Growth ad development of a pre-schooler Chapter 27

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."

A first-time father calls the pediatric nurse stating he is concerned that his 4-year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate?

"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."

The parent of a 4-year-old is expressing concern that this child is not talking as much—or as well—as her other children did at that age. Which question should the nurse prioritize when assessing this preschooler for this concern?

"Has your child had her hearing tested?"

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."

A young hospitalized patient cries constantly for daddy even though her mother has not left her side. When talking to the child's mother, the nurse learns that the 4 year old wants only her father. The child has even told her mother that she hates her on numerous occasions. What would be the best response by the nurse to support this mother?

"Her behavior is normal for her age. She will outgrow it."

The parents of a 6-year-old 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 responses 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 Play-Doh? These are the types of toys suggested for preschoolers."

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 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."

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 providing teaching to the mother of a 4-year-old girl about bike safety. Which statement by the mother indicates a need for further teaching?

"She can ride on the street if I am riding with her."

A 3-year-old tells the nurse that he has 19 brothers. The nurse knows that the child has two brothers. What would be the nurse's best response concerning his brothers?

"That's a good pretend answer, but tell me the names of the brothers you really have."

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention?

"The school is quite structured and advocates corporal punishment."

A bilingual family tells the nurse their desire for their child to learn Spanish as well as English. English is the predominant language spoken in the home. The parents ask the nurse when is the best time to teach the child a second language. What time period would the nurse respond?

During the preschool years

A nurse is preparing a presentation for a health fair discussing various aspects of toddlers. Which example should the nurse use to best illustrate dramatic play?

Acting out a troubling or stressful situation

A 3-year-old is hospitalized unexpectedly and is frightened about the experience. What action could the nurse take to minimize the anxiety the child is experiencing?

Allow the child to handle the equipment before it is used on the child.

While the nurse is taking a blood pressure on a 4-year-old, the child states that the blood-pressure cuff is too tight and angrily says, "That hurt, you big poo-poo head." What is the most appropriate response by the nurse?

Calmly explain that you don't mean to hurt her, loosen the cuff, and tell her that is isn't nice to call you names.

The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local daycare. 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 caring for a preschool-aged child who needs a CT scan. Which action would the nurse use to best prepare the child for this diagnostic test?

Help the child to pretend that the CT scan machine is a camera.

The nurse is assessing a 4-year-old on a routine well-child visit. When assessing the gross motor skills of this preschooler, which activity will the nurse predict the child to be able to successfully accomplish?

Hop on one foot

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

A nurse is describing growth and development during the preschool period. What would the nurse identify as a predominant and heightened characteristic for this age group?

Imagination

A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe?

Imitative play

Parents tell the nurse their 3½-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?

Iron deficiency

A mother tells a nurse that her child has recently established some friendships for the first time. In which age group do you expect this child to be?

Preschool

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 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 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.

A nurse instructor is educating the parents about activities preschoolers can successfully perform independently. Which activities would the nurse include? Select all that apply.

Washing hands Brushing teeth Dressing self Playing active games

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.

A type of play seen in the preschool child encourages children to act out troubling situations, such as one that might occur in the hospitalized child who must undergo an upsetting procedure. This type of play is referred to as:

dramatic play

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.

When assessing the growth and development of a 4-year-old, which would the nurse note as being appropriate?

tells a fantasy story about a bear and a car

The nurse is caring for a 5-year-old who has been hospitalized after an episode of asthma. As the nurse prepares to teach the child how to use the nebulizer, which action should the nurse prioritize?

Allow the child to touch and play with the nebulizer for a few minutes before the treatment.

While the nurse is talking with a 6-year-old who has been a client of the clinic since birth, the child begins to tell the nurse that he is the star of a popular children's television program. What is the nurse's best response?

"I bet you like that show a lot. Which character is your favorite?"

The pediatric nurse is meeting with a group of preschoolers' family members to discuss various health topics. The nurse determines the sexual development session is successful after overhearing which comment by one of the participants?

"I feel better knowing that her curiosity is normal."

Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium?

Orange

A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family?

Parental anxiety related to lack of understanding of childhood development

The nurse is caring for a preschool child in the hospital with severe developmental delays. The parents have 3 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