Growth and Development: Infant (Practice Questions)

A mother is discussing her 10-month-old boy with the nurse. Which comment indicates a need for teaching? "I wipe my son's teeth every day with a fresh washcloth." "We have safety gates at the top and bottom of our stairs." "He gets a few sips of apple juice each day from a regular cup, not a sippy cup." "He loves being in his walker and 'zips' around the house."

"He loves being in his walker and 'zips' around the house." Explanation: Walkers are safety hazards and not recommended by the American Academy of Pediatrics. They cause falls plus promote the ability to reach items on surfaces otherwise inaccessible. The other comments are age appropriate and acceptable practice.

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. -honey -rice cereal -cooked peas -pureed beef -whole grapes

-honey -whole grapes Explanation: Grapes can be a choking hazard and should be cut up to reduce this risk. Honey has a risk of botulism and should not be provided to children under 1 year of age. The other foods are all appropriate choices for a child this age.

A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse? -"We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." -"Delays are normal when a child is premature." -"All children mature and develop at different rates so it is unwise to compare them in this way." -"You should talk wterm-37ith the doctor about getting your son tested."

-"Delays are normal when a child is premature." Explanation: When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse.

During a well-baby visit the mother tells the nurse that she thinks her baby has a decayed tooth and doesn't understand how this could have happened. What are appropriate questions for the nurse to ask this mother? Select all that apply. -"Do you frequently put your baby to bed with a bottle of milk or juice?" -"Did you read any of the nutrition information we send home with each visit?" -"Is your child using a bottle for milk?" -"Does your baby use no-spill sippy cups?" -"Haven't you seen a dentist yet?"

-"Do you frequently put your baby to bed with a bottle of milk or juice?" -"Is your child using a bottle for milk?" -"Does your baby use no-spill sippy cups?" Explanation: Milk and juice pool around teeth leading to dental caries (tooth decay) when babies are given bottles in bed and with the use of no-spill sippy cups, so these are appropriate questions. Using a bottle after the age of 12 to 15 months can also lead to dental caries. Asking the mother, "Haven't you seen a dentist yet?" or "Did you read any of the nutrition information we send home with each visit?" are very accusatory questions and will likely make the mother very defensive.

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 become clingy around strangers within the next month." -"I can expect my infant to laugh out loud within the next month." -"I can expect my infant to be able to raise the head up when on the stomach within the next month." -"I can expect my infant to be able to hold a rattle within the next month."

-"I can expect my infant to be able to raise the head up when on the stomach within the next month." Explanation: It is expected that a 3-month-old infant can raise the head to 45 degrees while laying on the stomach. Becoming clingy around strangers occurs in the infant around 6 to 8 months of age. The infant can begin to hold a rattle around 5 months of age. At 4 to 5 months, the infant will typically begin to laugh out loud.

A nurse in a pediatrician's office is educating a parent of a 2-month-old infant about developmental milestones. Drag words from the choices below to fill in each blank in the following sentence. The parent requires further education when the parent states ________ ,_______ , and _______. Client Statements: -"I will be able to play games like peek-a-boo with my infant when they are 4 months old." -"At 6 months, my baby should be able to feed themselves." -"My infant should be able to sit on their own by 3 months." -"My infant should be able to support themselves on elbows and wrists when lying on stomach" -"My infant should be able to crawl by 9 months."

-"I will be able to play games like peek-a-boo with my infant when they are 4 months old." -"At 6 months, my baby should be able to feed themselves." -"My infant should be able to sit on their own by 3 months." Explanation: An infant is not able to sit on their own until 6 months of age.An infant is able to feed themselves with a cup and a spoon by 12 to 18 months of age.At 9 months of age, an infant can play games such as "peek-a-boo," not at 4 months of age.

The nurse is reinforcing teaching with a group of caregivers related to the nutritional needs of the infant. One caregiver asks why the 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse? -"Milk will not fully provide the child's needs for iron, which is found in solid foods." -"By this age the child becomes interested in trying new skills." -"Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods." -"The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex."

-"Milk will not fully provide the child's needs for iron, which is found in solid foods." Explanation: At about 4 to 6 months of age, the infant's milk consumption alone is not likely to be sufficient to meet caloric, protein, mineral, and vitamin needs. In particular, the infant's iron supply becomes low, and supplements of iron-rich foods are needed. It is also around 4 to 6 months when the infant is able to swallow solids effectively and has the necessary enzymes necessary to digest them. It is true that the child becomes interested in new skills, but this is not the primary rationale for introducing solids. Few parents will understand the "extrusion reflex" so using that term is not effective in teaching. The nurse should, however, describe the reflex to the parents. Breastfeeding does not become painful when the child develops teeth. Many mothers nurse for long after their infants develop teeth.

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." -"I will place my infant on the back to sleep every night." -"I have a crib in my room so that I can breastfeed my baby." -"By keeping the room at a neutral temperature, I do not have to use blankets."

-"My husband gave the baby a special bear that I will place in the crib." Explanation: The nurse should reinforce that stuffed animals, blankets, pillows, and soft mattresses are suffocation hazards for infants.

The nurse is admitting a 12-month-old to the medical unit. During the admission process the parents tell the nurse that their child is very advanced because he says "ball" when he picks up a football. How should the nurse respond? -"He really isn't any more advanced than most 12-month-old children." -"Parents usually think their child is far more advanced than other children." -"If he were advanced in language skills he would be putting several words together to form short sentences." -"That is great that he is recognizing objects and is able to name them. He is right on target for language skills."

-"That is great that he is recognizing objects and is able to name them. He is right on target for language skills." Explanation: Recognizing the parents' excitement about their child's language skills while still letting them know that this is what the expected level is for language is a polite and accurate way to respond. The other responses do not give notice to the parents' pride and would likely make the parents feel defensive about their child's skill.

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 -Pots and pans from the kitchen cupboard -Brightly colored stacking toy -A push-pull toy

-A yellow rubber duck for the bath Explanation: The rubber duck is most appropriate. It is safe, visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.

The nurse is providing anticipatory guidance to the parent of a 9-month-old infant during a well-baby visit. Which topic would be most appropriate? -Instructing on safety procedures during baths -Warning about leaving small objects on the floor -Cautioning about putting the baby in a walker -Advising how to create a toddler-safe home

-Advising how to create a toddler-safe home Explanation: The most appropriate topic for this parent would be advising on how to create a toddler-safe home. The infant will very soon be pulling oneself up to standing and cruising the house. This will give the infant access to areas yet unexplored. Warning about leaving small objects on the floor, telling about safety procedures during baths, and cautioning about using baby walkers would no longer be anticipatory guidance as the infant has passed these stages.

What will the nurse include in the care plan for a hospitalized 8-month-old infant based on developmental needs? -Have the parent leave the room during painful procedures to avoid association with pain. -Assign a primary nurse to provide care when possible. -Demonstrate procedures on a doll prior completing on the child. -Provide the child with advance warning for any painful procedures.

-Assign a primary nurse to provide care when possible. Explanation: Fear of strangers peaks at 8 months old, so providing the same nurse can help to establish familiarity and decrease fear in a child this age. The parent is a comfort for the child, and their absence may increase anxiety during procedures. Demonstration on a doll and advance warning are strategies for older hospitalized children.

The nurse is assessing a 6-month-old infant in the clinic. Which characteristic represents normal language development for this age? -Cooing -Babbling -Producing noises when spoken to -Laughing out loud

-Babbling Explanation: Cooing begins in the first 4 weeks of life, productions of noises when spoken to and laughing out loud are seen later than 6 months of age. Infants begin to babble around 6 months of age.

A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply. -Only small pillows should be used in cribs. -Car seats should be placed in back seats. -Crib and playpen bars should be no more than 2 3/8 inches apart. -A safe temperature for hot water heaters in households with infants is 120°F (48.9°C). -Bottle should only be propped for infants 8 months or older.

-Crib and playpen bars should be no more than 2 3/8 inches apart. -Car seats should be placed in back seats. -A safe temperature for hot water heaters in households with infants is 120°F (48.9°C). Explanation: Crib and playpen bars should be no more than 2 3/8 inches apart so the infant can be safe from getting body parts caught between the bars. Car seats are placed in the back seat and manufacturers' instructions are followed regarding forward or backward facing depending on the age and size of the child. Water heaters should be set no higher then 120°F (48.8°C) to prevent potential burns. Bottles should never be propped and pillows are not placed in cribs of infants.

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? -Uses two or three words with meaning -Feeds self with spoon (but spills) -Sits from standing position -Cruises around furniture

-Cruises around furniture Explanation: At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year.

Infant development is best described by which statement? -Development proceeds cephalocaudally. -Development varies greatly from infant to infant. -Development is not sequential but predictable. -Development proceeds from fine to gross.

-Development proceeds cephalocaudally. Explanation: Growth and development both proceed from head to toe, or in a cephalocaudal sequence. The baby needs first to learn to lift the head. Once that developmental milestone has been achieved then progression can occur to rolling over and then learning to sit. Development proceeds in a proximodistal fashion. Skills are learned in a gross motor fashion before developing fine motor skills. Infants may develop skills at different ages but the process is always sequential. Unless there are other problems to interfere with development, all children will develop in the same manner.

The parents of a 5-month-old child are concerned that the child has a slightly flat spot on one side of the back of the head. The child sleeps on their back with the head tilted to one side. What will the nurse recommend? Select all that apply. -Encourage "tummy time" when awake. -Hold child upright with pressure off head. -Encourage tilting head to the other side when sleeping and resting. -Limit car seat use when not in car. -Place child on stomach to sleep.

-Encourage "tummy time" when awake. -Limit car seat use when not in car. -Encourage "tummy time" when awake. Explanation: The child is showing signs of mild plagiocephaly (flattening of the back of the head) from the sleep position on one side of the head. The sleep position should still be on the back, but parents should be encouraged to limit pressure on that part of the head during awake times, by limiting time in the car seat and varying positions. The parents should provide plenty of "tummy time" for the child. They should also try to get the child to tilt the head to the other side, often achieved through positioning in the opposite direction in the crib.

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. -Irritability and awakening from sleep -Fever and diarrhea -Increased sucking on hands -Drooling and biting -Refusing to eat

-Irritability and awakening from sleep -Increased sucking on hands -Drooling and biting -Refusing to eat Explanation: Infants at age 5 months are in the process of cutting their first teeth, typically the upper or lower central incisors. Symptoms associated with the mouth and feeding are common. Fever and diarrhea are considered signs of illness, not teething.

The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? -Most infants sit steadily at 3 months; this infant is slightly delayed. -Sitting ability and the age of first tooth eruption are correlated. -Most infants sit steadily at 4 months; this infant is normal. -Most infants do not sit steadily until 8 months; this infant is normal.

-Most infants do not sit steadily until 8 months; this infant is normal. Explanation: At 3 months of age the infant should be able to raise the head about 45 degrees when in the prone position. The infant does yet have the developmental skills for sitting. Most infants are unable to sit steadily until 8 months of age. Gross motor skill development does not correlate with tooth eruption. The nurse should reassure the parent that this infant is on tract developmentally.

While evaluating the development of a 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? -Object permanence -Binocular vision -Hand regard -Depth perception

-Object permanence Explanation: By 10 months, an infant looks under a towel or around a corner for a concealed object (beginning of object permanence, or become aware an object out of sight still exists). Hand regard, which is typically demonstrated by 3-month-olds, is a phenomenon that involves the infant holding his hands in front of his face and studying them. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when they follow moving objects with their eyes. Depth perception allows 7-month-olds to transfer toys from hand to hand.

The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention? -Observe the mother while she feeds and burps her infant. -Recommend the mother offer smaller and more frequent feedings. -Offer assurance that spitting up is normal. -Describe the capacity of a 5-week-old infant's stomach.

-Observe the mother while she feeds and burps her infant. Explanation: Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is helpful information but not the priority.

What feeding practice used by the parents of an 8-month-old should the nurse discourage? -Continuing to offer foods the child rejects. -Placing all liquids given the child in a "no spill" sippy cup. -Including the infant at family meals in her high chair. -Giving the child soft table food and finger foods.

-Placing all liquids given the child in a "no spill" sippy cup. Explanation: No-spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times when avoiding spills is a must. The other feeding practices are age appropriate and safe. Soft table food and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.

The caregivers of an infant state that their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and develop a sense of security when the child's primary caregiver is out of sight? -Give her dolls and stuffed animals so she learns to distract herself. -Slowly increase the amount of time allowed to cry before being picked up. -Play peek-a-boo with the child when happy. -Pick the child up as soon as she begins to cry.

-Play peek-a-boo with the child when happy. Explanation: For the infant, self-assurance is necessary to confirm that objects and people do not cease to exist when out of sight. This is a learning experience on which the infant's entire attitude toward life depends. The ancient game of "peek-a-boo" is a universal example of this learning technique. It is also one of the joys of infancy as the child affirms the ability to control the disappearance and reappearance of self. In the same manner by which the infant affirms self-existence, she learns to confirm the existence of others, even when they are temporarily out of sight.

Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? -Read age-appropriate books to the infant daily. -Respond promptly when the infant cries. -Appropriately enunciate words when speaking to the infant. -Praise the infant when a new milestone is reached.

-Respond promptly when the infant cries. Explanation: The developmental task of the infant year, according to Erikson, is to gain a sense of trust. This can be accomplished by promptly meeting the infant's needs during the first year of life. If the infant does not learn to trust, mistrust will develop. Praising will help meet the future developmental tasks of the child. Reading books and appropriately enunciating words will aid in the infant's language development.

The parents of a 10-month-old infant ask the nurse for recommendations for television programs for their infant. What will the nurse recommend? -Screen time is not recommended for infants of this age. -Cartoons should be avoided due to violence. -Bright colors and music will be most engaging for an infant this age. -Programs with simple language can help to promote language development.

-Screen time is not recommended for infants of this age. Explanation: Television and screen time are not recommended for children under the age of 2, and should be limited in toddler and preschool-aged children. The other options all recommend different types of programs, which is not consistent with screen time recommendations.

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? -Object permanence -Secondary circular reaction -Primary circular reaction -Binocular vision

-Secondary circular reaction Explanation: By the third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when they follow moving objects with their eyes, although not past the midline.

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? -Building a tower of four cubes -Turning a doorknob -Sitting independently -Walking independently

-Sitting independently Explanation: Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.

Which milestone would the nurse expect an infant to accomplish by 8 months of age? -Creeping on all fours -Sitting without support -Being able to sit from a standing position -Pulling self to a standing position

-Sitting without support Explanation: Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk.

At what age would it be okay to introduce carrots to an infant's diet? -Solid food can be introduced whenever the child seems ready. -Solid food can be introduced at 4 to 6 months of age. -Solid food can be introduced after 9 months of age. -Solid food can be introduced at 7 to 9 months of age.

-Solid food can be introduced at 4 to 6 months of age. Explanation: The tongue extrusion reflex is present until the infant is 4 to 6 months of age. After this reflex disappears then solid food may be introduced. The infant's ability to swallow solid foods is not completely functional until this age nor are the enzymes present which are needed to process foods. The infant must be ready to handle spoon-feeding. By 7 months onward, the baby should be eating solid foods regularly and drinking from a cup in addition to breast or bottle feeds.

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 not yet had all of their vaccinations and is more prone to severe illness. -The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration. -The 3-year-old child is taking solid foods they can be fed at home, but the 4-month-old infant requires greater nutritional support. -The 3-year-old child has a milder case of the illness, and the 4-month-old infant has a more severe case.

-The 4-month old infant has a greater proportion of extracellular fluid, which increases risk of dehydration. Explanation: The extracellular fluid accounts for approximately 35% of an infant's body weight, with intracellular fluid accounting for approximately 40%, in contrast to adult proportions of 20% and 40%, respectively. This proportional difference increases an infant's susceptibility to dehydration from illnesses, such as diarrhea, because the loss of extracellular fluid could result in the loss of more than one-third of an infant's body fluid.

The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg) and was 20 in (50.8 cm) in length. Which finding is most consistent with the normal infant growth and development? -The baby weighs 24 lb (10.9 kg) and is 26 in (66.0 cm) in length. -The baby weighs 15 lb (6.8 kg) and is 24 in (61.0 cm) in length. -The baby weighs 21 lb (9.5 kg) and is 30 in (76.2 cm) in length. -The baby weighs 18 lb (8.2 kg) and is 26 in (66.0 cm) in length.

-The baby weighs 18 lb (8.2 kg) and is 26 in (66.0 cm) in length. Explanation: The average infant's weight doubles at 4 months and will triple at 1 year of life. The infant's length will increase by 50% by the first year.

The nurse is assessing a 4-month-old infant during a scheduled visit. Which findings might suggest a developmental problem? -The child does not say dada or mama. -The child does not babble. -The child does not make sounds in response to voices. -The child does not make high pitched noises.

-The child does not make sounds in response to voices. Explanation: The fact that the child does not vocally respond to voices might suggest a developmental problem. At 4 to 5 months of age, most children are making simple vowel sounds, laughing aloud, doing raspberries, and vocalizing in response to voices. The child is too young to babble (make verbal noises), squeal, yell (high pitched sounds), or say dada or mama.

At the 6-month-old well-child visit, the parent is concerned that the child is unsteady and often falls over when sitting. What will the nurse advise the parent about this? -The child should have a referral for a neuromuscular assessment. -The child should be provided with a baby seat to support the sitting position. -The child is progressing well on other milestones so there's no cause for worry. -The child's stability will progress to independent sitting over the upcoming months.

-The child's stability will progress to independent sitting over the upcoming months. Explanation: It is a normal finding for the 6-month-old child to be shaky and fall over when learning to sit and for the child to often only sit with a "tripod" sit supported by the hands. No further assessment or support is needed.

What action shows an example of Erik Erikson's developmental task for the infant? -The infant cries when they have a wet diaper. -The infant cries and the caregiver picks the child up. -The infant smiles as people walk past the crib. -The infant plays the game peek-a-boo.

-The infant cries and the caregiver picks the child up. Explanation: Erikson's psychosocial developmental task for the infant is to develop a sense of trust. The development of trust occurs when the infant has a need and that need is met consistently. Crying with a wet diaper without a change of the diaper leads to an unmet need. Playing peek-a boo and smiling are developmental tasks that indicate a normal healthy, happy baby. These would be attributed to Piaget theory.

The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply. -The infant is unable string together 2 word sentences. -The infant has frequent episodes of crossed eyes. -The infant seems disinterested in the surrounding environment. -The infant does not pay attention to noises behind him. -The infant babbles.

-The infant has frequent episodes of crossed eyes. -The infant does not pay attention to noises behind him. -The infant seems disinterested in the surrounding environment. Explanation: Warning signs that may indicate problems with sensory development include the following: young infant does not respond to loud noises; child does not focus on a near object; infant does not start to make sounds or babble by 4 months of age; infant does not turn to locate sound at age 4 months; infant crosses eyes most of the time at age 6 months. Language development at this stage of development does not include stringing together 2-word sentences.

The nurse in a community clinic is assessing a 2-month-old infant. The parent asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 2 months of age? -The infant raises head and chest while on stomach. -The infant stays seated in the tripod position. -The infant transfers objects from one hand to the other. -The infant laughs aloud and responds to name.

-The infant raises head and chest while on stomach. Explanation: Infants have gained some neck control and can independently raise head and chest by 2 months of age. Transferring objects from one hand to another is expected at 7 months of age. Laughing aloud and responding to his or her name is expected between 4 to 5 months of age. Sitting in the tripod position is not expected until 6 months of age.

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 requires some use of hands for support to sit. -The infant crawls with the abdomen off the floor. -The infant's head leads the body when pulled to sit. -The infant walks independently.

-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. Explanation: Infants exhibit phenomenal increases in their gross motor skills over the first 12 months of life. At about 5 months of age, the infant is able to roll from supine to prone and back again. Around 4 months of age, the infant's head leads the body when being pulled to sit. Around 7 months, the infant sits alone with some use of hands for support and by 8 months of age the infant is able to sit unsupported; therefore, at 9 months of age, this infant should not require support to sit. Around 9 months the infant crawls with the abdomen off the floor. Typically around 12 months, the infant walks independently; therefore, this is not an observation the nurse should expect for a 9-month-old.

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 squeals with pleasure -The infant coos, babbles, and gurgles -The infant imitates her father's cough -The infant says "da-da" when looking at her father

-The infant says "da-da" when looking at her father Explanation: By 9 months, an infant usually speaks a first word: "da-da" or "ba-ba." The other answers refer to earlier milestones in language development. In response to a nodding, smiling face, or a friendly tone of voice, a 3-month-old infant will squeal with pleasure or laugh out loud. By 4 months, infants are very "talkative," cooing, babbling, and gurgling when spoken to. At 6 months, infants learn the art of imitating. They may imitate a parent's cough, for example, or say "Oh!" as a way of attracting attention.

The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which finding(s) is normal for this infant? Select all that apply. -heart rate 101 beats/min -respiratory rate 28 breaths/min -infant has moderate head lag -infant walks independently -temperature 100.6°F (38.1°C)

-heart rate 101 beats/min -infant walks independently -respiratory rate 28 breaths/min Explanation: The respiratory rate slows from an average of 30 to 60 breaths/min in the newborn to about 20 to 30 breaths/min in the 12-month-old infant. As the cardiovascular system matures, the average pulse rate decreases from 120 to 140 beats/min in the newborn to about 100 beats/min in the 12-month-old infant. Walking independently often occurs at 12 months of age. Head lag should not be present in a 12-month-old infant (usually not present by 4 months of age). A temperature of 100.6°F (38.1°C) is abnormal and could indicate an infection.

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? -The infant can be expected to display developmental skills consistent with a 8-month-old infant. -By 8 months of age, the child's skill level will vary greatly and cannot be predicted. -The infant will likely show the skills of an infant with the adjusted age of 7 months. -The infant will most likely present with developmental skills consistent with a 6-month-old infant.

-The infant will most likely present with developmental skills consistent with a 6-month-old infant. Explanation: When assessing the growth and development of a premature infant, the nurse will use the infant's adjusted age to determine expected outcomes. To determine adjusted age, the nurse subtracts the number of weeks that the infant was premature from the infant's chronological age. The infant who was born at 32 weeks' gestation was 8 weeks (or 2 months) premature. To determine the adjusted age, the nurse subtracts 2 months from the chronological age of 8 months: 6 months.

The nurse is assessing the respiratory system of a newborn. Which anatomic differences place the infant at risk for respiratory compromise? Select all that apply. -The bronchi and bronchioles are shorter and wider. -The tongue is smaller. -The larynx is more funnel shaped. -There are significantly fewer alveoli. -The trachea and chest wall are less compliant. -The nasal passages are narrower.

-The nasal passages are narrower. -The larynx is more funnel shaped. -There are significantly fewer alveoli. Explanation: In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel shaped, the tongue is larger, and there are significantly fewer alveoli. These anatomic differences place the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels of maturity until about 7 years of age.

The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child? -The newborn does not respond to a loud noise. -The newborn's eyes wander and occasionally are crossed. -The newborn becomes more alert with stroking when drowsy. -The newborn's eyes focus on near objects.

-The newborn does not respond to a loud noise. Explanation: Though hearing should be fully developed at birth, the other senses continue to develop as the infant matures. The newborn should respond to noises. Sight, smell, taste, and touch all continue to develop after birth. The newborn's eyes wander and occasionally cross, and the newborn is nearsighted, preferring to view objects at a distance of 8 to 15 inches. Holding, stroking, rocking, and cuddling calm infants when they are upset and make them more alert when they are drowsy.

A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? -Use the crib for sleeping only, not for play activities. -Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. -Let the baby cry during the night and she will eventually fall back to sleep. -Put the baby to bed at various times of the evening.

-Use the crib for sleeping only, not for play activities. Explanation: A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.

The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? -Cannot pull self to standing -Crawls with stomach down -Uses only the left hand to grasp -Picks up small objects using entire hand

-Uses only the left hand to grasp Explanation: Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks.

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone? -develop a fear of strangers -have many "blue" or moody periods -be able to turn over onto the back -insist on things being done the infant's way

-be able to turn over onto the back Explanation: At four months of age, the infant is able to lift the head and look around. The infant can roll from prone to supine. When being pulled up, the head leads. The 4-month-old infant can make simple vowel sounds, laugh aloud, and vocalize in response to voices. A fear of strangers does not occur until the child is older; a 4-month-old infant has not developed emotionally to have "moody" periods and is dependent on parental care.

The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance? -advising fluid intake per feeding of 5 or 6 ounces -advocating iron supplements with bottle-feeding -substituting cow's milk if breast milk is not available -discouraging the addition of fruit juice to the diet

-discouraging the addition of fruit juice to the diet Explanation: Discouraging the addition of fruit juice to the child's diet is the most effective anticipatory guidance. Fruit juice can displace important nutrients from breast milk or formula. Cow's milk is likely to result in an allergic reaction. If breast milk is not available, infant formula may be substituted. Advising fluid intake per feeding of 5 or 6 ounces is too much for this neonate, but is typical for an infant 4 to 6 months of age. Advocating iron supplements with bottle-feeding is unnecessary so long as the formula is fortified with iron.

A 6-month-old girl weighs 14.7 pounds (6.7 kg) during a scheduled check-up. Her birth weight was 8 pounds (3600 g). What is the priority nursing intervention? -increasing the number of breast-feedings -discussing the child's feeding patterns -talking about solid food consumption -discouraging daily fruit juice intake

-discussing the child's feeding patterns Explanation: Assessing the current feeding pattern and daily intake is the priority intervention. Talking about solid food consumption may not be appropriate for this child yet. Discouraging daily fruit juice intake or increasing the number of breastfeedings may not be necessary until the situation is assessed.

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: -looking for a toy in her crib at the last place she saw it. -pushing a spoon from her high chair tray to the floor. -smiling at herself in the mirror. -shaking a rattle to enjoy the sound.

-looking for a toy in her crib at the last place she saw it. Explanation: Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant's behaviors show use of her senses and motor activity but do not illustrate object permanence.

The nurse in a community clinic is caring for a 6-month-old infant and parent. Which nursing intervention is priority? -recommending higher-calorie solid foods -monitoring the infant's weight and height -obtaining the infant's current feeding pattern -encouraging a more frequent feeding schedule

-monitoring the infant's weight and height Explanation: Monitoring the infant's weight and height is the priority intervention. Ongoing assessments of growth are important so that too-rapid or inadequate growth can be identified early. With early identification, the cause can be diagnosed and the potential for further appropriate growth maximized. Encouraging a more frequent feeding schedule, obtaining the infant's current feeding pattern, and recommending higher-calorie solid foods are interventions that would be used should assessment show that the client's nutrition level does not meet body requirements.

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: -refer the infant for developmental and/or neurologic evaluation. -consider this a normal response for the age. -suggest more awake tummy time for the child. -conclude the earlier assessments carried out fatigued the infant.

-refer the infant for developmental and/or neurologic evaluation. Explanation: There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.

The best way for an infant's parent to help the child complete the developmental task of the first year is to: -keep the infant stimulated with many toys. -respond to the infant consistently. -talk to the infant at a special time each day. -expose the infant to many caregivers to help the infant learn variability.

-respond to the infant consistently. Explanation: The developmental task of an infant is gaining a sense of trust. The infant develops this sense from the caretakers who respond to the child's needs, such as feeding, changing diapers, being held. It is a continuous process. A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust. An infant is too young to have variability in caretakers. This causes mistrust. The parents or caretakers do not need a special time to talk to the infant each day. It should be done with each interaction. Providing too much stimulus before the infant develops gross motor skills causes frustration from the child and not enjoyment.

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: -is a protective reflex and retained for life. -should be pronounced and easy to elicit. -should have disappeared. -is expected to appear within 1 month.

-should have disappeared. Explanation: This primitive (not protective) reflex should be present at birth and disappear around age 4 months.

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? -cannot sit without assistance -reaches for nearby objects -rolls from prone to supine position -unable to support head

-unable to support head Explanation: An infant at 4 months of age who cannot support his or her head should be referred for evaluation. A 4-month-old infant should be able to reach for objects of interest and should be able to roll from a prone to a supine position. A 4-month-old infant is not able to sit alone without support.

The nurse in a pediatric clinic is reviewing the chart of an infant who is 12 months old. The infant weighed 8 lb 3 oz (3720 g) at birth. What does the nurse anticipate the infant's weight to be in kilograms if the infant meets normal growth expectations? Record your answer using one decimal place.

11.2 kg Explanation: Most infants triple their birth weight by 12 months of age. If the infant weighed 8 lb 3 oz (3720 g) at birth, triple that weight at 12 months would be 11160 g. 100 g = 1 kg; 11160 g = 11.16 kg, rounded to 11.2 kg.