Growth and Development of the Neonate and Infant

What consequences may result if an infant's needs are ignored by the parent? 1.Feelings of insecurity 2.Emotional resilience 3.An early development of independence 4.Inappropriate survival mechanism development

1 (If the infant's needs are not met, the child will develop feelings of insecurity at an early age, which can continue throughout life, along with a feeling of dissatisfaction) rationales: -If the child's needs are ignored, this can have an impact on the child's growth and development. This will not help the child develop emotional resilience. -The infant will not develop a level of independence if the needs are ignored. Later in childhood development is when the child will start to develop some autonomy but even then the child's needs cannot be ignored. -The infant does not have an innate survival mechanism and will need the love and care of the parent in order to survive and develop a secure relationship with the parent.

Which statement can the nurse use to educate the parent on leaving a child who shows emotional distress when having to leave the parent? 1. Separations should be accomplished swiftly without dwelling on the separation. 2. The mother should reciprocate and show the child that she too is emotionally a bit upset. 3. Separations should not be done too fast as this can create emotional turmoil in the child. 4. Separations should be accomplished swiftly, and with repeated emphasis on reassuring the child that the mother will return shortly.

1 (This statement suggesting the parent leave swiftly, yet with care, would help the parent-child interaction where the child is upset at leaving the mother) rationale: -If the mother shows this type of behavior, it can make the child a bit more emotionally upset. -Suggesting this type of departure can create more emotional distress in a child experiencing some separation anxiety, therefore this suggestion would not be helpful. -This statement should not be mentioned to the parent as an emphasis on reassuring the child at separation can create a stronger emotional response.

Which important anticipatory guidance would parents need to learn prior to the development of the infant's pincer grasp (around 9 months of age)? 1. Electrical outlets should be covered with socket safety panels. 2. Parents should place stove pot handles away from the child's reach. 3. Parents should keep unsafe objects locked out of reach of the infant. 4. The infant's food items should be cut into small, manageable pieces. 5. Parents should place hand protectors on the child to help protect them from injury.

1,2,3,4

A mother has brought in her infant for the infant's 6-month well-child checkup. You notice the infant's left eye intermittently not aligning with the right eye and an inability to focus both eyes on the same spot. What is the appropriate response? 1. Ensure the infant's "red reflex" is normal. 2.Place the infant in isolation as this can be a sign of conjunctivitis. 3.Do nothing, as infants do not gain extraocular eye coordination until 9 months of age. 4. Stress the importance of eye exercises to help prevent worsening of the condition. 5. Notify the child's provider, as extraocular eye alignment should be achieved by 6 months of age.

1,5 -This is an important part of any pediatric eye exam. -Infants under 3 to 4 months of age often lack eye coordination and alignment but should achieve proper coordination by age 4 to 6 months. By 3 months, infants should be able to track and reach for objects as their eye-hand coordination begins to develop.

A mother of a 3-month-old infant is requesting information on the motor milestones she can expect to see in her child. The nurse can tell the parent to expect to see which activities at 3 months? 1. Puts foot in mouth 2. Places hand in mouth 3.Turns from back to abdomen 4.Turns from abdomen to back 5. Can lift head off bed in prone position.

2 (The nurse can tell the parent that at 3 months the child will attempt to place their hand in the mouth) 5 (By 3 months the infant should be able to lift the head off a bed in prone position, so the nurse can tell the parent to expect this activity) ratonale: -By 3 months the child will not place foot in mouth, but rather this activity will be seen at 5 months. -The child will not be able to turn from back to abdomen at 3 months. This activity will be seen at around 6 months of age. -By 3 months the child will not yet be able to turn from abdomen to back. This activity will be seen by 4 and 5 months of age.

The nurse is observing a mother who is interacting with her infant and notices the infant trying to imitate the sounds that the mother is making. The nurse knows that the child must be at least what age? 1. 3-4 months 2.4-6 months 3.6-8 months 4.1-3 months

3 (An infant who is 6-8 months of age will be able to imitate the sounds the mother is making and therefore the nurse knows the patient must be at least this age) rationale: -A child at 3-4 months will not be imitating sounds that the mother is making. The infant will be making mostly babbling sounds to self. -At 4-6 months the child may repeat sounds to self but at this age will not be imitating sounds. -When a child is 1-3 months old they will enjoy making sounds and will respond to voices but will not be imitating the mother's sounds.

Parent--infant attachment is the most important association for which type of development? 1. Biological 2. Physiological 3. Psychosocial 4. Sociocultural

3 (Psychosocial development needs to be reinforced in the infant's life. This is one of the most important aspects in the development of parent-infant attachment) rationale: - The innate or biological development is going to depend on the parent-infant attachment but is not the most important factor involved. -Parent-infant attachment will influence physiological development but the parent-infant attachment will influence a more important aspect of the child's development. -Parent-infant attachment will have an influence on a child's social development, but this attachment will have a stronger effect on another, more important aspect of infant development.

A new mother at the clinic asks at what age her baby will be able to actively participate in a game of pat-a-cake with her. Which would be the correct response from the nurse? 1. 4 months 2. 6 months 3. 9 months 4. 12 months

4 (At 12 months the child is likely to participate in pat-a-cake with the mother. This is considered a critical developmental milestone) rationales: -A 4-month-old will not likely play a clapping game with the parent. The child would more likely watch a mother and smile as she clapped. -At 6 months, a mother can begin to engage the child in pat-a-cake, but the child will more likely reach for the mother's hand rather than clap the hand and participate actively. -At 9 months, the child will want to reach and touch the mother's hand but will not likely engage in a clapping game.

A mother brings her 5-month-old infant to the clinic and is concerned that the child does not seem to smile as much as her niece, who is the same age. How will the nurse respond? 1. This is normal as you can expect to see a smile at 6 months of age. 2.All children start to smile at a different age, so be patient. There is no need to worry. 3.This is a concern since the child should be showing a social smile by no later than 1 month of age. 4.This is a concern since the child should be showing a social smile by no later than 3 months of age.

4 (Since the child should be showing a social smile by no later than 3 months, this is the correct response that the nurse should make to this parent) rationale: -Suggesting the child should start to smile at 6 months is not accurate and therefore this is not how the nurse should respond to the parent. -Telling the parent that all children begin smiling at different ages is not the appropriate response. There are social milestones that parents can expect to see through infancy. -Suggesting that the child should be smiling by 1 month is not the correct information and therefore is not how the nurse should respond to the parent.

How can the parent-infant attachment be strengthened immediately after birth? 1. The mother needs to have time alone to ensure she does not overwhelm the child. 2. A mother should cuddle with the baby but allow the child to cry alone if the baby is upset. 3. The mother should give the infant some space to allow for natural biological development. 4. Reciprocal interactions that include holding the child, touching the child, and speaking gently to the child.

4 (This is an example of how the parent-infant interaction can be strengthened after birth and therefore a lot of positive physical and emotional interactions between the parent and child should be encouraged) rationale: -Instead of spending time alone, the mother or parent should be encouraged to shower the infant with love to ensure a strong parent-infant attachment. -This action does not describe what is expected between the parent and the child. If the baby begins to cry, the mother should respond promptly and be sure to answer the baby's cries. -If the mother gives the infant space after birth, this will not encourage or strengthen the parent-infant attachment.

Which series of activities best reflects the motor development of an infant from 1 month of age to 4 months? a. At 4 months, the rooting reflex disappears. b.At 1 month, the child will hold a fist tightly clenched. c.At 3 months the child will be able to crawl a minimal distance. d.At 3 months the child will be able to lift the head 90 degrees from a prone position. e.At 4 months the child can hold the head steadily erect in a sitting position.

a,b,d,e - There are several primitive reflexes that disappear after the first year of life. The Moro reflex and the rooting reflex will disappear by 4 months of age. -At one month the child will keep the hand clenched and this will start to change by 2 months of age. -The muscle strength in the baby's head by 3 months of age will allow for lifting to 90 degrees in a prone position. -At four months a child has motor development sufficient enough to hold the head erect in the sitting position. rationales: This motor development will not usually be seen between 1 and 4 months of age. Crawling is more likely to be seen by 6 months of age.

A weight gain of 1.49 lb (0.68 kg) per month is expected from birth until which month? a. 6 months b. 8 months c. 10 months d. 12 months

a. An infant is expected to gain 1.49 lb (0.68 kg) per month from birth until 6 months. rationale: - A weight gain of 1.49 lb (0.68 kg) per month is not expected from birth until 8 months. -An infant is not expected to gain 1.49 lb (0.68 kg) per month from birth until 10 months. -A weight gain of 1.49 lb (0.68 kg) per month is not expected from birth until 12 months.

A mother of a 10-month-old comes to the nurse concerned that her child has had two upper respiratory infections in one month and asks if something is wrong with her child. How can the nurse respond? a. To prevent infection the infant will need prophylactic antibiotics. b. Infants have an immature immune system, which makes them susceptible to infections. c. An infant's immune system should be developed by 6 months and so the child needs further evaluation. d. The infant's infections are a sign that the child will develop asthma.

b. Telling the parent that the child has an immature immune system, making them more susceptible to infection, will be the best explanation for the nurse to give the parent. The nurse can explain to the parent that the airways are small and collapsible, making it easier for pathogens to cause an infection. rationales: -Offering prophylactic antibiotics will not be the best way to respond to the parent. The parent should be reassured that this can be normal for a child who is this age. -Suggesting the child should have a fully developed immune system by 6 months is not accurate and therefore it is not the best explanation to give the parent. -Telling the parent that the infections are a sign that the child will develop asthma is not accurate and therefore this is not the best response to give the parent.

At which age should infants achieve proper eye coordination? a. Infants should achieve proper eye coordination by 2 weeks to 1 month. b. Infants should achieve proper eye coordination by 1-2 months. c. Infants should achieve proper eye coordination by 2 to 4 months. d. Infants should achieve proper eye coordination by 4 to 6 months.

d. Infants under 3-4 months of age often lack eye coordination and alignment but should achieve proper coordination by 4 to 6 months. By 3 months infants should be able to track and reach for objects as their eye-hand coordination begins to develop. rationale: - Two weeks of age is not the time that proper eye coordination can be expected to occur. At this age there will be little coordination and the eyes will appear to wander. -At 1-2 months, an infant lacks eye coordination and the eyes may seem to wander or appear crossed. -At this age the infant's nerves and muscles are still underdeveloped, therefore the infant lacks eye coordination and the eyes may seem to wander or appear crossed.

The mother of a newborn child enquires about having her child's hearing checked. What is the best response by the nurse? a. All newborns should be screened before 1 year of age. b. At 6 months you can return and we will screen your infant. c. Your newborn will be screened at the four-month well-baby visit. d. All newborns should be screened for hearing before one month of age.

d. Stating that the child will be screened for hearing before one month of age is accurate and therefore this is the best response for the nurse to make. rationales: -Suggesting all newborns be screened before 1 year of age is not the correct advice, therefore this is not the response the nurse should give. -Telling the mother to return at 6 months is not the appropriate advice to give and therefore should not be the response made by the nurse. -Suggesting the mother have her baby screened at 4 months is not accurate and therefore not the best response.