Prepu: Chapter 5: Growth and Development of the Preschooler
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? "He enjoys eggs and fortified cereal for breakfast." "He eats a well-balanced diet." "He loves milk and drinks it every time he is thirsty." "He does not like spinach, but he does like chicken and beef."
"He loves milk and drinks it every time he is thirsty." Explanation: This is likely to result in a very high intake of milk. Excess milk drinking may lead to iron deficiency since the calcium in milk blocks iron absorption. The nurse needs to emphasize this fact and suggest an appropriate daily milk intake. The other statements all include iron-rich foods and would not point to a risk for iron deficiency. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, TAKE NOTE, p. 135. Chapter 5: Growth and Development of the Preschooler - Page 135
A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond? "I would suggest getting books with pictures to help explain the differences between male and female genitalia." "You should answer his questions by whatever feels most comfortable to you." "That is a difficult subject to address. I'm not sure what is the best way to answer that question." "It's best to answer his questions using accurate anatomical names and keep your answers simple."
"It's best to answer his questions using accurate anatomical names and keep your answers simple." Explanation: Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 125. Chapter 5: Growth and Development of the Preschooler - Page 125
The mother of a 4-year-old child is concerned that she caught him masturbating in the bath tub. Which is the most appropriate response by the nurse? "If you catch your child masturbating, you should immediately make them stop." "Masturbation is a normal part of preschool development." "You will need to speak with the doctor about that behavior since I cannot address sexual issues in a child." "Masturbation is not a normal behavior for a child of that age."
"Masturbation is a normal part of preschool development."
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? "There is a very low student-teacher ratio, and they do a lot of hands-on projects." "The school requires processed foods and high sugar foods be avoided." "The school has a loose environment, which is a good match for his temperament." "The school is quite structured and advocates corporal punishment."
"The school is quite structured and advocates corporal punishment." Explanation: The nurse needs to emphasize that there are number of reasons that a parent should not choose a preschool that utilizes corporal punishment. It may negatively affect a child's self-esteem as well as ability to achieve in school. It may also lead to disruptive and violent behavior in the classroom and should be discouraged. The other statements would not warrant further discussion or intervention. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, Choosing a Preschool/ Starting Kindergarten, p. 132. Chapter 5: Growth and Development of the Preschooler - Page 132
The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed? "He never rides in the street." "Our son always wears a helmet." "We just got him a new bike he can grow into." "He is able to ride without training wheels."
"We just got him a new bike he can grow into."
If the child is gaining weight at an expected rate, a child who weighs 36 lb (16.3 kg) at 3 years of age would weigh what amount at age 5? 58 to 60 lb (26.3 to 27.2 kg) 44 to 46 lb (20 to 21 kg) 50 to 52 lb (22.7 to 23.6 kg) 38 lb to 40 (17.2 to 18.1 kg)
44 to 46 lb (20 to 21 kg) Explanation: The preschool age child gains about 4 to 5 lb (1.8 to 2.3 kg) each year and grows about 2.5 to 3 in (6.3 to 7.6 cm). So a 36 lb (16.3 kg) child at 3 years gaining 4 to 5 lb (1.8 to 2.3 kg) per year would be 44 to 46 lb (36 lb + 8 lb = 44 lb; 36 lb + 10 lb = 46 lb). Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, PHYSICAL GROWTH, p. 120. Chapter 5: Growth and Development of the Preschooler - Page 120
to bed at night and to sleep. Which practice will the nurse suggest they discontinue? Planning for the child to get 12 hours of sleep daily Providing a nightlight Allowing the preschooler to fall asleep wherever and whenever the child is tired enough Taking the TV set out of the child's room Eliminating caffeine sources beginning late afternoon
Allowing the preschooler to fall asleep wherever and whenever the child is tired enough Explanation: Consistent bedtimes and places for sleep promote good sleep habits. Caffeine (soft drinks) interferes with sleep. A nightlight can reduce fear of the dark common in preschoolers. Removing the TV from the child's room prevents viewing and screen light from keeping her awake. Twelve hours of sleep daily is an average amount for preschoolers. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, Promoting Healthy Sleep and Rest, p. 136. Chapter 5: Growth and Development of the Preschooler - Page 136
The nurse is caring for a preschool-aged child who needs a CT scan. Which action would the nurse use to best prepare the child for this diagnostic test? Explain that the child must behave because the technician is busy. Tell the child to follow directions to avoid being hurt. Help the child to pretend that the CT scan machine is a camera. Tell the child that the CT scan is a picture of the dark parts inside the body.
Help the child to pretend that the CT scan machine is a camera. Explanation: Because preschoolers' imagination is so active, this leads to several fears such as fear of the dark and mutilation. The nurse needs to help the child understand that the CT scanner is like a camera to take pictures of the body parts. Threatening the child to follow directions or becoming hurt plays into the child's fear of mutilation. Telling the child to behave creates a fear of punishment. Telling the child that the CT scan is a picture of the body's dark parts plays into the child's fear of the dark. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, Fears, p. 126. Chapter 5: Growth and Development of the Preschooler - Page 126
An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step? Conservation Accommodation Industry Perfectionism
Industry
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in? Pretending to be mommies and daddies in the playhouse Playing a board game Painting pictures in the art corner of the room Watching a movie with other children their age
Pretending to be mommies and daddies in the playhouse Explanation: Preschool children have imitative play, pretending to be the mommy, the daddy, a policeman, a cowboy, or other familiar characters. The school-aged child enjoys group activities, such as board games, and making things, such as drawings, paintings, and craft projects. The adolescent enjoys activities he or she can participate in with their peers. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, Promoting Growth and Development Through Play, p. 130. Chapter 5: Growth and Development of the Preschooler - Page 130
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? The nurse should explain to the child that there are no friends present. 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 nurse should document the reports of hallucinations by the child.
The nurse should recognize this behavior as normal for the child's developmental age and do nothing. Explanation: Preschool-aged children often interact with imaginary friends. The nurse should recognize this as normal for the age group. No special actions are needed. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 121. Chapter 5: Growth and Development of the Preschooler - Page 121
The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish? ride a bicycle hop on one foot walk backwards with heel to toe jump rope
hop on one foot Explanation: The 4-year-old should be able to hop on one foot and can control movements of the hands. By the age of 5 the child can walk backwards heel to toe, throw and catch a ball well, and jump rope. Reference: Kyle, T., & Carman, S., Essentials of Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 5: Growth and Development of the Preschooler, TABLE 5.2 Motor Skill Development, p. 123. Chapter 5: Growth and Development of the Preschooler - Page 123
The developmental task of the school-aged period, according to Erikson, is gaining a sense of: autonomy versus shame. industry versus inferiority. independence versus dependence. identity versus failure.
industry versus inferiority.
The most important safety precaution for parents to teach preschoolers is: not to watch their father mow the lawn. to chew bites of food three times. not to ride in a car with strangers. not to begin formal dance classes.
not to ride in a car with strangers.
