Chapter 25: Growth and Development of the Preschool Child: 3 to 6 Years

The caregiver of a 6-year-old expresses concern that the child cannot yet print her first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?

"By the age of 6, most children can print some letters and maybe their first name." Explanation: By 3 years of age, a child should be able to hold a pencil in the writing position. By age 4, the child can draw circles and squares and a body with four parts. At age 5, the child can print letters, copy a triangle and a picture of a person with six parts and cut with scissors. The 6-year-old child can print letters or numbers and may be able to print his or her own name. Children do not write in cursive until school age.

A mother comes to the clinic with her 4-year-old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the client has a normal vocabulary for age. The nurse is aware that language for a 4-year-old consists of at least approximately how many words?

A mother comes to the clinic with her 4-year-old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the client has a normal vocabulary for age. The nurse is aware that language for a 4-year-old consists of at least approximately how many words? You Selected: 1500 words Correct response: 1500 words Explanation: A 4-year-old has a vocabulary of approximately 1500 words, whereas a 5-year-old has mastered more than 2100 words.

A 5-year-old child is overheard by her parents calling her dog a "fat boo-boo butt" and they are concerned. What advice would the nurse provide for them regarding this behavior?

Calmly correct the child, telling her not to say those words again. Explanation: Children this age often try out naughty words to see what kind of reaction they will get from their parents. Parents are encouraged to express their disapproval with the language and calmly tell the child not to say those words again. Ignoring the behavior will not correct it and punishment is not necessary.

The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative?

Reward the child for initiative in order to build self-esteem. Explanation: The building of self-esteem continues throughout the preschool period. It is of particular importance during these years, as the preschooler's developmental task is focused on the development of initiative rather than guilt. A sense of guilt will contribute to low self-esteem, whereas a child who is rewarded for his or her initiative will have increased self-confidence. Routine and ritual continue to be important throughout the preschool years, as they help the child to develop a sense of time as well as provide the structure for the child to feel safe and secure. Also, consistent limits provide the preschooler with expectation and guidance. Giving children opportunities to decide how and with whom they want to play also helps them develop initiative.

What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother?

Specific program goals to be accomplished should be available. Explanation: Preschool is used for toddlers to foster social skills and to acclimate them to the group environment. When a parent is searching for a preschool, he or she should check the school's accreditation, the teacher's qualifications, and seek the recommendations of other parents. Parents should visit the school to see the teacher interact with the children, the focus of the activities, and hygiene practices. Parents should look at the school's daily schedule and the types of activities offered. Are the activities structured or loose? Preschoolers need planned activities. They are very ready to learn, but the activities should be planned to focus on their short attention spans.

A nurse is instructing a young mother on how to ensure a safe bath time for her 4-year-old son. Which are important suggestions for the nurse to give to the mother? Select all that apply. Turn down the temperature of the water heater to under 120°F. Do not leave the child unsupervised in the bathtub. Assist the child in cleaning under fingernails and around ears. Do not hang a mobile over the tub. Have the child drink cranberry juice to avoid developing infections from the bath.

Turn down the temperature of the water heater to under 120°F. Do not leave the child unsupervised in the bathtub. Assist the child in cleaning under fingernails and around ears Explanation: When possible, parents should turn down the temperature of the water heater in their home to under 120°F to help prevent scalds. Although preschoolers certainly sit well in bathtubs, they should still not be left unsupervised at bath time in case they decide to add more hot water or to practice swimming and then be unable to get their head out of the water again. Although not well studied, cranberry juice may help prevent these infections the same as in adult women. Cranberry juice is not needed. Preschoolers do not clean their fingernails or ears well, so these areas often need "touching up" by a parent or older sibling. Using a nonirritating shampoo and hanging a mobile over the tub so they have a reason to look up while their hair is rinsed helps make hair washing a fun procedure.

The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play?

cooperative play Explanation: Cooperative play is when children play in a group with each other, and play by rules. Examples are board games or sports. Associative play involves allowing the child to work through feelings about procedures and separation; parallel play involves children playing side to side with each engaging in his/her own activities; dramatic play involves living out of the drama of human life.

The parents of a preschooler ask the nurse, "What snacks are appripriate for us to give our child?" Which suggestion would the nurse provide? Select all that apply.

sliced cheese sticks Explanation: Parents should offer the child healthy options that are not choking hazards. Cheese sticks that have been cut are healthy and are not a potential choking hazard. Whole carrots and grapes are healthy but also hold the potential to cause choking. Unhealthy snacks include candy such as jelly beans or sweets such as donut holes.

When assessing the growth and development of a 4-year-old, which would the nurse note as being appropriate?

tells a fantasy story about a bear and a car Explanation: The nurse should recognize that by age 4, the preschooler should have a vocabulary of about 1,400 words. Preschool-age children are able to communicate in sentences of five words or more and often like to use their imagination. This is a normal part of growth and development and should be encouraged.

The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening?

viewing her baby sister's illness as her fault Explanation: Since the preschool-age child is facing the psychosocial task of initiative versus guilt, it is natural for the child to experience guilt when something goes wrong. The child may have a strong belief that if someone is ill or dying, he or she may be at fault and the illness or death is punishment. It is less likely that the girl would be at risk of harming the baby or experiencing clinical depression as a result of the baby's illness. The child may create an imaginary friend to cope with the illness, but would not withdraw or express sadness as a result of the imaginary friend.