Prepu: Chapter 3: Growth and Development of the Newborn and Infant
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. "Food is so expensive. I can't afford for my child to leave any food on the plate." "I try to eat healthy in front of my daughter so she will hopefully pick up good eating habits." "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." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "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."
"Food is so expensive. I can't afford for my child to leave any food on the plate." "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." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." Explanation: Encouraging children to eat everything on their plate can lead to overeating and obesity. Children may need to be exposed to new food at least 20 times before determining if they like it or not. Letting a child eat whatever he wants does not lead to good choices as the child matures. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Nutrition, p. 78. Chapter 3: Growth and Development of the Newborn and Infant - Page 78
The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance." "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "We should get some rest in about 1 month when the newborn starts sleeping through the night."
"I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance." "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." Explanation: Newborn stools will become yellowish in color after the first few days of life. Newborns typically lose 5% to 10% of their birthweight the first few days of life, and begin to gain weight after this period. Newborns have better up-close vision and begin to recognize human faces during their newborn stage. Most infants will not sleep through the night until about 3 months of age. There is no evidence that rice cereal keeps a newborn from waking and the practice of feeding rice cereal to newborns is discouraged by physicians as the newborn needs formula or breast milk specifically. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Stools; Weight; Sight, p. 65, 60, 69. Chapter 3: Growth and Development of the Newborn and Infant - Page 65, 60, 69
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? "Increases in body size are referred to as growth." "Both growth and development are influenced by heredity." "Development refers to the increase in skills the child demonstrates as they grow and age." "Maturation refers to the child's increases in body size."
"Maturation refers to the child's increases in body size." Explanation: Growth refers to an increase in physical size. Development is the sequential process by which infants and children gain various skills and functions. Heredity influences growth and development by determining the child's potential, while environment contributes to the degree of achievement. Maturation refers to an increase in functionality of various body systems or developmental skills. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, INTRODUCTION, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
The postpartum nurse observes new mothers as they put their newborns in the bassinet to sleep. Which actions by the new mothers require further instruction from the nurse? Select all that apply. A mother places her newborn on its side after falling asleep. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off. A mother tells her husband to be sure to place the newborn on his back when putting the baby in the bassinet. A mother places the baby comforter her grandmother made over the newborn's body. A mother states all of her children like sleeping on their abdomen and this newborn likes it too.
A mother places her newborn on its side after falling asleep. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off. A mother places the baby comforter her grandmother made over the newborn's body. A mother states all of her children like sleeping on their abdomen and this newborn likes it too. Explanation: Newborns and infants should be on their backs when sleeping in order to help prevent sudden infant death syndrome (SIDS). A firm mattress without pillows or comforters should also be used. The baby's bed should be placed away from air conditioner vents, open windows, and open heaters. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Healthy Sleep and Rest, p. 85. Chapter 3: Growth and Development of the Newborn and Infant - Page 85
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?
putting the infant to bed with a bottle of milk or juice Explanation: 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 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. 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Healthy Teeth and Gums, p. 85. Chapter 3: Growth and Development of the Newborn and Infant - Page 85
The nurse is interacting with several parents of infants. Which parent statement would alert the nurse to refer the infant for further evaluation by the health care provider? "My 2-week-old infant seems to prefer looking at designs that are black and white." "My 9-month-old infant is beginning to track objects when we show her favorite objects." "My 1-month-old infant's eyes occasionally cross and wander when looking at me." "My 3-month-old infant does not seem to be able to see things at a distance."
"My 9-month-old infant is beginning to track objects when we show her favorite objects." Explanation: Infants should be tracking objects by 7 months of age, so an older infant who is just "beginning to track objects" would warrant further evaluation. The newborn shows preference for items with contrast, such as black and white stripes so this is a normal finding. The newborn's eyes may cross and wander and this is a normal finding for this age. Distance vision develops by 7 months of age, so a younger child would not be expected to have developed distance vision yet. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Sight, p. 69. Chapter 3: Growth and Development of the Newborn and Infant - Page 69
The nurse enters a client's room to find the new mother crying softly. The client states, "I had my heart set on breastfeeding but my infant was born with a cleft lip. My dreams of breastfeeding are destroyed." Which response by the nurse is appropriate?
"You may still breastfeed your infant. I will show you appropriate techniques to use." Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4 ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, BREASTFEEDING TECHNIQUE, p. 80. Chapter 3: Growth and Development of the Newborn and Infant - Page 80
The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent?
Bath time provides an opportunity for play Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4 ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Growth and Development Through Play, p. 76. Chapter 3: Growth and Development of the Newborn and Infant - Page 76
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? Most infants sit steadily at 4 months; this infant is normal. Most infants do not sit steadily until 8 months; this infant is normal. Sitting ability and the age of first tooth eruption are correlated. Most infants sit steadily at 3 months; this infant is slightly delayed.
Most infants do not sit steadily until 8 months; this infant is normal. Explanation: At 3 months of age the infant should be able to raise the head about 45 degrees when in the prone position. The infant does yet have the developmental skills for sitting. Most infants are unable to sit steadily until 8 months of age. Gross motor skill development does not correlate with tooth eruption. The nurse should reassure the parent that this infant is on tract developmentally. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Gross Motor Skills, p. 68. Chapter 3: Growth and Development of the Newborn and Infant - Page 68
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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4 ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, FEEDING PATTERNS, p. 82. Chapter 3: Growth and Development of the Newborn and Infant - Page 82
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? Read age-appropriate books to the infant daily. Respond promptly when the infant cries. Praise the infant when a new milestone is reached. Appropriately enunciate words when speaking to the infant.
Respond promptly when the infant cries. Explanation: The developmental task of the infant year, according to Erikson, is to gain a sense of trust. This can be accomplished by promptly meeting the infant's needs during the first year of life. If the infant does not learn to trust, mistrust will develop. Praising will help meet the future developmental tasks of the child. Reading books and appropriately enunciating words will aid in the infant's language development. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, PSYCHOSOCIAL DEVELOPMENT, p. 67. Chapter 3: Growth and Development of the Newborn and Infant - Page 67
A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours and 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. What should be the primary nursing diagnosis in this situation? Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food Risk for aspiration related to feeding the infant an inappropriate food Readiness for enhanced nutrition, related to the age of the infant
Risk for aspiration related to feeding the infant an inappropriate food
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 (3.6 kg) and was 20 in (50.8 cm) in length. Which finding is most consistent with the normal infant growth and development? The baby weighs 15 lb (6.8 kg) and is 24 in (61.0 cm) in length. The baby weighs 24 lb (10.9 kg) and is 26 in (66.0 cm) in length. The baby weighs 21 lb (9.5 kg) and is 30 in (76.2 cm) in length. The baby weighs 18 lb (8.2 kg) and is 26 in (66.0 cm) in length.
The baby weighs 18 lb (8.2 kg) and is 26 in (66.0 cm) in length. Explanation: The average infant's weight doubles at 4 months and will triple at 1 year of life. The infant's length will increase by 50% by the first year. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
What action shows an example of Erik Erikson's developmental task for the infant?
The infant cries and the caregiver picks the child up. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4 ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, PSYCHOSOCIAL DEVELOPMENT, p. 67. Chapter 3: Growth and Development of the Newborn and Infant - Page 67
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? They sing to her before she goes to sleep. They put her to bed when she falls asleep. If she is safe, they lie her down and leave. The child has a regular, scheduled bedtime.
They put her to bed when she falls asleep. Explanation: 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. 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Healthy Sleep and Rest, p. 85. Chapter 3: Growth and Development of the Newborn and Infant - Page 85
A mother asks the nurse where the microwave is so that she can warm up breast milk to feed her baby. What is the best response by the nurse? "Breast milk can be given cold, so there is no need to heat it." "Make sure that you test the milk on your wrist before feeding." "You should warm the milk under warm water instead." "You should only give fresh breast milk to an infant."
"You should warm the milk under warm water instead." Explanation: A microwave can heat unevenly and cause burns and therefore should never be used to heat breast milk or formula for an infant. In addition, it can change the immune properties of the breast milk. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Breastfeeding, p. 78. Chapter 3: Growth and Development of the Newborn and Infant - Page 78
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? 13 lb (5900 g) 10 lb 8 oz (4760 g) 15 lb 4 oz (6920 g) 19 lb 8 oz (8825 g)
19 lb 8 oz (8825 g) Explanation: The average newborn weighs 7.5 lb (3400 g). The average newborn loses 10% of birth weight over the first week of life but regains it in about 10 to 14 days. Most infants double their birth weight by 4 to 6 months of age and triple their birth weight by the time they are 1 year old. If the newborn weighed 6 lb 8 oz (2,950 g) at birth and tripled that weight at 12 months, the infant should weigh 19 lb 8 oz (6.5 lb × 3 = 19.5 lb) or 8825 g. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
When performing neurological reflexes on the infant, which primitive reflex will be present longest? step rooting Babinski Moro SUBMIT ANSWER
Babinski Explanation: Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. Except for the Babinski, which disappears around 1 year of age, these primitive reflexes diminish over the first few months of life, giving way to protective reflexes. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Reflexes, p. 61. Chapter 3: Growth and Development of the Newborn and Infant - Page 61
Which milestone would the nurse expect an infant to accomplish by 8 months of age? Being able to sit from a standing position Pulling self to a standing position Creeping on all fours Sitting without support
Sitting without support Explanation: 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. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Gross Motor Skills, p. 68. Chapter 3: Growth and Development of the Newborn and Infant - Page 68
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? "That is not how you get him to eat." "You will never get him to eat all unwrapped like that." "You are doing a wonderful job attempting to wake the baby." "Maybe you should watch the breastfeeding video again."
"You are doing a wonderful job attempting to wake the baby." Explanation: 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. The other responses do not emotionally support the mom or contribute to a positive learning environment. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Breastfeeding, p. 78. Chapter 3: Growth and Development of the Newborn and Infant - Page 78
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? "Babies really can't tell the difference between people at that age." "You may be right, since infants can sense their mother's smell as early as 7 days old." "I'm not sure a 4-week-old infant can tell their mother from another woman's smell." "Maybe she just knows your voice better than your mother's."
"You may be right, since infants can sense their mother's smell as early as 7 days old." Explanation: 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Smell and Taste, p. 69. Chapter 3: Growth and Development of the Newborn and Infant - Page 69
Which milestone would the nurse expect an infant to accomplish by 8 months of age? Creeping on all fours Pulling self to a standing position Being able to sit from a standing position Sitting without support
Sitting without support Explanation: 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. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Gross Motor Skills, p. 68. Chapter 3: Growth and Development of the Newborn and Infant - Page 68
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? The infant will likely show the skills of an infant with the adjusted age of 7 months. The infant will most likely present with developmental skills consistent with a 6-month-old infant. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. The infant can be expected to display developmental skills consistent with a 8-month-old infant.
The infant will most likely present with developmental skills consistent with a 6-month-old infant. Explanation: 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 chronological 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 chronological age of 8 months: 6 months. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Integumentary System, p. 66. Chapter 3: Growth and Development of the Newborn and Infant - Page 66
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend? a rear-facing 5-point harness restraint a forward-facing convertible booster a rear-facing booster seat a forward-facing 5-point harness restraint
a rear-facing 5-point harness restraint An infant until 2 years of age should be in a rear-facing car seat. The 5-point harness seat is made for children up to 40 pounds (18 kilograms) and the booster seat for children from 40 to 80 pounds (18 to 36 kilograms). Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Safety in the Car, p. 77. Chapter 3: Growth and Development of the Newborn and Infant - Page 77
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? choosing soft foods over hard foods increased biting and sucking frequent loose stools running a mild fever or vomiting
increased biting and sucking Explanation: The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Teething, p. 87. Chapter 3: Growth and Development of the Newborn and Infant - Page 87
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? "You are doing a wonderful job attempting to wake the baby." "Maybe you should watch the breastfeeding video again." "You will never get him to eat all unwrapped like that." "That is not how you get him to eat."
"You are doing a wonderful job attempting to wake the baby." Explanation: 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. The other responses do not emotionally support the mom or contribute to a positive learning environment. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Breastfeeding, p. 78. Chapter 3: Growth and Development of the Newborn and Infant - Page 78
A parent asks the nurse if the 2-month-old infant can have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which response? "When did you feed your other child bananas? "In 1 month you can try bananas if you think your infant is ready." "You can try bananas 2 or 3 months from now." "Sure, if you feel your infant is ready to have bananas."
"You can try bananas 2 or 3 months from now." Explanation: The nurse will educate the parent to wait 2 to 3 months, because solid foods are not recommended for infants at 2 months of age. The age of 4 to 6 months is when it is recommended to introduce solid foods. In 1 month, the infant will be only 3 month of age. The other responses will not help the parent determine the appropriate answer. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Progressing to Solid Foods, p. 83. Chapter 3: Growth and Development of the Newborn and Infant - Page 83
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? "You should buy barley cereal." "You should buy oat cereal." "You should buy rice cereal." "You should buy wheat cereal."
"You should buy rice cereal." Explanation: The rice cereal should be first. 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, CHOOSING APPROPRIATE SOLID FOODS, p. 84. Chapter 3: Growth and Development of the Newborn and Infant - Page 84
The infant weighs 7 lb 4 oz (3300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? 14 lb 8 oz (6.6 kg) 21 lb 12 oz (9.9 kg) 25 lb (11.3 kg) 28 lb 4 oz (12.8 kg)
21 lb 12 oz (9.9 kg) Explanation: The average weight of a newborn is 7.5 lb (3400 g). The infant gains about 30 g each day. By 1 year of age, the infant has tripled the birth weight and has grown 10 to 12 in (25 to 30 cm). 7.25 lb × 3 = 21.75 lb or 21 lb 12 oz (9.9 kg) Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
The nurse is providing education to the woman about foods commonly associated with allergies in infants and young children. What items should be included in this list? Select all that apply. strawberries peanut butter egg substitutes soy products cow's milk
strawberries peanut butter cow's milk Explanation: In infants and children, certain foods are associated with allergies. These foods include cow's milk, egg whites, peanut butter and strawberries. Soy products and egg substitutes are not among those foods associated with allergies in children. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, CHOOSING APPROPRIATE SOLID FOODS, p. 84. Chapter 3: Growth and Development of the Newborn and Infant - Page 84
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines:
the child weighs less than expected for age. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4 ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse? "Delays are normal when a child is premature." "All children mature and develop at different rates so it is unwise to compare them in this way." "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." "You should talk with the doctor about getting your son tested."
"Delays are normal when a child is premature." Explanation: When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Growth and Development Overview, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
What is the correct amount of wet diapers a mature infant should produce each day? An infant should have 6 to 8 wet diapers/day. An infant should have 9 to 10 wet diapers/day. An infant should have 3 to 5 wet diapers/day. An infant should have 1 to 2 wet diapers/day.
An infant should have 6 to 8 wet diapers/day. Explanation: Urination occurs in the first 24 hours of life. A normal amount of urine is 200 to 300 ml/day as the infant matures. This amount is equal to 6 to 8 wet diapers/day. The infant should have an intake of between 140 to 160 ml/kg/day to be well hydrated and nourished. This amount of intake will produce the 6 to 8 diapers/day. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, BREASTFEEDING TECHNIQUE, p. 80. Chapter 3: Growth and Development of the Newborn and Infant - Page 80
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend? a rear-facing 5-point harness restraint a forward-facing convertible booster a rear-facing booster seat a forward-facing 5-point harness restraint
a rear-facing 5-point harness restraint Explanation: An infant until 2 years of age should be in a rear-facing car seat. The 5-point harness seat is made for children up to 40 pounds (18 kilograms) and the booster seat for children from 40 to 80 pounds (18 to 36 kilograms). Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Safety in the Car, p. 77. Chapter 3: Growth and Development of the Newborn and Infant - Page 77
The best way for an infant's parent to help the child complete the developmental task of the first year is to: keep the infant stimulated with many toys. expose the infant to many caregivers to help the infant learn variability. talk to the infant at a special time each day. respond to the infant consistently.
respond to the infant consistently. Explanation: 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. An infant is too young to have variability in caretakers. This causes mistrust. The parents or caretakers do not need a special time to talk to the infant each day. It should be done with each interaction. Providing too much stimulus before the infant develops gross motor skills causes frustration from the child and not enjoyment. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 70. Chapter 3: Growth and Development of the Newborn and Infant - Page 70
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: the child weighs the expected amount for age. the child weighs less than expected for age. the child weighs more than expected for age. the weight assessment is blatantly inaccurate.
the child weighs less than expected for age. Explanation: Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11250 g). The child is underweight for age. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
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? the development of a 10-week-old the growth of a 5-month-old the growth of a 2-month-old the development of a 3-month-old
the development of a 3-month-old Explanation: 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Growth and Development Overview, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother? "Giving a bottle of milk when the infant goes to bed can lead to obesity." "You could occasionally give your baby a bottle of water at bedtime." "Giving your baby a pacifier at bedtime will satisfy the need to suck." "Bottles given at bedtime can cause erosion of the enamel on the teeth."
"Bottles given at bedtime can cause erosion of the enamel on the teeth." Explanation: The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable and a pacifier will satisfy the sucking need, the most appropriate response is to warn of possible enamel erosion. Giving a bottle at bedtime is not a factor that leads to obesity. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Teeth, p. 65. Chapter 3: Growth and Development of the Newborn and Infant - Page 65
An infant is breastfed. When assessing the stools, which findings would be typical? Harder stools than those of bottle-fed infants A strong odor Fewer stools than bottle-fed infants Less constipation than bottle-fed infants
Less constipation than bottle-fed infants Explanation: The first stool of the infant is meconium. It is the result of digestion of amniotic fluid and it is black-green color and sticky. Following that, in 1 to 2 days the infant's stools change to a yellowish-tan color. The stools of breastfed infants tend to be yellow-tan. They are looser in texture and appear "seedy." The stool of a bottle-fed baby has the consistency of peanut butter. The stools of breastfed babies generally have no odor since all milk is digested. Some babies will have a bowel movement with every feeding but it is small. Bottle-fed babies have less stools each day but they are larger and more likely to have an associated odor. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Stools, p. 65. Chapter 3: Growth and Development of the Newborn and Infant - Page 65
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? Put the baby to bed at various times of the evening. Let the baby cry during the night and she will eventually fall back to sleep. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. Use the crib for sleeping only, not for play activities.
Use the crib for sleeping only, not for play activities. Explanation: A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Promoting Healthy Sleep and Rest, p. 85. Chapter 3: Growth and Development of the Newborn and Infant - Page 85
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: is expected to appear within 1 month. should be pronounced and easy to elicit. is a protective reflex and retained for life. should have disappeared.
should have disappeared. Explanation: This primitive (not protective) reflex should be present at birth and disappear around age 4 months. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Reflexes, p. 61. Chapter 3: Growth and Development of the Newborn and Infant - Page 61
A parent asks the nurse if the 2-month-old infant can have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which response? "When did you feed your other child bananas? "You can try bananas 2 or 3 months from now." "Sure, if you feel your infant is ready to have bananas." "In 1 month you can try bananas if you think your infant is ready."
"You can try bananas 2 or 3 months from now." Explanation: The nurse will educate the parent to wait 2 to 3 months, because solid foods are not recommended for infants at 2 months of age. The age of 4 to 6 months is when it is recommended to introduce solid foods. In 1 month, the infant will be only 3 month of age. The other responses will not help the parent determine the appropriate answer. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Progressing to Solid Foods, p. 83. Chapter 3: Growth and Development of the Newborn and Infant - Page 83
Stacy is going to visit her son in the intensive care unit. She has been pumping breast milk and storing it in the fridge. Stacy is making her son's bottle for his feeding and goes to warm the breast milk. What option should the nurse give the mom to prepare the bottle? "Just use the microwave in our kitchen." "It is okay if the frozen milk is in the bottle." "Just take the bottle from the fridge and use it." "You can use the hot water tap to get warm water to warm the bottle."
"You can use the hot water tap to get warm water to warm the bottle." Explanation: The nurse should recommend using warm water or a warm-water tap to place the bottle in before feeding. A microwave should never be used; it could create hot spots and burn the infant. The other choices are not recommended and can cause stomach discomfort. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, BREAST MILK COMPOSITION, p. 79. Chapter 3: Growth and Development of the Newborn and Infant - Page 79
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?
weight of 16 lb (7300 g) and length of 26 in (66.0 cm) Explanation: 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. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 3: Growth and Development of the Newborn and Infant, Weight, p. 60. Chapter 3: Growth and Development of the Newborn and Infant - Page 60
