Peds - Chapter 18: Growth and Development of the Preschooler
The nurse is providing teaching about preventing poisoning. Which statement by the mother would warrant further discussion? a) "I never transfer cleaning products out of their original containers." b) "We keep our lawn and garden products on a high shelf in the garage." c) "We have the poison control number located near our phone." d) "All medicine in our bathroom is in childproof containers."
"All medicine in our bathroom is in childproof containers."
The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching? a) "The balls of her feet should reach both pedals while sitting." b) "She should always ride on the sidewalk." c) "She can ride on the street if I am riding with her." d) "Pedal back brakes are better for her age group."
"She can ride on the street if I am riding with her."
The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency? a) "He loves milk and drinks it every time he is thirsty." b) "He does not like spinach, but he does like chicken and beef." c) "He eats a well-balanced diet." d) "He enjoys eggs and fortified cereal for breakfast."
"He loves milk and drinks it every time he is thirsty."
The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares? a) "She is scared after she wakes up." b) "She screams and thrashes when we try to touch her." c) "She comes and wakes us up after she awakens." d) "She has a hard time going back to sleep."
"She screams and thrashes when we try to touch her."
The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best? a) "Kindergarten is a big step for a child. Be patient with him." b) "Talk to your son's new teacher and schedule a tour with him." c) "Be aware that he may have difficulty adjusting being away from home 5 days a week." d) "Remind him that kindergarten will be a lot of fun and he'll make new friends."
"Talk to your son's new teacher and schedule a tour with him."
The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed? a) "He never rides in the street." b) "He is able to ride without training wheels." c) "Our son always wears a helmet." d) "We just got him a new bike he can grow into."
"We just got him a new bike he can grow into."
A 5-year-old child is not gaining weight appropriately. Organic problems have been ruled out. What is the priority action by the nurse? 1. Allow the child unlimited access to the sippy cup to ensure adequate hydration. 2. Encourage sweets for the extra caloric content. 3. Teach the mother about nutritional needs of the preschooler. 4. Assess the child's usual intake pattern at home.
Assess the child's usual intake pattern at home.
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? a) 58 lbs. b) 38 lbs. c) 50 lbs. d) 44 lbs.
44 lb
The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation? a) Presence of 20 deciduous teeth b) Presence of 10 deciduous teeth c) Absence of dental caries d) Presence of 19 deciduous teeth
Presence of 10 deciduous teeth
Which of the following would be most effective in helping promote initiative and nutritional health for a preschooler? a) Praising the child for cleaning his large plate of food b) Encouraging the child to cut up small pieces of apple for a snack c) Allowing the child to spread soft cheese on crackers d) Giving the child a high carbohydrate snack after preschool
Allowing the child to spread soft cheese on crackers
A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage? a) Enunciating clearly and slowing down parental speech b) Giving the child opportunity to speak and finish her ideas c) Asking the girl to slow down and to think before she talks d) Looking at the child while she is speaking
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? a) Children are playing together in an activity without organization. b) Children are playing in an organized group with each other. c) Children are playing independently and are side-by-side. d) Children are playing apart from others without being part of a group.
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? a) Social isolation related to unwillingness to relate except through imaginary friend b) Compromised family coping related to abnormal behavior of child c) Deficient knowledge of normal preschool development d) Disturbed thought processes related to deep-set psychological need
Deficient knowledge of normal preschool development
A type of play seen in the preschool child encourages children to act out troubling situations such as occur in the hospitalized child who must undergo an upsetting procedure. This type of play is referred to as which of the following? a) Solitary independent play b) Parallel play c) Independent play d) Dramatic play
Dramatic play
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? a) Genu valgus b) Centering c) Electra complex d) Oedipus complex
Electra complex Explanation: An Electra complex is the attachment of a preschool girl to her father Oedipus complex refers to the strong emotional attachment a preschool boy demonstrates toward his mother. A daughter demonstrating an Electra complex might prefer to always sit beside her father at the table; she asks her father to tuck her in at night. She makes a point she is "Daddy's girl." `Many children at the beginning of the preschool period exhibit genu valgus (knock-knees); this disappears with increased skeletal growth at the end of the preschool period.
The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent? a) Encourage the parent to determine what the child's specific questions are and answer them briefly. b) Encourage the parent to provide a detailed discussion about human sexuality with the child. c) Advise the parent that sexual curiosity is unusual at this age. d) Advise the parent to explain to the child that he is too young to discuss such things.
Encourage the parent to determine what the child's specific questions are and answer them briefly.
Broken fluency is a serious condition, and children who exhibit it should be referred to a speech pathologist for treatment. a) False b) True
False
Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations. a) False b) True
False
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? a) Gross motor skills b) Vocabulary c) Imagination d) Fine motor skills
Imagination
Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify which of the following as the task of the preschooler? a) Industry b) Initiative c) Trust d) Autonomy
Initiative
The major developmental task according to Erikson is for the preschool child to develop which of the following? a) Autonomy b) Industry c) Trust d) Initiative
Initiative
Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify? a) Dental caries b) Obesity c) Iron deficiency d) Interference with growth
Iron deficiency
Teaching a group of caregivers about the topic of nutrition, one caregiver tells the group, "I use desserts as a reward for good behavior." A person in the group asks the nurse what she thinks about that idea. Which of the following statements by the nurse would be the most appropriate? Using dessert as a reward for good behavior may cause the child to a) Learn to use food to manipulate others' behavior b) Only behave on days when dessert is something she likes c) Cause the child to be overweight d) Learn to choose sweets over nutritious food
Learn to use food to manipulate others' behavior
Question: Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order. 1 If the child gets up, replace the child and restart the time. 2 Parent knows the misbehavior was intentional. 3 Remove the preschooler to a boring spot. 4 Set a timer for no more than 4 minutes. 5 Warn the child there will be a time-out if the behavior does not stop.
Parent knows the misbehavior was intentional. Warn the child there will be a time-out if the behavior does not stop. Remove the preschooler to a boring spot. Set a timer for no more than 4 minutes. If the child gets up, replace the child and restart the time.
Which of the following actions by a preschooler would suggest that his thinking is inconsistent with normal preschooler growth and development? a) Refusal to go to bed without his friend b) Refusal to play with "real" children c) Insistence that his imaginary friend watch television with him d) Insistence that this imaginary friend have dinner with the family
Refusal to play with "real" children
A mother brings her 4-year-old son in for a check-up. Which of the following findings should the nurse be concerned about? a) No increase in appetite compared with that in toddler years b) Weight gain of 5 lb in the past year c) Ectomorphic body type d) Resting pulse rate of 120
Resting pulse rate of 120
The nurse is discussing development of fine motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the fine motor skills of a 3-year-old? a) The child can button their clothes. b) The child can use scissors. c) The child can tie their shoelaces. d) The child can print a few letters.
The child can button their clothes
In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler? a) The child takes in new information at a rapid rate and asks "why" and "how." b) The child grows and develops skills more rapidly than at any other time in their life. c) The child insists they can "do it," and the next moment they revert to being dependent. d) The child has an increased attention span and can be interested in an activity for a long length of time.
The child takes in new information at a rapid rate and asks "why" and "how."
In teaching caregivers of preschool children, the nurse would reinforce that which of the following would be most important for this age group? a) The preschool child should cover mouth when coughing or sneezing. b) The preschool child should wear a seat belt when riding in a vehicle. c) The preschool child should be screened for amblyopia. d) The preschool child should brush and floss teeth after snacks and meals.
The preschool child should wear a seat belt when riding in a vehicle.
Fear of mutilation is significant during the preschool age. a) False b) True
True
The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention? a) Wake the child up nightly 30 to 45 minutes after going to sleep. b) Tell the parents to be sure to wake the child up during the next episode. c) Encourage the parents to let the child fall asleep in a safe place such as their bed. d) Explain that this is a developmental phase that will not last.
Wake the child up nightly 30 to 45 minutes after going to sleep.
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize: a) having the child wear a personal flotation device whenever near or on the water. b) enrolling the child in swimming lessons. c) using and renewing sunscreen regularly. d) adults learning infant/child cardiopulmonary resuscitation (CPR).
having the child wear a personal flotation device whenever near or on the water.
A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be? a) adolescence b) preschool c) school age d) toddler
preschool
In counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes: a) library visits and story hour. b) visiting the kindergarten. c) the home environment. d) enrollment in a preschool.
the home environment.
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 this statement is an example of: a) beginning empathy. b) magical thinking. c) animism. d) transduction.
transduction
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. a) "Try reading a favorite story before bedtime." b) "Set up some familiar bedtime rituals for your child." c) "Try using a night light in the child's room." d) "Keep the door closed and the lights off so that your child can fall asleep faster." e) "Avoid having your child watch frightening shows on TV before bedtime."
• "Try reading a favorite story before bedtime." • "Set up some familiar bedtime rituals for your child." • "Try using a night light in the child's room." • "Avoid having your child watch frightening shows on TV before bedtime."
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. a) Many car seats are installed improperly, making them unsafe. b) The back seat remains the safest place for children to ride. c) Children who weigh less than 40 pounds should use a car seat with harness and top tether. d) Booster seats should be used with both a shoulder and lap belt.
• Many car seats are installed improperly, making them unsafe. • The back seat remains the safest place for children to ride. • Children who weigh less than 40 pounds should use a car seat with harness and top tether. • Booster seats should be used with both a shoulder and lap belt.
The nurse is organizing an indoor play area for preschoolers. What play materials are least important? a) Dress-up clothes and hats and puppets b) Balls, blocks, and puzzles c) Cut, paste, drawing, and painting materials d) CD player with music and musical instruments e) Electronic teaching toys
Electronic teaching toys
A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? a) Group play b) Solitary play c) Parallel play d) Imitative play
Imitative play
A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master? a) Initiative vs. guilt b) Trust vs. mistrust c) Industry vs. inferiority d) Autonomy vs. shame
Initiative vs. guilt
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? a) The child can hop on one foot. b) The child can walk backwards with heel to toe. c) The child can jump rope. d) The child can throw and catch a ball.
The child can hop on one foot
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) A father who is overweight b) Expectations to eat everything on plate c) Fast food eaten once a month d) Mealtimes organized and regular e) Television on during meals f) Food used as reward or punishment
• A father who is overweight • Expectations to eat everything on plate • Television on during meals • Food used as reward or punishment
The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate? a) "Both your son's height and rate of growth are within normal limits for his age." b) "Is there a reason you are concerned about your child's height?" c) "Your son is slightly below the normal height for his age but he had demonstrated a normal growth rate this year." d) "Your son is slightly below the normal height for his age group but may still grow to be a normal height in the coming year."
"Both your son's height and rate of growth are within normal limits for his age."
The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching? a) "I have heard that both boys and girls often touch themselves at this age." b) "I will need to find an appropriate punishment for him if this continues." c) "This is probably a good time to talk about safety and who can touch him." d) "I should teach him certain rules about this activity."
"I will need to find an appropriate punishment for him if this continues."
The nurse is discussing the topic of nutrition with a group of caregivers of preschoolers. Which of the following statements made by the caregivers is most accurate regarding nutrition in the preschooler? a) "If I give snacks throughout the day, my child can meet her nutritional requirements." b) "It is important for me to give my child calcium so his muscles will grow." c) "It is hard for me to get my child to drink the 4 cups of milk he needs each day." d) "My child is growing so rapidly, she needs to eat three big meals a day."
"If I give snacks throughout the day, my child can meet her nutritional requirements."
The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which of the following statements made by the caregivers best indicates a common aspect of the diet and nutrition of the preschool child? a) "My 4-year-old eats as much as my adolescent does every day." b) "My husband is insistent that our 5-year-old not eat any snacks so he will eat he all of his meals at mealtime." c) "My child is so picky and eats the same thing every day for days on end!" d) "Our child gets into food jags where she will only eat one food all day long."
"My child is so picky and eats the same thing every day for days on end!"
The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits? a) "We eat fast food less than once a month." b) "Our family rule is that all children clean up their plates at each meal, and we feed them a lot." c) "I try to set a good example and eat a variety of fruits and vegetables." d) "She enjoys planning meals and helping me in the kitchen." e) "Her serving sizes are about half the size of ours."
"Our family rule is that all children clean up their plates at each meal, and we feed them a lot."
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? a) "I am sure there are ways to get your daughter to stop imitating you." b) "I can imagine that it would be very irritating." c) "Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development." d) "This is not normal behavior. I am going to get the doctor's advice."
"Preschoolers imitate as a healthy behavior--it is part of their imagination and normal growth and development."
The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching? a) "We should use only a pea-sized amount of toothpaste." b) "She should see a dentist every 6 months." c) "Too much fluoride can contribute to fluorosis." d) "She needs to floss her teeth before brushing."
"She needs to floss her teeth before brushing."
A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up? a) "We often have to translate his speech to others." b) "He can count to 30 but gets confused after that." c) "He knows his name and address." d) "He is always talking and telling detailed stories."
"We often have to translate his speech to others."
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? a) "What happened to my patient? Did you eat her?" b) "Oh no! I have a crocodile in my room. Please don't bite me!" c) "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you." d) "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."
"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."
The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer? a) Encourage the parent to consider allowing the child to sleep with her b) Encourage the parent to leave on the television in the child's room c) Encourage the mother to check for monsters under the bed in the presence of the child d) Encourage the parent to allow a small night light
Encourage the parent to allow a small night light
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? a) Rough-housing with his father b) Opening drawers in the room, pulling out supplies, and examining them c) Reading a book d) Singing a song he learned at preschool
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 these fruits contains the most calcium? a) Peach b) Apple c) Orange d) Banana
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? a) Physical growth accelerates. b) Personality growth slows. c) Cognitive growth slows. d) Physical growth slows.
Physical growth slows
The mother of a 4-year-old asks for advice on using time-out for discipline with her child. What advice should the nurse give the mother? 1. If spanking is not working, then time-out is not likely to be helpful either. 2. Place the child in time-out for 4 minutes. 3. Use time-out only if removing privileges is unsuccessful. 4. The child should stay in time-out until crying ceases.
Place the child in time-out for 4 minutes.
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3 year old is in which of the following stages as identified by Piaget? a) Tertiary circular reaction b) Primary circular reaction c) Preoperational thought d) Coordination of secondary schema
Preoperational thought
A 5-year-old boy's father was recently injured in a motorcycle accident, but has fully recovered. The father confides to the school nurse that he is concerned about the child not acting the way he did before the accident. The boy is not testing boundaries as he was before the accident. Which situation best describes the reason for the behavior Jack's father is seeing? a) The boy 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 he believes he caused the accident. b) The thought of losing his father was scary, and the child is trying to show his father how much he loves him. c) The child is afraid of being hurt himself and thinks being especially good will protect him from accidents. d) Everyone in the family is being nicer to each other and the boy is imitating the adults' behavior.
The boy 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 he believes he caused the accident.
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply. a) A time-out of about 8 minutes would be appropriate for intentional misbehavior. b) Books and stories can help preschoolers master proper behavior. c) When discussing improper behavior, call the behavior "bad" or "naughty," not the child. d) Spank with an open hand only and never with an object. e) Anticipate situations likely to cause misbehavior and redirect the child to another activity.
• Books and stories can help preschoolers master proper behavior. • 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.
The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated? a) "At this age it is helpful to remind children to go to the bathroom." b) "Consider restricting your daughter's fluid intake." c) "The frequency of these wetting episodes may be consistent with a low-grade urinary tract infection." d) "Discipline should be applied after these times."
"At this age it is helpful to remind children to go to the bathroom."
In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will: a) be able to use each language as a separate system. b) be prone to stuttering. c) mix the two languages in the same sentence. d) avoid asking questions.
be able to use each language as a separate system.
Language development is rapid in the preschool years. At the age of 2 most children use about 50 to 100 words. By the time the child is 5 years of age how many additional words do most children use? a) 3,000 words b) 2,000 words c) 1,500 words d) 1,000 words
2,000 words
A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best? a) "Do you think your daughter is hallucinating? b) "Is there a family history of mental illness?" c) "Attributing life-like qualities to inanimate objects is quite normal at this age." d) "Your daughter is demonstrating animism which is common."
"Attributing life-like qualities to inanimate objects is quite normal at this age."
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 response by the nurse would be most appropriate? a) "By the age of 6 most children can print some letters and maybe their first name." b) "Some children this age cannot hold a pencil or crayon well enough to write legibly." c) "Usually by the age of 6, most children can write numbers up to nine, but no letters." d) "It is not unusual for children of this age to be writing their first name in cursive."
"By the age of 6 most children can print some letters and maybe their first name."
The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination? a) 1 to 2 inches (2.54 to 5.07 cm) b) 2.5 to 3 inches (6.35 to 7.62 cm) c) 3.5 to 4 inches (8.89 to 10.16 cm) d) 0.5 to 1 inch (1.27 to 2.54 cm)
2.5 to 3 inches (6.35 to 7.62 cm)
The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated? a) The nurse should explain to the child that there are no friends present. b) The nurse should recognize this behavior as normal for the child's developmental age and do nothing. c) The nurse should document the reports of hallucinations by the child. d) The nurse should discourage the child from talking about the imaginary friend.
The nurse should recognize this behavior as normal for the child's developmental age and do nothing.
The developmental task of preschoolers is to achieve a sense of a) initiative versus guilt. b) accomplishment versus inefficiency. c) autonomy versus shame and doubt. d) cognition versus attitude.
initiative versus guilt.
The mother of a 3-year-old is concerned about her child's speech. She describes her preschooler as hesitating at the beginning of sentences and repeating consonant sounds. What is the nurse's best response? 1. Hesitancy and dysfluency are normal during this period of development. 2. Reading to the child will help model appropriate speech. 3. Expressive language concerns warrant a developmental evaluation. 4. The mother should ask her child's physician for a speech therapy evaluation.
Hesitancy and dysfluency are normal during this period of development.
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? a) Make a model for the child to follow so it will be easy to copy. b) Support whatever the child paints. c) Tell the child that it will be fun but that he or she should not make a mess. d) Draw a picture first for the child to see how to do it.
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? a) The fact that preschoolers have a harder time sharing than toddlers b) Playing in an even-number group of children (four) c) Testing and identification of group role d) Regression
Testing and identification of group role
The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to: a) provide her with clothes that snap rather than button. b) allow her to experiment with Play-Doh. c) teach her street-crossing safety. d) help her learn how to follow rules.
allow her to experiment with Play-Doh.
Which project or game would you anticipate that a preschooler would most enjoy while hospitalized? a) Playing an electronic, hand-held game b) Planting flower bulbs that she can watch grow next spring c) Turning out the lights to play hide and seek d) Dressing in her mother's coat to play house
Dressing in her mother's coat to play house
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? a) "He broke my favorite plate but blamed it on some friend he called Paul, but we don't know anyone named Paul." b) "He tries to sweep up cereal his brother spilled but cries when he can't do it well." c) "He refuses to hold my hand while we are crossing the street." d) "When I leave him with a babysitter he gets upset, but she says he still does what she asks him to do."
"He tries to sweep up cereal his brother spilled but cries when he can't do it well."
The nurse is doing teaching with a group of caregivers of preschool children on various topics. The topic of sexual development is discussed. Which of the following statements made by the caregivers indicates an understanding of the sexual development of the preschool age child? a) "I feel better knowing that what she is doing is normal." b) "When I find my son masturbating, I will tell him that is unacceptable." c) "I will tell my daughter that she will have time to explore her body as she gets older." d) "I will encourage my son to ask his father any questions that are sexual in nature."
"I feel better knowing that what she is doing is normal."
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? a) "He is allowed out of time-out when he is calm." b) "I put him in time-out when the problem occurs." c) "The time-out doesn't just have to be in his room." d) "I usually have him in time-out for about 10 minutes."
"I usually have him in time-out for about 10 minutes."
A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond? a) "Are you kidding me?" b) "Tell me about Boo-ga-loo." c) "I don't see anyone." d) "Where did you get that funny name?"
"Tell me about Boo-ga-loo."
The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond? a) "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?" b) "Tell me about your child's exposure to tobacco smoke." c) "Tobacco smoke is linked with an increased number of ear infections." d) "You should stop smoking around your child."
"Tell me about your child's exposure to tobacco smoke."
The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? a) "The school is quite structured and advocates corporal punishment." b) "The school requires processed foods and high sugar foods be avoided." c) "The school has a looser environment which is a good match for his temperament." d) "There is a very low student teacher ratio and they do a lot of hands on projects."
"The school is quite structured and advocates corporal punishment."
The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching? a) "We need to know the basics of CPR and first aid." b) "We need to continually remind her about safety rules." c) "She still needs a booster seat in the car." d) "We need to tell her that her vitamins are candy."
"We need to tell her that her vitamins are candy."
The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be a) "Your son may have a friend named Andrew, but it could be an imaginary friend." b) "You should watch this type of behavior closely since most children this age tell the truth." c) "You need to show your child the broken tool since at this age they must see something in order to understand." d) "You should punish your son because no child should be telling lies at this age."
"Your son may have a friend named Andrew, but it could be an imaginary friend."
A 4-year-old is hospitalized with a urinary tract infection. Based on what you know of her cognitive development, which approach would be best to prepare her for a radiograph? a) Tell her a radiograph is a picture of the dark inside her body. b) Help her pretend the x-ray machine is a camera. c) Explain that she must behave because the technician is busy. d) Tell her she must follow directions or she will be hurt.
Help her pretend the x-ray machine is a camera.
The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as 1. Problematic; the child is old enough to begin to have a basis in reality. 2. Normal, because the child is hospitalized and out of her routine. 3. Normal for this stage of growth and development. 4. Problematic, as it interferes with needed nursing care.
Normal for this stage of growth and development.
When planning how to respond to a child about telling stories, you would base your statement on the fact that a) preschoolers have a limited vocabulary. b) a 3-year-old knows the word two but not the concept 2. c) imagination in a 3-year-old is at its peak. d) a preschooler is in an insecure period.
imagination in a 3-year-old is at its peak.
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? a) Explain in a calm and everyday manner how the child should stay away from strangers in cars b) Don't worry about it; the odds of your child being abducted are very low c) It is your responsibility to keep your child safe, not your child's; keep her in your sight at all times d) Wait until the child is school-aged before telling her what to do, so she will be better able to handle it
Explain in a calm and everyday manner how the child should stay away from strangers in cars
Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds a) Johnny may be at risk for overweight or obesity. b) Johnny is following a normal pattern of growth for the preschool years. c) Johnny is growing slowly in height but rapidly in weight. d) Johnny's height and weight should be plotted on a growth chart.
• Johnny is growing slowly in height but rapidly in weight. • Johnny may be at risk for overweight or obesity. • Johnny's height and weight should be plotted on a growth chart.
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? a) "I usually have him in time-out for about 10 minutes." b) "He is allowed out of time-out when he is calm." c) "The time-out doesn't just have to be in his room." d) "I put him in time-out when the problem occurs."
"I usually have him in time-out for about 10 minutes."
