Chapter 33: The Preschooler and Family

A common characteristic of those who sexually abuse children is that they: - Pressure the victim into secrecy. - Are usually unemployed and unmarried. - Are unknown to victims and victims families. - Have many victims that are each abused only once.

- Pressure the victim into secrecy. Sex offenders may pressure the victim into secrecy, regarding the activity as a secret between us that other people may take away if they find out. Abusers are often employed upstanding members of the community. Most sexual abuse is committed by men and persons who are well known to the child. Abuse is often repeated with the same child over time. The relationship may start insidiously without the child realizing that sexual activity is part of the offer.

Echolalia and repetition are traits of what type of language - preschool-age language. - toddlers age language. - school age language.

- toddlers age language.

Preschoolers' fears can best be dealt with by which intervention? 1. Actively involving them in finding practical methods to deal with the frightening experience 2. Forcing them to confront the frightening object or experience in the presence of their parents 3. Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are 4. Ridiculing their fears so they understand that there is no need to be afraid

1. Actively involving them in finding practical methods to deal with the frightening experience Actively involving the child in finding practical methods to deal with the frightening experience is the best way to deal with fears. Forcing a child to confront fears may make the child more afraid. Preconceptual thought prevents logical understanding. Ridiculing fears does not make them go away.

Which statement best describes a child who is abused by the parent(s)? 1. Unintentionally contributes to the abusing situation 2. Belongs to a low socioeconomic population 3. Is healthier than the nonabused siblings 4. Abuses siblings in the same way as child is abused by the parent(s)

1. Unintentionally contributes to the abusing situation A childs temperament, position in the family, additional physical needs, activity level, or degree of sensitivity to parental needs unintentionally contributes to the abusing situation. Socioeconomic status is an environmentalcharacteristic. This child is less likely to be abused than one who is premature, disabled, or very young. The abused child does not in turn abuse his or her siblings.

What is descriptive of the preschooler's understanding of time? 1. Has no understanding of time 2. Associates time with events 3. Can tell time on a clock 4. Uses terms like yesterday appropriately

2. Associates time with events In a preschoolers understanding, time has a relation with events such as, Well go outside after lunch. Preschoolers develop an abstract sense of time at age 3 years. Children can tell time on a clock at age 7 years. Children do not fully understand use of time-oriented words until age 6 years.

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad." The nurse's best interpretation of this comment is that it is: 1. A sign of stress. 2. Common at this age. 3. Suggestive of maladaptation. Suggestive of excessive discipline at home

2. Common at this age. Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think that they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age show stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.

In terms of language and cognitive development, a 4-year-old child would be expected to: 1. Think in abstract terms. 2. Follow simple commands. 3. Understand conservation of matter. 4. Comprehend another persons perspective

2. Follow simple commands. Children ages 3 to 4 years can give and follow simple commands. Children cannot think abstractly at age 4 years. Conservation of matter is a developmental task of the school-age child. A 4-year-old child cannot comprehend anothers perspective.

The parent of a 4-year-old son tells the nurse that the child believes "monsters and the boogeyman" are in his bedroom at night. The nurse's best suggestion for coping with this problem is to: 1. Insist that the child sleep with his parents until the fearful phase passes. 2. Suggest involving the child to find a practical solution such as a night-light. 3. Help the child understand that these fears are illogical. 4. Tell the child frequently that monsters and the boogeyman do

2. Suggest involving the child to find a practical solution such as a night-light. A night-light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with parents or telling the child that these creatures do not exist will not get rid of the fears. A 4-year-old is in the preconceptual age and cannot understand logical thought.

The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurse's best response is: 1. They will be here soon. 2. They will come after dinner. 3. Let me show you on the clock when 6 PM is. 4. I will tell you every time I see you how much longer it will be

2. They will come after dinner. A 4-year-old understands time in relation to events such as meals. Children perceive soon as a very short time. The nurse may lose the childs trust if his parents do not return in the time he perceives as soon. Children cannot read or use a clock for practical purposes until age 7 years. This answer assumes that the child understands the concept of hours and minutes, which is not developed until age 5 or 6 years.

During the preschool period, the emphasis of injury prevention should be placed on: 1. Constant vigilance and protection. 2. Punishment for unsafe behaviors. 3. Education for safety and potential hazards. 4. Limitation of physical activities.

3. Education for safety and potential hazards. Education for safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers. Constant vigilance and protection is not practical at this age since preschoolers are becoming more independent. Punishment may make children scared of trying new things. Limitation of physical activities is not appropriate.

In terms of fine motor development, what could the 3-year-old child be expected to do? 1. Tie shoelaces. 2. Use scissors or a pencil very well. 3. Draw a person with seven to nine parts. 4. Copy (draw) a circle.

4. Copy (draw) a circle. Three-year-olds are able to accomplish the fine motor skill of drawing a circle. Tying shoelaces, using scissors or a pencil very well, and drawing a person with multiple parts are fine motor skills of 5-year-old children.

Which is the causative agent of scarlet fever? 1.Enteroviruses 2.Corynebacterium organisms 3.Scarlet fever virus 4. Group A b-hemolytic streptococci (GABHS)

4. Group A b-hemolytic streptococci (GABHS) GABHS infection causes scarlet fever. Enteroviruses do not cause the same complications. Corynebacterium organisms cause diphtheria. Scarlet fever is not caused by a virus.

gross motor skill of 5-year-old children

Jumping rope, riding a two-wheel bike, and skipping on alternate feet

A 4-year-old child tells the nurse that she does not want another blood sample drawn because "I need all my insides, and I don't want anyone taking them out." Which is the nurse's best interpretation of this?

Preschoolers have poorly defined body boundaries.

In providing anticipatory guidance to parents whose child will soon be entering kindergarten, which is a critical factor in preparing a child for kindergarten entry?

The parent's interactions and responsiveness to the child

A useful skill that the nurse should expect a 5-year-old child to be able to master is to: a. Tie shoelaces. c. Hammer a nail. b. Use a knife to cut meat. d. Make change from a quarter.

a. Tie shoelaces. Tying shoelaces is a fine motor task typical of 5-year-olds. Using a knife to cut meat is a fine motor task of a 7- year-old. Hammering a nail and making change from a quarter are fine motor tasks of an 8- to 9-year-old.

Fine motor skills of 5 year olds

Tying shoelaces, using scissors or a pencil very well, and drawing a person with multiple parts

Which play patterns does a 3-year-old child typically display (select all that apply)? a. Imaginary play b. Parallel play c. Cooperative play d. Structured play e. Associative play

a. Imaginary play b. Parallel play c. Cooperative play e. Associative play Children between ages 3 and 5 years enjoy parallel and associative play. Children learn to share and cooperate as they play in small groups. Play is often imitative, dramatic, and creative. Imaginary friends are common around age 3 years. Structured play is typical of school-age children.

Strict isolation is required for a child who is hospitalized with (select all that apply): a. Mumps. b. Chickenpox. c. Exanthema subitum (roseola). d. Erythema infectiosum (fifth disease). e. Parvovirus B19.

a. Mumps. b. Chickenpox. c. Exanthema subitum (roseola). d. Erythema infectiosum (fifth disease). Childhood communicable diseases requiring strict transmission-based precautions (Contact, Airborne, and Droplet Precautions) include diphtheria, chickenpox, measles, mumps, tuberculosis, adenovirus, Haemophilus influenzae type B, mumps, pertussis, plague, streptococcal pharyngitis, and scarlet fever. Strict isolation is not required for parvovirus B19.

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child (select all that apply)? a. Plastic telephone b. Hand puppets c. Jigsaw puzzle (100 pieces) d. Farm animals and equipment e. Jump rope

a. Plastic telephone b. Hand puppets d. Farm animals and equipment

In terms of cognitive development, the 5-year-old child would be expected to: a. Use magical thinking. b. Think abstractly. c. Understand conservation of matter. d. Be able to comprehend another persons perspective.

a. Use magical thinking. Magical thinking is believing that thoughts can cause events. Abstract thought does not develop until school- age years. The concept of conservation is the cognitive task of school-age children ages 5 to 7 years. Five-year- olds cannot understand anothers perspective.

Acyclovir (Zovirax) is given to children with chickenpox to: a. Minimize scarring. c. Prevent aplastic anemia. b. Decrease the number of lesions. d. Prevent spread of the disease.

b. Decrease the number of lesions. Acyclovir decreases the number of lesions, shortens duration of fever, and decreases itching, lethargy, and anorexia; however, it does not prevent scarring. Preventing aplastic anemia is not a function of acyclovir. Only quarantine of the infected child can prevent the spread of disease.

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits (select all that apply)? a. Think in abstract terms. b. Follow directional commands. c. Understand conservation of matter. d. Use sentences of eight words. e. Tell exaggerated stories.

b. Follow directional commands. e. Tell exaggerated stories. Children ages 3 to 4 years can give and follow simple commands and tell exaggerated stories. Children cannot think abstractly at age 4 years. Conservation of matter is a developmental task of the school-age child. Five- year-old children use sentences with eight words with all parts of speech.

Which statement, made by a 4-year-old child's father, is true about the care of the preschooler's teeth? a. Because the baby teeth are not permanent, they are not important to the child. b. My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth. c. My sons permanent teeth will begin to come in at 4 to 5 years of age. d. Fluoride supplements can be discontinued when my sons permanent teeth erupt.

b. My son can be encouraged to brush his teeth after I have thoroughly cleaned his teeth. Toddlers and preschoolers lack the manual dexterity to remove plaque adequately, so parents must assume this responsibility. Deciduous teeth are important because they maintain spacing and play an important role in the growth and development of the jaws and face and in speech development. Secondary teeth erupt at about 6 years of age. If the family does not live in an area where fluoride is included in the water supply, fluoride supplements should be continued.

Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which is the most appropriate recommendation the nurse should make? a. Punish children so this behavior stops. b. Neither condone nor condemn the curiosity. c. Allow children unrestricted permission to satisfy this curiosity. d. Get counseling for this unusual and dangerous behavior.

b. Neither condone nor condemn the curiosity. Three-year-olds become aware of anatomic differences and are concerned about how the other works. Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. Encouraging the children to ask questions of the parents and redirecting their activity are more appropriate than giving permission. Exploration is age-appropriate and not dangerous behavior.

A normal characteristic of the language development of a preschool-age child is: a. Lisp. c. Echolalia. b. Stammering. d. Repetition without meaning.

b. Stammering. Stammering and stuttering are normal dysfluencies in preschool-age children. Lisps are not a normal characteristic of language development. Echolalia and repetition are traits of toddlers language.

When is a child with chickenpox considered to be no longer contagious? a. When fever is absent c. 24 hours after lesions erupt b. When lesions are crusted d. 8 days after onset of illness

b. When lesions are crusted When the lesions are crusted, the chickenpox is no longer contagious. This may be a week after onset of disease. The child is still contagious once the fever has subsided and after the lesions erupt, and may or may not be contagious any time after 6 days as long as all lesions are crusted over.

gross motor skill of 3 year olds children

balancing on one foot.

Which type of play is most typical of the preschool period? a.. Solitary c. Associative b. Parallel d. Team

c. Associative Associative play is group play in similar or identical activities but without rigid organization or rules. Solitary play is that of infants. Parallel play is that of toddlers. School-age children play in teams.

Imaginary playmates are beneficial to the preschool child because they: a. Take the place of social interactions. b. Take the place of pets and other toys. c. Become friends in times of loneliness. d. Accomplish what the child has already successfully accomplished

c. Become friends in times of loneliness. One purpose of an imaginary friend is to be a friend in time of loneliness. Imaginary friends do not take the place of social interactions but may encourage conversation. Imaginary friends do not take the place of pets or toys. They accomplish what the child is still attempting, not what has already been accomplished.

The nurse is performing an assessment on a child and notes the presence of Koplik's spots. In which communicable disease are Koplik's spots present? a. Rubella c. Chickenpox (varicella) c. Measles (rubeola) d. Exanthema subitum (roseola)

c. Measles (rubeola) Kopliks spots are small, irregular red spots with a minute, bluish white center found on the buccal mucosa 2 days before systemic rash. Kopliks spots are not present with rubella, varicella, or roseola.

20. Vitamin A supplementation may be recommended for the young child who has: a. Mumps. c. Measles (rubeola). b. Rubella. d. Erythema infectiosum.:

c. Measles (rubeola). Evidence shows that vitamin A decreases morbidity and mortality associated with measles. Vitamin A will not lessen the effects of mumps, rubella, or fifth disease.

By what age would the nurse expect that most children could understand prepositional phrases such as "under," "on top of," "beside," and "in back of"? a.18 months c. 3 years b. 24 months d. 4 years

d. 4 years At 4 years, children can understand directional phrases. Children 18 to 24 months and 3 years of age are too young.

Which accomplishment would the nurse expect of a healthy 3-year-old child? a. a. Jump rope b. Ride a two-wheel bicycle c. Skip on alternate feet d. Balance on one foot for a few second

d. Balance on one foot for a few second Three-year-olds are able to accomplish the gross motor skill of balancing on one foot. Jumping rope, riding a two-wheel bike, and skipping on alternate feet are gross motor skills of 5-year-old children.

Which is probably the most important criterion on which to base the decision to report suspected child abuse? a. Inappropriate parental concern for the degree of injury b. Absence of parents for questioning about childs injuries c. Inappropriate response of child d. Incompatibility between the history and injury observed

d. Incompatibility between the history and injury observed Conflicting stories about the accident are the most indicative red flags of abuse. Inappropriate response of caregiver or child may be present, but is subjective. Parents should be questioned at some point during the investigation.

Which common childhood communicable disease may cause severe defects in the fetus when it occurs in its congenital form? a. Erythema infectiosum c. Rubeola b. Roseola d. Rubella

d. Rubella Rubella causes teratogenic effects on the fetus. There is a low risk of fetal death to those in contact with children affected with fifth disease. Roseola and rubeola are not dangerous to the fetus.

Which characteristic best describes the language of a 3-year-old child? a.Asks meanings of words b. Follows directional commands c. Can describe an object according to its composition d. Talks incessantly, regardless of whether anyone is listening

d. Talks incessantly, regardless of whether anyone is listening Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly, regardless of whether anyone is listening. A 4- to 5-year-old asks lots of questions and can follow simple directional commands. A 6-year-old can describe an object according to its composition.

The nurse is guiding parents in selecting a day care facility for their child. When making the selection, it is especially important to consider: a. Structured learning environment. b. Socioeconomic status of children. c. Cultural similarities of children. d. Teachers knowledgeable about development.

d. Teachers knowledgeable about development. A teacher knowledgeable about development will structure activities for learning. A structured learning environment is not necessary at this age. Socioeconomic status is not the most important factor in selecting a preschool. Preschool is about expanding experiences with others; cultural similarities are not necessary.

Which medication may be given to high risk children after exposure to chickenpox to prevent varicella? a.Acyclovir b. Vitamin A c. Diphenhydramine hydrochloride d. Varicella zoster immune globulin (VZIG)

d. Varicella zoster immune globulin (VZIG) VZIG is given to high risk children to help prevent the development of chickenpox. Immune globulin intravenous may also be recommended. Acyclovir is given to immunocompromised children to reduce the severity of symptoms. Vitamin A reduces morbidity and mortality associated with the measles. The antihistamine diphenhydramine is administered to reduce the itching associated with chickenpox.

Fine motor skills of 3 year olds

drawing a circle.