Pedi Exam 1 Prep U Questions

The nurse is promoting nutrition to a 13-year-old child who is overweight. Which instruction should the nurse include? "Go out for a sport at school." "You need to go on a low-fat diet." "Eliminate sugar from your diet." "Keep a food diary."

"Keep a food diary."

The parents of an 11-year-old child ask the nurse for suggestions to promote good nutrition for their child. Which response by the nurse would be most appropriate? "Be sure to limit protein to one meal every day." "Eat dark green leafy vegetables about twice a week." "Use whole-grain or enriched breads and cereals." "Have eggs on the average of once a week."

"Use whole-grain or enriched breads and cereals."

*The infant measured 20 in (50 cm) at birth. If the infant is following a normal pattern of growth, which range would be an expected height for this child at the age of 12 months? 30 to 32 in (76 to 81 cm) 40 to 42 in (102 to 107 cm) 36 to 38 in (91 to 96 cm) 26 to 28 in (66 to 71 cm)

30 to 32 in (76 to 81 cm) (The average newborn is 20 in (50 cm) in length. The infant grows more quickly in length during the first 6 months of life than the last 6 months of their first year. By 12 months the infant's length has increased 50%. That would mean a 20-in (50-cm) infant would have grown approximately 10 in (25 cm) in 1 year, making the normal length be 30 to 32 in (76 to 81 cm).)

If the child is gaining weight at an expected rate, a child who weighs 36 lb (16.3 kg) at 3 years of age would weigh what amount at age 5? 44 to 46 lb (20 to 21 kg) 50 to 52 lb (22.7 to 23.6 kg) 38 lb to 40 (17.2 to 18.1 kg) 58 to 60 lb (26.3 to 27.2 kg)

44 to 46 lb (20 to 21 kg) (Gain 4.5 lbs/yr during preschool)

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? A feeling of inferiority A sense of mistrust A sense of doubt A sense of shame

A feeling of inferiority

A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise? A sense of shame A feeling of inferiority A sense of doubt A sense of mistrust

A feeling of inferiority

nurse is caring for a hospitalized 7-year-old child whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group? A card game such as solitaire A paint-by-numbers activity creating a picture An activity focusing on learning fractions A board game such as monopoly

A paint-by-numbers activity creating a picture

The nurse is assessing a toddler's fine motor skills. Which finding will concern the nurse? Put shapes into matching openings Ability to turn door knobs Able to use a spoon to self-feed Ability to hold a crayon to write

Ability to turn door knobs

A nurse is preparing a presentation for a health fair discussing various aspects of toddlers. Which example should the nurse use to best illustrate dramatic play? Playing apart from others without being part of a group Acting out a troubling or stressful situation Playing a video game with several other children Watching television or videos

Acting out a troubling or stressful situation

A nurse is examining a 17-year-old adolescent in the emergency room who is being disruptive in the waiting area. On assessment, the nurse finds dilated pupils, and the teen is talking very fast. Which of the following drugs does the nurse suspect the teen may be abusing? Barbiturates Marijuana Amphetamines Opiates

Amphetamines

The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful? Have the child sit still during the story. Read a different book if he knows the story. Keep story time a reward for being good. Ask the child questions as you read.

Ask the child questions as you read.

While treating a minor playground injury for an 8-year-old girl, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? Assess the situation with the help of the school staff and parents. Question those responsible for the bullying. Determine if there have been other playground bullying incidents. Immediately call the bullied child's parents.

Assess the situation with the help of the school staff and parents.

Which patient education should the nurse provide a mother of a preschooler with broken fluency? A.Encourage the preschooler to recite in front of friends. B.Allow the preschooler to have time to talk. C.Encourage the preschooler to speak slowly. D.Stop the preschooler and tell him or her to start over.

B. Allow the preschooler to have time to talk.

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

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

A client has confided in a nurse that her 13-year-old daughter has recently changed dramatically in her social interactions with others. What is a social behavior most likely to be exhibited by a girl at this age? Banding together with boys and girls but maintaining her own unique style Hanging out with girls but maintaining her own unique style Banding together with other girls and dressing like them Hanging out primarily with boys her own age

Banding together with other girls and dressing like them

**The nurse is educating an adolescent's parents on the importance of self-esteem. Which factor will the nurse include as being most important to an adolescent's self-esteem? Friends selected by the adolescent Body image Morals and values Strong authority figures

Body image

The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler? Button clothes. Tie shoelaces. Print a few letters. Use scissors.

Button clothes. (The 3-year-old should be able to button his clothes and use a pencil or crayon. By the age of 4 to 5, the child should be able to use scissors, tie shoelaces, and print his first name)

A 4-year-old boy will not stop throwing sand at his sister. Which of the following punishments would be most effective with this child? A.Send him to his room for 15 minutes. B.Restrict television viewing for a day. C.Sit him in "time-out" for 4 minutes. D.Spank him on his bottom.

C.Sit him in "time-out" for 4 minutes.

Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers? Compares his soccer abilities with his peers. "Cooks" a meal on the toy stove. Dresses up and pretends to be a superhero. Asks the parent "why" about everything that happens.

Compares his soccer abilities with his peers.

*During the admission process the nurse learns a 14-year-old female client has not experienced menarche yet. Which nursing action is appropriate? Notify the primary health care provider. Assess the client's hormonal levels. Determine when the client's mother experienced menarche. Continue with the admission process.

Continue with the admission process.

The school nurse is presenting information to a group of high school students who are asking about vegetarian diets? Which foods will the nurse point out are not eaten when following the vegan diet? Red meat and possibly poultry Meat, poultry, fish and eggs Dairy products, meat, poultry, fish, and eggs Red meat, poultry and fish

Dairy products, meat, poultry, fish, and eggs

When describing the various changes that occur in organ systems during adolescence, what would the nurse include? Significant increase in brain size Decrease in activity of sebaceous glands Decrease in heart rate Ossification completed later in girls

Decrease in heart rate

A school health nurse is supporting a 15-year-old young woman with acne. What is a common myth related to acne in adolescent populations? Makeup may increase lesion formation. Excessive face washing is not necessary to prevent lesions from forming. Diet plays a significant role in acne production. Do not pick or squeeze acne lesions because it will just increase symptoms.

Diet plays a significant role in acne production.

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? Remind them staying in the hospital now will help the child get well quicker and be home soon, but the other children should not be alone. Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment. Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out. 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."

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."

*An 8-year-old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health? Encourage the child to abstain from eating sugary snacks at school. Accept that the child is genetically predisposed to having more cavities than most children. Have the child's teeth professionally cleaned every 3 months. Ensure that the child brushes his teeth after each meal and snacks.

Ensure that the child brushes his teeth after each meal and snacks.

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? She talks incessantly. She asks many questions. She uses complete 3- to 4-word sentences. Her vocabulary is between 10 and 15 words.

Her vocabulary is between 10 and 15 words. (A 3-year-old child typically has a vocabulary of approximately 900 words, asks many questions, uses complete sentences consisting of 3 to 4 words, and talks incessantly. Thus a vocabulary of 10 to 15 words suggests a language problem.)

During a well-child visit, the parent of a 10-year-old mentions to the nurse that they are thinking about getting a trampoline for their daughter. When responding to the mother, the nurse would need to keep in mind which of the following? Home trampoline use should be discouraged. Group play on a trampoline poses less risk than individual use. The risk for head and neck injuries is minimal. The family's homeowners insurance usually is protective.

Home trampoline use should be discouraged.

During a wellness care visit, the parents of a 2-year-old toddler report that they are struggling to deal with their toddler's daily and increasing number of tantrums. What information should be provided to the parents? Select all that apply. Tapping the toddler on the hands and voicing displeasure in the toddler's actions can successfully interrupt the behavior. Tantrums at this age can signal the development of an aggression disorder in a toddler. Maintaining a consistent daily routine can help to reduce tantrums. Ignoring the behavior is often helpful in reducing the duration of the tantrum. Tantrums are a common occurrence for a toddler of this age.

Maintaining a consistent daily routine can help to reduce tantrums. Ignoring the behavior is often helpful in reducing the duration of the tantrum. Tantrums are a common occurrence for a toddler of this age.

The caregiver of a 17-year-old girl is concerned she is not getting enough nutrition since starting a lactovegetarian diet and asking for menu ideas. Which food items should the nurse point out the child is choosing not to eat based on this diet?

Meat, poultry, fish, and eggs

**The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child? Have a routine physical exam every 6 months Needs 10 to 12 hours of sleep per night Be screened for scoliosis once a year Should brush their teeth at bedtime

Needs 10 to 12 hours of sleep per night (The school-aged child needs 10 to 12 hours of sleep per night. They need to brush their teeth after every meal and at bedtime. A routine physical exam once a year is all that is necessary. Children are screened around the age of 10 or 11 for scoliosis.)

The mother of a 10-year-old daughter is concerned that her child is becoming overweight. Her weight plots in the 95th percentile in the growth chart. Which action would the nurse recommend to the mother to address her concerns? Offer to go walking every day after school with her for 30 minutes. Remind the child daily that she needs to watch what she eats. Limit daily fat intake to 40% of the total calories for the day. Place the child on a diet, eliminating all sweets and snacks.

Offer to go walking every day after school with her for 30 minutes.

While preforming a preoperative assessment on a 3-year-old client, a nurse should be aware of what type of cognitive thought process by the child? Sensorimotor - Responses to the assessment are based off of reflex activity. Concrete operations - The child will understand the order of the assessment. Formal operations - The child requires no formal introduction to the equipment. Preoperational - The child will want to play with the equipment.

Preoperational - The child will want to play with the equipment.

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? Primary circular reaction Coordination of secondary schema Tertiary circular reaction Preoperational thought

Preoperational thought

A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be? School age Toddler Adolescence Preschool

Preschool

What resource should school-aged children be taught to use whenever they have questions about sex education, if their parents will not discuss the subject? Older siblings Material found on the internet Their friends School nurse

School nurse

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

The infant cries and the caregiver picks the child up.

The nurse observing toddlers in a day care center notes that they may be happy and pleasant one moment and overreact to limit setting the next minute by throwing a tantrum. What is the focus of the toddler's developmental task that is driving this behavior? The need for separation and control The need for safety and security The need for peer approval The need for love and belonging

The need for separation and control

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

The newborn does not respond to a loud noise.

An infant who is 4 months old continues to be seen at doctor visits for illness prevention. What would be the next scheduled appointment that this infant should attend to be evaluated? The next visit would be at 9 months. The next visit would be in 1 month. The next visit would be at 6 months. The next visit would be in 3 months.

The next visit would be at 6 months.

In teaching caregivers of preschool children, the nurse would reinforce that which activity would be most important for this age group? The preschool child should cover mouth when coughing or sneezing. The preschool child should brush and floss teeth after snacks and meals. The preschool child should be properly restrained when riding in a vehicle. The preschool child should be screened for amblyopia.

The preschool child should be properly restrained when riding in a vehicle.

The nurse is providing anticipatory guidance and education to the parents of child entering into the preschool age group. What information would the nurse include in the teaching? The child's cognitive growth will not be as intense as the child leaves the toddler stage. The preschool-age child will be less tolerant of separation from parents than during the toddler stage. The child will have an emergence of permanent teeth by the age of 4 years. The preschool-age child's physical growth will slow compared to previous years.

The preschool-age child's physical growth will slow compared to previous years.

A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess? Knowledge of full name Verbalization of 4 to 6 words Ability to name one color Use of a two-word noun-verb sentence

Use of a two-word noun-verb sentence

A nurse is assessing a 2-year-old's language development. What would the nurse expect to assess? Use of a two-word noun-verb sentence Verbalization of 4 to 6 words Knowledge of full name Ability to name one color

Use of a two-word noun-verb sentence

mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" What foods would be appropriate for the nurse to suggest? Select all that apply. Cookies Yogurt Cheese Pieces of apples Orange slices

Yogurt Cheese Pieces of apples Orange slices

The parent of a 4-year-old expressed concern to the nurse that the child still believes the pet that died will come back. What explanation should the nurse give to the parent? a. Counseling may be necessary for this child to face the pet's death. b. Preschoolers regress when a stressful event takes place in their lives. c. The child is in the stage of magical thinking and cannot understand death. d. Denial is a strong mechanism that prevents seeing death as permanent.

c. The child is in the stage of magical thinking and cannot understand death.

The school-age child develops the ability to recognize that if a block of clay is in a round ball and then is flattened, the shape changes but not the amount of clay. What understanding has this child developed? decentration reversibility classification conservation

conservation

A nursing student will correctly identify that growth is measured by which of the following patterns? changes in maturation height and weight developmental tasks milestones

height and weight

According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as: autonomy vs. doubt and shame. intimacy vs. isolation. identity vs. role confusion. industry vs. inferiority.

identity vs. role confusion.

*The parents of an 11-year-old tell the nurse they are concerned their child may have experimented with some type of inhalant. The nurse should teach the parents to observe for which symptom of inhalation? Select all that apply. irregular heart rate drowsiness irritability irregular respirations giddiness

irregular heart rate irregular respirations giddiness

A nursing instructor is teaching students about changes in the preschool-aged child. One such change is genu valgum, which refers to: innocent heart murmur. slim body type. knock-knees. large body type.

knock-knees.

A nurse is speaking with a 7-year-old boy in the hospital. The boy asks the nurse, "Where is the westroom? I need to use the westroom." The nurse recognizes that this developmental problem is which of the following? broken fluency malocclusion caries poor articulation

poor articulation

A pediatric nurse observes an infant holding a rattle. Upon dropping the rattle, the baby cannot pick it up with his fingers on his own. The nurse correctly identifies this to be an example of which type of growth? abnormal development proximodistal abnormal growth cephalocaudal

proximodistal

A pediatric nurse observes an infant holding a rattle. Upon dropping the rattle, the baby cannot pick it up with his fingers on his own. The nurse correctly identifies this to be an example of which type of growth? cephalocaudal abnormal growth proximodistal abnormal development

proximodistal

During a well-child visit to the health care provider, the parent reveals a family struggling with the changes from their "sweet, cuddly 16-month-old child" to that of a negative, more aggressive 2-year-old toddler. After the clinic visit, the nurse will document which priority nursing focus for this visit? ready for enhanced family coping potential risk for child abuse malfunctioning family coping impairment in family's resilience

ready for enhanced family coping (The most appropriate nursing focus would be that the family is ready for enhanced family coping related to the parents' ability to adjust to the new needs of the toddler. There is no indication in the scenario presented that the other issues require a nursing action.)

Parents share that their toddler often needs a snack in between meals. Which snack choice is nutritious enough to give the toddler energy but also may help prevent dental caries? Select all that apply. yogurt cheese slices sugar-free candy bars orange slices raisin oatmeal cookies

yogurt cheese slices orange slices

The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment? "Do play any instruments?" "Do you like to construct models?" "Do you participate in any sports?" "Do you like to do puzzles?"

"Do you participate in any sports?"

The health care provider has prescribed oral tetracycline for an adolescent girl to help clear acne. What statement about the medication made by the girl would require additional teaching from the nurse? "It is important for me to check the expiration date on the bottle." "I need to take the medication with food every day." "My periods will continue to be regular while on the medication." "I will see improvement on my face after 4 weeks of therapy."

"I need to take the medication with food every day."

The nurse is speaking with the parent of a 4-year-old child. Which statement by the parent would suggest a need for further investigation? "I think it is so cute when my child wants to help my spouse with yardwork." "My child loves to play dress-up with friends at day care." "My son loves to follow around his older sister." "When we go to the park, my child never wants to play with the other children." "Sometimes I wish my child would play with a toy in the way it was intended. My child is constantly pretending it is something else."

"When we go to the park, my child never wants to play with the other children."

When assessing a 33-month-old, the nurse would expect to find how many teeth? 20 8 12 16

(child is almost 3 - typically have all 20 teeth by 2.5-3 yrs)

During a well-child visit, a mother tells the nurse that she uses time-out to discipline her 2-year-old. The nurse determines that the mother understands the concept of time-out when the mother states that she keeps the toddler in time-out for _______ minutes.

2 minutes

*The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? A yellow rubber duck for the bath A push-pull toy Pots and pans from the kitchen cupboard Brightly colored stacking toy

A yellow rubber duck for the bath (The rubber duck is most appropriate. It is safe, visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant (12 months). Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered (8 months). A 5-month-old does not have the fine motor coordination to use stacking toys.)

When interviewed by the school nurse, a 13-year-old adolescent female states she has a boyfriend and that her parents do not talk about sex with her. She says is confused about the facts and wants to know the truth. Which approach would best address this adolescent's concerns? Offer to provide her some brochures to help her better understand how her body works. Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner. Refer the adolescent to a local health department for sexual counseling and pregnancy prevention. Explain that a discussion about sex is best handled by her parents and she should go home and ask them.

Sit down with her and openly discuss her concerns and questions in an honest, straightforward manner.

The nurse is conducting family teaching with the caregivers of school-age children on various topics. Which of the following statements is most accurate? Foods containing sugar should only be eaten as snacks, not at meal times. At the age of 6, children should have an initial screening for scoliosis. The child should have fluoride applied to his or her teeth at least twice a year. Children who are school-age should be encouraged to set their own bedtime.

The child should have fluoride applied to his or her teeth at least twice a year.

*Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? Half of speech understood by outsider Uses two-word sentences or phrases Talks about a past event Asks "why" often

Uses two-word sentences or phrases (A child nearly 3 years of age should speak in three- to four-word sentences. The other findings indicate normal expressive language for the age.)

*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? time to establish relationships with the opposite sex a sense of security as children gain independence time to remain dependent on their parents an opportunity for children to become self sufficient

a sense of security as children gain independence

What genetic and environmental factors influence the growth and development of children? Select all that apply. DNA transcription activity level temperament adaptability rhythmicity

activity level temperament adaptability rhythmicity

A seasoned pediatric nurse realizes that a hospitalized child's need for identity is strongest in which of the following groups? infants toddlers adolescents school-aged children

adolescents

A hospitalized 2-year-old is toilet training and excited to show the nurse the product created in the toilet. What stage does the nurse recognize this child is in according to Freud? anal stage phallic stage oral stage Oedipal stage

anal stage

*A group of 10-year-old girls have formed a "girls only" club. It is only open to girls who still like to play with dolls. How should this behavior be interpreted? poor peer relationships encouragement for bullying and sexism appropriate social development immaturity for this age group

appropriate social development

A nurse is preparing a teaching plan for the parents of a newborn. When explaining the neurologic development, how should the nurse point out that this occurs? outward-to-inward center-to-outside toe-to-head lateral-to-medial

center-to-outside

The parent of 3 1/2-year-old preschooler tells the nurse that the child argues quite a bit and says that the child is always right. The nurse interprets this information as indicating: initiative. centering. guilt. conservation.

centering.

While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their backyard a few days ago. The nurse explains that this is an instance of which of the following? deferred imitation parallel play assimilation autonomy

deferred imitation

A nursing instructor is preparing a teaching plan about the growth and development of toddlers. Which topics would the instructor include in the planned teaching? Select all that apply. noticeable respirations from the chest weight gain of approximately 10 lbs per year evidence of a prominent abdomen average heart rate of 120 beats per minute wide-stance gait when walking

evidence of a prominent abdomen wide-stance gait when walking

When preparing a care plan for an overweight child, the nurse should include what goal? Select all that apply. exercise plan support groups quick reduction of weight 1,500 calorie intake family counseling

exercise plan support groups family counseling

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

refer the infant for developmental and/or neurologic evaluation. (Head lag should go away at 4 months)

If the infant is following a normal pattern of dentition, the child would most likely have how many teeth by the age of 14 months? 14 to 18 teeth four teeth six to 12 teeth 24 teeth

six to 12 teeth (first tooth @ 6 months then 1 tooth per month after - The central incisors erupt between 6 and 12 months of age and lateral incisors erupt between 9 and 13 months. The other lateral incisors erupt between 10 and 16 months, so by age 14 months the infant could have up to 12 teeth.)

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. playing in an even-number group of children (four). regression. preschoolers having a harder time sharing than toddlers.

testing and identification of group role.

A nursing instructor teaching about normal growth and development identifies a need for further instruction when the student makes which statement? "A growth chart is the best tool to diagnose growth problems." "From fetal life through adulthood the body proportions change." "A growth chart is used only for comparison." "If a child does not fall into the 'normal' range, it does not mean that there is a problem."

"A growth chart is the best tool to diagnose growth problems."

*A high school athlete comes to the emergency department with hypertension, aggressiveness, and psychosis. What question would be important for the nurse to ask the client? "Do you take cocaine?" "Do you take anabolic steroids?" "Do you take human growth hormone?" "Do you take amphetamines?"

"Do you take anabolic steroids?"

The mother of a 3-month-old infant expresses concern that her infant's head is misshapen. Which would be the most appropriate question by the nurse? "Is the infant rolling over yet?" "Do you use "tummy time" with the infant?" "Have you thought of using a helmet?" "Does the infant sleep on its side?"

"Do you use "tummy time" with the infant?"

An 8-month-old child is diagnosed with a second ear infection and the father is concerned the infections are being caused by something he is doing or by something in the child's development. Which question should the nurse prioritize to collect more information to answer this father's questions? "Are you supplementing the baby's home-prepared formula with vitamin C?" "Does the baby go to bed with a bottle of formula each night?" "Does the baby teething appear to be teething?" "Are the baby's scalp and hair shampooed often?"

"Does the baby go to bed with a bottle of formula each night?"

*Parents are beginning potty training their 2-year-old child and seek advice from the nurse on how to be successful in this endeavor. Which statement by the parents indicates that further teaching is needed? "We will place him on the potty for 5 minutes for each session." "He wants to accompany me to the bathroom but I prefer to go alone." "I will wait until he is off the toilet before flushing it." "I bought him big boy underwear for him to use instead of diapers."

"He wants to accompany me to the bathroom but I prefer to go alone." (Allowing a toddler to observe a parent or older sibling going to the bathroom serves as a positive role model and helps the child understand what they are to do when they are there).

A male nurse is meeting with a group of high school boys to discuss various health topics. After the session on testicular self-exam, the nurse determines the session is successful when one of the students responds with which comment? "I am almost 15 now, so that means I could possibly get this disease." "Men my grandfather's age will probably die if they don't do these exams." "It sounds like we will need to know how to do this when we are in our 20s, so we might as well learn now." "My uncle had testicular cancer after he got married and had my cousin."

"I am almost 15 now, so that means I could possibly get this disease."

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." "When she doesn't eat well at meals we give her nutritious snacks." "New foods are offered along with ones she likes." "She drinks three 6-ounce cups of whole milk each day."

"I give my daughter juice at breakfast and when she is thirsty during the day."

During the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old toddler's caregiver indicates that the toddler is developing autonomy? "When my toddler falls down, he or she always wants me to pick him or her up." "My toddler has temper tantrums when we go to the store." "My toddler uses the potty chair and is dry all day long." "Every night my toddler follows the same routine at bedtime."

"My toddler uses the potty chair and is dry all day long."

*An overly tired school-aged child enters the school clinic. The nurse asks the child to state the times he/she usually goes to bed at night and wakes up in the morning. The child answers 11:00 PM and 6:00 AM. Which is the best response made by the nurse? "Why do you go to bed so late at night?" "That should be enough sleep. Let's talk about your eating habits." "Do your parents always let you stay up so late at night?" "That is not enough sleep. You should get at least 9 to 12 hours of sleep each night."

"That is not enough sleep. You should get at least 9 to 12 hours of sleep each night." (The school-aged child needs 9 to 12 hours of sleep per night. Seven hours of sleep is not enough sleep for this child. It is not appropriate to ask judgmental questions concerning parenting skills nor why the child goes to bed at 11:00 PM.)

A nurse walks into the room to check on a preschool client. When the nurse asks the preschooler how she is doing, the child says she is Tinker Bell. What is the best response by the nurse? "That will be fun if you want to pretend you are Tinker Bell!" "I will not call you Tinker Bell. I like the name Whitney better." "You are not Tinker Bell. Your name is Whitney." "Hello, Tinker Bell."

"That will be fun if you want to pretend you are Tinker Bell!"

During a health history, the nurse explores the sleeping habits of a 3-year-old boy by interviewing his parents. Which statement from the parents reflects a recommended guideline for promoting healthy sleep in this age group? "Our son still sleeps in a crib because we feel it is the safest place for him at night." "Our son sleeps through the night, and we insist that he takes two naps a day." "We keep a strict bedtime ritual for our son, which includes a bath and bedtime story." "Our son occasionally experiences night walking so we allow him to stay up later when this happens."

"We keep a strict bedtime ritual for our son, which includes a bath and bedtime story."

A group of caregivers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which statement made by these caregivers is appropriate related to this form of discipline? "Our time-out chair is in the master bedroom so my child cannot see anyone else in the family." "My child is 3 years old now and I put my child in time-out for 5 to 10 minutes when misbehaving." "We use the time-out chair when our child gets tired but does not want to take a nap." "When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."

"When my child starts getting frustrated and aggressive, I remind the child throwing a fit will end up in a time-out."

A mother asks the nurse where the microwave is so that she can warm up breast milk to feed her baby. What is the best response by the nurse? "Make sure that you test the milk on your wrist before feeding." "You should warm the milk under warm water instead." "Breast milk can be given cold, so there is no need to heat it." "You should only give fresh breast milk to an infant."

"You should warm the milk under warm water instead."

*A 13-year-old girl has grown rapidly in height over the past 2 years and is taller than most of the boys in her class. She wonders when she will stop growing. What should the nurse tell her as a general guideline for the ages at which most girls stop growing? 20 to 21 years old 14 to 15 years old 18 to 19 years old 16 to 17 years old

16 to 17 years old

The infant weighs 6 lb 8 oz (2,950 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 12 months? 19 lb 8 oz (8825 g) 10 lb 8 oz (4760 g) 13 lb (5900 g) 15 lb 4 oz (6920 g)

19 lb 8 oz (8825 g)

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit? 28 pounds (12.7 kg) and 32 inches (80 cm) 20 lb (9.1 kg) and 28 inches (70 cm) 24 pounds (10.8 kg) and 30 inches (75 cm) 16 lb (7.2 kg) and 26 inches (65 cm)

24 pounds (10.8 kg) and 30 inches (75 cm) (triples in weight in first year, grows 50%)

The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months? 27.5 in (70 cm) 29 in (74 cm) 32 in (81 cm) 30.5 in (77.5 cm)

27.5 in (70 cm) (Infants gain about 0.5 to 1 in (1.25 to 2.5 cm) in length for each of the first 6 months of life. Therefore, a 21.5-in (54.6-cm) infant adding 6 in (15 cm) of growth would be 27.5 in (70 cm). Infants grow the fastest during the first 6 months of life and slow down the second 6 months. By 12 months of age, the infant's length has increased by 50%, making this infant 32 in (81 cm) at 1 year old.)

The nurse is performing a physical assessment of a 10-year-old child. The nurse notes that 1 year ago the child weighed 80 lb (36.3 kg). Which weight, if noted during this assessment, would alert the nurse to further assess the child for appropriate growth and development? 82 lb (37.2 kg) 87 lb (39.5 kg) 86 lb (39 kg) 88 lb (40 kg)

82 lb (37.2 kg) (From 6 to 12 years of age, an increase of 7 lb (3 to 3.5 kg) per year in weight is expected, so would be a target weight of 87 lb (39.5 kg). A child weighing near 87 lb, such as 86 lb (39 kg) or 88 lb (40 kg), would be considered appropriate. If the child weighed only 82 lb (37.2 kg), this would alert the nurse to further assess the child for lagging growth.)

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? 14-month-old toddler who walks with a parent's assistance 9-month-old infant who can pull self up to a standing position 24-month-old toddler who engages in parallel play 3-year-old preschool-aged child who goes up stairs on hands and knees

3-year-old preschool-aged child who goes up stairs on hands and knees

The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. A regular routine and rituals will provide stability and security. A sense of control can be provided through offering limited choices. Aggressive behaviors such as hitting and biting are common in toddlers.

A regular routine and rituals will provide stability and security.

A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship? A willingness to take initiative An ability to be autonomous A sense of trust and identity An understanding of socialization and of isolation

A sense of trust and identity

*The school nurse is preparing a program on sexuality and birth control for a class of 14- to 16-year-olds. Which behavior will have the most influence on how the information is presented? Adolescents understand that actions have consequences. Adolescents tend to take risks. Teens are adjusting to new body images. Teenagers are able to think in the abstract.

Adolescents tend to take risks.

A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development? After age 12 children can think in the abstract, including complex problem solving. Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. From ages 7 to 11 years, children internalize actions and can perform them in the mind.

After age 12 children can think in the abstract, including complex problem solving.

What would be most effective in helping promote initiative and nutritional health for a preschooler? Giving the child a high carbohydrate snack after preschool Allowing the child to spread soft cheese on crackers Praising the child for cleaning his large plate of food Encouraging the child to cut up small pieces of apple for a snack

Allowing the child to spread soft cheese on crackers

Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue? Planning for the child to get 12 hours of sleep daily Allowing the preschooler to fall asleep wherever and whenever the child is tired enough Providing a nightlight Eliminating caffeine sources beginning late afternoon Taking the TV set out of the child's room

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough

A patient who has just given birth to her second child is concerned that her preschooler will be jealous when people bring gifts for the newborn. What would be the best suggestion to make to this mother about the gifts? Have the preschooler go in the other room so that he or she does not see the gifts. Ask the preschooler if he or she likes the new baby. Ask people to bring a small second gift for the preschooler as well. Tell visitors to come only when the preschooler is napping.

Ask people to bring a small second gift for the preschooler as well.

A previously toilet trained 4-year-old child has many episodes of urinary incontinence while in the hospital for a fractured femur. Which of the following actions should the nurse implement? A. Awaken the child every 2 hours through the night to try to use the bedpan. B. Explain that children will usually quickly regain control over a previously mastered skill once home again. C. Send a urine specimen for analysis. D. Limit consumption of fluids between meals.

B. Explain that children will usually quickly regain control over a previously mastered skill once home again.

The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue? Before answering questions, find out what the child thinks about the subject. Be prepared to thoroughly cover a topic before the child asks about it. Provide a less than honest response to shelter the child from knowledge that is too advanced. Expand upon the topic when answering questions to prevent further confusion.

Before answering questions, find out what the child thinks about the subject.

*The nurse is preparing a presentation for a community health fair on the topic of helping school-aged children develop the self-confidence they will need to mature into responsible adults. Which suggestion should the nurse prioritize to caregivers to enable them to help their children in this area? Encourage older siblings to include the child in their activities. Ensure that the child has the best teacher possible. Caregivers should maintain consistent rules and expectations. Encourage the child to cheer on their friends at games.

Caregivers should maintain consistent rules and expectations.

Which measures should receive priority in the care plan for an infant client who has sensitive skin? Use only cloth diapers Use baby power with each change Use scented wipes with stool Change diapers frequently

Change diapers frequently

A new mother tells the nurse that she a bought car seat for her infant at a garage sale when she was pregnant but that a friend recently told her that she should buy a new one. Which instruction would the nurse give initially? Check the expiration date on the car seat Inspect the car seat for any cracks or damage Have the car seat installed by a professional Clean all fabric that touches the infant

Check the expiration date on the car seat

The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply. Cookies and juice Cheese and crackers Turkey sandwich Whole grain granola with yogurt Strawberries and bananas

Cheese and crackers Turkey sandwich Whole grain granola with yogurt

*The parents of a 3-year-old who had bone cancer that resulted in amputation of the lower left leg ask their health care provider about expected behaviors for their child. Which behavior is expected and acceptable during hospitalization for treatments? Soiling with feces is unacceptable if the child was toilet trained prior to the hospitalization and should be addressed each time it occurs. Crawling may be their preferred mode of travel because they may not want to wait for help to put the prosthesis on. During hospitalizations, there should be no regression in their toilet training since many staff members are available to take the child to the restroom. If the child throws a tantrum, the nurses should also assess for seizures related to the use of pain medication following current treatment modalities.

Crawling may be their preferred mode of travel because they may not want to wait for help to put the prosthesis on.

The 11-year-old arrives in the emergency department presenting with the following: nosebleed with no apparent trauma, disoriented, confused, difficulty walking, nausea, and coughing. The nurse should question the child concerning which potential activity? Falling on the playground at school Exposure to a respiratory disease Eating a food he is allergic to Experimenting with an inhalant

Experimenting with an inhalant

*The nurse is preparing the anticipatory guidance sheets that are provided to parents. When organizing the sheets, place the milestones in their proper sequence from earliest to latest. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Creep up stairs 2 Engage in parallel play 3 Name one color 4 Zip up their own jackets 5 Run and jump in place

Creep up stairs Run and jump in place Engage in parallel play Name one color Zip up their own jackets (A 15-month-old can creep upstairs. An 18-month-old can run and jump in place. A 24-month-old engages in parallel play; a 30-month-old can name one color. Zipping their jackets occurs around their third birthday.)

A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply. Pick the toddler up and take her to the restroom for a spanking. Reason with the toddler and explain that the candy is not nutritious for her. Do not reward the behavior by giving into the toddler's demands and buying the candy. Remain calm and ignore the tantrum. Pick the toddler up and move her to a safe environment but do not give in to her desires.

Do not reward the behavior by giving into the toddler's demands and buying the candy. Remain calm and ignore the tantrum. Pick the toddler up and move her to a safe environment but do not give in to her desires.

Nursing students are reviewing information about preschooler growth and development. The students demonstrate understanding of the information when they identify which of the following as a common fear during this period? Select all that apply. Fear of the dark Fear of independence Fear of abandonment Fear of mutilation Fear of separation

Fear of the dark Fear of abandonment Fear of mutilation Fear of separation

The school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. What is the most important element to emphasize to maximize compliance, healthy habits, and long-term change? Include both parents and children in the wellness program. Incorporate activity in parts of the daily schedule. Eliminate sweetened, carbonated beverages in the cafeteria. Serve fruits and vegetables in the cafeteria.

Include both parents and children in the wellness program.

A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers? Learning to act on one's own Learning to speak Learning to understand and respond to discipline Learning to trust

Learning to act on one's own

*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? Remind the child to stop each time the behavior is witnessed. Apply a nail biting product to the nails to deter biting. Get a description of the classroom behavior from the teacher. Make time each day to spend with the child individually.

Make time each day to spend with the child individually. (Many first graders are capable of mature action at school but appear less mature when they return home. They may bite their fingernails, suck their thumb, or talk baby talk. Scolding, nagging, threatening, or punishing does not stop the problem and can actually make them worse. Methods such as bad-flavored nail polish or restraining the child's hands make the problems worse. These behaviors stop when the underlying stress is discovered and alleviated. Parents should be urged to spend time with the child after school or in the evening so the child continues to feel secure in the family and does not feel pushed out by being sent to school.)

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

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

A parent with a 2-year-old invites a friend with a toddler over for a play date when they notice their children are not really interacting while playing. The children are playing side-by-side when one toddler gets up and grabs a toy car out of the hands of the other toddler, which results in both toddlers crying. To prevent this from occurring again, which intervention should the parents make? Parents should decide that they need to wait about a year when the children are more ready to share toys. Sit the toddlers down and give a lecture about "sharing." Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy. Parent of the toddler who started the fight should put this child in "time out."

Parents should ensure that toys in front of each child are "similar" to prevent fighting over one toy.

*The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity? Painting pictures in the art corner of the room Pretending to be mommies and daddies in the play house Playing with the plastic vacuum cleaner and pushing it around the room Watching a movie with other children their age

Playing with the plastic vacuum cleaner and pushing it around the room (Playtime for the toddler involves imitation of the people around them such as adults, siblings, and other children. Push-pull toys allow them to use their developing gross motor skills. Preschool children have imitative play, pretending to be the mommy, the daddy, a policeman, a cowboy, or other familiar characters. The school-age child enjoys group activities and making things, such as drawings, paintings, and craft projects. The adolescent enjoys activities they can participate in with their peers.)

The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in? Watching a movie with other children their age Playing a board game Pretending to be mommies and daddies in the playhouse Painting pictures in the art corner of the room.

Pretending to be mommies and daddies in the playhouse

A nurse is admitting a 16-year-old male to the floor for an appendectomy. How can the nurse prepare this client for hospitalization? Select all that apply. Remind him that there are strict rules regarding meal times and when lights are turned out on the floor. Provide privacy when client is changing into the hospital gown or going to the bathroom. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Encourage parents to do as much as possible for the client, including ADLs and meal selection. Encourage him to keep his cell phone nearby to communicate with his friends.

Provide privacy when client is changing into the hospital gown or going to the bathroom. Interview the adolescent separately from the parent to allow expression of information that he may not be comfortable sharing in front of the parent. Encourage him to keep his cell phone nearby to communicate with his friends.

A female client tells the nurse about noticing an increase in weight and fat deposits during the past year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time? Share what foods can be eaten on a low-fat diet to prevent fat deposits. Review dietary measures to assist in controlling weight gain. Provide reassurance that these are normal changes. Encourage increased exercise to control weight gain.

Provide reassurance that these are normal changes.

*The nurse teaches parents of adolescents that teenagers need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance? Teaching personal hygiene routines Maximizing learning potential Promoting adequate physical growth Reducing risk-taking behavior

Reducing risk-taking behavior

*The nurse is teaching the parents of a preschool-age child about injury prevention. Which method would the nurse advise for the parents as the best way to enforce injury prevention? Constant vigilance Safety rules Repetition, modeling, and reinforcement Repetition and reinforcement Adequate supervision

Repetition and reinforcement (Injury prevention involves adults actively searching the indoor and outdoor environment of the home and other areas where the child may frequently spend time. This keeps the environment "explorable," prevents conflicts, and enables the child to expand on skills that need mastering. Safety rules and constant vigilance are only a small part of enforcing injury prevention.)

*The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant? Bears weight on legs when held in standing position Grasps objects and brings them to the mouth Able to sit up and roll over Smiles at significant others

Smiles at significant others (3 months -> Smile at sight of parents' faces & can LOL. Developed social smile at 6 weeks)

A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity? Make a model for the child to follow so it will be easy to copy. Support whatever the child paints. Tell the child that it will be fun but that he or she should not make a mess. Draw a picture first for the child to see how to do it.

Support whatever the child paints.

*A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client? Take her to the teen lounge so she can meet and interact with other teens. Call the hospital's mental health unit to see if she can get some counseling. Ask her caregivers to bring her siblings and friends to visit. Suggest that she read books and magazines from the hospital bookmobile.

Take her to the teen lounge so she can meet and interact with other teens.

The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur? Increased attention span and can be interested in an activity for a long length of time Insists doing something and the next moment reverts to being dependent Takes in new information at a rapid rate and asks "why" and "how" Grows and develops skills more rapidly than at any other time in their life

Takes in new information at a rapid rate and asks "why" and "how"

*The nurse is assessing developmental milestones for a 5-year-old girl. Which of the following activities is normal? The child sleeps 10 hours a night. She is able to use a table knife. The child can button a shirt. She is able to read simple books.

The child can button a shirt.

The nurse is supervising lunch time for children on a pediatric ward. Which observation is considered abnormal for this age group? The child has no difficulty chewing and swallowing meat. The child uses his fingers and refuses to use a fork. The child is a picky eater. The child has a full set of primary teeth.

The child uses his fingers and refuses to use a fork. (The preschool child has learned to use utensils fairly effectively to feed himself or herself, has a full set of primary teeth, and is able to chew and swallow competently. Preschool children may be picky eaters. They may eat only a limited variety of foods or foods prepared in certain ways and may not be very willing to try new things.)

An 18-year-old client is planning to attend college in the fall. The health care nurse informs the adolescent that a visit with the primary care physician (PCP) will need to be scheduled before the start of college. What primary purpose does this PCP visit serve? To assess for health problems To discuss diet To obtain birth control To update immunizations

To update immunizations

The nurse is watching toddlers at play. Which normal behavior would the nurse observe? Toddlers engage in solitary play. Toddlers engage in cooperative play. Toddlers do not engage in play outside the home. Toddlers engage in parallel play.

Toddlers engage in parallel play.

Fear of mutilation is significant during the preschool age. False True

True

A nurse in a busy pediatric clinic is educating a group of parents with toddlers about the nutritional needs of this age group. Which concepts should be addressed in this educational presentation? Select all that apply. Try to limit the fat intake to less than 35% of total calories. Active, "busy" toddlers may need up to 1,400 cal/day. Milk is still important to incorporate in the diet for bone health. There is no need to worry about the amount of trans fats in a toddler diet. Children can have as many cookies they want if that is the only thing they will eat from breakfast.

Try to limit the fat intake to less than 35% of total calories. Active, "busy" toddlers may need up to 1,400 cal/day. Milk is still important to incorporate in the diet for bone health.

The nurse plans an activity for a chronically ill hospitalized child. Which activity is the best choice to provide stimulation for the child? reading a book playing a video game listening to music painting a picture

painting a picture

When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation? Weight is above an expected range and height is within an expected range. Weight and height are within expected patterns of growth. Weight falls within an expected range and height is less than what would be expected. Weight is below an expected range and height is above an expected range.

Weight is above an expected range and height is within an expected range. (Preschoolers gain 2-3.5 in & 4.5 lb/yr on average)

A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend? a forward-facing convertible booster a rear-facing 5-point harness restraint a forward-facing 5-point harness restraint a rear-facing booster seat

a rear-facing 5-point harness restraint

A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks? maturation developmental proximodistal cephalocaudal

developmental

The student nurse is preparing a short oral report for post clinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of the middle adolescence stage? grapple with everyday issues struggle with career choices fluctuations in self-assurance desire for goal attainment

fluctuations in self-assurance

What mineral is an important factor in tooth development? fluoride potassium iron magnesium

fluoride

The nurse is completing a physical assessment of a 15-month-old. Which objective data would the nurse document as normal findings? Select all that apply. lordosis waddling gait predominance of baby fat heart rate of 100 beats per minute sunken abdomen

lordosis waddling gait heart rate of 100 beats per minute

According to Kohlberg, which of the following considerations is central to human development? safety morality influence agency

morality

A father shares with a nurse that his 12-year-old son has begun ejaculating in his sleep and is deeply embarrassed about it. The father says he has tried to explain to his son that this is a normal occurrence in puberty, but the son is still humiliated by it. The nurse recognizes this occurrence as which of the following? gynecomastia premature ejaculation nocturnal emissions dysmenorrhea

nocturnal emissions

**The school nurse receives a report that a child is having difficulty with grades and always appears hungry. When the nurse is assessing this child, what information would be most important to ascertain? amount of food consumed daily relationship with parents recent illnesses amount of sleep

relationship with parents (Children who live with a parent with alcohol use disorder are at greater risk for having emotional problems than others because of the frequent disruption in their lives. Two symptoms children may exhibit are poor nutrition and decreasing grades in school because the parent's behavior is so erratic that no regular schedule of meal times or bed times exists. The child may experience helplessness to change the situation. Recent illnesses, the amount of sleep the child receives, and the amount of food consumed daily are also important factors, but in order to improve those the nurse would first need to understand the dynamics of the family and any problems with the parents.)

A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3750 g) at birth. Weight now is 20 pounds 8 ounces (9300 g). The nurse determines: the child weighs more than expected for age. the child weighs less than expected for age. the child weighs the expected amount for age. the weight assessment is blatantly inaccurate.

the child weighs less than expected for age.

According to Erikson, normal adolescent behavior includes trying on new roles and possibly even rebelling. What is the purpose of this behavior in adolescents? to avoid inferiority to gain autonomy to establish a sense of identity to establish a sense of security

to establish a sense of identity

A 12-year-old girl has recently begun menstruating and is well into puberty. She is visiting the doctor today for a routine physical examination. Which of the following findings should cause concern in the nurse? irregular periods vulvar irritation supernumerary nipple breasts of slightly different sizes

vulvar irritation

The nurse is presenting information about school-aged children at a community event. Which statement should the nurse prioritize for further teaching and providing more information? "I make sure they have good teeth by giving them calcium and phosphorus." "Sometimes we have to be firm, but our children wash their hands before eating." "Even if the weather is cool and cloudy, our children play outside every day." "Food is so expensive, we always make our children eat everything on their plates."

"Food is so expensive, we always make our children eat everything on their plates."

The school nurse is conducting a health class with a group of high school students on the topic of sex and sexuality issues. The nurse determines the session is successful when the students correctly choose which aspect as most important? "Males as well as their partners are responsible for avoiding an unwanted pregnancy." "Girls should carry their own condoms and use them to avoid pregnancy." "It is important for adolescents to abstain from sexual activity." "Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."

"Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."

first-time father calls the pediatric nurse stating he is concerned that his 4-year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate? "Disciplining is not likely to be effective, but if the child keeps wetting the bed it may be necessary." "Nightly bedwetting up to age 12 is developmentally typical, so you will need to practice patience with your daughter." "Setting rules is a parent's job to help the child have acceptable social behavior, so take away a privilege each time she wets the bed." "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."

"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."

Which statement by a school-aged child demonstrates Erikson's psychosocial stage of industry versus inferiority? "I can take control, dress myself" versus "What I did is bad." "I am really helping others" versus "I only do things that benefit me." "I am just not able to trust anyone so I will just have to trust myself." "I have friends and I succeed" versus "I have no friends and am incapable."

"I have friends and I succeed" versus "I have no friends and am incapable."

A nurse in the teen clinic is using anticipatory guidance to educate parents about preventing violence in teens. Which of the following responses by a parent would show the nurse that the teaching on suicide was effective? "I will check for signs of depression and a lack of peers." "I will become good friends with my child's peers." "I will watch for aggressive behavior." "I will monitor all electronic games and TV."

"I will check for signs of depression and a lack of peers."

The nurse is meeting with a group of new mothers of infants and is leading the discussion related to weaning. Which suggestion should the nurse prioritize to this group of mothers concerning weaning their infant? "If the infant is eating from a dish and drinking from a cup, they no longer need a bottle or breast feeding." "The infant who is interested in watching others drink from a cup is ready to be weaned." "It is best to just pick a day and stop breast or bottle feeding and wean the infant to a cup." "It is important to let the infant set the pace for weaning, no matter what age they are."

"It is important to let the infant set the pace for weaning, no matter what age they are."

The parents of a toddler express some frustration because they are having a hard time getting their child to take a nap, even though the child is acting tired and cranky. Which suggestion for the parents to try is most appropriate when working with toddlers? "We'll go to the park after naptime." "If you take your nap, I will see if your friend can come play." "I think you should go take a nap. Please do not disobey me or you will not get any ice cream later." "It's naptime, do you want to sleep with your stuffed bear or with your sock monkey?"

"It's naptime, do you want to sleep with your stuffed bear or with your sock monkey?"

During an annual visit of a 6-year-old boy, the nurse observes dental caries on two of the child's primary teeth. Which response by the parents suggests more education is needed regarding the importance of primary teeth? "I see now we need to use a fluoride toothpaste for our child." "I guess we will need to supervise our son while he brushes." "These are only his baby teeth so we are not worried." "I guess we better look for a pediatric dentist for our son."

"These are only his baby teeth so we are not worried."

The nurse is teaching the parents of a 12-year-old boy about common approaches when raising an adolescent. Which instruction is most important? "Try to be open to his views." "Maintain a firm set of rules." "Remind him that he is still your little boy." "Find out if his friends are worthy of him."

"Try to be open to his views."

A home visit nurse is providing health promotion on safety to a family of a 1-week-old infant. Which of the following statements by the parents indicates the need for further teaching? "We will swaddle our son to keep him quiet and warm to sleep." "We will give our son a pacifier before placing him in his crib." "We will place our infant in a rear-facing car seat in the back seat of the car." "We will position our infant on his side for sleeping."

"We will position our infant on his side for sleeping." (Infants should be placed on their backs for sleeping to reduce the risk of SIDS. All other choices are safe infant practices Can't roll over until 4 months)

When providing anticipatory guidance to parents about their preschool son who was caught in a lie, what would the nurse emphasize? "The misbehavior is usually more serious than the lying itself." "You need to determine the reason for lying before punishing the child." "Lying should never be tolerated and the child should be punished." "It is okay to become angry when dealing with the child's lying."

"You need to determine the reason for lying before punishing the child."

A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? "Don't worry, your daughter will probably give you very definite signals." "Most children are ready for toilet training by the time they are 18 months old." "Your daughter can understand holding urine and stool by about 1 year of age." "You'll probably notice that your daughter is uncomfortable in wet diapers."

"You'll probably notice that your daughter is uncomfortable in wet diapers."

*The nurse teaches a 14-year-old client's mother about the adolescent developmental task of identity versus role confusion. What is the best way for the mother to help her adolescent complete this task? Set limits and offer concrete choices. Allow the adolescent to participate in decisions. Set limits according to what other adolescents are allowed to do. Allow the adolescent to set his/her own limits.

Allow the adolescent to participate in decisions.

A nurse is caring for a 4-year-old child who 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? Distract the child with games and candy. Don't discuss the procedure in front of the child. Allow the child to play with a procedure doll. Take the child to the playroom for coloring.

Allow the child to play with a procedure doll.

*What activities would a nurse recommend to the families of school-aged children to promote attainment of Erikson's developmental stage of industry vs. inferiority? Select all that apply. Voicing parental doubts when the child begins a new activity, such as playing a musical instrument to avoid embarrassment Commiserating with the child when he or she does not get selected for the school choir Allowing the child to assist her teacher in straightening up the classroom Participating on the school soccer team Praising the child for their academic efforts

Allowing the child to assist her teacher in straightening up the classroom Participating on the school soccer team Praising the child for their academic efforts

The English-speaking nurse is assessing a 12-month-old child with an English-speaking father and a Spanish-speaking mother. The child does not use words like "drink" "dog" or "ball." What is the nurse's priority intervention? encouraging the parents to speak only one language to the child asking the mother if the child uses Spanish words for those items performing a developmental evaluation of the child referring the child to a developmental specialist to rule out developmental delay

Asking the mother if the child uses Spanish words for those items

*A parent of a 4-year-old preschooler asks the nurse about how to discipline her child for bad behavior. The nurse would recommend that the parent take which steps to discipline the child? Select all that apply. Attend only to the good behavior—ignore acting out. Set consistent limits and adhere to them. Place the child in time out for 8 minutes. Take away the child's favorite toy until behavior improves. Spank the child, explaining what he or she did wrong.

Attend only to the good behavior—ignore acting out. Set consistent limits and adhere to them. Take away the child's favorite toy until behavior improves.

The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers? Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues. Teenagers spend so much time with their peers, and that is usually how they find out about sex. Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. Most schools have excellent programs to teach adolescents about sex and sexuality.

Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality.

The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation? Girls grow at a slower, steadier rate than do boys. Boys and girls grow at the same rate. Boys grow at a slower, steadier rate than do girls. Boys grow at a rapid, sporadic rate.

Boys grow at a slower, steadier rate than do girls.

Like many 4-year-olds, Ethan is constantly seeking out and exploring new experiences and repeatedly asking his parents why-type questions. Ethan's behavior suggests that he is successfully navigating an important developmental task within the developmental theory of: Freud. Fowler. Kohlberg. Erikson.

Erikson. (Initiation vs. Guilt)

An 8-year-old boy who says he wants to be a doctor when he grows up pleads with the nurse to let him put on his own band-aid after receiving an injection. The nurse agrees and watches as the boy very carefully lines the band-aid up with the mark left by the injection and applies it to his skin. Then he asks, "Did I do it right?" and waits eagerly for the nurse's feedback. The nurse recognizes in this situation the boy's attempt to master the primary developmental step of school age. What is that step? Perfectionism Conservation Industry Accommodation

Industry

*The nurse is describing the maturation of various organ systems during toddlerhood to the parents. What would the nurse correctly include in this description? Toddlers typically have strong abdominal muscles by the age of 2. Alveoli reach adult numbers by 3 years of age. Urine output in a toddler typically averages approximately 30 ml/hour. Myelinization of the brain and spinal cord is complete at about 24 months.

Myelinization of the brain and spinal cord is complete at about 24 months. (Myelinization of the brain and spinal cord continues to progress and is complete around 24 months of age. Alveoli reach adult numbers usually around the age of 7. Urine output in a toddler typically averages 1 ml/kg/hour. Abdominal musculature in a toddler is weak, resulting in a pot-bellied appearance.)

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? Playing with a jack-in-the-box Playing with blocks Writing letters to friends Participating in a craft project

Participating in a craft project

Which gross motor skill would the 4-year-old child have most recently attained? The child can button his/her clothes. The child can tie his/her shoelaces. The child can cut his/her food. The child can hop on one foot.

The child can hop on one foot.

A group of nursing students are reviewing information about bullying and children who are bullied. The students demonstrate a need for additional review when they identify which as characteristic of a bullied child? having numerous friends insecurity little social skills low self-esteem

having numerous friends

The mother of a 5-year-old girl expresses concern over the fact that her daughter is not nearly as verbal as her older two children when they were at that age. She wonders about the reason for this difference. Which factor is most likely to account for this difference? ordinal position in the family parent-child relationship nutrition genetics

ordinal position in the family

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: onlooker play. solitary play. associative play. parallel play.

parallel play

A mother is concerned about her 2-year-old son acquiring sufficient protein while following the family's vegan diet. Which of the following foods would be appropriate for the nurse to recommend to this mother? broccoli milk and cheese peanut butter and wheat bread eggs

peanut butter and wheat bread

The nurse is counseling the parents of a 10-year-old child who was caught stealing at school. Which topic should the nurse cover? Finding out what is currently going on at home Discussing ways for the child to save face Having the child return the property in front of his or her class Reminding the child each day that stealing is wrong

Finding out what is currently going on at home

A parent calls the health care provider about the 7-year-old child's dental hygiene. The child has had three cavities. The parent does not know what to do and asks the nurse for guidance. How should the nurse respond? "What type of toothbrush does your child use?" "Are you able to supervise your child's brushing?" "Did you teach your child how to brush the teeth?" "Is there fluoride toothpaste available for use?"

"Are you able to supervise your child's brushing?"

The mother of a 6-month-old infant asks the nurse at a community health center what she should do about her baby, who always wants to put everything in his mouth. What would be an appropriate response by the nurse, based on Freud's theory? "There must be something wrong...your baby should not be doing that." "Babies at this age explore and enjoy their world with their mouths." "This usually does not happen until babies are 2 years old." "I don't know if that is normal or not, but I will check on it."

"Babies at this age explore and enjoy their world with their mouths."

The parent of a 14-year-old adolescent states to the nurse that the adolescent is moody, shuts oneself in the bedroom, and fights with a younger sibling. Which comment is most helpful to support the parent? "Set some rules for family etiquette." "This is normal for the age." "Take away all of the adolescent's privileges until your adolescent starts acting better." "Calmly talk to your adolescent about your concerns."

"Calmly talk to your adolescent about your concerns."

During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family? "Difficulties with speaking generally indicate that the adults in the child's life are not reading to the child enough." "Children of this age may stutter while they search for just the right word." "Stuttering is common in young children because they are not physically capable of forming all the sounds." "Stuttering is usually indicative of a hearing loss."

"Children of this age may stutter while they search for just the right word."

A nurse is educating a middle school class of male adolescents about sex education. The topic of multiple partners is discussed. Which of the following statements from the nurse would be the most effective? "Compared with male teens, female teens are more susceptible to STIs." "Be careful, or you will end up being a teen parent." "Teens account for 25% of all sexually transmitted infections (STI) in the population." "Contraception is a responsibility of both parties involved."

"Contraception is a responsibility of both parties involved."

A black adolescent male has been diagnosed with hypertension. Which statement made by the adolescent indicates to the nurse that additional teaching is needed? "My blood pressure should remain less than 130/90 mm Hg." "Drinking sodas is not related to my blood pressure." "My dad has hypertension, so I have to be careful." "Playing baseball is good exercise for me."

"Drinking sodas is not related to my blood pressure."

*The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by a caregiver best indicates a common aspect of the diet and nutrition of the preschool child? "My child is so picky and eats the same thing every day for days on end!" "My spouse is insistent that our 5-year-old not eat any snacks so that he will eat all of his meal at mealtime." "Our child gets into food jags where he will only eat one food all day long." "My 4-year-old eats as much as my teenager does every day."

"My child is so picky and eats the same thing every day for days on end!"

The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize? "You're taller than what would be expected." "You're following expected patterns of growth." "Your weight is more revealing than your height." "Your height is less than expected."

"You're following expected patterns of growth."

Based on Erikson's developmental theory, what is the major developmental task of the adolescent? Gaining independence Finding an identity Mastering motor skills Coordinating information

Finding an identity

The parent of a 20-month-old toddler 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. "Your care providers may be frightening to your toddler." "Establishing a routine for saying goodbye to your toddler will be helpful." "This is a normal happening for a toddler of this age." "This is actually a regression for your toddler because separation anxiety normally occurs in infancy." "As your toddler begins to learn that you will return the toddler will become less upset."

"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 school nurse is teaching a health class on nutrition with some adolescents. Which comment by a student should the nurse prioritize and provide more teaching? "I had lunch with my boyfriend before his game and all he ate were carbohydrates." "I don't really like it, but I have been drinking lots of skim milk." "I hate eating with my family. I would much rather snack all day." "I am feeling so fat. I think I need to exercise a few extra hours today."

"I am feeling so fat. I think I need to exercise a few extra hours today." (Even after the body has become emaciated, the adolescent may believe that he or she is still fat and, therefore, unattractive. This condition is called anorexia nervosa and is a serious health concern related to adolescents and their nutritional status. Even if the adolescent doesn't eat with the family, he or she can still consume needed nutrients. Although carbohydrate-loading is a concern, this statement does not indicate the adolescent girl was following this eating pattern. Skim milk has adequate nutrients.)

nurse is educating a 15-year-old obese teen who is not very active about nutrition. The nurse educates the teen about menu choices so that the teen can make his/her own choices. The nurse knows the teaching is effective by which of the teen's responses? "I am going to avoid all servings with fat in them." "I need to choose 2 servings of fruit each day of the week." "When I try to lose weight, I will limit my protein to 2-4 servings a day." "Since I am a teen, my dairy servings have no limits."

"I need to choose 2 servings of fruit each day of the week."

A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development? From ages 7 to 11 years, children internalize actions and can perform them in the mind. Up to age 2, children learn by touching, tasting, and feeling. They learn to control body movement. Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view. After age 12 children can think in the abstract, including complex problem solving.

After age 12 children can think in the abstract, including complex problem solving.

A 15-year-old is hospitalized for acute appendicitis. Which activities would the nurse include in the client's plan of care? Select all that apply. Arrange care to provide for extra rest and sleep. Have the nurse control the patient's care as much as possible. Include the parents when educating the client. Allow friends to visit during visiting hours. Keep the client in hospital gowns for sanitary reasons.

Arrange care to provide for extra rest and sleep. Include the parents when educating the client. Allow friends to visit during visiting hours.

A 5-year-old child is overheard by her parents calling her dog a "fat boo-boo butt" and they are concerned. What advice would the nurse provide for them regarding this behavior? Ignore the behavior and she should quit using these words. Tell the child that language is unacceptable and place the child in time-out. Calmly correct the child, telling her not to say those words again. Wash her mouth out with soap if she says it again and tell her it is wrong.

Calmly correct the child, telling her not to say those words again (Children this age often try out naughty words to see what kind of reaction they will get from their parents. Parents are encouraged to express their disapproval with the language and calmly tell the child not to say those words again. Ignoring the behavior will not correct it and punishment is not necessary.)

*To help prevent obesity, which intervention would the nurse include in an adolescent's plan of care? Encourage sources of proteins with fat. Plan a diet of 1,500 calories per day. Plan a diet of 3,000 calories per day. Describe a normal serving size.

Describe a normal serving size.

Nursing students reviewing information about discipline demonstrate a need for additional education when they identify what information as correct? Discipline helps children know what is expected. When discipline breaks down, the consequence is punishment. Discipline involves setting rules. Discipline and punishment are interchangeable.

Discipline and punishment are interchangeable.

Parents of an 18-month-old tell the nurse that the child eats very little during meals but is constantly asking for snacks. Which recommendation should the nurse make? Give nutritious snacks throughout the day. Provide a firm explanation to the child. Offers rewards with meals to increase eating. Avoid snacks to increase mealtime hunger.

Give nutritious snacks throughout the day.

The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight? Change to a very low-fat and no-carbohydrate diet. Encourage activities that will increase his physical activity. Encourage the child to not worry about weight until he is older. Encourage portion control at each meal

Encourage activities that will increase his physical activity.

A 6-month-old arrives for a well-baby visit with a case of diaper rash that the parent believes is normal for infants. The parent reports changing the baby's diaper when he wakes up and before naps or bedtime. Which frequency should the nurse point out will better help heal and prevent future incidences of diaper rash? Every 2 to 4 hours Every 1 to 2 hours Every 3 to 5 hours Every hour

Every 2 to 4 hours

*A 13-month-old child is brought to the clinic for a well-child visit. The child's parent expresses concern that the child has not started to walk yet. What is the best action should the nurse take? Ask the parent if the child has been ill recently. Refer the child to a developmental specialist for evaluation. Explain that the child could start walking any day. Explain that children can take their first steps as late as 18 months of age.

Explain that children can take their first steps as late as 18 months of age

*The parents of a 2-year-old child born with short-gut syndrome feed their toddler via a feeding tube. Knowing this is a developmental time when children usually feed themselves, the parents are asking the nurses what they can do to help foster the child's independence. Which suggestion would be most appropriate at this time? Try to focus the child's energy on learning to read simple books that are age appropriate. Imitate placing food in the child's mouth as long as the food is large enough so it cannot be swallowed. Play catch with the child while others are eating so they do not have to feel left out. Let the child choose what clothing he or she will wear the next day.

Let the child choose what clothing he or she will wear the next day. (If children are tube fed, they receive no experience at all with finger foods. For these children, parents should try to provide other, comparable experiences in independence, such as letting them choose what toy to take to bed or what clothing to wear. Playing, reading, or pretending a toy is food at feeding time are not appropriate activities since the child's feeding is usually scheduled around normal meal times.)

*The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local day care. What information would the nurse include in this education session? Select all that apply. Parents will need to supervise tooth-brushing and be responsible for flossing. Preschoolers only need to wear bicycle helmets if they are going on long rides. Preschoolers are capable of taking a bath independently. Encourage children to select their own clothing to wear each day. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing.

Parents will need to supervise tooth-brushing and be responsible for flossing. Encourage children to select their own clothing to wear each day. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing.

When providing anticipatory guidance to a group of parents with school-aged children, what would the nurse describe as the most important aspect of social interaction? Peer relationships Family Temperament School

Peer relationships

While caring for a 16-year-old client expected to be hospitalized for several months, the nurse will perform which action to assist the client in meeting the current stage of psychosocial development? Allow the client to touch equipment before procedures. Permit peers to visit during open visitation hours. Provide video games for the client to play. Explain medical concepts by providing handouts and brochures.

Permit peers to visit during open visitation hours.

The nurse is discussing proper discipline with the parent of a 15-month-old toddler. Which teaching is most important? Physical punishment such as spanking is discouraged. Only use praise after the child has corrected a wrong behavior. Rules and limits should be simple and few. Toddlers are unable to follow instructions easily.

Physical punishment such as spanking is discouraged.

*A nurse realizes safety teaching has been successful when the parents identify which action to help prevent the leading cause of death in preschoolers? Putting latches on lower cabinets Placing the child in an approved car seat Using gates at the top of the stairs Washing hands after using the bathroom

Placing the child in an approved car seat

A female client tells the nurse about noticing an increase in weight and fat deposits during the past year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time? Encourage increased exercise to control weight gain. Provide reassurance that these are normal changes. Review dietary measures to assist in controlling weight gain. Share what foods can be eaten on a low-fat diet to prevent fat deposits.

Provide reassurance that these are normal changes.

The parents express concern about their child who has an imaginary friend. The nurse explains that as long as the imaginary friend does not become the center of attention and also the child has real friends, this can be beneficial. What benefits are discussed? Select all that apply. Provides an outlet by which the child can express innermost feelings. Helps the child know what is real and what is not. Protects the child by separating from those who are unkind. Serves as someone to blame or decrease the child's guilt. Encourages language development by conversation.

Provides an outlet by which the child can express innermost feelings. Helps the child know what is real and what is not. Serves as someone to blame or decrease the child's guilt. Encourages language development by conversation.

The mother of a 15-year-old boy confides in the nurse that she is concerned because her son is about to turn 16 and is pressuring her and her husband to buy him a motorcycle. Her husband is okay with the idea, but she is concerned about his safety. What information should the nurse mention to the mother regarding motorcycle safety? Select all that apply. Insist on age and not emotional maturity as the qualification for obtaining a driver's license. Require the son to wear a helmet. Require the son to wear a seat belt. Require the son to learn all relevant safety rules. Require the son to wear long pants. Require the son to wear full body covering.

Require the son to wear a helmet. Require the son to learn all relevant safety rules. Require the son to wear long pants. Require the son to wear full body covering.

The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution? Use plastic protectors in all electrical outlets Safely store all chemical substances Close supervision during bath time Properly use car seats

Safely store all chemical substances

The nurse is preparing a presentation for a local parent-teacher organization about the growth and development of school-age children. Which of the following would the nurse include? Secondary sex characteristics are often embarrassing for both sexes. Boys mature much more quickly than girls of the same age during this time. The child's body size is in direct correlation with his or her maturity level. From 6 to 12 years of age, children grow an average of 4 inches per year.

Secondary sex characteristics are often embarrassing for both sexes.

A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client? Suggest that she read books and magazines from the hospital bookmobile. Call the hospital's mental health unit to see if she can get some counseling. Take her to the teen lounge so she can meet and interact with other teens. Ask her caregivers to bring her siblings and friends to visit.

Take her to the teen lounge so she can meet and interact with other teens.

The nurse is helping the parents and their underweight adolescent collaborate on planning a healthy menu. The nurse should be aware of which nutritional requirement of adolescents? Teenage girls who are active require about 1,800 calories per day. Teenage boys who are active require between 2,000 and 2,500 calories per day. Teenagers have a need for increased calories, zinc, calcium, and iron for growth. Adolescents require about 1,000 to 1,200 mg of calcium each day.

Teenagers have a need for increased calories, zinc, calcium, and iron for growth.

The nurse is providing guidance after observing a mother interact with her negative 2-year-old boy. For which interaction will the nurse advise the mother that she is handling the negativism properly? Telling the child to stop tearing pages from magazines Telling the child firmly that we don't scream in the office Asking the child if he would please quit throwing toys Saying, "Please come over here and sit in this chair. OK?"

Telling the child firmly that we don't scream in the office

The parents of a preschooler express concern to the nurse about their son's new habit of masturbating. What is an appropriate response to this concern? Consult a psychotherapist to determine the reason for this behavior. Tell the child in a firm manner that this behavior is not acceptable. When the child displays this behavior, place him in a "time-out." Treat the action in a matter-of-fact manner, emphasizing safety.

Treat the action in a matter-of-fact manner, emphasizing safety.

*A nurse is assessing a 3 year old at a well-child visit. Which developmental milestones would the nurse expect to assess? Select all that apply. Throws a ball overhand Laces sneakers independently Undresses self without difficulty Completes simple buttons Stacks a tower of blocks

Undresses self without difficulty Stacks a tower of blocks (A 3 year old typically can undress himself or herself and stack a tower of blocks. Simple buttoning is more characteristic of 4 year olds. The ability to lace sneakers or shoes and throw overhand are typical of 5 year olds.)

*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. Urge your children to report others who are bullying. Urge children never to talk to or accept a ride from a stranger. Wait until children are old enough to tell them how to call for help in an emergency. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

Urge your children to report others who are bullying. Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

*A runaway female adolescent has come to the community clinic because she is pregnant. When developing a plan of care, the nurse should identify which priority goal for this client? monthly prenatal visits adequate nutrition returning home to parents safe housing

safe housing

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply. "Have your child hold hands with a grown-up in parking lots." "Role-model bicycle safety by wearing a helmet too." "Do not allow your child to approach strange dogs." "Allow your child to ride in the front seat of the car." "Do not refer to medicines as candy."

"Have your child hold hands with a grown-up in parking lots." "Role-model bicycle safety by wearing a helmet too." "Do not allow your child to approach strange dogs." "Do not refer to medicines as candy."

A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds 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 weaning him all at once so that he will be more interested in the solid food." "It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate." "It is not normal for toddlers to lose their appetites; spoon feed him yourself to make sure he gets proper nutrition." "It is not normal for toddlers to lose their appetites; have him tested for a gastrointestinal condition."

"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."

*After teaching the mother of a 13-month boy old about suggestions for bathing and hygiene, the nurse determines that the teaching was successful when the mother states: "I'll drain the tub while he's still in it so he won't fall." "I'll wash his hair everyday with just plain soap." "It might be best to give him a bath in the evening." "I can use bubble baths to lure him into the tub."

"It might be best to give him a bath in the evening." (The young child's increased activity level necessitates bathing daily or every other day. A good time to bathe the child is after eating, either after breakfast or in the evening. Hair is washed two to three times per week with a mild shampoo. Bubble baths should be avoided, to prevent urethral irritation and possible development of cystitis. Some children may have fears associated with bathing such as being afraid of being sucked down the plug hole. In this case, do not drain the tub until the child is out of the room.)

The clinic nurse is assessing a 14-year-old client. The client states "I am worried I have a brain tumor. I am so clumsy when I play sports now that it is totally embarrassing." Which response by the nurse is appropriate? "I understand why you are worried. Has anyone else in your family had a brain tumor." "Have you noticed any changes in your vision or hearing lately?" "I will request the primary health care provider prescribe a magnetic resonance image (MRI)." "You are experiencing rapid and uneven growth now which can interfere with coordination."

"You are experiencing rapid and uneven growth now which can interfere with coordination."

An adolescent who is depressed states, "Nothing ever seems to be right in my life." Which would be the most appropriate response by the nurse? "Things will be better when you go off to college." "Being a teenager is hard work." "Try to look at the bright side of things." "You are feeling sad right now. It's a hard time."

"You are feeling sad right now. It's a hard time."

*A school nurse is assisting in Sports Physical Day with a 15-year-old teen who has a pierced navel. Which of the following statements by the nurse would be the best for health promotion? "You will need to clean the navel several times a day." "This piercing is considered a wound and could get infected." "This piercing puts you at risk for hepatitis and tetanus." "I hope the equipment used in your piercing was clean."

"You will need to clean the navel several times a day."

The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize? "Your weight is more revealing than your height." "You're following expected patterns of growth." "Your height is less than expected." "You're taller than what would be expected."

"You're following expected patterns of growth."

A chronically ill adolescent is readmitted to the hospital with an infected wound requiring long-term dressing changes. What is the best way the nurse can encourage independence for this client? Allow the adolescent to choose the time for the dressing change. Have the school provide homework. Teach the parents to perform dressing changes at home. Have the adolescent go to the teen room every day.

Allow the adolescent to choose the time for the dressing change

A nurse is discussing ways a parent can foster the development of self-confidence in their school-aged child. Which action if stated by the parent would lead the nurse to continue the discussion? Comparing the child to an older sibling regarding academic achievements Having clear expectations of behavior whenever the family is out in public. Being accepting of mistakes the child makes Focusing on what the child is saying in a conversation

Comparing the child to an older sibling regarding academic achievements

**The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group? Remove children's security blankets at this stage to help them assert their autonomy. Distract toddlers from exploring their own body parts, particularly their genitals. Offer toddlers many choices to foster control over their environment. Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior.

Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior. (Toddlers should not be blamed for their aggressive behavior; adults can assist the toddler in building *empathy* by pointing out when someone is hurt and explaining what happened. Adults should allow toddlers to rely upon a security item to self-soothe, as this is a function of autonomy and is viewed as a sign of a nurturing environment rather than one of neglect. Toddlers may question parents about the difference between male and female body parts and may begin to explore their own genitals. This is normal behavior in this age group. Offering limited choices is one way of allowing toddlers some control over their environment and helping them to establish a sense of mastery.)

*A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg ) and grown 2.5 in (6.25 cm) since his last visit a year ago. How should the nurse respond to this mother's concerns? Tell the mother that she needs to return to the pediatrician's office in 3 months to re-weigh the child and measure his height for any changes. Ask the mother if there are other small people in her family. Tell her that her child's growth is less than is expected and gather a nutritional history on the child. Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.

Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about. (Normally, a toddler's growth is 5 to 10 pounds per year and about 3 inches in height. This child falls within the recommended parameters of growth and the mother has nothing to be worried about.)

The nurse is designing a nursing care plan for a toddler with lymphoma who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? Planning physical therapy for the child Monitoring the toddler for developmental delays Limiting visitors to scheduled visiting hours Introducing the toddler to other toddlers in the unit

Monitoring the toddler for developmental delays (When the toddler is hospitalized, growth and development may be altered. The toddler's primary task is establishing autonomy, and the toddler's focus is mobility and language development. The nurse caring for the hospitalized toddler must use knowledge of normal growth and development to be successful in interactions with the toddler, promote continued development, and recognize delays. Parents should be encouraged to stay with the toddler to avoid separation anxiety. Planning activities and socialization of the toddler are important, but the priority intervention is monitoring for, and addressing, developmental delays that may occur in the hospital.)

The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play? Playing independently and are side-by-side. Playing apart from others without being part of a group. Playing in an organized group with each other. Playing together in an activity without organization.

Playing in an organized group with each other.

*A nurse is presenting a class on toilet training to a group of parents with toddlers. Which information would the nurse include in the class? Select all that apply. Putting the child on the potty chair at regular intervals during the day Allowing at least 6 weeks to prepare the child psychologically for the training Keeping the child on the potty chair for as long as necessary Praising the child when he or she urinates or defecates Using training pants that slide down easily and quickly

Putting the child on the potty chair at regular intervals during the day Praising the child when he or she urinates or defecates Using training pants that slide down easily and quickly

*Parents of a toddler are expressing concern about their child's extreme negativism. Every question is answered with a forceful, "no." Which information would be most appropriate for the nurse to share with this couple about their toddler's negativity? Select all that apply. Rather than ask, "Do you want to come to dinner now?" instead state, "It's dinner time. Do you want to drink milk or water with your dinner?" This is not only normal for toddlers but demonstrates a positive stage of development. With regards to bath time, ask the child "Will you please go get ready to take your bath?" After one warning, place the child in time-out if they say "no" again in response to questions. This is a step in the child's development toward independence and to take care of his or her own needs.

Rather than ask, "Do you want to come to dinner now?" instead state, "It's dinner time. Do you want to drink milk or water with your dinner?" This is not only normal for toddlers but demonstrates a positive stage of development. This is a step in the child's development toward independence and to take care of his or her own needs.

*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 Tried to refocus the child's attention as tantrum behavioral cues appeared Made sure the child was rested and not hungry before going to the mall Remained relatively calm even though embarrassed

Reasoned with the child to stop the behavior (The child having a tantrum is out of control, making reasoning impossible. Calmly bear hugging the child provides control, especially in a public place. The other actions are helpful in preventing a tantrum.)

**The nurse is assessing a 9-year-old girl during her well-child checkup and notes the child weighs 86 lb (39 kg). After noting she weighed 9.5 lb (4.30 kg) at birth and her growth has been within normal patterns, the nurse determines this girl is within which category? Slightly underweight Slightly overweight Significantly underweight Significantly overweight

Slightly overweight (By age 7, a child weighs about seven times as much as at birth, so at 7, Jasmine should have weighed approximately 66.5 lb (30.16 kg). Because average annual weight gain is about 5 to 6 lb (2.26 to 2.72 kg), by the time she is 9, Jasmine should weigh approximately 76.5 to 80.5 lb (34.69 to 36.51 kg) . The child's current weight puts her 5.5 to 9.5 lbs overweight (2.49 to 4.30 kg).)

*The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers? Need three big meals a day due to rapid growth Snacks throughout the day help the child meet nutritional requirements Need extra calcium for proper muscle growth Should drink at least 4 cups of milk each day

Snacks throughout the day help the child meet nutritional requirements

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

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

A 9-year-old boy is admitted into the hospital with a broken femur. What is important for the nurse to consider when caring for this child? If a child's behavior regresses, it should be accepted because the parents cannot help but feel guilty when their child is hospitalized. Children this age are not old enough yet to worry about their body image and how they look to their friends. The child should be prepared for procedures and should be allowed to view and handle equipment that is going to be used when appropriate. Some questions children ask cannot be answered truthfully without increasing their anxiety; therefore, those questions should be deferred to their parents.

The child should be prepared for procedures and should be allowed to view and handle equipment that is going to be used when appropriate.

A 7-year-old seen in the clinic for a routine well-child visit is noted on assessment to have gained 5 lb (2.26 kg) and grown 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters? Weight is within expected range and height is above expected range. Weight and height are within expected patterns of growth. Weight is above expected range and the height is within an expected range. Weight is within expected range and height is less than expected.

Weight is within expected range and height is above expected range.

When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation? Weight is below an expected range and height is above an expected range. Weight is above an expected range and height is within an expected range. Weight falls within an expected range and height is less than what would be expected. Weight and height are within expected patterns of growth.

Weight is above an expected range and height is within an expected range.

*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? raking leaves vacuuming folding clothes putting books on shelf

putting books on shelf (School age children need rewards for their accomplishments. Small chores which can be completed quickly give this type of reward. Children can survey their finished work and see they have done a good job. Picking up toys or putting books on the shelf offers a reward because children can clearly see the result of their work. Vacuuming is a chore children do not necessarily like because once finished the rug looks the same before they started. There is no reward for the process. Raking leaves serves as only a temporary reward because even though the child can see the result of the leaves in a pile the leaves still need to be bagged or disposed. Folding clothes also offers small reward because for many 6-year-olds larger pieces of clothing can be too cumbersome to fold correctly and they are not rewarded as the clothes still need to be put away)

The nurse is teaching a group of school-aged children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching? "Girls typically experience a rapid growth spurt before boys." "Menarche is usually the first sign of puberty in school-aged girls." "Boys normally grow an average of 5 in (12.5 cm) each year." "There are not many physical differences between school-aged boys and girls."

"Girls typically experience a rapid growth spurt before boys."

**The nurse is caring for a 13-year-old girl. The child has been identified as overweight with no underlying psychological or secondary causes. The nurse is reviewing the child's weight-loss progress and nutrition at a follow-up visit. What finding indicates a need for further discussion and teaching? "My daughter is helping us plan our family's weekly menu." "We are using family outings and activities as a reward for weight loss." "Our whole family has changed our eating habits." "Her goal is to be a size smaller by our vacation in two weeks."

"Her goal is to be a size smaller by our vacation in two weeks." Explanation: The mother must be reminded that a successful weight loss program emphasizes long-term permanent changes, not rapid weight loss or short-term diets to meet a short-term goal.

**Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital? "I will be back later this afternoon." "I will come back when it is time for your bath tonight." "I will be back after you eat your dinner and SpongeBob goes off." "I will be back in the morning. Mommy loves you."

"I will be back after you eat your dinner and SpongeBob goes off." (Toddlers have no real concept of time and equate time to events in their lives. So, the best way for the mother to tell the child when she will be back at the hospital is to relate her arrival to events such as the child's dinner and TV programs the child likes.)

*The parent of a preschooler asks the nurse, "Now that my child goes to preschool and goes to friends' houses, how can I make sure that he is eating enough?" Which response by the nurse would be most appropriate? "Keeping an eye on how active he is will give you a good indication." "Just give him some extra food when he's with you to make up for anything he missed." "You need to get a list from everyone about what he has eaten throughout the day." "Ask the child what he has eaten and drank at school and at his friend's house."

"Keeping an eye on how active he is will give you a good indication." (Preschoolers begin to eat away from home at friends' homes or at child care or stay overnight with friends or grandparents, so parents don't observe daily food intake as accurately as before. The best suggestion would be to inform the parent to observe whether the child is growing and being active, good indicators of nutrition. This action would be better than monitoring any one day intake, including attempting to get a list from others, or asking the child what he has eaten. Giving the child extra food could foster overeating.)

A 3 1/2 year-old child is found masturbating in the family living room. Which response by the parent would best address this behavior? "We do not touch ourselves in public. Please go to your room if you want to continue this behavior." "You need to quit that right now. It's not nice to touch your privates." "I will ask your father to talk to you about this since he is a male too." "Your penis is very interesting, isn't it? But you can injure it by touching it so much."

"We do not touch ourselves in public. Please go to your room if you want to continue this behavior." (Although masturbation in this age group is not an uncommon behavior, the child must be told in a matter-of-fact manner that this is not appropriate activity in public. The parent needs to remain calm and not get angry or embarrassed. Usually, masturbation is just part of a young child's curiosity about his or her body.)

*The nurse is teaching the parents of a 2-year-old child how to handle the child's temper tantrums. The nurse determines that the teaching was successful if the parents make which statement? "We will offer our child a treat to stop having the tantrum." "We will ignore our child while having the tantrum." "We will place our child in time-out for 5 minutes after the tantrum." "We will attempt to reason with our child to limit tantrums."

"We will ignore our child while having the tantrum." (The best response is to tell a child simply that the parent disapproves of the tantrum and then ignore it. Bribery, such as saying that the child can have a treat if the behavior stops, is rarely effective because by accepting the child's wishes, the parent is encouraging the child to have more tantrums because he or she was successful. Placing the child in time-out does not deal with the actual tantrum. When a child is placed in time-out, the appropriate length is 1 minute per year of age (2 minutes for this child). Tantrums are a result of the child not being able to appropriately express his or her needs, desires, or frustrations. It is not appropriate to attempt to reason with a upset 2-year-old child.)

A mother of a 2-year-old girl is asking her friend when she should start potty training the child. The mother expresses concern about the high cost of diapers and training pants and would really like to have her trained as soon as possible. Which advice by the friend would be considered the best response? "It doesn't hurt to start when they turn 2 as long as you don't punish them for having many accidents." "I started training my kids when they started to pull themselves up to a standing position." "When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a good indication she is ready for potty training." "You will just have to condition yourself to take her to the potty chair every hour until they get the hang of it."

"When she is uncomfortable in her wet diaper and brings a clean diaper to you, that's a good indication she is ready for potty training."

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? "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do." "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous system control." "The best time to start toilet training is as soon as the child begins walking." "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."

During a visit to the school nurse, an adolescent confides in recently having feelings of attraction to a member of the same gender. How should the nurse best respond to the adolescent? "Do these feelings make you feel bad about yourself?" "How long have you been having these feelings?" "Would you like to talk about these feelings?" "These feelings are normal for your age."

"Would you like to talk about these feelings?"

*The nurse is preparing to teach a class to a group of young parents with infants the basics of introducing solid foods into the diet. Which factor about the food should the nurse point out the infants respond to best when introducing solid foods into the diet? Thickened An interesting texture Bland Well heated

Bland

The mother of a preschooler finds a broken plate in her kitchen floor and asks the child what happened. The child tells the mother that her imaginary friend Lulu dropped it when she was getting it out of the cabinet. How should the mother interpret this fabrication? Blaming an imaginary friend for accidents is normal behavior for this age group. Telling the mother that an imaginary friend did it is concerning and the child needs to be evaluated. The child feels guilty and wants to pass the blame to someone else. The child is lying to cover up her wrongdoing to avoid punishment.

Blaming an imaginary friend for accidents is normal behavior for this age group.

What foods could a parent provide that would be the most beneficial to support healthy dentition for a school-aged child? Fish, spinach salad and a glass of milk Chicken sandwich with pretzels and apple juice Bagels and cream cheese with sherbet Hamburger and a cherry Coke

Fish, spinach salad and a glass of milk

Which of the following is accurately related to growth patterns in adolescent girls? Growth slows after the beginning of menstruation. Girls grow in height about 2 in (5 cm) per year from age 14 to age 18. The girl's pelvic bones begin to broaden several years after menarche begins. Growth spurts are common in girls after the age of 16.

Growth slows after the beginning of menstruation.

A 17-year-old girl has come to the clinic to get a rubella immunization that is required by the college she plans to attend. Before administering this immunization, the child should have which screening or test? pregnancy test screening for tuberculosis scoliosis screening HIV test

HIV test

An 8-year-old male child is being seen for a well-child visit. His weight at his visit last year was 50 lb (22.7 kg) and his height was 47 in (119 cm). If he is developing normally, which finding will the nurse expect to note this year? The child's weight is seven times his birth weight. The child has all of his adult teeth present. Height 49.5 in (124 cm) Weight 62 lb (28.1 kg)

Height 49.5 in (124 cm) (Gain 3-5 lb/yr & 1-2 in)

The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching? "I have heard that both boys and girls often touch themselves at this age." "I will need to find an appropriate punishment for him if this continues." "I should teach him certain rules about this activity." "This is probably a good time to talk about safety and who can touch him."

"I will need to find an appropriate punishment for him if this continues."

Parents are asking a pediatric nurse how to deal with separation anxiety every time they try to have an adult night out. Which advice by the nurse sounds like the most appropriate way to handle this situation? "Note if your child cries as you leave because this may be an indication the babysitter is ignoring the child." "If your child starts crying, stay a little longer and read a story before leaving." "Inform the child that you are going out but the regular babysitter will care for them and put them to bed." "Try to sneak out the back door to avoid the long crying scene at the door."

"Inform the child that you are going out but the regular babysitter will care for them and put them to bed." (Most toddlers react best to separation if a regular babysitter is employed or if the day care center has consistent caregivers. It helps if toddlers have fair warning they will have a babysitter. No matter how well prepared toddlers are, they may cry when the babysitter actually appears or may greet the babysitter warmly only to cry when the parents reach for their coats. It helps if parents say good-bye firmly, repeat the explanation they will be there when the child wakes in the morning, and then leave. Prolonged good-byes only lead to more crying. Sneaking out prevents crying and may ease the parents' guilt, but it can strengthen a child's fear of abandonment and so should be discouraged.)

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

"Milk will not fully provide the child's needs for iron, which is found in solid foods."

A nurse is assisting in a parent education class on accident prevention. Which statement by a parent indicates that further education is needed? "We will be sure that our daughter wears a life jacket the next time we go boating at the lake." "My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets." "I will teach my son not to arrange a meeting with someone he met on the Internet." "I will teach my daughter her full name and phone number."

"My son can let his friend ride as a passenger on his bicycle as long as they both wear helmets."

The nurse is caring for a 6-year-old child. During the course of a routine wellness examination, the parent proudly reports that the child eats whatever the parent puts on the plate. The nurse wants to emphasize the importance of allowing the child to make some choices regarding the types of foods eaten. How should the nurse communicate this to the parent? "Now is the time to let your child choose some of the meals." "I want you to give your child choices about the food eaten." "You need to make sure your child has input regarding the food eaten." "You must let your child make some choices for oneself."

"Now is the time to let your child choose some of the meals."

**During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" What would be appropriate for the nurse to suggest? Select all that apply. "Use time-out every other time she tells you no." "Limit the number of questions you ask of her." "Offer her two options from which to choose." "Make a statement instead of asking a question." "Offer her something she would like, such as ice cream, to distract her."

"Offer her two options from which to choose." "Make a statement instead of asking a question." *"Limit the number of questions you ask of her."* (A toddler's "no" can best be eliminated by limiting the number of questions asked of the child. In addition, using statements instead of asking questions and giving the child a choice of two options are effective. Using time-out is a discipline measure and would be inappropriate to counteract a toddler's negativism. Offering a choice rather than a bribe such as ice cream is more effective and long-lasting for modifying the child's behavior.)

The nurse is caring for a 3-year-old at a well-child checkup. The parent states that her child still has an afternoon nap but she has a friend whose toddler no longer naps in the afternoon. She is seeking advice on what do to. When providing anticipatory guidance to the parent about sleep patterns, what is the most appropriate response by the nurse? "Children begin to give up afternoon napping at 2 years." "Children no longer nap in the afternoon after 1 year." Since they are in school now all day, napping ends at 6 years. "Often, the afternoon nap will be no longer needed after 4 years."

"Often, the afternoon nap will be no longer needed after 4 years."

The nurse is providing teaching about car safety to the parents of a 5-year-old girl who weighs 45 pounds. What should the nurse instruct the parents to do? "Place her in a booster seat with lap and shoulder belts in the back seat." "Place her in a booster seat with lap and shoulder belts in the front seat." "Place her in the back seat with the lap and shoulder belts in place." "Place her in a forward-facing car seat with a harness and top tether."

"Place her in a booster seat with lap and shoulder belts in the back seat."

*An adolescent's parent states not knowing what to do with the adolescent. The parent reports the teenager is taking two or three showers a day when not that long ago the parent could barely get the teen to take a shower at all. What should the nurse's reply be to the parent? "Do not encourage multiple baths; it can be very drying to the skin." "Remind the adolescent about needing to be on a schedule so as to not disrupt the family." "Reinforce the family rules but also allow the adolescent to develop one's own routine." "Reevaluate the adolescent's ability to perform hygiene care since showering is so frequent."

"Reinforce the family rules but also allow the adolescent to develop one's own routine."

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? "Reward the child with candy or some other treat each time the child keeps the seat belt on." "Explain that wearing a seat belt is a law and the police officer will give a ticket if the seat belt is not buckled." "Set a good example. Wear your own seat belt every time you drive." "Stop the car any time the preschooler unbuckles the restraints."

"Set a good example. Wear your own seat belt every time you drive.

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. "Set up some familiar bedtime rituals for your child." "Keep the door closed and the lights off so that your child can fall asleep faster." "Try using a night light in the child's room." "Try reading a favorite story before bedtime." "Avoid having your child watch frightening shows on TV before bedtime."

"Set up some familiar bedtime rituals for your child." "Try using a night light in the child's room." "Try reading a favorite story before bedtime." "Avoid having your child watch frightening shows on TV before bedtime."

The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond? "Tell me about the circumstances when this occurs." "That's normal; don't worry about it." "Suddenly having accidents can be a sign of diabetes." "Is there a family history of diabetes?"

"Tell me about the circumstances when this occurs."

*The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond? "Tobacco smoke is linked with an increased number of ear infections." "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?" "You should stop smoking around your child." "Tell me about your child's exposure to tobacco smoke."

"Tell me about your child's exposure to tobacco smoke." (The nurse needs to emphasize that parents should protect their child from all tobacco smoke. It is best to ask an open-ended question to determine who uses tobacco products or where exposure to tobacco smoke could be occurring. The nurse should not assume that the parents are smokers and telling them to stop is inappropriate. Telling the parent tobacco smoke can be linked to ear infection and behavioral difficulties is true but is unlikely to open a dialogue.)

During a health check-up without the parents present, a 17-year-old adolescent tells the nurse about being gay. Which statement from the nurse is best? "You are not gay; you are confused." "This puts you in an at-risk category." "We need to talk about safe sex." "Tell me what makes you think you are gay."

"Tell me what makes you think you are gay."

The parents are concerned their 14-year-old child is always eating. The child weighs 54 kg and is 65 inches (165 cm) tall. What is the best explanation the nurse can give the parents? "He is substituting food for unfilled needs." "He needs the calories because he participates in sports." "His calorie intake predisposes him to future obesity." "The calories help his body increase muscle mass."

"The calories help his body increase muscle mass."

*The mother of an infant questions the nurse about her baby's teething. The nurse provides client education. Which statement by the mother indicates understanding of the information provided? "The first teeth that will likely appear are the lower incisors." "By 1 year my baby should have about three teeth." "My baby's first tooth will likely appear between 5 and 6 months." "My baby will most likely have his upper middle teeth come in first."

"The first teeth that will likely appear are the lower incisors." (Teeth will begin erupting between 6 and 8 months. Traditionally, the first teeth to erupt will be the lower incisors, followed by the upper incisors. By the age of 12 months, the infant will have between 4 and 8 teeth, if progressing normally.)

The nurse is interviewing a 3-year-old girl who tells the nurse: "Want go potty." The parents tell the nurse that their daughter often speaks in this type of broken speech. What would be the nurse's appropriate response to this concern? "This is a condition known as echolalia and can be corrected if you work with your daughter on language skills." "This is considered a developmental delay in the 3-year-old and we should consult a speech therapist." "This is a condition known as stuttering and it is a normal pattern of speech development in the toddler." "This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech."

"This is a normal, common speech pattern in the 3-year-old and is called telegraphic speech." (Telegraphic speech is common in the 3-year-old. Telegraphic speech refers to speech that contains only the essential words to get the point across, much like a telegram. In telegraphic speech the nouns and verbs are present and are verbalized in the appropriate order. Echolalia (repetition of words and phrases without understanding) normally occurs in toddlers younger than 30 months of age. "Why" and "what" questions dominate the older toddler's language. Stuttering usually has its onset at between 2 and 4 years of age. It occurs more often in boys than in girls. About 75% of all cases of stuttering resolve within 1 to 2 years after they start.)

*The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents? "This is normal for this age group. It's referred to as solitary independent play." "Perhaps getting your child interested in sports will improve their other play habits." "You should try to get your child involved in a local Boys and Girls club to encourage more interaction." "Your child is involved with others, just indirectly. See how they sit next to the other children and play with the same toys?"

"This is normal for this age group. It's referred to as solitary independent play." (Solitary independent play means playing apart from others without making an effort to be part of the group or group activity, which is normal for this age group. Associative play occurs when children play together and are engaged in a similar activity but without organization, rules, or a leader, and each child does what she or he wishes. During cooperative play, children play in an organized group with each other as in team sports. Parallel play occurs when the toddler plays alongside other children but not with them. As the child continues to mature, they will be more prepared and willing to join with others to play alongside in organized or unorganized situations.)

*The caregiver of 7-month-old twins tells the nurse that she has noticed that both of her children enjoy playing with a toy by moving the object back and forth between their hands over and over again. Which statement made by the nurse most accurately explains this behavior? "This is one of the ways that infants develop their fine motor skills." "Development in nerve endings makes tactile activity more pleasurable at 7 months." "Fine motor skills using the hands are mastered at approximately 7 months." "At 7 months the child can finally focus enough to follow objects with the eyes as he moves the object from hand to hand."

"This is one of the ways that infants develop their fine motor skills." (Transferring objects is one of the manifestations of fine motor skills development, which is not fully mastered by this early age. References to nerve endings do not address the parent's query.)

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? "With the increase in tissue size, tonsillitis is suspected." "An allergic reaction is often the cause. What type of allergies does she have?" "A pituitary disorder may be the cause. Blood work may be indicated." "This may be normal growth of lymphatic tissue for this age."

"This may be normal growth of lymphatic tissue for this age." (The immunoglobulins IgG and IgA each reach adult levels during the school-age period; lymphatic tissue continues to grow in size until about age 9)

*The parents of a toddler ask the nurse about disciplining their 2-year-old toddler. What suggestions will the nurse provide? Select all that apply. "Try using time-out, assigning 1 minute per year of your toddler's age." "You need to wait until the toddler is old enough to understand the rules." "If you allow an unwanted behavior one time at this age, it is difficult to reverse later." "It is better to praise correct behavior than to punish wrong behavior." "Avoid using physical punishment unless your toddler's behavior is really out of line."

"Try using time-out, assigning 1 minute per year of your toddler's age." "If you allow an unwanted behavior one time at this age, it is difficult to reverse later." "It is better to praise correct behavior than to punish wrong behavior." (Parents should begin to instill some sense of discipline early in life because part of it involves safety limits. Two general rules to follow include the need to be consistent and the use of praise for correct behavior rather than punishment for wrong behavior so that the child can learn the rules. Parents should implement consistent discipline early. Once an unwanted behavior is allowed, it is difficult to reverse as the child grows older. Time-out is an effective technique to help children learn that actions have consequences. One minute per year of the child's age is the common standard. Physical punishment is not recommended. Having a consistent caregiver is important for reducing separation anxiety.)

The parent of a 4-year-old child tells the nurse about being frustrated because all the parent seems to do lately is fight with the child over what the child wants to eat and wear. The parent notes sometimes wanting to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this parent? "Use the time-out technique for discipline." "It is not normal to feel that way." "Take some toys away when the child acts like that." "Spank lightly to get the child's attention."

"Use the time-out technique for discipline."

**The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son? "Encourage your son to watch his older siblings use the toilet." "Each time you change his diaper, tell your son how important and fun it is to use the potty chair." "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." "Get your son a potty chair and have him sit on it for a few minutes each day."

"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." (To be able to cooperate in toilet training, the child's anal and urethral sphincter muscles must have developed to the stage where the child can control them. Control of the anal sphincter usually develops first. The child also must be able to postpone the urge to defecate or urinate until reaching the toilet or potty and must be able to signal the need before the event. In addition, before toilet training can occur, the child must have a desire to please the caregiver by holding feces and urine rather than satisfying his/her own immediate need for gratification. This level of maturation seldom takes place before the age of *18 to 24 months.*)

A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. What would be the best response for the nurse to give the child? "What happened to my client? Did you eat her?" "Oh no! I have a crocodile in my room. Please don't bite me!" "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile." "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you."

"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."

The nurse is conducting a class for new parents of infants. The nurse determines the session is successful when the parents correctly choose which instruction concerning bathing their infant? "When I bathe my baby, I shampoo his hair each time as well." "My husband uses plain water on our baby's face but I use mild soap." "Now that my baby is bigger, she seems to enjoy having powder applied after her bath." "Giving my baby a bath every day during cold weather will help her stay warm."

"When I bathe my baby, I shampoo his hair each time as well." (prevents cradle cap)

The mother of a preschooler finds a broken plate in her kitchen floor and asks the child what happened. The child tells the mother that her imaginary friend Lulu dropped it when she was getting it out of the cabinet. How should the mother interpret this fabrication? Telling the mother that an imaginary friend did it is concerning and the child needs to be evaluated. The child is lying to cover up her wrongdoing to avoid punishment. The child feels guilty and wants to pass the blame to someone else. Blaming an imaginary friend for accidents is normal behavior for this age group.

Blaming an imaginary friend for accidents is normal behavior for this age group. (scapegoating) (Children this age often have imaginary friends to play with and may blame the friend for accidents or other occurrences in the home that they may have caused. This should not be interpreted as intentionally lying or abnormal but rather normal preschool behavior.)

*The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation? He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day. He has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship. He is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. He is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend.

He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.

The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish? Walk backwards with heel to toe Ride a bicycle Hop on one foot Jump rope

Hop on one foot (The 4-year-old should be able to hop on one foot and can control movements of the hands. By the age of 5 the child can walk backwards heel to toe, throw and catch a ball well, and jump rope.)

A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply. If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries. Consistency in the rules is important so the child understands what is expected. If a child hits or bites another child, the parents should scold them, saying such things as "You are very naughty for biting Rachel." Toddlers cannot learn self-control until at least 3 to 4 years of age.

If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. Even at this young age, children need boundaries. Consistency in the rules is important so the child understands what is expected.

*A nurse is teaching the parent of a 6-year-old with decay in several deciduous teeth about tooth care and the importance of seeing a dentist. What instruction is best for the nurse to inform the parent about the new 6-year molars? If the 6-year molars become decayed and have to be pulled, the child could have dental problems later. The 6-year molars are not important in shaping the jaw, so it will not be a problem if they are decayed. It is important to begin dental care when the permanent teeth, such as the 6-year molars, begin to come in. The 6-year molars are temporary teeth and will fall out, so it doesn't matter if there is decay.

If the 6-year molars become decayed and have to be pulled, the child could have dental problems later. (The 6-year molars are of the utmost importance: they are the key or pivot teeth that help to shape the jaw and affect the alignment of the permanent teeth. If these molars are allowed to decay so severely that they must be removed, the child will have dental problems later.)

**The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital? Insists on doing a new skill and then asking for help Will be interested in an activity for a long period of time Will go home knowing how to do more things Learns new things quickly by asking questions

Insists on doing a new skill and then asking for help

*The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula? Calcium Vitamin D Vitamin E Iron

Iron (Infants who are fed home-prepared formulas (based on evaporated milk) need supplemental vitamin C and iron. Evaporated milk has adequate amounts of vitamin D, which is unaffected by heat used in the preparation of formula. Calcium and vitamin E would not be a concern in this infant's formula.)

A 15-month-old toddler is brought to the pediatrician's office for a well-child checkup and the nurse is reviewing health promotion with the family. What recommendation(s) would the nurse make to the family to help ensure the child's health? Select all that apply. Keep all medications locked up and out of reach for the child. Turn the hot water heater temperature down to 120℉ (48.9℃). Never allow the child to ride in the car unless secured in a car seat. Begin dental examinations at age 1 year. Provide foods rich in calories and carbohydrates for the child.

Keep all medications locked up and out of reach for the child. Turn the hot water heater temperature down to 120℉ (48.9℃). Never allow the child to ride in the car unless secured in a car seat.

The nurse is performing an assessment of the reproductive system of a 17-year-old girl. What would alert the nurse to a developmental delay in this girl? Mature distribution and coarseness of pubic hair Lack of occurrence of first menstrual period Areola and papilla separate from the contour of the breast Developed breast tissue

Lack of occurrence of first menstrual period

*A 15-year-old girl is in the hospital for surgery and is confined to bed. The nurse can tell that the client is nervous about being in the hospital. She tells the nurse that she feels "gross" and "on display" in her hospital gown. What should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image? Offer to assist the girl in washing her hair and let her pick the shampoo. Allow the girl to wear her own clothes, despite hospital policy. Assist the girl with using the bed pan to urinate. Brush the girl's hair for her.

Offer to assist the girl in washing her hair and let her pick the shampoo. Explanation: When caring for hospitalized adolescents, providing time for self-care, such as shampooing hair, is important to include in an adolescent's nursing care plan. Offering to assist the client in washing her hair and letting her pick the shampoo both encourages a sense of autonomy to the client and offers her dignity related to her body image. Brushing the girl's hair for her and assisting her with using the bed pan for urination do not encourage a sense of autonomy. If it is the hospital's policy to require clients to be dressed in a hospital gown while admitted, the nurse should not allow the girl to wear her own clothes.

The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics? Plan time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant. Have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit. Move the toddler to a new bedroom with a "grown-up-bed." Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.

Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.

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. Urge your children to report others who are bullying. Wait until children are old enough to tell them how to call for help in an emergency. Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

Urge your children to report others who are bullying. Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

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? "Giving a bottle of milk when the infant goes to bed can lead to obesity." "You could occasionally give your baby a bottle of water at bedtime." "Giving your baby a pacifier at bedtime will satisfy the need to suck." "Bottles given at bedtime can cause erosion of the enamel on the teeth."

"Bottles given at bedtime can cause erosion of the enamel on the teeth." (Baby Bottle Tooth Decay)

A parent states, "I do not let my child eat any carbohydrates because they will make her fat." What is the best response by the nurse? "Carbohydrates are essential for the body's process of building muscles." "Carbohydrates must be taken daily to maintain effective levels in the body." "Carbohydrates are a secondary source of fuel and stored as fat." "Carbohydrates are a necessary fuel for the body, especially neurologic functions."

"Carbohydrates are a necessary fuel for the body, especially neurologic functions."

A parent is comparing a child's development on the growth chart with those of another child and is concerned that her child is not in the "normal" range. What can the nurse inform the parent to alleviate her anxiety? "I can certainly understand your fear. If your child is not falling into the 'normal' range, it can indicate that there may be some developmental delays." "Growth charts are just a standard measurement. If your child doesn't fall into the 'normal' range, it doesn't indicate something is wrong." "Everyone is scared that their child will not be normal. Let's just wait and see what will happen with your child." "Maybe the other child is advanced and your child is growing slower. We will keep a close eye or your baby to make sure nothing is wrong."

"Growth charts are just a standard measurement. If your child doesn't fall into the 'normal' range, it doesn't indicate something is wrong."

The parent of a preschooler tells the nurse, "When my preschooler tells me stories or recounts a situation, often there is information in the story that is not true. I do not want my child to think lying is permissible." How would the nurse respond? "Help the child differentiate between fantasy/imagination and the truth with a conversation." "I would recommend your child see a mental health counselor." "Ask the child to retell the story again and this time, to avoid being dishonest." "This behavior is normal in the school-aged child, but usually not in a preschool aged child."

"Help the child differentiate between fantasy/imagination and the truth with a conversation."

*A nurse is providing health promotion education to a family of an infant at the family birth center. The nurse knows the parents need more education when they state which response? "I will give my infant a drinking cup gradually around 6 months." "I will introduce soft foods for my infant around 6 months of age." "I will introduce new foods one at a time." "I will switch to whole milk when my infant is around 6 months of age."

"I will switch to whole milk when my infant is around 6 months of age."

The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her baby crying. Which is the best response from the nurse to help this mother? "By ignoring his crying you will help him develop patience." "It is important for him to be with you, so you should take him with you." "He knows you are in the next room and he is attempting to get your attention." "If he cannot see you he thinks you are gone and that is frightening."

"If he cannot see you he thinks you are gone and that is frightening." (Object permanence not until 10 months)

An elementary school nurse is leading a group session discussing nutrition with a group of students and their caregivers. The nurse should provide additional teaching if which statement is made by one of the participants? "Eating too much could affect my child's ability to do some activities." "If my child has good nutrition she won't get childhood illnesses." "I ate healthy as a child and that has a lot to do with the way I eat now." "My children are at various ages and they all have different daily requirements."

"If my child has good nutrition she won't get childhood illnesses."

*A client who is breastfeeding asks the nurse if she can give the newborn a pacifier. Which nursing response is most appropriate? "This decision should be made by you and your partner based on your personal preferences." "It is recommended to wait until breastfeeding is well-established before introducing a pacifier." "I will request the lactation consultant come talk to you about pacifier usage while breastfeeding." "I know a lot of people who breastfed and also gave their newborns a pacifier."

"It is recommended to wait until breastfeeding is well-established before introducing a pacifier." (It is recommended to wait to introduce a pacifier once breastfeeding is well-established, which can take about 1 month. This is to limit nipple confusion and promote an adequate milk supply. Stating other people have done this does not provide education to the client, nor does it address this specific client's situation. While the decision is up to the newborn's parents, this response does not address the client's concern. Requesting a lactation consultant come does not address the client at this moment. The nurse can provide education now, and also request the consultant for follow-up information.)

*A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate? "Put the infant in an infant seat after eating." "Limit burping to once during a feeding." "Keep the baby sitting up for about 30 minutes afterward." "Feed the same amount but space out the feedings."

"Keep the baby sitting up for about 30 minutes afterward." (Keeping the baby upright for 30 minutes after the feeding, burping the baby at least 2-3x during feedings, and feeding smaller amounts on a more frequent basis may help to decrease spitting up. Positioning the infant in an infant seat compresses the stomach and is not recommended.)

*A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother? "The baby might be allergic to the particular foods you offered, so try different kinds of food." "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." "The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this." "The baby might not be ready for solid food, so wait a month or so and try again."

"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this." (The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating.)

*A first-time mother, who is breastfeeding, phones the clinic nurse because she is concerned about her 3-month-old infant's stools. Which statement by the mother would alert the nurse to contact the health care provider? "My infant grunts and squirms when having a bowel movement." "The stools are loose and seedy." "My infant has not had a bowel movement in almost 8 hours." "The stools are small and hard."

"The stools are small and hard." (The breastfed infant has stools that appear yellow and seedy. Consistency of stool is more important than frequency. Small, hard stools are a concern, and the infant should be evaluated for gastrointestinal issues. The nurse will contact health care provider. It is normal for infants to appear to have difficulty with bowel movements because the gastrointestinal system is still immature. It is common for infants to go several days without having a bowel movement.)

The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother? "This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site." "All babies have similar reactions but you should call back if he is still fussy in 24 hours." "You need to bring the baby to the emergency department to be sure he is not having an allergic reaction." "You can give your child ice cold fluids and cover the injection site so that he doesn't scratch the site and get it infected."

"This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."

A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation? "This indicates a blockage in the intestine and must be reported to the physician." "This is normal behavior for infants unless the stool passed is hard and dry." "This is normal behavior for infants due to the immaturity of the gastrointestinal system." "This is normal behavior for infants unless the stool passed is black or green."

"This is normal behavior for infants unless the stool passed is hard and dry." (Due to the immaturity of the gastrointestinal system, newborns and young infants often grunt, strain, or cry while attempting to have a bowel movement. This is not of concern unless the stool is hard and dry. Stool color and texture may change depending on the foods that the infant is ingesting. Iron supplements may cause the stool to appear black or very dark green.)

*The mother of a 2-year-old coming for a well checkup at the new clinic is embarrassed when the child voids on the examining table, soiling the exam table cover. Which response by the nurse should be given to the mother? "Toilet training accidents can occur with all children." "Can I help you dry and change your child?" "We have plenty of exam covers to replace the wet ones." "I have a great pamphlet that will help with the toilet training."

"Toilet training accidents can occur with all children." (Children at this age do have the muscular ability and bladder capacity for toilet training. The child would be in Freud's anal stage of psychosexual development. Mastery over using the anal and bladder muscles are developmental tasks to be accomplished. The goal is to proceed without trauma to the child so psychosocial adjustment will not be impaired. Handling the situation in a matter-of-fact manner, not finding fault with the child, and expecting some accidents helps maintain the child's sense of control and prevents parents from being embarrassed and worried. Learning new tasks takes time and practice. Regression occurs with new situations or when the child is under stress. It is best for the mother to change the child as the nurse would be a stranger to the child. Giving a pamphlet at this point may imply to the mother that she has not been successful in the toilet training process and may decrease her feelings of competence as a parent. The statement about extra exam covers does nothing to explain the normal behavior of toileting accidents and does not help the mother with her feelings of embarrassment."

A mother of a 10-month-old states to the nurse, "I brush my child's teeth every day with flavored kids' toothpaste." Which is the most appropriate response by the nurse? "That is great, infants typically hate toothpaste." "Toothpaste is not necessary; it is the scrubbing that is required." "Drinking water is really all you need to do to rinse your child's mouth." "Toothpaste plays an important role in overall oral health."

"Toothpaste is not necessary; it is the scrubbing that is required."

A parent asks the nurse if the 2-month-old infant can have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which response? "Sure, if you feel your infant is ready to have bananas." "When did you feed your other child bananas? "In 1 month you can try bananas if you think your infant is ready." "You can try bananas 2 or 3 months from now."

"You can try bananas 2 or 3 months from now." (The nurse will educate the parent to wait 2 to 3 months, because solid foods are not recommended for infants at 2 months of age. The age of 4 to 6 months is when it is recommended to introduce solid foods. In 1 month, the infant will be only 3 month of age. The other responses will not help the parent determine the appropriate answer.)

A parent takes the 4-month-old infant to the health care provider. The parent asks what type of baby cereal to provide now that the infant is starting solid foods. How should the nurse respond? "You should buy oat cereal." "You should buy rice cereal." "You should buy barley cereal." "You should buy wheat cereal."

"You should buy rice cereal."

A mother who is vegan, when asked about the nutritional intake of her 18-month-old, tells the nurse not to worry because she is providing plenty of protein to her daughter. "And," she says, "I avoid giving her fats." Which of the following would be the most appropriate response for the nurse to give this mother? "Fat is important in an 18-month-old's diet; it is the secret to strong bones and reduction of osteoporosis later in life." "Your child needs fat in the diet at this age, as it is needed for myelination of spinal nerves." "You should include some fat in your child's diet, as it can prevent constipation." "That's excellent. Protein is essential, but fat intake is not necessary at this age."

"Your child needs fat in the diet at this age, as it is needed for myelination of spinal nerves."

The infant weighs 7 lb 4 oz (3,300 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? 25 lb (11.3 kg) 28 lb 4 oz (12.8 kg) 14 lb 8 oz (6.6 kg) 21 lb 12 oz (9.9 kg)

21 lb 12 oz (9.9 kg) (infant weight triples in first year)

*A homeless mother arrives in the emergency department with her 5-year-old son who appears to have the mumps. During assessment, the nurse discovers the child is behind on his immunization schedule. Which information should the nurse prioritize for this family? A chart depicting the recommended immunization schedules for infants and children A list of organizations that assist families to get food, shelter, and medical benefits A list of primary care physicians who are taking new patients A list of organizations that provide referral and counseling for partner abuse, drug and alcohol addiction, and mental illness

A list of organizations that assist families to get food, shelter, and medical benefits (A list of organizations that will help them to get food, shelter, and medical benefits will likely be most useful because it offers practical, down-to-earth information. She is unlikely to be able to afford a primary care physician, and their living situation is too unstable to guarantee regular visits. Knowing about recommended vaccination schedules would likewise not be useful if the family does not have access to regular care. Although some homeless families have problems with partner abuse, drug and alcohol addiction, or mental illness, you cannot assume that this family is one of them.)

*A nursing student realizes that which of the following is true about Kohlberg's theory of moral development? During the first 2 years, children already have moral sensitivity. During the first 2 years, the child realizes how behavior affects others. At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act. In stage 1, the child obeys a person and understands the principle for this.

At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act. (In Kohlberg's theory of moral development, children have no moral sensitivity during the first 2 years. The child is not aware of how his or her behavior affects others. In stage 1 the child determines right and wrong by the physical consequence of a particular act. The child simply obeys the person in power with no understanding of the underlying moral principle.)

The nurse is developing a care plan for several clients who were seen in the clinic that day. Which situation will the nurse conclude is most likely to experience challenges in the growth and development of the children? Children who attend school while the father works and then sleep in their car at night A family living with the parents of the mother who is working two jobs A divorced mother who shares an apartment with her best friend and her children Both parents work during the day and the child comes home after school to an empty house

Children who attend school while the father works and then sleep in their car at night

A mother calls the clinic every couple of weeks concerned that her infant is not developing appropriately. What would be an appropriate nursing diagnosis for the nurse to assign to this client? Ineffective role performance related to new responsibilities Social isolation related to lack of adequate social support Deficient knowledge related to normal infant growth and development Health seeking behaviors related to adjusting to parenthood

Deficient knowledge related to normal infant growth and development

A nurse is teaching a 7-year old diabetic child who is in Piaget's concrete operational stage about insulin injections. Based on Piaget's theory, what would be the nurse's best method of preparation for this child? Show the child a video about diabetes and insulin. Explain the procedure to the child in detail. Give the child a pamphlet on diabetes to read. Demonstrate the procedure on a teddy bear.

Demonstrate the procedure on a teddy bear.

*When preparing to administer a vaccine to a 3-year old child what actions by the nurse are appropriate? Select all that apply. Discuss with the child's parent the use of therapeutic hugging during the injection. Explain the procedure to the child in simple terms. Chat with the child during the injection. Utilize a restraint board to help hold the child still. Require the child to remain silent during the injection.

Discuss with the child's parent the use of therapeutic hugging during the injection. Explain the procedure to the child in simple terms. Chat with the child during the injection. (Restraining a child during a painful procedure can increase the child's stress. Atraumatic care suggests using positions of comfort such as therapeutic hugging to help decrease the child's stress. The use of distraction techniques such as singing a song or counting can help decrease the child's stress. Requiring the child remain silent may cause an increase in the child's fear. Providing information to the child at a level the child is able to understand is recommended.)

The nurse is reviewing growth and development for infants. Place the following developmental milestones in the correct order, from first to last for the growing and developing infant. Use all options. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1 Infant sits independently, unsupported 2 Infant pulls to standing position 3 Infant turns head when lying in prone position 4 Infant rolls over from back to front or front to back 5 Infant crawls

Infant turns head when lying in prone position Infant rolls over from back to front or front to back Infant sits independently, unsupported Infant crawls Infant pulls to standing position

The nursing instructor is conducting a class on the development of an infant. The instructor determines the class is successful when the students correctly illustrate which as the proximodistal development in an infant? Roll over, then learns to follow an object with the eyes Walk for several steps, then learns to run Imitate speech-like sounds, then learns to speak a language Kick and to wave the arms, then learns to grasp the foot and pull it to the mouth

Kick and to wave the arms, then learns to grasp the foot and pull it to the mouth

The nursing instructor is leading a discussion on the theories of Sigmund Freud with a group of nursing students. The instructor determines the session is successful when the students correctly choose which example as indicating a child is in the anal stage of development? Has a desire to mold and control the environment Recognizes the physical differences between boys and girls Beginning to develop a sense of moral responsibility Finds satisfaction through making noises and crying

Has a desire to mold and control the environment

As the fetus develops, certain growth and development trends are regular and predictable. The first trend is cephalocaudal growth. What does this mean? Legs and feet develop first. Head and brain develop first. Gross motor skills are learned last. Both sides of the body develop first equally.

Head and brain develop first.

The nurse is performing an assessment on a newborn client. Which assessment should the nurse use to measure the client's growth? Select all that apply. Height Turning and lifting head Weight Head circumference Grasping

Height Weight Head circumference

The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? Natal teeth noted in the mouth that are loose Gluteal folds are present and symmetrical The neck is short, thick and mobile The newborn startles to loud sounds

Natal teeth noted in the mouth that are loose

Using Erikson's theory, a nurse asks a young adult questions about family, friends, and support systems. Why is this important during assessments of adolescents? Restrictions on new experiences may lead to feelings of guilt. Overprotection by parents may result in feelings of shame and doubt. Without peer acceptance, feelings of inferiority may result. Fear of commitments may lead to loneliness and isolation.

Fear of commitments may lead to loneliness and isolation.

The nurse is educating a new parent regarding nutritional needs for the newborn. Which statement is accurate and should be taught regarding the nutritional needs of a newborn? Growth during newborn stage is slow, so fewer calories are needed then when the infant is older. Newborns require additional water to supplement their diet if they are only formula feeding. Formula is designed to provide similar amounts of calories as breast milk would provide. Cow's milk is similar to breast milk in terms of calories and nutrients and is appropriate for the newborn.

Formula is designed to provide similar amounts of calories as breast milk would provide.

*A trend with growth and development of the infant is that development is proximodistal. This means: Growth progresses from gross motor movements to fine motor movements. All humans experience the same growth patterns. As nerve pathways develop, they become more specialized. Both sides of the body grow equally.

Growth progresses from gross motor movements to fine motor movements. (Cephalocaudal (proceeding from head to tail) development is the first trend, with the head and brain developing first, followed by the trunk, legs, and feet. The second trend is proximodistal development, which means that growth progresses from gross motor movements (such as learning to lift one's head) to fine motor movements (such as learning to pick up a toy with the fingers). The last trend is symmetric development of the body, with both sides of the body developing equally.)

The parent of a toddler indicates to the nurse that the toddler frequently yells, "No" to requests of the parent. What activity does the nurse recommend to the parent to increase additional vocabulary in the toddler? Reading books to the toddler Telling the toddler to avoid using the word "No" Repeating the request again and with firmness Playing toddler-friendly television shows

Reading books to the toddler

*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? Keep all pots and pans in lower cabinets. Restrain the baby in a car seat. Lock all cabinets that contain cleaning supplies. Give warm bottles of formula to the baby.

Restrain the baby in a car seat.

The school nurse is aware that providing proper care involves cooperation from the adolescent. Which technique will the nurse prioritize to develop open communication with the adolescents? Ask the parents questions first and then ask the adolescent the same question. Avoid asking questions about their friends, hobbies, and school activities. Show interest in the adolescent and develop a rapport before asking questions. Focus the interview on the problems rather than on the adolescent themselves.

Show interest in the adolescent and develop a rapport before asking questions.

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

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

The nursing instructor is explaining the various aspects of growth and development to a group of nursing students. The instructor determines the session is successful when the students point out which example best illustrates the concept of development? The 10-year-old who weighs the same amount as his 8-year-old brother The 3-year-old who has been toilet trained for 6 months The 5-month-old whose head circumference and chest measurement are the same The 5-year-old who is 2 inches taller than she was 4 months ago

The 3-year-old who has been toilet trained for 6 months

A parent is distressed because the infant is on the 26th percentile for height and the 17th percentile for weight. What should the nurse teach the client? The child is healthy, provided the percentile for height exceeds that of weight. The infant's pediatrician will be made aware of these findings promptly. The infant is still heavier and longer than most other infants of the same age. The child's position on a growth chart does not necessarily indicate a health problem.

The child's position on a growth chart does not necessarily indicate a health problem.

*A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns? At 6 months, you need to quit breast-feeding because he is not getting enough iron or Vitamin C and D and that should help him transition to solids better. If you give him one or two bottles of juice each day, he should get all the vitamins he needs. You can begin fruits and cereal in 1 month. You can begin feeding the infant fruits and vegetables now followed by iron-enriched cereal to ensure that he gets enough iron. The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron.

The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron. (Breast-feeding is the best method for feeding infants, according The Academy of Pediatrics Committee on Nutrition. However, by 4 to 6 months of age, breast-fed infants need supplements of iron and vitamin D. Solids are introduced at the same age and begins with iron-fortified rice cereal. The infant may also have diluted fruit juice in small portions.)

*The nurse is conducting a physical examination of a 8-month-old infant. Which observation may be cause for concern about the infant's neurologic development? The infant grasps a finger when it is placed in the palm. The infant's toes hyperextend when the bottom of the foot is stroked. The anterior fontanel (fontanelle) is open and easily palpated. The infant displays an asymmetric tonic neck reflex (fencing reflex).

The infant displays an asymmetric tonic neck reflex (fencing reflex). (The tonic neck reflex normally disappears by btwn 4 and 7 months, the palmar grasp reflex by between 3 and 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) between 12 and 24 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel (fontanelle), which remains open for brain growth, closes between 12 and 18 months of age.)

*A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? The infant squeals with pleasure The infant coos, babbles, and gurgles The infant imitates her father's cough The infant says "da-da" when looking at her father

The infant says "da-da" when looking at her father (First word by 9 months. Should already be imitating at 5, squeals for pleasure are at 3 months, & coos, babbles & gurgles are at 4 months)

*The nurse is caring for a hospitalized 8-year-old child whose parents have been divorced. Which of the following is most important for the nurse to do for this child? The nurse should respect the child's wishes regarding the parents visiting. The nurse should interpret the child's feelings. The nurse should introduce the child to other children from divorced families. The nurse should have clear information about who may contact the child.

The nurse should have clear information about who may contact the child. (When a child of a divorce is hospitalized, be certain to have clear information about who is the custodial parent, as well as who may visit or otherwise contact the child. The custodial parent's instructions and wishes should be honored.)

A first-time mother calls the pediatrician's office to ask the nurse about her baby's tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby's dentition? A baby's first teeth should erupt by 8 to 10 months of age and are the two lower front teeth. Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption. If the baby does not have any teeth come in by next month, the mother needs to bring him back for x-rays. Look for the baby to start running a fever and develop a stuffy nose and that will indicate his teeth are coming in.

Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption.

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

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

A nurse at a pediatric clinic is assessing a young client at a well-child visit. After the assessment, the nurse determines the child is in Erikson's autonomy stage based on which finding? Will perform tasks by themselves, even when it takes a long time They want to know the rules and enjoy being good and getting approval. Will interact with others and like to compete Learning to trust that needs are met when they cry

Will perform tasks by themselves, even when it takes a long time

A 2-year-old wants to feed herself and becomes agitated when the nurse attempts to feed her. What does the nurse understand is the developmental age of this child according to Erikson? industry vs. inferiority initiative vs. guilt autonomy vs. doubt and shame trust vs. mistrust

autonomy vs. doubt and shame

What is the appropriate time when children should be taught genitalia terminology and about personal privacy? middle childhood early childhood preadolescence late childhood

early childhood (Phallic = Preschooler 3-5 yrs) (Children in early childhood can identify their sex. Language is progressing and children can learn the appropriate terms to use for body parts. Children explore their body parts and ask questions. This is also the time when children should be taught when exploration of the body is acceptable and who and under what condition may be permitted to touch "private" parts (genitals).)

A nurse is performing a routine physical examination of a 5-year-old girl. Which of the following should the nurse note as developmentally inappropriate for this child? a brain the size of that of an adult evidence of early breast development a spleen that is palpable 1 or 2 cm below the left ribs tonsils twice the size of those of an adult

evidence of early breast development

A 10-year-old girl is excited when she receives the "most improved player" award on her softball team. Although she was not the strongest player on the team, she always tried to perform at her best level and never gave up on practicing her skills. What stage of psychosocial development according to Erik Erikson is this child demonstrating? autonomy versus shame and doubt initiative versus guilt industry versus inferiority identity versus role confusion

industry versus inferiority

*Erik Erikson described human psychosocial development as a series of tasks that must be mastered before moving on to the next task. The stage in which the child is more assertive and starts to accept punishment for doing wrong is which stage? trust vs. mistrust autonomy vs. doubt and shame identity vs. role confusion initiative vs. guilt

initiative vs. guilt (In the stage of development referred to as initiative vs. guilt, the child engages in active, assertive play and develops a conscience. The child accepts punishment for doing wrong because it relieves feelings of guilt.)

According to the theories of child development of Sigmund Freud, the child who is between 6 and 10 years old is in which stage? phallic stage latency stage genital stage anal stage

latency stage

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

looking for a toy in her crib at the last place she saw it.

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

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

A school-aged child always follows the rules and obeys traffic lights when crossing the street. Based on Kohlberg's theory, what type of development is being demonstrated? moral psychosocial cognitive intellectual

moral

*Based on Piaget's theory of cognitive development, what type of activities would a nurse recommend to parents of children in the preoperational stage? church lessons toilet training play activities organized sports

play activities (According to Piaget, the preoperational stage (ages 2 to 7) of cognitive development is characterized by the beginning use of symbols, through increased language skills and pictures, to represent the preschooler's world. Play activities during this time help the child understand life events and relationships. The other activities would not be appropriate in the preoperational stage.)

In what stage of Kohlberg's Moral Development Theory do people make judgments based solely on their own needs? preconventional conventional preoperational postconventional

preconventional

Which of the following can have an influence over the individual's physiologic growth and development trajectory? intelligence ethnicity and culture temperament sensory stimulation and nutrition

sensory stimulation and nutrition

According to Freud, which of the following influences is the primary force that drives an individual's development? faith sexuality autonomy security

sexuality

The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: is expected to appear within 1 month. should have disappeared. should be pronounced and easy to elicit. is a protective reflex and retained for life.

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

When assessing a 4-year-old, the nurse understands that the client is developing a conscience when the client performs which action? wants to sit in the parent's lab tattles on a sibling carries a security blanket is scared of the medical equipment

tattles on a sibling

Genetics have an influence on many aspects of growth and development. The genetic influence that has to do with the way a person thinks, behaves, and reacts is referred to as: temperament. growth. development. maturation.

temperament.

A 2-year-old with pneumonia has recently been hospitalized. When the lunch tray arrives to the floor, the nurse caring for the client sets up the tray and allows the child to self-feed with a spoon despite the mess. What is the nurse's best reason for these actions? to foster trust to foster autonomy to foster industry to foster initiative

to foster autonomy

While assessing an adolescent, a nurse would assess which behavior as indicating the use of formal thought processes? uses abstract thought while engaging in conversations views self as being separate from others judges experiences solely by the results understands literal instructions

uses abstract thought while engaging in conversations

*When discussing a nutritional diet with a parent, the father says, "We don't eat leafy green vegetables." For what vitamins will the child be at risk for deficiency? Select all that apply. vitamin D vitamin A vitamin E vitamin B vitamin K

vitamin A vitamin K Leafy green vegetables are an excellent source of vitamins A and K.)