Growth and Development of the Preschooler

The nurse is providing teaching about preventing poisoning. Which of the following statements by the mother would warrant further discussion?

"All medicine in our bathroom is in childproof containers."

The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and the caregiver is wondering if this is normal. Which of the following responses by the nurse would be most appropriate?

"By the age of 6 most children can print some letters and maybe their first name."

The nurse is conducting a well-child exam of a 4-year-old boy. Which of the following statements 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 mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone?

"He tries to sweep up cereal his brother spilled but cries when he can't do it well."

The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

"I usually have him in time-out for about 10 minutes."

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 of the following statements by the father would indicate a need for further teaching?

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

A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. Which of the following would be the best response for the nurse to give the child?

"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order.

1.Parent knows the misbehavior was intentional. 2.Warn the child there will be a time-out if the behavior does not stop. 3.Remove the preschooler to a boring spot. 4.Set a timer for no more than 4 minutes. 5.If the child gets up, replace the child and restart the time.

If the child is gaining weight at an expected rate, a child who weighs 36 lbs. at 3 years of age would weigh which of the following at age 5?

44 lbs.

A mother comes to the clinic with her 3 year old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the patient has a normal vocabulary for age. The nurse is aware that language for a 3 year old consists of approximately at least how many words?

900 words

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage?

Asking the girl to slow down and to think before she talks

The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play?

Children are playing in an organized group with each other.

A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family?

Deficient knowledge of normal preschool development

A mother confides in a nurse that her preschool daughter only wants to play with her father as soon as he comes home from work in the evenings and doesn't seem to have any interest in spending time with the mother. This phenomenon is an example of which of the following?

Electra complex

A mother is discussing with the nurse a recent story in the local news about a child being abducted. She is concerned about the safety of her preschool child and wonders what she should tell her child to keep her safe but without frightening her. Which of the following would be the best recommendation for the nurse to give the mother in this case?

Explain in a calm and everyday manner how the child should stay away from strangers in cars

A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group?

Imagination

A nurse is observing a 3-year-old preschooler engaged in play. Which of the following would the nurse most likely expect to observe?

Imitative play

The major developmental task according to Erikson is for the preschool child to develop which of the following?

Initiative

Recently, 5-year-old Jack's father was injured in a motorcycle accident. The father is healthy and back at work. Jack's father confides to the school nurse that he is concerned about Jack. When questioned further, he tells the nurse that Jack is not acting like he was before the accident. He says he keeps telling Jack he is a good boy; indeed Jack is not testing or challenging his boundaries like he was before the accident. Which of the following best describes the reason for the behavior Jack's father is seeing?

Jack wanted to go with his father on the motorcycle ride. When he was told he couldn't go he told his father he hoped he would crash, so Jack believes he caused the accident.

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?

Opening drawers in the room, pulling out supplies, and examining them

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of the following is the highest calcium-containing fruit?

Orange

A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is which of the following?

Physical growth slows.

A mother reports to the nurse that her 4 year old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother?

Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development."

A mother brings her 4-year-old son in for a check-up. Which of the following findings should the nurse be concerned about?

Resting pulse rate of 120

A 4 year old is going to finger paint for the first time. Which of the following is the best action for the adult supervisor of this activity?

Support whatever the child paints.

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to which of the following?

Testing and identification of group role

The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old?

The child can hop on one foot.

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply.

• Children who weigh less than 40 pounds should use a car seat with harness and top tether. • Many car seats are installed improperly, making them unsafe. • The back seat remains the safest place for children to ride. • Booster seats should be used with both a shoulder and lap belt.

In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler?

The child takes in new information at a rapid rate and asks "why" and "how.

When collecting data on a preschool-age child during a well-child visit, the nurse finds that the child has gained 12 lb and grown 2.5 inches in the last year. Using knowledge of normal growth patterns of the preschool child, the nurse recognizes that these findings indicate which of the following?

The child's weight is above an expected range and the height is within an expected range.

The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that the girl is demonstrating which of the following?

Transduction

Fear of mutilation is significant during the preschool age.

True

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of the following? Select all that apply.

When discussing improper behavior, call the behavior "bad" or "naughty," not the child. • Anticipate situations likely to cause misbehavior and redirect the child to another activity. • Books and stories can help preschoolers master proper behavior.

The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to

allow her to experiment with PlayDoh.

When planning how to respond to a child about telling stories, you would base your statement on the fact that

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

The developmental task of preschoolers is to achieve a sense of

initiative versus guilt.

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.

• "Try using a night light in the child's room." • "Set up some familiar bedtime rituals for your child." • "Avoid having your child watch frightening shows on TV before bedtime." • "Try reading a favorite story before bedtime."

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply.

• A father who is overweight • Food used as reward or punishment • Television on during meals • Expectations to eat everything on plate

A mother describes her 4-year-old girl's eating habits as "picky" and goes on to describe using wheedling, coaxing, and threatening measures to get her to eat. The nurse determines the child is growing normally. What interventions will be suggested? Select all that apply.

• Offer a variety of healthy foods including those liked and refused. • Approach mealtime matter-of-factly. • Allow the child to decide how much she will eat. • Ignore the pickiness. • Offer only nutritious between-meal snacks. • Focus on quality, not quantity.

A nurse is instructing a young mother on how to ensure a safe bath time for her 4-year-old son. Which of the following are important suggestions for the nurse to give to the mother? (Select all that apply.)

• Turn down the temperature of the water heater to under 120°F • Do not leave the child unsupervised in the bath tub • Assist the child in cleaning under fingernails and around ears