Family Centered Nursing Exam 1

A nurse is educating a middle school class of male adolescents about sex education. The topic of multiple partners is discussed. Which of the following statements from the nurse would be the most effective?

"Contraception is a responsibility of both parties involved."

What kinds of cognitive developments are expected of preschoolers?

-Learning a lot rapidly. This is the age where children soak up new languages like sponges. -Understanding conservation -Understanding order of operations

Describe the play of a preschooler.

-Not a huge need for toys, because they have a big imagination. -Will play imitation games related to things they see in real life. -Fantasy is huge. They will think cartoon characters are real. -They are able to take turns in play.

The parents of a hospitalized 8-month-old client tell the nurse "We have such anxiety when we have to leave since the our baby screams and becomes so upset. We can hear screaming the whole way down the hall." How will the nurse respond?

"This is normal behavior at this age and the staff will care for the infant."

What are the best ways to foster initiative in preschool-aged kids?

-Encourage their creativity. Let them wear costumes and dress themselves in a way that makes them feel accomplished (even if their socks don't match). -Give them exposure to many different textures and sensory experiences, such as play-doh, finger paint, bubbles, trips to the zoo, etc.

A hospitalized 4-year-old child reports having difficulty falling asleep at night due to a fear of monsters. How will the nurse respond?

"You sound scared. I will show you under the bed that there are no monsters."

What is the typical vocabulary of a preschooler?

-900 words at 3 years old is typical. Increases to 2,100 by 5 years old. -Asks "Why?" up to 400 times per day.

Cow's milk should not be introduced to infants until they are _________ old.

1 year.

What gross motor skills are apparent in preschoolers? (3)

1. Can run 2. Can stand on one foot 3. Can ride a tricycle

What are the physical attributes of a preschooler? (5)

1. Tonsils appear enlarged. 2. Body contour changes to be more childlike than babylike: can begin distinguish different body types. 3. No new teeth develop 4. Genu valgus (the knees touch while the ankles are apart) may be present. 5. Increased coordination, which lends to bicycle riding, kicking, and running.

When should toilet training for toddlers begin? (3)

1. When the child can control their rectal and urethral sphincters (this happens around the time they start walking). 2. When they have a cognitive understanding of what it means to hold stool and urine in. 3. When they have the desire for immediate gratification via social acceptance--routine and praising help!

At what age to babies develop object permanence?

10 months.

How much sleep do school-aged kids require?

10-12 hours

What is the average blood pressure of a preschooler?

100/60

What is the average heart rate for an infant, and how does it change through the first year?

110-160 BPM -Pre-term babies have a faster heart rate. -It slows down to 100-120 BPM by the end of the first year.

At what age can babies hold their heads up?

2 months.

At what age do babies develop different cries for "hungry," "lonely," and "wet"?

2 months.

At what age do babies begin to focus their eyes?

2-3 months.

How many inches does the average preschooler grow per year?

2-3.5 inches

By the end of the first year, a baby's brain reaches _________ of its adult size.

2/3

At what age should babies begin to roll over?

3 months

At what age do babies respond to faces?

3 months.

At what age do children typically have all of their deciduous (baby) teeth?

3 years

At what age to babies no longer have head lag when pulled into a sitting position?

4 months.

At what age to babies coo, babble, gurgle, and laugh, as well as say simple vowel sounds like "goo-goo gah-gah"?

4-5 months.

By 12 months how many words does a baby say?

4.

How many pounds does the average preschooler gain per year?

4.5 lbs

How many inches does the average toddler grow per year?

5 inches.

How much weight does the average toddler gain per year?

5-6 lbs.

A baby's height/length will increase by _________ within the first year.

50%

At what age do infants typically sit up on their own?

6 months

At what age do infants develop thermal control?

6 months.

At what age to babies typically stand on their own?

6 months. This increases muscle tone in preparation for walking.

At what age can infants sit up securely with no support?

8 months.

What is the average pulse of a preschooler?

85 BPM.

At what age do babies typically say their first word?

9 months.

The pattern of growth in which the child is able to control the head and neck before the arms and legs is known as which of the following?

Cephalocaudal Rationale: Growth of the child follows an orderly pattern starting with the head and moving downward. This pattern is referred to as cephalocaudal. The child is able to control the head and neck before being able to control the arms and legs.

When teaching the parents of a school-aged child about promoting adequate sleep, what priority suggestion(s) should the nurse emphasize? Select all that apply. A. Consistent bedtime B. Bedtime routine C. Darkened room D. Use of music E. Play prior to bed

A and B Rationale: A darkened room isn't always best. Some school-aged children are scared of the dark and a nightlight is preferred. Both music and play can be too stimulating before bed.

A mother calls the clinic nurse asking for recommendations on comfort measures for her infant who is teething. What recommendations should the nurse make? Select all that apply. A. Teething rings B. Ice cubes C. Over-the-counter numbing gel D. Teething biscuits E. Acetaminophen

A and E Rationale: Ice cubes and teething biscuits are a choking hazard and OTC numbing gel can numb the esophagus and cause aspiration.

What should the inside of a baby's crib look like?

A flat-fitted sheet is all babies need. -Pillows, blankets, or stuffed animals pose suffocation risks. -No co-sleeping: babies need their own safe environment.

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. Rationale: An infant until 2 years of age should be in a rear-facing car seat. The 5-point harness seat is made for children up to 40 pounds (18 kilograms) and the booster seat for children from 40 to 80 pounds (18 to 36 kilograms).

The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. A. Plans activities and makes up games B. Initiates activities with others C. Acts out roles of other people D. Engages in parallel play with peers E. Classifies or groups objects by their common elements F. Understands relationships among objects

A, B, and C

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age?

Banding together with other girls and dressing like them.

What is the pincer grasp? At what age is it developed?

An infant's ability to bring the thumb and finger together to pick up objects. This is preparation for them to be able to feed themselves, and is also a good assessment for coordination. -Happens at 10 months.

What is the most common language development issue for school-aged children?

Articulation. It usually disappears after third grade, but if not, speech therapy can be helpful.

A nurse hands a toddler a toy hammer. Instead of hitting or pounding the hammer on an object, the toddler begins shaking it. What concept related to growth and development is the toddler displaying?

Assimilation Rationale: Assimilation is the concept of taking in information and changing it to fit existing ideas. The baby's existing schema of toys includes rattles; therefore, the baby is treating the hammer like a rattle by shaking it.

What is the difference between assimilation and accommodation?

Assimilation is taking in information to fit existing ideas. For example, a child playing an imagination game about knights might take a toy broom and use it as a sword. This is very typical of preschool-aged children. Accomodation happens as children begin to progress past assimilation. This is when ideas are changed to fit reality, rather than the inverse.

A parent comes to the clinic with concerns about flattened skull bones on the back of their baby's head. What does the nurse recommend to the parent?

Because babies should always be placed on their backs to sleep, this flattened spot is quite common. Making sure that they have "tummy time" in prone position during the day will help get rid of the flat spot.

What is a critical milestone of language development for toddlers?

Being able to form a two-word sentence (a noun and a verb) by 2 years of age.

What is broken fluency is relation to preschoolers?

Broken fluency is a preschooler's tendency to struggle to get out words. This is common and different from a stutter. Parents should not finish the sentence for them or call attention to it, as it can make the child self-conscious and increase their stress.

A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially?

Check the expiration date on the car seat.

The child in Kohlberg's preconventional stage of development is incentivized to follow the rules for what reason? What age range aligns with this stage?

Children at this stage follow rules to avoid punishment from their parents. In other words, clear guidance and instructions are needed for the child to determine right or wrong. This stage occurs from 2-7 years old.

The child in Kohlberg's conventional stage of development is incentivized to follow the rules for what reason? What age range aligns with this stage?

Children at this stage follow rules to be a good person in the eyes of themselves and others. They enjoy following rules from authority figures and being praised for good behavior. This stage occurs from 7-12 years old.

What is recommended to treat diaper dermatitis (diaper rash)?

Clean skin with soap and water and let it air out.

What is cognitive development and how is it assessed?

Cognitive development refers to the ability to learn or understand from experience, to acquire and retain knowledge, to respond to a new situation, and solve problems. It may be assessed by intelligence tests and by observing a child's ability to function in different environments.

What developmental milestones are anticipated for adolescents?

Driving, hanging out with friends, team loyalty, part-time jobs. -Lots of time is spent talking to peers, both face-to-face and electronically.

What is egocentrism is relation to preschoolers?

Egocentrism is perceiving one's thoughts as better and more important than others. This is strong during the preschool period. Preschoolers expect others to know who they are and also define objects in relation to themselves, e.g. a spoon is, "What I eat with,"

A 6-month-old arrives for a well-baby visit with a case of diaper rash that the parent believes is normal for infants. The parent reports changing the baby's diaper when he wakes up and before naps or bedtime. Which frequency should the nurse point out will better help heal and prevent future incidents of diaper rash?

Every 2-4 hours.

How often should new foods be introduced to babies?

Every 3 days. This way, if an allergic reaction occurs, there's no confusion about what caused it.

A new parent brings their 3-month old infant into the clinical for a checkup. You notice that the infant is sucking on a preemie pacifier. Upon questioning the parent, they say that the infant is especially attached to that pacifier and refuses to use any other ones. How should the nurse respond?

Explain to the parent that giving their child a pacifier that is under their age range is a choking hazard, because it is too small.

T or F: It is important to change a newborn's diaper on a strict schedule, even if that means waking the newborn from sleep.

False. Newborns wake up to eat every 2-3 hours, so they should be changed at that time if necessary.

T or F: It is important not to hold babies too much, as excessive holding can spoil them.

False. Touch is extremely important to a baby's development, and there is no such thing as holding them too much.

At a 12-week old infant's checkup, the parents express concern that their baby isn't getting enough nutrients. They ask the nurse if they can start feeding their baby soft fruits like bananas and peaches. How should the nurse respond?

For the first six months of life, breastmilk or formula has all of the nutrients they need. Babies have an immature GI tract and cannot digest solid food until 5 or 6 months. The solid food would just take up extra space in the stomach and be difficult to digest.

What is the best way to reduce school anxiety in preschool-aged kids?

Get them excited about school and focus on the positives.

What is the difference between growth and development, and which 3 markers would you assess for each?

Growth is defined as an increase in physical size, including: 1. Height 2. Weight 3. Head circumference Development refers to the progression toward maturity in: 1. Mental markers 2. Physical markers 3. Social markers -Maturation is synonymous with development.

A hospitalized infant is being formula-fed while his parents are not present. What should the nurse do while feeding the infant to foster their sense of trust?

Hold the baby during the feeding.

Describe Erikson's developmental task for an adolescent.

Identity vs. Role Confusion: Adolescents piece together the different facets of their personality to develop a whole identity. Or they become confused about what kind of person they are and who they want to become. -Common for adolescents to explore and express their identity in different ways.

What is the toilet paper roll rule in regard to infant safety?

If an object is small enough to fit through the cardboard center of a toilet paper roll, it is a choking hazard.

A nursing instructor asks the class to describe growth and development using only one word. Which would be the best choice?

Individualized.

Describe Erikson's developmental task for a school-age kid.

Industry vs. Inferiority: As social interaction increases, children will start to notice areas where they are more successful than their peers and feel a sense of accomplishment. With repeated failures or unsupportive caregivers, they will instead feel inferior. -Foster their sense of industry with encouragement with schoolwork and household chores. -They should have much more industry than inferiority.

Describe Erikson's developmental task for a preschooler.

Initiative vs. Guilt: Preschooler fosters their sense of creativity by drawing, building, playing dress-up, and asking questions. If they feel like they're not allowed to be creative or their questions are a nuisance, they develop guilt which later manifests as trouble brainstorming or needing guidance from others before acting. -Foster their creativity by giving them lots of different textures, arts and crafts, and learning experiences. -A small amount of guilt for bad behavior is appropriate. Too much guilt will carry into school years.

Describe Erikson's developmental task for a late adolescent.

Intimacy vs. Isolation: The late adolescent can relate well to other people in preparation for developing future relationships. Or they don't foster relationships and socially isolate themselves, consequently leading to feelings of loneliness.

Why should you avoid putting a baby to bed with a bottle?

Milk is very sugary. It can erode enamel and lead to baby bottle tooth decay syndrome.

Most babies will double their weight by __________, and triple their weight by __________.

Most babies will double their weight by six months, and triple their weight by one year.

What is negativism in toddlers and what advice should the nurse give to parents who are exasperated by it?

Negativism is a toddler's tendency to say "No!" to every request. This is normal for toddlers, but can be exhausting for parents. Attempting to force obedience on the child can often be met with more resistance, so it is suggested to provide the child with simple choices, e.g. "Do you want to bring your blue rubber ducky or your pink rubber ducky into the bath tonight?"

How should newborns be dressed to ensure they are warm enough?

Newborns should always be in one extra layer than you are.

What type of play behavior would you expect of two toddlers?

Parallel play: playing beside each other independently.

When planning guidance for parents of a child with a developmental delay, what is important to keep in mind?

Parents of a child with a developmental delay may use denial as a protective mechanism. Planning may have to focus on acceptance of the current situation and providing the appropriate resources.

The child in Kohlberg's postconventional stage of development is incentivized to follow the rules for what reason? What age range aligns with this stage?term-47

People in this stage follow rules for the greater good of society. This stage occurs from 12+

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 kinds of language skills are expected from school-aged kids?

Reading and speaking full sentences, reading small chapter books, learning other languages if in a bilingual home, can define objects by use. -Bathroom humor swear words are common

What recommendations would you give to a parent whose toddler is experiencing language delays?

Reading simple books with them every day will help.

The school nurse receives a report that a school-aged child is having difficulty with grades and always appears irritated. When the nurse is assessing this child, what information would be there most important to ascertain?

Relationship with parents. **A similar PrepU question says peers instead. When I asked Richter about this, she said, "I want you to understand that parents are relevant in school-age kids. Would a peer be more important to a first-grader? They are school-age."

What are the most common safety hazards for adolescents?

STIs, date rape, substance use, depression, self-injury, eating disorders, body image issues, and bullying.

A runaway female adolescent has come to the community clinic because she is pregnant. When developing a plan of care, the nurse should identify which priority goal for the adolescent?

Safe housing.

When interviewed by the school nurse, a 13-year-old adolescent female states she has a boyfriend and that her parents do not talk about sex with her. She says is confused about the facts and wants to know the truth. Which approach would best address this adolescent's concerns?

Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner.

What kinds of gross motor developments are expected from school-aged kids?

Skipping, hopscotch, bikes without training wheels, better hand-eye coordination. -They always want to move and play.

What is the average respiratory rate for an infant and how does it change within the first year?

Slows from 30-60 to 20-30 breaths per minute by the end of the first year.

What is the average blood pressure for an infant, and how does it change through the first year?

Slows from 80/40 to 100/60 by the end of the first year.

What kind of diet is recommended for infants after 6 months of age?

Solid foods can now be introduced per pediatrician's recommendation . -High protein, high calorie diet. -100-120 calories per kg.

What advice should the nurse give to parents who are concerned about their infant frequently spitting up after eating?

Spitting up is fairly normal, but can sometimes be helped by: 1. Burping the baby thoroughly after the feeding. 2. Having the baby be upright for thirty minutes after feeding. 3. Avoiding overfeeding, which happens more frequently with formula-fed babies.

What kind of exercise is recommended for babies?

Stimulating play, tummy time, rolling over, and letting them stand all promote building muscles to help with new developments like walking and standing.

A 10-day old infant has to have their blood drawn. What does the nurse anticipate administering as the analgesic?

Sucrose. Rationale: Sucrose is an analgesic for the first 21 days of life.

A preschool-aged child tells the nurse that, on his family's vacation to the beach, his brother turned into a shark. How should the nurse respond to the child's story?

Telling tall tales is common for preschoolers, as they have an active imagination. Acknowledge that they're telling a story, then ask what really happened on vacation.

What is the Moro reflex and how does it relate to development? How would you suggest that a new parent soothes this reflex?

The "startle" reflex. If you lay a baby on their back, they feel like they're falling and will jerk while spreading out their arms. Can also be elicited by a loud noise or jarring the bassinet. It is strongest in the first 8 weeks of life. We know babies are developing correctly when they grow out of this. -Suggest swaddling to parents to help soothe this reflex.

What is binocular vision? At what age does it typically develop?

The ability to focus the two eyes in a coordinated manner in order to see one image. -Develops at 2 months.

What decentering in relation to school-aged kids?

The ability to project one's self into other people's situations and see the world from another viewpoint. As school-aged kids move into Piaget's stage of concrete operational thought, they learn to do this.

What is class inclusion in relation to school-aged kids?

The ability to understand that objects can belong in more than one class.

The nurse observes an infant repeatedly sucking her thumb and putting toys in her mouth. Her parents tell you that her favorite things to do are play with rattles and listen to tapes of their voices reading lullabies. How old is the infant? Which one of Piaget's substages of sensorimotor development does the nurse suspect the baby is in, and what explanation does the nurse give for why the infant finds these activities pleasurable?

The baby is most likely 1-4 months old, and in Piaget's primary circular reaction substage of the sensorimotor stage. Because hand-mouth and ear-eye coordination develop during this phase, infants discover pleasurable actions around their own bodies.

What is the extrusion reflex, and at what age does it disappear?

The extrusion reflex is when a baby pushes solid food out of its mouth with its tongue. It is both a protective reflex to prevent aspiration and a reflex that helps latch to a nipple. It disappears at 6 months.

Why is it especially important to not let strangers/distant relatives kiss infants under two months old?

The infant does not have a functional immune system under two months old (though, they do get some antibodies from breast milk). The baby will be susceptible to STIs like herpetic lesions, which can actually kill them.

What is temperament?

The reaction pattern of an individual or an individual's characteristic manner of thinking, behaving, or reacting to environmental stimuli. It is not developed in stages; rather, different children have different temperaments. Temperament is a huge reason why children approach problems differently.

What kind of dental care should be given to an infant who has not yet developed teeth?

Their gums can be washed with a washcloth until the first tooth appears, then brushing can start.

Why is it important to assess head circumference in infants?

Their head size is indicative of their growth patterns and can also indicate abnormalities: -Assessing head circumference is important to ensure that there isn't an increase in cerebrospinal fluid or tumors. -As they grow, their head should slowly become not the largest part of their body. -When they're under 6 months, the large head helps them roll over. Their proportions change as to help with balance as they begin to walk.

What is the primary cue that a toddler is ready to start toilet training?

They are visibly uncomfortable in a wet diaper and possibly even bring their caretaker a clean one when soiled.

Describe ritualistic behavior in relation to toddlers.

Toddlers may have special comfort objects like blankies/stuffed animals, or always want to drink from the same cup. These behaviors are comforting and provide coping skills.

The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. What is an appropriate response to this concern?

Treat the action in a matter-of-fact manner, emphasizing safety.

T or F: It is normal for babies to run a low-grade fever when teething.

True.

Describe Erikson's developmental task for an infant.

Trust vs. Mistrust: With consistent care, infants will trust that their caregiver will meet their needs. With inconsistent care, they learn not to trust. -When they're hungry, they get fed; when they're cold, they get clothed. -Bonding, routines, and rituals build trust. -Mistrusts occurs when care is inconsistent, but can also occur in small quantities by letting strangers hold the infant or letting them cry for a few minutes before coming to get them. -A bit of mistrust is necessary too, or the child won't know how to handle their needs not being met 24/7.

Which vitamin should be supplemented to breast-fed babies?

Vitamin D

What is the Landau reflex and when does it develop?

When held in ventral suspension, the infant's head, legs, and spine extend. When the head is depressed, the hips, knees, and elbows flex. This is helpful for increasing muscle tone in the neck. -Develops at 3 months.

What is the parachute reflex?

When infants are suddenly lowered toward an examining table, the arms extend as if to protect themselves from falling. Children with cerebral palsy do not demonstrate this response because they flex their extremities too tightly.

What is the Babinski reflex?

When stroking the sole of the foot, a baby's toes will fan out. In contrast, an adult will flex their foot if stroked in the same way. -It typically lasts until the baby is 3 months old.

When does puberty begin and end for the different sexes during adolescence?

Women: Begins when menstruation starts. Men: Begins when they start producing sperm. Ends for both when skeletal growth has ended. -Girls typically start and end earlier.

What kinds of fine motor skills are expected from school-aged kids?

Writing, drawing, and coloring.

When teaching parents, what information should the nurse include related to healthy diets for children? (2)

1. Children should experience a variety of foods. 2. Eat sugars in moderation for obesity control.

A toddler has to stay in the hospital for several days following a procedure, but is displaying signs of separation anxiety when his parents have to leave. What advice does the nurse give to the parents to help combat the separation anxiety? (3)

1. Give the child warning that you are going to leave soon. 2. Always tell them that you're leaving before you leave. Sneaking away can cause trust issues. 3. Be consistent and tell them when you'll be back.

Describe Freud's 5 psychosexual stages and with which age group they align.

1. Infants: Oral stage. -Child explores the world by using the mouth. 2. Toddler: Anal stage. -Child learns to control urination and defecation. 3. Preschooler: Phallic stage. -Child learns sexual identity through awareness of the genital area. 4. School-Aged Child: Latency stage. -Child's personality development appears to be non-active or dormant. 5. Adolescent: Genital Stage. -Adolescent develops sexual maturity and learns to establish satisfactory relationships with others.

What are common sources of unintentional injury for school-aged kids and how to prevent them?

1. Motor vehicle: car seats, teach street-crossing safety. 2. Bicycles: helmets, no passenger rides. 3. Community: teach them to say "no" to anyone who touches them in an unwanted way. 4. Burns: safety with candles, matches, and campfires. 5. Falls: skateboard, scooter, skating safety. 6. Sports injuries: protective gear 7. Drowning: don't swim beyond limits of a child's capability. 8. Drugs: avoid tobacco, alcohol, drugs. 9. Firearms: keep firearms locked.

A parent states difficulty in preparing the child for school each morning. What actions will the nurse will include in a plan of care for a child with school refusal? (5)

1. Perform physical psychosocial assessment 2. Identify school counselor assigned to school. 3. Evaluate family dynamics, particularly among members of home. 4. Define school day guidelines according to policy. 5. Refer family to counseling services outside the school.

Which 4 foods should not be introduced to babies until they are one year old?

1. Egg whites 2. Peanut butter 3. Strawberries 4. Honey (higher risk for botulism since it's not pasteurized)

What are some common fears of preschool-aged kids? (3)

1. Fear of mutilation: they can vividly imagine their insides coming out with just a small cut. 2. Fear of the dark, monsters under the bed. 3. Fear of abandonment.

Describe the physical characteristics of toddlers (5)

1. Prominent abdomen due to weak abdominal muscles. 2. Unsteady, waddling gait. 3. Lordosis (forward curve of the spine) 4. Baby fat begins to disappear. 5. Chest circumference becomes bigger than head.

The nurse is developing a care plan for several clients who were seen in the clinic that day. Which situation will the nurse conclude is most likely to experience challenges in the growth and development of the children? A. Both parents work during the day and the child comes home after school to an empty house. B. Children attend school while the father works and then sleep in their car at night. C. Child's parents are divorced, and the child sees their dad on the weekends.

Children attend school while the father works and then sleep in their car at night. Rationale: Homelessness creates many stresses for the family, including affecting the growth and development of the children in the family. Living with an extended family, being a latchkey kid, and children of divorce also can affect growth and development, but homelessness is most likely to affect the family and child.

The nurse is assessing a 12-week old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant?

Smiles at significant others

What are the biggest safety concerns for preschool-aged kids? (3)

1. Bicycle safety: always model helmet-wearing! 2. Stranger danger: educate them on not accepting rides from strangers, how to call for help in an emergency, and explaining that if an adult tells them to keep a secret about anything that makes them uncomfortable, they should tell their parents or another trusted adult. 3. Pool safety: gates and locks around the pool to prevent accidental drowning.

What is the recommended punishment for toddlers?

Time-out: 1 minute per year of age.

What are the Healthy People 2030 goals for preschool-aged kids? (5)

1. Reduce traumatic brain injuries 2. Reduce the number of children who have had 3 or more ear infections in 1 year. 3. Increase coverage for TDaP vaccination. 4. Increase coverage for MMR vaccination. 5. Reduce passenger deaths that result from not wearing a seatbelt.

Which 8 factors influence growth and development?

1. Temperament 2. Genetics 3. Gender 4. Health 5. Environment 6. Parent-child relationship 7. Ordinal position (first child, middle child, etc.) 8. Nutrition

What are the nine characteristics that define temperament?

1. Activity level 2. Rhythmicity: how predictable are their biologic functions like hunger and sleep? 3. Approach: how anxious/open are they to new experiences? 4. Adaptability: how easily do they cope with changes in routine? 5. Intensity of Reaction 6. Distractibility: how quickly can they shift their attention to new situations? 7. Attention Span and Persistence: how long do they maintain interest in an activity? 8. Threshold of Response: how intense of stimuli of needed to evoke a reaction? 9. Mood Quality: are they positive or negative?

How should the nurse help a parent who is struggling with their toddler's temper tantrums? (4)

1. Assess the circumstances around when the tantrums occur to see if routine changes can be made: if they frequently happen before bedtime, perhaps an earlier bedtime is needed. 2. Instruct the parent to ensure the toddler is safe during the tantrums and unable to harm themselves, hit their head on something sharp, etc. 3. Once it's clear that the toddler is safe, advise the parents to ignore the tantrum. 4. Once the tantrum is over, the parents can calmly tell the child that they did not like the behavior.

What fine motor skills are apparent in preschoolers? (4)

1. Can undress self 2. Can stack a tower of blocks 3. Can draw small symbols 4. Can do simple buttons

What are the four different temperaments for children?

1. The Easy Child: Children with predictable rhythmicity, approach, and adapt to new situations readily; mild-to-moderate intensity of reaction, and overall positive mood quality. Most parents rate their children as being in this category. 2. The Difficult Child: Children with irregular habits, negative mood quality, and withdraw rather than approach new situations. Only about 10% of children fall into this category. 3. The Intermediate Child: Some characteristics of both easy and difficult are present. 4. The Slow-to-Warm-Up Child: Children who are fairly inactive, respond only mildly and adapt slowly to new situations, and have a generally negative mood. Only about 15% of children display this pattern.

At what age do babies typically start walking?

10-13 months. It's important to incorporate play to stimulate their minds and motor development.

Describe Piaget's sensorimotor stage and which age group it aligns with.

At this age, infants cannot use words or symbols for thinking and problem-solving yet. Instead, they relate to the world through their senses. Object permanence is discovered during this stage.

Describe Piaget's preoperative period and which age group it aligns with.

At this stage, toddlers and preschoolers begin to develop cognitive skills such as symbolic thought and egocentric thinking. Trial and error is used for discovery. -The concept of object permanence is completed in this stage (but starts at 10 months). - They start to draw conclusions from obvious facts they see.

Describe Erikson's developmental task for a toddler.

Autonomy vs. Shame or Doubt: Toddler becomes more independent ("No!" "I do it!") and takes pride in their new motor abilities. Or with too much scolding or discouragement from trying new things, they doubt their abilities and develop a stronger sense of shame than autonomy. -To encourage their autonomy, let them make simple choices: "Do you want the red bowl or the blue bowl?" -Yes/no choices are not appropriate for toddlers.

The nurse is giving a presentation to a parent's group about child safety and poison prevention. The nurse understands that _________ is the primary risk factor for toddler poisoning?

Curiosity

When describing the various changes that occur in organ systems during adolescence, what would the nurse include?

Decrease in heart rate Rationale: During adolescence, the heart rate decreases while the systolic blood pressure increases. Brain growth continues, but the size of the brain does not increase significantly. Ossification is more advanced in girls and occurs at an earlier age. Sebaceous gland activity increases during adolescence.

A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks?

Developmental

What is the difference between discipline and punishment?

Discipline = Setting rules so children know what is expected of them. Punishment = The consequence that results from disregard of the rules set. "Consistency is key. Inconsistency leads to anarchy," --Richter

What is hand regard and how does it relate to development? At what age does this typically occur?

Hand regard is when infants place their hand in front of their face to study it. This typically happens when an infant gains the ability to follow an object across their midline. -Develops at 3 months.

Why is it important as a nurse to understand a child's temperament?

Understanding a child's temperament may help the nurse anticipate reactions to care. For example, a child with an intense reactivity pattern may voice minor discomfort loudly while a child with a less intense pattern may barely react. Variations in temperament may make it difficult to perform accurate assessments.

The nurse observes an infant playing peek-a-boo and smiling at his parents. His parents tell you that the infant enjoys touching and grabbing objects. How old is the infant? Which one of Piaget's substages of sensorimotor development does the nurse suspect the baby is in, and what explanation does the nurse give for why the infant finds these activities pleasurable?

The baby is most likely 4-8 months old and in Piaget's secondary circular reaction substage of the sensorimotor stage. Because the infant is learning to initiate, recognize, and repeat pleasurable experiences from the environment during this phase, the response from others prompts the infant to repeat the action.

A preschooler sees orange juice poured from a long, skinny glass into a short, squat glass. What would they think about the quantity of the orange juice, and to which concept does this relate?

They would think that there is less orange juice in the short, squat glass. This is because preschoolers lack conservation, or the ability to discern truth when physical properties change.

A parent comes to the clinic concerned that their toddler will eat four meals one day, then only want a few goldfish crackers the next. What nutritional advice does the nurse give the parent?

This behavior is normal for toddlers. -Supply them with nutritious snacks like cheese slices, yogurt, or orange slices. -It's best for them to drink water over juice to stay hydrated. -Give them small meals initially and let them ask for more.

The 7-year-old child is joining a dance class. The child insists the parent stay in the dance room, frequently requests to use the bathroom, and refuses to join in the actual dance activity until the last 5 minutes of the class. When discussing the child's behavior with the parent, the nurse will base the instruction on which temperament style? How should the nurse discuss the child's temperament with the parents?

This is a slow-to-warm-up child. When discussing this temperament with parents, try to use positive terms such as, "ways to find a healthy fit for your child," rather than stressing the ways the child is hard to manage.

Describe Piaget's period of formal operational thought and which age group it aligns with.

This period goes with adolescents. At this stage, kids can think in abstract (what could be), instead of what already is (concrete). Because of this, they can use scientific reasoning.

Describe Piaget's period of concrete operational thought and which age group it aligns with.

This period goes with school-aged kids. At this age, children learn cause-and-effect relationships, understand conservation, and use practical solutions for everyday problems.

A parent comes to the clinic concerned that their infant's thumb-sucking will cause their teeth to grow in abnormally. What advice does the nurse give to the parents?

Thumb sucking is common and does not deform the jaw in infancy; however, children who continue to suck their thumb into school age years can cause dental abnormalities.

What nursing interventions can be implemented for an infant in the hospital to ensure that they have adequate sensory stimulation for each of the five senses?

Vision: Pictures of family members, drawings near their crib, or items the infant would normally see at home. Hearing: Play soft, musical sounds and speaking in a soft, cooing voice to them. Try to avoid harsh or loud sounds. Touch: Made sure they get plenty of skin-to-skin contact, wear comfortable clothes, and are handled with assurance yet gentleness. Taste: Mealtime should foster trust and be done at the infant's pace. Smell: Avoid harsh or irritating odors like strong perfumes.