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What are common causes of speech problems? (Select all that apply). a. Autism. b. Prematurity. c. Hearing loss. d. Developmental delay. e. Overstimulated environment.
a. Autism. c. Hearing loss. d. Developmental delay. -Common causes of speech problems are hearing loss, developmental delay, autism, lack of environmental stimulation, and physical conditions that impeded normal speech production. Prematurity and an overstimulated environment are not causes of speech problems.
Parents ask the nurse, "Should we be concerned our preschooler has an imaginary friend, and how should we react?" Which responses should the nurse give to the parents? (Select all that apply). a. "The imaginary playmate is a sign of health." b. "You can acknowledge the presence of the imaginary companion." c. "It is normal for a preschool-aged child to have an imaginary friend." d. "If your child wants a place setting at the table for the child, it is best to refuse." e. "It is OK to allow the child to blame the imaginary playmate to avoid punishment."
a. "The imaginary playmate is a sign of health." b. "You can acknowledge the presence of the imaginary companion." c. "It is normal for a preschool-aged child to have an imaginary friend." -Parents should be reassured that the child's fantasy is a sign of health that helps differentiate between make-believe and reality. Parents can acknowledge the presence of the imaginary companion by calling him/her by name and even agreeing to simple requests such as setting an extra place at the table, but the should not allow the child to use the playmate to avoid punishment or responsibility.
The nurse is teaching parents of a 3-year-old child about language developmental milestones. What milestones should the nurse include in the teaching session? (Select all that apply). a. Asks many questions. b. Names one or more colors. c. Repeats sentence of six syllables. d. Uses primarily telegraphic speech. e. Has a vocabulary of 1500 words or more.
a. Asks many questions. c. Repeats sentence of six syllables. d. Uses primarily telegraphic speech. -The language milestones of a 3-year-old child include asking many questions, repeating a sentence of six syllables, and using primarily telegraphic speech. Naming one or more colors and having a vocabulary of 1500 words or more footing are language milestones seen at the age of 4 years.
Parents are worried that their preschool-aged child is showing hyper aggressive behavior. What are signs of hyper aggressive behavior? (Select all that apply). a. Disrespect. b. Noncompliance. c. Infrequent impulsivity. d. Occasional temper tantrums. e. Unprovoked physical attacks on other children.
a. Disrespect. b. Noncompliance. e. Unprovoked physical attacks on other children. -Hyperaggressive behavior in preschoolers is characterized by unprovoked physical attacks on other children and adults, destruction of others' property, frequent intense temper tantrums, extreme impulsivity, disrespect, and noncompliance.
The nurse has just give a subcutaneous injection to a preschool child, and the child asks for a Band-Aid over the site. Which action should the nurse implement? a. Place a Band-Aid over the site. b. Massage the injection site with an alcohol swab. c. Show the child there is no bleeding from the site. d. Explain that a Band-Aid is not needed after a subcutaneous injection.
a. Place a Band-Aid over the site. -Despite the advances in body image development, preschoolers have poorly defined body boundaries and little knowledge of their internal anatomy. Intrusive experiences are frightening, especially those that disrupt the skin integrity (e.g., injections and surgery). They fear that all their blood and insides can leak out if the skin is broken. Therefore, preschoolers may believe it is critical to use bandages after an injury. The nurse should place a Band-Aid over the site.
A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. What is the most appropriate intervention? a. Refer the child for a professional psychosocial assessment. b. Explain that this is normal behavior, especially boys. c. Encourage the parent to try more consistent and firm discipline. d. Talk to the preschool teacher to obtain validation for behavior parents reports.
a. Refer the child for a professional psychosocial assessment. -The preschool years are a time when children learn socially acceptable behavior. The difference between normal and problematic behavior is not the behavior but the severity, frequency, and duration. This child's behavior meets the definition of requiring professional evaluation. Some aggressive behavior is within normal limits, but at 8 to 10 weeks, this behavior has persisted too long. There is no indication that the parent is using inconsistent discipline. A part of the evaluation is to obtain validation for behavior parent reports.
The nurse is teaching parents of a 3-year-old child about gross motor developmental milestones. What milestones should the nurse include in the teaching session? (Select all that apply). a. Rides a tricycle. b. Catches a ball reliably. c. Jumps off the bottom step. d. Stands on one foot for a few seconds. e. Walks downstairs using alternate footing.
a. Rides a tricycle. c. Jumps off the bottom step. d. Stands on one foot for a few seconds. -The gross motor milestones of a 3-year-old child include riding a tricycle, jumping off the bottom step, and standing on one foot for a few seconds. Catching a ball reliably and walking downstairs using alternate footing are gross motor milestones seen at the age of 4 years.
What is the reason pedestrian motor vehicles increase in the preschool age? (Select all that apply). a. Riding tricycles. b. Running after balls. c. Playing in the street. d. Crossing streets at the crosswalk. e. Crossing streets with an adult.
a. Riding tricycles. b. Running after balls. c. Playing in the street. -Pedestrian motor vehicle injuries increase because of activities such as playing in the street, riding tricycles, running after balls, and forgetting safety regulations when crossing streets. Crossing streets at the crosswalk or with an adult are safety measures.
What is descriptive of the nutritional requirements of preschool children? a. The quality of food consumed is more important than the quantity. b. The average daily intake of preschoolers should be about 3000 calories. c. Nutritional requirements for preschoolers are very different from requirements for toddlers. d. Requirements for calories per unit of body weight increase slightly during the preschool period.
a. The quality of food consumed is more important than the quantity. -Parents need to be reassured that the quality of food eaten is most important than the quantity. Children are able to self-regulate their intake when offered foods high in nutritional value. The average daily caloric intake should be approximately 1800 calories. Toddlers and preschoolers have similar nutritional requirements. There is an overall slight decrease in needed calories and fluids during the preschool period.
According to Piaget, magical thinking is the belief of which? a. Thoughts are powerful. b. God is an imaginary friend. c. Evens have cause and effect. d. If the skin is broken, the insides will come out.
a. Thoughts are powerful. -Because of they egocentrism and transductive reasoning, preschoolers believe that thoughts are powerful. Believing God is an imaginary friend is an example of concrete thinking in a preschoolers spiritual development. Cause-and-effect implies logical though, not magical thinking. Believing that the skin is broken, the insides will come out is an example of concrete thinking in development of body image.
The nurse is teaching parents of a 4-year-old child about socialization developmental milestones. What milestones should the nurse include in the teaching session? (Select all that apply). a. Very independent. b. Has mood sings. c. Has better manners. d. Eager to do things right. e. Tends to be selfish and impatient.
a. Very independent. b. Has mood sings. e. Tends to be selfish and impatient. -The socialization milestones of a 4-year-old child include being very independent, having mood swings, and tending to be selfish and impatient. Having better manners and being eager to do things right are socialization milestones seen at the age of 5 years.
What developmental achievements are demonstrated by a 4-year-old child? (Select all that apply). a. Cares for self totally. b. Throws a ball overhead. c. Has a vocabulary of 1500 words. d. Can skip and hop on alternate feet. e. Tends to be selfish and impatient. f. Commonly has an imaginary playmate.
b. Throws a ball overhead. c. Has a vocabulary of 1500 words. e. Tends to be selfish and impatient. f. Commonly has an imaginary playmate. -Developmental achievements for a 4-year-old child include throwing a ball overhead, having a vocabulary of 1500 words, tending to be selfish and impatient, and perhaps having an imaginary playmate. Caring for oneself totally and skipping and hopping on alternate feet are achievements normally seen in the 5-year-old age group.
The nurse is teaching parents about instilling a positive body image for the preschool age. What statement made by the parents indicates the teaching is understood? a. We will make sure our child is praised about his or her looks. b. We will help our child compare his or her size with other children. c. We understand our child will have well-defined body boundaries. d. We will be sure our child understands about being little for his/her age.
a. We will make sure our child is praised about his or her looks. -Because these are formative years for both boys and girls, parents should make efforts to instill positive principles regarding body image. Children at this age are aware of the meaning of words such as pretty or ugly, and they reflect the opinions of others regarding their own appearance. Despite the advances in body image development, preschoolers have poorly defined body boundaries. By 5 years of age, children compare their size with that of their peers and can become conscious of being large or short, especially if others refer to them as so big or so little for their age. Parents should not suggest their child compare him/herself with other children in regard to size, and parents should not focus on their child's size as being little.
The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse they will be back to visit at 6 PM. When he asks the nurse when his parents are coming, what would the nurse's best response be? a. "They will be here soon." b. "They will come after dinner." c. "Let me show you on the clock when 6 PM is." d. "I will tell you every time I see you how much longer it ill be."
b. "They will come after dinner." -A 4-year-old child understands time in relation to events such as meals. Children perceive "soon" as a very short time. The nurse may lose the child's trust if his parents do not return in the time he perceives as "soon." Children cannot read or use a clock for practical purposes until age 7 years. "I will tell you every time I see you how much longer it will be" assumes the child understands the concepts of hours and minutes, which does not occur until age 5 or 6 years.
The nurse is explaining average weight gain during the preschool years to a group of parents. Which average weight gain should the nurse suggest to the parents? a. 1 to 2 kg. b. 2 to 3 kg. c. 3 to 4 kg. d. 4 to 5 kg.
b. 2 to 3 kg. -The average weight gain remained approximately 2 to 3 kg (4.56 to 5 lb) per year during the preschool period.
A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was bad. What is the nurse's best interpretation of this comment? a. Sign of stress. b. Common at this age. c. Suggestive of maladaptation. d. Suggestive of excessive discipline at home.
b. Common at this age. -Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age react to stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.
In terms of fine motor development, what should the 3-year-old child be expected to do? a. Tie shoelaces. b. Copy (draw) a circle. c. Use scissors or a pencil very well. d. Draw a person with seven to nine parts.
b. Copy (draw) a circle. -Three-year-old children are able to accomplish the fine motor skill of copying (drawing) a circle. The ability to tie shoe laces, to use scissors or a pencil very well, and to draw a person with seven to nine parts are fine motor skills of a 5-year-old child.
What are sources of stress in preschoolers? (Select all that apply). a. Shares possessions. b. Damages or destroys objects. c. May fear dogs or other animals. d. Seems to be in perpetual motion. e. May stutter or stumble over words.
b. Damages or destroys objects. c. May fear dogs or other animals. d. Seems to be in perpetual motion. e. May stutter or stumble over words. -Sources of stress in preschoolers include damaging or destroying objects, fearing dogs or other animals, in perpetual motion, and may stutter or stumble over words. Guarding possessions, not sharing, is a source of stress.
The parent of a 4-year-old boy tells the nurse that the child believes monsters and bogeyman are in his bedroom at night. What is the nurse's best suggestion for coping with this problem? a. Let the child sleep with his parents. b. Keep a night light on in the child's bedroom. c. Help the child understand that these fears are illogical. d. Tell the child that monsters and bogeyman do not exist.
b. Keep a night light on in the child's bedroom. -Involve the child in problem solving. A night light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with his parents will not get rid of the fears. A 4-year-old child is in the pre conceptual stage and cannot understand logical thought.
Parents tell the nurse they found their 3-year-old daughter and male cousin of the same age inspecting each other closely as they used the bathroom. What is the most appropriate recommendation for the nurse to make? a. Punish the children so this behavior stops. b. Neither condone nor condemn the curiosity. c. Get counseling for this unusual and dangerous behavior. d. Allow the children unrestricted permission to satisfy this curiosity.
b. Neither condone nor condemn the curiosity. -Three-year-old children become aware of anatomic differences and are concerned about how the other sex works. Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. This is age appropriate and not dangerous behavior. Encouraging the children to ask their parents questions and redirecting their activity is more appropriate than giving permission.
A child age 4 1/2 years sometimes wakes her parents up at night screaming, thrashing, sweating, and apparently frightened, yet she is not aware of her parents presence when they check on her. She lies down and sleeps without any parental intervention. This is most likely what? a. Nightmare. b. Sleep terror. c. Sleep apnea. d. Seizure activity.
b. Sleep terror. -This is a description of a sleep terror. The child is observed during the episode and not disturbed unless there is a possibility of injury. A child who wakes from a nightmare is distressed. She is aware of and reassured by the parents' presence. This is not the case with sleep apnea. This behavior is not indicative of seizure activity.
In terms of cognitive development, a 5-year-old child should be expected to do which? a. Think abstractly. b. Use magical thinking. c. Understand conservation of matter. d. Understand another person's perspective.
b. Use magical thinking. -Magical thinking is believing that thoughts can cause events. An example is thinking of the death of a parent might cause it to happen. Abstract thought does not develop until the school-age years. The concept of conversation is the cognitive task of school-age children, ages 5 to 7 years. A 5-year-old child cannot understand another person's perspective.
A parent taking a preschool child to school on the first day asks the nurse, "What do I do if my child wants me to stay?" What is an appropriate response by the nurse? a. "It is better if you do not stay." b. "It is best to stay and participate in the activities." c. "It is OK to stay part of the first day, but be inconspicuous." d. "It would be better to have a good friend take your child to class the first day."
c. "It is OK to stay part of the first day, but be inconspicuous." -On the first day of preschool, in some instances, it is helpful for parents to remain for at least part of the firs day until the child is comfortable. If parents stay, they should be available to the child but inconspicuous. It would not be appropriate not to stay, to have someone else take the child to school, or to stay and participate in activities.
The nurse is teaching parents of a 4-year-old child about fine motor developmental milestones. What milestones should the nurse include in the teaching session? (Select all that apply). a. Can lace shoes. b. Use scissors successfully. c. Builds a tower of nine or 10 cubes. d. Builds bridge with three cubes. e. Adeptly places small pellets in a narrow-necked bottle.
c. Builds a tower of nine or 10 cubes. d. Builds bridge with three cubes. e. Adeptly places small pellets in a narrow-necked bottle. -The fine motor milestones of a 4-year-old child include building a tower of nine or 10 cubes, building a bridge with three cubes, and adeptly placing small pellets in a narrow-necked bottle. Lacing shoes and using scissors successfully are fine motor milestones seen at the age of 5 years.
The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night. What intervention should the nurse suggest in helping the parent to cope with this sleep disturbance? a. Establish a consistent punishment if the child does not go to bed when told. b. Allow the child to fall asleep in a different room and then gently move the child to his or her bed. c. Establish limited rituals that signal readiness for bedtime. d. Allow the child to watch television until almost asleep.
c. Establish limited rituals that signal readiness for bedtime. -An appropriate intervention for a child who resists going to bed is to establish limited rituals such as a bath or story that signal readiness for bed and consistently follow through with the ritual. Punishing the child will not alleviate the resistance problems and may only add to the frustration. Allowing the child to fall asleep in a different room and to watch television to fall asleep are not recommend approaches to sleep resistance.
What signals the resolution of the Oedipus or Electra complex? a. Learns sex differences. b. Learns sexually appropriate behavior. c. Identifies with the same-sex parent. d. Has guilt over feelings toward the father or mother.
c. Identifies with the same-sex parent. -The resolution of the Oedipus or Electra complex is identification with the same-sex parent. Learning sex differences and sexually appropriate behavior is a goal in further differentiation of oneself but does not signal the resolution of the Oedipus or Electra complex. Guilt over feelings toward the father or mother is seen as a stage in the complex, not the resolution.
The nurse understands that trusts of gifted children include what? (Select all that apply). a. Fair memory skills. b. Limited sense of humor. c. Perfectionism as a focus. d. Inquisitive; always asking questions. e. Displays intense feelings and emotion.
c. Perfectionism as a focus. d. Inquisitive; always asking questions. e. Displays intense feelings and emotion. -Characteristics of gifted children include perfectionism as a focus; inquisitive, always asking questions; and displaying intense feelings and emotion. Memory skills are pronounced, and humor is exceptional.
During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his soon is ready for kindergarten. The boy's birthday is close to the cut-off date, and he has not attended preschool. What is the nurse's best recommendation? a. Start kindergarten. b. Talk to other parents about readiness. c. Perform a developmental screening. d. Postpone kindergarten and go to preschool.
c. Perform a developmental screening. -A developmental assessment with a screening tool that addresses cognitive, social, and physical milestones can help identify children who may need further assessment. A readiness assessment involves an evaluation of skill acquisition. Stating the child should start kindergarten or go to preschool and postpone kindergarten does not address the father's concerns about readiness for school. Talking to the other parents about readiness does not ascertain if the child is ready and does not address the father's concerns.
A 4-year-old child tells the nurse that she doesn't want another blood sample drawn because "I need all of my insides and I don't want anyone taking them out." What is the nurse's best interpretation of this? a. The child is being overly dramatic. b. The child has a disturbed body image. c. Preschoolers have poorly defined body boundaries. d. Preschoolers have a good understand of their bodies.
c. Preschoolers have poorly defined body boundaries. -Preschoolers have little understanding of body boundaries, which leads to fears of mutilation. The child is not capable of being dramatic at this age. She truly has fear. Body image is just developing in school-age children. Preschoolers do not have good understanding of their bodies.
What dysfunctional speech pattern is a normal characteristic of the language development of a preschool child? a. Lisp. b. Echolalia. c. Stammering. d. Repetition without meaning.
c. Stammering. -Stammering and stuttering are normal disfluency in preschool-age children. Lisps are not a normal characteristic of language development. Echolalia and repetition are traits of toddlers' language.
What should the nurse suggest to parents of preschoolers about sensitive questions regarding sex? a. "Distract your child from the topic." b. "Offer complete factual information." c. "Dismiss the topic until the child is older." d. "Find out what your child knows or thinks."
d. "Find out what your child knows or thinks." -Two rules govern answering sensitive questions about topics such as sex. The first is to find out what children know and think. By investigating the theories children have produced as a reasonable, parents can not only give correct information but also help children understand why their explanation is inaccurate. Another reason for ascertaining what the child thinks before offering any information is to avoid giving an unasked answer. The child should not be distracted from the topic. If parents offer too much information, the child will simply become bored or end the conversation with an irrelevant question. What matters is that parents are approachable and do not dismiss their child's inquiries.
Parents of a preschool child tell the nurse, "Our child seems to have many imaginary fears." What suggestion should the nurse give to the parents to help their child resolve the fears? a. "Ignore the fears; they will go away." b. "Explain to your child the fears are not real." c. "Give your child some new toys to allay the fears." d. "Help your child to resolve the fears though play activities."
d. "Help your child to resolve the fears though play activities." -Preschoolers are able to work through many of their unresolved fears, fantasies, and anxieties through play, especially if guided with appropriate play objects (e.g., dolls or puppets) that represent family members, health professionals, and other children. the fears should not be ignored because they may escalate. Preschools are not cognitively prepared for explanations about fears. They gain security and comfort from familiar objects such as toys, dolls, or photographs of family members, so new toys should not be introduced.
At a seminar for parents with preschool-age children, the nurse has discussed anticipatory tasks during the preschool years. Which statement by a parent should indicate a correct understanding of the teaching? a. "I should be worried if my 4-year-old child has an increase in sexual curiosity because this is a sign of sexual abuse." b. "I should expect my 5-year-old to change from a tranquil child to an aggressive child when school starts." c. "I should be concerned if my 4-year-old child starts telling exaggerated stories and has an imaginary playmate, since these could be signs of stress." d. "I should expect my 3-year-old child to have a more stable appetite and an increase in food selection."
d. "I should expect my 3-year-old child to have a more stable appetite and an increase in food selection." -A 3-year-old child exhibits a more stable appetite than during toddler years and is more willing to try different foods. A 4-year-old child is imaginative and indulges in telling tall tales and may have an imaginary playmate; these are normal findings, not signs of stress. Also a 4-year-old has an increasing curiosity in sexuality, which is not a sign of child abuse. A 5-year-old is usually tranquil, not aggressive like a 4-year-old child.
Which type of play is most typical of the preschool period? a. Team. b. Parallel. c. Solitary. d. Associative.
d. Associative. -Associative play is group play in similar or identical activities but without rigid organization or rules. School-age children play in teams. Parallel play is that of toddlers. Solitary play is that of infants.
The nurse is conducting an assessment of fine motor development in a 3-year-old child. Which is the expected drawing skill for this age? a. Can draw a complex stick figure. b. Holds the instrument with the fist. c. Can copy a triangle and diamond. d. Can copy a circle and imitate a cross.
d. Can copy a circle and imitate a cross. -A 3-year-old copies a circle and imitates a cross and vertical and horizontal lines. He or she holds the writing instrument with the fingers rather than the firs.t A 3-year-old is not able to draw a complete stick figure but draws a circle, later adds facial features, and by age 5 or 6 years can draw several parts (head, arms, legs, body, and facial features). Copying a triangle and diamond are mastered sometime between ages 5 and 6 years.
The nurse is explaining the pre conventional stage of moral development to a group of nursing students. What characterizes this stage? a. Children in this stage focus on following the rules. b. Children in this stage live up to social expectations and roles. c. Children in this stage have a concrete sense of justice and fairness. d. Children in this stage have little, if any, concern for why something is wrong.
d. Children in this stage have little, if any, concern for why something is wrong. -Young children's development of moral judgment is at the most basic level in the pre conventional stage. They have little, if any, concern for why something is wrong. Following the rules, living up to social expectations, and having a concrete sense of justice and fairness are characteristics in the conventional stage.
The nurse is planning to bring a preschool child a toy from the playroom. What toy is appropriate for this age group? a. Building blocks. b. A 500-piece puzzle. c. Paint by number picture. d. Farm animals and equipment.
d. Farm animals and equipment. -The most characteristic and pervasive activity is imitative, imaginative, and dramatic play. Farm animals and equipment would provide hours of self-expression. Building blocks are appropriate for older infants and toddlers. A 500-piece puzzle or a paint by number picture would be appropriate for a school-age child.
What characteristic best describes the language skills of a 3-year-old child? a. Asks meaning of words. b. Follows directional commands. c. Can describe an object according to its composition. d. Talks incessantly regardless of whether anyone is listening.
d. Talks incessantly regardless of whether anyone is listening. -Because of the dramatic vocabulary increase at this age, 3-year-old children are known to talk incessantly regardless of whether anyone is listening. A 4- to 5-year-old child asks a lot of questions and can follow simple directional commands. A 6-year-old child can describe an object according to its composition.
During the preschool period, the emphasis of injury protection should be placed on what? a. Limitation of physical activities. b. Punishment for unsafe behaviors. c. Constant vigilance and protection. d. Teaching about safety and potential hazards.
d. Teaching about safety and potential hazards. -Education about safety and potential hazards is appropriate for preschoolers because they begin to understand dangers. Limitation of physical activities is not appropriate. Punishment may make children of trying new things. Constant vigilance and protection are not practical at this stage because preschoolers are becoming more independent.
