Chapter 5: Growth and Development of the Preschooler

When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that:

imagination in a 3-year-old is at its peak

A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?

"Attributing lifelike qualities to inanimate objects is quite normal at this age."

The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?

"He loves milk and drinks it every time he is thirsty."

The nurse is caring for a family with a preschool-aged child. Which statement(s), when made by the parent, would alert the nurse to provide further teaching to the parents about the risk for obesity for their child? Select all that apply.

"I have been overweight since I was an adolescent, so I will be sure to watch for obesity as my child reaches adolescence." "I like to reward my child with a fresh sliced apple or orange if my child completes the chores each day." "I limit the amount of fruit juice my child drinks to 2 cups per day." "I make sure the servings I serve my child are 3/4 the amount I serve myself." "We are so glad our child loves to drink milk...we go through a lot of milk each day."

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?

"I will need to find an appropriate punishment for him if this continues."

During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents?

"Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here."

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

The nurse has completed an education program on normal communication abilities in the preschool-age child. Which statement by a participant indicates a need for further education?

"Stating his name and address is too hard for my 5-year-old child; it will be another year before he can do that."

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

"The school is quite structured and advocates corporal punishment."

The nurse is speaking with the parent of a 4-year-old child. Which statement by the parent would suggest a need for further investigation?

"When we go to the park, my child never wants to play with the other children."

Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough

The parents of a 5-year-old tell the nurse that it "seems like our child is afraid of everything from fireworks to butterflies." What actions should the nurse take? Select all that apply.

Ask the parents if they can identify anything that may be causing their child be fearful. Suggest to the parents to talk with their child about his fears. Work with the parents and child to devise strategies to help deal with the fears.

While the nurse is taking a blood pressure on a 4-year-old, the child states that the blood-pressure cuff is too tight and angrily says, "That hurt, you big poo-poo head." What is the most appropriate response by the nurse?

Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names

The nurse is caring for a preschool-aged child who needs a CT scan. Which action would the nurse use to best prepare the child for this diagnostic test?

Help the child to pretend that the CT scan machine is a camera.

Which would be a nutritional goal for a preschool client?

Introduce new food gradually and include variety.

A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be?

Preschool

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

A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply.

Urge children never to talk to or accept a ride from a stranger Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

The community health nurse is providing a class to a group of adolescents training to become "safe babysitters." When discussing activities that are appropriate for 3-year-old children, which should be included? Select all that apply.

Walking up stairs using alternate feet Running outside and tagging an item

The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond?

Your child is not expected to be able to perform those activities at 3 years of age."

When assessing a preschool-aged child, which activity is most closely associated with the primary psychosocial task of this age group?

attempting to dress oneself

The most important safety precaution for parents to teach preschoolers is:

not to ride in a car with strangers.

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?

presence of 10 deciduous teeth

The pediatric nurse is discussing the daily activities of a 4-year-old with the caregiver to assess growth and development status. The nurse would document that the child has reached the initiative stage of development if the caregiver indicates the child participates in which activity?

tries to sweep up spilled cereal but cries when can't do well

The nurse is observing several children interacting during a community health event. Which observed behavior would be indicative of a 4-year-old child?

"Look! I am a nurse, and I am helping people feel better!"

The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?

hop on one foot