Pediatrics: Growth & Development infant & toddlers
An infant is breastfed. When assessing the stools, which findings would be typical? Less constipation than bottle-fed infants Harder stools than those of bottle-fed infants A strong odor Fewer stools than bottle-fed infants
Less constipation than bottle-fed infants
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 rear-facing 5-point harness restraint
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse?
"Delays are normal when a child is premature." Rationale: When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant, use the infant's adjusted age to determine expected outcomes. To determine adjusted age, subtract the number of weeks that the infant was premature from the infant's chronological age. Plot growth parameters and assess developmental milestones based on adjusted age. Delays will not necessarily be resolved by the age of 6 months. While the mother should talk with the physician about concerns, this is not the best initial response by the nurse.
The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as they should. What question should the nurse ask to help determine if their fears are warranted?
"Does your infant move a toy back and forth from one hand to the other when you give it to them?"
The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as they should. What question should the nurse ask to help determine if their fears are warranted? "Does your infant place toys into a box or container and take them out?" "Does your infant move a toy back and forth from one hand to the other when you give it to them?" "Is your infant able to hold a pencil and scribble on paper?" "Is your infant able to drink with a cup by themselves?"
"Does your infant move a toy back and forth from one hand to the other when you give it to them?"
The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply. "Food is so expensive. I can't afford for my child to leave any food on the plate." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "I try to eat healthy in front of my daughter so she will hopefully pick up good eating habits." "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up." "I plan on encouraging my son to cook with me when he is old enough so that he will enjoy a variety of foods and learn how to cook too."
"Food is so expensive. I can't afford for my child to leave any food on the plate." "I have tried at least 10 times with every green vegetable and I can't get my son to like them." "I let my child eat whatever he wants right now so that we don't argue about food. Hopefully he will like healthy foods when he grows up."
The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? as soon as the infant begins to eat fruit by 12 months of age when weaning is complete as soon as the first tooth erupts
as soon as the first tooth erupts
The nurse is providing anticipatory guidance to the parent of a 2-month-old infant in relation to growth and development. Which statement from the parent demonstrates proper understanding? "I can expect my infant to be able to raise the head up when on the stomach within the next month." "I can expect my infant to be able to hold a rattle within the next month." "I can expect my infant to laugh out loud within the next month." "I can expect my infant to become clingy around strangers within the next month."
"I can expect my infant to be able to raise the head up when on the stomach within the next month."
The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "We should get some rest in about 1 month when the newborn starts sleeping through the night." "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance."
"I will not be concerned if my newborn has stools that begin to have a yellowish color to them." "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." "My newborn can see up-close things, like our faces, better than things at a distance."
A client who is breastfeeding asks the nurse if she can give the newborn a pacifier. Which nursing response is most appropriate? "It is recommended to wait until breastfeeding is well-established before introducing a pacifier." "This decision should be made by you and your partner based on your personal preferences." "I know a lot of people who breastfed and also gave their newborns a pacifier." "I will request the lactation consultant come talk to you about pacifier usage while breastfeeding."
"It is recommended to wait until breastfeeding is well-established before introducing a pacifier."
The student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction? "Maturation refers to the child's increases in body size." "Increases in body size are referred to as growth." "Both growth and development are influenced by heredity." "Development refers to the increase in skills the child demonstrates as they grow and age."
"Maturation refers to the child's increases in body size."
A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?
"The baby can sleep in your room in an infant crib, but not in an adult bed."
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate?
"What does his stool look like?"
The nurse goes in to check on a new mother to see how breastfeeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse?
"You are doing a wonderful job attempting to wake the baby."
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?
"You can try bananas 2 or 3 months from now."
During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse? "Babies really can't tell the difference between people at that age." "Maybe she just knows your voice better than your mother's." "You may be right, since infants can sense their mother's smell as early as 7 days old." "I'm not sure a 4-week-old infant can tell their mother from another woman's smell."
"You may be right, since infants can sense their mother's smell as early as 7 days old."
The nurse enters a client's room to find the new mother crying softly. The client states, "I had my heart set on breastfeeding but my infant was born with a cleft lip. My dreams of breastfeeding are destroyed." Which response by the nurse is appropriate?
"You may still breastfeed your infant. I will show you appropriate techniques to use."
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? 15 lb 4 oz (6920 g) 19 lb 8 oz (8825 g) 10 lb 8 oz (4760 g) 13 lb (5900 g)
19 lb 8 oz (8825 g)
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) Rationale: 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 providing client education to the parent about bathing the infant. What would be important to instruct the parent? Infants need a daily bath Never use soap on an infant's hair Soap lubricates and oils an infant's skin Bath time provides an opportunity for play
Bath time provides an opportunity for play
The postpartum nurse observes new parents as they put their newborns in the bassinet to sleep. Which action(s) by a new parent require further instruction from the nurse? Select all that apply. A parent tells their spouse to be sure to place the newborn on their back when putting the newborn in the bassinet. A parent states all of their children like sleeping on their abdomen and this newborn likes it too. A parent places a newborn on its side after falling asleep. A parent places the comforter the grandparent made over the newborn's body. A parent states their newborn looks too warm, so they are moving the bassinet in front of the air conditioner to cool off the newborn.
A parent states all of their children like sleeping on their abdomen and this newborn likes it too. A parent places a newborn on its side after falling asleep. A parent places the comforter the grandparent made over the newborn's body. A parent states their newborn looks too warm, so they are moving the bassinet in front of the air conditioner to cool off the newborn.
A newborn requires skin care that includes bathing. Besides hygiene, what is another reason for bathing the newborn?
Bathing is a time for bonding with the parents.
Infant development is best described by which statement?
Development proceeds cephalocaudally.
The nurse establishes the following plan of care based on the nursing diagnosis: Caregiver role strain related to infant crying throughout night as manifested by parents stating, "We are exhausted." Which nursing interventions are included in the plan of care? Select all that apply. At bedtime, ensure the child is in a deep sleep then place in crib. During night awakening, keep interactions minimal. Establish a quieting ritual for infant before bed. Having one parent awake at a time with infant Add rice cereal to the evening bottle to prevent hunger and awakening.
During night awakening, keep interactions minimal. Establish a quieting ritual for infant before bed. Having one parent awake at a time with infant
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
The nurse is 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 E Vitamin D Iron
Iron
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability? Sitting ability and the age of first tooth eruption are correlated. Most infants sit steadily at 4 months; this infant is normal. Most infants sit steadily at 3 months; this infant is slightly delayed. Most infants do not sit steadily until 8 months; this infant is normal.
Most infants do not sit steadily until 8 months; this infant is normal.
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
The clinic nurse is assessing a 9-month-old client. The parents state, "Our baby is having a really hard time teething." Which nursing action is appropriate? Tell the parents to give the infant acetaminophen every 4 hours. Have the parent's apply a topical numbing cream to the infant's gums hourly. Encourage the parents to feed the infant warmer foods while teething. Recommend the parents provide the infant a cold teething ring to chew
Recommend the parents provide the infant a cold teething ring to chew
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life?
Respond promptly when the infant cries.
Which activity will the nurse encourage new parents to complete in order to assist their infant in accomplishing Erikson's developmental task for the first year of life? Appropriately enunciate words when speaking to the infant. Respond promptly when the infant cries. Read age-appropriate books to the infant daily. Praise the infant when a new milestone is reached.
Respond promptly when the infant cries.
Which milestone would the nurse expect an infant to accomplish by 8 months of age?
Sitting without support. Rationale: Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk.
What action shows an example of Erik Erikson's developmental task for the infant?
The infant cries and the caregiver picks the child up.
The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.
The infant does not pay attention to noises behind him. The infant has frequent episodes of crossed eyes. The infant seems disinterested in the surrounding environment.
The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care.The group will be helping the parents with infant care. Which instruction should the nurse prioritize with this group?
The infant sleeps 10 to 12 hours at night and can take two to three naps during the day.
The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments? By 8 months of age, the child's skill level will vary greatly and cannot be predicted. The infant can be expected to display developmental skills consistent with a 8-month-old infant. The infant will likely show the skills of an infant with the adjusted age of 7 months. The infant will most likely present with developmental skills consistent with a 6-month-old infant.
The infant will most likely present with developmental skills consistent with a 6-month-old infant.
The student nurse is reviewing the chart of a newborn. The document indicates the newborn is in the quiet alert state. Which is the best description of this sleep phase?
The newborn's eyes are open and no body movements are noted.
The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?
The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? Put the baby to bed at various times of the evening. Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime. Let the baby cry during the night and she will eventually fall back to sleep. Use the crib for sleeping only, not for play activities.
Use the crib for sleeping only, not for play activities.
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?
increased biting and sucking
The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which finding(s) is normal for this infant? Select all that apply. infant walks independently heart rate 101 beats/min infant has moderate head lag respiratory rate 28 breaths/min temperature 100.6°F (38.1°C)
infant walks independently heart rate 101 beats/min respiratory rate 28 breaths/min
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is:
looking for a toy in her crib at the last place she saw it.
The nurse is assessing the oral cavity of a 6-month-old child. When palpating the location in which the first primary teeth erupt, which location is being assessed?
lower central gumline
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? 1 upper tooth no teeth 1 to 2 lower teeth 1 to 3 natal teeth
no teeth
The best way for an infant's parent to help the child complete the developmental task of the first year is to: keep the infant stimulated with many toys. expose the infant to many caregivers to help the infant learn variability. respond to the infant consistently. talk to the infant at a special time each day.
respond to the infant consistently.
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: should be pronounced and easy to elicit. should have disappeared. is a protective reflex and retained for life. is expected to appear within 1 month.
should have disappeared.
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 the expected amount for age. the child weighs less than expected for age. the weight assessment is blatantly inaccurate. the child weighs more than expected for age.
the child weighs less than expected for age.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that: the newborn's stomach can hold between 0.5 oz and 1 oz. demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night. most newborns need to eat about 4 times per day. the best feeding schedule offers food every 4 to 6 hours.
the newborn's stomach can hold between 0.5 oz and 1 oz.
The nurse is assessing an infant at the 6-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3600 g) and was 20 in (50.8 cm) in length. Which finding is consistent with the normal infant growth and development? weight of 20 lb (9100 g) and length of 30 in (76.2 cm) weight of 18 lb (8200 g) and length of 28 in (71.1 cm) weight of 16 lb (7300 g) and length of 26 in (66.0 cm) weight of 14 lb (6400 g) and length of 24 in (61.0 cm)
weight of 16 lb (7300 g) and length of 26 in (66.0 cm)
