Chapter 16-20
The nurse discusses child-proofing the home for safety with the mother of a 9-month-old. Which statement made by the mother would indicate an unsafe behavior?
"In the car, she rides in a front-facing car seat."
Which stage of cognitive development is a 9-year-old child in according to Piaget?
Concrete operations
The parent of a 4 -year-old child tells the nurse, "Bedtime is difficult. I can't get my son to go to bed at night." The nurse and the child's mother discuss options. What intervention is the most appropriate choice?
Establish a bedtime routine and use it consistently.
A mother is concerned because her 10-month-old is lethargic. What is the best action the nurse can advise this mother to implement?
Handle the infant slowly and gently
The school nurse is preserving a tooth that was knocked out on the school playground. What will the nurse be especially careful to do?
Handle the tooth only by the crown.
What is the most appropriate intervention when dealing with occasional aggression in a 4-year-old child?
Have the child take a time-out in the corner for 4 minutes.
What tasks would be appropriate to expect of a 5-year-old?
Setting the table with paper plates
When selecting a potty chair, the parents are encouraged to select one that has which characteristic(s)? (Select all that apply.)
Small enough for the child's feet to touch floor Sturdy and stable Supportive of child's back and arms
The parents of an 8-year-old tell the nurse the child wakes the household crying out during his frequent nightmares. What is the nurse's most helpful response to explain nightmares?
They are a normal extension of the child's fear of mutilation.
What would the nurse expect a 4-month-old to be able to accomplish?
Lift head and shoulders.
What instruction would the nurse include when planning anticipatory guidance for parents of a toddler?
Limit-setting should include praise.
The nurse is talking with a parent about tooth eruption. What teeth will the nurse explain are the first deciduous teeth to erupt?
Lower central incisors
Parents tell the nurse they are frustrated with their toddler's recent behavior and refusal to agree with anything they ask of them. What does the nurse explain as the term for when a toddler tests their own power?
Negativism
What can the nurse suggests as a good dietary source of zinc for an adolescent who is a vegetarian?
Nuts
A new mother is voicing concern she is breastfeeding her newborn too frequently. How often does the nurse instruct this mother she should expect her newborn to feed?
Every 2 to 3 hours
A seventh-grade girl tells the school nurse that her art teacher, a woman, is her hero. What is the most appropriate interpretation of the girl's comment?
Hero worship is a normal phenomenon.
The nurse cautions that children who have unmet hunger needs will likely display which characteristic(s)? (Select all that apply.)
Irritability Ineffective feeding patterns No predictable sleep-wake cycle Distrust
What does adolescent acne result from?
Oily skin
What should the teaching plan include about infant fall precautions? (Select all that apply.)
Remove all unsteady furniture. Keep crib rails up and in locked position. Steady infant with hand when on changing table. Keep infant seat on the floor.
The school nurse is educating high school students about guidelines to be followed when participating in sports. Which statement by a student alerts the nurse of the need for further information?
"I drink large amounts of fluid when working out."
A 13-year-old boy states, "The girls in my class tower over me." What would be the nurse's most informative response?
"It may seem that way because girls have a growth spurt 2 years earlier than boys."
A father is concerned about how long his preschool-age child will continue sucking his thumb. What is the most helpful response from the nurse?
"Most children will stop thumb-sucking naturally by school age."
The nurse discusses preparation for school with the parents of a 6-year-old girl who will soon be starting first grade. What statement by the girl's father leads the nurse to determine that the parents understood the information?
"We'll have her meet some children who will be in her class."
What could the nurse recommend to a child's mother to encourage a toddler to practice independence?
Offer him a choice between two items.
The nurse is educating parents of a 2-month-old about immunizations. What immunizations against illness should their child receive? (Select all that apply.)
Pertussis (whooping cough) Influenza Diptheria Tetanus Polio
Parents ask the pediatric nurse how school life might influence their growing child. What area of development will the nurse indicate that school affects the least?
Physical development
A parent comments that her adolescent daughter seems to be daydreaming a lot. What does the nurse understand this behavior to indicate regarding their daughter?
She is mentally preparing for real situations
Why does day care for the toddler differ from that of the preschooler?
Toddlers have a shorter attention span
What is the earliest age at which an infant is able to sit steadily alone?
8 months
The nurse is assessing development in a 9-month-old infant. What would the nurse expect to observe?
Creeping along the floor
What will the nurse take into consideration when educating parents regarding infant nutrition? (Select all that apply.)
Cultural practices Parental knowledge Infant's developmental level Parent-child interaction
What is best for the nurse to suggest to the parents of an overweight 9-year-old to help prevent obesity?
Encourage the child to engage in physical activity for at least an hour a day.
What is the best suggestion by the nurse for an appropriate toy for a hospitalized 6-year-old boy?
Handheld video game
A 9-year-old boy is often cranky and irritable, and his school performance has declined. What is the most probable factor causing this behavior?
He sleeps only 6 to 7 hours a night.
What is the best advice the nurse can offer a parent concerned because her 2-year-old is very active and does not eat much?
Help the child wind down with a quiet activity before mealtime.
Which statement best describes the 3-year-old child?
Helpful, wants to assist with chores
What is the earliest age at which the infant should be able to walk independently?
12 to 15 months
How many hours should toddlers be able to stay dry for the nurse to suggest they are ready to begin bladder training?
2
When does the posterior fontanelle close?
2 to 3 months
A 16-year-old excitedly tells his parents that he was offered a part-time job. Which response represents an effective problem-solving approach for his parents?
"How do you think you will manage your school work and a job?"
The parent of a toddler tells the nurse, "My daughter's appetite has decreased. Thank goodness she loves to drink milk." What is the most appropriate response by the nurse?
"How much milk does she drink in a day?"
What statement made by a parent indicates correct understanding of infant feeding?
"I give the baby any new foods before he takes his bottle."
What statement by an 11-year-old leads the nurse to determine he has moved from the mind set of egocentrism?
"I'm sorry. I bet that hurt your feelings."
Parents of a 5-year-old child tell the nurse they are concerned about their child's speech development by stating, "No one can understand him but us." What clinical classification of speech disorder does the nurse suspect?
Articulation disorder
The pediatric nurse is presenting school-age children with information on safety issues to follow when going home alone. What guidelines should they be educated to follow? (Select all that apply.)
Ask for identification before letting someone in the house Keep doors locked. Do not enter house if door is ajar Walk to and from school with friends.
A school-age child becomes frustrated with a school assignment and says, "I can't do this!" What is the most developmentally supportive response from the parent?
Ask, "What is it that is so difficult?"
A parent brings a 6-month-old infant to the pediatric clinic for her well-baby examination. Her birth weight was 8 pounds, 2 ounces. What will the nurse weighing the infant today would expect her weight to be?
At least 16 pounds
The nurse considers what "rites of passage" valued by the adolescent in American society? (Select all that apply.)
Attaining legal drinking age Obtaining a driver's license High school graduation
The nurse is planning a safety program for high school students. To what will the nurse relay that most accidental deaths in adolescence are related?
Automobiles
The nurse using the PACE interview guide for persons at risk for substance abuse arrives at a score of 2 for an adolescent patient. How would the nurse interpret this score?
Indication for referral for counseling
A 3-year-old child, while playing with his favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. What behavior will the nurse anticipate from this child?
Will become angry and a physical response might ensue
The nurse is planning to explain the use of time-outs to the parent of a 3-year-old. How many minutes will the nurse indicate is appropriate for a child of this age?
3
What foods would be a healthy choice for an adolescent who just finished playing in a strenuous sports game?
A bagel and skim milk
What should the nurse suggest as the most appropriate toy choice for a 3-year-old?
A large construction set
A 13-year-old girl tells the nurse she is concerned because she has not had her first menstrual period. What is the best initial response from the nurse?
"Age of first menstrual cycle varies."
The nurse is discussing preschoolers' sexual curiosity with the parent. What statement by the mother leads the nurse to determine that the mother understands the information?
"Answer their questions when they ask."
A 4-year-old child tells the nurse she will not eat peas because they are green. Of what is this an example?
Centering
A 16-month-old child is attending a well-child visit at a pediatric clinic. Which assessment would indicate the biggest cause for concern?
Does not walk independently
How does the nurse characterize the play of 5-year-old children?
Following rules
What is an abnormal finding in an evaluation of growth and development for a 6-month-old infant?
Head lag present
Which finding would concern the nurse assessing vital signs on a 2-year-old?
Respirations of 36 breaths/min
What would the nurse assessing growth and development of a 2-year-old child expect to find?
The child jumps with both feet.
An adolescent's parent comments, "My son seems so preoccupied with his appearance these days. Is this normal?" What is the nurse's best response?
"His preoccupation with his looks is quite normal."
A preschool-age child is asked, "Why do trees have leaves?" Which response would be an example of animism?
"To hide behind when they are scared."
What does the nurse consider as an appropriate snack for a 2-year-old child?
Applesauce
What fear is unique to the preschool period?
Bodily harm
The nurse is assessing a school-age child. What will the nurse expect in regard to physical development of this child?
Gain of 5 to 7 pounds per year
At what stage is the adolescent considered to be,according to Freud's theory?
Genital
What will children who are unable to express themselves with words often do?
Have tantrums and act out
Which behavior reported by a parent of an 18-month-old toddler would the nurse report to the pediatrician as a cause for concern?
Walks by holding onto furniture
Parents of a 6-month-old infant ask the nurse why it is necessary to offer iron-rich formula to their child. What is the correct response?
"The infant has exhausted maternal iron stores."
A mother is concerned because her 9-year-old boy has developed the habit of twitching his eyes and flipping his hair while communicating with anyone. What is the best nursing response to this parent?
"Tics appear when a child is under stress."
The school nurse is planning a program for girls about the physical changes of puberty. Toward what age girl should this program be directed?
10 years
The nurse is assessing a 3-year-old. What is the expected weight gain for this age child?
4 times the birth weight
The parent of a 3-month-old infant asks the nurse, "At what age do infants usually begin drinking from a cup?" What is the nurse's most accurate response?
5 months
A parent asked the nurse, "At what age are children capable of assuming more responsibility for personal belongings?" What is the nurse's best response based on knowledge of growth and development?
9 years
What guideline should an adult follow when speaking to a toddler?
Be at eye level with the child.
The nurse points out what advantage(s) of a nursery school or preschool experience? (Select all that apply.)
Increasing self-confidence Fostering group cooperation Detecting adjustment problems Playing experiences with other children
When asked about her activities, a 10-year-old girl responded, "I like school. I play the flute in the school band, and I take tennis lessons." What does the nurse know these activities will help this child develop?
Industry
What does an adolescent's peer group serve as related to development?
Initial separation from family
What will the nurse advise a parent to do when introducing solid foods?
Introduce each new food 4 to 7 days apart.
The nurse observed three toddlers playing side by side with dolls. Closer observation revealed that the children were not interacting with one another. What type of play is this?
Parallel
The school nurse is preparing an educational program for new teachers regarding school-age children. What information is accurate for the nurse to include? (Select all that apply.)
Participation in group activity increases Thinking is logical Understand cause and effect
A 13-year-old girl tells the school nurse that she is getting fat, especially in her hips and legs. What understanding by the nurse would best guide the response?
Puberty is often preceded by fat deposits in these areas.
The nurse is aware that the 7-month-old can signal feeding readiness by which action(s)? (Select all that apply.)
Pulling spoon toward mouth Manipulating finger foods
Parents of an infant inform the nurse they are planning home preparation of solid foods. What directions should the nurse provide? (Select all that apply.)
Puree food in electric blender. Add sugar sparingly.
The nurse is assessing a 1-year-old infant in the pediatric office. What finding should the nurse report to the physician immediately?
Respiratory rate of 60 breaths per minute
A mother calls the pediatrician's office because her infant is "colicky." What is the most helpful measure the nurse can suggest to the mother?
Rock the fussy infant slowly and gently.
What type of relationships are the preferred social interactions for the school-age child?
Same-sex peer groups
What should the nurse keep in mind when planning to teach a class on nutrition to fourth-grade students?
School-age children think logically and concretely.
The nurse observes a 10-month-old infant using her index finger and thumb to pick up pieces of cereal. What does this behavior indicate the infant has developed?
The pincer grasp
How might the nurse demonstrate the parachute reflex with an infant?
Thrusting the infant downward into the crib
How would the nurse advise a parent who states, "I never know how much food to feed my child"?
Use 1 tablespoon of each food for each year of age as a guideline.
Which statement indicates the mother of an 8-month-old understands infant sleep patterns?
"I put the pacifier in the crib so that she can find it when she wakes up."
What statement made by a parent indicates an understanding about helping a 13-year-old manage his allowance?
"I set amounts he can earn for particular chores."
At what age does an infant's birth weight triple?
1 year
The nurse suggests the use of "I" messages to communicate a parent's feeling to an adolescent. What is the most appropriate example of an "I" message?
"I feel frightened when you stay out past your curfew."
The nurse is educating a group of preschool parents about the importance of safety. Which statement by a parent indicates the need for further education?
"I only leave my child in the car for brief moments."
A mother reports that she has a new job and her 12-year-old child is home alone for a time after school. Which statement made by the parent alerts the nurse to a potentially unsafe situation for this child?
"I told him that he could invite a few friends after school."
A parent states, "My 7-year-old really wants a dog. His 10-year-old brother has allergies to animal dander. I don't know what to do." What type of pet should the nurse suggest as the best choice?
A poodle, which does not shed, making it a good choice for people with allergies
The nurse is planning care of an adolescent. What psychosocial task does the nurse understand is important for the adolescent to develop?
A sense of identity
A parent confides in the school nurse that her 8-year-old twins argue and bicker constantly. What is the best response by the nurse?
Offer reassurance that such behavior is normal for 8-year-olds.
What does including play in the plan of care for a 5-year-old allow the child to do? (Select all that apply.)
Exercise his imagination Assume a role and act it out Offers an emotional outlet Interact with other children
The nurse suggests offering which food(s) to support the toddler's desire to self-feed? (Select all that apply.)
Finger foods Foods in colorful dishes Foods that are varied and colorful
The nurse is preparing to outline principles of discipline for parents of an infant. What information should the nurse include? (Select all that apply.)
Firmly say "No." Distract the child to another activity Remain consistent.
The nurse is discussing toilet training with parents. What behavior by the child would identify toilet training readiness?
Able to communicate that he or she is wet
Which major developmental tasks will the nurse expect a child to accomplish by the end of the preschool years? (Select all that apply.)
Acceptance of separation Increased communication skills Control of bodily functions
The parent of a 3 -year-old child tells the nurse, "My daughter points instead of speaking whenever she wants me to get something for her, but she understands me when I ask her to do something." Based on the parent's comment, what does the nurse suspect?
An expressive language delay
A parent is concerned because her infant has a diaper rash. What is the best action the nurse would advise the parent to implement?
Apply a protective ointment on the area.
What type of play is most appropriate when planning care for a child with moderate intellectual deficiency?
Be adjusted to mental age rather than chronological age.
What developmental milestone(s) assist the 5-year-old boy toward developing his sexual identity? (Select all that apply.)
Begins to be less focused on his mother Forms a romantic attachment to the mother Identifies with the parent of the same sex
A parent remarks, "My 18-month-old daughter carries her blanket around everywhere. Is this normal?" What is the best explanation a nurse who has an understanding of toddler development might give?
Carrying her favorite blanket is self-consoling behavior.
What intervention might the nurse suggest as helpful for the child with enuresis?
Decreasing fluid intake after the evening meal
The school nurse is discussing challenges of the adolescent years with a group of high school students in health class. What challenges toward adolescent development will the nurse include?
Developing intimacy Searching for identity Adjusting to body changes Establishing future goals
To what is the restlessness seen in the adolescent considered to be attributed? (Select all that apply.)
Drive to be accepted by society as an individual Urge for independence Establishment of a personal identity Intense libido
What is the most appropriate toy for the nurse to select for a normal 2-year-old child?
Dump truck
A girl tells the nurse that she and her best friend belong to the popular clique. She states, "I love Katy Perry, and I want to be a singer." The nurse recognizes the girl's statement as characteristic of what time period?
Early adolescence
The nurse is assessing a 13-year-old boy. With what do physical changes in the pubertal male begin?
Enlargement of testicles
A mother confides in the school nurse that she witnessed her son kissing another boy. Which concepts should guide the nurse to base a reply? (Select all that apply.)
Homosexual behavior in adolescents is not uncommon. Adolescents often desire to explore alternative lifestyles.
A 4-year-old child insists he has more money with a nickel than his father has with a dime. What is this perception, as described in Piaget's theory?
Intuition
The nurse is leading a discussion group with parents of adolescents. One parent comments, "My son can't do anything without checking with his friends first. My opinion doesn't count anymore." What knowledge in regard to this behavior would the nurse formulate as a response?
It is a normal phenomenon during adolescence.
What is the nurse's best advice to a parent about a preschooler's "imaginary friend"?
It is common for preschoolers to have imaginary friends.
A 10-year-old child with disabilities is begging her parents for a dog. When at the pediatric clinic, the parents inquire about possible benefits pet ownership may provide to their child. What benefits of pet ownership should the nurse indicate? (Select all that apply.)
Lower blood pressure Improve communication Foster trust Ease path to socialization
What basic "feeling" words should the nurse use in attempting to help a 7-year-old girl express her feelings about being in a new school? (Select all that apply.)
Mad Glad Sad Scared
What is the most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old?a. Ride a tricycle.
Play with push-pull toys.
On a home visit, the nurse notes that the parents require teaching intervention to protect the 15-month-old child who lives there. What observation would lead the nurse to this conclusion?
The dining room table has a tablecloth on it.
The nurse is documenting the pediatrician's assessment of a female patient. When assessing Tanner's stages of breast development there is elevation of papilla only. What stage of development will the nurse document?
Stage 1
Parents of a toddler are discussing the emotion of fear with the pediatric nurse. What information can the nurse offer regarding fear and the toddler? (Select all that apply.
Stress increases fear. Rituals help deal with fear. Once fear is learned it is difficult to eliminate.
The nurse is advising parents of a 10-year-old boy about the most developmentally supportive experiences for their son. What is the best experience for this child according to Erikson's theory?
Successful performance in Little League
Which bedtime preparation rituals are the most appropriate for the nurse to suggest? (Select all that apply.)
Telling a story Placing a favorite toy in bed Placing a glass of water at the bedside Turning on a night light
When planning to answer a 16-year-old girl's questions about menstruation, the nurse must consider cognitive development. What is developed during adolescence according to Piaget?
The ability to consider hypothetical situations
The parents of a 4-year-old boy are concerned because they have noticed him frequently touching his penis. What knowledge would act as the basis for the nurse's response?
This behavior indicates a normal curiosity about sexuality.
The nurse points out which physiological change(s) in the toddler that serve(s)as protection against disease? (Select all that apply.)
Toughening of the skin Increased capillary response for thermoregulation Stabilization of body temperature Enlarged adenoids and tonsils
Which is an example of associative play?
Two children playing house, one playing the role of the dad and the other playing the mom
What would be an expected finding when assessing language development in a 2-year-old?
Use of two-word sentences
The school nurse is planning sex education classes for school-age children. What should the nurse be sure to do?
Use simple terms.
What are the best breakfast choices for the nurse to point out prior to a big exam, to provide high levels of alertness and increased memory? (Select all that apply.)
Whole grain cereal and yogurt Oatmeal and sliced apples
The mother of an infant born prematurely tells the nurse, "The baby is irritable. She cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe her?" What is the most appropriate recommendation to help this parent?
Wrap the infant snugly when you hold them.
A parent is concerned about her children's reaction should their grandmother die. What understanding will guide the nurse's response?
Young children often understand that other people die, but do not equate it with themselves.
