Chapter 15 Care of the newborn and infant
The nurse is providing anticipatory guidance to the mother of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? 1. "Start brushing her teeth after all the baby teeth come in." 2. "Use a washcloth with toothpaste to clean her mouth." 3. "Clean your baby's gums, then new teeth, with a washcloth." 4. "Rinse your baby's mouth with water after every feeding."
"Clean your baby's gums, then new teeth, with a washcloth."
Bob and Nancy have financial issues and 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? a) "No, you cannot use a borrowed crib." b) "You can use the crib, but there are guidelines to follow." c) "You should just buy a new crib to be on the safe side." d) "You can use any crib that you want."
b) "You can use the crib, but there are guidelines to follow."
What is the correct amount of urine diapers a mature infant should have each day? a) An infant should have 3 to 5 wet diapers/day. b) An infant should have 6 to 8 wet diapers/day. c) An infant should have 1 to 2 wet diapers/day. d) An infant should have 9 to 10 wet diapers/day.
b) An infant should have 6 to 8 wet diapers/day.
Infant development is best described by which of the following statements? a) Development proceeds cephalocaudally. b) Development is not sequential but predictable. c) Development varies greatly from infant to infant. d) Development proceeds from fine to gross.
Development proceeds cephalocaudally.
While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated? a) Binocular vision b) Object permanence c) Depth perception d) Hand regard
Object permanence
The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern? a) The child measures 21 in (53 cm) in length. b) Head size has increased 5 in (12 cm) since birth. c) The child weighs 10 lb 2 oz (4.6 kg). d) The child exhibits palmar grasp reflex.
Head size has increased 5 in (12 cm) since birth.
Put the following developmental milestones related to an infant's hearing in correct chronological order: 1 Stop activity in response to spoken word 2 Locate sounds made above3 Locate & turn toward sound in any direction 4 Turn head to locate sound 5 Recognize name when spoken 6 Locate sounds downward and to side
Stop activity in response to spoken word Turn head to locate sound Locate sounds downward and to side Locate sounds made above Recognize name when spoken Locate & turn toward sound in any direction
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a) The development of a 3-month-old b) The growth of a 5-month-old c) The development of a 10-week-old d) The growth of a 2-month-old
The development of a 3-month-old 40weeks - birth week = months to minus from current age40-32=8wks (2 months)[5mos-2mos=3mos]
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? a) His toes hyperextend when the bottom of the foot is stroked. b) The infant grasps a finger when it is placed in his palm. c) The infant displays an asymmetric tonic neck reflex (fencing reflex). d) The anterior fontanel is open and easily palpated
The infant displays an asymmetric tonic neck reflex (fencing reflex). (Birth-4mos)
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: a) is a protective reflex and retained for life. b) should be pronounced and easy to elicit. c) should have disappeared. d) is expected to appear within 1 month.
c) should have disappeared.
The nurse comes into infant Lucy's room on the pediatric floor. She is going to try and feed her for the first time since her surgery. How does the nurse know what infant state Lucy is in by what Mom says and that it is okay to try and feed Lucy? a) "Lucy has been crying every time someone picks her up." b) "Lucy is so quiet today, that is not like her." c) "Lucy is still sleeping, I guess she is worn out." d) "Lucy has been a chatterbox and smiles just like her brother."
d) "Lucy has been a chatterbox and smiles just like her brother."
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? a) Increased biting and sucking b) Running a mild fever or vomiting c) Frequent loose stools d) Choosing soft foods over hard foods
a) Increased biting and sucking
A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? a) Restrain the baby in a car seat. b) Lock all cabinets that contain cleaning supplies. c) Keep all pots and pans in lower cabinets. d) Give warm bottles of formula to the baby.
a) Restrain the baby in a car seat.
Sonograms demonstrate thumb sucking as early as in utero.a) False b) True
b) True
The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is :1. "She just needs love and attention. Don't worry; she's too young to spoil." 2. "Consistently meeting the infant's needs helps promote a sense of trust." 3. "Infants need to be fed and cleaned; if you're sure those needs are met, just let her cry." 4. "Consistency in meeting needs is important, but you're right, holding her too much will spoil her."
"Consistently meeting the infant's needs helps promote a sense of trust."
Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior? 1. Crying when left with the sitter may indicate difficulty with building trust. 2. Stranger anxiety should not occur until toddlerhood; this concern should be investigated .3. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. 4. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.
.3. Separation anxiety is normal at this age; the infant recognizes parents as separate beings.
A 3-month-old still has a Moro reflex. Which statement is most true of this reflex? a) A Moro reflex present at 3 months of age requires referral for a neurologic exam. b) Most 3-month-olds still have a Moro reflex. c) It is not important how long the reflex persists, only that it is present at birth. d) A Moro reflex normally lasts until 9 months.
Most 3-month-olds still have a Moro reflex.
The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability? a) Most babies do not sit steadily until 8 months; she is normal. b) Most babies sit steadily at 3 months; she is slightly delayed. c) Sitting ability and the age of first tooth eruption are correlated. d) Most babies sit steadily at 4 months; she is normal.
a) Most babies do not sit steadily until 8 months; she is normal.
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Building a tower of four cubes b) Sitting independently c) Turning a doorknob d) Walking independently
b) Sitting independently
The infant weighs 6 lbs. 8 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of four months? a) 10 lbs. 8 oz. b) 16 lbs. c) 13 lbs. d) 15 lbs. 4 oz.
c) 13 lbs.
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? a) The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. b) The respirations of a 1-month-old infant are normally irregular and periodically pause. c) An infant at this age should have regular respirations. d) The irregularity of the infant's respirations are concerning; I will notify the physician.
b) The respirations of a 1-month-old infant are normally irregular and periodically pause.
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) If she is safe, they lie her down and leave. b) They put her to bed when she falls asleep. c) They sing to her before she goes to sleep. d) The child has a regular, scheduled bedtime.
b) They put her to bed when she falls asleep
The nurse at a family health clinic is teaching a group of parents about normal infant development.What patterns of communication should the nurse tell parents to expect from an infant at age 1? a) Uses speech-like rhythm when talking with an adult b) Understands "no" and other simple commands c) Squeals and makes pleasure sound d) Uses multisyllabic babbling
b) Understands "no" and other simple commands
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a) pushing a spoon from her high chair tray to the floor. b) looking for a toy in her crib at the last place she saw it. c) shaking a rattle to enjoy the sound. d) smiling at herself in the mirror.
b) looking for a toy in her crib at the last place she saw it.
The best way for an infant's father to help his child complete the developmental task of the first year is to a) talk to her at a special time each day. b) respond to her consistently. c) expose her to many caregivers to help her learn variability. d) keep her stimulated with many toys.
b) respond to her consistently.
The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months? a) 28 lbs. 4 oz. b) 25 lbs. c) 21 lbs. 12 oz. d) 14 lbs. 8 oz.
21 lbs. 12 oz.
The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months? a) 36-38 inches b) 26-28 inches c) 30-32 inches d) 40-42 inches
30-32 inches
The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething? Select all that apply. a) Fever and diarrhea b) Refusing to eat c) Irritability and awakening from sleep d) Drooling and biting e) Increased sucking on hands
• Refusing to eat• Irritability and awakening from sleep• Drooling and biting• Increased sucking on hands
The mother of 1-week-old boy voices concerns about her baby's weight loss since birth. At birth the baby weighed 7 lb (3.2 kg); the baby currently weighs 6 lb 1 oz (2.8 kg). Which response by the nurse is most appropriate? a) "All babies lose a substantial amount of weight after birth." b) "Your baby has lost a bit more than the normal amount." c) "Your baby has lost too much weight and may need to be hospitalized." d) "Your baby's weight loss is well within the expected range."
"Your baby has lost a bit more than the normal amount."
Lea is 3 months old. At what age would it be okay for Lea's mother to introduce carrots to her for dinner? a) Solid food can be introduced at 9 months of age. b) Solid food can be introduced at 7 to 9 months of age. ) Solid food can be introduced at 4 to 6 months of age. d) Solid food can be introduced whenever the child seems ready.
) Solid food can be introduced at 4 to 6 months of age.
Which of the following would you include when teaching the parents of an infant about colic? a) Their child will need future follow-up for a "nervous" bowel. b) Formula intake should be doubled to keep her from losing weight .c) Colic symptoms will probably fade at 3 months of age. d) Symptoms will decrease if she is laid on her back after feedings.
.c) Colic symptoms will probably fade at 3 months of age.
The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months? a) 30 ½ inches b) 27 ½ inches c) 29 inches d) 32 inches
27 ½ inches
The mother of a 3-month-old boy asks the nurse about starting solid foods. What is the most appropriate response by the nurse? 1. "It's okay to start puréed solids at this age if fed via the bottle." 2. "Infants don't require solid food until 12 months of age." 3. "Solid foods should be delayed until age 6 months, when the infant can handle a spoon on his own." 4. "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."
4. "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."
When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about a) 16 pounds and grown 4-6 inches b) 16 pounds and grown 2-3 inches c) 8 pounds and grown 4-6 inches d) 8 pounds and grown 2-3 inches
8 pounds and grown 4-6 inches
n working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant .a) The child grows and develops skills more rapidly than at any other time in their life b) The child has an increased attention span and can be interested in an activity for a long length of time c) The child takes in new information at a rapid rate and asks "why" and "how" d ) The child insists they can "do it," the next moment they revert to being dependent
A. The child grows and develops skills more rapidly than at any other time in their life
A 9-month-old infant's mother is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in her response? 1. It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. 2. Cow's milk is iron poor and does not provide the proper balance of nutrients for the infant. 3. As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. 4. If the mother cannot afford the infant formula, she should dilute it to make it last longer.
Cow's milk is iron poor and does not provide the proper balance of nutrients for the infant.
The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which ability should appear at this age? a) Sits from standing position b) Uses two or three words with meaning c) Cruises around furniture d) Feeds self with spoon (but spills)
Cruises around furniture
The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? a) Puts down a little ball to pick up a stuffed toy b) Enjoys hitting a plastic bowl with a large spoon c) Picks up an object using his thumb and finger tips d) Shifts a toy to his left hand and reaches for another
Puts down a little ball to pick up a stuffed toy
Using knowledge of normal growth and development, which of the following would be expected when observing a 12-week-old infant? a) The infant smiles at significant others b) The infant bears weight on legs when held in standing position c) The infant grasps objects and brings them to the mouth d) The infant is able to sit up and can roll over
The infant smiles at significant others
An infant is breastfed. When assessing her stools, which of the following data would be typical? a) Breastfed infants are less likely to be constipated than bottle-fed infants. b) Breastfed infants usually have fewer stools than bottle-fed infants. c) Stools of breastfed infants are usually harder than those of bottle-fed infants. d) Stools of breastfed infants tend to have a strong odor.
a) Breastfed infants are less likely to be constipated than bottle-fed infants.
Which of the following milestones would you expect an infant to accomplish by 8 months of age? a) Sitting without support b) Pulling self to a standing position c) Creeping on all fours d) Being able to sit from a standing position
a) Sitting without support
A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him? a) The child's gum line will be tender. B) The child will not play or eat for 2 days. c) He can expect his child to be constipated for 2 days. d) The child's temperature may go as high as 102°F.
a) The child's gum line will be tender.
Which of the following shows an example of Erik Erikson's developmental task for the infant? a) The infant cries and the caregiver picks the child up. b) The infant smiles as people walk past the crib. c) The infant cries when they have a wet diaper. d) The infant plays the game peek-a-boo.
a) The infant cries and the caregiver picks the child up.
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. Which of the following represents the most advanced milestone of language development that the nurse should expect to see in this child? a) The infant says "da-da" when looking at her father b) The infant coos, babbles, and gurgles c) The infant squeals with pleasure d) The infant imitates her father's cough
a) The infant says "da-da" when looking at her father
The mother of an infant asks you when to begin tooth brushing with her son. Your best response would be a) as soon as the first tooth erupts. b) as soon as he begins to eat fruit. c) when weaning is complete. d) by 12 months of age.
a) as soon as the first tooth erupts.
The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be: a) "Giving a bottle of milk when the infant goes to bed can lead to obesity." b) "Giving your baby a pacifier at bedtime will satisfy the need to suck." c) "Bottles given at bedtime can cause erosion of the enamel on the teeth." d) "You could give your baby a bottle of water at bedtime occasionally."
c) "Bottles given at bedtime can cause erosion of the enamel on the teeth."
A parent who is feeding his child formula prepared at home using evaporated milk is concerned about whether the child is receiving all necessary nutrients. Which of the following would be important for this parent to add to his child's diet to supplement the formula? a) Calcium b) Vitamins D c) Iron d) Vitamin E
c) Iron
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 just demonstrated? a) Binocular vision b) Primary circular reaction c) Secondary circular reaction d) Object permanence
c) Secondary circular reaction
The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a) Provide small portions that must be eaten b) Let the child eat only the foods she prefers c) Serve new foods several times d) Actively urge the child to eat new foods
c) Serve new foods several times
The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term? a) Educating the parents about when colic stops b) Assessing the parents' care and feeding skills c) Urging the baby's mother to take time for herself away from the child d) Watching how the parents respond to the child
c) Urging the baby's mother to take time for herself away from the child
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a) Picks up small objects using entire hand b) Cannot pull self to standing c) Uses only the left hand to grasp d) Crawls with stomach down
c) Uses only the left hand to grasp
When teaching an infant's mother about bathing her, it would be important to instruct her that a) she should never use soap on a baby's hair. b) soap lubricates and oils an infant's skin. c) bath time provides an opportunity for play. d) infants need a daily bath.
c) bath time provides an opportunity for play.
A frustrated mother comes to a 9-month well-baby checkup complaining to you that her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which of the following statements would be most appropriate for the nurse to say to this mother? a) "The baby might not be ready for solid food, so wait a month or so and try again." b) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." c) "The baby might be allergic to the particular foods you offered, so try different kinds of food." d) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
d) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about: a) ½ inch smaller than the chest b) Equal in size to the chest c) 2 inches larger than the chest d) 1 inch larger than the chest
d) 1 inch larger than the chest
What is a true statement regarding developmental milestones of the 30-month-old? a) Triples birth weight b) Anterior fontanel closes c) Head circumference equals chest circumference d) Full set of primary teeth
d) Full set of primary teeth
The nurse is promoting a healthy diet to the mother of a 6-month-old girl. What action would have the most effect on the infant's neurologic development? a) Adding fruit juice daily b) Establishing an adequate level of dietary iron intake c) Requiring more solid foods in the diet d) Promoting continuation of breastfeeding
d) Promoting continuation of breastfeeding
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines: a) The weight assessment is blatantly inaccurate .b) The child weighs more than expected for age. c) The child weighs the expected amount for age. d) The child weighs less than expected for age.
d) The child weighs less than expected for age.
Anticipatory guidance for an infant for the 4th month should include the fact that she probably will a) have many "blue" or moody periods. b) develop a fear of strangers .c) insist on things being done her way. d) be able to turn over onto the back.
d) be able to turn over onto the back.
The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: a) conclude the earlier assessments carried out fatigued the infant. b) refer the infant for developmental and/or neurologic evaluation. c) consider this a normal response for the age. d) suggest more awake tummy time for the child.
refer the infant for developmental and/or neurologic evaluation.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother: a) the newborn's stomach can hold between one-half to 1 ounce. b) most newborns need to eat about 4 times per day. c) the best feeding schedule offers food every 4 to 6 hours. d) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.
the newborn's stomach can hold between one-half to 1 ounce.