommended by the American Academy of Pediatrics. They cause falls plus promote the ability to reach items on surfaces otherwise inaccessible. NOT 1.2.3. The other comments are age appropriate and acceptable practice.

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. 1 The infant babbles. 2 The infant does not pay attention to noises behind him. 3 The infant has frequent episodes of crossed eyes. 4 The infant seems disinterested in the surrounding environment. 5 The infant is unable string together 2 word sentences.

Warning signs that may indicate problems with sensory development include the following: young infant does not respond to loud noises; child does not focus on a near object; infant does not start to make sounds or babble by 4 months of age; infant does not turn to locate sound at age 4 months; infant crosses eyes most of the time at age 6 months. Language development at this stage of development does not include stringing together 2-word sentences

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? 1 "I can expect my infant to be able to raise the head up when on the stomach within the next month." 2 "I can expect my infant to become clingy around strangers within the next month." 3 "I can expect my infant to be able to hold a rattle within the next month." 4 "I can expect my infant to laugh out loud within the next month."

1 It is expected that a 3-month-old infant can raise the head to 45 degrees while laying on the stomach. NOT 2 Becoming clingy around strangers occurs in the infant around 6 to 8 months of age. 3 The infant can begin to hold a rattle around 5 months of age. 4 At 4 to 5 months, the infant will typically begin to laugh out loud.

Which milestone would the nurse expect an infant to accomplish by 8 months of age? 1 Sitting without support 2 Creeping on all fours 3 Pulling self to a standing position 4 Being able to sit from a standing position

1 Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. NOT 2.3. They are able to creep at 9 months and pull to a standing position by 10 months. 4 At 12 months the infant is able to sit from a standing position and is learning to walk.

The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective? 1 The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog 2 The parent spanks the child while taking the child into another room away from the dog 3 The parent allows the child to continue pulling at the dog and states, "If the dog bites her she will learn." 4 The parent places the child in time-out and explains the reason for the time-out

1 Providing a safe environment, redirection away from undesirable behaviors, and saying "no" in appropriate instances are effective forms of discipline for an infant's developmental level. NOT 2 Infants are at an increased risk for injury from spanking and do not understand the reason for the spanking. 3.4. Infants do not understand time-outs or the reason for this type of discipline.

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? 1 Maintain a feed-on-demand approach. 2 Apply warm compresses to the breast. 3 Encourage the infant to latch on properly. 4 Maintain adequate diet and fluid intake.

1 The best way to ensure effective feeding is by maintaining a feed-on-demand approach rather than a set schedule. NOT 2 Applying warm compresses to the breast helps engorgement. 3 Encouraging the infant to latch on properly helps prevent sore nipples. 4 Maintaining proper diet and fluid intake for the mother helps ensure an adequate milk supply.

The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old infant for the parent. Which action is accurate? 1 Telling the parent that abdominal breathing disappears by 9 month of age 2 Advising the parent that the infant's usual respiratory rate should slow to about 20 breaths per minute by age 6 months 3 Explaining to the parent the risk for infection is high due to the lack of antibodies 4 Informing the parent that the respiratory system reaches maturity similar to the adult's by 12 months of age.

3 Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. NOT 2 The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. 1 Abdominal breathing persists until 6 to 12 years of age. 4 The respiratory system matures by age 7 years

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? 1 Lock all cabinets that contain cleaning supplies. 2 Keep all pots and pans in lower cabinets. 3 Give warm bottles of formula to the baby. 4 Restrain the baby in a car seat.

4 The client should restrain the baby in a car seat when driving. Infants are especially vulnerable to injuries resulting from falls from changing tables or being unrestrained in automobiles. NOT 1.2.3. Locking the cabinets and giving warm bottles of formula to the baby are secondary teachings.

The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? A. 1 to 3 natal teeth B. no teeth C. 1 to 2 lower teeth D. 1 upper tooth

B Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.

The parent of an infant questions the nurse about the baby's teething. The nurse provides client education. Which statement by the parent indicates understanding of the information provided? 1 "By 1 year my baby should have about three teeth." 2 "The first teeth that will likely appear are the lower incisors." 3 "My baby will most likely have the upper middle teeth come in first." 4 "My baby's first tooth will likely appear between 5 and 6 months."

2 Traditionally, the first teeth to erupt will be the lower incisors, followed by the upper incisors. NOT 4 Teeth will begin erupting between 6 and 8 months. 1. By the age of 12 months, the infant will have between 4 and 8 teeth, if progressing normally.

The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent? 1 Infants need a daily bath 2 Soap lubricates and oils an infant's skin 3 Bath time provides an opportunity for play 4 Never use soap on an infant's hair

3 The work of children is play. Play provides a natural way for the infant to learn. In early infancy infants prefer their parents rather than toys. Parents can talk and sing to infants during feeding, bathing, and changing diapers. NOT 1 Infants do not need a daily bath as long as the diaper area is washed with diaper changes. 2 Soap is actually drying to an infant's skin. 4 Washing the hair with soap can help remove excess oil.

The nurse is teaching the parent of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? (Select all that apply.) 1 Assuring the parent this behavior won't cause malocclusion 2 Advising the parent this behavior is a form of self-comfort 3 Advising the parents to draw attention to the issue as this may help child learn to stop 4 Telling the parent this behavior usually decreases by 6 to 9 months of age 5 Informing the parent that thumb sucking occurs more often during periods of stress

1.2.4.5. All are accurate and should help the parent better understand and accept the behavior.

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? 1 not cleaning the infant's gums after eating meals or snacks 2 putting the infant to bed with a bottle of milk or juice 3 using a cloth instead of a brush for cleaning the infant's teeth 4 brushing the infant's teeth with fluoride-free toothpaste

2 The nurse will warn against putting the infant to bed with a bottle of milk or juice because this allows the sugar content of these fluids to pool around the infant's teeth at night. NOT 1.3. Not cleaning the infant's gums when the infant is done eating will have minimal impact on the development of dental caries, as will using a cloth instead of a brush for cleaning teeth when they erupt. 4 Failure to clean the teeth with fluoridated toothpaste is not a problem if the water supply is fluoridated. Fluoridated toothpaste is recommended for use once the infant is able to not swallow during brushing.

At what age would it be okay to introduce carrots to an infant's diet? 1 Solid food can be introduced whenever the child seems ready. 2 Solid food can be introduced after 9 months of age. 3 Solid food can be introduced at 7 to 9 months of age. 4 Solid food can be introduced at 4 to 6 months of age.

4 The tongue extrusion reflex is present until the infant is 4 to 6 months of age. After this reflex disappears then solid food may be introduced. The infant's ability to swallow solid foods is not completely functional until this age nor are the enzymes present which are needed to process foods. The infant must be ready to handle spoon-feeding. By 7 months onward, the baby should be eating solid foods regularly and drinking from a cup in addition to breast or bottle feeds.

The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted? 1 "Does he move a toy back and forth from one hand to the other when you give it to him?" 2 "Does he place toys into a box or container and take them out?" 3 "Is he able to drink with a cup by himself?" 4 "Is he able to hold a pencil and scribble on paper?"

1 Transferring an object from one hand to the other is expected at 7 months of age, so this would be expected of an 8-month-old. NOT 2.3.4. The other options are not expected until later months, so questioning the parents about these skills would not help in determining if he was at the motor skill developmental level that should be expected.

The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething? (Select all that apply.) 1 Fever and diarrhea 2 Increased sucking on hands 3 Refusing to eat 4 Drooling and biting 5 Irritability and awakening from sleep

2.3.4.5. Fever and diarrhea (1) are considered signs of illness, not teething. The others are typical of teething

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? 1 By 8 months of age, the child's skill level will vary greatly and cannot be predicted. 2 The infant can be expected to display developmental skills consistent with a 8-month-old infant. 3 The infant will most likely present with developmental skills consistent with a 6-month-old infant. 4 The infant will likely show the skills of an infant with the adjusted age of 7 month.

3 When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronologic age. The infant who was born at 32 weeks' gestation was 8 weeks or 2 months premature. To determine the adjusted age, the nurse subtracts 2 months from the chronologic age of 8 months: 6 months.

Parents state they are "worn out" at their child's 6-month check-up because their child awakens each night and cries. The nurse suggests which measures? 1 At bedtime, rock the child to sleep and then place in crib. 2 Add rice cereal to the evening bottle to prevent hunger and awakening. 3 During night awakening, do not interact with the child. 4 Establish a quieting ritual before bed.

4 Bedtime rituals help both promote sleep. NOT 3 During awakenings, the parents should interact with the child, but minimize attention and stimulation. 2 Adding rice cereal to bottles does not promote sleeping through the night and isn't recommended. 1 Rocking the child to sleep and then placing them into the crib does not teach the child to self-soothe and fall asleep independently

The nurse is promoting a healthy diet to the parent of a 6-month-old infant. What action would have the most effect on the infant's neurologic development? 1 Requiring more solid foods in the diet 2 Adding fruit juice daily 3 Establishing an adequate level of dietary iron intake 4 Promoting continuation of breastfeeding

4 Continuing to breastfeed ensures the proper level of nutritional fat for myelination of the nervous system. NOT 3 Having adequate dietary iron would help prevent anemia as the stores from fetal development are depleted. 1 Promoting increased intake of solid foods is not necessary at 6 months and may diminish the amount of breast milk consumed. 2 Fruit juice in the diet is not recommended. Fruits provide more nutrition and will soon be gradually added to the infant's diet.

The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3600 g) and was 20 in (50.8 cm) in length. Which finding is consistent with the normal infant growth and development? 1 weight of 14 lb (6400 g) and length of 24 in (61.0 cm) 2 weight of 16 lb (7300 g) and length of 26 in (66.0 cm) 3 weight of 18 lb (8200 g) and length of 28 in (71.1 cm) 4 weight of 20 lb (9100 g) and length of 30 in (76.2 cm)

2 The average newborn weighs 7.5 lb (3400 kg) at birth. Most infants double their birth weight at 4 to 5 months and will triple by the time they are 1 year old. If this infant was 8 lb (3600 kg) at birth, then it is most likely now 16 lb (7300 g). The average newborn is 20 in (50 cm) long at birth. They grow more quickly in length over the first 6 months, than during the second 6 months. By 12 months of age, the infant's length has increase by 50%. At 1 year, this infant will most likely be 30 in (76.2 cm) in length; however, since most of the growth occurs in the first 6 months, it is possible for the infant to grow an additional 6 in (15 cm) during that time

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? 1 Vitamin D 2 Vitamin E 3 Iron 4 Calcium

3 Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. NOT 1 Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. 2.4. Calcium and vitamin E would not be a concern in this infant's formula

The nurse is teaching the parent of a 2-month-old infant about the social and emotional developments that will occur in the next 8 weeks. Which behavior is most likely to occur? 1 Participating in a game of peek-a-boo 2 Becoming clingy around strangers 3 Mimicking parent's facial expressions 4 Crying when the parent is out of sight

3 Infants will mimic the facial expressions of their parents when they are 3 to 4 months old. NOT 2 Becoming clingy around strangers probably won't occur until the child reaches 6 months. 1 Engaging in peek-a-boo becomes fun between 6 and 8 months. 4 Crying when the parent is out of sight indicates separation anxiety and is common after 6 to 8 months of age

The best way for an infant's parent to help the child complete the developmental task of the first year is to: 1 expose the infant to many caregivers to help the infant learn variability. 2 talk to the infant at a special time each day. 3 respond to the infant consistently. 4 keep the infant stimulated with many toys.

3 The developmental task of an infant is gaining a sense of trust. The infant develops this sense from the caretakers who respond to the child's needs, such as feeding, changing diapers, being held. It is a continuous process. A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust. NOT 1 An infant is too young to have variability in caretakers. This causes mistrust. 2 The parents or caretakers do not need a special time to talk to the infant each day. It should be done with each interaction. 4 Providing too much stimulus before the infant develops gross motor skills causes frustration from the child and not enjoyment.

The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? 1 The neck is short, thick and mobile 2 The newborn startles to loud sounds 3 Natal teeth noted in the mouth that are loose 4 Gluteal folds are present and symmetrical

3 The presence of 1 or 2 teeth at birth (natal teeth) is a finding that may be benign or may point to other congenital abnormalities. NOT 1 The neck should be short, thick and mobile. 4 The gluteal folds should be symmetrical. 2 It is normal for the newborn to startle to loud sounds

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? 1 "You should buy wheat cereal." 2 "You should buy oat cereal." 3 "You should buy rice cereal." 4 "You should buy barley cereal."

3 The rice cereal should be first. NOT 1.2.4. The infant should be monitored for food allergies by following the rice cereal with oats, barley, and wheat. Wheat has the highest allergy reaction in infants.

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? 1 "Babies really can't tell the difference between people at that age." 2 "Maybe she just knows your voice better than your mother's." 3 "You may be right, since infants can sense their mother's smell as early as 7 days old." 4 "I'm not sure a 4-week-old infant can tell their mother from another woman's smell."

3 The sense of smell develops rapidly: the 7-day-old infant can differentiate the smell of his or her mother's breast milk from that of another woman and will preferentially turn toward the mother's smell.

A parent mentioned to the nurse that the usually smiling, happy 8-month-old child was clingy and intensely serious when the grandparent visited from a distant city. The nurse explained the child was experiencing: 1 cephalocaudal development. 2 separation anxiety. 3 colic. 4 stranger anxiety. 5 changes in temperament.

4 Stranger anxiety occurs around 8 months and manifests as the parent described. This behavior indicates the infant sees himself as a separate person. NOT 1.2.3. The other options are incorrect and not related to social/emotional development.

A 3-month-old infant has a Moro reflex. Which statement is most true of this reflex? 1 A Moro reflex normally lasts until 9 months. 2 It is not important how long the reflex persists, only that it is present at birth. 3 A Moro reflex present at 3 months of age requires referral for a neurologic examination. 4 Infant may retain the Moro reflex at 3 month old; it fades between 2 and 4 months.

4 The Moro reflex is seen in the infant as a sudden extension of the head with the arms abducted and moving upward. In this position the hands form the letter "C". This reflex is known as the "startle reflex" because the infant looks startled when this reaction is seen. This reflex is present at birth; it begins to fade at 2 months of age and disappears by 4 months. It is a normal reflex for some 3-month-old infants; thus, there is no need for medical intervention.