Conception through Adolescence

A nurse is reviewing nutritional guidelines with the parents of a 2-year-old toddler. Which of the following parent statements should indicate to the nurse an understanding of the teaching?

"i'll give my son about 2 tablespoons of each food at mealtime" Serving size for toddlers should be 1 Tbsp of solid food per year of age

A parent has brought her 6-month-old infant in for a well-child check. Which of her statements indicates a need for further teaching?

"I've started giving her plenty of fruit juice as a way to increase her vitamin intake." The use of fruit juices and nonnutritive drinks such as fruit-flavored drinks or soda should be avoided since these do not provide sufficient and appropriate calories during this period

A nurse is reviewing safety measures with the parent of an 8-month-old infant. Which of the following statements by the parent indicates an understanding of safety for the infant?

"My baby loved to play with the crib gym, but I took it out of the crib" Removing gyms and mobiles at 4-5 months prevents injury rom choking or strangulation

A nurse is talking with guardians who are concerned about several issues with their preschooler. Which of the following issues should the nurse identify as the priority?

"My child has temper tantrums every time we tell them to do something they don't want to do" It is a task of the toddler stage to develop autonomy vs. shame and doubt. This is still acting out with negativism, Which is a persistent negative response to requests, often manifested in tantrums.

A nurse is talking with caregivers of a 12 year old child. Which of the following issues verbalize by the caregivers should the nurse identify as a priority?

"We just don't understand why our child can't keep up with the other kids in simple activities like running and jumping." Using the urgent vs non urgent approach to client care, the priority issue is the delay in motor skills, which could indicate an illness and requires further investigation

A nurse is evaluating teaching about nutrition with the guardians of an 11-year-old child. Which of the following statements should indicate to the nurse an understanding of the teaching?

"We reward school achievements with a point system instead of pizza or ice cream" Guardians should avoid rewarding children with food for good behavior or achievements. Association between food and feeling good can lead to weight problems

A nurse is talking with the caregivers of a 10-year-old who is concerned that their child is becoming secretive, including closing the door when showering and dressing. Which of the following responses should the nurse make?

"At this age, children tend to become modest and value their privacy" School age children develop a need for privacy. Caregivers should show trust in the child and respect the child's need for privacy.

A nurse is talking with an adolescent who is having difficulty dealing with several issues. Which of the following issues should the nurse identify as the priority?

"I am so fat, I skip meals to try to lose weight" The greatest risk to the client is injury due to an eating disorder. The priority issue is to provide counseling to promote body image and ensure proper nutrition.

A nurse is providing information on prevention of sudden infant death syndrome (SIDS) to the mother of a young infant. Which of the following statements indicates that the mother has a good understanding?

-"I'll be sure that my baby doesn't spend any time on her abdomen." -"I'll place my baby on her back for sleep." -"I'll be sure to keep my baby's room cool." Safeguards that reduce the risk of SIDS include proper positioning on the back; removing stuffed animals, soft bedding, and pillows; and avoiding overheating the infant.

The mother of a 7-month-old infant tells the nurse at the pediatric clinic that her baby has been fussy with occasional loose stools since she started feeding him fruits and vegetables. Which of the following responses should the nurse make?

-"Let me make you a list of baby foods your baby is eating so we can spot any problems" -"Did the changes begin after you started on one particular food?" Start with feeding an infant one new food at a time -"Has your baby been vomiting since starting these new foods?" Assess a food allergy or intolerance. Start with feeding an infant one new food at a time

A school nurse is counseling an obese 10-year-old child. Which factors would be important to consider when planning an intervention to support the child's health?

-Consider both the child and the family when addressing the issue. -Plan food intake to allow for growth. School-age children need to participate in educational programs that enable them to plan, select, and prepare healthy meals and snacks. Children need adequate caloric intake for growth throughout childhood accompanied by activity for continued gross-motor development.

A nurse is giving a presentation about accident prevention to a group of parents of toddlers. Which of the following accident-prevention strategies should the nurse include?

-Store toxic agents in locked cabinets -Turn pot handles toward the back of the stove -Place safety gates across stairways

A nurse is reviewing the Centers for Disease Control and Prevention's (CDC) immunization recommendations with the guardians of preschoolers. Which of the following vaccines should the nurse include in their discussion?

-Varicella -Polio -Seasonal influenza

What is the expected order of gross-motor development beginning with the earliest skill?1. Move from prone to sitting unassisted 2. Sit down from standing position 3. Sit upright without support 4. Roll from abdomen to back 5. Can turn from side to back

5. can turn from side to back 4. Roll from abdomen to back 3. Sit upright without support 1. Move from prone to sitting unassisted 2. Sit down from standing position

A nurse is planning diversionary activities for preschoolers on an inpatient pediatric unit. Which of the following activities should the nurse include?

Assembling puzzles -Helps develop fine motor and cognitive skills Using musical toys -Helps develop fine motor skills and coordination Playing with puppets -Helps develop oral language and actively uses their imagination Coloring with crayons -Helps develop fine motor skills and coordination

When nurses are communicating with adolescents, they should:

Be alert to clues to their emotional state. Do not avoid discussing sensitive issues. Asking questions about sex, drugs, and school opens the channels for further discussion. Ask open-ended questions. Look for the meaning behind their words or actions. Be alert to clues to their emotional state.

Which approach would be best for a nurse to use with a hospitalized toddler?

Establish a supportive relationship with the mother. Creating an environment that supports parents helps greatly in gaining the cooperation of the toddler. Establishing a trusting relationship with the parents often results in toddler acceptance of treatment.

A nurse is teaching the parents of a toddler about discipline. Which of the following actions should the nurse suggest?

Establish consistent boundaries for the toddler Toddler's need consistent boundaries for discipline to be effective

A nurse is planning diversionary activities for school age children on an inpatient pediatric unit. Which of the following activities should the nurse include?

Building models -Helps develop fine motor and cognitive skills Playing video games -Educational and nonviolent video games helps develop fine motor and cognitive skills Reading books -Helps develop cognitive and communication skills Playing board games -Helps build cognitive skills and promotes social interaction

An 8-year-old child is being admitted to the hospital from the emergency department with an injury from falling off her bicycle. Which of the following will most help her adjust to the hospital?

Explain hospital routines such as mealtimes to her. Illness and hospitalization threaten children's control in these areas. Therefore it is important to allow them to participate in care and maintain as much independence as possible. Nurses need to provide for privacy and offer explanations of common procedures.

Which of the following statements is most descriptive of the psychosocial development of school-age children?

Children frequently have "best friends." The school-age child prefers same-sex to opposite-sex peers. In general, girls and boys view the opposite sex negatively. Peer influence becomes quite diverse during this stage of development. Clubs and peer groups become prominent. School-age children often develop "best friends" with whom they share secrets and with whom they look forward to interacting on a daily basis.

You are working in an adolescent health center when a 15-year-old patient shares with you that she thinks she is pregnant and is worried that she may now have a sexually transmitted infection (STI). Her pregnancy test is negative. What is your next priority of care?

Counsel her on safe sex practices. Nurses need to be sensitive to the emotional cues from adolescents before initiating health teaching to know when the teen is ready to discuss concerns. In addition, discussions with adolescents need to be private and confidential. Adolescents define health in much the same way as adults and look for opportunities to reach their physical, mental, and emotional potential.

The type of injury to which a child is most vulnerable at a specific age is most closely related to which of the following?

Developmental level of the child An understanding of the major developmental accomplishments allows for injury-prevention planning.

A nurse is teaching the guardian of a 12-year-old male client about manifestations of puberty. The nurse should explain that which of the following physical changes occurs first?

Enlargement of the testes and scrotum An increase in size of the testes and scrotum, and hair growth are the first prepubescent change in boys

A nurse is planning diversionary activities for toddlers on an inpatient unit. Which of the following activities should the nurse include?

Filling and emptying containers -Helps develop fine motor skills & coordination Playing with blocks -Helps develop fine motor skills Looking at books -Helps prepare a toddler to read

A nurse is talking with the guardian of a 4-year-old child who reports that the child is waking up at night with nightmares. Which of the following interventions should the nurse suggest?

Have the child go to bed at a constant time every day Going to bed at the same time every day promotes a bedtime routine. Bathing and reading before bedtime promotes reassurance and ensures the child to get adequate sleep.

A nurse is preparing to administer medications to a preschooler. Which of the following strategies should the nurse implement to increase the child's cooperation in taking medications?

Have the guardians bring in a favorite toy from home -Having familiar objects nearby is therapeutic for children during hospitalization and is useful as a distraction to the child. Engage the child in a pretend play with a toy medical kit -

In an interview with a pregnant patient, the nurse discussed the three risk factors that have been cited as having a possible effect on prenatal development. They are:

Nutrition, stress, and mother's age. A woman's diet can have a significant effect on fetal development. Pregnancy also brings physiological, cognitive, and emotional states that can cause stress and anxiety, which can affect fetal development. An older mother's fetus is at risk for chromosomal defects; and adolescent mothers have an increased risk when they expose their fetuses to alcohol, drugs, and tobacco.

A nurse is preparing a wellness presentation for families about health screening for adolescents. Which of the following information should the nurse include?

Obtain a periodic mental status evaluation -Reduces the risk fro suicide, eating disorders, or substance use disorders Discuss preventions of STDs -Reduces the risk for developing an STD Regularly screen for tuberculosis -Reduces the risk of spreading tuberculosis Provide education about drug and alcohol use -Reduces the risk for the use of alcohol and recreational drugs

A nurse is reviewing car seat safety with the parents of a 1-month-old infant. When reviewing car seat use, which of the following instructions should the nurse use?

Position the car seat so that the infant is rear-facing Until age 2 or outgrows the seat limitation the infant should be rear facing and in the center of the vehicle.

A nurse is planning a health promotion and primary prevention class for the caregivers of school-age children. Which of the following actions should the nurse plan to take?

Provide information about the risk of childhood obesity -Caregivers should be aware of nutritional strategies for preventing obesity Discuss the danger of substance use disorders -Caregivers need to know hoe to teach children to say no to illicit drugs, alcohol, or harmful addictive substances Promote discussion about sexual issues -Caregivers should discuss sexual issues to promote healthy behavior Reinforce stranger awareness -Caregivers should address stranger safety as soon as they are old enough to understand, and continue to reinforce it throughout all stages of childhood.

At a well-child examination, the mother comments that her toddler eats little at mealtime, will only sit briefly at the table, and wants snacks all the time. Which of the following should the nurse recommend?

Provide nutritious snacks. Mealtime has psychosocial and physical significance. If the parents struggle to control toddlers' dietary intake, problem behavior and conflicts can result. Toddlers often develop "food jags," or the desire to eat one food repeatedly. Rather than becoming disturbed by this behavior, encourage parents to offer a variety of nutritious foods at meals and to provide only nutritious snacks between meals.

You are caring for a 4-year-old child who is hospitalized for an infection. He tells you that he is sick because he was "bad." Which is the most correct interpretation of his comment?

Representative of his cognitive development If two events are related in time or space, preschool children link them in a causal fashion. For example, the hospitalized child reasons, "I cried last night, and that's why the nurse gave me the shot."

A nurse is talking with the parents of a 6-month-old infant about gross motor development. Which of the following gross motor skills are expected findings in the next 3 months?

Rolls back to front -By 6 months old Bears weight on legs -By 7 months old Sits unsupported -By 8 months old

A nurse is assessing a 2-week-old newborn during a routine checkup. Which of the following findings should the nurse expect?

Sleeps 14 to 16 hs each day -Newborns should sleep 15 hrs a day Hands remain in a closed position -Until about 2 months old Current weight same as birth weight -Expect the newborn to lose 5%-10% of birth weight the first few days of life and regain the weight by week 2

A nurse on a pediatric unit is caring for an adolescent who has multiple fractures. Which of the following interventions should the nurse take?

Suggest that the guardians bring in video games to play Provide a television and movies for the adolescent to watch Involve the adolescent in treatment decisions when possible -Helps promote independence and control Allow the adolescent to perform morning self-care -Helps promote a sense of independence and shows respect for their privacy.

A mother tells the nurse that her 2-year-old toddler has temper tantrums and says "no" every time the mother tries to help them get dressed. The nurse should recognize the toddler is manifesting which of the following stages of development?

Trying to increase their independence Toddlers express a drive for independence by opposing the desires of authority

A nurse is reviewing the CDC's immunization recommendations with the guardians of an adolescent. Which of the following recommendations should the nurse include in this discussion?

Varicella Human papilloma virus Seasonal influenza

Parents are concerned about their toddler's negativism. To avoid a negative response, which of the following is the best way for a nurse to demonstrate asking the toddler to eat his or her lunch?

Would you like apple slices or applesauce with your sandwich? Nurses and parents can deal with the negativism by limiting the opportunities for a "no" answer.