Pediatrics Chapter 5
Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of he information when they identify which of the following as the task of the preschooler?
Initiative
A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be?
preschool
A nurse is caring for a 4-year-old girl. The parents indicate that their daughter often reports that objects in the house are her friends. They are concerned because the girl says that the grandfather clock in the hallway smiles and sings to her. Which response by the nurse is best?
"Attributing life-like qualities to inanimate objects is quite normal at this age."
The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate?
"Both your son's height and rate of growth are within normal limits for his age." The average 4-year-old child is 40.5 in (103 cm). The average rate of growth per year is between 2.5 and 3 in (6.35 and 7.62 cm).
The nurse is conducting a well-child exam of a 4-year-old boy. Which of the following statements would alert the nurse that the child is at risk for iron deficiency?
"He loves milk and drinks it every time he is thirsty."
The mother of a preschool-age child is discussing normal development of this age child with the pediatric nurse. The nurse explains the developmental milestone of initiative. The mother makes the following statements about her son. Which statement is an example of what might be this developmental milestone?
"He tries to sweep up cereal his brother spilled but cries when he can't do it well."
The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?
"I usually have him in time-out for about 10 minutes."
The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which of the following statements made by the caregivers 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!"
The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement indicates a need for further teaching?
"She can ride on the street if I am riding with her."
The nurse is providing teaching about proper dental care for the parents of a 5-year-old girl. Which response indicates a need for further teaching?
"She needs to floss her teeth before brushing."
The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares?
"She screams and thrashes when we try to touch her."
The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best?
"Talk to your son's new teacher and schedule a tour with him."
The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?
"The school is quite structured and advocates corporal punishment."
The mother of a 4 year old tells the nurse that she is frustrated, because all she seems to do lately is fight with the child over what the child wants to eat and wear. The mother says that she sometimes wants to spank the child for always disagreeing. What would be the best suggestion for the nurse to make to this mother?
"Use the timeout technique for discipline."
If the child is gaining weight at an expected rate, a child who weighs 36 lbs. at 3 years of age would weigh which of the following at age 5?
44 lbs. The preschool age child gains about 4 to 5 lbs. each year (1.8 to 2.3 kg) and grows about 2.5 to 3 inches (6.3 cm).
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?
Allowing the preschooler to fall asleep wherever and whenever the child is tired enough
A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage?
Asking the girl to slow down and to think before she talks Many preschoolers stutter as thinking races ahead of their ability to articulate ideas. Most of this stuttering, when not made an issue, will resolve on its own. Calling attention to the dysfluency often exacerbates it. All the other practices are helpful.
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of cooperative play?
Children are playing in an organized group with each other.
A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which of the following nursing diagnoses is most applicable for his family?
Deficient knowledge of normal preschool development
The nurse is organizing an indoor play area for preschoolers. What play materials are least important?
Electronic teaching toys
The mother of a 3-year-old child reports her son is afraid of the dark. She asks the nurse for help. Which advice is best for the nurse to offer?
Encourage the parent to allow a small night light
Telling tall tales is harmless and should be encouraged in preschoolers because it helps them develop their imaginations.
False
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:
Having the child wear a personal flotation device whenever near or on the water
A nurse is describing growth and development during the preschool period. Which of the following would the nurse identify as a predominant and heightened characteristic for this age group?
Imagination
A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which of the following activities that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?
Opening drawers in the room, pulling out supplies, and examining them
The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of the following is the highest calcium-containing fruit?
Orange
A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is which of the following?
Physical growth slows.
The nurse is conducting a well child assessment of a 4-year-old. Which assessment finding warrants further investigation?
Presence of 10 deciduous teeth The preschooler should have 20 deciduous teeth present.
The nurse is observing a playgroup of children of all ages. The preschoolers in the group would most likely be doing which activity?
Pretending to be mommies and daddies in the playhouse.
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 which of the following?
Testing and identification of group role
The nurse is discussing development of motor skills in the preschool-age group with a group of nursing students. Which of the following statements is most accurate regarding the gross motor skills of a 4-year-old?
The child can hop on one foot.
Which of the following gross motor skills would the 4-year-old child have most recently attained?
The child can hop on one foot.
In working with the preschool-age child, the nurse recognizes which of the following as a characteristic of the preschooler?
The child takes in new information at a rapid rate and asks "why" and "how."
In counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes:
The home environment
The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that the girl is demonstrating which of the following?
Transduction
Fear of mutilation is significant during the preschool age.
True
When planning how to respond to a child about telling stories, you would base your statement on the fact that
imagination in a 3-year-old is at its peak.
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." • "Try reading a favorite story before bedtime." • "Avoid having your child watch frightening shows on TV before bedtime." • "Try using a night light in the child's room."
A nurse is providing a routine wellness examination for a 5-year-old boy. Which response by the parents indicates a need for an additional referral or follow-up?
"We often have to translate his speech to others."
The nurse is providing teaching about child safety to the parents of a 4-year-old girl. Which statement by the parents indicates a need for further teaching?
"We need to tell her that her vitamins are candy."
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. Which of the following would be the best response for the nurse to give the child?
"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."
The father of a 4-year-old confides in the school nurse that he is concerned about his child not telling the truth. The father states, "I found a broken tool in my garage and when I asked my son about it, he said that his friend Andrew broke it, but we don't know anyone named Andrew." The best response by the nurse would be
"Your son may have a friend named Andrew, but it could be an imaginary friend."
The nurse is conducting a well child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?
2.5 to 3 inches (6.35 to 7.62 cm)
Which project or game would you anticipate that a preschooler would most enjoy while hospitalized?
Dressing in her mother's coat to play house
In teaching caregivers of preschool children, the nurse would reinforce that which of the following would be most important for this age group?
The preschool child should wear a seat belt when riding in a vehicle.
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of the following? Select all that apply.
• When discussing improper behavior, call the behavior "bad" or "naughty," not the child. • Anticipate situations likely to cause misbehavior and redirect the child to another activity. • Books and stories can help preschoolers master proper behavior.
The developmental task of preschoolers is to achieve a sense of
initiative versus guilt.
