Developmental Care and Anticipatory Guidance (CPN)

You note that Josh's head circumference is now smaller than his chest circumference. His age is most likely?

30 months (head smaller than the chest circumference at 24 months)

Carlos is a healthy infant. His mother is concerned about starting him on baby foods. You know that the earliest time to start baby food is?

4 months

Emily was 22 inches at birth and now measures 44 inches.

4 years (doubles in 4 years)

Sammy enjoys copying shapes and can identify most colors. He draws a picture of the nurse with just 2 body parts. Sammy is most likely how old?

4 years old

The nurse would expect a 4 month old to?

attempt to roll over

When examining a 6 month old who is quietly sitting on mom's lap, which of the following should the nurse do first?

auscultation of the chest

When assessing a toddler's growth and development, the nurse understands that a child in this age group displays behavior that fosters which developmental task?

autonomy

Jose, a 2 year old admitted with RSV, is in which of the following stages of psychosocial development?

autonomy vs. shame and doubt

The mother of a 2 year old voices concern because her child does not share and uses the word "mine". You know that this is typical of which developmental stage according to Erikson?

autonomy vs. shame and doubt

Mrs. Garcia brings her 5 year old Jeffery to a local museum where children are encouraged to interact with the attractions. She praises and helps him explore the museum. What kind of play is this known as?

mutual play (when parents support while playing)

A healthy 6 month old infant brought to the well baby clinic for a check up. When assessing the infant's anterior fontanel, the nurse expects it to be?

open

Which of the following assessment findings are normal in a healthy 6 month old?

open anterior (12-18 mths) and closed posterior fontanel (2 mths)

The nurse is watching a group of toddlers in the playroom. Which of the following type of play is typical of older toddlers?

parallel

Which of the following developmental milestones would you expect to see the 9 month old developing?

pincer grasp

A baby's length is 20 inches at birth. You approximate her height at 4 years of age to be?

40 inches (doubles at 4 years old)

The mother of a 1 year old asks the nurse how many words she should have in her vocabulary. The nurse emphasizes that each child's vocabulary develops in a unique manner and tells the mother that most 12 month olds have?

5 words

The 5-year-old uses how many words in a sentence?

5-6

The nurse is caring for Marissa and notes that she pushes up from her stomach onto her knees and rocks back and forth. Which of the following most likely represents Marissa's age?

6 months

The nurse should begin lead screening when the child reaches what age?

6 months

The nurse is caring for a child who is very outgoing and likes to talk about his friends. He asks to play a board game and is very concerned about the rules of the game. When the nurse wins the game, he throws the game and says "you cheated!" How old is this child likely to be?

7

The nurse is playing with an infant who has just had a PICC line placed. When the nurse hides a toy rattle under a blanket, the infant actively looks for it while lifting up the blanket. How old is this infant most likely to be?

8 months

A group of children are playing in the playroom. The children are tested on the concept of conservation. One child has just mastered this concept. How old is this child most likely to be?

8 years old

The mother of an infant asked the nurse at what age she should giver her daughter cheerios as a snack. When providing an answer to the mother, the nurse remembers that the pincer grasp is usually developed by which of the following ages?

9 months

Which is an example of cephalocaudal development?

A child lifts his head before lifting his shoulders; sits with support before sitting without support

A parent calls the clinic to express concern over her child's eating habits. She says the child eats very little and consumes only a single type of food for weeks on end. The nurse knows this behavior is characteristic of?

preschool aged children

Ella is a 15 year old adolescent admitted with a diagnosis of asthma. During the admission history, she admits that she is currently smoking. The nurse incorporated a long term goal of smoking cessation in Ella's care plan. Which of the following interventions would be most effective in quitting?

have Ella attend a smoking cessation group led and attended by other teens

Four month old Jessie is being evaluated in the developmental clinic. Which of the following is the most concerning?

he doesn't hold objects in his hands

You are the inpatient nurse caring for a 12 year old who has been admitted for appendicitis. He shares with you that he is concerned about his short stature. Based on your knowledge of growth and development you know that?

in boys, height spurt occurs later in puberty than in girls

Which of the following would be the most accurate information to share with the mother of an 8 year old girl who is asking about the onset of puberty?

in girls, puberty begins on average at 10 years with the development of breast buds

8 year old Sarah is being admitted today for a diagnostic evaluation for Wilm's tumor. You know that she is in which of the following developmental stages according to Erikson?

industry vs inferiority

Julianne is a 4 year old newly diagnosed with diabetes that is frightened of finger sticks. The nurse's best response is?

Encourage Julianne to play with the equipment and "practice" on her dolls

You are the nurse at the community health clinic. The mother of a 2-year-old male expresses concern to you that her previously health child is non-verbal. Which of the following responses is most appropriate?

" Given your son's age, we should probably test his hearing to be sure that is not the source of his delayed language skills."

Jessica's physical reveals that her BMI is at the 90th percentile. You correctly explain to her mother?

"A BMI in the 90th percentile indicated that Jessica is overweight, would you like to talk to a dietician?"

A bottle fed 3 month old infant is brought to the pediatrician's office for a well baby visit. During the previous visit, the nurse taught the mother about infant nutritional needs. Which statement by the mother during the current visit indicates effective teaching?

"I will start my baby on infant cereal between 4-6 months."

A preschooler's mother states she is concerned that her child has an imaginary playmate. Which of the following is the nurse's best response?

"Many 4 year olds have imaginary playmates, it really isn't cause for concern."

The father of a 9 month old brings his daughter to the clinic for a well baby assessment. The father asks why it is important to record Julie's length and weight on a growth chart?

"The growth chart shows how Julie's length and weight compare to the other infants her age as well as show us a pattern over time."

A 6 year old is being seen in the emergency room after falling off her bike. The nurse is preparing to assist with suturing her scalp laceration when she cries out, "I'm sorry I didn't wear my helmet, I promise I'll be good next time, please don't hurt me!"

"We need to fix your head, you are doing such a good job of trying to stay still."

Whole milk is essential in which of the following age groups?

1-2 years

The nurse asks a child if it is ever okay to tell a fib. The child responds" I think that telling a lie to get out of trouble is wrong, but telling your mom you like her hair cut when it's really ugly is okay" What age is the child?

10 years old

Evan who measured 20 inches at birth, now measures 30 inches. Which of the following most likely represents Evan's current age?

12 months (50% by 1 year)

The school nurse is teaching a health education class to a group of adolescents. One of the girls in the class asks the nurse when she should expect her period to start. The nurse knows the average age of the start of menses is which of the following?

13 years

An infant, age 6 months, is brought to the clinic for a well-baby visit. The mother reports that the infant weighed 7 lbs at birth. Based on the nurse's knowledge of infant weight gain, which current weight would be considered the minimum weight expected for this infant to be within normal range of weight?

14 lbs (double by 6 months)

You expect which of the following developmental assessments of a 2 year old in your primary care clinic?

2-3 word sentences

Sam is a 2 month old who weighed 8 lbs at birth. Based on your knowledge of pediatric growth, you know that his weight at 1 yr should be at least?

24 lbs (triple by 1 year)

The nurse is observing a group of children playing at a park. She notes that one child is running and overhears her mother say" Look at Cindy go! She just learned how to run!"

24 months

The nurse is caring for an infant who raises her chest when lying on her stomach, is beginning to babble, and follows an object 180 degrees with her eyes. What age is this child?

3 month

The nurse is caring for a child who knows his first and last name, speaks in 3 to 4 work sentences and knows his age. This child is at least how old?

3 years

You are the nurse in an adolescent clinic caring for a 14 year old, Lisa, who experienced menarche one year ago. Lisa is concerned that she is short and wants to know if she will grow much taller.

In girls, menarche occurs late in puberty after the height spurt

The nurse is working in the developmental clinical evaluating 4 year old Lucie. Which is of greatest concern?

Lucie cannot throw a ball overhand

You are the nurse working at a telephone triage hotline. The mother of a 2 year old reports her son has swallowed an unknown substance. You instruct the mother to call poison control and to?

Make child NPO to avoid induction of vomiting

The clinic nurse measures the head circumference of a 6 month old and finds that is has changed from the 25th percentile to the 75th percentile.

Measure their head again to check for accuracy

The nurse is teaching a parenting class to a group of expectant parents. One of the parents asks at what age a child typically begins to develop modesty.

Most children develop modesty by age 4

The nurse is caring for a 5 year old with leukemia. When planning the care for this child, the nurse considers that the child is in which of the following Erikson's stages?

initiative vs guilt

Two year old Maria's mother needs to briefly leave the hospital to pick up Maria's sister Christie from preschool. She is worried about how Maria will react. The nurse's best response is:

Tell Maria that you need to go get Christie and you will be back when lunch is over and Dora the Explorer comes on TV

The mother of a 3 month old tells the nurse that she is concerned he doesn't turn his head toward her when she talks to him. Which of the following is the nurse's best response?

This can be a concern, tell me more about things that you've noticed regarding his hearing.

Mr. Gilbert tells the nurse that he has concerns regarding the manner in which his 12 month old son Mark plays with his toys. He says that Mark hits and throws anything that is handed to him.

Try not to worry, this is normal behavior. Mark is learning about his world by feeling, hitting, and throwing objects.

The nurse is caring for a 3 year old child who is restricted to bed rest due to a fractured femur. Which of the following toys should the nurse select for this child?

a play hammer and pounding board

Which of the following would likely pose the greatest fear for 7 year old Dana who was recently admitted to your unit for treatment of osteomyelitis?

a rectal temperature

The nurse is caring for 3 year old Emily diagnosed with diabetes. Which of the following should be included in her plan of care?

allow Emily to handle and play with equipment being used in her care

What ist he best way to prepare a 4 year old for an admission to the hospital for same day surgery?

allow them to play with the medical equipment at the preoperative office visit and explain that he will be staying in the hospital for a few days

Four year old Erika is being admitted today for treatment of pyelonephritis. You know that Erika is in which developmental stage according to Erikson?

initiative vs guilt (3-6 years)

Which of the following is not a risk factor for iron deficiency anemia in infants?

introduction to baby foods

When performing a physical assessment of a 10 year old girl, the nurse keeps in mind that the first sign of sexual maturity in girls is?

breast bud development

The nurse is caring for a 2.5 year old hospitalized with cellulitis. When selecting a toy for him, which of the following is the best choice?

large dump and garbage trucks

The mother of an infant tells the nurse " Molly used to put her hands in her mouth but now she is placing her feet in her mouth". The nurse knows that this is an example of what concept of development?

cephaocaudal (head to toes)

When you are instructing the mother of a healthy infant about the introduction of baby food, you know that the recommended order of progression for baby food introduction is?

cereals, fruit, meat

Which of the following assessments would be abnormal for a newborn?

closed anterior fontanel

When assessing a school age child's development the nurse understands that a primary developmental task of this age group is?

developing friends

Which of the following statements concerning growth and development is true?

development refers to the maturation of structures of the body and included growth

A group of preschool aged children are playing with dress up clothes. This kind of play is known as?

dramatic play

The nurse is teaching a parenting class when a mother asks when a child develops a conscience. Basing her response on Erikson's theory of development, the nurse knows that this usually occurs during?

during the preschool stage

Ben, a 3 year old with nephroblastoma, is very fearful of healthcare professionals. What would be most helpful while performing Ben's assessment?

encourage ben to put the blood pressure cuff on his stuffed bear and take the bear's blood pressure

Which of the following is an important nursing intervention to reduce the risk of SIDs?

encourage the use of a pacifier

When developing a plan of care for an adolescent, the nurse considers the child's psychosocial needs. During adolescence, psychosocial development depends on?

establishing an identity

Which of the following assessments would be most concerning in a 3 month old?

failure to track objects through visual fields

Which of the following formula feeding patterns would warrant further evaluation for 1 year old infant?

five feedings of 8 oz each

9 year old Jordan is being seen in the diabetic clinic. He tells the nurse that he is responsible for testing his own blood sugar and administering his own insulin based on a sliding scale. Which of the following is the most appropriate action for the nurse?

gather more information about Jordan's diabetic care from his parents

In comparing height growth spurt among males/females, which of the following is accurate?

girls have a low potential for growth after the beginning of menarche

14 year old Thalia is being treated for acute renal failure. In order to help meet her developmental needs, which of the following is important to include in her plan of care?

provide privacy and respect her need for modesty

Which nursing action would be most important in the psychosocial support of a 2 year old who is having an invasive procedure performed?

providing for parental presence

The nurse notes that an infant develops arm movements before fine motor skills and interprets this as an example of which pattern of development?

proximodistal (trunk to extremities)

A mother plans to provide her baby with breast milk post operatively. The nurse instructs the mother in the use of a breast pump because?

pumping will maintain the mother's supply of breast milk

Which of the following developmental milestones of the 5 month old best reflects the principle of proximodistal growth and development?

raking objects

The nurse should expect a 3 year old child to be able to perform which action?

ride a tricylce

In which of the following age groups does the child experience the fastest rate of growth in the limbs?

school aged (limbs)

According to Piaget, the child who is beginning to imitate behavior is in which of the following stages?

sensorimotor

At 18 months, Jose is admitted for same day surgery. What does the nurse anticipate as his biggest fear?

separation anxiety

Which of the following developmental milestones would be most advanced for a 6 month old?

sitting up unsupported for short periods

Which of the following is the first sign of puberty in males?

testicular enlargement

When assessing the development of 6 month old, which of the following would be most concerning?

the child does not transfer objects from one hand to the other (5 months)

Which of the following is accurate regarding puberty in females?

the growth spurt occurs before menarche

Which of the following is a cause for concern in a 6 month old child?

the infant does not grasp and hold objects

The nurse is preparing to provide education to a 9 year old girl with asthma. Which of the following should be taken into consideration?

the parent should be the focus of education

Why does the nurse instruct the mother of an infant who is being introduced to baby foods for the first time to wait a few days before adding another new type of food to his diet?

to determine if he has any allergies to new foods

What is the most important consideration when telling a 4 year old child about an upcoming procedure?

use simple terms

A 7 month old infant lives with his parents, is kept clean dry, and is picked up and comforted when he cries. By consistently meeting his basic needs, which psychological strength are his parents promoting?

will (trust vs mistrust virtue)

Which of the following would be most helpful when assessing a child's bone age?

x-rays