Chapter 22: Conception through Young Adult

The pregnant young adult asks the nurse when she will be able to hear the fetal heart beat. Which is the nurse's best response?

"At your 12-week appointment, you will be able to hear the heart beat by Doppler." Explanation: The fetal heart beat is audible by Doppler by 12-weeks-gestation. The client will be able to hear the heart beat at an appointment around 12 weeks of pregnancy.

A newborn is scheduled for a circumcision and the parent is concerned with the baby feeling pain. What is the best response by the nurse?

"Baby's feel the sensation of touch and pain." Explanation: Neonates use senses to respond to the environment, they see color and form, hear and turn toward sound, smell and taste, and feel touch and pain. Anesthesia is usually given with circumcisions. It is not known how long a newborn will remember felt pain. It is not empathetic to tell the client's family that the baby cannot feel the pain or it only last one to two minutes.

A nurse is providing care to a new mother who yesterday gave birth to a healthy neonate. The new mother asks, "I was reading that it's important to bond and attach with my baby. But is there a difference in the two?" Which response by the nurse demonstrates understanding of these two concepts?

"Bonding is the immediate connection you have with your baby while attachment occurs over the long term." Explanation: Bonding and attachment are different. Attachment is an active, affectionate, reciprocal relationship between two people. Bonding, described by Klaus and Kennell (1982), occurs during a sensitive period in the first few hours after birth (although bonding also may occur later in the first few months) and is necessary for later attachment. Bonding may be considered the emotional linkage of two people, and attachment the long-term maintenance and strengthening of the linked state. Bonding and attachment are not associated with satisfaction or development of trust.

A father is concerned because his 3-year-old daughter has been using the bathroom independently for the past 6 months, but has had a few "accidents" since her hospitalization. Which of the following is the nurse's best response?

"Her regressive behaviors are a reaction to being hospitalized." Explanation: Regression in toilet training is a normal reaction for a 3-year-old child who is hospitalized. The father should be reassured this is a normal reaction, and will disappear after being discharged. Taking her to the bathroom more often or rewarding her may not stop the regression.

A mother brings her 28-month old boy to the clinic for a well-child visit. During the visit, the mother tells the nurse, "Whenever I ask my child to do something, all I get is no. It seems like that's the only word he knows." Which response by the nurse would be most appropriate?

"His 'no' is his way of trying to gain control over his surroundings." Explanation: Negativism, which is characteristically expressed by saying "no" and outbursts of temper, result from the toddler's efforts at control over the environment. It is normal for this stage of development. Saying "no" is not a carryover from infancy, nor is it a reflection of language development. Separation anxiety occurs in response to separation from the mother. It is not reflected by "no" statements.

The mother of a girl 6 years of age is exasperated at her daughter's persistent enuresis. How can the nurse best respond to this mother's concern?

"Most children outgrow their bedwetting at around your daughter's age or shortly after." Explanation: Enuresis typically ends between ages 6 and 8. Bedwetting at age 6 does not likely necessitate a referral to a specialist and is unlikely to be related to a pathological process. Enuresis is not noted to be more common among girls than boys.

An 8-year-old girl is brought to the health care provider's office for a well-child visit. During the visit, the child's mother asks the nurse, "When should she get the human papillomavirus (HPV) vaccine? Which response by the nurse would be best?

"The first dose should be given at about 9 or 10 years of age." Explanation: The CDC recommends vaccination with two doses of human papillomavirus (HPV) vaccine before age 15, with the first dose given at 9 or 10 years of age, to prevent the types of HPV that can cause cervical cancer and genital warts.

A parent brings the 18-month-old to the clinic for treatment of a head cold. The child has been coughing for the last two days and nights. The parent says, "When my older kids were this age, the only thing that would stop their cough was a cough syrup containing codeine." How should the nurse respond?

"We have discovered that codeine does not work well with young children." Explanation: The US Food and Drug Administration has changed labeling to indicate that medications containing codeine or hydrocodone should not be used in children. In addition, data indicate that these drugs have minimal therapeutic value for this age group.

A nurse is providing education to a group of new parents about ways to minimize the risk for sudden infant death syndrome (SIDS). The nurse determines that the teaching was successful based on which statement by the group? Select all that apply.

"We should put our baby on the back to sleep." "The sleeping surface should be firm." "The crib should be free of any soft objects or toys." Explanation: The American Academy of Pediatrics recommends safe sleep guidelines for infants that include placing the infant on the back to sleep for every sleep; using a firm sleep surface; keeping soft objects (including toys) and loose bedding away from the infant's sleep area; and considering the use of a pacifier at naptime and bedtime.

A nurse is assessing a 12-month-old infant who is brought to the clinic by the parents for well-child visit. The nurse reviews the infant's health history and notes that the infant weighed 8 lb at birth. When assessing the infant's weight at this visit, the nurse would anticipate that the infant would weight approximately how much at this time?

24 lb Explanation: Although weight gain during the first year varies and is highly individualized, birth weight usually triples by 1 year. Using this guideline, the nurse would anticipate that the infant who weighed 8 lb at birth would weigh approximately 24 lb.

A nurse is teaching a "Preschool Childcare" class and Tiffany, one of the parents, asks when her toddler will have all of her baby teeth. Which of the following responses would be appropriate

3 years Explanation: By 3 years of age most children have a full set of deciduous teeth. They begin to fall out at about age 6, with permanent teeth replacing them.

During a well-child visit, a mother says, "My child received a meningococcal vaccine at age 11." Which information should the nurse provide to this mother?

A booster shot at age 16 is recommended. Explanation: Meningococcal immunizations should be given at age 11 to 12 with a booster at age 1

9-year-old child has been admitted to the orthopedic unit for treatment of a fractured leg due to an all-terrain vehicle accident. What would be a priority concern experienced by the child during hospitalization?

Absence from school and activities Explanation: Peer relationships are important for a 9-year-old child. The priority concern would be missing school and school activities. Placement in unfamiliar surroundings, fear of painful treatments, and worry over restricted mobility may be concerns, but they are not the priority for the school-age group.

A nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks how the baby develops soon after conception. Which is an accurate statement from the nurse about the embryonic stage?

All basic organs are established here Explanation: The embryonic stage occurs from the 4th through the 8th week. Rapid growth and differentiation of the cell layers take place. By the end of this stage, all basic organs have been established, the bones have begun to ossify, and some human features are recognizable. Because this is a period of such rapid growth and change, the fetus is especially vulnerable to any factor that might cause congenital anomalies (such as maternal use of alcohol, nicotine, over-the-counter medications, or drugs).

A 2-year-old toddler just underwent a tonsillectomy and adenoidectomy surgery. The postanesthesia care unit (PACU) nurse is checking on him. What is the best course of action regarding the developmental care of this child?

Allow the parents into the PACU before the child wakes. Explanation: Toddlers are prone to separation anxiety. Allowing the child to be with the parents will lower anxiety levels for all members of the family. This will subsequently ease the care for the bedside nurse.

The nurse has admitted a school-aged child with a diagnosis of asthma. Based on the child's developmental level, what actions would be appropriate? Select all that apply.

Answer the child's questions with clear and direct information Offer child foods high in vitamin D Inquire about school, friends, and activities Supply the child with quiet activities from the playroom Explanation: School-aged children typically require appropriate and accurate information to their questions. School-aged children are growing and need vitamin D for bone growth. At this age, school and friendships are extremely important. Quiet activities such as video games, reading, and board games can provide diversion. School-aged children should not be questioned without a caregiver present and medications should be validated.

A nurse is participating in a local community health fair. The nurse is providing information about sexually transmitted infections. Which infection would the nurse describe as being the most common?

Chlamydia Explanation: Although syphilis, herpes simplex type II, and gonorrhea are sexually transmitted infections, chlamydia, an infection of the genital tract, is the most common STI in the United States.

During assessment the 5-year-old child says, "I feel good today. I am filled with the Holy Spirit." How does the nurse evaluate this statement?

Concepts such as this are rarely understood by children this age. Explanation: Concepts such as holy spirits are usually not understood by children at age 5 years even if they attend church regularly. This statement is unusual at this age. There is nothing to suggest the family is hyper-religious; the child may be mimicking a statement heard in church or a statement made by an adult. At age 5 years, the child may have a simple understand of the presence of the deity discussed in the family.

The nurse is providing care for an 11-year-old child who has been diagnosed with central auditory processing disorder. Which strategy should the nurse use when teaching this child how to apply a wrist brace?

Demonstration-return demonstration Explanation: The child with central auditory processing disorder has problems with processing and remembering language-based tasks. The nurse should demonstrate the application of the brace and ask the child to return demonstrate the skill so that additional teaching can occur if necessary. Showing a video without return demonstration does not allow the nurse to determine if learning has occurred. Explaining the process in detail will be confusing to this child. Written instructions do not allow the nurse to assess learning.

A nurse is counseling pregnant women about the detrimental effects of smoking and drinking on a fetus. During what stage of development is the fetus most susceptible to these teratogens?

Embryonic stage Explanation: The fetus is most susceptible to teratogens during the embryonic stage.

A father brings his daughter to the community clinic for an annual physical exam. After the father steps out of the room, the adolescent informs the nurse that she is frightened by her father's behavior because "he yells at me every day and tells me I am a failure because I don't get good grades, and I am fat." The nurse recognizes the reported father's behavior as which type of maltreatment?

Emotional abuse Explanation: The nurse recognizes the emotional neglect or abuse as the failure of a caregiver to provide for the child's basic needs with an adequate level of care and support. Physical abuse is the deliberate physical infliction of battery by a parent or caregiver. Sexual abuse includes incest, molestation, exhibitionism, child pornography, child prostitution, and pedophilia. Neglect involves a failure to provide a child's basic needs.

A nurse is providing care to a 2 1/2-year-old girl recently admitted to the hospital for an exacerbation of asthma. When developing this child's care plan, which intervention would the nurse likely include?

Encouraging the parents to provide care to the child Explanation: Toddlers who require hospital care experience stress and separation anxiety when parents are not present. To decrease stress from unfamiliar surroundings and caregivers, parents should be encouraged to provide care and remain with the toddler as much as possible. Every effort should be made to have consistency of health care providers and to maintain familiar routines and rituals. When ill or in pain, toddlers often regress to earlier behaviors, such as wanting a bottle or thumb-sucking. However, reporting regressive behaviors is not required.

The nurse is caring for a female client 15 years of age who is hospitalized with a fractured ankle. Her father tells the nurse that this happened during a gymnastics lesson. He goes on to explain that every six or eight months it seems his daughter is trying something different; right now it is gymnastics. The nurse knows that this behavior fits with which of the following theorist's developmental tasks for adolescents?

Erikson Explanation: Based on Erikson's theory, the adolescent tries out different roles, personal choices, and beliefs in the stage called "identity versus role confusion." Through a series of stages, Piaget proposed four stages of cognitive development: the sensorimotor, preoperational, concrete operational and formal operational period. Freud's theory of personality is that it is formed through conflicts among three fundamental structures of the human mind: the id, ego, and superego. Havighurst emphasized that learning is basic and that it continues throughout life span. Growth and Development occurs in six stages.

The nurse is caring for a young adult client . What developmental task for this age group does the nurse identify as a priority?

Establishing an intimate relationship and family Explanation: Developmental tasks of the young adult center on establishing intimate relationships, a home, and a family. Developing a self-identity independent from parents should have already occurred. They may still be trying out new things and portraying themselves as totally independent, but that is not at the center of the main developmental tasks.

A nurse is preparing to assess the developmental patterns of a toddler using the Denver Developmental Screening Test (DDST II). When using this tool, which area would the nurse assess? Select all that apply.

Fine motor skills Language Social interaction Explanation: The Denver Developmental Screening Test (DDST II) is commonly used to quickly assess for atypical developmental patterns in infants and children. The crucial areas of development assessed in the DDST II are gross motor behavior and skills, fine motor behavior and skills, language acquisition, and personal and social interaction. The test identifies problem areas that require more precise assessments. Head circumference and reflexes are not part of the DDST II.

The nurse is teaching child safety and nutrition to a group of parents at a public health clinic. In answer to a question about childhood obesity, the nurse talks about the causes of school-age children being overweight. The nurse should include which of the following? Choose all that apply.

Genetic and health factors Diets that are high in saturated fats Consuming more calories than expended Lack of adequate, appropriate exercise Explanation: Many obese school-aged children have diets that are high in saturated fats, do not meet fruit and vegetable daily requirements, are low in fiber and calcium. As with adults, obesity in children is the result of more calories consumed than expended. Genetics and health factors may be a contributing factor.

You are the nurse providing prenatal education to a group of pregnant teenagers. One of the group members asks you to talk about how the baby develops soon after conception. An accurate statement from you about the zygote and pre-embryonic stage would be which of the following?

Has a total of three distinct cell layers Explanation: The pre-embryonic stage lasts for about 3 weeks. The zygote, which implants in the uterine wall, has three distinct cell layers. The endoderm (inner layer) becomes the respiratory system, the digestive system, the liver, and the pancreas. The mesoderm (middle layer) becomes the skeleton, connective tissue, cartilage, muscles, and the circulatory, lymphoid, reproductive, and urinary systems. The ectoderm (outer layer) becomes the brain, spinal cord, nervous system, and outer body parts (skin, hair, and nails). The basic organs are not established until the embryonic stage. Reflexes are not present until fetal development is occurring.

A school nurse is aware of the importance of creating and carrying out interventions that resonate with the developmental tasks of the adolescent population. Such interventions should appeal to adolescents' prioritization of their what

Identity Explanation: One of the key developmental tasks in adolescence is the creation and maintenance of an independent identity. This consideration frequently trumps goal orientation. While adolescents may often be skeptical and vulnerable, the role of identity is central to this population.

A nurse is teaching a parenting class for parents with infants. What is an example of an appropriate teaching point for this developmental age?

If choking occurs, give back blows and chest thrusts or CPR. Explanation: The most appropriate teaching point for a class for parents with infants would be what to do if choking would occur. The other responses are incorrect. An infant should be placed in the supine position, on the back. The infant crib should not be lined with bumpers as the bumpers could lead to a child choking or suffocating. Weaning from the breast would not be encouraged as early as 9 months.

A 9-year-old who is in the 3rd grade has great difficulty with reading. The child is becoming very withdrawn and depressed. According to Erik Erikson's developmental theory, the child is at risk for developing which self-concept?

Inferiority Explanation: The school-aged child is in the industry-versus-inferiority stage of Erikson's theory, with the child focused on learning useful skills and thereby developing positive self esteem. The client is withdrawn so thereby exhibiting inferiority to the other children in the class. Autonomy versus shame and doubt is the developmental task of the toddler, according to Erikson's theory.

The nurse is educating a new parent about what type of physical activities the infant will be able to achieve in the first year. What activities will the nurse discuss with the parent? Select all that apply.

Manipulate building blocks Ambulation may start Crawl on all fours Explanation: The infant, 1 month to 1 year, will develop motor abilities that may include use of building blocks, attempting to feed self, crawling, and walking. Toilet training and speaking in complete sentences does not usually occur until toddlerhood or preschool age.

The clinic nurse is seeing a female client 18 years of age who needs to renew her asthma prescription. The client tells the nurse that she is going to another province in a few weeks to attend college and will be living in a dorm. The nurse recommends which of the following while the client is being seen in the clinic?

Meningococcal vaccine Explanation: College freshmen living in dormitories are at risk for meningococcal disease and require the vaccine for protection from it. A TB skin test is usually done if the client has been exposed to tuberculosis. Polio boosters are not given to this age group. Hep B series should have already been done and the series is not completed in a single visit.

A school-aged child is attentive to following the rules at school, respects his teachers, and views justice as a means of fair play. These are characteristics of which type of development typical of this age group?

Moral development Explanation: Following the rules at school, respecting teachers, and viewing justice as a means of fair play are important moral development characteristics. Spiritual development involves religious faith and spiritual beliefs. Psychosocial development includes theories by Freud, Erikson, and Havighurst. Physiologic development during the school-aged period focuses on growth and motor development.

A school nurse is providing a health education class for a group of high school students. When discussing the issue of safety, which area would the nurse identify as the leading cause of death in adolescents?

Motor vehicle crashes Explanation: Although suicide, substance use, and sexually transmitted infections are important concerns for adolescents, injuries are the leading cause of death for adolescents and young adults. Motor vehicle crashes are the most common cause of mortality, often associated with the use of alcohol or other drugs.

While providing education to a young adult during an annual health exam, the nurse discusses health problems common during this stage of development. What is the most common cause of mortality during this stage?

Motor vehicle crashes Explanation: Injuries are the leading cause of death for adolescents and young adults. Motor vehicle crashes are the most common cause of mortality, often associated with the use of alcohol or other drugs

A nurse is providing care to a female adolescent diagnosed with binge eating disorder. The nurse understands that which situation is most often associated as the underlying issue with this disorder?

Negative self-concept Explanation: Binge eating disorder refers to excessive eating that is not followed by purging, excessive exercise, or fasting. Although depression and anxiety may be associated with this eating disorder, it almost always involves a negative self-concept. Egocentrism is not associated with any eating disorder.

A nurse is assessing neonates in a hospital nursery. Which neonates are exhibiting expected developmental characteristics? Select all that apply.

Neonate who displays the Moro and stepping reflex Neonate who eliminates urine and stool Neonate who exhibits both an active crying state and a quiet alert state Neonate who inherits a transient immunity from infections from the mother Explanation: The neonate would exhibit reflexes to include the Moro reflex and the stepping reflex. A neonate does eliminate urine and stool. The neonate exhibits both an active crying state and a quiet alert state. The neonate inherits a transient immunity from infections from the mother. The neonate's body temperature responds quickly to environmental temperature. A neonate's senses are developed enough to feel pain from a heel-stick

Accurate instruction regarding the typical growth and development patterns for adolescents would include which of the following guidelines?

Peer relationships characterize the adolescent years. Explanation: Concern over body normality, sports competition, and social and peer relationships can create major hurdles.

A nurse is providing care to an adolescent recently hospitalized for a sports-related injury. When planning this client's care, which group would the nurse identify as being extremely important to him or her?

Peers Explanation: According to Erikson's theory, the adolescent tries out different roles, personal choices, and beliefs in the stage called identity versus role confusion. Self-concept is being stabilized, with the peer group acting as the greatest influence.

A school nurse is teaching a sexuality class to 5th- and 6th-grade girls. The nurse talks about secondary sexual characteristics and explains that these are which of the following? Choose all that apply.

Presence of body hair Breast development Facial hair growth in boys Voice changes in boys Explanation: Primary and secondary sexual development occurs with maturation of the genitalia; presence of body hair; breast development and menstruation in girls; and facial hair growth, voice changes, and spermatogenesis in boys. Presence of internal genitalia is a primary sexual characteristic.

A nurse records an Apgar score of 3 for a newborn taken one minute after birth. What would be a priority intervention for this newborn?

Provide immediate life-saving support. Explanation: The neonate is assessed immediately after birth. Of several existing measurement scales, the Apgar rating scale is the most commonly used. This scale is used to assess neonates 1 minute and 5 minutes after birth. The scale has of a maximum of 10 points, ranking five categories on a scale from 0 to 2. The five categories are heart rate, respiratory effort, muscle tone, reflex irritability, and color. A score of 7 to 10 would be considered normal. A score from 4 to 6 would require a newborn to have special medical assistance. A score of less than four would require a newborn to have immediate life-saving support. Since the Apgar is taken one minute after birth, the primary care provider is present at this time.

A school nurse is preparing a presentation for the parent-teacher association at the local elementary school. The nurse is focusing on the topic of nutrition in this age group. Which suggestion would be appropriate for the nurse to include? Select all that apply.

Providing foods that are high in calcium Encouraging foods high in vitamin D Avoiding foods that contain empty calories Explanation: School-aged children need adequate calories and may also require increased amounts of vitamin D and calcium. Increased vitamin D and calcium are needed as bones enlarge and to prevent later osteoporosis, especially in girls. In addition, the school-aged child needs foods that meet nutritional needs and do not supply empty calories (as found in junk food and fast food). American children eat too much salt, sugar, and fats. Therefore, nutrition should focus on a balanced intake of salt, sugar, and fats.

After assessing a female adolescent, a nurse collects the following data: development of breast tissue, growth spurt in height and weight, appearance of axillary hair, and initiation of menarche. Which stage of sexual development does this data confirm?

Pubescence Explanation: Adolescent sexual development is divided into three categories: prepubescence, pubescence, and postpubescence. Prepubescence would be defined by rounding of the hips, appearance of breast buds, and appearance of downy pubic hair. Pubescence would be defined by development of breast tissue, growth spurt in height and weight, appearance of axillary hair, and initiation of menarche. Postpubescence would be defined by completion of sexual growth and development and fertility. Precocious puberty is puberty that begins prior to age 8 in girls, and age 9 in boys. Certain conditions such as infections, brain abnormalities, tumors, or hormone disorders may cause precocious puberty.

A nurse is preparing to assess a newborn immediately after birth using the Apgar score. Which area would the nurse include in this assessment? Select all that apply.

Respiratory effort Color Heart rate Muscle tone Explanation: The Apgar score assesses five categories: heart rate, respiratory effort, muscle tone, reflex irritability, and color. Blood pressure is not a component of the Apgar score.

A preschool child is hospitalized with an infection. The child refuses to eat anything but macaroni and cheese and ice cream. What is the nurse's best way of getting the child to eat more?

Rewarding the child with ice cream for eating more nutritious foods. Explanation: The best answer is "Rewarding the child with ice cream for eating more nutritious foods." Allowing the toddler to choose a favorite food has resulted in an unhealthy diet. The child would not understand the need for fruits and vegetables but does need a healthier diet. Preschool children like rewards. Using a favorite food as a reward may result in eating more nutritious foods. The focus of Kohlberg's preconventional phase of moral development is receiving awards.

The nurse is conducting a preoperative assessment of a girl 5 years of age who is scheduled for surgery later that day. The nurse should be aware that the client's imminent surgery is likely to cause what?

Separation anxiety and fear of pain. Explanation: When caring for a preschool-aged child who is scheduled for surgery or requires hospitalization, nurses must recognize the importance of the child's fear of pain as well as separation anxiety. However, the experience is unlikely to impair her overall development. There is unlikely to be a significant risk for shame, guilt, or mistrust associated with the procedure.

A nurse is working as part of a community health team addressing the issue of child abuse in the community. The team assesses the community for possible risk factors that may be contributing to the increased incidence. Which factor would the team likely identify? Select all that apply.

Substance use by caregivers Poverty Community violence Social isolation of families Explanation: Although child abuse occurs in all ethnic groups and at all levels of society, certain factors increase the risk, including caregivers' substance use; caregivers experiencing stress from poverty or unemployment; history of violence in the family or community; lack of family and social support for caregivers; social isolation of families; lack of family cohesion; single caregivers; and young caregivers.

An 18 year old with a chronic illness tells the school nurse that he has recently started using marijuana with his friends on weekends. Which of the following should be the nurse's next action?

Teach him about effects of marijuana on his illness and potential complications with marijuana use Explanation: The role of the nurse with adolescents and young adults is teaching to promote health. Teaching him the effects of marijuana on his illness and complications of it's use is the nurse's first action. Then she can explain about the legalities of its use and discuss peer pressure.

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks how the baby develops after the first trimester. An accurate statement from the nurse about the fetal stage would be which of the following?

The heartbeat can be heard Explanation: The fetal stage lasts from 9 weeks to birth. All body organs and systems continue to grow and develop. At the end of the first trimester (12 weeks' gestation), some reflexes are present, kidney secretion begins, the heartbeat can be heard by Doppler, and the sex of the infant is distinguishable by outward appearance. The bones continue to ossify. The baby continues to be vulnerable to toxins during the entire pregnancy.

Which of the following characteristics of a neonate would be reflected in her Apgar score?

The infant's hands and feet appear blue. Explanation: The assessment domains of an Apgar score are heart rate, respiratory effort, muscle tone, reflex irritability, and color. Blue-tinged extremities are thus reflected in the score, while response to stimulus, eyes, and the presence of oral mucus are not.

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks about how the baby develops soon after birth. An accurate statement from the nurse about neonatal development would be which of the following?

The neonate is able to hear and turn toward sound Explanation: The neonate is assessed immediately after birth at one and five minutes using the Apgar scale. The neonatal period lasts from birth to 28 days. The physical characteristics and behaviors of normal neonates include active reflexes (Moro, stepping, and grasp), hand-to-mouth activity, sucking, swallowing, blinking, sneezing, and yawning. Stool and urine are eliminated. Senses are used to respond to the environment, see color and form, hear and turn toward sound, smell and taste, and feel touch and pain. The Braden scale predict pressure sore risk. The neonate has difficulty regulating body temperature and a loss of heat occurs from the largest body surface area, the head.

The nurse is providing prenatal education to a group of pregnant teenagers. One of the group members asks about the advantages of breastfeeding. An accurate statement from you about breastfeeding would be which of the following?

Transient immunity is provided by breast milk. Explanation: Breastfeeding provides further protection against bacterial and viral infections through antibodies, immunoglobulins, and leukocytes in breast milk. The high lactose content in breast milk, combined with limited protein, promotes an acid environment that is unsuitable for bacterial growth.

A school nurse is reviewing the medical record of a child who was just diagnosed with a learning disability. The record reveals that the child has problems with letters and activities that require hand-eye coordination. The nurse interprets this as which type of learning disability?

Visual perceptual/visual motor deficit Explanation: A visual perceptual/visual motor deficit involves problems with letters and activities that require hand-eye coordination. Aphasia involves a language disability, including understanding, reading, writing, and verbal expression. Dyslexia involves difficulty in language skills, reading, and spelling. Nonverbal learning disorders involve difficulty with nonverbal cues and coordination.

While teaching a sex education class to a group of preadolescents, the school nurse explains that human growth and development begins at which of the following events?

When ovum is fertilized by sperm Explanation: When ovum and sperm unite, genetic material is combined to begin growth and development. Intercourse is needed for the ovum and sperm to unite. Human growth and development has already occurred before implantation in the uterus. Ovulation is release of the ovum from the ovary.

At which stage of pregnancy is the developing fetus most at risk for developing congenital anomalies?

embryonic stage Explanation: Because the embryonic stage is a period of such rapid growth and change, the embryo is especially vulnerable to any factor that might cause congenital anomalies. The pre-embryonic stage is the stage of cell division. The fetal stage is growth of the organs formed in the embryonic stage. The ovum is the egg to be fertilized.

The pregnant young adult states, "I heard all babies develop colic. What causes infant colic?" How does the health care provider explain the causes of infant colic to the client? Select all that apply.

swallowing too much air with feeding laying infant down with propped up bottle allergies to the formula causes abdominal pain Explanation: Causes of infant colic include swallowing too much air during feeding, laying infant down with a propped bottle making it difficult for the infant to control ingestion, and allergies to the formula. Feeding slowly and a quiet environment typically do not contribute to infant colic.

When assessing the health of a neonate, the nurse should be aware that:

the neonate hears and turns toward sound and can smell and taste. Explanation: The neonate's senses are used to respond to the environment; see color and form; hear and turn toward sound, smell, and taste; and feel touch and pain. The neonate's reflexes include the Moro reflex, the stepping reflex, grasp reflex, hand-to-mouth activity, sucking, swallowing, blinking, sneezing, and yawning. The neonate's body temperature responds quickly to the environmental temperature.