Page 1-5 PEDs exam

In terms of fine motor development, the infant of 7 months should be able to: a. Transfer objects from one hand to the other. b. Use thumb and index finger in a crude pincer grasp. c. Hold a crayon and make a mark on paper. d. Release cubes into a cup.

A. transfer objects from one hand to the other By age 7 months, infants can transfer objects from one hand to the other, crossing the midline. The crude pincer grasp is apparent at about age 9 months. The infant can scribble spontaneously at age 15 months. At age 12 months, the infant can release cubes into a cup.

Which is appropriate play for a 6-month-old infant? a. Pat-a-cake, peek-a-boo b. Ball rolling, hide-and-seek game c. Bright rattles and tactile toys d. Push and pull toys

A Feedback A Six-month-old children enjoy playing pat-a-cake and peek-a-boo. B Nine-month-old infants enjoy rolling a ball and playing hide-and-seek games. C Four-month-old infants enjoy bright rattles and tactile toys. D Twelve-month-old infants enjoy playing with push and pull toys.

In terms of gross motor development, what would the nurse expect a 5-month-old infant to do? a. Roll from abdomen to back. b. Roll from back to abdomen. c. sit erect without support d. Move from prone to sitting position.

A. roll from abdomen to back Rolling from abdomen to back is developmentally appropriate for a 5-month-old infant. The ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually achieved by 8 months. The 10-month-old infant can usually move from a prone to a sitting position.

When a child broke her favorite doll during a hospitalization, her primary nurse bought the child a new doll and gave it to her the next day. What is the best interpretation of the nurse's behavior? a. The nurse is displaying signs of overinvolvement. b. The nurse is a kind and generous person. c. The nurse feels a special closeness to the child. d. The nurse wants to make the child happy.

ANS: A Feedback A Buying gifts for individual children is a warning sign of overinvolvement. B Nurses are kind and generous people, but buying gifts for individual children is unprofessional. C Nurses may feel closer to some patients and families. This does not make giving gifts to children or families acceptable from a professional standpoint. D Replacing lost items is not the nurse's responsibility. Becoming overly involved with a child can inhibit a healthy relationship.

Which statement best describes development in infants and children? a.Development, a predictable and orderly process, occurs at varying rates within normal limits. b.Development is primarily related to the growth in the number and size of cells. c.Development occurs in a proximodistal direction with fine muscle development occurring first. d.Development is more easily and accurately measured than growth

ANS: A Feedback A Development, a continuous and orderly process, provides the basis for increases in the child's function and complexity of behavior. The increases in rate of function and complexity can vary normally within limits for each child. B An increase in the number and size of cells is a definition for growth. C Development proceeds in a proximodistal direction with fine muscle organization occurring as a result of large muscle organization. D Development is a more complex process that is affected by many factors; therefore, it is less easily and accurately measured. Growth is a predictable process with standard measurement methods.

The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is a. Erikson b. Freud c. Kohlberg d. Piaget

ANS: A Feedback A Erik Erikson viewed development as a series of conflicts affected by social and cultural factors. Each conflict must be resolved for the child to progress emotionally, with unsuccessful resolution leaving the child emotionally disabled. B Sigmund Freud proposed a psychosexual theory of development. He proposed that certain parts of the body assume psychological significance as foci of sexual energy. The foci shift as the individual moves through the different stages (oral, anal, phallic, latency, and genital) of development. C Lawrence Kohlberg described moral development as having three levels (preconventional, conventional, and postconventional). His theory closely parallels Piaget's. D Jean Piaget's cognitive theory interprets how children learn and think and how this thinking progresses and differs from adult thinking. Stages of his theory include sensorimotor, preoperations, concrete operations, and formal operations.

The environment, both physical and psychosocial, is a significant determinate of growth and development outcomes before and after birth. Nurses can assist parents in preventing environmental injury for their 2-year-old toddler by teaching them to avoid the most common sources of exposure. This anticipatory guidance includes teaching related to a. Avoiding sun exposure, secondhand smoke, and lead b. Socioeconomic status, primarily poverty c. Maternal smoking and alcohol intake during pregnancy d. The passing of environmental toxins through breast milk

ANS: A Feedback A Lead can be present in the home and in toys made overseas. Environmental injury can also be the result of mercury, pesticides (flea and tick collars), radon, and exposure to the sun and secondhand smoke. It is important for the nurse to provide health teaching related to these factors. B The nurse is unable to influence socioeconomic status. C It is too late for the nurse to instruct the mother regarding smoking or alcohol intake during pregnancy. This should have been included in prenatal teaching. D It is unlikely that a 2-year-old child will still be breastfeeding.

A 3-month-old infant born at 38 weeks of gestation will hold a rattle if it is put in her hands, but she will not voluntarily grasp it. The nurse should interpret this as a. Normal development b. Significant developmental lag c. Slightly delayed development as a result of prematurity d. Suggestive of a neurologic disorder such as cerebral palsy

ANS: A Feedback A This is indicative of normal development. Reflexive grasping occurs during the first 2 to 3 months and then gradually becomes voluntary. B The infant is expected to be able to perform this task by age 3 months. If the child's age is corrected because of being 2 weeks preterm, the child is at the midpoint of the range for this developmental task. C The infant is expected to be able to perform this task by age 3 months. If the child's age is corrected because of being 2 weeks preterm, the child is at the midpoint of the range for this developmental task. D The child is age-appropriate. No evidence of neurologic dysfunction is present.

Which information should the nurse include when preparing a 5-year-old child for a cardiac catheterization? a. A detailed explanation of the procedure b. A description of what the child will feel and see during procedure c. An explanation about the dye that will go directly into his vein d. An assurance to the child that he and the nurse can talk about the procedure when it is over

ANS: B Feedback A Explaining the procedure in detail is probably more than the 5-year-old child can comprehend, and it will likely produce anxiety. B For a preschooler, the provision of sensory information about what to expect during the procedure will enhance the child's ability to cope with the events of the procedure and will decrease anxiety. C Using the word "dye" with a preschooler can be frightening for the child. D The child needs information before the procedure.

An important consideration for the nurse who is communicating with a very young child is to a. Speak loudly, clearly, and directly. b. Use transition objects, such as a puppet. c. Disguise own feelings, attitudes, and anxiety. d. Initiate contact with child when parent is not present.

ANS: B Feedback A Speaking in this manner will tend to increase anxiety in very young children. B Using a transition object, such as a puppet or doll, allows the young child an opportunity to evaluate an unfamiliar person (the nurse). This will facilitate communication with a child of this age. C The nurse must be honest with the child. Attempts at deception will lead to a lack of trust. D Whenever possible, the parent should be present for interactions with young children.

Approximately how much would a newborn who weighed 7 pounds 6 ounces at birth weigh at 1 year of age? a. 14 3/4 lb b. 22 1/8 lb c. 29 1/2 lb d. Unable to estimate weigh at 1 year

ANS: B Feedback A An infant doubles birth weight by 6 months of age. B An infant triples birth weight by 1 year of age. C An infant quadruples birth weight by 2 years of age. D Weight at 6 months, 1 year, and 2 years of age can be estimated from the birth weight.

The nurse is assessing a 4-month-old boy during a scheduled visit. Which of the following findings might suggest a developmental problem? A) The child does not coo or gurgle. B) The child does not babble or laugh. C) The child never squeals or yells. D) The child does not say dada or mama.

B Feedback: The fact that the child does not babble or laugh might suggest a developmental problem. At 4 to 5 months of age most children are making simple vowel sounds, laughing aloud, doing raspberries, and vocalizing in response to voices. The child should have developed past cooing or gurgling, but is too young to squeal, yell, or say dada or mama.

The nurse is providing anticipatory guidance to a mother of a 5-month-old boy about introducing solid foods. Which statement by the mother indicates that effective teaching has occurred? A) "I'll start with baby oatmeal cereal mixed with low-fat milk." B) "The cereal should be a fairly thin consistency at first." C) "I can puree the meat that we are eating to give to my baby." D) "Once he gets used to the cereal, then we'll try giving him a cup."

B) "The cereal should be a fairly thin consistency at first." Iron-fortified rice cereal mixed with a small amount of formula or breast milk to a fairly thin consistency is typically the first solid food used. As the infant gets older, a thicker consistency is appropriate. Strained, pureed, or mashed meats may be introduced at 10 to 12 months of age. A cup is typically introduced at 6 to 8 months of age regardless of what or how much solid food is being consumed.

Trust is important in establishing and maintaining a therapeutic relationship. Maintaining the balance between appropriate involvement and professional separation is quite challenging. Which behaviors may indicate professional separation or underinvolvement? Select all that apply. a. Avoiding the child or his or her family b. Revealing personal information c. Calling in sick d. Spending less time with a particular child e. Asking to trade assignments

ANS: A, C, D, E Feedback Correct Whether nurses become too emotionally involved or find themselves at the other end of the spectrum—being underinvolved—they lose effectiveness as objective professional resources. These are all indications of the nurse who is underinvolved in a child's care. Incorrect Revealing personal information to a patient or his or her family is an indication of overinvolvement.

What is the most important consideration for effectively communicating with a child? a. The child's chronological age. b. The parent-child interaction. c. The child's receptiveness. d. The child's developmental level.

d. The child's developmental level (The child's developmental level is the basis for selecting the terminology and structure of the message most likely to be understood by the child. The child's age may not correspond to the developmental level; therefore, it is not the most important consideration for communicating with children. Parent-child interaction is useful in planning communication with children, but it is not the primary factor in establishing effective communication. The child's receptiveness is a consideration in evaluating the effectiveness of communication.)

Which behavior is most likely to encourage open communication? a. Avoiding eye contact b. Folding arms across chest c. Standing with head bowed d. Soft stance with arms loose at the side

ANS: D Feedback A Avoiding eye contact does not facilitate communication. B Folding arms across the chest is a closed body posture, which does not facilitate communication. C Standing with head bowed is a closed body posture, which does not facilitate communication. D An open body stance and positioning such as loose arms at the side invite communication and interaction.

The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths

ANS : A

The nurse is teaching the parents of an overweight 18-month-old girl about diet. Which intervention will be most effective for promoting proportionate growth? A) Remove high-calorie, low-nutrient foods from the diet. B) Ensure 30 minutes of unstructured activity per day. C) Avoid sharing your snacks and candy with the child. D) Reduce the amount of high-fat food the child eats.

ANS: A

Which statement made by a mother is consistent with a developmental delay? a. "I have noticed that my 9-month-old infant responds consistently to the sound of his name." b. "I have noticed that my 12-month-old child does not get herself to a sitting position or pull to stand." c. "I am so happy when my 1 1/2-month-old infant smiles at me." d. "My 5-month-old infant is not rolling over in both directions yet."

ANS: B Feedback A An infant who responds to his name at 9 months of age is demonstrating abilities to both hear and interpret sound. B Critical developmental milestones for gross motor development in a 12-month-old include standing briefly without support, getting to a sitting position, and pulling to stand. If a 12-month-old child does not perform these activities, it may be indicative of a developmental delay. C A social smile is present by 2 months of age. D Rolling over in both directions is not a critical milestone for gross motor development until the child reaches 6 months of age.

Which expected outcome is developmentally appropriate for a hospitalized 4-year-old child? a. The child will be dressed and fed by the parents. b. The child will independently ask for play materials or other personal needs. c. The child will be able to verbalize an understanding of the reason for the hospitalization. d. The child will have a parent stay in the room at all times.

ANS: B Feedback A Parents need to foster appropriate developmental behavior in the 4-year-old child. Dressing and feeding the child do not encourage independent behavior. B Erikson identifies initiative as a developmental task for the preschool child. Initiating play activities and asking for play materials or assistance with personal needs demonstrates developmental appropriateness. C A 4-year-old child cannot be expected to cognitively understand the reason for hospitalization. Expecting the child to verbalize an understanding for hospitalization is an inappropriate outcome. D Parents staying with the child throughout a hospitalization is an inappropriate outcome. Although children benefit from parental involvement, parents may not have the support structure to stay in the room with the child at all times.

Which is the preferred site for administration of the Hib vaccine to an infant? a. Deltoid b. Anterolateral thigh c. Upper, outer aspect of the arm d. Dorsal gluteal region

ANS: B Feedback A The deltoid muscle is not used for infants. B The anterolateral thigh is the preferred site for intramuscular administration of vaccines for infants. C Subcutaneous injections can be given in the upper arm. The HIB vaccine is given by the intramuscular route. D The dorsal gluteal site is never used for vaccines.

Which child is most likely to be frightened by hospitalization? a. A 4-month-old infant admitted with a diagnosis of bronchiolitis b. A 2-year-old toddler admitted for cystic fibrosis c. A 9-year-old child hospitalized with a fractured femur d. A 15-year-old adolescent admitted for abdominal pain

ANS: B Feedback A Young infants are not as likely to be as frightened as toddlers by hospitalization because they are not as aware of the environment. B Toddlers are most likely to be frightened by hospitalization because their thought processes are egocentric, magical, and illogical. They feel very threatened by unfamiliar people and strange environments. C The 9-year-old child's cognitive ability is sufficient enough for the child to understand the reason for hospitalization. D The 15-year-old adolescent has the cognitive ability to interpret the reason for hospitalization.

In planning care for a preschool-age child, the nurse knows that which open body postures encourage positive communication? Select all that apply. a.Leaning away from the preschooler b.Frequent eye contact c.Hands on hips d.Conversing at eye level e.Asking the parents to stay in the room

ANS: B, D Feedback Correct Frequent eye contact and conversing at eye level are both open body postures that encourage positive communication. Incorrect Leaning away from the child and placing your hands on your hips are both closed body postures that do not facilitate effective communication. Asking the parents to stay in the room while the nurse is talking to the child is helpful but is not an open body posture.

Which is the most appropriate question to ask when interviewing an adolescent to encourage conversation? a. "Are you in school?" b. "Are you doing well in school?" c. "How is school going for you?" d. "How do your parents feel about your grades?"

ANS: C Feedback A Direct questions with "yes" or "no" answers do not encourage conversation. B Direct questions that can be interpreted as judgmental do not enhance communication. C Open-ended questions encourage communication. D Asking adolescents about their parents' feelings may block communication.

What is an appropriate preoperative teaching plan for a school-age child? a. Begin preoperative teaching the morning of surgery. b. Schedule a tour of the hospital a few weeks before surgery. c. Show the child books and pictures 4 days before surgery. d. Limit teaching to 5 minutes and use simple terminology.

ANS: C Feedback A Preoperative teaching a few hours before surgery is more appropriate for the preschool child. Preoperative materials should be introduced 1 to 5 days in advance for school-age children. B Preparation too far in advance of the procedure can be forgotten or cause undue anxiety for an extended period of time. C Preparatory material can be introduced to the school-age child several days (1 to 5) in advance of the event. Books, pictures, charts, and videos are appropriate. D A very short, simple explanation of the surgery is appropriate for a younger child such as a toddler.

An effective technique for communicating with toddlers is to a. Have the toddler make up a story from a picture. b. Involve the toddler in dramatic play with dress-up clothing. c. Use picture books. d. Ask the toddler to draw pictures of his fears.

ANS: C Feedback A Most toddlers do not have the vocabulary to make up stories. B Dramatic play is associated with older children. C Activities and procedures should be described as they are about to be done. Use picture books and play for demonstration. Toddlers experience the world through their senses. D Toddlers probably are not capable of drawing or verbally articulating their fears.

When meeting a toddler for the first time, the nurse initiates contact by a. Calling the toddler by name and picking the toddler up b. Asking the toddler for her first name c. Kneeling in front of the toddler and speaking softly to the child d. Telling the toddler that you are her nurse

ANS: C Feedback A Picking a toddler up at an initial meeting is a threatening action and will more likely result in a negative response from the child. B Toddlers are unlikely to respond to direct questions at a first meeting. C More positive interactions occur when the toddler perceives the meeting in a nonthreatening way. Placing yourself at the toddler's level and speaking softly can be less threatening for the child.

An 8-year-old girl asks the nurse how the blood pressure apparatus works. The most appropriate nursing action is to a. Ask her why she wants to know. b. Determine why she is so anxious. c. Explain in simple terms how it works. d. Tell her she will see how it works as it is used.

ANS: C Feedback A The nurse should respond positively for requests for information about procedures and health information. By not responding, the nurse may be limiting communication with the child. B The child is not exhibiting anxiety, just requesting clarification of what will be occurring. C School-age children require explanations and reasons for everything. They are interested in the functional aspect of all procedures, objects, and activities. It is appropriate for the nurse to explain how equipment works and what will happen to the child. D The nurse must explain how the blood pressure cuff works so that the child can then observe during the procedure.

Which children are at greater risk for not receiving immunizations? a. Children who attend licensed daycare programs b. Children entering school c. Children who are home schooled d. Young adults entering college

ANS: C Feedback A All states require immunizations for children in daycare programs. B All states require immunizations for children entering school. C Home-schooled children are at risk for being underimmunized and need to be monitored. D Most colleges require a record of immunizations as part of a health history.

Which factor has the greatest influence on child growth and development? a. Culture b. Environment c. Genetics d. Nutrition

ANS: C Feedback A Culture is a significant factor that influences how children grow toward adulthood. Culture influences both growth and development but does not eliminate inborn genetic influences. B Environment has a significant role in determining growth and development both before and after birth. The environment can influence how and to which extent genetic traits are manifested, but environmental factors cannot eliminate the effect of genetics. C Genetic factors (heredity) determine each individual's growth and developmental rate. Although factors such as environment, culture, nutrition, and family can influence genetic traits, they do not eliminate the effect of the genetic endowment, which is permanent. D Nutrition is critical for growth and plays a significant role throughout childhood.

Frequent developmental assessments are important for which reason? a. Stable developmental periods during infancy provide an opportunity to identify any delays or deficits. b. Infants need stimulation specific to the stage of development. c. Critical periods of development occur during childhood. d. Child development is unpredictable and needs monitoring.

ANS: C Feedback A Infancy is a dynamic time of development that requires frequent evaluations to assess appropriate developmental progress. B Infants in a nurturing environment will develop appropriately and will not necessarily need stimulation specific to their developmental stage. C Critical periods are blocks of time during which children are ready to master specific developmental tasks. The earlier those delays in development are discovered and intervention initiated, the less dramatic their effect will be. D Normal growth and development is orderly and proceeds in a predictable pattern based on each individual's abilities and potentials.

What does the nurse need to know when observing a chronically ill child at play? a. Play is not important to hospitalized children. b. Children need to have structured play periods. c. Children's play is a form of communication. d. Play is to be discouraged because it tires hospitalized children.

ANS: C Feedback A Play is important to all children in all environments. Play for children is a mechanism for mastering their environment. B Although children's play activities appear to be unorganized and at times chaotic, play has purpose and meaning. Imposing structure on play interferes with the tasks being worked on. C Play for all children is an activity woven with meaning and purpose. For chronically ill children, play can indicate their state of wellness and response to treatment. It is a way to express joy, fear, anxiety, and disappointments. D Children who have fewer energy reserves still require play. For these children, less-active play activities will be important.

The nurse is planning a teaching session for a young child and her parents. According to Piaget's theory, the period of cognitive development in which the child is able to distinguish between concepts related to fact and fantasy, such as human beings are incapable of flying like birds, is the _______ period of cognitive development. a. Sensorimotor b. Formal operations c. Concrete operations d. Preoperational

ANS: C Feedback A The sensorimotor stage occurs in infancy and is a period of reflexive behavior. During this period, the infant's world becomes more permanent and organized. The stage ends with the infant demonstrating some evidence of reasoning. B Formal operations is a period in development in which new ideas are created through previous thoughts. Analytic reason and abstract thought emerge in this period. C Concrete operations is the period of cognitive development in which children's thinking is shifted from egocentric to being able to see another's point of view. They develop the ability to distinguish fact from fantasy. D The preoperational stage is a period of egocentrism in which the child's judgments are illogical and dominated by magical thinking and animism.

Which milestone is developmentally appropriate for a 2-month-old infant? a.Pulled to a sitting position, head lag is absent. b.Pulled to a sitting position, the infant is able to support the head when the trunk is lifted. c.The infant can lift his or her head from the prone position and briefly hold the head erect. d.In the prone position, the infant is fully able to support and hold the head in a straight line.

ANS: C FeedbackA: A 2-month-old infant's neck muscles are stronger than those of a newborn; however, head lag is present when pulled to a sitting position. BA 2-month-old infant continues to have some head lag when pulled to a sitting position. CA 2-month-old infant is able to briefly hold the head erect when in a prone position. If a parent were holding the infant against the parent's shoulder, the infant would be able to lift his or her head briefly. DIt is not until 4 months of age that the infant can easily lift his or her head and hold it steadily erect when in the prone position.

The nurse is developing a teaching plan for toddler safety to present at a parenting seminar. Which safety intervention should the nurse address? A) Encourage parents to enroll toddlers in swimming classes to avoid the need for constant supervision around water. B) Advise parents to keep pot handles on stoves turned outward to avoid accidental burns. C) Encourage parents to smoke only in designated rooms in the house or outside the house. D) Advise parents to use a forward-facing car seat with harness straps and a clip, placed in the backseat of the car.

ANS: D

Communication entails much more than words going from one person's mouth to another person's ears. A positive, supportive technique that is effective from birth throughout adulthood is a. Listening b. Physical proximity c. Environment d. Touch

ANS: D Feedback A Listening is an essential component of the communication process. By practicing active listening skills, nurses can be effective listeners. Listening is a component of verbal communication. B Individuals have different comfort zones for physical distance. The nurse should be aware of these differences and move cautiously when meeting new children and families. C It is important to create a supportive and friendly environment for children including the use of child-sized furniture, posters, developmentally appropriate toys, and art displayed at a child's eye level. D Touch can convey warmth, comfort, reassurance, security, caring, and support. In infancy, messages of security and comfort are conveyed when they are being held. Toddlers and preschoolers find it soothing and comforting to be held and rocked. School-aged children and adolescents appreciate receiving a hug or pat on the back (with permission).

Which strategy is most likely to encourage a child to express his feelings about the hospital experience? a. Avoiding periods of silence b. Asking direct questions c. Sharing personal experiences d. Using open-ended questions

ANS: D Feedback A Periods of silence can serve to facilitate communication. B Direct questions can threaten and block communication. C Talking about yourself shifts the focus of the conversation away from the child. D Open-ended questions encourage conversation.

When counseling parents and children about the importance of increased physical activity, the nurse can emphasize a. Anaerobic exercise should comprise a major component of the child's daily exercise. b. All children should be physically active for at least 2 hours per day. c. It is not necessary to participate in physical education classes at school if a student is taking part in other activities. d. Making exercise fun and a habitual activity.

ANS: D Feedback A Aerobic exercise should comprise a major component of children's daily exercise; however, physical activity should also include muscle and bone strengthening activities. B Children and adolescents should be physically active for at least 1 hour daily. C Encourage all student to participate fully in any physical education classes. D It is important to make exercise a fun and a habitual activity. Encourage parents to investigate their community's different activity programs. This includes recreation centers, parks, and the YMCA.

You are preparing immunizations for a 12-month-old child who is immunocompromised. Which immunizations cannot be given? Select all that apply. a. DTaP b. HepA c. IPV d. Varicella e. MMR

ANS: D, E Feedback Correct: Children who are immunologically compromised should not receive live viral vaccines. Varicella is a live vaccine and should not be given except in special circumstances. MMR is a live vaccine and should not be given to immunologically compromised children. Incorrect: DTaP, HepA, and IPV can be given safely.

The rate of Sudden Infant Death Syndrome (SIDS), now the third leading cause of death in infants, has increased despite international efforts and the Back to Sleep campaign. Is this statement true or false?

ANS: F This statement is incorrect. SIDS, which for a long time was the second leading cause of infant deaths, has decreased in part because of the Back to Sleep program. It is important for both hospital and clinic nurses to educate parents on safe sleep strategies for their infant.

Breastfeeding is the ideal method for providing nutrition to the human infant and is recommended by the American Heart Association, the American Academy of Pediatrics, and the World Health Organization. Infants should be exclusively breastfed for a minimum of 4 months and preferably 6 months. Is this statement true or false?

ANS: T This statement is correct. Solid food should not be introduced until 4 to 6 months of age. Breastfeeding should accompany solid food introduction until 1 year of age.

The mother of a 12-year-old boy is talking with the school nurse about her son's clumsiness. She reports that he seems to fall a lot, his writing is horrible, and as much as he practices he can't play his guitar very well. How should the nurse respond to the mother? A)"Boys tend to take a bit longer than girls to mature." B)"Have you spoken with your pediatrician about your observations?" C)"Boys tend to refine their fine motor skills by this age." D)"I will make a note of your observations and talk to his teachers."

ANS:B

The parent of a 6-month old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A) "Thumb sucking is a healthy self-comforting activity." B) "Thumb sucking leads to the need for orthodontic braces." C) "Caregivers should pay special attention to the thumb sucking to stop it." D) "Thumb sucking should be replaced with the use of a pacifier."

Ans: A Feedback: Thumb sucking is a healthy self-comforting activity. Infants who suck their thumbs or pacifiers often are better able to soothe themselves than those who do not. Studies have not shown that sucking either thumbs or pacifiers leads to the need for orthodontic braces unless the sucking continues well beyond the early school-age period. The infant who has become attached to thumb sucking should not have additional attention drawn to the issue, as that may prolong thumb sucking. Pacifiers should not be used to replace thumb sucking as this habit will also need to be discouraged as the child grows

The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. A) The nasal passages are narrower. B) The trachea and chest wall are less compliant. C) The bronchi and bronchioles are shorter and wider. D) The larynx is more funnel shaped. E) The tongue is smaller. F) There are significantly fewer alveoli.

Ans: A, D, F In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel shaped, the tongue is larger, and there are significantly fewer alveoli. These anatomic differences place the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels of maturity until about 7 years of age.

A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information? A) "This is a primitive reflex known as the plantar grasp." B) "This is a primitive reflex known as the palmar grasp." C) "This is a protective reflex known as rooting." D) "This is a protective reflex known as the Moro reflex."

B) "This is a primitive reflex known as the palmar grasp." Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski. During the palmar grasp, the infant reflexively grasps when the palm is touched. The plantar grasp occurs when the infant reflexively grasps with the bottom of the foot when pressure is applied to the plantar surface. The root reflex occurs when the infant's cheek is stroked and the infant turns to that side, searching with mouth. The Moro reflex is displayed when with sudden extension of the head, the arms abduct and move upward and the hands form a "C."

The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A) Carrying the baby may increase the length of crying. B) Reducing stimulation may decrease the length of crying. C) Using vibration, white noise, or swaddling may increase crying. D) Using a swing or car ride may increase the incidence of crying episodes.

B) Reducing stimulation may decrease the length of crying. Prolonged crying leads to increased stress among caregivers. Reducing stimulation may decrease the length of crying, and carrying the infant more may be helpful. Some infants respond to the motion of an infant swing or a car ride. Vibration, white noise, or swaddling may also help to decrease fussing in some infants. Parents should try one intervention at a time, taking care not to stimulate the infant excessively in the process of searching for solutions.