Care of the Preschooler

The nurse is caring for a 5-year-old boy who is terminally ill. Which intervention would best meet the needs of this dying child?

Assure the child that he did nothing wrong.

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

Imagination

The nurse is preparing to assess the abdomen of a preschool-aged child. Which technique should the nurse use first?

Inspection

A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be?

Preschool

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

Which technique should the nurse use to administer ear drops to a 4-year-old child?

Pull the pinna of the ear up and back.

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:

testing and identification of group role.

The nurse examines a 3-year-old girl in a health maintenance setting. What is the first question the nurse would ask her mother to obtain a health history?

"Do you have any concerns about your daughter?"

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply.

"Have your child hold hands with a grown-up in parking lots." "Do not allow your child to approach strange dogs." "Do not refer to medicines as candy." "Role-model bicycle safety by wearing a helmet too."

The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which statement would indicate that the boy is having nightmares instead of night terrors?

"He will tell us about what happened in his dream."

A first-time father calls the pediatric nurse stating he is concerned that his 4-year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate?

"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."

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?

"At this age it is helpful to remind children to go to the bathroom."

A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?

"Attributing lifelike qualities to inanimate objects is quite normal at this age."

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?

"It's best to answer his questions using accurate anatomical names and keep your answers simple."

The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement by the mother indicates a need for further teaching?

"She can ride on the street if I am riding with her."

During an assessment, a preschool-aged child tells the nurse about having 12 siblings. The nurse is aware that the child has two older brothers. What would be the nurse's best response?

"That is a good pretend answer but tell me the names of the brothers you really have."

The parents of a 5-year-old are concerned that their son is too short for his age. The nurse measures the child's height at 40 inches (101.6 cm). How should the nurse respond?

"The average height for a 5-year-old is 43 inches tall (118.5 cm), so your son is within the normal range for height."

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 reading a favorite story before bedtime." "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."

The parent of a 4-year-old child tells the nurse about being frustrated because all the parent seems to do lately is fight with the child over what the child wants to eat and wear. The parent notes sometimes wanting to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this parent?

"Use the time-out technique for discipline."

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior?

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior."

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. What 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."

The nurse wants to find out how much time a preschooler spends in various activities throughout the day. What should the nurse do to learn this information?

Ask the parents to complete a day history.

The father of a 5-year-old is very concerned that his daughter is not developing sufficient language skills because she tends to stutter frequently. What are appropriate responses by the nurse? Select all that apply.

"When your daughter stutters, try to get her to speak more slowly." "I'm sure you are concerned but it is very common for children of this age to stutter."

When providing anticipatory guidance to parents about their preschool son who was caught in a lie, what would the nurse emphasize?

"You need to determine the reason for lying before punishing the child."

The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond?

"Your child is not expected to be able to perform those activities at 3 years of age."

A mother describes her 4-year-old girl's eating habits as "picky" and goes on to describe using coaxing and threatening measures to get her to eat. The girl is at the 40th percentile for weight and 50th percentile for height. What interventions will be suggested? Select all that apply.

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

The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?

Allow the child to touch and play with the nebulizer for a few minutes before the treatment.

During therapeutic play, a 4-year-old child draws a girl with a head and body but no arms or legs. What response by the nurse is appropriate?

Appreciate that 4-year-old children often draw people with missing body parts.

A 3-year-old girl is admitted to the hospital for eye surgery. You provide her with a doll and syringe for therapeutic play. She sticks the doll in the eye with the syringe and says, "You won't watch TV again when I tell you not to!" What is your best response to this?

Ask her if she thinks having surgery is punishing her.

During a previous well-child visit, the nurse reviews the importance of immunizations for the preschool-age child with the parents. Which outcome indicates that the nurse's instruction to the parents has been effective?

Child has all immunizations up to date.

Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers?

Compares his soccer abilities with his peers.

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

Deficient knowledge of normal preschool development

The parent of a preschooler asks the nurse for methods to orient the child to school. Which activity would the nurse recommend the parent perform?

Talking about school as an enjoyable experience

The nurse is caring for a preschool-age child who is receiving palliative care for end-stage cancer. What would be the focus of age-appropriate interventions for this child?

Teaching the child that death is not punishment.

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

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

When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?

Weight is above an expected range and height is within an expected range.

The nurse is working to gain a preschooler's cooperation to swallow an oral medication. What would be the nurse's best approach?

ask if the child would like to take the medicine in a cup or through an oral syringe

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?

presence of 10 deciduous teeth

The nurse is assessing a 4-year-old child. The child tells the nurse about her friend, Nancy, who lives in her room at home. The mother tells the nurse that Nancy is not a real person. The nurse would use which term when documenting this assessment finding?

imaginary friend

A nursing instructor is teaching students about changes in the preschool-aged child. One such change is genu valgum, which refers to:

knock-knees.

A 4-year-old child is brought to the clinic by his parents for evaluation of a cough. Which action by the nurse would be least appropriate in promoting atraumatic care for the child?

wrapping the child tightly in a blanket to prevent him from moving around