Ch. 23 peds prep u
Marcy asks the nurse if her 9-month-old son is drinking the recommended amount of breast milk or formula every day. What would the appropriate response be?
"He needs 7 ounces every 6 hours."
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding?
"I can expect my infant to be able to raise the head up when on the stomach within the next month."
The mother of a 2-month-old baby tells the nurse, "I'm worried because my baby isn't able to sit independently." Which response by the nurse would be appropriate?
"That's not unusual because most babies do not sit by themselves until about 8 months."
The caregiver of 7-month-old twins tells the nurse that she has noticed that both of her children enjoy playing with a toy by moving the object back and forth between their hands over and over again. Which statement made by the nurse most accurately explains this behavior?
"This is one of the ways that infants develop their fine motor skills."
Two parents who have financial issues ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents?
"You can use the crib, but there are guidelines to follow."
At birth, the newborn's head and chest circumference were measured. The nurse knows that the head should be about
1 inch larger than the chest
A nurse is developing a plan for the parents of a 12-month-old infant to ensure adequate nutritional intake to promote growth and development. The infant weighs 22 lb (10 kg). The nurse creates a plan based on the infant's need for how many calories per day?
1000 calories
The nurse is teaching the parents of an infant about bathing. The nurse will inform the parents to set the home hot water heater to which temperature?
100°F (37.8℃)
The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months?
19 lb 8 oz (8825 g)
The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months?
27.5 in
The infant measured 20 in (50 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months?
30 to 32 in (76 to 81 cm)
The nurse measures the head circumference of a 6-month-old infant. Which measurement would the nurse interpret as most appropriate?
43.5 cm
The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?
A yellow rubber duck for the bath
A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially?
Check the expiration date on the car seat.
The nurse is providing discharge teaching regarding formula preparation for a new mother. Which guideline would the nurse include in the teaching plan?
Do not add cereal to the formula in the bottle or sweeten the formula with honey.
The nurse establishes the following plan of care based on the nursing diagnosis: Caregiver role strain related to infant crying throughout night as manifested by parents stating, "We are exhausted." Which nursing interventions are included in the plan of care? Select all that apply.
Establish a quieting ritual for infant before bed During night awakening, keep interactions minimal Having one parent awake at a time with infant
The nurse is assessing Julie, a 3-month-old infant. Which developmental milestone would the nurse expect?
Julie can hold her head erect and steady.
The nurse working in the child clinic observes infant Max. He is 8 months old. What type of activity should the nurse be observing?
Max is on the floor picking up blocks from a bucket
The nurse is teaching a parenting class to a group of first-time mothers. She recommends which of the following as positive caregiver-infant interactions? Select all that apply.
Mother offers adequate types and amounts of food for the infant Mother holds the infant in an appropriate position while feeding Mother burps the baby during and after feeding Mother provides age-appropriate toys for the infant
After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur?
My husband gave the baby a special bear that I will place in the crib."
What feeding practice used by the parents of an 8-month-old should the nurse discourage?
Placing all liquids given the child in a "no spill" sippy cup.
A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl demonstrated?
Secondary circular reaction
Which milestone would the nurse expect an infant to accomplish by 8 months of age?
Sitting without support
The mother of a 2-month-old baby tells the nurse, "I'm worried because my baby isn't able to sit ndependently." Which response by the nurse would be appropriate?
That's not unusual because most babies do not sit by themselves until about 8 months."
A parent has a 3-year-old child and a 4-month-old infant who both have gastroenteritis. The 3-year-old child is well enough to be cared for at home, but the 4-month-old infant requires hospitalization. How does the nurse explain the difference between these outcomes to the family?
The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration.
The nurse is assessing a 4-month-old infant during a scheduled visit. Which findings might suggest a developmental problem?
The child does not make sounds in response to voices.
What action shows an example of Erik Erikson's developmental task for the infant?
The infant cries and the caregiver picks the child up.
The nurse is conducting a physical examination of an 8-month-old infant. Which observation may be cause for concern about the infant's neurologic development?
The infant displays an asymmetric tonic neck reflex (fencing reflex).
The nurse is evaluating the growth and development of a 9-month-old infant. Which action(s) would the nurse expect to observe? Select all that apply.
The infant rolls from supine to prone to back again The infant's head leads the body when pulled to sit The infant crawls with the abdomen off the floor
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?
The infant says "da-da" when looking at her father
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?
This is a primitive reflex known as the palmar grasp.
The nurse is conducting an educational session at a local community health fair illustrating the various reflexes which are normal in a newborn and how they change as the infant grows and matures. The nurse determines more education is necessary after a member of the audience points out which finding as an expected occurrence?
an extrusion reflux at 9 months of age
A new mother is concerned about the risk of her 6-month-old aspirating and choking. Which of the following should the nurse recommend to her? Select all that apply.
dont prop up baby's bottle when feeding him use only clothing without decorative buttons
An infant is being introduced to drinking fluids from a cup. The nurse instructs the mother that fruit juice can now be added. Which of the following would the nurse suggest the mother try first? Select all that apply.
apple juice white grape juice
Which measures should receive priority in the care plan for an infant client who has sensitive skin?
change diapers frequently
The nurse is completing an infant history on a 5-month-old and documents the following symptoms. Which will the nurse attribute to teething? Select all that apply.
drooling and biting increased sucking on hands irritability and awakening from sleep refusing to eat
The nurse assesses a 9-month-old client during a well-child visit (above). Which assessment finding should the nurse report to the health care provider?
gross motor development
Which assessment findings if noted in a 4-month-old infant would the nurse recognize as normal growth and development?
holds head up when prone, bears partial weight on legs, reflexes are fading
A client's caregivers ask the nurse about good choices for solid foods for their 10-month-old child. The caregivers are lacto-ovo vegetarian and wish to raise their child with the same diet. What food(s) will the nurse recommend? Select all that apply.
iron fortified infant cereal cooked egg yolk yogurt or cottage cheese
A nurse is instructing the mother of a newborn about bathing and skin care. When discussing bathing, the nurse includes which of the following besides hygiene as an important reason for bathing?
promoting parental bonding
In providing anticipatory guidance related to choking hazards for infants, what should the nurse include in the teaching? Select all that apply.
propping a bottle raw carrots plastic bags
The nurse is visiting a mother who has a 3-month-old infant who has been hospitalized for cardiac problems. Which nursing diagnosis should the nurse use to guide care for this family at this time?
risk for impaired parenting related to hospitalization of infant
The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration.
rolling only front to back
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:
should have disappeared.
The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance?
telling how and when to introduce rice cereal
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines
the child weighs less than expected for age.
The nurse is providing education about nutrition and feeding to the parents of a healthy 10-month-old child. What foods, if reported by the parents, indicate the need for further education? Select all that apply.
white grapes honey
