Chapter 3 Questions
The infant exhibits a first real smile at age 2 months. By about 3 months of age the infant will start an interaction with a caregiver by smiling widely and possibly gurgling. The 3- to 4-month-old will also mimic the parent's facial movements, such as widening the eyes and sticking out the tongue. Separation anxiety may also start in the last few months of infancy. Around the age of 8 months the infant may develop stranger anxiety. At 6 to 8 months of age the infant may enjoy socially interactive games such as patty-cake and peek-a-boo.
The nurse observes an infant interacting with his parents. What are normal social behavioral developments for this age group?
6-12
Abdominal breathing persists until age ____ to _____
0.6 inch (1.5cm)
The infant's head circumference increases rapidly during the first 6 months: the average increase is about ________________ per month
First year of life
The infant's heart doubles in size over what time?
refer the infant for developmental and or neurological evaluation
The nurse pulls he 5 month old infant to sitting position from supine and notes head lag. The nurse's response is to:
120-140, 100
As the cardiovascular system matures in an infant, the average pulse rate decreases from _________________ in the newborn to about __________ in the 1-year-old.
At 1 month the infant lifts and turns the head to the side in the prone position At 4 months the infant lifts the head and looks around At 7 months the infant sits alone with some use of hands for support. At 9 months the infant crawls with the abdomen off the floor. At 10 months the infant pulls to stand up. At 12 months the infant walks independently.
Gross motor skills milestones over the first 12 months of life:
Drooling and biting, increased sucking on hands, irritability and awakening from sleep, refusing to eat
Signs of teething? (4)
The child does not vocally respond to voices.
The nurse is assessing a 4-month-old boy during a scheduled visit. Which findings might suggest a developmental problem?
about 7 years old
The respiratory system does not reach adult levels of maturity until?
present at birth and disappear around 4 months
The tonic neck reflex should present and disappear at what ages?
Moro reflex
reflex is displayed when with sudden extension of the head, the arms abduct and move upward and the hands form a "C."
The root reflex
when the infant's cheek is stroked and the infant turns to that side, searching with mouth
4-6 months, 1 year old
Most infants double their birthweight by _________________ of age and triple their birthweight by the time they are __________________.
1. Step 2. Root 3. Moro 4. Plantar 5. Babinski
Place these primitive reflexes of infancy in the order in which they will disappear as the child matures: plantar root moro step babinski
Maternal iron stores are transferred to the fetus throughout the last trimester of pregnancy. Infants born prematurely miss all or at least a portion of this iron store transfer, placing them at increased risk for iron-deficiency anemia compared with term infants.
The neonatal nurse assesses newborns for iron-deficiency anemia. Which newborn is at highest risk for this disorder?
A.
The nurse in a community clinic is caring for a 6-month-old boy and his mother. Which intervention is priority to promote adequate growth? A) Monitoring the child's weight and height B) Encouraging a more frequent feeding schedule C) Assessing the child's current feeding pattern D) Recommending higher-calorie solid foods
C
The nurse is assessing a 12-month-old boy with an English-speaking father and a Spanish-speaking mother. The boy does not say mama or dada yet. What is the priority intervention? A. Performing a developmental evaluation of the child B. Encouraging the parents to speak English to the child C. Asking the mother if the child uses Spanish words D. Referring the child to a developmental specialist
4
The nurse is assessing the developmental milestones of an infant. The infant was born 8 weeks ago and was 4 weeks premature. The nurse anticipates that the infant will be meeting milestones for what age of child?
An infant rapidly moves from deep sleep to crying An infant moves from active alert state to drowsiness An infant frequently skips the quiet alert state during the six stages of consciousness
The nurse is assessing the infants in the nursery for the six stages of consciousness. The nurse becomes concerned when assessing which infants?
B
The nurse is educating a first-time mother who has a 1-week-old boy. Which is the most accurate anticipatory guidance? A) Describing the effect of neonatal teeth on breastfeeding B) Explaining that the stomach holds less than 1 ounce C) Informing that fontanels will close by 6 months D) Telling that the step reflex persists until the child walks
Lactose intolerance
The nurse is performing a health assessment of a 3-month-old African-American boy. For what condition should this infant be monitored based on his race?
Discouraging the addition of fruit juice to the child's diet is the most effective anticipatory guidance. Fruit juice can displace important nutrients from breast milk or formula.
The nurse is promoting a healthy diet to guide a mother when feeding her 2-week-old girl. Which is the most effective anticipatory guidance? A. Substituting cow's milk if breast milk is not available B. Advocating iron supplements with bottle-feeding C. Advising fluid intake per feeding of 5 or 6 ounces D. Discouraging the addition of fruit juice to the diet
C
The nurse is providing anticipatory guidance to a mother to help promote healthy sleep for her 3-week-old baby. Which recommended guideline might be included in the teaching plan? A) Place the baby on a soft mattress with a firm, flat pillow for the head. B) Place the head of the bed near the window to provide fresh air, weather permitting. C) Place the baby on his or her back when sleeping. D) If the baby sleeps through the night, wake him or her up for the night feeding.
blacks, Native Americans, and Asians
3 ethnic groups that tend to be lactose intolerant?
D
A 6-month-old girl weighs 14.7 pounds during a scheduled check-up. Her birth weight was 8 pounds. What is the priority nursing intervention? A) Talking about solid food consumption B) Discouraging daily fruit juice intake C) Increasing the number of breastfeedings D) Discussing the child's feeding patterns
4-5
At ____________ months of age most children are making simple vowel sounds, laughing aloud, doing raspberries, and vocalizing in response to voices.
1 inch
At birth the newborn's head should be ______ larger than the chest
6 months
At which age would the nurse expect to find the beginning of object permanence?
Bedtime rituals and minimal interactions during night awakening
How to promote sleep through the night in a 6 month old?
6-8 months
Teeth begin erupting at what age?
'This is normal behavior for infants unless the stool passed is hard and dry.' Due to the immaturity of the gastrointestinal system, newborns and young infants often grunt, strain, or cry while attempting to have a bowel movement. This is not of concern unless the stool is hard and dry.
A new mother expresses concern to the nurse that her baby is crying and grunting when passing stool. What is the nurse's best response to this observation?
'This is a primitive reflex known as the palmar grasp.'
A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm. How might the nurse respond to this information?
A,B,C
A new mother tells the nurse that she is having difficulty breastfeeding her baby. When observing the mother, which actions prompt the nurse to provide teaching about proper breastfeeding techniques? Select all that apply. A) The mother carefully washes her breasts prior to feeding the infant. B) The mother feeds the infant every hour. C) The mother supplements feedings with water. D) The mother holds her breast in the "C" position. E) The mother strokes the nipple against the infant's face.
The infant should be placed to sleep on the back. The baby should sleep on a firm mattress without pillows or comforters. The baby's bed should be placed away from air conditioner vents, open windows, and open heaters.
Measures to prevent SIDS:
wash nipples and bottles in hot soapy water and rinse well or run nipples and bottles through the dishwasher; store tightly covered ready-to-feed formula can after opening in refrigerator for up to 48 hours; after mixing concentrate or powdered formula, store tightly covered in refrigerator for up to 48 hours; do not reheat and reuse partially used bottles; throw away the unused portion after each feeding; do not add cereal to the formula in the bottle; do not sweeten formula with honey; warm formula by placing bottle in a container of hot water; and do not microwave formula.
Proper formula preparation includes the following:
B
The nurse is caring for a 4-week-old girl and her mother. Which is the most appropriate subject for anticipatory guidance? A) Promoting the digestibility of breast milk B) Telling how and when to introduce rice cereal C) Describing root reflex and latching on D) Advising how to choose a good formula
A
The nurse is caring for a 7-month-old girl during a well-child visit. Which intervention is most appropriate for this child? A) Discussing the type of sippy cup to use B) Advising about increased caloric needs C) Explaining how to prepare table meats D) Describing the tongue extrusion reflex
B
The nurse is counseling the mother of a newborn who is concerned about her baby's constant crying. What teaching would be appropriate for this mother? A) Carrying the baby may increase the length of crying. B) Reducing stimulation may decrease the length of crying. C) Using vibration, white noise, or swaddling may increase crying. D) Using a swing or car ride may increase the incidence of crying episodes.
A
The nurse is providing anticipatory guidance to the mother of a 9-month-old girl during a well-baby visit. Which topic would be most appropriate? A) Advising how to create a toddler-safe home B) Warning about small objects left on the floor C) Cautioning about putting the baby in a walker D) Telling about safety procedures during baths
The newborn does not respond to a loud noise.
The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child?
C
The nurse is teaching a new mother the proper techniques for breastfeeding her newborn. Which is a recommended guideline that should be implemented? A) Wash the hands and breasts thoroughly prior to breastfeeding. B) Stroke the nipple against the baby's chin to stimulate wide opening of the baby's mouth. C) Bring the baby's wide-open mouth to the breast to form a seal around all of the nipple and areola. D) When finished the mother can break the suction by firmly pulling the baby's mouth away from the nipple.
A
The parent of a 6-month-old infant asks the nurse for advice about his son's thumb sucking. What would be the nurse's best response to this parent? A) 'Thumb sucking is a healthy self-comforting activity.' B) 'Thumb sucking leads to the need for orthodontic braces.' C) 'Caregivers should pay special attention to the thumb sucking to stop it.' D) 'Thumb sucking should be replaced with the use of a pacifier.'
By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain weighs 2.5 times what it did at birth.
What is a developmental milestone occurring in infancy about the brain
When the infant knows the object still exists even though she cannot see it. Ex: Looking at a toy in her crib in the last place she saw it
What is an example of object permanence in Piagets theory in the sensorimotor stage of cognitive development.
The nasal passages are narrower. The larynx is more funnel shaped. There are significantly fewer alveoli.
Which anatomic differences place the infant at risk for respiratory compromise?
Step reflex. The step reflex is a primitive reflex that appears at birth and disappears at 4 to 8 weeks of age.
Which reflex, if found in a 4-month-old infant, would cause the nurse to be concerned?
D
A mother is concerned about her infant's spitting up. Which suggestion would be most appropriate? A) "Put the infant in an infant seat after eating." B) "Limit burping to once during a feeding." C) "Feed the same amount but space out the feedings." D) "Keep the baby sitting up for about 30 minutes afterward."
The child's head size is large for his adjusted age (7.5 months), which would be cause for concern
A 10 month old boy born 10 weeks early with a head circumference of 19.5 inches. Is this normal?
