Nursing Care of Children "Moderate"

A nurse is providing education about the introduction of solid foods for the parent of an infant. Which of the following instructions should the nurse include? A. Begin after the extrusion reflex has diminished B. Introduce solids between 2 and 3 months of age C. Wait until the infant's first tooth erupts D. Add a sweetener such as light corn syrup to bland foods

A. Begin after the extrusion reflex has diminished The nurse should explain that the extrusion reflex results in food being pushed out of the mouth instead of being swallowed. The tongue extrusion reflex diminished after 4 months of age. - B: Prior to 4 to 6 months of age, the infant's digestive tract is too immature to digest complex nutrients and has increased sensitivity to potential food allergens. Solid foods should not be introduced before 4 to 6 months of age. - C: Tooth eruption occurs at 8 months of age, on average. Solids can be introduced before the eruption of the first tooth, as infants do not have to chew the initial foods introduced. - D: The parents should not add corn syrup or honey to the infant's food. Both corn syrup and honey may contain botulism spores, which can lead to infantile botulism.

A nurse is caring for a preschooler who has a terminal illness. The nurse should expect the preschooler to have which of the following perspectives about death? A. Believes that her own thoughts can cause death B. Has an understanding of the finality of death C. Exhibits curiosity about what happens to the body after death D. Views funeral services as unnecessary

A. Believes that her own thoughts can cause death The nurse should expect preschoolers to believe that their own thoughts or actions can cause death, and they might believe that death is a punishment for wrong-doing. - B: The nurse should expect a preschooler to view death as a temporary occurrence like sleeping. The preschooler might believe the person can "wake up" again. - C: The nurse should expect a school-aged child to be curious about what happens to a body following death, not a preschooler. - D: The nurse should expect an adolescent, not a preschooler, to reject traditions surrounding death such as funeral services as unnecessary or unimportant.

A nurse is assessing a child who is postoperative and received a unit of packed RBCs during a surgical procedure. Which of the following findings indicates the child is experiencing a hemolytic transfusion reaction? A. Chills and flank pain B. Pruritus and flushing C. Rales and cyanosis D. Bradycardia and diarrhea

A. Chills and flank pain Chills and flank pain indicate an incompatibility of the transfused blood product with the client's blood. The nurse should identify that the child is having a hemolytic reaction. - B: Pruritus and flushing indicate a response to allergens present in the transfused blood product. The nurse should identify that the child is having an allergic reaction. - C: Rales and cyanosis indicate the blood product might have been administered too quickly. The nurse should identify these findings as an indication the child is experiencing fluid overload. - D: Bradycardia and diarrhea indicate a complication due to the transfusion of large amounts of blood or a problem with the kidneys. The nurse should identify these findings as an indication the child is experiencing an electrolyte imbalance.

A nurse is teaching the parent of an infant about food allergens. Which of the following is the most common food allergy in children? A. Cow's milk B. Wheat bread C. Corn syrup D. Eggs

A. Cow's milk According to evidence-based practice, cow's milk is the most common food allergy in children. Some children are sensitive to the protein casein found in cow's milk. They have difficulty metabolizing casein and are, therefore, allergic to cow's milk.

A nurse is caring for a female adolescent who is being treated for frequent UTIs. Which of the following statements by the adolescent indicates a possible cause of the UTIs? A. I have bowel movements every 4 to 5 days B. My mom taught me to wipe from front to back after going to the bathroom C. I urinate every 2 to 3 hours during the day D. I don't wear nylon underwear

A. I have bowel movements every 4 to 5 days The nurse should identify that this frequency of UTIs indicates the adolescent is constipated. Therefore, large stool masses might prevent complete emptying of the bladder and lead to urinary stasis and infection. - B: The adolescent will improve perineal hygiene by wiping from front to back, which decreases the likelihood of a UTI. - C: Emptying the bladder every 2 to 3 hours prevents urinary stasis and infection. - D: The adolescent should wear cotton underwear to help prevent UTIs, as nylon underwear is more likely to trap bacteria in the genital area of a female client.

A nurse is providing dietary teaching to the parent of a child who has cystic fibrosis. Which of the following dietary recommendations should the nurse make? A. Increase the child's protein intake B. Decrease the child's calorie intake C. Increase the child's fiber intake D. Decrease the child's salt intake

A. Increase the child's protein intake The nurse should recommend an increased protein intake for the child who has cystic fibrosis. These children require up to 150% of the recommended daily allowance to meet their nutritional needs. - B: The calorie intake for a child who has cystic fibrosis should be increased, not decreased. - C: Increasing the child's fiber intake could increase bulk, and malabsorption might occur; therefore, it is not indicated for this child. - D: Decreasing the child's salt intake is not indicated for cystic fibrosis.

A nurse is caring for a toddler who is postoperative following a cleft palate repair. Which of the following actions should the nurse take? A. Restrain the toddler's arms at the elbows B. Feed the toddler with a spoon C. Monitor the toddler's oral temperature D. Weigh the toddler every 48 hours

A. Restrain the toddler's arms at the elbows When caring for a toddler who is postoperative following a cleft palate repair, the nurse should apply elbow restraints (unless prescribed otherwise) to prevent the toddler from rubbing or disrupting the sutured area. - B: The nurse should avoid the use of hard utensils due to the risk of injury to the repair. - C: The nurse should avoid placing rigid objects in the mouth such as a thermometer due to the risk of injury to the repair. - D: The nurse should weigh the infant at the same time each day using the same scale in order to check nutritional status.

A nurse is caring for a school-aged child who has sickle cell anemia and was admitted for a vast-occlusive crisis. Which of the following findings should the nurse report to the provider immediately? A. Slurred speech B. Hemoglobin level of 9 g/dL C. Hematuria D. Pain level of 7 on the FACES scale

A. Slurred speech The nurse should identify that slurred speech in a child who has sickle cell anemia is an indication of a stroke. The nurse should report this finding to the provider immediately. - B: This is an expected finding for a child who has sickle cell anemia. A hemoglobin level of 9 g/dL is below the expected reference range of 10 to 15.5 g/dL. - C: Hematuria is an expected finding of a vast-occlusive crisis. - D: Pain is an expected finding of a vast-occlusive crisis and the nurse should implement interventions to promote the child's level of comfort.

A nurse is reviewing the laboratory results of a child who has experienced diarrhea for the past 24 hr. Which of the following values for urine specific gravity should the nurse expect? A. 1.010 B. 1.035 C. 1.020 D. 1.005

B. 1.035 1.035 is a concentrated specific gravity, which is an expected value for a child who is dehydrated; therefore, this is an expected urine specific gravity for a child who has experienced diarrhea for 24 hours. - A & C: These are within the expected reference range for urine specific gravity. - D: 1.005 is a decreased urine specific gravity, which could indicate excessive fluid intake rather than dehydration

A nurse is assessing the fine motor skill development of a 4-year-old child. The nurse should expect the child to be able to perform which of the following activities? A. Tying shoelaces into a bow B. Copying a square C. Drawing a person with at least 8 parts D. Printing the letters of her name

B. Copying a square The nurse should expect a 3-year-old child to have the fine motor ability to copy a circle. A 4-year-old child should have the ability to copy a square. - A: The nurse should expect a 5-year-old child to have the fine motor ability to tie her shoes. - C: The nurse should expect a 5-year-old child to have the fine motor ability to draw a stick figure with 7 to 9 parts. - D: The nurse should expect a 5-year-old child to have the fine motor ability to print the letters of her name.

A nurse is performing a nutritional screening for a 12-year-old client who weighs 41 kg (90 lb) and has a height of 1.5 m (60 in). Which of the following values is the client's body mass index (BMI)? A. 1.5 B. 3.6 C. 18.2 D. 27.3

C. 18.2 To calculate the client's BMI, the nurse should divide the client's weight in kilograms by the square of the client's height in meters. - Therefore, 41 kg divided by the square of 1.5 m gives a correct BMI of 18.2.

A nurse is assessing an infant who was born at 32 weeks gestation and is now 8 months old. Which of the following developmental ages should the nurse expect the infant to demonstrate? A. 2 months B. 4 months C. 6 months D. 8 months

C. 6 months Because the infant was born 8 weeks prematurely, the nurse should use this data to determine that the infant's setback age is 6 months. Therefore, the nurse should expect the infant to have achieved the developmental milestones of a 6-month-old infant.

A nurse is caring for an infant who is breastfed and is receiving amoxicillin for an upper respiratory infection. An assessment of the mouth reveals whitish patches on the tongue that will not scrape off. Which of the following actions should the nurse take? A. Offer the infant water before feedings B. Discontinue amoxicillin C. Administer an anti fungal medication after feedings D. Give the infant formula instead of breast milk

C. Administer an anti fungal medication after feedings The nurse should administer an antifungal medication to the infant after feedings to ensure adequate contact time with the oral mucosa and tongue to enhance treatment of the oral candidiasis. - A: The nurse should rinse the infant's mouth with water after feedings and prior to the application of antifungal medication. - B: The nurse should identify that oral candidiasis is an adverse effect of antibiotic therapy. The nurse should implement measures to treat the candidiasis rather than discontinue treatment for the respiratory infection. - D: The nurse should identify the need to treat both the infant and mother for candidiasis simultaneously rather than discontinuing breastfeeding.

A nurse is caring for a 4-month-old child who has acute otitis media and a fever of 38.3c (101f). Which of the following medications should the nurse administer? A. Diphenhydramine B. Furosemide C. Amoxicillin D. Ibuprofen

C. Amoxicillin A child who has acute otitis media should take an antibiotic to help alleviate the infection. - A: Diphenhydramine is an antihistamine used for allergic reactions. - B: Furosemide is a diuretic used to decrease edema. - D: Children who are younger than 6 months old should not take ibuprofen. Acetaminophen is the preferred choice for children of this age.

A nurse is providing dietary teaching to the parent of a toddler who has phenylketonuria. Which of the following foods should the nurse recommend? A. Whole milk B. Ground beef C. Cooked carrots D. Eggs

C. Cooked carrots The nurse should instruct the parent to offer the toddler foods that are low in protein such as cooked carrots and fruits. - A, B, & D: The nurse should instruct the parent to avoid foods that are high in protein such as whole milk, ground beef, or eggs.

A nurse in an emergency department is caring for a toddler who is in acute respiratory distress. Which of the following findings should alert the nurse to the possibility of epiglottitis? A. Lethargy B. Spontaneous coughing C. Drooling D. Hoarseness

C. Drooling Epiglottitis is a disorder caused by an inflammation of the epiglottis. It results in rapid swelling of the epiglottis, which can obstruct breathing. - Drooling is an expected finding due to the toddler's inability to swallow saliva. - A: A toddler who has epiglottitis is restless and appears anxious rather than lethargic. - B: A toddler who has epiglottitis has an absence of spontaneous coughing due to inflammation of the epiglottis. - D: Hoarseness would be present in a toddler who has acute spasmodic laryngitis rather than epiglottitis.

A nurse is preparing to administer recommended immunizations to a 2-month-old infant. Which of the following immunizations should the nurse plan to administer? A. Human papillomavirus (HPV) and hepatitis A B. Measles, mumps, and rubella (MMR) and tetanus, diphtheria, and acellular pertussis (TDaP) C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) D. Varicella (VAR) and live attenuated influenza vaccine (LAIV)

C. Haemophilus influenzae type B (Hib) and inactivated polio virus (IPV) The recommended immunizations for a 2-month-old infant include Hib and IPV. - The Hib immunization series consists of 3 to 4 doses, depending on the immunization used. At minimum, it is administered at 2 months, 4 months, and 12 to 15 months of age. - The IPV immunization series consists of 4 doses and is administered at 2 months, 4 months, 6 to 18 months, and 4 to 6 years of age. - A: The HPV immunization series is started at the age of 11 years, and the hepatitis A immunization series is started at the age of 12 months. - B: The first dose of the MMR immunization is administered at 12 to 15 months of age, and the TDaP immunization is administered at 11 to 12 years of age. - D: Varicella is not administered to children younger than 12 months, and the LAIV immunization is not administered to children under 2 years of age.

A nurse is caring for a preschooler who is immediately postoperative following the removal of a brainstem tumor. Which of the following actions should the nurse take? A. Have the child deep-breathe and cough every hour B. Offer the child clear liquids after the procedure C. Monitor the child's temperature every 30 minutes D. Place the child in Trendelenburg position

C. Monitor the child's temperature every 30 minutes The nurse should monitor the child's temperature every 15 to 30 minutes. Surgery on the brainstem can cause hyperthermia. - A: The child should avoid coughing because this can increase intracranial pressure. - B: The nurse should not offer the child clear liquids for at least 24 hours following the procedure. The gag and swallow reflexes are frequently depressed, increasing the risk of aspiration. - D: The nurse should not place the child in the Trendelenburg position because it increases intracranial pressure and raises the risk of postoperative hemorrhage.

A nurse is assessing a 4-year-old child for growth and developmental milestones during a well-child visit. Which of the following findings suggests a possible delay in development? A. Inability to tie shoes B. Adding 3 parts to a stick figure C. Speaking using 2- or 3-word sentences D. Inability to walk backward

C. Speaking using 2- or 3-word sentences A 4-year-old child should be speaking in 4- to 5-word sentences. Speaking in 2- to 3-word sentences is typical of a 2-year-old child. - A: Tying shoelaces is a skill expected of a 5-year-old child. - B: This is an expected finding in a 4-year-old child. - D: Walking backward is a skill expected of a 5-year-old child.

A nurse is assessing a 6-month-old infant who was recently admitted with acute vomiting and diarrhea. Which of the following findings indicates the infant has moderate dehydration? A. Bulging anterior fontanel B. Bradycardia C. Tachypnea D. Polyuria

C. Tachypnea An infant who has moderate dehydration will have slight tachypnea. - A: An infant who has moderate dehydration will have a flat or sunken fontanel. - B: An infant who has moderate dehydration will have a slightly increased heart rate. - D: An infant who has moderate dehydration will have decreased urinary output.

A nurse in the emergency department is assessing an infant who recently started taking digoxin to treat a supra ventricular arrhythmia. Which of the following findings should the nurse identify as an indication of digoxin toxicity? A. Irritability B. Diaphoresis C. Vomiting D. Tachycardia

C. Vomiting The nurse should identify that vomiting, especially when unrelated to feedings, is a manifestation of digoxin toxicity. The nurse should report this finding to the provider immediately. - A, B, & D: Irritability, diaphoresis, and tachycardia are not manifestations of digoxin toxicity.

A nurse is assessing a toddler who has AIDS. Which of the following findings is an indication of an opportunistic infection? A. Koplik spots B. Peripheral neuropathy C. Chancre D. Candidiasis

D. Candidiasis Candidiasis (oral thrush) results from the overgrowth of Candida albicans, an opportunistic fungus that commonly infects the oral cavity of clients who have immature or compromised immune systems. - Candidiasis appears as a cheesy, white plaque that looks like milk curds on the buccal mucosa and tongue. - Thrust is often the initial opportunistic infection in an HIV-positive child who is developing AIDS. - A: Koplik spots are oral lesions that indicate rubeola. They are small, irregular spots with a blue/white center that appear on the buccal mucosa opposite the molars in the prodromal stage of measles. - B: Peripheral neuropathy can develop as an adverse effect of medications used to treat AIDS; however, it is not an indication of an opportunistic infection. - C: A chancre is a red, circumscribed, crusted oral lesion of the lip that is the primary manifestation of syphilis.

A nurse is caring for an infant who is 6 months old and has moderate dehydration. Which of the following findings should the nurse expect? A. Absent tears B. Weight loss >10% C. Lethargy D. Dry mucous membranes

D. Dry mucous membranes Dry mucous membranes are an expected finding of moderate dehydration. - A, B, & C: Absent tears, a weight loss of >10%, and lethargy are all expected findings of severe dehydration.

A clinic nurse is providing teaching to a parent of a 1-month-old infant who has gastroesophageal reflux. Which of the following statements by the parent indicates an understanding of the teaching? A. I will give lansoprazole 30 min after my baby's feedings B. I will lay my baby on her side after feedings C. I will give my baby a bottle just before bedtime D. I will add rice cereal to my baby's feedings

D. I will add rice cereal to my baby's feedings The parent should add 1 tsp to 1 tbsp of rice cereal per ounce of formula or expressed breast milk to thicken the feedings and decrease the number of vomiting episodes. - A: The parent should give the medication to the infant 30 minutes before feeding because it is most effective during mealtime when the infant's plasma concentration is at its peak. - B: The infant should be placed in an infant seat or at a 30 degree angle for 1 hour after feedings. - C: The nurse should instruct the parent to avoid feedings just before bedtime.

A nurse is assessing a school-aged child who has acute glomerulonephritis. Which of the following manifestations should the nurse expect? A. Hypokalemia B. Decreased blood pressure C.Increased urine volume D. Periorbital edema

D. Periorbital edema Periorbital edema is a manifestation of acute glomerulonephritis. Swelling is usually worse in the mornings and spreads throughout the day to the genitalia, abdomen, and extremities. - A: Hypokalemia is not a manifestation of acute glomerulonephritis. - B: The blood pressure of a school-age child who has acute glomerulonephritis can suddenly become dangerously high. - C: A reduced urine volume is a manifestation of acute glomerulonephritis.

A nurse is admitting a child who has a history of tonic-clonic seizures. Which of the following items is the priority to have in the child's room? A. Pulse oximeter B. Oxygen therapy C. Bag valve mask D. Suction equipment

D. Suction equipment When using the ABC approach to client care, the nurse should determine that the priority item to have in the child's room is suction equipment. - If the child experiences a tonic-clonic seizure, the child is at risk for aspiration and airway occlusion due to secretions, food, or fluids. The nurse should have suction equipment available to maintain a patent airway for effective respiration, administration of oxygen, and use of a bag valve mask if needed. - A, B, & C: The nurse should have a pulse oximeter, oxygen therapy equipment, and a bag. valve mask available in the child's room; however, suction equipment is the priority for the nurse to have in the child's room.

A nurse is assessing an infant who has untreated congenital hypothyroidism. Which of the following manifestations should the nurse expect? A. Constipation B. Hyperreflexia C. Oily skin D. Hyperthermia

A. Constipation The nurse should expect an infant who has untreated congenital hypothyroidism to exhibit constipation and an enlarged abdomen. - B: The nurse should expect an infant who has uncreated congenital hypothyroidism to exhibit hyporeflexia and decreased muscle tone. - C: The nurse should expect an infant who has uncreated congenital hypothyroidism to exhibit dry, scaly skin. - D: The nurse should expect an infant who has uncreated congenital hypothyroidism to exhibit hypothermia and cool extremities.

A nurse is caring for a child who has electrical burns on the lower arms and hands. Which of the following findings indicate the child is experiencing a complication of the injury? A. Dark urine B. 2+ radial pulses C. Respiratory rate of 20/min D. Minimal pain

A. Dark urine Dark urine can be an indication of myoglobinuria. It results from the elimination of waste products from muscle damage and can cause renal failure. - B: Radial pulses of +2 are within the expected reference range. They are a reflection of circulatory status, not burn complications. - C: A respiratory rate of 20/min is within the expected reference range. It reflects respiratory status, not burn complications. - D: Electrical injuries can cause major, full-thickness burns that destroy the nerve endings in the skin, thus reducing the amount of pain the client feels.

A nurse is assessing a 12-month-old male infant's vital signs during a well-child visit. The infant is in the 90th percentile for height. Which of the following findings should the nurse report to the provider? A. Heart rate 175/min B. Respiratory rate 26/min C. Blood pressure 88/40 mmHg D. Temperature 37.6c (99.7f)

A. Heart rate 175/min A heart rate of 175/min is above the expected reference range for a 12-month-old infant; therefore, the nurse should report this finding to the provider. - B, C, & D: These are within the expected reference ranges for a 12-month-old infant.

A nurse is assessing an infant who is at risk for increased intracranial pressure (ICP). Which of the following findings should indicate to the nurse that this complication is developing? A. High-pitched cry B. Sunken fontanel C. Tachycardia D. Increased awake time

A. High-pitched cry The nurse should identify that an infant's high-pitched cry is an indication of increased ICP. Other manifestations include a bulging fontanel, a high-pitched cry, and increased sleeping. - B: The nurse should identify that a firm and bulging fontanel is an indication of increased ICP. - C: The nurse should identify bradycardia as an indication of increased ICP. - D: The nurse should identify increased sleep time as an indication of increased ICP.

A nurse is providing teaching to an adolescent who has scoliosis and a new prescription for a Boston brace. Which of the following responses by the adolescent indicates an understanding of the teaching? A. I can take my brace off to sleep every night at bedtime B. I can take my brace off for about an hour daily to shower C. I should loosen the straps on my brace if it is rubbing against my skin D. I should place the pads of the brace against my skin with a t-shirt over them

B. I can take my brace off for about an hour daily to shower The nurse should instruct the child to wear the brace for 23 hours each day and only to remove it for showering or participating in physical therapy. - A: The child should wear the brace for 23 hours each day. At night, the child might be prescribed a bending brace that confines the spine to an over-corrected position. - C: The nurse should instruct the adolescent to avoid loosening the straps of the brace if rubbing occurs because this can decrease compression and contraction. - D: The brace should be worn over a t-shirt to prevent the plastic pads from touching the skin and causing excoriation.

A nurse is assessing a 3-year-old preschooler. Which of the following developmental milestones should the nurse expect the preschooler to demonstrate? A. Stacking 10 blocks B. Printing 1 letter C. Tying shoelaces D. Using 7-word sentences

A. Stacking 10 blocks The nurse should expect a 3-yar-old preschooler to have the fine motor ability to stack 10 blocks. - B: The nurse should expect a 3-year-old preschooler to have the ability to draw a circle but not print letters until age 5. - C: The nurse should expect a 3-year-old preschooler to have the fine motor ability to put on shoes but not tie shoelaces until age 5. - D: The nurse should expect a 3-year-old preschooler to have the language ability to use 3- to 4-word sentences. Seven-word sentences are not expected until age 5.

A nurse is planning to teach a 9-year-old client who has a new diagnosis of diabetes mellitus. The nurse should identify that school-age children are attempting to master which of the following developmental tasks? A. Initiative vs. guilt B. Industry vs. inferiority C. Trust vs. mistrust D. Identity vs. role confusion

B. Industry vs. inferiority School-age children are attempting to master the developmental task of industry vs. inferiority. During this stage, children enjoy learning new skills and experiencing the sense of accomplishment that comes with mastery of the skill. - A: Initiative vs. guilt is the developmental task of a preschool child - C: Trust vs. mistrust is the developmental task of an infant - D: Identity vs. role confusion is the developmental task of a young adult

A nurse is caring for a preschool-age child who has mucosal ulceration after receiving chemotherapy. Which of the following actions should the nurse take? A. Place viscous lidocaine on the child's oral lesions B. Instruct the child to use a soft-sponge toothbrush when brushing her teeth C. Encourage the child to rinse her mouth with hydrogen peroxide every 2-4 hours D. Give the child lemon glycerin swabs to use after each meal

B. Instruct the child to use a soft-sponge toothbrush when brushing her teeth The child should use a soft-sponge toothbrush when brushing her teeth because a regular toothbrush may cause further irritation to the mucosal ulcers. - A: Preschool-age children should not take viscous lidocaine because it depresses the gag reflex, increasing their risk of aspiration. - C: Children who have mucosal ulcers should not use hydrogen peroxide as a mouth rinse because the drying effects on the mucosa may cause further ulceration. - D: Children who have mucosal ulcerations should avoid using lemon glycerin swabs because they are irritating, especially on eroded tissues.

A nurse is teaching an adolescent who has asthma about how to use a peak expiratory flow meter (PEFM). Which of the following responses by the adolescent indicates an understanding of the teaching? A. I will breathe in through the mouthpiece, hold my breath for 5 sec, and then exhale B. If I get a reading in the green zone, I will tell my parents immediately so they can call the doctor C. I will slowly exhale through the mouthpiece over a 10 sec interval D. I will record the highest reading of three attempts

D. I will record the highest reading of three attempts After establishing a personal best, the client should routinely check the PEFM by performing 3 attempts and recording the highest reading of the 3. - A: The nurse should instruct the adolescent to take a deep breath, place the lips around the mouthpiece, and then blow into the mouthpiece as hard and fast as possible. - B: Values in the green zone represent 80% to 100% of the child's personal best; therefore, this does not warrant calling the provider. - C: Slowly exhaling over a 10-second interval is an incorrect method of using the PEFM.

A nurse is assessing the gross motor skills of a 4-year-old preschooler. The nurse should expect the preschooler to perform which of the following activities? A. Hopping on 1 foot B. Skipping on alternate feet C. Jumping rope D. Roller skating

A. Hopping on 1 foot The nurse should expect a 4-year-old preschooler to hop on 1 foot. - B, C, & D: A 5-year-old preschooler should be able to skip on alternate feet, jump rope, and roller skate.

A nurse in a pediatric clinic is assessing a toddler at a well-child visit. Which of the following actions should the nurse take? A. Perform the assessment in a head-to-toe sequence B. Minimize physical contact with the child initially C. Explain procedures using medical terminology D. Stop the assessment if the child becomes uncooperative

B. Minimize physical contact with the child initially The nurse should initially minimize physical contact with the toddler and progress from least traumatic to the most traumatic procedures. - A: The nurse should start with the least invasive interventions and proceed to the more invasive. The head-to-toe approach is recommended for preschool-age and older children. - C: The nurse should describe procedures using age-appropriate language the child can understand. - D: If the child becomes uncooperative, the nurse should perform the procedures more quickly.

A nurse in a provider's office is observing children playing in the waiting room. The nurse should expect to identify parallel behavior in which of the following age groups? A. Infants B. Toddlers C. Preschoolers D. School-age children

B. Toddlers Toddlers demonstrate parallel play. - A: Infants demonstrate solitary play - C: Preschoolers demonstrate associative play - D: School-age children demonstrate cooperative play

A nurse is assisting a provider during a femoral venipuncture on a toddler. The nurse should place the child in which of the following positions? A. Side-lying B. Semi-recumbent C. Flexed sitting D. Supine

D. Supine The client should be placed in the supine position, with the legs in a frog position. - A: The side-lying position may be used during a lumbar puncture. - B: A semi-recumbent position is used when performing a gavage feeding. The client's head and chest should be elevated. - C: The flexed sitting position may be used during a lumbar puncture.

A nurse is assessing a 6-year-old client at a well-child visit. Which of the following findings requires further assessment by the nurse? A. Presence of sparse, fine pubic hair B. Decreased head circumference compared to full height C. Increased leg length in relation to height D. Presence of a loose central incisor

A. Presence of sparse, fine pubic hair The development of sexual characteristics prior to the age of 9 years in boys and 8 years in girls is an indication of precocious puberty and requires further evaluation. - B: The head circumference of a school-aged child decreases when compared to full height due to skeletal lengthening. - C: Body proportion varies with a slimmer appearance and longer legs in a school-age child. Leg length increases and waist circumference decreases related to height in this age group. - D: The deciduous teeth start shedding at this age, beginning with the lower central incisors.

A nurse is performing a physical assessment on a 12-month-old infant. Which of the following findings should the nurse report to the provider? A. The infant's current weight is double his birth weight B. The infant's posterior fontanel is closed C. The infant is unable to walk without support D. A total of 6 teeth are present

A. The infant's current weight is double his birth weight The nurse should expect a 12-month-old infant's weight to be triple his birth weight; therefore, the nurse should report this finding to the provider. - B: The nurse should expect the infant's posterior fontanel to be closed at about 2 months of age. - C: Although the ability to walk independently varies among infants, the nurse should not expect this gross motor skill until the infant is 13 to 15 months of age. - D: The nurse should expect a 12-month-old infant to have 6 to 8 teeth present.

A nurse is assessing a 9-month-old infant during a well-child visit. Which of the following findings indicates that the infant has a developmental delay? A. Creeping on hands and knees B. Inability to vocalize vowel sounds C. Using a crude pincer grasp D. Standing by holding onto a support

B. Inability to vocalize vowel sounds The infant should begin vocalizing vowel sounds at the age of 7 months. By the age of 10 months, the infant should be able to say at least 1 word. - A: The infant should creep on hands and knees at the age of 9 months and begin to stand while holding onto furniture at the age of 10 months. - C: Most infants demonstrate a crude pincer grasp at 9 months of age; the use of a dominant hand is also evident. - D: The ability to stand while holding onto a support is typically present at 10 months of age.

A nurse is planning care for a toddler who has acute gastroenteritis and was recently admitted. Which of the following should the nurse plan to provide for the child? A. Oral rehydration solution B. Bananas or applesauce C. Chicken or beef broth D. Hypertonic IV solution

A. Oral rehydration solution The nurse should plan to provide an oral rehydration solution (ORS) to this child who has acute gastroenteritis. ORS promotes the body's reabsorption of water and sodium and is more effective and less traumatic than the administration of IV fluids for the treatment of dehydration due to diarrhea and emesis.

A nurse is caring for an infant who has a cleft palate. The parents ask the nurse how long they should wait before the child can have corrective surgery. The nurse should explain that the parents should wait no longer than 6 to 12 months for surgery to prevent which of the following outcomes? A. Repeated ear infections B. Nutritional deficits C. Immune system deficits D. Difficulty with language acquisition

D. Difficulty with language acquisition Clients who have a cleft palate can have difficulty acquiring language because they need to use the palate for vocalizing sounds. Because of the cleft in the palate, these infants could develop poor speech habits. - A: Infants who have a cleft palate are at increased risk of ear infections; however, this can persist even after the repair of the palate. - B: Infants who have a cleft palate are at increased risk for poor nutrition due to feeding difficulties. However, there are multiple strategies to teach the parents to promote nutrition and to help the infant create a seal and generate suction to feed. - C: Repair of a cleft palate does not affect the child's immune system. However, repairing the palate too soon can affect the skeletal growth of the mid portion of the child's face.

A nurse in a pediatric clinic is caring for a 3-year-old child who has a blood lead level of 3 mpg/dL. When teaching the toddler's parent about the correlation of nutrition with lead poisoning, which of the following pieces of information is appropriate for the nurse to include? A. Decrease the child's vitamin C intake until the blood lead level decreases to zero B. Administer a folic acid supplement to the child each day C. Give pancreatic enzymes to the child with meals and snacks D. Ensure the child's dietary intake of calcium and iron is adequate

D. Ensure the child's dietary intake of calcium and iron is adequate A child who has an elevated blood lead level should have an adequate intake of calcium and iron to reduce the absorption of and effects from the lead. Dietary recommendations should include milk as a good source of calcium. - A: Vitamin C does not influence absorption or excretion of lead, and intake does not need to be reduced for a child who has an elevated blood lead level. Over time, a reduced intake can result in a vitamin C deficiency. - B: A 3-year-old child does not need a folic acid supplement. This will not influence absorption or excretion of lead. - C: Pancreatic enzymes are administered to children who have cystic fibrosis, not an elevated blood lead level.

A nurse at a pediatric clinic is assessing a 5-month-old infant during a well-child visit. Which of the following findings should the nurse report to the provider? A. Head lagging when the infant is pulled from a lying to a sitting position B. Absence of startle and crawl reflexes C. Inability to pick up a rattle after dropping it D. Rolling from back to side

A. Head lagging when the infant is pulled from a lying to a sitting position At the age of 5 months, the infant should have no head lag when pulled to a sitting position; therefore, the nurse should report this finding. - B: The startle reflex disappears by the age of 4 months, and the crawl reflex disappears around the age of 6 weeks. - C: At the age of 5 months, the infant can visually follow a dropped object but is unable to pick up the object until around the age of 6 months. - D: The infant should be able to roll from back to side at the age of 4 months.

A nurse is providing teaching to the parents of a child who has strabismus. Which of the following instructions should the nurse include to prevent the development of amblyopia? A. Patch the unaffected eye B. Administer mydriatic eye drops daily C. Obtain prescription eyeglasses D. Administer antihistamines

A. Patch the unaffected eye Amblyopia is a disorder of the eye in which unilateral central blindness occurs as a result of another problem such as strabismus. With strabismus, muscle weakness allows an eye to wander so that the child cannot focus on an object with both eyes at the same time. This confusion causes the brain to ignore the signals from the weak eye in favor of the strong eye. This will result in central blindness if the child does not receive treatment by 6 years of age. - To strengthen the weak eye muscles, the parents should patch the unaffected eye. - B: Providers instill mydriatic eye drops for ophthalmic examinations, not for strabismus. - C: Prescription glasses will not help prevent amblyopia. - D: Amblyopia is not an allergic disorder; therefore, antihistamines will have no therapeutic effect.

A nurse is teaching a school-age child who has a new diagnosis of type 1 diabetes mellitus. Which of the following statements should the nurse make? A. If you take too much insulin, drink a sugar-free cola B. You will need to decrease your insulin dosage when you become a teenager C. You can use a vial of insulin for up to 30 days D. Stop taking your insulin if you are vomiting

C. You can use a vial of insulin for up to 30 days The child can use an opened vial of insulin for 28 to 30 days stored at room temperature or in the refrigerator. - A: Sugar-free cola will not increase the blood sugar because it does not contain sugar. The nurse should encourage the child to drink juice or milk and eat a complex carbohydrate. - B: Insulin requirements increase during puberty due to a decreased sensitivity to insulin, resulting in an increase in the child's insulin dosage. - D: Blood glucose levels rise during times of illness and stress; therefore, the child might need to contact the provider for an increased insulin dosage.

A nurse is caring for a child with a vesicular rash that has been present for 6 days. The nurse should expect that the child has which of the following conditions? A. Measles B. Fifth disease C. Tetanus D. Varicella

D. Varicella Children who have varicella may present first with a maculopapular rash that progresses to vesicles on erythematous bases, which eventually rupture and crust over. - A: A child who has measles might develop Koplik spots, a transient cephalocaudal rash of maculopapular eruptions of the upper trunk and face. The rash becomes more confluent as it spreads to the lower areas of the body. - B: Fifth disease usually begins with bright red cheeks, producing a "slapped-cheek" appearance. Then, a rash appears on the extremities and trunk. The rash fades centrally, giving a lacy (reticulated) appearance. - C: A child who has tetanus will develop lockjaw and muscle rigidity; however, there is no rash associated with tetanus.

A nurse is caring for a 16-year-old client who reports dysmenorrhea and asks about alternative therapies for treatment. Which of the following statements should the nurse make? A. Herbal medication can be effective but should be monitored by your provider B. You should place a cold compress on your lower abdomen to decrease inflammation C. You should limit exercise, which can increase the pain D. Avoid touching the painful areas because this can increase your discomfort

A. Herbal medication can be effective but should be monitored by your provider Herbal medicine may be helpful in relieving menstrual pain. However, there is a risk of toxicity and drug interactions if herbal medicine is taken in the wrong doses or with other medications. The nurse should ask the client is she is using herbal medication and document the dose and effects. - B: Dysmenorrhea can result from uterine ischemia and lower abdominal cramping. A cold compress causes vasoconstriction and can increase uterine ischemia. A heating pad or hot bath might provide relief of cramping through muscle relaxation and vasodilation, which can help minimize uterine cramping. - C: Exercise helps relieve pain by increasing vasodilation, thereby reducing uterine ischemia, which is a cause of dysmenorrhea. Pelvic rocking is a helpful exercise that the nurse can recommend. - D: Therapeutic touch can provide pain relief. Massaging the lower back can help relax the muscles and increase pelvic blood flow. Also, effleurage (gentle and rhythmic touching) can help distract the client from the pain and provide an alternative focal point.

A nurse working on a maternal-newborn unit is teaching a group of newly licensed nurses about assisting new mothers with breastfeeding. The nurse should include which of the following infant conditions as a contraindication for breastfeeding? A. Galactosemia B. Hyperbilirubinemia C. Glycogen storage disease D. Hypothyroidism

A. Galactosemia An infant who has galactosemia cannot metabolize lactose. - Breast milk contains lactose, which can cause failure to thrive, cirrhosis, developmental delays, and even death in affected infants. - An infant who has galactosemia is fed with formula made with milk substitutes. - B: An infant who has hyperbilirubinemia can develop jaundice due to the accumulation of bilirubin in the system. Breastfeeding is encouraged in the early postpartum period for infants who develop hyperbilirubinemia because the colostrum in breast milk is a natural laxative that promotes the excretion of excess bilirubin. - C: Glycogen storage disease is a congenital disorder in which glycogen, which is usually stored in the liver and metabolized into glucose when needed, cannot be metabolized into glucose due to a missing or deficient enzyme. As a result, the infant develops hypoglycemia and can experience neurological damage. Treatment involves continuous nasogastric or gastrostomy feedings during the night. However, breastfeeding is not contraindicated for infants who have glycogen storage disease. - D: Infants who are born with congenital hypothyroidism will require lifelong treatment with a thyroid-replacement medication. However, breastfeeding is not contraindicated for infants who have hypothyroidism.

A nurse is providing teaching about foods high in fiber to the guardian of a child who has chronic constipation. Which of the following foods should the nurse recommend? A. 1/2 cup whole milk B. 1/2 cup cooked pinto beans C. 1 cup green leaf lettuce D. 1 cup apple juice

B. 1/2 cup cooked pinto beans The nurse should recommend foods high in fiber for a child who has chronic constipation. A half cup of cooked pinto beans contains approximately 5 g of fiber. Therefore, the nurse should instruct the guardian to include this food in the child's diet. - A, C, & D: A half cup of whole milk, one cup of green leaf lettuce, and one cup of apple juice contain no fiber.

A nurse is facilitating a group discussion with preschool teachers about child abuse. Which of the following examples should the nurse use to illustrate a suggestive finding? A. Bruising of both knees with sutures on 1 B. Arm cast for a spiral fracture of the forearm C. Consistent bedwetting at nap time D. Frequent, vague reports of a stomachache or a headache

B. Arm cast for a spiral fracture of the forearm Spiral fractures occur from the twisting of an extremity. In most instances, spiral fractures of the arm result from an abusive injury. - A: Bruising of the knees and sutures are typical findings associated with accidental childhood injuries, such as falling off a bicycle. Lacerations or abrasions to the backs of the legs are suggestive of physical abuse. - C: Bedwetting has many causes and affects many preschoolers. In the absence of other findings, it does not indicate abuse. Pain with urination or recurrent urinary tract infections suggest sexual abuse. - D: In the absence of other findings, these reports do not indicate abuse. However, abdominal pain and swelling accompanied by indications of punching are suggestive of physical abuse.

A nurse is caring for a child who received penicillin IM 15 minutes ago. The child is now irritable and restless. Which of the following actions should the nurse take first? A. Administer diphenhydramine B. Assess for laryngeal edema C. Initiate hourly urine output monitoring D. Give epinephrine IV push

B. Assess for laryngeal edema The greatest risk to this child is bronchoconstriction due to an anaphylactic reaction to penicillin. Therefore, the first action the nurse should take is to assess the child for laryngeal edema and implement interventions to maintain a patent airway. - A: The nurse should administer an antihistamine such as diphenhydramine to treat the anaphylactic reaction to penicillin. However, there is another action the nurse should take first. - C: The nurse should frequently monitor the child's urine output to determine the effects of the anaphylactic reaction. However, there is another action the nurse should take first. - D: The nurse should administer epinephrine to treat the anaphylactic reaction to penicillin. However, there is another action the nurse should take first.

A nurse is performing a physical assessment on a 6-month-old infant. Which of the following reflexes should the nurse expect to find? A. Stepping B. Babinski C. Extrusion D. Moro

B. Babinski The Babinski reflex, which is elicited by stroking the bottom of the foot and causing the toes to fan and the big toe to dorsiflex, should be present until the age of 1 year. - A: The stepping reflex, in which the infant takes reflexive steps when placed on his or her feet in an upright position, disappears by the age of 4 weeks. - C: The extrusion reflex, which causes the infant to spit out food placed on the tongue rather than moving it to the back of the mouth, is absent by the age of 4 months. - D: The Moro reflex should disappear at the age of 3 to 4 months. It is an extension of the arms and flexion of the elbows in response to a sudden jarring, followed by flexion and adduction of the extremities.

A nurse is performing a well-child assessment on a 7-year-old client who takes great pride in bringing school papers home. The nurse recognizes that this behavior demonstrates which of the following of Erikson's stages of psychosocial development? A. Initiative vs. guilt B. Industry vs. inferiority C. Identity vs. role confusion D. Autonomy vs. shame and doubt

B. Industry vs. inferiority The developmental task of industry vs. inferiority is reflected by a child's level of motivation in relation to personal achievements that build good character during the school-age years (ages 6 to 12 years). - A: Initiative vs. guilt is the developmental task of early childhood (ages 3 to 6 years). - C: Identity vs. role confusion is the task of the adolescent (ages 13 to 19 years). - D: Autonomy vs. shame and doubt is the developmental task of a toddler (ages 12 months to 3 years).

A nurse is assessing a 6-month-old infant. The guardian reports that the infant does not appear interested in the brightly colored mobile hanging above the crib at home. Which of the following techniques should the nurse use to check the infant's visual acuity? A. Shine a penlight briefly into the left eye and then the right eye B. Move a brightly colored toy from side to side in front of the infant's face C. Ask the guardian to sit in front of the infant and nod his head up and down D. Observe the infant's ability to grasp the feet and pull them to the mouth

B. Move a brightly colored toy from side to side in front of the infant's face The nurse should check the infant's ability to see by positioning the infant upright and holding a brightly colored toy or object in front of the infant's face and moving it from side to side. The nurse should observe the infant's ability to fixate on the toy and track its movement. The nurse can also perform this assessment using the human face as a visual target. - A: The nurse should use this technique to check light perception and pupillary constriction; however, this assessment does not check the infant's ability to see. - C: The nurse can use the human face to check the infant's vision; however, up and down movement will not provide adequate data about the infant's ability to track movement. - D: The nurse should observe the infant's ability to grasp the feet and pull them to the mouth as part of a developmental assessment; however, the nurse should use a different technique to check the infant's visual acuity.

A nurse is caring for a 4-week-old infant who is 2 weeks postoperative following surgical correction of biliary atresia. Which of the following findings is an indication that the surgery was successful? A. The infant has lost 2.2 kg (1 lb) since the surgery B. The infant has a total bilirubin level of 0.3 mg/dL C. The infant has an aspartate aminotransferase (AST) level of 120 units/L D. The infant's stools are gray in color

B. The infant has a total bilirubin level of 0.3 mg/dL A bilirubin level of 0.3 mg/dL is within the expected reference range and indicates the surgery was successful. - A: Weight loss is an indication that the surgery was not successful. The infant should gain weight following the surgery due to improved intestinal absorption. - C: An AST level of 120 units/L is above the expected reference range and indicates continued biliary obstruction. - D: If the surgical correction was successful, the infant's stools should turn yellow and then brown in color. Gray stools indicate continued biliary obstruction.

A nurse is providing teaching about immunizations to the parents of a severely immunocompromised child who has human immunodeficiency virus (HIV). Which of the following statements should the nurse include in the teaching? A. Your child's immunizations today will be half-doses B. The pneumococcal and influenza vaccines are recommended for your child C. Immunizations will be delayed until your child tests HIV-negative D. Your child will need to restart the immunization schedule once your child's laboratory values are within the reference range

B. The pneumococcal and influenza vaccines are recommended for your child Immunization against common childhood illnesses, including influenza and pneumococcal disease, is recommended for all children exposed to and infected with HIV. - A: Half doses of immunizations do not provide the immunity necessary to protect the child from common childhood illnesses. - C: Delaying immunizations places the child at risk of contracting an illness. - D: Immunizations do not need to be restarted once the client is no longer immunocompromised.

A nurse is teaching the guardian of an 18-month-old toddler about otic medication administration. Which of the following statements should the nurse make? A. Administer the drops immediately after removing the medication from the refrigerator B. Place the child in a seated position with the head tilted to the side for administration C. Gently pull the ear cartilage down and back when administering the medication D. Position the medication bottle so the drops do not touch the side of the ear canal

C. Gently pull the ear cartilage down and back when administering the medication The nurse should instruct the guardian to pull the pinna gently down and back to straighten the Eustachian tube when administering the medication. - A: The medication should be at room temperature or slightly warmer to prevent pain and vertigo during administration. - B: The child should be prone or supine with the head turned to the side to administer the drops. The child should remain in this position for 2 to 3 minutes following administration so the medication can fully enter the ear canal. - D: The guardian should position the bottle so the ear drops fall against the side of the ear canal to avoid placing the drops directly onto the tympanic membrane.

A nurse is planning care for a preschooler who is scheduled for a surgical procedure. The nurse should identify that the preschooler is in which of the following of Erikson's psychosocial stages of development? A. Industry vs. inferiority B. Trust vs. mistrust C. Initiative vs. guilt D. Identity vs. role confusion

C. Initiative vs. guilt A preschooler is in the developmental stage of initiative versus guilt. - Preschoolers initiate play activities and experience a feeling of guilt if their efforts at independence receive a negative reaction from caregivers. - A: A school-aged child is in the developmental stage of industry vs inferiority. In this stage, the child takes initiative for learning and doing things well. Support and positive reinforcement foster the child's sense of pride, while a lack of appreciation can lead to a feeling of inferiority. - B: An infant is in the developmental stage of trust vs mistrust. In this stage, a caregiver's response to the infant's needs builds trust and reassures the infant that his or her needs are being met. A caregiver who is inconsistent or rejecting can cause a feeling of mistrust. - D: An adolescent is in the developmental stage of identity vs role confusion. In this stage, the adolescent combines his or her various roles and experiences into a person identity. Failure to integrate these various images can lead to role confusion or uncertainty of identity or goals.

A nurse on a pediatric unit is caring for a child who is not eating well. Which of the following suggestions should the nurse offer to the parents to promote the child's food intake? A. Make dietary selections for your child B. Offer foods that have strong flavors or smells C. Let your child eat with others when possible D. Make sure your child eats most of the food on his plate

C. Let your child eat with others when possible Socialization with others promotes nutrition by making the child feel more comfortable in his surroundings and enhancing the enjoyment of meal times. - A: The child will be more likely to eat foods if he has participated in the menu selection. - B: Highly seasoned foods and foods with strong odors are typically unappealing to clients who aren't feeling well. The parents should offer foods that are familiar and do not have strong flavors or smells. - D: Forcing the child to eat can result in rebellion, and the child might begin using food refusal as a control mechanism. Parents should instead offer meals and frequent snacks, make foods attractive and appealing, and praise the child when he does eat.

A nurse is caring for a 6-month-old infant who has intussusception. Which of the following actions should the nurse take? A. Prepare to administer high-dose steroids B. Give the child magnesium hydroxide PO C. Prepare the child for a barium enema D. Inform the parents that the child will need a colostomy

C. Prepare the child for a barium enema The pressure created by a barium enema might force the bowel to resume a normal configuration. Some children with intussusception are treated with the barium enema and do not require surgical intervention. - A: Intussusception is a mechanical obstruction, not an inflammatory process. - B: Abdominal pain observed with intussusception is a contraindication for receiving magnesium hydroxide, a laxative. In addition, children with this condition are NPO and should not receive anything by mouth. - D: During surgical intervention, the provider will remove the nonviable portion of the bowel so the bowel is anastomosed; there is no need for a colostomy.

A nurse is providing teaching to the parent of a toddler who is undergoing insertion of tympanostomy tubes. Which of the following statements should the nurse include? A. The doctor will replace the tubes routinely about every 2 years B. If your child gets water in her ears will not cause any further problems C. The tubes should stay in place until they fall out on their own D. Now that the tubes are in place, she should not have any further problems with hearing

C. The tubes should stay in place until they fall out on their own Tympanostomy tubes allow drainage from and ventilation to the middle ear. They usually fall out on their own within 6 to 12 months after insertion. - A: Most children do not need tympanostomy tubes for more than 1 year. - B: With tympanostomy tubes in place, the child should wear earplugs whenever there is a possibility of getting contaminated or soapy water inside her ears. - D: Hearing impairment is common with recurrent otitis media and can continue after tympanostomy tubes are in place.

A nurse is teaching the guardians of an infant who has mild gastroesophageal reflux (GER). Which of the following instructions about feeding therapies should the nurse recommend? A. Apply the infant's diaper snugly prior to feedings B. Administer nasogastric feedings C. Thicken feedings with rice cereal D. Place the infant in a lateral position for 1 hour after feedings

C. Thicken feedings with rice cereal The nurse should instruct the guardians about the correct way to thicken feedings with rice cereal. Thickened feedings with rice cereal decrease the infant's manifestations of GER and promote weight gain if needed. - A: The nurse should instruct the guardians to keep clothing and diapers loose around the infant's abdomen to decrease pressure on the stomach. Increased abdominal pressure increases the manifestations of GER. - B: The nurse should inform the guardians that nasogastric feedings are indicated if GER becomes severe and the infant exhibits manifestations of failure to thrive. - D: The nurse should instruct the guardians to hold the infant upright for at least 30 minutes after each feeding. This upright position helps decrease the infant's manifestations of GER.

A nurse at a community health department is discussing the nutritional needs of children with a group of parents and guardians. Which of the following pieces of information should the nurse include? A. Infants should be transitioned to low-calorie milk at 12 months B. Preschoolers need 10-12 g of protein per day C. Toddlers can be given up to 120-180 mL (4-6 oz) of juice per day D. School-age children should be encouraged to avoid afternoon snacks

C. Toddlers can be given up to 120-180 mL (4-6 oz) of juice per day Parents should limit a toddler's juice intake to 120-180 mL per day because juice is high in sugar and should not replace more important nutrients. - A: Infants and toddlers should avoid low-calorie milk because the dietary fat in milk is essential for growth and development. - B: Preschoolers need 13 to 19 g of protein per day to support growth and development. - D: School-age children usually prefer afternoon snacks but should be encouraged to make healthy food choices.

A nurse is teaching the parent of a 12-month-old infant about nutrition. Which of the following statements by the parent indicates a need for further teaching? A. I can give my baby 4 oz of juice to drink each day B. I will offer my baby dry cereal and chilled banana slices as snacks C. I am introducing my baby to the same foods the family eats D. My infant drinks at east 2 qt of skim milk each day

D. My infant drinks at east 2 qt of skim milk each day As the infant transitions into toddlerhood, whole milk intake should average 24 to 30 oz per day. Too much milk can affect the child's intake of solid foods and result in iron deficiency anemia. - Skim milk is not recommended until after age 2 since it lacks essential fatty acids, which are needed for growth and development. - A: Children should not exceed 4-6 oz of juice per day between the ages of 1 and 6 years. Infants who are under 4-6 months of age should not be given juice. - B: At 12 months of age, infants should be offered finger foods. Finger foods stimulate the pincer grasp, which aids fine motor development. Cereal is small but dissolves in the infant's saliva and would not cause an airway obstruction. Chilled banana slices are an appropriate food choice and help relieve teething. - C: Introducing infants to foods prepared for the rest of the family is appropriate and helps them feel included. At 12 months of age, infants are able to eat soft table foods such as mashed potatoes, green beans, bread, and finely chopped meat.

A nurse is assessing a 6-month-old infant during a well-child visit. Which of the following motor activities should the nurse expect the infant to have achieved? A. Sitting alone B. Attempting to stack objects C. Picking up small objects with a crude pincer grasp D. Turning from back to stomach

D. Turning from back to stomach A 6-month-old infant should be able to turn over completely, sit momentarily without support, and reach to be picked up. - A: A 6-month-old infant is not able to sit alone. Infants usually achieve this motor activity around 9 months of age. - B: A 6-month-old infant cannot stack objects. A 12-month-old infant might attempt to build a 2-block tower but usually fails. - C: A 6-month-old infant cannot pick up objects with a crude pincer grasp. Infants usually achieve this motor activity around 9 months of age. By 6 months of age, infants should: - Be able to try to get things that are in reach, show affection for caregivers, respond to sounds around them, get things to their mouth, make vowel sounds ("ah", "eh", "oh"), roll over in either direction, laugh, or make squealing sounds. A parent should worry if their 6-month-old child: - Cannot do any of the actions listed above - Seems very stiff with tight muscles, or seems very floppy like a rag doll.