Pediatric Growth and Development Quiz CCP

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by: a. Supporting the parent in his/her presence and caregiving b. Keeping the infant warm and dry c. Holding and rocking the infant d. Providing opportunity for nonnutritive sucking

A Rationale: All of the actions by the nurse would be helpful in reducing stress. However, the 6-month-old, who prefers his parents to other caregivers, will be stressed the least by having that person available to provide basic care and give comfort.

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching? a) "He is allowed out of time-out when he is calm." b) "I put him in time-out when the problem occurs." c) "I usually have him in time-out for about 10 minutes." d) "The time-out doesn't just have to be in his room."

"I usually have him in time-out for about 10 minutes." Explanation: A time-out should be timed appropriately. The time-out should occur at the time the offense occurred, to ensure the child relates the offense (the behavioral problem) to the time-out period. Brief time-outs are more effective than very long ones, because a long time-out enables the child to redirect attention from calming down to being resentful. The maximum time-out duration should be 1 minute for each year of age, but it may be necessary to start with much shorter time-outs. A time-out should end as soon as the child is calm. Time-outs do not have to occur in the child's room; any location where the child is removed from activity and has an opportunity to become calm will do.

The nurse caring for a 6-month-old infant can best reduce the stress of hospitalization by: a) supporting the parent in his or her presence and caregiving. b) keeping the infant warm and dry. c) providing opportunity for nonnutritive sucking. d) holding and rocking the infant.

A. supporting the parent in his or her presence and caregiving

The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. Which of the following should the nurse say in response? a) "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do." b) "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous control." c) "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." d) "The best time to start toilet training is as soon as the child begins walking."

C. "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child? a) The child demonstrates separation anxiety. b) The child follows directions when made one at a time. c) The child copies a circle on a piece of paper. d) The child imitates the nurse in use of a stethoscope.

The child demonstrates separation anxiety.

With summer approaching, the nurse discusses sun safety with a group of teen girls. Which suggestion is most likely to be followed? Wear sunglasses. Do not attempt to get a tan. Limit sun exposure between 10:00 AM and 2:00 PM. Wear a hat when in the sun.

Wear sunglasses. Explanation: Sunglasses can be a fashion statement and are likely to be accepted. The other pieces of advice are less appealing to adolescents who link a tan body to beauty. Unfortunately sun exposure is cumulative over a lifetime, and much of it occurs in youth making protecting young skin important.

A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? a) "You'll probably notice that your daughter is uncomfortable in wet diapers." b) "Most children are ready for toilet training by the time they are 18 months old." c) "Your daughter can understand holding urine and stool by about 1 year of age." d) "Don't worry, your daughter will probably give you very definite signals."

a) "You'll probably notice that your daughter is uncomfortable in wet diapers."

The best way for parents to aid a toddler in achieving his developmental task would be to a) allow him to make simple decisions. b) help him learn to count. c) urge him to dress himself completely alone. d) give him small household chores to do.

a) allow him to make simple decisions.

The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed? a) "Childproofing our home will make it less necessary to say 'No!'" b) "We will make sure she shares her toys with cousins her age." c) "Both of us, as parents, will agree on and consistently enforce the limits we set." d) "We will give her a choice whenever possible."

b) "We will make sure she shares her toys with cousins her age."

The nurse is talking with the parents of a hospitalized child who has three siblings at home being cared for by the grandparents. The main idea the nurse wants the parents to understand is that siblings may experience: a) jealousy toward their ill brother or sister. b) stress equal to that of the affected child. c) guilt, believing they caused their bother's or sister's illness. d) resentment toward the parents.

b) stress equal to that of the affected child.

Parents are proud of their toddler's fast-developing fine motor skills. Which skill they describe should the nurse point out as a safety risk? a) Turn book pages b) Hold crayon to write c) Ability to turn knobs d) Put shapes into matching openings

c) Ability to turn knobs

What is the best advice about nutrition for the toddler? 1. Encourage cup drinking and give water between meals and snacks. 2. Encourage unlimited milk intake, because toddlers need the protein for growth. 3. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. 4. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.

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

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. Which of the following is part of this stage of Erikson's theory? a) The principle of conservation b) A sense of competence, mastery, and worth c) The conventional stage of development d) Lack of the ability to think abstractly

A sense of competence, mastery, and worth Explanation: Erikson states that school-agers receive satisfaction from developing new skills and successfully using them to accomplish goals (industry). Failing (without adult support) or being unable to meet expectations that are set too high can result in feelings of inferiority. Lacking the ability for abstract thought is a cognitive skill and part of Piaget's theory, as is the principle of conservation. The conventional stage belongs to Kohlberg's theory of moral development.

quizlet The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply. a. Infants should be in rear-facing car seats until at least age 1 or older. b. Children who are 4 to 7 years of age who weigh less than 40 pounds should use a forward-facing car seat with a harness. c. Booster seats should be used with both a shoulder and lap belt. d. Keep children in the back seat until at least age 7.

A, B, D.

A 15-year-old boy asks numerous questions about recovery from anesthesia and typical behaviors of someone awakening from sedation. The nurse interprets the concern of this teen to be: a) about his ability to control his own behavior. b) about a change in body image. c) adequacy of postsurgical pain control. d) anxiety related to the surgical procedure itself.

A. About his ability to control his own behavior.

The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. Which of the following is part of this stage of Erikson's s theory? A. The conventional stage of development B. A sense of competence, mastery, and worth C. Lack of the ability to think abstractly D. The principle of conservation

B. A sense of competence, mastery, and worth

The nurse is caring for a technology-dependent school-age child in his home. Which action best builds a trusting relationship? a) Changing the date and time of the child's physical therapy to fit the family schedule b) Discussing care and treatment with the parent and child together c) Talking with the brother of the child who feels ignored d) Encouraging the parents to join a support group

B. Discussing care and treatment with the parent and child together

The 10-year-old girl hospitalized for bladder surgery will be most stressed when nurses provide what care? A. Auscultation of breath and bowel sounds B. Perineal and indwelling catheter care C. Abdominal dressing change D. Change of hospital gown

B. Perineal and indwelling catheter care

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a) Be prone to stuttering. b) Mix the two languages in the same sentence. c) Be able to use each language as a separate system. d) Avoid asking questions.

Be able to use each language as a separate system. Explanation: The ability to use both languages separately is developed by 4 years. Mixing the two languages occurred during toddlerhood. The other options are not related to bilingualism and are incorrect.

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify? a) Interference with growth b) Obesity c) Iron deficiency d) Dental caries

Iron deficiency Explanation: Meat is an important iron source while calcium in milk consumed in large quantities can block iron absorption. Alternate protein sources can replace the meat in the child's diet for growth. Excess milk intake that boosts calories consumed can be an obesity-causing factor. Lactose from milk in constant contact with the teeth can promote development of dental caries. However, these risks are slight, with the iron deficiency risk pronounced.

In helping parents anticipate puberty in their son, the nurse explains that a first sign will be: Axillary hair Testicular enlargement Pubic hair Deepening of the voice

Testicular enlargement

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.

The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important? a) Never spank the child for any reason. b) Use praise when the child is doing something right. c) Toddlers are unable to learn rules easily. d) Rules and limits should be simple and few.

a) Never spank the child for any reason.

A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to a) give him secondary, not primary, choices. b) ask no further questions of him. c) pretend she does not hear him. d) tell him never to say, "No" again.

a) give him secondary, not primary, choices.

A 6-year-old needs to cough and deep breathe following surgery. To accomplish this, the nurse will: a) instruct the parents to remind the child to cough and deep breathe every 2 hours. b) arrange for respiratory therapy to do coughing and deep breathing exercises with the child. c) teach the young school-ager to use an incentive spirometer. d) blow a pinwheel and bubbles with the child.

blow a pinwheel and bubbles with the child.

Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a) Asks "why" often b) Talks about a past event c) Uses two-word sentences or phrases d) Half of speech understood by outsider

c) Uses two-word sentences or phrases

The nurse who wishes to be as supportive as possible to the hospitalized preschooler makes great effort to avoid threatening the 4-year-old's: a) verbal skills. b) food preferences. c) body integrity. d) creativity.

c. body integrity

An infant is breastfed. When assessing her stools, which findings would be typical? a) Stools of breastfed infants tend to have a strong odor. b) Stools of breastfed infants are usually harder than those of bottle-fed infants. c) Breastfed infants usually have fewer stools than bottle-fed infants. d) Breastfed infants are less likely to be constipated than bottle-fed infants.

d) Breastfed infants are less likely to be constipated than bottle-fed infants. Explanation: The stools of breastfed infants tend to be yellow and looser than those of bottle-fed babies.

The nurse is providing home care for an 8-year-old girl who is dependent on a ventilator, and for her family. What is a part of case management for the child and family? a) Problem solving with the parents and child ways to get the child's homework when she is unable to attend school b) Teaching the parents how to do passive range of motion and active range of motion with their child c) Doing the complex sterile dressing changes the child requires d) Scheduling respite care of the child with a child care provider

d) Scheduling respite care of the child with a child care provider

In discussing with the nurse their 2-year-old's behavior, which of the parents' descriptors suggests the child may be ready for toilet teaching? a) The child often removes her shoes and socks. b) The child frequently repeats words parents just said. c) The toddler walks with a wide, swaying gait. d) The child hides behind her bedroom door when defecating.

d) The child hides behind her bedroom door when defecating.

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The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. a) Telling the mother this behavior usually decreases by 6 to 9 months of age b) Informing the mother that thumb sucking occurs more often during periods of stress c) Advising the mother this behavior is a form of self-comfort d) Assuring the mother this behavior won't cause malocclusion

• Advising the mother this behavior is a form of self-comfort • Assuring the mother this behavior won't cause malocclusion • Informing the mother that thumb sucking occurs more often during periods of stress • Telling the mother this behavior usually decreases by 6 to 9 months of age

The father of an 11-year-old boy is worried that the child spends too much time watching TV. What information should the nurse share with this father? Select all that apply.

• The American Academy of Pediatrics recommends 2 hours or less of TV daily. • Establish a list of acceptable TV programs to view.

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply.

• When discussing improper behavior, call the behavior "bad" or "naughty," not the child. • Anticipate situations likely to cause misbehavior and redirect the child to another activity. • Books and stories can help preschoolers master proper behavior.

A mother in the outpatient setting is explaining how she plans to prepare her 5-year-old for hospital admission. What remark indicates the parent requires additional teaching? a) "We found several books for him at the library that talk about being in the hospital." b) "We have a date to visit pediatrics and tour their department." c) "We watched a program for kids on public television about being in the hospital." d) "We told him to use his manners and behave like a big, brave boy."

D. "We told him to use his manners and behave like a big, brave boy."

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

D. Placing all liquids given the child in a "no spill" sippy cup Explanation: 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. Soft table and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.

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 behavior is most likely to occur? a) Crying when the mother is out of sight b) Becoming clingy around strangers c) Mimicking mother's facial expressions d) Participating in a game of peek-a-boo

Mimicking mother's facial expressions

The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. Which of the following is the most appropriate intervention? a) Wake the child up nightly 30 to 45 minutes after going to sleep. b) Tell the parents to be sure to wake the child up during the next episode. c) Encourage the parents to let the child fall asleep in a safe place such as their bed. d) Explain that this is a developmental phase that will not last.

Wake the child up nightly 30 to 45 minutes after going to sleep. Explanation: Awakening children early in their sleep cycle often interrupts the night terror events and should be continued nightly for about 7 days. Suggesting the parent wake the child during a night terror is both difficult and ineffective. A major reason parents find night terrors frightening is that the child does not respond to the parent's presence. Indicating this is a developmental phase may be somewhat accurate, but does not assist the parents in handling the situation. Having the child fall asleep in a "safe" place or the parents' bed is likely to predispose to other sleep problems without helping to solve this one.

A mother is discussing her 10-month old boy with the nurse. Which comment indicates a need for teaching?

"He loves being in his walker and 'zips' around the house." 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. The other comments are age appropriate and acceptable practice.

The nurse is working with a group of caregivers of 6-year-olds. One of the mothers states her son has been lying and making up stories; she asks for some advice about how to address the issue. Which of the following would be an appropriate response by the nurse?

"Children this age sometimes can't distinguish between fantasy and reality."