Growth & Development
The mother of a 6-year-old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse?
"Children this age sometimes can't distinguish between fantasy and reality."
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?
"Delays are normal when a child is premature."
The parent of a 20-month-old todder reports the toddler has been becoming distraught when the parent leaves. The parent asks the nurse for advice about what is going on and how to best manage it. What information can be provided? Select all that apply.
"Establishing a routine for saying goodbye to your toddler will be helpful." "This is a normal happening for a toddler of this age." "As your toddler begins to learn that you will return the toddler will become less upset."
The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet?
"Give him more healthy choices with less junk food available."
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?
"He doesn't respond if I wave to him." The fact that the child does not respond when the mother waves to him suggests he may have a vision problem.
The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?
"He loves milk and drinks it every time he is thirsty." Excess milk drinking may lead to iron deficiency since the calcium in milk blocks iron absorption.
What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?
"I give my daughter juice at breakfast and when she is thirsty during the day."
The school nurse is teaching a group of 7-year-olds about proper dental hygiene. Which statement made by a 7-year-old indicates a good understanding of dental hygiene? Select all that apply.
"I will brush my teeth twice daily." "It's OK if I eat candy if I brush my teeth good." "I will drink water with fluoride for strong teeth."
A 10-year-old child tells the school nurse that she is embarrassed that she is afraid of the dark. Which is the best response by the nurse?
"It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?"
The mother of an 18-month-old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated?
"It is normal for children to engage in play alongside other children at this age."
The parents of a 3-year-old boy tell the nurse that they are having another baby in several months. They ask the nurse for suggestions to help their son adapt to the new baby. What would the nurse suggest?
"Let the child participate in caring for the new baby."
During a health history assessment, the mother of a 10-year-old girl tells you that her daughter does not have time to "play" because she is busy going to gymnastics, cheerleading, art class, flute lessons, reading club, and soccer. What should the nurse's response be?
"Play helps children to develop cognitively, socially, physically, and emotionally." It is important to recognize that the child is busy with other activities but that this does not replace the need to engage in play. Children need time to play because it helps them to develop cognitively, socially, physically, and emotionally. Play at this age embodies the needs for rules and structures. Engaging in group activities allows children to be part of a social group.
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?
"Set a good example. Wear your own seat belt every time you drive."
The mother of a 11-month-old has come to the clinic with concerns. She reports to the nurse that her baby's "soft spot in the front" is now gone. The nurse assesses the infant and notes the fontanel has closed. What response by the nurse is most appropriate?
"The soft spot or fontanel has closed." The anterior fontanel traditionally closes between 12 and 18 months. In some infants this may close sooner. This does not indicate there is any abnormality in the development of the infant.
The clinical nurse specialist is working with first-time parents of a newborn girl. Prior to discharge the parents demonstrate knowledge of care of their newborn with which statements? Select all that apply.
"We better get our rest when she is sleeping for these first few months." "I can't believe she is going to sleep 20 hours per day. I want to see her beautiful eyes." "I will most likely be awake every 1 to 3 hours breastfeeding during this first month or so."
The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response?
"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group?
"You have lots of hormone changes going on right now."
A mother asks the nurse where the microwave is so that she can warm up breastmilk to feed her baby. What is the best response by the nurse?
"You should warm the milk under warm water instead
A mother comes to the clinic with her 4-year-old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the client has a normal vocabulary for age. The nurse is aware that language for a 4-year-old consists of at least approximately how many words?
1500 words
A pediatric nurse is providing care to several children. The nurse is reviewing the assessment findings for each of the children. Which finding requires the nurse to intervene?
3-year-old preschool-aged child who goes up stairs on hands and knees At 3 years of age, a child should be able to climb the stairs one step up at a time or using alternating feet. If the child can only go up on hands and knees, further evaluation is needed.
During a well-child visit, the parents of an adolescent ask the nurse about how much physical activity their adolescent should engage in each day. The nurse would instruct the parents to encourage how many minutes of physical activity each day?
60
The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory?
A sense of competence, mastery, and worth
A nurse is caring for a 4-year-old child that will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement?
Allow the child to play with a procedure doll.
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
The nurse is caring for an 18-month-old child. The nurse is aware that the child is which stage according to Erikson?
Autonomy versus shame and doubt
Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.
Avoid having your child watch frightening shows on TV before bedtime." "Try using a night light in the child's room." "Try reading a favorite story before bedtime." "Set up some familiar bedtime rituals for your child."
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn?
Bathing is a time for bonding with the parents.
The caregiver of a 6-year-old expresses concern that the child cannot yet print the first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?
By the age of 6, most children can print some letters and maybe their first name."
The parent of a 2-year-old toddler tells the nurse needing to constantly scold the toddler for having wet pants. The parent says the toddler was potty trained at 12 months, but since starting to walk, the toddler wets the pants all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training It is probable that a toddler toilet trained at 12 months of age was not truly trained, because the infant would not be developmentally able to complete the task. It is most likely the parent used a training method of reminding the infant or placing the infant on a toilet frequently during the day. When the toddler begins to play independently, the toddler forgets the regimented schedule. This toddler is not toliet trained independently.
The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?
Document the findings as normal.
The nurse is talking to the parent of a 19-month-old toddler about setting limits and supervising activities. In which situation will the nurse recommend letting the toddler do as he or she pleases?
Exploring one's body
The family who are vegetarian voice concern that their child is not growing well. The nurse should suggest which food to increase the calcium intake for adequate bone growth?
Foods highest in calcium are green leafy vegetables, enriched breads, and cereals. Soybeans, legumes, grains, and immature seeds are high in protein. Oatmeal and quinoa are both high in protein. Sweet potatoes are high in fiber, vitamin A, and potassium.
The nurse is educating a new parent regarding nutritional needs for the newborn. Which is accurate and should be taught about the nutritional needs of a newborn?
Formula is designed to provide similar amounts of calories as breast milk would provide.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
The nurse is observing a 3-year-old boy in a day care center. Which behavior might suggest an emotional problem?
Has persistent separation anxiety
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?
Her vocabulary is between 10 and 15 words.
To gain cooperation from a toddler, what is the best approach by the nurse? Immediately pick the toddler up from the mother's lap. Kneel in front of the toddler while he or she is on the mother's lap. Do the nursing tasks quickly so the toddler can play. Ask the toddler if it is okay if you begin the needed task.
Kneel in front of the toddler while he or she is on the mother's lap.
A mother states that her 6-year-old has starting biting nails and regressing to baby talk since beginning school. What instructions are best for the nurse to give the mother regarding this behavior?
Make time each day to spend with the child individually.
The nurse is providing anticipatory guidance to the mother of a 2-month-old in relation to interpersonal development. Which behavior is most likely to occur over the next 8 weeks?
Mimicking mother's facial expressions
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 do not sit steadily until 8 months; this infant is normal.
A nurse is reading a journal article about adolescents and major causes of injuries in this age group. The nurse demonstrates understanding of this information by identifying which situation as the major cause of adolescent injuries?
Motor vehicle crashes
Once a temper tantrums has started, which intervention is appropriate?
Move objects out of the way or move the toddler to prevent injury
The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? You Selected:
Natal teeth noted in the mouth that are loose
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?
No teeth The first primary teeth typically erupt between the ages of 6 and 8 months.
A nurse is caring for a hospitalized 10-year-old child. What would be an appropriate activity for this child to meet the developmental tasks of this age group?
Participating in a craft project
A mother reports her 2-year-old daughter has gradually eaten more and more poorly since her 1-year-old well-child visit. The nurse assesses the child's growth and development as normal. What concept explains the mother's concern?
Physiologic anorexia
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?
Playing independently and are side by side
The nurse is supervising a play group of children on the unit. The nurse expect the toddlers will most likely be involved in which activity?
Playing with the plastic vacuum cleaner and pushing it around the room
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget?
Preoperational thought
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?
Reasoned with the child to stop the behavior
The clinic nurse is assessing a 9-month-old client. The parents state, "Our baby is having a really hard time teething." Which nursing action is appropriate?
Recommend the parents provide the infant a cold teething ring to chew
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?
Share that the heads of children at this age are large in proportion to the rest of their body.
Which milestone would the nurse expect an infant to accomplish by 8 months of age?
Sitting without support
The school nurse is reviewing the chart of a 12-year-old student who has had excessive absences due respiratory infections. What is the best action by the nurse?
Speak with the parents about the unusual increased number of respiratory infections In the school-age child the respiratory system continues to mature with the development of the lungs and alveoli, resulting in fewer respiratory infections.
The nurse is assessing the language development of a 3-year-old girl. Which finding would suggest a problem?
Speaks in 2- to 3-word sentences
What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother?
Specific program goals to be accomplished should be available.
A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply. You Selected:
Teach your children to say "no" to anyone whose touching makes them feel uncomfortable. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Urge children never to talk to or accept a ride from a stranger.
During an assessment, a preschool-aged child tells the nurse about having 12 siblings. The nurse is aware that the child has two older brothers. What would be the nurse's best response?
That is a good pretend answer but tell me the names of the brothers you really have."
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
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?
The adolescent's need for privacy should be respected.
The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child?
The child demonstrates separation anxiety.
In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching?
The child hides behind her bedroom door when defecating
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 does not pay attention to noises behind him. The infant seems disinterested in the surrounding environment. The infant has frequent episodes of crossed eyes.
The student nurse is reviewing the chart of a newborn. The document indicates the newborn is in the quiet alert state. Which is the best description of this sleep phase?
The newborn's eyes are open and no body movements are noted.
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?
The respirations of a 1-month-old infant are normally irregular and periodically pause.
A 2-year-old is having a temper tantrum. What advice should the nurse give the mother? For safety reasons, the toddler should be restrained during the tantrum. Punishment should be initiated, as tantrums should be controlled. The mother should promise the toddler a reward if the tantrum stops. The tantrum should be ignored as long as the toddler is safe.
The tantrum should be ignored as long as the toddler is safe.
The mother of a 14-year-old girl voices concerns that her daughter is likely to be not getting enough nutrients. How many calories should be ingested by the teen daily?
The teen girl who is active should consume about 2000 calories per day.
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler?
The toddler should speak in two-word sentences ("Me go").
Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply.
When discussing improper behavior, call the behavior "bad" or "naughty," not the child. Anticipate situations likely to cause misbehavior and redirect the child to another activity.
which age group is most concerned with body integrity? a. toddler b. preschool c. school age d. adolescent
c. school age (what does my body do?, speaks to logic...can live without appendix)
A school-aged child develops school phobia. When counseling her mother, the nurse would advise her that the accepted action is to:
make her child attend school every day.
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:
preoccupation with death and dying is common in the school-aged child.
A mother tells the nurse she is having difficulty getting her 6-year-old to do chores. Based on the child's developmental level, what activity would be best for the nurse to recommend to the mother?
putting books on shelf
8-9 month old have
stranger danger
A mother calls the clinic nurse asking for recommendations on comfort measures for her infant who is teething. What recommendation should the nurse make? Select all that apply.
teething rings acetaminophen
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to:
testing and identification of group role. Although 4-year-olds continue to enjoy play groups, they may become involved in arguments more than they did at age 3, especially as they become more certain of their role in the group. This development, like so many others, may make parents worry a child is regressing. However, it is really forward movement, involving some testing and identification of their group role.
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?
The development of a 3-month-old
A 2-month-old infant has inconsolable crying, is gassy, and constantly draws the legs up. It has been determined that the infant has colic. What intervention should the nurse recommend to treat colic?
The infant is bottle fed, so the parent needs to try a different formula to assess for sensitivity. Correct response:
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response?
as soon as the first tooth erupts
which statement describes a toddler's cognitive devleopment at 20 months? a. searches for an object only if he or she sees it being hidden b. realizes that "out of sight" is not out of reach c. puts ovbjects into a container but cannot take them out d. understands the passage of time such as "just a minute," and "in an hour"
b. realizes that "out of sight" is not out of reach a. object permenance is est 8-12 M c. under 12 months d. preschool/school understands passage of time
what is an important consideration for the nurse who is communicating with a very young child? a. speak loudly, clearly, & directly b. use transition objects such as a doll c. disguise own feelings, attitudes, & anxiety d. initiate contact with child when parent is not present
b. use transition objects, such as a doll not, because a. they are not deaf, come off as "not nice" d. need parent to feel safe
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?
be able to turn over onto the back
a 10-y/o is to be hospitalized for several weeks. The most appropriate activity to promote development for the nurse to include when planning diversionary activities would be:
encouraging continuation of school work
The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as problematic, as it interferes with needed nursing care. normal for this stage of growth and development. normal because the child is hospitalized and out of his routine.
normal for this stage of growth and development (negativism)
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
object permanence.
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:
parallel play
The best way for an infant's parent to help the child complete the developmental task of the first year is to:
respond to the infant consistently.
What is the best advice about nutrition for the toddler? Encourage cup drinking and give water between meals and snacks. Encourage unlimited milk intake, because toddlers need the protein for growth. Avoid sugar-sweetened fruit drinks and allow as much natural fruit juice as desired. Allow the toddler unlimited access to the sippy cup to ensure adequate hydration.
Encourage cup drinking and give water between meals and snacks. wean to cup by 12 - 15 M, real fruit juice 4 - 6 oz/day, milk 16 - 25 oz/day, and give it with meals and snacks
A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?
Restrain the baby in a car seat.
Which is the best way for parents to aid a toddler in achieving the developmental task?
allow the toddelr to make simple decisions Allowing the child to make decisions is a good way to help the toddler achieve autonomy and gain independence.
A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed?
Drinking sodas is not related to my blood pressure." Drinking soda regularly increases the amount of sodium intake daily, thus having an impact on the blood pressure.
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?
I am so glad I can get rid of all of those bath toys because they take up so much room." Bath toys that squeak, float and squirt are appropriate toys for preschoolers. Creative toys like crayons, chalk and finger paints; gross motor toys like tricycles, big wheels and swing sets; and a sandbox with shovels and other toys for building are also appropriate toys for preschoolers.
A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that her breathing will be obstructed. The girl has no pain, fever or other symptoms. Following this data collection, which instruction is best?
This may be normal growth of lymphatic tissue for this age."
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:
having the child wear a personal flotation device whenever near or on the water. 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.
The developmental task of the school-aged period, according to Erikson, is gaining a sense of:
industry versus inferiority.
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.
A 2-year-old toddler holds the breath until passing out when the toddler wants something the parent does not want the toddler to have. The nurse would base evaluation of whether these temper tantrums are a form of seizure on the basis that:
seizures are not provoked; temper tantrums are
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 caregivers of a 2-year-old are concerned the child is not learning how to share and play well with other children. While acknowledging their concern and devotion, the nurse should point out which activity would be best for this child's developmental level?
Mowing the lawn with a toy lawnmower Toddlers enjoy talking on a play telephone. They like pots, pans, and toys such as brooms, dishes, and lawnmowers that help them imitate the adults in their environment and promote socialization. Toys that involve the toddler's new gross motor skills, such as push-pull toys, rocking horses, large blocks, and balls are popular. Fine motor skills are developed by use of thick crayons, modeling clay, finger paints, wooden puzzles with large pieces, toys with pieces that fit into shaped holes, and cloth books. The toddler will not be interested in sharing toys until the later stage of toddlerhood; adults should not make an issue of sharing at this early stage.
A mother is concerned because her 14-month-old son, who had a big appetite when breast-feeding a few months ago, seems uninterested in eating solid food. She still breast-feeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother?
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
In girls, what is the initial indication of puberty? a. menarche b. growth spurt c. growth of pubic hair d. breast development
d. breast development (Tanner stages)
school age children need explanations in
concrete terms
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?
Bottles given at bedtime can cause erosion of the enamel on the teeth
The student nurse is preparing a presentation on signs of developmental delay in preschoolers. Which examples of delays should be included? Select all that apply.
Potential signs of delays include a 4-year-old that does not use sentences with three or more words, not five or more words. A 4-year-old that cannot use the words "me" and "you" appropriately and a 5-year-old that is often unhappy or cannot use plurals or past tense when speaking are all signs of developmental delay.
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? You Selected:
Sitting independently
The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?
a sense of security as children gain independence
The nurse working in an adolescent clinic in a large city should be aware that the best avenue for communication with an adolescent would be
establishing a relationship over time
A toddler's parents want to begin toilet training. As a rule, the best instruction the nurse could give them is:
bowel training is easier than urine training.
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? a. "Start brushing her teeth after all the baby teeth come in." b. "Use a washcloth with toothpaste to clean her mouth." c. "Clean your baby's gums, then new teeth, with a washcloth." d. "Rinse your baby's mouth with water after every feeding.
c. "Clean your baby's gums, then new teeth, with a washcloth."
The predominant characteristic of the intellectual development of the child ages 2 to 7 years is egocentricity. What best describes this concept? a. Selfishness b. Self-centeredness c. Preferring to play alone d. Inability to put self in another's place
d. inability to put self in another's place
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate?
"What does his stool look like?"
The nurse goes in to check on a new mother to see how breast-feeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse?
"You are doing a wonderful job attempting to wake the baby."
The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?
"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth."
The mother of a preschooler reports that her daughter seems to believe in magic. She voices concern that this "fantasy world" may become a problem. What response by the nurse is indicated? Select all that apply.
"Your daughter is engaging in what we call magical thinking." "This type of thought process allows your daughter to begin to observe the differences in the world."
A 5-y/o girl is receiving a course of chemo. One day the nurse observes the child crying. The child tells the nurse, "Alll my hair is gone & everyone states at me." The nurse's most appropriate response would be:
"why don't we ask your mother to bring in a hat for you to wear until your hair grows back?"
The infant weighs 7 lb 4 oz (3,248 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?
21 lb 12 oz (9.9 kg)
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 would the nurse prepare to document for this visit?
24 pounds (10.8 kg) and 30 inches (75 cm)
The nurse is reviewing sleep and rest activities of a 16-month-old child with the parents. The father states, "I have told my wife it is unhealthy for our child to sleep with us. It's time for him to sleep in his own bed. What do you think?" What is the nurse's best initial response?
"It must be difficult for the two of you to both feel strongly about what is best for you and your child."
The nurse is assessing a 2-year-old boy during a well child visit. The nurse correctly identifies the child's current stage of Erickson's growth and development as:
Autonomy versus shame and doubt
A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?
In two months you can try bananas if you think she is ready."
The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?
Newborn
The parents of a 30-month-old toddler have brought the toddler into the emergency department because of a seizure. During the health history, the nurse suspects the toddler had a breath-holding spell. Which parental report suggests breath-holding?
a tantrum preceeded the event
you tell the parent of a 4 y/o being admitted that you need to ask some questions. She ask "why do you have to ask so many questions?" which explanation should you offer? SATA a. it's something we are required to do for every child who is in the hospital b. by learning about your child's routines, we can try to minimize some of the changes he will be going through c. knowing more about your child can help predict how the hospital stay will go & will also help us choose a good roommate for him when more children arrive at the hospital d. gaining more info about our child, such as current meds, will help us provide the best care e. this will give you an opportunity to ask questions as well
a. it's something we are required to do for every child who is in the hospital b. by learning about your child's routines, we can try to minimize some of the changes he will be going through d. gaining more info about our child, such as current meds, will help us provide the best care e. this will give you an opportunity to ask questions as well
what is probably the single most important influence on growth at all stages of development? a. nutrition b. heredity c. culture d. environment
a. nutrition
When introducing hospital equipment to a preschooler who seems afraid, the nurse's approach should be based on which principle? a. The child may think the equipment is alive. b. The child is too young to understand what the equipment does. c. Explaining the equipment will only increase the child's fear. d. One brief explanation is enough to reduce the child's fear.
a. the child may think equipment is alive (magical thinking)
Although a 14-month-old girl received a shock from an electrical outlet recently, her parent finds her about to place a paper clip in another outlet. Which of the following is the best interpretation of this behavior? a.Her cognitive development is delayed. b.This is typical behavior because toddlers are not very developed. c.This is typical behavior because of inability to transfer knowledge to new situations. d.This is not typical behavior because toddlers should know better than to repeat an act that caused pain.
this is typical behavior because of inability to transfer knowledge to a new situation (Piaget)
The nurse is explaining safety precautions for toddlers to the mother of a normal 30-month-old boy. Which activity might the nurse suggest may be done without supervision?
undressing himself
the primary care nurse, assigned to a 4 M/o infant admitted to the hospital, understand that the infant's emotional development should make the infant
welcome the attention that the nurse gives her
A group of caregivers of toddlers are discussing the form of discipline in which the toddler is placed in a "time-out" chair. Which statement made by these caregivers is most appropriate related to this form of discipline?
"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out."
A mother takes her 4-month-old to the doctor for a visit. She asks the nurse what type of baby cereal she should buy now that her child is starting solid foods. How should the nurse respond?
"You should buy rice cereal."
An infant has been brought to the clinic for a well-child check. The infant is 12 months of age. The child's birth weight was 6 pounds, 7 ounces. What is the anticipated weight for the child at this visit? You Selected:
19 pounds, 5 ounces
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?
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."
The mother of a 15-month-old is concerned about a speech delay. She describes her toddler as being able to understand what she says, sometimes following commands, but using only one or two words with any consistency. What is the nurse's best response to this information? The toddler should have a developmental evaluation as soon as possible. If the mother would read to the child, then speech would develop faster. Receptive language normally develops earlier than expressive language. The mother should ask her child's physician for a speech therapy evaluation.
Receptive language normally develops earlier than expressive language.
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 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.
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 will most likely present with developmental skills consistent with a 6-month-old infant.
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? You Selected:
They put her to bed when she falls asleep.
which accomplish would a nurse expect of a health 3 y/o: a. jump rope b. ride a 2 wheeled bike c. skip on alternate feet d. balance on one foot for a few seconds
d. balance on one foot for a few seconds appropriate when a. jumping rope= 5 Y b. 2 wheel bike = school age c. skip on alternated feet = school age
which of the following are functions of play? SATA: a. provides diversion & brings about relaxation b. keeps the child occupied & directs concerns away from himself or herself c. helps the child feel more secure in a strange environment d. lessens the stress of separation & the feeling of homesickness e. provides a means for release of tension & expression of feelings f. allows the parents to have a break from the unit for a respite period.
a. provides diversion & brings about relaxation c. helps the child feel more secure in a strange environment d. lessens the stress of separation & the feeling of homesickness e. provides a means for release of tension & expression of feelings
when discharging a pediatric pt, which response indicates a need for more teaching? SATA: a. the physician said my son can have clear liquids when we return home, which would include Jell-o, pudding, & apple juice b. the other nurse explained that I can use other things to help with pain, such as distration (reading a book, music, or a movie), after the pain medication is given c. I can get my child's RX tomorrow, so I'll go to my regular pharmacy where they can explain the med to me d. I am waiting for my husband to come, he'll drive so I can watch my son in the car on the way home. e. I understand I will be contact tomorrow for a follow-up but I should not hesitate to call if I have concerns before then.
a. the physician said my son can have clear liquids when we return home, which would include Jell-o, pudding, & apple juice c. I can get my child's RX tomorrow, so I'll go to my regular pharmacy where they can explain the med to me
The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is: a. "She just needs love and attention. Don't worry; she's too young to spoil." b. "Consistently meeting the infant's needs helps promote a sense of trust." c. "Infants need to be fed and cleaned; if you're sure those needs are met, just let her cry." d. "Consistency in meeting needs is important, but you're right, holding her too much will spoil her."
b. "Consistently meeting the infant's needs helps promote a sense of trust."
Binocularity, the ability to fixate on one visual field with both eyes simultaneously, is normally present by what age? *a.* 1 month. *b.* 3 to 4 months. *c.* 6 to 8 months. *d.* 12 months.
b. 3-4 months, (when do you expect a baby to recognize mom?)
the nurse is taking a sexual hx on an adolescent girl. The best way to determine whether she is sexually active is to: a. ask her, "are you sexually active?" b. Ask her, "Are you having sex with anyone?" c. Ask her, "are you having sex with a boyfriend?" d. Ask both the girl & her parent if she is sexually active.
b. Ask her, "Are you having sex with anyone." not, because a. could be masturbation d. may not get a true answer
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? a. It is permissible to substitute cow's milk for formula at this age as he is so close to 1 year old. b. Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant. c. As long as the mother provides whole milk, rather than skim, she can start cow's milk in infancy. d. If the mother cannot afford the infant formula, she should dilute it to make it last longer.
b. Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant.
what is descriptive of the preschooler's understanding of time? a. has no understanding of time b. associates time with events c. can tell time on a clock d. uses terms like "yesterday" appropriately
b. associates time with events a. no understanding = infants c. can tell time on clock = school age d. yesterday appropriately = school age
By the time children reach their twelfth birthday, they should have learned to trust others and should have developed a sense of: a. Identity. b. Industry. c. Integrity. d. Intimacy.
b. industry a. adolescent d. young adult
the nurse observes some children in the playroom. which play situation exhibits the characteristics of parallel play? a. 2 children sharing clay to each make things b. one child laying with his truck next to another child playing with a truck c. 4 children playing a board game together d. a child playing with a music box on her mother's lap
b. one child playing with his truck next to another child playing with a truck a. cooperative play c. cooperative play d. solitary play
what is characteristic of the preoperational stage of cognitive developement? a. thinking is logical b. thinking is concrete c. reasoning is inducive d. generalization can be made
b. thinking is concrete
while orienting a new nurse to the ICU, she asks, "how do these children sleep & not become frightened with all the lights & noises?" how should you respond? SATA: a. these children are sicker than those on the peds unit, so the noises & lights are necessary b. we try to organize care into clusters so that infants & children can sleep & we can turn down the lights c. we silence alarms to allow for periods of sleep, esp at night d. when possible, we allow for uninterrupted sleep cycle-for infants 90 M & for older children 60 M e. we encourage parents to site with and touch their child as often as possible
b. we try to organize care into clusters so that infants & children can sleep & we can turn down the lights e. we encourage parents to site with and touch their child as often as possible
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? a. Crying when left with the sitter may indicate difficulty with building trust. b. Stranger anxiety should not occur until toddlerhood; this concern should be investigated. c. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. d. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.
c. Separation anxiety is normal at this age; the infant recognizes parents as separate beings.
which stress reaction corresponds to the adolescent stage? a. refusal to eat, difficulty sleeping, crying quietly, continually asking when the parents will vistit, or withdrawing from others. b. separation anxiety comes in stages: protest, despair, and detachment c. loss of peer group contact may pose an emotional threat because of loss of group status, inability to exert group control or leadership, & loss of group acceptance d. may need & desire guidance or support from other adults but may be unable or unwilling to ask for it.
c. loss of peer group contact may pose an emotional threat because of loss of group status, inability to exert group control or leadership, and loss of group acceptance. not, because a. toddlers b. toddler/preschool
a nurse is caring for an adolescent hospitalized for cellulitits. The nurse notes that the adolescent experiences many "mood swings" throughout the day. The nurse interprets the behavior as: a. reguiring a referral to a mental health counselor b. requiring some further lab testing c. normal behavior d. related to feeling of depression
c. normal behavior
identifyy a psychosocial developmental task of toddlerhood a. development of a conscience b. recognition of sex differences c. ability to get along with age mates d. ability to withstand delayed gratification
d. ability to withstand delayed gratification a. conscience begins with preschool age b. sex difference is apprx. 2 y/o but not a developmental task c. get along with age mates is preschool
when planning care for adolescents, the nurse should consider which intervention? a. teach parents first, and they, in turn will teach the teenager b. provide info for the long-term health needs - teenagers respond best to long-range planning c. maintain the parents' role by providing explanation for tx & procedures to the parents only d. give info privately to adolescents about how they can manage specific problems that they identify
d. give info privately to adolescents about how they can manage the specific problems that they identify
a parent asks the nurse about how to respond to nefativism in toddlers (asserting autonomy). what is the most appropriate recommendation? a. punish the child b. provide more attention c. ask child not always to say "no" d. reduce the opportunities for a "no" answer
d. reduce the opportunities for a "no" answer -- they need choices, give choices that you can live with b. giving more attention, lets the child est control
the mother of a 3 month old boy asks the nurse about starting solid foods. What is the most appropriate response? a. it is okay to start pureed solids at this age if feed via bottle b. infants don't require solid food until 12M c. solid foods should be delayed until age 6 M, when the infant can handle a spoon on his own d. the tongue extrusion reflex disappears at age 4 - 6 M, making it a good time to start solid foods
d. the tongue extrusion reflex disappears at age 4 -6 M, making it a good time to start solid foods
what is the characteristic of dishonest behavior in children 8 - 10 y/o? a. cheating during games is now more common b. lying results form the inability to distinguish between fact & fantasy c. they may steal because their sense of property rights is limited d. they may lie if they feel they don't measure up to expectations set by others
d. they may lie if they feel they don't measure up to expectations set by others a. won't cheat bc they want to do it right b. inability to distinguish fact from fantasy is preschool
