Chapter 25: Growth and Development of the Newborn and Infant

The mother of an infant born prematurely tells the nurse, "The baby is irritable. He cries during diaper changes and feedings. Can you make some suggestions about what I should do to soothe him?" The most appropriate recommendation to help this parent would be

Cover the baby snugly when you hold him

A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply.

Crib and playpen bars should be no more than 2 3/8 inches apart. Car seats should be placed in back seats. A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).

The nurse is aware that the age at which an infant is able to sit steadily alone is

8 months

The statement made by a parent that indicates correct understanding of infant feeding is

I give the baby any new foods before he takes his bottle

The statement that indicates the mother of an 8-month-old understands infant sleep patterns is

I put the pacifier in the crib so she can find it when she wakes up

When assessing development in a 9-month-old infant, the nurse would expect to observe the infant

Imitating sounds such as da-da

The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted?

"Does he move a toy back and forth from one hand to the other when you give it to him?"

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."

The nurse is evaluating the effectiveness of nutrition counseling for new mothers. Which comments by the mothers indicate the need for more instruction? Select all that apply.

"It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better.", "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth."

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 parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse?

"With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks."

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?

"You may be right, since infants can sense their mother's smell as early as 7 days old."

A parent takes the 4-month-old infant to the health care provider. The parent asks what type of baby cereal to provide now that the infant is starting solid foods. How should the nurse respond?

"You should buy rice cereal."

The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?

"Your baby's stomach is small and can only hold about 0.5 to 1 oz at birth."

The nurse knows that an infants birthweight should be tripled by

1 year

The nurse is aware that the age at which the posterior fontanelle closes is:

2 to 3 months

The infant weighs 7 lb 4 oz (3,300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?

21 lb 12 oz (9.9 kg)

The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements reflecting height/weight would the nurse expect to document for this visit?

24 pounds (10.8 kg) and 30 inches (75 cm)

The parent of a 3-month-old infant asks the nurse, "At what age do infants usually begin drinking from a cup?" The nurse would reply

5 months

The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent?

Bath time provides an opportunity for play

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.

The nurse would advise a mother who is concerned because her 10-month-old is lethargic, to

Handle the infant slowly and gently

The abnormal finding in an evaluation of growth and development for a 6-month-old infant would be

Head lag present

The nurse would advise a parent when introducing solid foods to

Introduce each new food 4 to 7 days apart

An infant is breastfed. When assessing the stools, which findings would be typical?

Less constipation than bottle-fed infants

The nurse would expect a 4-month-old to be able to

Lift head and shoulders

When talking with a parent about tooth eruption, the nurse explains that the first deciduous teeth to erupt are the

Lower central incisors

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 nurse observes a 10-month-old infant using her index finger and thumb to pick up Cheerios. This behavior is evidence that the infant has developed the

Pincer grasp

What feeding practice used by the parents of an 8-month-old should the nurse discourage?

Placing all liquids given the child in a "no spill" sippy cup.

The most appropriate activity to recommend to parents to promote sensorimotor stimulation for a 1-year-old would be

Play with push-pull toys

The nurse is aware that the 7-month-old can signal feeding readiness by (Select all that apply)

Pulling spoon toward mouth, Manipulating finger foods

A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?

Restrain the baby in a car seat.

A mother calls the pediatricians office because her infant is colicky. The helpful measure the nurse would suggest to the parent is:

Rock the fussy infant slowly and gently

Which milestone would the nurse expect an infant to accomplish by 8 months of age?

Sitting without support

A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?

The infant says "da-da" when looking at her father

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?

The infant will most likely present with developmental skills consistent with a 6-month-old infant.

A parent asks the nurse what symptoms to expect with normal teething in the infant. How should the nurse respond?

The infant's gumline will be tender.

The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?

They put her to bed when she falls asleep.

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

Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?

be able to turn over onto the back

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 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 have disappeared.

The nurse is teaching the parents of a 6-month-old infant about proper dental care. Which action will the nurse indicate as most likely to cause dental caries in this infant?

putting the infant to bed with a bottle of milk or juice

The best way for an infant's parent to help the child complete the developmental task of the first year is to:

respond to the infant consistently.

The nurse is providing education to the woman about foods commonly associated with allergies in infants and young children. What items should be included in this list? Select all that apply.

strawberries cow's milk peanut butter

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 less than expected for age.

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 16 lb (7300 g) and length of 26 in (66.0 cm)

The nurse discusses safety-proofing the home with the mother of a 9-month-old. The statement made by the mother that indicates an unsafe behavior is

In the car, she rides in a front-facing car seat

The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?

"Bottles given at bedtime can cause erosion of the enamel on the teeth."

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."

Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

Sitting independently

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?

Most infants do not sit steadily until 8 months; this infant is normal.

A parent is concerned because her infant has a diaper rash. The nurse would advise the parent to

Apply a protective ointment on the area

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.

The infant should be able to walk independently by the age of

12-15 months

A parent brings a 6-month-old infant to the pediatric clinic for her well-child examination. Her birthweight was 8 pounds, 2 ounces. The nurse weighing the infant today would expect her weight to be at least

16 pounds

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?

19 lb 8 oz (8825 g)