Peds - Development

The parents of a 10-year-old girl voice concern to the nurse because their daughter seems to "have a higher amount of body fat" than they expect based on the healthy eating habits and high activity level of the family. What is the best response by the nurse?

"Before adolescence the body fat composition of school-age children increases earlier and in greater amounts in girls than in boys." Boys have more lean body mass per inch of height than girls during the late school-age years, in preparation for adolescence.

The nurse is collecting data from a 15-year-old boy who is being seen at the ambulatory care clinic for immunizations. During the initial assessment, he voices concerns about being shorter than his peers. What response by the nurse is indicated?

"Boys your age will often continue growing a few more years"

The parents of an 8-year-old boy report their son is being bullied and teased by a group of boys in the neighborhood. Which response by the nurse is best?

"Bullying can have lifelong effects on the self-esteem of a child."

A 3 ½-year-old girl is admitted to the hospital with a severe respiratory infection. The parents tell the nurse that they have noticed that their child has been using "baby talk" and has been wetting the bed. The parents are concerned and ask the nurse what they should do. How should the nurse respond?

"It is normal for children to regress during a stressful event like a hospitalization. Just praise her good behavior and don't give attention to the regressive behavior." Regression is very common during any stressful events in a preschool child's life. Praising good behavior and ignoring the regressive behavior tends to be the best way to deal with regression. Once the stressful event has passed the regressive behavior should disappear. Page 119

When the nurse discharges a new mom and infant, the nurses 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." The nurse should notice this is not the proper place for a car seat. The car seat should be rear facing and in the center of the back seat of the car. The nurse would review car seat safety with Julie and have Julie install the seat properly. The nurse should provide written materials if available. The other responses are not appropriate and do not ensure that proper installation will occur and that infant safety will be maintained

The nurse is collecting data from an adolescent being seen for a well-child check. During the interview, the teen reports he sleeps about 6 hours per night during the week but is able to sleep 8 to 9 hours on the weekend. What response by the nurse is most appropriate?

"Let's talk about ways to increase the amount of rest you get during the week." It is recommended that teens get 8 to 9.5 hours of sleep per night. Teens who do not get adequate rest during the week often sleep more hours on the weekend. The best practice would be to determine ways to improve daily rest patterns.

The nurse is discussing home safety with the parents of a 10-year-old client. Which statement by the client's parents most concerns the nurse?

"Our child swims alone before we get home from work."

The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits?

"Our family rule is that all children clean up their plates at each meal, and we feed them a lot." Children should not be expected to always eat everything on their plates, nor should they be rewarded for doing so. Appropriate serving sizes are important here. Children need to learn to self-regulate and eat only until full. The other statements indicate knowledge of healthy eating habits and are useful in developing positive attitudes toward eating and toward trying different foods.

A teenage girl and her mother are in the office. When the teen uses the restroom, her mother asks the nurse about the changes that Linda is going through. She would like to talk to her about sexuality and its changes but she is unsure of how to do this. What reminders should the nurse give to the mother for when she discusses sex?

Promote open lines of communication; listen instead of lecture; and share family values.

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern?

"Remain calm, pick the child up, and move to a quiet and neutral place until she gains self-control; don't give in to her demands."

The nurse is documenting the relationship between a postpartum mother and her infant. Which observation would demonstrate attachment?

"The mom is talking to the infant while breast-feeding the infant." The nurse would document attachment when she observes eye-to-eye contact between infant and mother, and the mother holding the infant close and talking softly with the infant. The attachment relationship occurs with eye-to eye contact, communication, and physical contact. The other choices display none of these characteristics between infant and mother.

The nurse is performing an admission assessment of an adolescent with the teen and the parents. During the assessment the nurse suspects that the teen may be pregnant. What is the best way for the nurse to address this situation?

Ask the parents to wait in the family lounge while finishing the assessment, then ask the teen during the assessment During health care visits the adolescent or parent may have concerns that they are hesitant or uncomfortable talking about in front of each other. Asking the parents to wait in the lounge while completing the assessment allows the nurse to talk with the teen. This allows time for the teen to confide in a nonjudgmental adult. Asking the child in front of the parents or asking the parents without speaking to the teen first may cause unnecessary conflict. While it is important to speak with the client's physician, the best opportunity to discuss the concerns is at the present time.

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age?

Banding together with other girls and dressing like them