chapter 27 growth and development of the preschooler
A school nurse has completed an educational program for parents of preschool children. Which statement by a participant indicates a need for further education?
"My 5-year-old son still needs me to dress and undress him."
The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by a caregiver best indicates a common aspect of the diet and nutrition of the preschool child?
"My child is so picky and eats the same thing every day for days on end!"
A nurse walks into the room to check on a preschool client. When the nurse asks the preschooler how she is doing, the child says she is Tinker Bell. What is the best response by the nurse?
"That will be fun if you want to pretend you are Tinker Bell!"
A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?
"Attributing lifelike qualities to inanimate objects is quite normal at this age."
The caregiver of a 6-year-old expresses concern that the child cannot yet print her first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate?
"By the age of 6, most children can print some letters and maybe their first name."
The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?
"He loves milk and drinks it every time he is thirsty."
The parents of a 4-year-old child tell the school nurse that they are worried that their child will fall behind other children academically because they are not able to afford expensive toys like computer games and handheld electronic devices. Which are acceptable response(s) by the nurse? Select all that apply.
"I understand how this can be frustrating, but rest assured this does not place your child at a disadvantage academically." "All of these expensive toys that are advertised and purchased by some people are not necessary for preschoolers. Simple toys like chalk and Legos are great." "Do you play with your child and provide means of play through things like dolls, puzzles, crayons, and child-safe modeling clay? These are the types of toys suggested for preschoolers.
The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?
"I usually have him in time-out for about 10 minutes."
The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?
"I will need to find an appropriate punishment for him if this continues."
During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents?
"Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here."
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?
"Set a good example. Wear your own seat belt every time you drive."
The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond?
"Tell me about your child's exposure to tobacco smoke."
A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. What would be the best response for the nurse to give the child?
"What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile."
The nurse is speaking with the parent of a 4-year-old child. Which statement by the parent would suggest a need for further investigation?
"When we go to the park, my child never wants to play with the other children."
The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond?
"Your child is not expected to be able to perform those activities at 3 years of age."
A nurse is caring for a 4-year-old child who will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement?
Allow the child to play with a procedure doll.
The nurse is conducting a well-child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?
2.5 to 3 inches (6.35 to 7.62 cm)
If the child is gaining weight at an expected rate, a child who weighs 36 lb (16.3 kg) at 3 years of age would weigh what amount at age 5?
44 to 46 lb (20 to 21 kg)
What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother?
Specific program goals to be accomplished should be available.
A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client?
Delayed growth and development related to frequent illness
Nursing students are reviewing information about preschooler growth and development. The students demonstrate understanding of the information when they identify which of the following as a common fear during this period? Select all that apply.
Fear of the dark Fear of mutilation Fear of separation Fear of abandonment
A parent brings her 3-year-old child in for a sick visit for the third time this year. The child, who attends a preschool program, continues to develop upper respiratory infections. The parent is frustrated with the situation and asks the nurse for advice. What would be the best recommendation for the nurse to give to the parent in this situation?
Make sure that frequent handwashing is being stressed at the preschool.
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget?
Preoperational thought
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?
Pretending to be mommies and daddies in the playhouse
A community health center is planning a seminar about the 2020 National Health Goals for preschool-age children. Which topics would be included in this seminar to address safety? Select all that apply.
Protection against second-hand smoke Providing helmets before riding a bicycle Using appropriate restraints in motor vehicles
The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur?
Takes in new information at a rapid rate and asks "why" and "how"
Which gross motor skill would the 4-year-old child have most recently attained?
The child can hop on one foot.
A 4-year-old child is drawing with crayons. Which creation by the child would most be reflective of the anticipated skill level of this age?
The child is able to draw shapes such as circles and squares.
In teaching caregivers of preschool children, the nurse would reinforce that which activity would be most important for this age group?
The preschool child should be properly restrained when riding in a vehicle.
Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.
Try using a night light in the child's room." "Set up some familiar bedtime rituals for your child." "Avoid having your child watch frightening shows on TV before bedtime." "Try reading a favorite story before bedtime."
A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply.
Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable
When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?
Weight is above an expected range and height is within an expected range.
Which type of play should the nurse encourage for a preschool-age child who is hospitalized?
dressing in the mother's coat to play house
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:
having the child wear a personal flotation device whenever near or on the water.
The nurse is assessing a 4-year-old child. The child tells the nurse about her friend, Nancy, who lives in her room at home. The mother tells the nurse that Nancy is not a real person. The nurse would use which term when documenting this assessment finding?
imaginary friend
The most important safety precaution for parents to teach preschoolers is:
not to ride in a car with strangers.
A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson?
opening drawers in the room, pulling out supplies, and examining them
A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be?
preschool
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to
testing and identification of group role
The nurse is caring for a preschool-age child in the hospital with severe developmental delays. The parents have three other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highest priority in regard to the parents at this time?
Risk for caregiver role strain
The mother of a 4-year-old child is concerned that she caught him masturbating in the bath tub. Which is the most appropriate response by the nurse?
"Masturbation is a normal part of preschool development."
During an assessment, a preschool-aged child tells the nurse about having 12 siblings. The nurse is aware that the child has two older brothers. What would be the nurse's best response?
"That is a good pretend answer but tell me the names of the brothers you really have."
The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local day care. What information would the nurse include in this education session? Select all that apply.
Encourage children to select their own clothing to wear each day. Parents will need to supervise tooth-brushing and be responsible for flossing. Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry clothing.
The nurse is completing a care plan for a preschool-age child with the nursing diagnosis of Imbalanced nutrition, less than body requirements. Which interventions should the nurse include? Select all that apply.
Limit milk to 16 to 24 ounces per day. Provide at least 3 meals and 2 healthy snacks per day. Weigh child weekly on the same scales at home.
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers?
Snacks throughout the day help the child meet nutritional requirements
A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity?
Support whatever the child paints.
A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond?
"It's best to answer his questions using accurate anatomical names and keep your answers simple."
The nurse is observing several children interacting during a community health event. Which observed behavior would be indicative of a 4-year-old child?
"Look! I am a nurse, and I am helping people feel better!"
The father of a 4-year-old is concerned his child is not telling the truth and blaming others for things that have happened. Which response should the nurse prioritize after the father shares that the child is blaming someone named "Andrew" for a broken tool, and they have no idea who this is?
"Your son may have a friend named Andrew, but it could be an imaginary friend."
When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that:
imagination in a 3-year-old is at its peak.
