growth and development 2019
The pediatric home-care nurse is visiting a toddler born with a genetically related illness. Which comment by the parent is the greatest cause for the nurse to assess for additional information? 1. "I am having more difficulty keeping her confined." 2. "A chronically ill child affects the entire family." 3. "The other children seem so accepting of the illness." 4. "Hospitalization would cause some severe stress."
ANS 1 1 This is correct. When the parent states increasing difficulty keeping this toddler confined, the nurse needs to assess for additional information. The nurse needs to reinforce that play is what children do, and playing is important to learn the developmental skills needed to reach the most optimal functioning. Confinement may not be appropriate. 2 This is incorrect. The parent is expressing a truth; chronically ill children do affect the entire family. However, this is not the comment that gives the nurse the greatest cause for seeking additional information. 3 This is incorrect. Other children, especially siblings, often accept the chronically ill child without difficulty. This is not the comment that gives the nurse cause to seek additional information. 4 This is incorrect. It is true that hospitalization of a child does cause severe stress on the child and family members. However, the comment that causes the nurse to seek additional information is related to promoting behavior and development.
To meet Ericksons developmental task of industry, the nurse caring for a 7 year old would choose an activity such as a. working a jigsaw puzzle b. looking at a comic book c. Playing a competitive board game d. coloring a picture in a coloring book
ANS A In the developmental period of late childhood, children are striving to develop a sense of industry. the completion of a jigsaw puzzle is industrious play
The nurse assessing patterns of growth in a child would investigate further if A. previous weight was in the 75th percentile, and present weight is in the 25th percentile B. Height is in the 90th percentile, and weight is in the 75th percentile C. Last weight was in the 5th percentile and present weight is in the 10th percentile. D. Weight is in the 50th percentile, and siblings weight at the same age was in the 75th percentile
ANS A The child showing a difference of two or more percentile levels from an established growth pattern should undergo further evaluation
The nurse encourages a Puerto Rican family to bring food to a child because he is not eating the food served on his tray at the hospital. The nurse would expect the child to eat a. dried beans mixed with rice b. crisp vegetables c. spaghetti and metaballs d. wild berries, roots, and seeds
ANS A a common food choice of Americans of Puerto Rican descent is dried beans mixed with rice
The nurse explains that when a mother tells her 4 year old child that balls should be played with outside and not inside the house, the child is likely to obey the rule because she a. does not want to be punished b. wants to please her mother c. respects authority figures d. believes that following the rules is right
ANS A according to Kohlberg, children in the preconventional stage, 4-7 years, are obedient to their parents of fear of punishment
The nurse has discussed with the mother about introducing sold foods to the 6 month old infant. The nurse determines that the mother understands the information when she states the first food she will give to the infant is a. rice cereal b. yellow vegetables c. egg yolks d. fruits
ANS A solid foods are usually introduced at about 6 months of age starting with rice cereal, which is the least allergenic
A mother asks the nurse how much food should be offered to her 2 year old. The nurse responds that a good rule of thumb for serving size would be a. 2 tablespoons b. 3 tablespoons c. 4 tablespoons d. 5 tablespoons
ANS A the role of thumb for serving sizes is to ogger 1 tablespoon per year of age
A mother reports that she and her husband have had one child together, but both have children from previous marriages living in their home, The nurse will base the care planning on the fact this family types is a A. nuclear family B. blended family C. Alternate family D. Extended family
ANS B A blended family involves the remarriage of persons with children
AN infants birthweight is 7 pounds, 8 ounces. the nurse can project the weight at 6 months to be a. 12 pounds b. 15 pounds c 18 pounds d. 22 pounds
ANS B An infant usually doubles his or her birth weight by 5 to 6 months
When a small group of preschool age children were playing house, each child was pretending to be a particular family member. The nurse recognizes this as which type of play? a. Parallel b. Cooperative c. Symbolic d. Fantasy
ANS B In cooperative play, children play with each other, each taking a specific role
When the nurse asks the 10 year old American Indian if he is ready to go to therapy, he does not answer immediately. the nurse assesses this as a. indecision b. considering the answer in silence c. shyness with strangers d. fear of medical personnel
ANS B Native Americans value silence. They need to sit and consider matters before replying to questions
The nurse planning anticipatory guidance for the caregiver of a preschool-age would explain that permanent teeth begin erupting about the age of a. 4 years b. 6 years c. 8 years d. 10 years
ANS B Permanent teeth do not erupt through the gums until the sixth year
The nurse observes that a 2 year old is able to use a spoon steadily at mealtime. The nurse recognizes that being able to feed himself is important to the toddler in developing a. good nutrition b. a sense of independence c. adequate height and weight d. healthy teeth
ANS B by the end of the second year, toddlers can feed themselves. This helps them to develop a sense of independence
The mother of a 7 month old reports that the first lower central incisor has erupted. She asks the nurse, how many teeth will he have by his first birthday? The nurse would explain that by 1 year of age, the infant usually has a. two teeth b. four teeth c. six teeth d. eight teeth
ANS C The 1 year old infant usually has about six teeth, four above and two below
When demonstrating a bath procedure to parents of Vietnamese origin, the nurse should avoid A. Talking directly to the mother B. Exposing the child's genitals C. Touching the child's head D. Using cool water
ANS C The Vietnamese are very sensitive about anyone touching a child's head because that is where consciousness lies
The mother of a 7 month old states, the baby is eating food now. Should I give him regular milk, too? the nurse would respond a. you should give the baby low fat milk b. try the milk, see if he has any digestive problems c. continue breast milk or iron fortified formula until 1 year of age. d. at this age, infants can tolerate a lactose free or soy based milk
ANS C Whole milk should not be introduced before 1 year of age. Low fat milk should not be introduced before 2 years of age
When the nurse notes that an infant can lift her head before she can sit, the nurse is assessing A. specific to general development B. Proximodistal development C Cephalocaudal D. General t o specific development
ANS C development proceeds from head to toe
A unique organization of characteristics that determines an individuals pattern of behavior is known as a. environment b. heredity c. personality d. experience
ANS C one definition of personality states that it is a unique organization of characteristics that determines the individuals typical or recurrent pattern of behavior
An assessment of a childs nutritional status reveals the child is alert, with shiny hair, firm gums, firm mucous membranes, and regular elimination. this childs nutrition status would be described as a. overnourished b. undernourished c. well nourished d. borderline
ANS C well nourished children show steady gains in height and weight and have shiny hair, firm gums and mucous membranes, and regular elimination
The nurse recognizes Piagets concrete operational thinking when a. 2 year old says, its night time when his room is darkened b. 4 year old refers to the hospital as my house c. a 5 year old coloring a picture of a puppy says, this is my puppy d. a 7 year old says, I am sick because I have germs in my chest
ANS D The 7 year olds remark reflecting the cause and effect of germs and illness is an example of operational thinking. All other options are examples of preoperational thought, which is egocentric and symbolic
At a well baby visit, parents of a 6 month old ask when to take the infant for the first dental visit. The nurses best response would be: a. If the teeth are brushed regularly, the child should see a dentist by 3 years of age b. the first dental visit should be arranged after the first tooth erupts c. the child should have a dental examination when all deciduous teeth have erupted d. a dental visit by 1 year of age is recommended by the American academy of pediatric dentistry
ANS D The academy of pediatric dentistry recommends that the first dental visit occur by 1 year of age
A mother tells the nurse, my 11 month old son is not as active as my other children were at this age. He is the youngest of four and the other children love to dote on him. Which factor is influencing this childs language develpment? a. Heredity b. Sex c. Mothers heath during pregnancy d. Ordinal position
ANS D motor development of the youngest child may be prolonged if the child is babied by others in the family
When the 8 year old child comes to the school nurse with his central incisor in his hand and reports he knocked his tooth out on the water fountain, the nurse should a. give him an ice cube to suck on b. have him wash his mouth out with peroxide and water c. wrap the tooth in a clean tissue d. wash off the tooth and place it in a container of milk
ANS D the tooth should be washed off and put in a container of milk to preserve it for possible reimplantation
The nurse in a pediatric clinic is performing well-baby checks. The nurse is checking an infant who is 7 months old for developmental milestones. Which finding is of greatest concern to the nurse? 1. The infant remains flat when in a prone position. 2. The infant exhibits a Babinski reflex. 3. The infant opens and closes her hands to grasp objects. 4. The infant exhibits a lack of startle reflex to sound.
ANS: 1 An infant should be able at the age of 2 to 3 months to raise the head and chest and support the upper body with arms while in a prone position. The finding that the infant at 7 months lies flat when placed prone is a matter of concern to the nurse. It is not a matter of concern to the nurse if the 7-month-old infant still exhibits a Babinski sign. The Babinski reflex disappears by the age of 1 year. The ability to grasp objects by opening and closing the hands is normally present at the age of 2 to 3 months. The presence of this skill is expected to continue. This ability alone is not a reason for concern; however, assessment for progression is important. The startle reflex disappears around 4 to 6 months; the absence of this reflex in a 7-month-old infant is not cause for concern.
During a well-baby checkup, the mother of an infant states, "Even if he is occupied with a toy, he cries as soon as he notices I have left the room." Which explanation by the nurse is best? 1. "Your baby does not know you exist if he cannot see you." 2. "Babies learn very quickly how to get an adult's attention." 3. "You should move the baby with you if you leave the room." 4. "Just ignore him; he will soon learn that you are still present."
ANS: 1 Object permanence is one of the most important developments in the sensorimotor stage. The child will learn that an object exists even when it cannot be seen or heard. Prior to this, the child does not understand that someone or something did not disappear. Playing peek-a-boo is a good way to help the development of object permanence. The nurse's comment is not the best answer; the baby is most likely to cry because of a lack of object permanence. Instructing the mother to move the baby when she leaves the room is not the best answer. The nurse needs to explain the development of object permanence and share ideas of how to assist the development. Ignoring the baby is not the best suggestion. The mother needs to understand what development is taking place and how to assist in the process
The nurse is counseling parents about management of their children who are 2, 4, and 6 years of age. One of the parents states, "We believe in Kohlberg's theory of social-moral development." The nurse is aware that the preconventional stage of this theory involves which characteristic? 1. Behavior is adjusted according to good/bad and right/wrong thinking. 2. A personal and functional value system is constructed by the child. 3. The focus of the child is on following rules and maintaining social order. 4. Value systems are independent of authority figures and peers.
ANS: 1 The children in the family are all in the preconventional level of Kohlberg's theory. Stages include obedience and punishment orientation, and individualism and exchange. Characteristics include following rules set by those in authority and behavior adjusted according to good/bad and right/wrong thinking. A personal and functional value system is constructed by the child and is a characteristic of the postconventional autonomous level of Kohlberg's theory. When the focus of the child is on following rules and maintaining social order, the nurse recognizes the conventional level of Kohlberg's theory. When a child's value systems are independent of authority figures and peers, the child is exhibiting the characteristics of the postconventional autonomous level of Kohlberg's theory
The nurse in a pediatric clinic is counseling a parent who expresses concern about a toddler who plays alone at daycare and does not interact with the other children who are present. Which information does the nurse provide to alleviate the parent's concern? 1. Parallel play is being exhibited and is normal at this age. 2. The toddler is likely to grow into a shy, introverted adult. 3. It is important for the child to learn to be alone at this age. 4. The toddler is exhibiting the normal behavior of solitary play.
ANS: 1 Using knowledge about Erikson's theory of psychosocial growth and development, the nurse needs to reassure the parent that the toddler is expected to exhibit parallel play. Parallel play is part of the autonomy versus shame and doubt stage of Erikson's theory; autonomy and independence is being developed. The toddler's play behavior is normal and is not an indication of becoming a shy, introverted adult. The manner of play being exhibited by the toddler is more closely related to the development of autonomy and independence and not part of learning to be alone. Solitary play is expected during Erikson's stage of trust versus mistrust (birth to 1 year) and is not what the toddler is exhibiting.
A widowed parent of two children informs the nurse of an upcoming marriage to a woman who has three children. The expressed intention is to adopt the three stepchildren. Which definition of family will the nurse apply? Select all that apply. 1. A nuclear family after the adoption of the stepchildren. 2. A nonnuclear family after the marriage has taken place. 3. A blended family after the marriage of the adults occurs. 4. A nuclear family before adoption if all children live in the home. 5. A blended family after the intention of marriage is expressed.
ANS: 1, 2, 3 1. This is correct. The nuclear family is composed of a mother, a father, and a biological or adopted child or children. 2. This is correct. The term nonnuclear family describes family forms other than traditional, such as single-parent homes, grandparents functioning in the role of parents, same-sex parents with a child or children, and blended families. 3. This is correct. Blended families are those in which families from divorce are joined together by remarriage. This can also occur when a spouse has died and the remaining spouse remarries. 4. This is incorrect. The blended family does not become a nuclear family just because all the children live in the same home. 5. This is incorrect. The term blended family is not applied until after marriage occurs between two persons, each having biological children.
The school nurse is asked to assess a student in the third grade who is failing to demonstrate academic success. Using Maslow's hierarchy of needs, the nurse can create a needs list based on which comments by the student? Select all that apply. 1. "I have to go to bed at 10:00 every night." 2. "I worry because my mom and dad fight all the time." 3. "Game and movie nights are always fun at my house." 4. "My grandma says I'm stupid just like my mother." 5. "I taught my little brother to ride a bike in just one day."
ANS: 1, 2, 4 1. This is correct. If the student in question goes to bed every night at 10:00 the nurse recognizes a physiological need that is not being met. Children need more sleep than adults. Sleep deprivation can impact the growth and development of a child and cause delays. 2. This is correct. If the student in question expresses worry about fighting between parents, the nurse recognizes the child has the need to be protected from harm and may not feel safe. Fear and worry can interfere with developmental achievements. 4. This is correct. Negative feedback interferes with the development of esteem, which is related to the need to respect one's self and be respected by others. 3. This is incorrect. When the student in question expresses pleasure during family game and movie nights, the student feels loved and has a sense of belonging. 5. This incorrect. The student is expressing the feeling of self-esteem related to successfully teaching a sibling a physical skill.
The nurse is gathering information during a routine checkup for a preschool-age child who lives with grandparents. The grandmother expresses distress about "how loud and busy" the child is, and "how expensive it is to feed and clothe" the child. Which referrals does the nurse make to the grandmother? Select all that apply. 1. Community programs for the child aimed at playing and learning 2. Social service for determination of benefits available for the care of the child 3. Legal services to assist in obtaining financial support from the parents 4. Child protection services to survey the home and psychosocial environment 5. Caretaker programs and support groups for grandparents performing as parents
ANS: 1, 2, 5 1. This is correct. The grandmother's statement indicates stress related to the expected behavior of a preschool child. A referral for community programs for the child aimed at playing and learning is appropriate and beneficial. 2. This is correct. The nurse needs to make a referral to social services who can determine if the household is entitled to assistance for raising a grandchild. Services can include food, clothing, childcare, and medical services, to name a few. 5. This is correct. The nurse needs to be sensitive that the grandmother may be expressing caregiver stress. The nurse needs to make referrals to programs that can benefit the grandparents physically, psychosocially, and spiritually. 3. This is incorrect. The nurse does not have enough information to make a referral to legal services. The scenario does not clarify the reasons why the child is being raised by grandparents. 4. This is incorrect. The scenario does not provide any information indicating the child is being neglected, abused, or living in an unfit environment.
The nurses on a pediatric unit are concerned about developmental delays in patients who are hospitalized frequently and for extended periods of time. Which interventions do the nurses initiate to alleviate the concerns? Select all that apply. 1. Design a play/recreational area with age-appropriate sections. 2. Provide nurses with allotted time to play with confined children. 3. Extend the services of the child-life specialists to all patients. 4. Encourage family to bring favorite toys and books from home. 5. Have age-appropriate educational TV channels available.
ANS: 1, 3, 5 1. This is correct. Play is what children do and should not be overlooked when a child is in the hospital. Play is important for younger children to build the skills needed for development. All ages of pediatric patients can use play as a stress reducer. 3. This is correct. Many pediatric facilities have a child-life specialist on staff who can assist the child in fostering growth and developmental needs through play. An extension of services to meet the needs of all hospitalized children is appropriate. 5. This is correct. When hospitalized, patients will view TV as a distraction to the manifestations of illness and effects of treatment. However, with pediatric patients, TV provides an opportunity for skills development as well as entertainment. 2. This is incorrect. Confined children will benefit from designated play time. However, the pediatric nurse is focused on nursing care. A better plan is to have a program where volunteers will come and play with patients who are confined. 4. This is incorrect. Hospitalized pediatric patients feel more comfortable with their own favorite toys and books from home. However, this intervention does not necessarily address the nurses' concerns about developmental delays.
The pediatric nurse is providing care for a 14-year-old female patient. After the patient's parents leave the hospital, the patient begins to cry. The nurse explores the patient's feelings using therapeutic communication. Which information causes the nurse to report suspected sexual abuse? 1. The patient is frequently denied access to needed health care. 2. The patient reports frequent episodes of genital irritation. 3. The patient admits to multiple incidences of skipping school. 4. The patient states that an older brother frequently "hurts" her.
ANS: 2 2 This is correct. Frequent episodes of genital irritation is indicative of possible sexual abuse and should be reported as such 1 This is incorrect. Being denied needed medical attention is an indication of medical neglect and should be reported as such.. 3 This is incorrect. The patient's admission of multiple incidences of skipping school may or may not indicate educational neglect; additional information is needed. 4 This is incorrect. When the patient reports that an older brother "hurts" her, the nurse recognizes possible physical abuse; however, sexual abuse may or may not be present. Additional information is needed before reporting sexual abuse, but physical abuse is reported.
The nurse in a pediatric clinic is checking the developmental milestones for a 3-year-old patient. Which finding causes the nurse to perform additional assessments? 1. The patient's tee-shirt is on backward. 2. The patient loses balance when kicking a ball. 3. The patient draws a circle that is closed but oblong. 4. The patient jumps with both feet about 2 inches high.
ANS: 2 Between the ages of 2 to 3 years, a toddler should be able to kick a ball. The fact that the patient loses balance when attempting this skill may require additional assessment. At the age of 3 years, the patient is beginning to self-dress; the backward shirt indicates the skill is developing but not refined. The backward shirt may also be indicative of toddler independence. Toddlers correctly draw a circle when the curved line is closed; the shape is not the most important factor. No matter how high, jumping with both feet off the floor is an expected developmental skill for a toddler.
The nurse works in an elementary school with students ranging from 6 to 11 years of age. The nurse uses knowledge related to Freud's psychosocial theory to identify which behavior in this pediatric population? 1. Oedipal or Electra conflicts 2. Energy focused on socialization 3. Curiosity about anatomical differences 4. Mild struggles with sexuality
ANS: 2 The energy focus is on socialization and increasing problem-solving abilities. Oedipal or Electra conflicts, which existed during the phallic stage, are resolved during the latency stage (6 to 11 years of age). Curiosity about anatomical differences occurs in the phallic stage. The school-aged child's sexual drives are submerged
The nurse in a pediatric clinic is performing an assessment on an infant in the presence of both parents. The parents are short and moderately overweight. The father states, "We are going to do everything we can to raise a strong, tall, athletic child." How does the nurse respond? 1. Provides materials about healthy diets and lifestyles for families 2. Shares the impact of genetics and environmental conditions on growth 3. Suggests to the parents how to alter their lifestyles 4. Recognizes the parents for having positive attitudes and goals
ANS: 2 The nurse is aware that nature involves the traits, capacities, and limitations that a person inherits from parents at conception. Genetically, the infant may not become tall due to any nurturing behaviors; however, the infant can be strong and athletic because of nurturing. Materials for healthy diets and lifestyles may be helpful for the parents to alter their behaviors and implement good nurturing skills into their parenting; however, the topic of nature also needs to be addressed. At some point, the nurse can introduce information about how the parents can alter their lifestyles and positively impact the nurturing of their infant. At this time there is a more immediate need. The nurse needs to clarify the impact of both nature and nurturing during the infant's lifetime.
Erickson's psychosocial development theory proposes that the school-aged child between ages 6 and 12 years is in the stage of industry vs. inferiority. Based on this theory, how will the pediatric nurse design activities as part of a diversional program for children who are in a long-term medical facility? Select all that apply. 1. Identify adequate activities suited for solitary play. 2. Provide activities that involve more than one person. 3. Allow participation in simple tasks on the unit of care. 4. Designate methods of recognition for completed tasks. 5. Set guidelines and policies that are clear and enforceable.
ANS: 2, 3, 4, 5 2. This is correct. The school-aged child enjoys working in groups and forming social relationships. 3. This is correct. Developing a sense of industry provides the child with purpose and confidence in being successful; participation in small tasks will fulfill this need. 4. This is correct. If a child is unable to be successful, this can result in a sense of inferiority. Success needs to be recognized and rewarded. 5. This is correct. The school-aged child in this stage follows the rules and likes order. 1. This is incorrect. Play during this stage is known as cooperative play and involves more than one person
The nurse is performing a clinic assessment on a 1-month-old new patient. During the interview, the mother shares personal information. Which comments will cause the nurse concern about growth and development? Select all that apply. 1. "I was anemic during pregnancy and still take iron pills." 2. "Fat people are gross; I only gained 16 pounds during pregnancy." 3. "I don't think I even had a single cold during my pregnancy." 4. "During my pregnancy I never even took care of the cat." 5. "I really decreased my smoking habit during my pregnancy."
ANS: 2, 5 2 This is correct. The nurse is concerned by this comment on two levels. Poor nutrition in the mother can lead to low-birth-weight babies, as well as slow development, compromised neurological performance, and impaired immune status. The mother's attitude about "fat people" may carry over through the lifetime of the infant and cause insufficient nutrition for growth and development and/or psychosocial issues. 5. This is correct. Maternal smoking can result in infants with low birth weight and/or congenital anomalies such as cleft lip and cleft palate. The nurse needs to provide teaching about the effects of smoking during pregnancy, especially if another pregnancy is planned. 3. This is incorrect. The comment by the mother that she was healthy during pregnancy does not cause the nurse concern. Certain maternal illnesses can harm the fetus, such as rubella. 4. This is incorrect. The avoidance of cat feces during pregnancy does not cause the nurse concern. 1. This is incorrect. Anemia during pregnancy can cause anemia in the infant; however, the mother's comment indicates the condition was treated during pregnancy and continues. The comment does not cause the nurse concern.
The nurse is performing a development assessment on a 3-month-old infant who was 6 weeks premature. The nurse states the infant's development is normal. The parent expresses that the baby seems behind what other babies the same age are doing. Which information does the nurse share to provide reassurance to the parent? 1. The infant will catch up developmentally by age 1 year. 2. Developmental milestones vary from infant to infant. 3. The infant's age is adjusted because of prematurity. 4. Each infant is an individual with unique development.
ANS: 3 3 This is correct. Premature infants can experience delayed growth and development and are thus expected to reach developmental milestones at the same age they would have reached them if born at normal gestational age. Age is adjusted for assessments: subtract the weeks/months that the infant was born prematurely from the current chronological age 1 This is incorrect. The premature infant is expected to catch up developmentally by 2 years of age. 2 This is incorrect. Developmental milestone have a narrow range for normal; variation is not extensive.. 4 This is correct. Infants are unique; however, the ranges set for developmental milestones are accurate enough for early detection of delays and other issues.
The nurse is visiting the home of a new mother and a 2-month-old infant. The nurse notices the infant vigorously sucking on the fist and whining but not crying. The mother validates that the behavior is common. Which information does the nurse need to obtain from the mother? 1. If the mother is breast or bottle feeding 2. How long the infant sleeps at night 3. What type of feeding schedule is followed 4. If the infant draws up the legs when crying
ANS: 3 Normal development requires not depriving oral gratification, such as weaning too soon or a rigid feeding schedule. Because of the infant's vigorous fist sucking, the nurse needs to ascertain what type of feeding schedule is being followed. Freud's psychosexual theory states that from birth to 1 year, sexual gratification is achieved orally. However, it is not important if the mother breast or bottle feeds her infant. The infant may be attempting to gratify sexual urges with oral behaviors such as sucking, biting, chewing, and eating. It is not important to the nurse how long the infant sleeps at night. Asking if the infant draws up the legs when crying may be assessing for the presence of colic; the information is not related to the infant's
The school nurse in a high school setting expresses concern to school administration regarding the increase in student complaints about bullying, physical violence, and rejection. Which concern related to psychosocial development does the nurse share as being most important? 1. Students are preoccupied with how they are seen in the eyes of others. 2. Students who are bullied will develop issues related to sexual orientation. 3. Students may be unable to provide a meaningful definition of self. 4. Students who are aggressive will develop a strong sense of guilt as adults.
ANS: 3 The nurse's concern is focused on the possibility the students involved in any aspect of bullying, physical violence, and rejection will be unable to provide a meaningful definition of self, which places them at risk for role confusion in one or more roles throughout life. During the identity versus role confusion stage of Erikson's theory, 12- to 18-year-olds are preoccupied with how they are seen in the eyes of others. However, this manifestation exists even in the absence of peer violence. Sexual orientation issues are not manifestations of bullying; however, sexual orientation can cause a person to be a target for bullying and other violence. Students who are aggressive may develop a strong sense of guilt as adults, but this is just one aspect of the impact of bullying, physical violence, and rejection—not the most important one
A mother of a 9-month-old infant asks the nurse about what toys are age appropriate. Using Piaget's theory of development, which toy does the nurse recommend? 1. Building blocks 2. Colorful mobiles 3. Picture books 4. Musical rattles
ANS: 4 At 8 months, the infant should be in Piaget's stage 4: coordination of secondary schemata. To achieve a desired effect, the infant will repeat an action, such as repeatedly shaking a rattle to make sounds. The nurse will recommend a variety of rattles as appropriate toys for this patient. The nurse would not expect an infant of 8 months of age to play with building blocks. An 8-month-old infant may or may not be interested in a colorful mobile. Tactile stimulation from this would be limited for safety reasons. An infant's interest in picture books is more likely to occur in Piaget's stage 6: inventions of new means/mental combinations, which occurs between 18 and 24 months.
The nurse is teaching a parenting class being held in a community clinic. The nurse is focusing on behaviors that will assist in increasing the number of children who score well in kindergarten readiness screening. Which comment by a parent indicates the need for additional information? 1. "I am not athletic, but the kids would love an outdoor play area." 2. "Practicing counting with the kids while traveling is a good idea." 3. "I like the suggestion to label basic items for word recognition." 4. "In our family we watch TV; books are a waste of money."
ANS: 4 The nurse needs to provide additional information to the parent who thinks books are a waste of money. The parent needs to be aware of community agencies that will supply books to children and of programs that provide reading/story times. The nurse's information is adequate if a parent recognizes the importance of physical activity and development, even though the parent identifies as being nonathletic. The nurse's information is adequate if a parent recognizes the value of using "lost" time for learning. The nurse's information is adequate if a parent understands that labeling items will lead to word recognition