Growth and Development Coursepoint/Kaplan
Which statement, made to the nurse by the parent of an 8-month-old client, indicates a possible delay in growth and development? 1. "My child has almost doubled the birth weight." 2."My child smiles at me when I walk in the room. 3. "My child cries and refuses to be held by the grandparents." 4."My child cannot say 'mama' yet."
1 (explanation: by 5 to 6 months the child weight should of doubled)
A 4-month-old (full-term) infant client is seen in the well-child clinic. The nurse is most concerned when which finding is observed? 1. The infant's head turns to the side when a sound is made at the level of the ear. 2. The infant's head lags when pulled from a lying to a sitting position. 3. The infant is drooling. 4. The infant does not focus on a toy held close to the face.
2
The 17-month-old client sucks the thumb, especially at night when quieting for sleep. Which is an appropriate suggestion by the nurse? 1. "Put a negative reinforcer, such as red pepper, on the thumb." 2. "Don't intervene; it will subside. The behavior usually peaks at 24 months." 3. "'It is a common form of self-stimulation. It should be discouraged." 4. "It will cause the teeth to malform. I would wrap the thumb at bedtime."
2
The nurse interviews an adolescent client. Which statement causes the nurse concern if made by the adolescent during the health history interview? 1. "Sometimes I feel really tired." 2. "I don't perspire like other kids." 3. "I can be a real klutz sometimes." 4. "I have two pimples on my forehead."
2
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 will need to find an appropriate punishment for him if this continues." b. "I have heard that both boys and girls often touch themselves at this age." c. "I should teach him certain rules about this activity." d. "This is probably a good time to talk about safety and who can touch him."
a
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. should have disappeared. b. should be pronounced and easy to elicit. c. is expected to appear within 1 month. d. is a protective reflex and retained for life.
a
The nurse has completed an examination of a 32-month-old girl with normal gross and fine motor skills. Which observation would suggest the child is experiencing a problem with language development? a. Her vocabulary is between 10 and 15 words. b. She asks many questions. c. She uses complete 3- to 4-word sentences. d. She talks incessantly.
a
The nurse is educating a 17-year-old adolescent after a new diagnosis of diabetes. What does the nurse understand about teaching an adolescent? a. The adolescent will likely have the greatest influence on one's own decisions. b. The parents will need to be instructed separately from the adolescent. c. The siblings of the adolescent will need to be taught healthy cooking classes related to diabetes. d. The adolescent will respond best to teaching about how to avoid future complications.
a
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance? a. Is there a gun in your home? b. How is his personal hygiene? c. Have his sleeping and eating habits changed? d. Does he exercise?
a
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? a. "Maturation refers to the child's increases in body size." b. "Development refers to the increase in skills the child demonstrates as they grow and age." c. "Increases in body size are referred to as growth." d. "Both growth and development are influenced by heredity."
a
Which milestone would the nurse expect an infant to accomplish by 8 months of age? a. Sitting without support b. Creeping on all fours c. Pulling self to a standing position d. Being able to sit from a standing position
a
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. adults learning infant/child cardiopulmonary resuscitation (CPR). d. using and renewing sunscreen regularly.
a (explanation: Preschool children are safe around water only when adult supervision is constant. Wearing a personal flotation device adds additional protection and should be as routine as "buckling up" in the car. At 5 years old, most preschoolers are mature enough to become swimmers, yet knowing how to swim does not make the preschooler safe without supervision. CPR is a life-saving skill and using sunscreen will protect the skin, but neither will be a factor in preventing drowning.)
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? a. Pretending to be mommies and daddies in the playhouse b. Playing a board game c. Painting pictures in the art corner of the room d. Watching a movie with other children their age
a (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.)
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent? a. The adolescent's need for privacy should be respected. b. The adolescent should be encouraged to call friends often. c. The adolescent's need for parental support should be discussed. d. The adolescent should be given freedom to participate in unit activities as desired.
a (explanation: The adolescent needs individualized attention, confidentiality, and the right to participate in decisions about one's own health care.)
A 15-year-old client's parent comments on the fact that the adolescent seems to always choose the opposite of what everyone else wants and that mood swings are a common occurrence. What statement shows the nurse that the client's parent understands these changes? a. "I know that my adolescent is doing this because of all the hormones." b. "This is common for this age group and it will get better with time." c. "This is my adolescent's temperament, and we will have to learn how to deal with it." d. "My adolescent will never find anyone to live with if the adolescent acts like this."
b
A nurse is reviewing the health records of several 4-month-old infants who were seen in the pediatric office today. Which infant behavior will require referral for further evaluation of growth and development? a. reaches for nearby objects b. unable to support head c. cannot sit without assistance d. rolls from prone to supine position
b
The caregiver of a 6-year-old expresses concern that the child cannot yet print her first and last name. 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. "Usually by the age of 6, most children can write numbers up to nine, but no letters." c. "Some children this age cannot hold a pencil or crayon well enough to write legibly." d. "It is not unusual for children of this age to be writing their first name in cursive."
b
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 mother of a 7-year-old girl is asking the nurse's advice about getting her daughter a 2-wheel bike. Which response by the nurse is most important? a. "Teach her where she'll land on the grass if she falls." b. "Be sure to get the proper size bike." c. "She won't need a helmet if she has training wheels." d. "Learning to ride the bike will improve her coordination."
b
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
b
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? a. "The balls of her feet should reach both pedals while sitting." b. "Pedal back brakes are better for her age group." c. "She should always ride on the sidewalk." d. "She can ride on the street if I am riding with her."
b
The nurse is talking with the parents of an 8-year-old child who has been cheating at school. Which comment by the nurse would be appropriate as a first step? a. "Punishment should be subtle to allow the child to confess to cheating and lessen the behavior." b. "Be sure the adults in the child's life, including you, as parents, demonstrate positive behavior." c. "Perhaps the academic environment is too easy for your child, causing the cheating." d. "If cheating is noted at this age, referral to a family counselor is highly recommended."
b
To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care? a. Plan a diet of 1,500 calories per day. b. Describe a normal serving size. c. Encourage sources of proteins with fat. d. Plan a diet of 3,000 calories per day.
b
What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother? a. A ratio of 10 children to 1 teacher is adequate. b. Specific program goals to be accomplished should be available. c. The longer the center has been in operation, the better it is. d. Research local newspapers to see if there are any complaints against the center.
b
A parent takes the 4-month-old infant to the health care provider. The parent asks what type of baby cereal to provide now that the infant is starting solid foods. How should the nurse respond? a. "You should buy wheat cereal." b. "You should buy oat cereal." c. "You should buy rice cereal." d. "You should buy barley cereal."
c
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother? a. Remind them staying in the hospital now will help the child get well quicker and be home soon, but the other children should not be alone. b. Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out. c. Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning." d. Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment.
c
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that: a. at this age, children are not afraid of death. b. discussing death and dying may hint at a psychological disorder. c. consistent thoughts of death and dying at this age lead to the later development of depression. d. preoccupation with death and dying is common in the school-aged child.
c
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit? a. 16 lb (7.2 kg) and 26 inches (65 cm) b. 20 lb (9.1 kg) and 28 inches (70 cm) c. 24 pounds (10.8 kg) and 30 inches (75 cm) d. 28 pounds (12.7 kg) and 32 inches (80 cm)
c
The nurse is discussing sensory development with the mother of a 2-year-old boy. Which parental comment suggests the child may have a sensory problem? a. "He wasn't bothered by the paint smell." b. "He was licking the dishwashing soap." c. "He doesn't respond if I wave to him." d. "I dropped a pan behind him and he cried."
c
The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments? a. The infant can be expected to display developmental skills consistent with a 8-month-old infant. b. By 8 months of age, the child's skill level will vary greatly and cannot be predicted. c. The infant will most likely present with developmental skills consistent with a 6-month-old infant. d. The infant will likely show the skills of an infant with the adjusted age of 7 months.
c
The parents of a 9-year-old child voice concern that the child seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased weight by 6 or 7 lb (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated? a. "Your child does seem to be rapidly gaining weight." b. "Children in this age range on average gain about 5 lb (2.3 kg) per year." c. "Weight gains of about 7 lb (3.2 kg) per year are normal for children in this age range." d. "On the contrary, your child's annual weight gain is somewhat low for this age."
c
The nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections? a. "I avoid all fat intake." b. "Because of my age, my dairy intake is unlimited. c. "I need to eat plenty of fruit each day." d. "To lose weight my protein intake should be limited to 2 to 4 servings per day."
c (explanation: The sedentary teen needs to consume approximately 1,600 calories each day. A balanced diet includes plenty of fresh fruit and a small amount of fat. To avoid all fat could place the child's health at risk. Protein intake is important for the development of tissue. The teen will need about 5 ounces of protein daily.)
The nurse is providing education to a teen mother about her 20-month-old daughter's growth. The teen says her daughter seems to have such a big head. What information should the nurse include in the response? a. Some children have large heads but that does not signal a problem. b. Explain that the child looks normal. c. Share that the heads of children at this age are large in proportion to the rest of their body. d. Teach the mother that this larger head than body appearance will be this way until the child is about 6 years old.
c. (explanation)Head circumference increases about 1 inch between 1 and 2 years of age, then increases an average of a half-inch per year until age 5. The anterior fontanel (fontanelle) should be closed by the time the child is 18 months old. Head size becomes more proportional to the rest of the body near the age of 3 years.
The nurse considers the developmental stage of a child client before choosing a toy. A push-pull toy is appropriate for which age range? 1. 6 weeks to 3 months. 2. 6 to 8 months. 3. 18 to 20 months. 4. 4 to 5 years.
3
The school nurse assesses children enrolled in the kindergarten class. The nurse is most concerned if which finding is observed? 1. A child throws and catches a ball. 2. A child is able to neatly tie shoelaces. 3. A child eats with the fingers. 4. A child walks down stairs by placing both feet on one step.
4
The family reports to the nurse that their adolescent always wants to argue, will not participate in family functions, and has poor school grades. What recommendation should the nurse make for an adolescent client who presents with these symptoms? a. Encourage participation in sports. b. Have the child visit the school counselor. c. Make an appointment with the health care provider. d. Supervise homework sessions.
c (explanation: In younger adolescents, depression may be manifested not so much by appearing sad, but by behavior problems such as disobedience, temper tantrums, truancy, and running away. Additional signs may be self-destructive behavior, difficulties in school, use of drugs and alcohol, sexual promiscuity or trouble with the legal system)
An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health? a. Encourage the child to abstain from eating sugary snacks at school. b. Accept that the child is genetically predisposed to having more cavities than most children. c. Ensure that the child brushes his teeth after each meal and snacks. d. Have the child's teeth professionally cleaned every 3 months.
c (explanation: Proper dental hygiene includes a routine inspection and conscientious brushing after meals. A well-balanced diet with plenty of calcium and phosphorus and minimal sugar is important to healthy teeth. Foods containing sugar should be eaten only at mealtimes and should be followed immediately by proper brushing. The school-aged child should visit the dentist at least twice a year for a cleaning and application of fluoride.)
The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a. Let the child eat only the foods she prefers. b. Actively urge the child to eat new foods. c. Provide small portions that must be eaten. d. Serve new foods several times.
d
