PEDI 23

The infant weighs 6 lbs. 8 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of six months?

13 lbs.

The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which of the following is the priority intervention to promote adequate growth?

Monitoring the child's weight and height

A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how?

"Bed sharing has positive effects on babies, let me get you information."

A 3-month-old still has a Moro reflex. Which statement is most true of this reflex?

Most 3-month-olds still have a Moro reflex.

Marcy asks the nurse if her 9-month-old son is drinking the recommended amount of breast milk or formula everyday. What would the appropriate response be?

"He needs 7 ounces every 6 hours."

At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about:

1 inch larger than the chest

The nurse measures the head circumference of a 6-month-old infant. Which measurement would the nurse interpret as most appropriate?

43.5 cm

Which of the following milestones would you expect an infant to accomplish by 8 months of age?

Sitting without support

The caregiver of 7-month-old twins tells the nurse that she has noticed that both of her children enjoy playing with a toy by moving the object back and forth between their hands over and over again. Which of the following statements made by the nurse most accurately explains this behavior?

"Depth perception develops at seven months so the child can recognize where the object is in relation to the hands."

A nurse is conducting a class for new mothers about infants and nutrition. One of the women asks, "What is the best nutrition for her 3-month-old infant? Which response by the nurse would be most appropriate?

"Human milk is the best nutrition for your child"

Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie?

"It is a personal decision, let me give you a pamphlet from the AAP."

Julie is an 18-year-old new mother. When the nurse discharges the mom and infant, she notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat?

"Let me go over car seat safety with you, so you can install your car seat properly."

At which age would the nurse expect to find the beginning of object permanence?

6 months

A nurse instructs the parents of an infant that the best awake state for interaction would be when the infant is which of the following?

Eyes wide and bright

The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability?

Most babies do not sit steadily until 8 months; she is normal.

A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him?

The child's gum line will be tender.

The best way for an infant's father to help his child complete the developmental task of the first year is to

respond to her consistently.

Donna takes her 4-month-old to the doctor for a visit. She asks the nurse what type of baby cereal she should buy now that Jimmy is starting solid foods. The nurse should respond how?

"You should buy rice cereal."

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

The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. Which of the following would be the best response by the nurse?

"Milk does not provide adequate amounts of iron which are found in solid foods."

Two-year-old Johnny does not like his new sister. When his mom leaves the room he tries to pull her out of her bouncy seat. She cries and Mom comes in running. Mom talks with the nurse at the pediatrician office about ways to discipline him. What is a positive strategy the nurse can offer the mother?

"You should try and reinforce to Johnny not to hurt the baby."

The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months?

21 lbs. 12 oz.

The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months?

27 ½ inches

The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months?

30-32 inches

The mother of a 4-month-old infant is working with the nurse to schedule well-child visits for her son. The mother would expect to schedule the next visit for her son at which age?

6 months

The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?

A yellow rubber duck for the bath

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which of the following topics would be most appropriate?

Advising how to create a toddler-safe home

The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say mama or dada yet. Which of the following is the priority intervention?

Asking the mother if the child uses Spanish words

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

The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which of the following should appear at this age?

Cruises around furniture

The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which of the following is the most effective anticipatory guidance?

Discouraging the addition of fruit juice to the diet

A 6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. Which of the following is the priority nursing intervention?

Discussing the child's feeding patterns

The nurse is caring for a 7-month-old girl during a well-child visit. Which of the following interventions is most appropriate for this child?

Discussing the type of sippy cup to use

The nurse is providing discharge teaching regarding formula preparation for a new mother. Which of the following guidelines would the nurse include in the teaching plan?

Do not add cereal to the formula in the bottle or sweeten the formula with honey.

A nurse is teaching the parents of an infant about oral care. Which of the following would the nurse include as being important for tooth protection and growth?

Fluoride

The nurse is teaching the mother of a 2-month-old girl about the social and emotional developments that will occur in the next 8 weeks. Which of the following behaviors is most likely to occur?

Mimicking mother's facial expressions

While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which of the following developmental phenomena has this infant demonstrated?

Object permanence

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. Which of the following should be the priority nursing intervention?

Observe the mother while she feeds and burps her infant.

What feeding practice used by the parents of an 8-month-old should the nurse discourage?

Placing all liquids given the child in a "no spill" sippy cup

The nurse is promoting a healthy diet to the mother of a 6-month-old girl. Which of the following would have the most effect on the infant's neurologic development?

Promoting continuation of breastfeeding

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

A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours but 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. Which of the following should be the primary nursing diagnosis in this situation?

Risk for aspiration related to feeding the infant an inappropriate food

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

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

Six to 12 teeth

A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing:

Stranger anxiety

The nurse is caring for a 4-week-old girl and her mother. Which of the following is the most appropriate subject for anticipatory guidance?

Telling how and when to introduce rice cereal

The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following findings might suggest a developmental problem?

The child does not babble or laugh.

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:

The child weighs less than expected for age.

In observing an infant who is six months of age, which of the following fine motor skills would the infant have most recently attained?

The infant can hold a bottle.

The child weighs less than expected for age.

The infant cries and the caregiver picks the child up.

Which of the following shows an example of Erik Erikson's developmental task for the infant?

The infant cries and the caregiver picks the child up.

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 at 6 months.

In working with infants, the nurse would expect the posterior fontanel to be closed in an infant who is which of the following ages?

Three months

Which developmental task, according to Erikson, should an infant accomplish during the infant year?

Trust

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which of the following observations points to a developmental risk?

Uses only the left hand to grasp

The mother of an infant asks you when to begin tooth brushing with her son. Your best response would be

as soon as the first tooth erupts.

When teaching an infant's mother about bathing her, it would be important to instruct her that

bath time provides an opportunity for play.

Anticipatory guidance for an infant for the 4th month should include the fact that she probably will

be able to turn over onto the back.

The nurse caring for newborns knows that infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. Which of the following statements accurately describe the typical infant's achievement of these milestones? Select all answers that apply.

• At 1 month the infant lifts and turns the head to the side in the prone position. • At 7 months the infant sits alone with some use of hands for support. • At 9 months the infant crawls with the abdomen off the floor. • At 12 months the infant walks independently.

Parents complain of being "worn out" at their child's 6-month check-up because their boy awakens each night and cries. The nurse suggests which measures? (Select all that apply.)

• Establish a quieting ritual before bed. • During night awakening, keep interactions minimal.

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?

"The cereal should be a fairly thin consistency at first."

A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information?

"This is a primitive reflex known as the palmar grasp."

An infant is being introduced to drinking fluids from a cup. The nurse instructs the mother that fruit juice can now be added. Which of the following would the nurse suggest the mother try first? Select all that apply.

• Apple • White grape juice

The nurse observes an infant interacting with his parents. Which of the following are normal social behavioral developments for this age group? Select all answers that apply.

• Around 2 months the infant exhibits a first real smile. • Around 3 months the infant smiles widely and gurgles when interacting with the caregiver. • Around 3 months the infant will mimic the parent's facial movements, such as sticking out the tongue. • Separation anxiety may also start in the last few months of infancy.

The infant in the exam room has the following signs and symptoms. Which ones 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

When teaching a new mother about "floor time," the nurse would instruct the mother to place the infant in which position? Select all that apply.

• Supine • Prone

Bob and Nancy have financial issues and 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 can use the crib, but there are guidelines to follow."

The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. What reaction should the nurse make?

"You should always hold your baby for feedings instead of propping the bottles."

Which measure would you suggest an infant's parents use to relieve teething discomfort?

Give her a cold teething ring to chew.

The nurse is teaching the parents of an infant about bathing. Which of the following would the nurse identify as a safe water temperature to use?

118 degrees F

When a cup is introduced to infants, the introduction of fruit juice may follow. What type of juice would be appropriate for an infant?

Apple juice

The nurse is assessing Julie, 3-month-old infant. Which of the following developmental milestones would the nurse expect?

Julie hold her head erect and steady

The nurse working in the child clinic observes infant Max. He is 8 months old. What type of activity should the nurse be observing?

Max is in the stroller playing peek-a-boo.

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:

Refer the infant for developmental and/or neurologic evaluation.

A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. Which of the following has the girl just demonstrated?

Secondary circular reaction

The nurse is conducting a physical examination of a 5-month-old boy. Which of the following observations may be cause for concern about the infant's neurologic development?

The infant displays an asymmetric tonic neck reflex (fencing reflex).

The nurse is assessing development of a 4-month-old boy during a well-child visit. Which of the following observations needs further investigation?

The infant responds to his mother when he sees her but not at other times when she is near.

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. Which of the following represents 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