Chapter 16: The Infant

The mother of an infant born prematurely tells the nurse, "The baby is irritable. She cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe her?" What is the most appropriate recommendation to help this parent? a. Play the radio or TV while you feed the infant. b. Put the infant in a room with sunlight. c. Wrap the infant snugly when you hold them. d. Change the infant's position quickly.

c. Wrap the infant snugly when you hold them. (A strategy that may be helpful is to swaddle the infant snugly in a light blanket with extremities flexed and hands near the face.)

When does the posterior fontanelle close? a. 2 to 3 months b. 3 to 6 months c. 6 to 9 months d. 9 to 12 months

a. 2 to 3 months (The posterior fontanelle closes between 2 and 3 months of age.)

The parent of a 3-month-old infant asks the nurse, "At what age do infants usually begin drinking from a cup?" What is the nurse's most accurate response? a. 5 months b. 9 months c. 1 year d. 2 years

a. 5 months (The infant can usually drink from a cup when it is offered at about 5 months.)

What will the nurse take into consideration when educating parents regarding infant nutrition? (Select all that apply.) a. Cultural influence b. Sex of the infant c. Parental knowledge d. Infant's developmental level e. Parent-child interaction

a. Cultural influence c. Parental knowledge d. Infant's developmental level e. Parent-child interaction (Parents have many concerns about feeding their infant during the first year of life. This is a period when readiness to receive nutrition education is usually high; therefore the nurse looks for opportunities to provide accurate information. Assessment of parental knowledge; infant development, behavior, and readiness; parent-child interaction; and cultural and ethnic practices is important. Sex of the infant does not enter into nutritional education.)

A new mother is voicing concern she is breastfeeding her newborn too frequently. How often does the nurse instruct this mother she should expect her newborn to feed? a. Every 2 to 3 hours b. Every 4 to 6 hours c. Every 6 to 8 hours d. Every 8 to 10 hours

a. Every 2 to 3 hours (Breastfed infants may require feedings at 2- to 3-hour intervals because breast milk is more easily digested. A flexible but regular schedule that provides a rest period between feedings is best for the parent and infant.)

The nurse cautions that children who have unmet hunger needs will likely display which characteristic(s)? (Select all that apply.) a. Every 2 to 3 hours b. Ineffective feeding patterns c. No predictable sleep-wake cycle d. Distrust e. Effective parent bonding

a. Every 2 to 3 hours b. Ineffective feeding patterns c. No predictable sleep-wake cycle d. Distrust (Children who experience frequent hunger do not have effective parental bonding. All other options are probable outcomes for a child who has unmet hunger needs.)

The nurse is talking with a parent about tooth eruption. What teeth will the nurse explain are the first deciduous teeth to erupt? a. Lower central incisors b. Upper central incisors c. Lower lateral incisors d. Upper lateral incisors

a. Lower central incisors (The first teeth to erupt, usually at about 7 months, are the lower central incisors.)

The nurse is aware that the 7-month-old can signal feeding readiness by which action(s)? (Select all that apply.) a. Pulling spoon toward mouth b. Biting at spoon with upper and lower incisors c. Pointing to food bowl d. Bouncing up and down with excitement at sight of food e. Manipulating finger foods

a. Pulling spoon toward mouth e. Manipulating finger foods (The 7-month-old pulls the spoon toward his or her mouth and can manipulate finger foods. The 7-month-old does not have upper incisors and has not developed adequately to recognize the food container or exhibit excitement related to the sight of food.)

What should the teaching plan include about infant fall precautions? (Select all that apply.) a. Remove all unsteady furniture. b. Keep crib rails up and in locked position. c. Steady infant with hand when on changing table. d. Use tray attachment on high chair as restraint. e. Keep infant seat on the floor.

a. Remove all unsteady furniture. b. Keep crib rails up and in locked position. c. Steady infant with hand when on changing table. e. Keep infant seat on the floor. (The tray attachment to a high chair is an inadequate restraint. All other options are good precautions to prevent an infant from a fall.)

The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately? a. Respiratory rate of 60 breaths per minute b. Pulse rate of 100 beats per minute c. Minimal verbalization d. Fussy behavior

a. Respiratory rate of 60 breaths per minute (Respirations of a 1-year-old should be 20 to 40 breaths per minute. Increased respiratory rate can lead to distress and should be reported immediately. Pulse rate of 100 to 140 beats/minute is normal. Minimal verbalization and fussy behavior are not emergency situations or abnormal for this age.)

The nurse observes a 10-month-old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed? a. The pincer grasp b. A grasp reflex c. Prehension ability d. The parachute reflex

a. The pincer grasp (By 1 year, the pincer-grasp coordination of index finger and thumb is well established.)

At what age does an infant's birth weight triple? a. 9 months b. 1 year c. 18 months d. 2 years

b. 1 year (The infant usually triples his or her birth weight by about 12 months of age.)

Which statement indicates the mother of an 8-month-old understands infant sleep patterns? a. "I put the baby in my bed until she falls asleep, then I put her in her crib." b. "I let the baby skip an afternoon nap so that she will fall asleep earlier." c. "I put the pacifier in the crib so that she can find it when she wakes up." d. "I rock the baby back to sleep if she wakes up at night."

c. "I put the pacifier in the crib so that she can find it when she wakes up." (The parent should assist the infant to develop self-soothing behaviors so that the infant can get back to sleep on her own.)

Parents of a 6-month-old infant ask the nurse why it is necessary to offer iron-rich formula to their child. What is the correct response? a. "The infant has limited ability to produce red blood cells." b. "The infant has ineffective digestive enzymes." c. "The infant has exhausted maternal iron stores." d. "The infant has need of the iron to support dentition."

c. "The infant has exhausted maternal iron stores." (Many pediatricians recommend iron-fortified formulas because maternal iron stores decrease by 6 months of age.)

What is the earliest age at which an infant is able to sit steadily alone? a. 4 months b. 5 months c. 8 months d. 15 months

c. 8 months (The infant can sit alone without support at about 8 months of age.)

The nurse is assessing development in a 9-month-old infant. What would the nurse expect to observe? a. Speaking in 2-word sentences b. Grasping objects with palmar grasp c. Creeping along the floor d. Beginning to use a spoon rather sloppily

c. Creeping along the floor (The 9-month-old tries to creep, has developed pincer movement, and can grasp a spoon without keeping food on it.)

Parents of an infant inform the nurse they are planning home preparation of solid foods. What directions should the nurse provide? (Select all that apply.) a. Boil foods in a large amount of water. b. Do not freeze foods. c. Add 1 teaspoon of salt per cup. d. Puree food in electric blender. e. Add sugar sparingly.

d. Puree food in electric blender. e. Add sugar sparingly. (Home-prepared infant food can be strained and pureed in an electric blender. Sugar should be added sparingly. Food should be boiled in small amounts of water and not over cooked to avoid destroying nutrients. Foods may be frozen in ice cube trays and defrosted for use.)

What is an abnormal finding in an evaluation of growth and development for a 6-month-old infant? a. Weight gain of 4 to 7 ounces per week b. Length increase of 1 inch in 2 months c. Head lag present d. Can sit alone for a few seconds

c. Head lag present (The infant should be holding the head up well by 5 months of age. If head lag is present at 6 months, the child should undergo further evaluation.)

What would the nurse expect a 4-month-old to be able to accomplish? a. Hold a cup. b. Stand with assistance. c. Lift head and shoulders. d. Sit with back straight.

c. Lift head and shoulders. (Because development is cephalocaudal, of these choices, lifting the head and shoulders is the one that the infant learns to do first. The infant can usually sit with support at about 5 months of age and can sit alone at about 8 months.)

What is the most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old? a. Ride a tricycle. b. Spend time in an infant swing. c. Play with push-pull toys. d. Read large picture books.

c. Play with push-pull toys. (Push-pull toys are appropriate to promote sensorimotor stimulation for a 1-year-old child.)

What statement made by a parent indicates correct understanding of infant feeding? a. "I've been mixing rice cereal and formula in the baby's bottle." b. "I switched the baby to low-fat milk at 9 months." c. "The baby really likes little pieces of chocolate." d. "I give the baby any new foods before he takes his bottle."

d. "I give the baby any new foods before he takes his bottle." (New solid foods should be introduced before formula or breast milk to encourage the infant to try new foods.)

A mother is concerned because her 10-month-old is lethargic. What is the best action the nurse can advise this mother to implement? a. Keep the infant's room well lit. b. Rub the infant's soles vigorously. c. Offer the infant a pacifier. d. Handle the infant slowly and gently.

d. Handle the infant slowly and gently. (Some infants respond to stimulating environments by shutting down. Move and handle infants slowly and gently.)

What will the nurse advise a parent to do when introducing solid foods? a. Begin with one tablespoon of food. b. Mix foods together. c. Eliminate a refused food from the diet. d. Introduce each new food 4 to 7 days apart.

d. Introduce each new food 4 to 7 days apart. (Only one new food is offered in a 4- to 7-day period to determine tolerance.)

A mother calls the pediatrician's office because her infant is "colicky." What is the most helpful measure the nurse can suggest to the mother? a. Sing songs to the infant in a soft voice. b. Place the infant in a well-lit room. c. Walk around and massage the infant's back. d. Rock the fussy infant slowly and gently.

d. Rock the fussy infant slowly and gently. (One technique the nurse can offer parents of a fussy infant is to rock the infant gently and slowly while being careful to avoid sudden movements.)

How might the nurse demonstrate the parachute reflex with an infant? a. Lifting the infant high in the air above her head b. Holding the infant in a football hold, cradling the head c. Seating the infant in a stroller in an upright position d. Thrusting the infant downward into the crib

d. Thrusting the infant downward into the crib (The infant, when thrust downward in a prone position, will protectively extend the arms.)

The nurse explains that an infant's prehensile development is progressive and logical. Arrange the development in the order from the simplest to the most complex. Put a comma and space between each answer choice (a, b, c, d, etc.) a. Hands held open most of the time b. Grasps with thumb on one side and three fingers on the other c. Picks up toy with squeeze action d. Thumb and forefinger hold object e. Hands held closed most of the time

e. Hands held closed most of the time a. Hands held open most of the time c. Picks up toy with squeeze action b. Grasps with thumb on one side and three fingers on the other d. Thumb and forefinger hold object (The development advances from the newborn's closed hands to the open star hands of the older infant, to the squeeze action, to a grasp with thumb and fingers, to the pincer movement of thumb and forefinger.)

The nurse is preparing to outline principles of discipline for parents of an infant. What information should the nurse include? (Select all that apply.) a. Firmly say "No." b. Distract the child to another activity. c. Bribe the child with a sweet treat. d. Remain consistent. e. Ignore the child until behavior improves.

a. Firmly say "No." b. Distract the child to another activity. d. Remain consistent. (Parental approval is important to the infant, and setting limits early is important (Anderson, 2008). Principles of discipline for an infant include lowering the voice to say "no" firmly, removing the child from the situation, distraction, and consistency.)

The nurse is educating parents of a 2-month-old about immunizations. What immunizations against illness should their child receive? (Select all that apply.) a. Pertussis (whooping cough) b. Influenza c. Diptheria d. Tetanus e. Polio

a. Pertussis (whooping cough) b. Influenza c. Diptheria d. Tetanus e. Polio (The first DPT, polio, and flu immunizations are given at the age of 2 months.)

The nurse discusses child-proofing the home for safety with the mother of a 9-month-old. Which statement made by the mother would indicate an unsafe behavior? a. "I put covers on all of the electrical outlets." b. "In the car, she rides in a front-facing car seat." c. "There are locks on all of the cabinets in the house." d. "I have a gate at the top and bottom of the stairs."

b. "In the car, she rides in a front-facing car seat." (A rear-facing infant car seat should be used for infants younger than 1 year of age.)

What is the earliest age at which the infant should be able to walk independently? a. 8 to 10 months b. 12 to 15 months c. 15 to 18 months d. 18 to 21 months

b. 12 to 15 months (For the majority of children, the milestone of walking alone is achieved between 12 and 15 months.)

A parent is concerned because her infant has a diaper rash. What is the best action the nurse would advise the parent to implement? a. Use commercial diaper wipes to clean the area. b. Apply a protective ointment on the area. c. Change the infant's diaper less frequently. d. Keep the diaper area covered all of the time.

b. Apply a protective ointment on the area. (A protective ointment can be applied when the skin in the diaper area appears pink and irritated.)

A parent brings a 6-month-old infant to the pediatric clinic for her well-baby examination. Her birth weight was 8 pounds, 2 ounces. What will the nurse weighing the infant today would expect her weight to be? a. At least 12 pounds b. At least 16 pounds c. At least 20 pounds d. At least 24 pounds

b. At least 16 pounds (Birth weight is usually doubled by 6 months of age.)