Chapter 3: Growth and Development of the Newborn and Infant - ML6
The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as they should. What question should the nurse ask to help determine if their fears are warranted?
"Does your infant move a toy back and forth from one hand to the other when you give it to them?"
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 have tried at least 10 times with every green vegetable and I can't get my son to like them." "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."
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding?
"I can expect my infant to be able to raise the head up when on the stomach within the next month."
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 will not be concerned if my newborn has stools that begin to have a yellowish color to them." "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."
A client who is breastfeeding asks the nurse if she can give the newborn a pacifier. Which nursing response is most appropriate?
"It is recommended to wait until breastfeeding is well-established before introducing a pacifier."
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction?
"Maturation refers to the child's increases in body size."
A first-time mother, who is breastfeeding, phones the clinic nurse because she is concerned about her 3-month-old infant's stools. Which statement by the mother would alert the nurse to contact the health care provider?
"The stools are small and hard."
A mother of a 10-month-old states to the nurse, "I brush my child's teeth every day with flavored kids' toothpaste." Which is the most appropriate response by the nurse?
"Toothpaste is not necessary; it is the scrubbing that is required."
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate?
"What does his stool look like?"
The parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse?
"With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks."
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."
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 rice cereal."
The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?
"Your baby's stomach is small and can only hold about 0.5 to 1 oz at birth."
The parent of 1-week-old infant voices concerns about the infant's weight loss since birth. At birth the infant weighed 7 lb (3.2 kg); the infant currently weighs 6 lb 5 oz (2.9 kg). Which response by the nurse is most appropriate?
"Your infant's weight loss is within the expected range."
An infant has been brought to the clinic for a well-child check. The infant is 12 months of age. The child's birth weight was 6 pounds, 7 ounces. What is the anticipated weight for the child at this visit?
19 pounds, 5 ounces
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?
21 lb 12 oz (9.9 kg)
The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months?
27.5 in (70 cm)
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 all of her children like sleeping on their abdomen and this newborn likes it too. A mother places the baby comforter her grandmother made over the newborn's body. A mother states her baby looks too warm, so she is moving the bassinet in front of the air conditioner to cool him off.
When performing neurological reflexes on the infant, which primitive reflex will be present longest?
Babinski
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
A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply.
Crib and playpen bars should be no more than 2 3/8 inches apart. Car seats should be placed in back seats. A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).
The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?
Iron
An infant is breastfed. When assessing the stools, which findings would be typical?
Less constipation than bottle-fed infants
The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding?
Natal teeth noted in the mouth that are loose
The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look?
Puts down a little ball to pick up a stuffed toy.
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?
Respond promptly when the infant cries.
Which milestone would the nurse expect an infant to accomplish by 8 months of age?
Sitting without support
What action shows an example of Erik Erikson's developmental task for the infant?
The infant cries and the caregiver picks the child up.
The nurse in a community clinic is assessing a 2-month-old infant. The parent asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 2 months of age?
The infant raises head and chest while on stomach.
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?
The infant says "da-da" when looking at her father
The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?
The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog
The parent of a 1-month-old infant voices concern about the infant's respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide?
The respirations of a 1-month-old infant are normally irregular and periodically pause.
The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term?
Urging the baby's mother to take time for herself away from the child.
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?
Use the crib for sleeping only, not for play activities.
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
Which assessment findings if noted in a 4-month-old infant would the nurse recognize as normal growth and development?
holds head up when prone, bears partial weight on legs, reflexes are fading
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is:
looking for a toy in her crib at the last place she saw it.
The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed?
lower central gumline
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
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:
should have disappeared.
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
sitting independently
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.
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 3-month-old
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)
The infant measured 20 in (50 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months?
30 to 32 in (76 to 81 cm)
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn?
Bathing is a time for bonding with the parents.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants
Grows and develops skills more rapidly than at any other time in their life.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
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 do not sit steadily until 8 months; this infant is normal.
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 most likely present with developmental skills consistent with a 6-month-old infant.
A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?
The infant's gumline will be tender.
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?
no teeth
The best way for an infant's parent to help the child complete the developmental task of the first year is to:
respond to the infant consistently.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:
the newborn's stomach can hold between 0.5 oz and 1 oz.
The nurse is caring for a parent following the birth of the newborn. The new parent asks the nurse, "When is the best time for me to start bonding with my baby?" Which response by the nurse is appropriate?
"You should interact with your newborn when the eyes are open wide and bright."
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?
"You may be right, since infants can sense their mother's smell as early as 7 days old."
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit?
24 pounds (10.8 kg) and 30 inches (75 cm)
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 put her to bed when she falls asleep.
The nurse is assessing the neurological status of a 10-month-old infant. Which finding(s) does the nurse determine to be abnormal when performing this assessment? Select all that apply.
The infant turns to the right side, searching with mouth, when the right side of the cheek is stroked. The infant demonstrates reflexive sucking when nipple or finger is placed in infant's mouth. The infant reflexively grasps when the nurse touches the palm. With sudden extension of the infant's head, the arms abduct and move upward and the hands form a "C".
