ch 17: care of a preschooler practice questions

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply. "Have your child hold hands with a grown-up in parking lots." "Do not refer to medicines as candy." "Allow your child to ride in the front seat of the car." "Role-model bicycle safety by wearing a helmet too." "Do not allow your child to approach strange dogs."

"Have your child hold hands with a grown-up in parking lots." "Do not refer to medicines as candy." "Role-model bicycle safety by wearing a helmet too." "Do not allow your child to approach strange dogs." Rationale:Appropriate safety measures include not referring to medicines as candy, not allowing the child to approach strange dogs, having the child continue to ride in the back seat of the car, ensuring that the child holds a grown-up's hand when in parking lots, and role modeling bicycle safety by wearing a helmet themselves.

During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. Which of the following is the best specific trigger question to determine the preschooler's linguistic and cognitive progress? "Is your son's speech clear enough that anyone can understand it?" "Does your son speak in complete sentences all the time?" "Would you say your son has a vocabulary of about 900 words?" "How well does your son communicate or follow instructions?"

"How well does your son communicate or follow instructions?" Rationale:Asking how well the boy communicates and follows instructions is the best trigger question because it is open-ended. Asking if the child uses complete sentences or speaks clearly will elicit a yes or no answer about only those specific areas of development. The parents would have no way of judging the size of their child's vocabulary.

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? "I usually have him in time-out for about 10 minutes." "He is allowed out of time-out when he is calm." "The time-out doesn't just have to be in his room." "I put him in time-out when the problem occurs."

"I usually have him in time-out for about 10 minutes." Rationale: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.

A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond? "You should answer his questions by whatever feels most comfortable to you." "It's best to answer his questions using accurate anatomical names and keep your answers simple." "That is a difficult subject to address. I'm not sure what is the best way to answer that question." "I would suggest getting books with pictures to help explain the differences between male and female genitalia."

"It's best to answer his questions using accurate anatomical names and keep your answers simple." Rationale:It is suggested to keep answers brief and use correct anatomical names of body parts. Offering this advice to the father will help guide him in how to address questions. It is not necessary to go into the detail of using books with pictures for children of this age.

The parent of a preschooler asks the nurse, "Now that my child goes to preschool and goes to friends' houses, how can I make sure that he is eating enough?" Which response by the nurse would be most appropriate? "Just give him some extra food when he's with you to make up for anything he missed." "You need to get a list from everyone about what he has eaten throughout the day." "Keeping an eye on how active he is will give you a good indication." "Ask the child what he has eaten and drunk at school and at his friends."

"Keeping an eye on how active he is will give you a good indication." Rationale:Preschoolers begin to eat away from home at friends' homes or at child care or stay overnight with friends or grandparents, so parents don't observe daily food intake as accurately as before. The best suggestion would be to inform the parent to observe whether the child is growing and being active, good indicators of nutrition. This action would be better than monitoring any one day intake, including attempting to get a list from others or asking the child what he has eaten. Giving the child extra food could foster overeating.

A 5-year-old is scheduled for a tonsillectomy. Which statement to the child by the nurse is most therapeutic? "When the doctor removes your tonsils, your throat will hurt for a couple of days." "Your tonsils are infected, and the doctor is going to take them out." "The doctor is going to remove your tonsils at the hospital." "The doctor is going to fix your tonsils while you are at the hospital."

"The doctor is going to fix your tonsils while you are at the hospital." Rationale:Children have difficulty telling which body parts are needed. This is why it is best to talk to a young child about fixing a part of the body as opposed to removing or taking it out.

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior? "I will ask your father to talk to you about this since he is a male too." "You need to quit that right now. It's not nice to touch your privates." "We do not touch ourselves in public. Please go to your room if you want to continue this behavior." "Your penis is very interesting, isn't it? But you can injure it by touching it so much."

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior." Rationale:Although masturbation in this age group is not an uncommon behavior, the child must be told in a matter-of-fact manner that this is not appropriate activity in public. The parent needs to remain calm and not get angry or embarrassed. Usually, masturbation is just part of a young child's curiosity about his or her body.

When providing anticipatory guidance to parents about their preschool son who was caught in a lie, what would the nurse emphasize? "Lying should never be tolerated and the child should be punished." "It is okay to become angry when dealing with the child's lying." "You need to determine the reason for lying before punishing the child." "The misbehavior is usually more serious than the lying itself."

"You need to determine the reason for lying before punishing the child." Rationale:Lying is common in preschool children and occurs for a variety of reasons, such as fearing punishment, getting carried away by imagination, or imitating what another person has done. Regardless, the parent should ascertain the reason for the lying before punishing the child. The child also needs to learn that the lying is usually far worse than the misbehavior. Parents need to remain calm and serve as a role model of an even temper.

The student nurse is preparing a presentation on signs of developmental delay in preschoolers. Which examples of delays should be included? Select all that apply. A 4-year-old that cannot use the words "me" and "you" appropriately. A 5-year-old that cannot use plurals or past tense when speaking. A 5-year-old that is unhappy often. A 4-year-old that does not use sentences with five or more words.

A 4-year-old that cannot use the words "me" and "you" appropriately. A 5-year-old that cannot use plurals or past tense when speaking. A 5-year-old that is unhappy often. Rationale:Potential signs of delays include a 4-year-old that does not use sentences with three or more words, not five or more words. A 4-year-old that cannot use the words "me" and "you" appropriately and a 5-year-old that is often unhappy or cannot use plurals or past tense when speaking are all signs of developmental delay.

The nurse is helping parents develop the developmental task of initiative in their preschool-aged child. Which activity would the nurse suggest the parents implement? Provide the child with clothes that snap rather than button. Teach the child street-crossing safety. Help the child learn how to follow rules. Allow the child to experiment with molding clay.

Allow the child to experiment with molding clay. Rationale: To gain a sense of initiative, preschoolers need exposure to a wide variety of play materials so they can learn as much about how things work as possible. The parents should be urged to provide play materials that encourage creative play such as modeling clay. Any experience with free-form play is helpful. Street-crossing safety, following rules, and providing clothes that snap will not support the developmental task of initiative as much as providing a substance to experiment during play.

A 4-year-old tells the nurse he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which nursing diagnosis is most applicable for his family? Compromised family coping related to abnormal behavior of child Disturbed thought processes related to deep-set psychological need Deficient knowledge of normal preschool development Social isolation related to unwillingness to relate except through imaginary friend

Deficient knowledge of normal preschool development Rationale:Because a preschooler's imagination is at a peak, imaginary friends are not uncommon.

A group of nursing students are completing a clinical day at a preschool. Which behaviors would they identify as common in this preschool group? Select all that apply. Difficulty with sharing Regression Imaginary friends Sibling rivalry Telling of tall tales Completing multi-step tasks

Difficulty with sharing Regression Imaginary friends Sibling rivalry Telling of tall tales Rationale:Common behavior variations of preschoolers include: telling tall tales, imaginary friends, regression, sibling rivalry and difficulty with sharing. Multi-step tasks are able to be completed by school aged children.

Which type of play should the nurse encourage for a preschool-age child who is hospitalized? Turning out the lights to play hide and seek Dressing in the mother's coat to play house Planting flower bulbs that can be watched growing next spring Playing an electronic handheld game

Dressing in the mother's coat to play house Rationale:Preschool-aged children have active imaginations and dressing up to play house would be an appropriate play activity for the nurse to encourage. The child's fine motor skills are not developed to play an electronic handheld game. Children of this age are afraid of the dark so turning out the lights to play hide and seek is not appropriate. Planting flower bulbs is an activity that is too long-term for this age range.

A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group? Gross motor skills Vocabulary Imagination Fine motor skills

Imagination Rationale:Although vocabulary, gross motor skills, and fine motor skills improve during this time, the imagination of preschoolers is keener than it will be at any other time in their lives. They imitate behavior that they see exactly.

The nurse is caring for a child who is described as being an inquisitive learner, loves to learn new things, and feels a sense of accomplishment when succeeding in activities. The nurse understands that this child is in which of Erikson's stages of development? Trust versus mistrust Initiative versus guilt Industry versus inferiority Autonomy versus shame and doubt

Initiative versus guilt Rationale:Erikson defines Initiative versus guilt as the preschool period. Erikson defines the toddler period as a time of autonomy versus shame and doubt. Erikson defines trust versus mistrust as the infancy period and industry versus inferiority as taking place during the school-age period.

The nurse is completing a care plan for a preschool child with the nursing diagnosis of imbalanced nutrition, less than body requirements. Which interventions should the nurse include? Select all that apply. Limit milk to 16 to 24 ounces per day. Feed the child whenever he wants to eat. Provide at least 3 meals and 2 healthy snacks per day. Limit juice to 6 to 8 ounces per day. Weigh child weekly on the same scales at home.

Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home. Rationale:Limiting milk to 16 to 24 ounces, providing at least 3 meals and 2 healthy snacks and weekly weights are all appropriate intervention. Juice should be limited to 4 to 6 ounces daily. Feeding the child on a similar schedule daily rather than when the child is hungry will develop better eating habits.

A parent of a 4-year-old preschooler asks the nurse about how to discipline her child for bad behavior. The nurse would recommend that the parent take which steps to discipline the child? Select all that apply. Set consistent limits and adhere to them. Spank the child, explaining what he or she did wrong. Place the child in time out for 8 minutes. Take away the child's favorite toy until behavior improves. Attend only to the good behavior—ignore acting out.

Set consistent limits and adhere to them. Take away the child's favorite toy until behavior improves. Attend only to the good behavior—ignore acting out. Rationale:Preschoolers require consistency in discipline and limit-setting. Although each family determines their limits, children need limits that are the same every time. Discipline for preschoolers also includes time out for one minute per year of age, ignoring negative behavior, and praising good behavior. Additionally, taking away a toy or activity that the child loves can be an effective form of discipline. Physical punishment removes the responsibility of correct behavior from the child and expresses anger by the parent.

A 6 year old who does not speak English is on bed rest at home and being seen by a home health nurse who speaks only English. The child's mother informs the nurse that her son is very bored, which makes it hard to keep him in bed. What could the nurse do for this patient? Play "Simon Says." Read him a book. Tell him a story. Stack/build blocks with him.

Stack/build blocks with him. Rationale:Because the child cannot understand English, the best option to help this patient would be to play games such as stacking blocks or building with Tinker toys. These activities can be done despite communication difficulty.

During a well-child visit, the nurse is providing anticipatory guidance to the parents of a 3 year old about language development. When talking with the parents about this topic, the nurse would instruct that most of the preschooler's questions typically focus on which? Select all that apply. Why What Where When How

Why How Rationale:The preschooler can ask up to 400 questions a day. Although the preschooler asks questions constantly, the majority of those questions focus on how and why.

During a well-child visit, parents asks the nurse what types of snack foods are recommended to give their preschooler to foster nutrition. What would be the nurse's best recommendation? peanuts and trail mix graham crackers and milk salsa dip and whole grain chips cheese cubes and apple slices

cheese cubes and apple slices Rationale:Snacks for preschoolers should be nutritious and not contain large amounts of sugar, like cookies or graham snacks. Additionally, they need to be safe for the child and not offer choking dangers, such as peanuts do. Children this age prefer nonspicy foods.

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to: playing in an even-number group of children (four). regression. testing and identification of group role. preschoolers having a harder time sharing than toddlers.

testing and identification of group role. Rationale:Although 4-year-olds continue to enjoy play groups, they may become involved in arguments more than they did at age 3, especially as they become more certain of their role in the group. This development, like so many others, may make parents worry a child is regressing. However, it is really forward movement, involving some testing and identification of their group role. Because 3-year-olds are capable of sharing, they play with other children their age much more agreeably than do toddlers, which makes the preschool period become a sensitive and critical time for socialization. The elementary rule that an odd number of children will have difficulty playing well together generally pertains to children at this age: two or four will play, but three or five will quarre