newborn and toddler
A mother asks the nurse, "Now that Jimmy is 14-months-old and drinking from a cup, how much milk should he be getting each day?"Which amount would the nurse recommend?
16 ounces
The anterior fontanel closes at
18-24 months
Understanding concepts such as on, under, or in is typical of a __ year old
3
The toddler grows about how many inches (centimeters) in height per year?
3 in (7.5 cm)
The toddler grows about how many inches in height per year?
3 inches
The toddler grows about how many inches in height per year? a) 3 inches b) 5 inches c) 7 inches d) 1 inch
3 inches Correct Explanation: The toddler age range is one to three years of age. Each year the toddler grows about 3 inches (7.62 cm).
A toddler requires 1.5 mL (.05 oz) of an antibiotic given intramuscularly (IM). How will the nurse administer this medication?
Divide the dose. Administer 0.75 mL (0.25 oz) IM in each vastus lateralis.
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
When 12-year-old Chelsie comes in for her annual check-up, the nurse must take a health history and do a physical exam. What is the most appropriate manner for the nurse to obtain a health history?
Ask Chelsie if she minds if her mother is in the room with her.
The nurse enters the room to give a subcutaneous injection of insulin to a 6-year-old female who is diabetic. What is the best method of medication administration?
Ask her where she would like to have the nurse give the injection.
The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful?
Ask the child questions as you read.
The nurse is educating a new parent regarding nutritional needs for the newborn. Which is accurate and should be taught about the nutritional needs of a newborn?
Formula is designed to provide similar amounts of calories as breast milk would provide.
What is a true statement regarding the developmental milestones of the 30-month-old child?
Full set of primary teeth
Which measure would you suggest an infant's parents use to relieve teething discomfort? a) Provide her with a fluid diet for 2 days. b) Ask her pediatrician for a sedative for her. c) Give her a cold teething ring to chew. d) Offer her Aspergum to chew.
Give her a cold teething ring to chew.
The nurse finds the diet of a 30-month-old girl to be low in calcium. What suggestion can significantly increase this toddler's calcium intake? a) Use unsweetened applesauce as a dessert. b) Include dark greens and spinach in her meals. c) Offer chocolate milk to increase milk intake. d) Give her slices of cheddar cheese as a snack.
Give her slices of cheddar cheese as a snack. Correct Explanation: Two and one-half ounces of cheddar cheese provides the toddler's daily requirement of 500 mg of calcium. Chocolate milk provides calcium but the sugar it contains should not be a regular part of a toddler diet. Applesauce provides fiber, not calcium. Spinach and dark greens do contain calcium, but that calcium has limited bioavailability.
Which of the following would you include when teaching the parents of an infant about colic? a) Their child will need future follow-up for a "nervous" bowel. b) Formula intake should be doubled to keep her from losing weight. c) Colic symptoms will probably fade at 3 months of age. d) Symptoms will decrease if she is laid on her back after feedings.
Colic symptoms will probably fade at 3 months of age.
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.
A 5-year-old boy is receiving an analgesic intravenously while in the hospital. What should the nurse do to determine whether the drug is being properly excreted from this child?
Monitor the child's fluid intake and output.
A 3-month-old infant has a Moro reflex. Which statement is most true of this reflex?
Most 3-month-old infants still have a Moro reflex.
The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability?
Most babies do not sit steadily until 8 months; she is normal.
The school nurse is preparing health promotion presentations regarding unintentional injuries for a high school health fair. On which topic should the nurse place as the priority when preparing the presentation?
Motor vehicle safety
A nurse is assisting the parents of 2-year-old who is having temper tantrums. Which of the following would the nurse encourage the parents to do once temper tantrums have started?
Move objects out of the way or move the child to prevent injury
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?
Increased biting and sucking
The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention? a) Describe the capacity of a 5-week-old infant's stomach. b) Offer assurance that spitting up is normal. c) Observe the mother while she feeds and burps her infant. d) Recommend the mother offer smaller and more frequent feedings.
Observe the mother while she feeds and burps her infant.
To obtain an accurate heart rate in an infant, what would be most important for the nurse to do?
Take the apical pulse.
The nurse is caring for a 13-year-old girl. As part of a routine health assessment the nurse needs to address areas relating to sexuality and substance use. Which statement or question should the nurse say first to encourage communication?
Tell me about some of your current activities at school.
The 18-month-old toddler has most likely attained which gross motor skill?
The ability to walk independently.
The nurse is admitting a 15-year-old adolescent to the hospital pediatric unit. What does the nurse recognize as a priority for this adolescent?
The adolescent's need for privacy should be respected.
A father asks the nurse what symptoms he can expect with normal teething in his infant. What would the nurse tell him?
The child's gumline will be tender.
A nurse taking a health history of a 2-year-old child and asks the parent if the child is kept in a playpen or given room to run. What does this question help the nurse learn from about the child?
The child's well-being and development
Which of the following shows an example of Erik Erikson's developmental task for the infant? a) The infant cries and the caregiver picks the child up. b) The infant smiles as people walk past the crib. c) The infant cries when they have a wet diaper. d) The infant plays the game peek-a-boo.
The infant cries and the caregiver picks the child up.
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?
The infant displays an asymmetric tonic neck reflex (fencing reflex)
The nurse is watching toddlers at play. Which normal behavior would the nurse observe?
Toddlers engage in parallel play.
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply.
When discussing improper behavior, call the behavior "bad" or "naughty," not the child. Anticipate situations likely to cause misbehavior and redirect the child to another activity. Books and stories can help preschoolers master proper behavior.
A mother tells the nurse she is having difficulty getting her 6-year-old to do chores. Based on the child's developmental level, what activity would be best for the nurse to recommend to the mother?
putting books on shelf
The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:
refer the infant for developmental and/or neurologic evaluation.
The nurse is teaching a new nurse how to assess vital signs of an infant. The mentor knows that teaching was effective when the nurse takes which measurement first?
respirations
The best way for an infant's father to help his child complete the developmental task of the first year is to a) talk to her at a special time each day. b) respond to her consistently. c) expose her to many caregivers to help her learn variability. d) keep her stimulated with many toys.
respond to her consistently.
The best way for an infant's parent to help the child complete the developmental task of the first year is to:
respond to the infant consistently.
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:
should have disappeared by 4 months
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:
should have disappeared.
Place these primitive protective reflexes of infancy in the order in which they will disappear as the child matures.
step, root, morro, palmer, plantar, babinski
The nurse is promoting a healthy diet to the mother of a 6-month-old. What action would have the most effect on the infant's neurologic development?
Promoting continuation of breast-feeding
Which food suggestion would be most appropriate for the mother of a preschooler to ensure an adequate intake of calcium?
White beans
The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look?
Puts down a little ball to pick up a stuffed toy
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.
The parents of a toddler ask the nurse about disciplining their son. What would be most helpful for the nurse to suggest? Select all that apply.
• "It's better to praise correct behavior than to punish wrong behavior."
Communication through words and gestures is typical of a __ year old
1
At birth the newborn's head and chest circumference were measured. The nurse knows that the head should be about: a) ½ inch smaller than the chest b) Equal in size to the chest c) 2 inches larger than the chest d) 1 inch larger than the chest
1 inch larger than the chest
The pediatric nurse is presenting basic safety tips at a local health fair for families. The nurse should point out the majority of hospital visits for toddlers can be prevented by exercising which precaution? A) Properly use car seats B) Safely store all chemical substances C) Use plastic protectors in all electrical outlets D) Close supervision during bath time
B) Safely store all chemical substances
Head circumference equals chest circumference at
12 months
The infant weighs 6 lb 8 oz (2,912 g) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of 4 months?
13 lb (5900 g)
The infant weighs 6 lbs. 8 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of four months? a) 10 lbs. 8 oz. b) 16 lbs. c) 13 lbs. d) 15 lbs. 4 oz.
13 lbs.
A mother comes to the clinic with her 4-year-old and tells the nurse that she is worried because the child does not talk much. Upon talking to the child, the nurse learns that the client has a normal vocabulary for age. The nurse is aware that language for a 4-year-old consists of at least approximately how many words?
1500 words
Pointing to named body parts is characteristic of a ___ year old
2
16 temporary teeth: Development milestone for what age?
2 years olf
When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about a) 16 pounds and grown 4-6 inches b) 16 pounds and grown 2-3 inches c) 8 pounds and grown 4-6 inches d) 8 pounds and grown 2-3 inches
8 pounds and grown 4-6 inches
When performing neurological reflexes on the infant, which primitive reflex will be present longest?
Babinski- until 1 year is normal
The caregivers of a 2-year-old are concerned the child is not learning how to share and play well with other children. While acknowledging their concern and devotion, the nurse should point out which activity would be best for this child's developmental level? A) Mowing the lawn with a toy lawnmower B) Looking at large print magazines C) Sharing finger paints and painting with the caregiver D) Throwing a baseball-sized ball
A) Mowing the lawn with a toy lawnmower
The nursing instructor is leading a discussion on school-aged children. The instructor determines the session is successful when the students correctly choose which factor as being a priority for the school-aged child? A) Needs 10 to 12 hours of sleep per night B) Should brush their teeth at bedtime C) Have a routine physical exam every 6 months D) Be screened for scoliosis once a year
A) Needs 10 to 12 hours of sleep per night
A nurse is caring for a 4-year-old child that 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.
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.
A 5-year-old child is being seen at the ambulatory care clinic for a well-child visit. The child is hiding behind his mother. What initial action by the nurse is indicated?
Allow the child to remain "hidden" during the initial part of the interview.
Parents are to bring their kindergarten child to the outpatient department for a venous blood sample. They have EMLA cream to apply at home prior to the procedure and have been shown two areas on the child's arms where they should place the cream. Transportation time is 15 minutes. Their appointment is for 2:45 p.m. At what time should the parents apply the cream and occlusive dressings to both arms?
Between 1:15 p.m. and 1:45 p.m.
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers? A) Need three big meals a day due to rapid growth B) Need extra calcium for proper muscle growth C) Snacks throughout the day help the child meet nutritional requirements D) Should drink at least 4 cups of milk each day
C) Snacks throughout the day help the child meet nutritional requirements
The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care. Which instruction should the nurse prioritize with this group? A) The infant should be dressed more warmly than older children and caregivers. B) The infant should wear hard-soled shoes in order to protect their feet from injury. C) The infant sleeps 10 to 12 hours at night and can take two to three naps during the day. D) The infant should be sound asleep before being put into the crib for sleeping.
C) The infant sleeps 10 to 12 hours at night and can take two to three naps during the day.
The nurse is assessing a child who is receiving TPN. The nurse determines the TPN bag was hung 24 hours ago. What initial action by the nurse is indicated?
Hang a new bag of TPN.
The nurse is teaching the mother of a 2-month-old girl about the social and emotional developments that will occur in the next 8 weeks. Which behavior is most likely to occur? a) Crying when the mother is out of sight b) Becoming clingy around strangers c) Mimicking mother's facial expressions d) Participating in a game of peek-a-boo
Mimicking mother's facial expressions
The mother of 2-year-old triplets is anxious and worried because one of the trio does not seem to be developing at the same rate as the other two. Which assessment finding would lead the nurse to question the need for further diagnostic testing for this child?
The tops of her ears are below the corners of her eyes.
Lea is 3 months old. At what age would it be okay for Lea's mother to introduce carrots to her for dinner? a) Solid food can be introduced at 9 months of age. b) Solid food can be introduced at 7 to 9 months of age. c) Solid food can be introduced at 4 to 6 months of age. d) Solid food can be introduced whenever the child seems ready.
Solid food can be introduced at 4 to 6 months of age.
The best way for parents to aid a toddler in achieving his developmental task would be to a) allow him to make simple decisions. b) help him learn to count. c) give him small household chores to do. d) urge him to dress himself completely alone.
allow him to make simple decisions. Correct Explanation: Making decisions is primary practice toward achieving independence.
The way you would advise a toddler's mother to handle temper tantrums would be to a) distract him with a toy when he begins breath holding. b) appear to ignore them. c) mimic his behavior by also holding her breath. d) promise him a special activity if he will stop.
appear to ignore them. Correct Explanation: Rewarding temper tantrums can teach children that they are an effective method of interaction. Ignoring tantrums teaches that they are ineffective.
The mother of an infant asks you when to begin tooth brushing with her son. Your best response would be a) as soon as the first tooth erupts. b) as soon as he begins to eat fruit. c) when weaning is complete. d) by 12 months of age.
as soon as the first tooth erupts.
A parent tells the nurse that no matter what is asked of the toddler, the toddler says, "No." What suggestion might the nurse make to help the parent handle this situation?
give the toddler secondary, not primary, choices
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.
According to Erikson, the adolescent develops his or her own sense of being an independent person with individual thoughts and goals. This stage is referred to as:
identity vs. role confusion.
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 developmental task of the school-aged period, according to Erikson, is gaining a sense of:
industry versus inferiority.
Cooperative play
occurs during a leader-follower relationship (seen in toddlers)
Associative play
occurs when children are playing together in a group without organization or leadership.
The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: a) conclude the earlier assessments carried out fatigued the infant. b) refer the infant for developmental and/or neurologic evaluation. c) consider this a normal response for the age. d) suggest more awake tummy time for the child.
refer the infant for developmental and/or neurologic evaluation.
A pediatric nurse is mentoring a new graduate nurse. Which action by the new nurse would require intervention by the pediatric nurse?
taking a rectal temperature on a newborn
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:
the newborn's stomach can hold between one-half and 1 ounce.
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother: a) the newborn's stomach can hold between one-half to 1 ounce. b) most newborns need to eat about 4 times per day. c) the best feeding schedule offers food every 4 to 6 hours. d) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.
the newborn's stomach can hold between one-half to 1 ounce.
Tertiary circular reaction is seen in
toddlers between 12 and 15 months
The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:
transduction.
Solitary play
when a child plays alone, absorbed in the activity and uninterested in the play of other children (Seen in infants )
A high-school athlete comes to the emergency department with hypertension, aggressiveness, and psychosis. What question would be important for the nurse to ask the client?
"Do you take anabolic steroids?"
The parents of an 8-month-old boy voice concern to the nurse that their child is not developing motor skills as he should. What question would be appropriate for the nurse to ask in determining if their fears are warranted?
"Does he move a toy back and forth from one hand to the other when you give it to him?"
When questioning a 15-year-old about his health history, what would be an appropriate way for the nurse to ask about the child's drug history?
"Have you heard that some teens like to smoke? Have you tried this?"
During a routine wellness examination, the nurse is trying to determine how well a 5-year-old boy communicates and comprehends instructions. What is the best specific trigger question to determine the preschooler's linguistic and cognitive progress?
"How well does your son communicate or follow instructions?"
What statement by the mother of a 20-month-old indicates a need for further teaching about nutrition?
"I give my daughter juice at breakfast and when she is thirsty during the day."
A parent asks the nurse to explain what a PET scan is after learning that the child will be having a PET scan of the abdomen. What is the nurse's best response?
"It is similar to a CT scan but uses an injection of dye to help visualize the abdominal organs."
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this?
A regular routine and rituals will provide stability and security.
The nurse is caring for a toddler who was just diagnosed with a hearing impairment. What would the nurse expect to assess in the child?
A delay or lack of clear, understandable speech pattern
A hospitalized 7-year-old is recovering from a head injury. Occupational therapy has been ordered to assist the child in regaining eye/hand coordination. If the child cannot master this skill, what feelings may arise?
A feeling of inferiority
A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship?
A sense of trust and identity
The nurse is assessing a 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life? A) Trust B) Feel anger C) Love D) Fear
A) Trust
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? A) "How often do you or a family member read to your child?" B) "Has your child had her hearing tested?" C) "Does your child have opportunities to have conversations with other people?" D) "Do you praise and give your child encouragement when she tries to talk with you?"
B) "Has your child had her hearing tested?"
Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital? A) "I will be back in the morning. Mommy loves you." B) "I will be back after you eat your dinner and SpongeBob goes off." C) "I will be back later this afternoon." D) "I will come back when it is time for your bath tonight."
B) "I will be back after you eat your dinner and SpongeBob goes off."
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, 'I just feel like my whole body is changing and I don't know why' what should the nurse point out to this group? A) "You will feel better about yourself as you get older." B) "You have lots of hormone changes going on right now." C) "You may feel like you are changing, but you still look the same." D) "Your other friends are feeling like this too."
B) "You have lots of hormone changes going on right now."
In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will:
be able to use each language as a separate system.
Every time a toddler's mother asks her a question, the response is "No!" regardless of what the mother asks the child. What would the nurse recommend to the mother to help alleviate this behavior? A) Don't ask the child any questions and just tell her what to do each day. B) Allow the child choices when asking questions such as "Do you want to wear the red or the blue top?" C) Ask the child to please quit saying no to everything asked of her. D) Respond negatively back to the child each tine the child responds to the parent in a negative fashion.
B) Allow the child choices when asking questions such as "Do you want to wear the red or the blue top?"
A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe?
Imitative play
The caregiver of a 6-year-old is concerned the child is not getting proper nutrition because on some days, the child will only eat one type of food. Which response should the nurse prioritize for this caregiver? A) "It is important that each time she eats, she has a variety of foods." B) "Food jags are common in this age. This probably won't last long." C) "Try having her eat with the family and she will want what others are eating." D) "She should be discouraged from having food likes or dislikes. Have her eat everything."
B) "Food jags are common in this age. This probably won't last long."
The nurse is assessing a 12-week-old infant in the clinic at a well-baby visit. Which assessment finding does the nurse predict to assess in this healthy infant? A) Able to sit up and roll over B) Smiles at significant others C) Grasps objects and brings them to the mouth D) Bears weight on legs when held in standing position
B) Smiles at significant others
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? A) "Disciplining is not likely to be effective, but if the child keeps wetting the bed it may be necessary." B) "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration." C) "Setting rules is a parent's job to help the child have acceptable social behavior, so take away a privilege each time she wets the bed." D) "Nightly bedwetting up to age 12 is developmentally typical, so you will need to practice patience with your daughter."
B) "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."
For reasons of anticipatory guidance, nurses should be aware that menarche appears earlier in some ethnic groups than others. In which ethnic group is menarche likely to appear first?
BLACK
The nurse is providing anticipatory guidance for parents of a preschooler regarding sex education. What is a recommended guideline when dealing with this issue?
Before answering questions, find out what the child thinks about the subject.
The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers?
Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality.
The nursing student is preparing to explain the appropriate steps for assessing an infant. The instructor determines the student's presentation is successful after illustrating which location as appropriate for obtaining an apical pulse?
Between the sternum and the left nipple
The nurse is presenting information about school-aged children at a community event. Which statement should the nurse prioritize for further teaching and providing more information? A) "Sometimes we have to be firm, but our children wash their hands before eating." B) "I make sure they have good teeth by giving them calcium and phosphorus." C) "Food is so expensive, we always make our children eat everything on their plates." D) "Even if the weather is cool and cloudy, our children play outside every day."
C) "Food is so expensive, we always make our children eat everything on their plates."
A male nurse is meeting with a group of 12-year-old boys to discuss expected bodily changes. After one of the boy's says, "My older brother told me my bed might be wet and that means I had a wet dream. Is that true?" What is the best response from the nurse? A) "When you are thinking about girls or having girlfriends you might have a wet dream." B) "It is not common to wet the bed or urinate when you have a wet dream." C) "Having wet dreams indicates that your body is going through a process of maturing." D) "It will be several years before you will start having wet dreams."
C) "Having wet dreams indicates that your body is going through a process of maturing."
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
Sitting independently
Parents are beginning potty training their 2-year-old child and seek advice from the nurse on how to be successful in this endeavor. Which statement by the parents indicates that further teaching is needed? A) "We will place him on the potty for 5 minutes for each session." B) "I bought him big boy underwear for him to use instead of diapers." C) "He wants to accompany me to the bathroom but I prefer to go alone." D) "I will wait until he is off the toilet before flushing it."
C) "He wants to accompany me to the bathroom but I prefer to go alone."
A male nurse is meeting with a group of high school boys to discuss various health topics. After the session on testicular self-exam, the nurse determines the session is successful when one of the students responds with which comment? A) "It sounds like we will need to know how to do this when we are in our 20s, so we might as well learn now." B) "My uncle had testicular cancer after he got married and had my cousin." C) "I am almost 15 now, so that means I could possibly get this disease." D) "Men my grandfather's age will probably die if they don't do these exams."
C) "I am almost 15 now, so that means I could possibly get this disease."
The school nurse is teaching a health class on nutrition with some adolescents. Which comment by a student should the nurse prioritize and provide more teaching? A) "I hate eating with my family. I would much rather snack all day." B) "I had lunch with my boyfriend before his game and all he ate were carbohydrates." C) "I am feeling so fat. I think I need to exercise a few extra hours today." D) "I don't really like it, but I have been drinking lots of skim milk."
C) "I am feeling so fat. I think I need to exercise a few extra hours today."
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Sitting independently b) Walking independently c) Building a tower of four cubes d) Turning a doorknob
Sitting independently
The nurse is meeting with a group of new mothers of infants and is leading the discussion related to weaning. Which suggestion should the nurse prioritize to this group of mothers concerning weaning their infant? A) "It is best to just pick a day and stop breast or bottle feeding and wean the infant to a cup." B) "If the infant is eating from a dish and drinking from a cup, they no longer need a bottle or breast feeding." C) "It is important to let the infant set the pace for weaning, no matter what age they are." D) "The infant who is interested in watching others drink from a cup is ready to be weaned."
C) "It is important to let the infant set the pace for weaning, no matter what age they are."
The nurse is teaching a nutritional class to a group of Asian adolescents who are lactose-intolerant. Which food should the nurse point out will help these adolescents consume the calcium they need for proper nutrition? A) Chocolate pudding B) Nonfat milk C) Soybean curd D) Cottage cheese
C) Soybean curd
The school nurse is conducting a health class with a group of high school students on the topic of sex and sexuality issues. The nurse determines the session is successful when the students correctly choose which aspect as most important? A) "It is important for adolescents to abstain from sexual activity." B) "Males as well as their partners are responsible for avoiding an unwanted pregnancy." C) "Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections." D) "Girls should carry their own condoms and use them to avoid pregnancy."
C) "Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."
The nursing instructor is conducting a class discussion exploring the normal dentition progression of the school-aged child. The instructor determines the session is successful when the students correctly choose which factor as most likely occurring in 10 year olds? A) All four central incisors have erupted. B) The child has only six permanent teeth. C) Two of the cuspid teeth have erupted. D) There are eight molars.
C) Two of the cuspid teeth have erupted.
Which milestone would the nurse expect an infant to accomplish by 8 months of age?
Sitting without support
Which milestone would you expect an infant to accomplish by 8 months of age?
Sitting without support
Parents bring a toddler age 19 months to the clinic for a regular checkup. When palpating the toddler's fontanels, what should the nurse expect to find?
Closed anterior and posterior fontanels
The nurse is about to see a 9-year-old girl for a well-child checkup. Knowing that the child is in Piaget's period of concrete operational thought, which characteristic should the child display?
Consider an action and its consequences.
The parents of a 4-year-old who is a picky eater ask the nurse what foods to include in their child's diet to provide adequate iron consumption. Which food would the nurse recommend?
Cooked lentils
The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play?
Cooperative play
A child needs a peripheral IV start as well as a venous blood sample for a laboratory test. The nurse will take what action?
Coordinate placing the peripheral IV and the lab blood draw.
The nurse is meeting with a group of young parents to discuss nutrition and their preschooler. Which response should the nurse prioritize when asked if using desserts as a reward for good behavior is an appropriate idea? A) Child may only behave on days when dessert is something that is liked B) Will learn to choose sweets over nutritious food C) Will result in the child being overweight D) Can use food to manipulate others' behavior
D) Can use food to manipulate others' behavior
Nursing students are reviewing developmental milestones for toddlers. They demonstrate understanding of these milestones when they put them in the proper sequence. Place the milestones in their proper sequence from earliest to latest. Name one body part Engage in parallel play Creep up stairs Name one color Run and jump in place
Creep up stairs Run and jump in place Name one body part Engage in parallel play Name one color Correct Explanation: A 15 month old can creep upstairs. An 18 month old can run and jump in place and name one body part. A 24 month old engages in parallel play; a 30 month old can name one color.
The nursing instructor is illustrating the various types of play. The instructor determines the class is successful when the students correctly choose which example as best representing onlooker play? A) Playing apart from others without being part of a group B) Acting out a troubling situation C) Playing in an organized group with each other D) Observing without participating
D) Observing without participating
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing? A) Playing apart from others without being part of a group B) Playing together in an activity without organization C) Playing in an organized group with each other D) Playing independently and are side by side
D) Playing independently and are side by side
The school nurse is preparing for a career fair at the local high school. Which factor should the nurse point out when presenting various medical career options to the students? A) The adolescent should seriously consider the parents' choice for the best career. B) The career choices may be limited after high school depending on location. C) Many individuals have already chosen what they want to do. D) The individual's sex no longer decides which career options are available.
D) The individual's sex no longer decides which career options are available.
The nurse in an emergency department is assessing a 17-year-old girl who is complaining of a gap in her memory of the previous night. She reports after drinking only one drink that she felt dizzy and disoriented. She woke up in a friend's bed but has no recollection of getting there. What action should the nurse prioritize for this client? A) Call Social Services to counsel her about blackouts related to alcohol abuse. B) Call Neurology so they can see her to rule out a neurological impairment. C) Have the client call her caregivers to get their permission to treat and counsel her. D) Complete a rape kit to rule out possible sexual abuse while she was blacked out.
D) Complete a rape kit to rule out possible sexual abuse while she was blacked out.
Infant development is best described by which of the following statements? a) Development proceeds cephalocaudally. b) Development is not sequential but predictable. c) Development varies greatly from infant to infant. d) Development proceeds from fine to gross.
Development proceeds cephalocaudally.
A nursing instructor is teaching students about changes during the preschool years. One predominant change that the teacher would emphasize is:
Physical growth slows.
The school nurse is presenting information to a group of high school students who are asking about vegetarian diets? Which foods will the nurse point out are not eaten when following the vegan diet? A) Red meat and possibly poultry B) Red meat, poultry and fish C) Meat, poultry, fish and eggs D) Dairy products, meat, poultry, fish, and eggs
D) Dairy products, meat, poultry, fish, and eggs
The nurse is discussing proper discipline with the mother of a 15-month-old boy. Which statement is most important?
Physical punishment such as spanking is discouraged.
Which milestone would you expect an infant to accomplish by 8 months of age? a) Pulling self to a standing position b) Being able to sit from a standing position c) Creeping on all fours d) Sitting without support
Sitting without support
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants? A) Has an increased attention span and can be interested in an activity for a long length of time. B) Takes in new information at a rapid rate and asks "why" and "how". C) Insists they can "do it" and the next moment they revert to being dependent. D) Grows and develops skills more rapidly than at any other time in their life.
D) Grows and develops skills more rapidly than at any other time in their life.
Developmental task of the preschool period
Initiative versus guilt
According to Eric Erikson, the developmental task of the toddler is developing autonomy. Which of the following describes Erikson's psychosocial development task for the toddler? a) Learning to understand and respond to discipline b) Learning to act on one's own c) Learning to speak d) Learning to trust
Learning to act on one's own Correct Explanation: Erikson's psychosocial developmental task for toddlers is to achieve autonomy (independence) while overcoming doubt and shame. Erikson's psychosocial developmental task for infants is to develop a sense of trust. Learning to speak and to understand and respond to discipline are not developmental tasks according to Erikson.
An infant is breastfed. When assessing the stools, which findings would be typical?
Less constipation than bottle-fed infants
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is:
Looking for a toy in her crib at the last place she saw it Looking for the toy where it was last seen indicates object permanence. The infant knows the object still exists even though she cannot see it. All the rest of the infant behaviors show use of her senses and motor activity but do not illustrate object permanence.
The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?
Magical thinking Thoughts are all-powerful
The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively?
Maintain a feed-on-demand approach
The nurse is teaching a first-time mother with a 14 month old boy about child safety. Which is the most effective overall safety information to provide guidance for the mother?
Never let him out of your sight
A young client is admitted with a fever, vomiting, and diarrhea. Upon taking the health history, the nurse asks the client's parent, "What did you do to help your child before coming to health facility?" This is an example of which type of question?
Open-ended
A child is having difficulty swallowing pills. What is the best action for the nurse to take to help this child swallow medications?
Place the pills in a bite of ice cream or applesauce.
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching?
Reasoned with the child to stop the behavior
The best way for an infant's father to help his child complete the developmental task of the first year is to:
Respond to her consistently.
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.
The nurse is assessing an infant at his 4-month well-baby check-up. The nurse notes that at birth the baby weighed 8 lb (3.6 kg)and was 20 in (50.8 cm)in length. Which finding is most consistent with the normal infant growth and development? a) The baby weighs 21 lb (9.5 kg)and is 30 in (76.2 cm) in length. b) The baby weighs 24 lb (10.9 kg) and is 26 (66.0 cm) in in length. c) The baby weighs 15 lb (6.8 kg)and is 24 in (61.0 cm) in length. d) The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length.
The baby weighs 16 lb (7.3 kg) and is 26 in (66.0 cm) in length.
Which gross motor skill would the 4-year-old child have most recently attained?
The child can hop on one foot.
The nurse is examining a 3-year-old girl during a regular visit. Which finding would disclose a developmental delay in this child?
The child demonstrates separation anxiety.
The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development?
The child does not use the names of familiar objects.
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?
The development of a 3-month-old
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms? a) The development of a 3-month-old b) The growth of a 5-month-old c) The development of a 10-week-old d) The growth of a 2-month-old
The development of a 3-month-old 40weeks - birth week = months to minus from current age 40-32=8wks (2 months) [5mos-2mos=3mos]
What is typical of a grade II heart murmur?
The murmur is soft but easily heard.
When testing the deep tendon reflexes of a child, a four-point grading scale is used. What would a 1+ result mean for a reflex tested?
The reflex is diminished.
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?
The respirations of a 1-month-old infant are normally irregular and periodically pause.
Fear of mutilation is significant during the preschool age.
True
Sonograms demonstrate thumb sucking as early as in utero. a) False b) True
True
The nurse is preparing to perform a physical examination of a toddler. Which is the preferred location to complete the assessment?
With the child seated on the caregiver's lap.
A mother of a 9-month-old 18-pound (8.2 kg) infant asks the nurse about choosing the best car seat. What should the nurse recommend?
a rear-facing 5-point harness restraint
The nurse is conducting a support group for parents of 9- and 10-year-olds. The parents express concern about the amount of time their children want to spend with friends outside the home. What should the nurse teach the parents that peer groups provide?
a sense of security as children gain independence
The first deciduous teeth that the preschool age child normally looses are the
central incisors
A nurse is providing anticipatory guidance to parents of a 3-year-old about nutrition and finger foods. Which of the following would be most appropriate for the nurse to suggest? Select all that apply
• Diced fruit • Shredded cheese • Cereal
The nurse is choosing foods for a toddler's diet that are high in vitamin A. What foods could be added to the menu? Select all that apply.
• Sweet potatoes • Spinach • Carrots
The nurse determines that a 20-month old is in Piaget's sensorimotor stage of cognitive development. Which of the following would support this assessment? Select all that apply
• The child has an imaginary playmate • The child has a limited concept of time. • The child demonstrates egocentricity.
A mother of a 2-year-old asks the nurse, "What would be a good between-meal snack?" What foods would be appropriate for the nurse to suggest? Select all that apply.
• Yogurt • Cheese • Pieces of apples • Orange slices
The caregiver of a 6-year-old tells the clinic nurse that he is concerned that his 5-year-old child cannot yet print his first and last name, and 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 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 mostappropriate?
"By the age of 6, most children can print some letters and maybe their first name."
During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family?
"Children of this age may stutter while they search for just the right word."
A 9-month-old has been brought to the clinic for a well-child visit. The mother reports her son was born 6 weeks prematurely. During the data collection, the child's mother reports her son seems to be a few months "behind" what she recalls from her older children. What is the best response by the nurse?
"Delays are normal when a child is premature."
The nurse is caring for an 11-year-old girl. The girl's mother reports that the girl does not want to play team sports like soccer or volleyball anymore. Her daughter insists she does not enjoy them. The mother is concerned that her daughter will not get enough physical activity and asks the nurse for guidance. How should the nurse respond?
"Give her some options; it's important to find something she enjoys."
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?
"I am so glad I can get rid of all of those bath toys because they take up so much room."
The nursing students are learning how to perform a health assessment on a pediatric client. The nursing instructor identifies a need for further teaching when a student states:
"I should take blood pressure on a child beginning at age 2 years."
The nurse is teaching a group of school age children about physical development. Which statement made by one of the children indicates the correct understanding of the teaching?
"I will grow an average of 2 inches per year"
The nurse is auscultating the lungs of a lethargic, irritable 6-year-old boy and hears wheezing. The nurse will most likely include which teaching point if the child is suspected of having asthma?
"I'm going to have this hospital worker take a picture of your lungs."
A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?
"In two months you can try bananas if you think she is ready."
A nursing instructor is teaching about taking a health history and how to elicit a chief concern. The instructor realizes a need for further education when a student makes with statement?
"Intensity refers to how often the concern occurs during the day."
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."
A mother is concerned because her 14-month-old son, who had a big appetite when breast-feeding a few months ago, seems uninterested in eating solid food. She still breast-feeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother?
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate."
The mother of a 5-year-old kindergarten student tells the school nurse she is concerned that her son doesn't seem to be able to pronounce words correctly that begin with the letters "th" and "r." What is the best response by the nurse?
"It is very common for children 6 years and younger to have difficulty with these sounds, but I will let our speech therapist know so it can be monitored."
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 student nurse is reviewing the records of a pediatric client. Which statement about the client's progress indicates the need for further instruction?
"Maturation refers to the child's increases in body size."
The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse? a) "By this age your child is ready to try new skills such as eating solid foods." b) "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods." c) "Milk does not provide adequate amounts of iron, which are found in solid foods." d) "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex."
"Milk does not provide adequate amounts of iron, which are found in solid foods."
The nurse is teaching a group of caregivers of school-age children about the importance of setting a consistent bedtime for the school-age child. Which statement made by a caregiver indicates an understanding of the sleep patterns and needs of the school-age child?
"My child sleeps between 11 and 12 hours a night."
During the toddler years, the child attempts to become autonomous. Which statement by a 3-year-old toddler's caregiver indicates that the toddler is developing autonomy?
"My toddler uses the potty chair and is dry all day long."
The parent of a 5-year-old child calls the doctor's office to seek advice about proper nutrition for her child. Which statement by the mother indicates that further teaching is needed?
"Since she doesn't like vegetables, we no longer serve them to her."
The nurse is obtaining a health history on a 10-year-old child and asks the parents about their health history, the health history of their other children, and of their parents' health history. The parents ask the nurse why this information is necessary. What is the best response by the nurse?
"The information can alert us to any disease process that might run in families."
The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse?
"The preschooler is developing a conscience."
The nurse is teaching parents how to avoid a power struggle with their 2-year-old girl. Which comment indicates that more teaching is needed?
"We will make sure she shares her toys with cousins her age."
The parents of a 9-year-old child voice concern that their daughter seems to be gaining weight rapidly. The nurse reviews the medical record and notes the child has increased his weight by 6 or 7 pounds (2.7 to 3.2 kg) per year for the past 2 years. What response by the nurse is indicated?
"Weight gains of about 7 pounds per year are normal for children in this age range."
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 goes in to check on a new mother to see how breast-feeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse?
"You are doing a wonderful job attempting to wake the baby."
The average preschool-age child will grow how many inches per year?
2.5 to 3 inches
At what age is measuring occipital head circumference in a child discontinued?
36 months
If a toddler is following a normal pattern of growth, which of the following weights would be most likely for a 3-year-old toddler who weighed 21 lbs. at the age of 12 months?
37 lbs.
The preschool age child gains about ____ pounds each year.
4 to 5 lbs each year
If the child is gaining weight at an expected rate, a child who weighs 36 pounds (16.3 kg) at 3 years of age would weigh what amount at age 5?
44 lbs. (20 kg)
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)
Each year the toddler gains
5 to 10 lbs
A nurse is caring for a hospitalized 7-year-old child whose family members have been unable to visit for 2 days. The nurse is preparing a diversional activity for the child. Which activity would best be suited for a child in this age group?
A paint-by-numbers activity creating a picture
A 5-year-old child is to receive long-term IV antibiotics. The mother is concerned about what type of administration method will be used. Which medication administration route may be the most easily accepted?
A peripherally inserted central catheter (PICC) line in an antecubital space
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which true statement best accomplishes this? a) A regular routine and rituals will provide stability and security. b) Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. c) Aggressive behaviors such as hitting and biting are common in toddlers. d) A sense of control can be provided through offering limited choices.
A regular routine and rituals will provide stability and security. Correct Explanation: Toddlers benefit most from routines and rituals that help them anticipate events and teach and reinforce expected behaviors. Knowing that a child can move from calm to temper tantrum very quickly, understanding the benefit of limited choices, and realizing that hitting and biting are common behaviors in toddlerhood provide information but not a guiding concept.
A neonate is to receive a hepatitis B vaccine within a few hours after birth. What is the best approach for the nurse to take when giving this medication?
Administer the medication in the neonate's vastus lateralis with a 25-gauge needle.
What scenario demonstrates the nurse's knowledge when using guided imagery to relieve pain in pediatric clients?
After achieving a relaxed state, begin by guiding the 13-year-old client to image of walking down a sandy beach and collecting seashells, a favorite activity
The school nurse is assessing a 16-year-old girl who was removed from class because of disruptive behavior. She arrives in the nurse's office with dilated pupils and is talking rapidly. Which drug might she be using?
Amphetamines
What is the correct amount of urine diapers a mature infant should have each day? a) An infant should have 3 to 5 wet diapers/day. b) An infant should have 6 to 8 wet diapers/day. c) An infant should have 1 to 2 wet diapers/day. d) An infant should have 9 to 10 wet diapers/day.
An infant should have 6 to 8 wet diapers/day.
What is the correct amount of wet diapers a mature infant should produce each day?
An infant should have 6 to 8 wet diapers/day.
The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. Which of the following should be included in the teaching plan? Select all that apply.
Assuring the mother this behavior won't cause malocclusion
Parents complain of being "worn out" at their child's 6-month check-up because their boy awakens each night and cries. The nurse suggests which measures? Select all that apply.
At bedtime, rock the child to sleep and then place in crib. Bedtime rituals and minimal interactions during night awakening both promote sleep. Adding rice cereal to bottles does not promote sleeping through the night and isn't recommended. Putting the infant asleep into the crib does not teach the child to self-soothe and fall asleep independently.
Which of the following is a true statement regarding developmental milestones of the 24-month-old? a) Anterior fontanel closes b) Triples birth weight c) At least 16 temporary teeth d) Head circumference equals chest circumference
At least 16 temporary teeth Correct Explanation: Developmental milestones of a 24-month-old include acquiring 16 temporary teeth. The 12-month-old should double his birth weight. The anterior fontanel closes at 18 to 24 months. Head circumference equals chest circumference at 12 months.
Developmental task of the toddler
Autonomy
The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother? A) "Giving a bottle of milk when the infant goes to bed can lead to obesity." B) "Bottles given at bedtime can cause erosion of the enamel on the teeth." C) "Giving your baby a pacifier at bedtime will satisfy the need to suck." D) "You could occasionally give your baby a bottle of water at bedtime."
B) "Bottles given at bedtime can cause erosion of the enamel on the teeth."
The parent reports the 13-month-old infant was using auditory expressive language. The vocalizations have been diminished over the last month and the child no longer says words. Select the best rationale for the infant's language behavior. a) The environment has changed since the grandparents moved in with the family. b) Biological factors such as otitis media could be causing hearing loss. c) The parent has decreased the usual sensory stimulation for the child. d) This behavior is common in children when autism is developing.
Biological factors such as otitis media could be causing hearing loss. Explanation: A primary influence on impaired auditory expressive language development is the occurrence of hearing loss. Hearing loss can be acquired or congenital. Approximately 2.2 million children are diagnosed annually with episodes of otitis media with effusion. Delays in speech development and loss of vocalizations are indicators hearing loss may be occurring. Evaluation of hearing is essential since the critical period for speech is within the first two years.
The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation?
Boys grow at a slower, steadier rate than do girls.
An infant is breast-fed. When assessing her stools, which findings would be typical?
Breast-fed infants are less likely to be constipated than bottle-fed infants.
A nurse is assessing a preschooler and asks the child a question about pets. The child responds by saying, "I-I-I have a t-t-turtle and a f-f-fish." The child's parent states that this problem just started over the past month or so. The nurse interprets this as which?
Broken fluency.
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby. Which suggestion should the nurse prioritize to help the mother establish healthy sleeping patterns in her infant? A) Put the baby to bed at various times of the evening. B) Let the baby cry during the night and she will eventually fall back to sleep. C) Use the crib for sleeping only, not for play activities. D) Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime.
C) Use the crib for sleeping only, not for play activities.
The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which of the following should appear at this age?
Cruises around furniture At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year.
The nurse is performing an assessment on a 12-year-old boy. Which finding is consistent with the child's age?
Curling pubic hair
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following?
Deferred imitation
A nurse has been administering normal saline intravenously to a pediatric client and notes edema, pallor, and blanching at the intravenous site. What should the nurse do next?
Discontinue the infusion and remove the cannula.
The nurse is caring for a 16-month-old child on the pediatric unit. The child's mother is a single mother who has two other young children at home. She must leave her 16-month-old daughter overnight in the hospital. Which of the following actions by the nurse will be most appropriate in helping the child feel secure and in reassuring this mother? a) Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment b) Remind the child and mother that by staying in the hospital now the child will get well and be home again soon, and that the other children also need their mother c) Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out d) Encourage the mother to give her daughter a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return such as "when breakfast comes in the morning."
Encourage the mother to give her daughter a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return such as "when breakfast comes in the morning." Correct Explanation: When the family caregiver must leave the toddler, it may be helpful for the adult to give the child some personal item to keep until the adult returns. The caregiver can tell the child he or she will return "when the cartoons come on TV" or "when your lunch comes." These are concrete times that the toddler will probably understand. The toddler is too young to understand that staying is important for her recovery. Distracting the child while the mother leaves may increase the child's anxiety when she realizes her mother is gone. Although the child will be watched closely in the hospital setting, toddlers explore their environment wherever they are
The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation?
Even slight malocclusions make chewing and jaw function less efficient.
A school-age child is scheduled for a diagnostic procedure. Which nursing approach is best for this age group?
Explain the procedure and the theory and reason behind it.
A 3-year-old client is being admitted for a tonsillectomy. The nurse notes the client is fussy, crying, and appears nervous about the procedure. Which action by the nurse will be most helpful in alleviating the child's anxiety?
Explain the procedure to the child using dolls and medical equipment
A toddler's "no" can best be eliminated by asking a question instead of making a statement. a) False b) True
False Correct Explanation: A toddler's "no" can best be eliminated by limiting the number of questions asked of the child. Making a statement instead of asking a question this way can avoid a great many negative responses.
The pediatric nurse recognizes that what statement is true regarding medications administered via the intravenous route?
Giving medications through the intravenous route is less traumatic than other routes.
The pediatric nurse is careful to monitor and assess the growth and development of all clients. Which characteristic should the nurse prepare to assess in the infants?
Grows and develops skills more rapidly than at any other time in their life.
Nursing students are reviewing information about the emotional development of the preschooler. They demonstrate understanding of the information when they identify what task as the task of the preschooler?
Initiative
A 3-year-old wants to do everything independently, including putting on shoes. Every day, no matter how hard he tries, he puts the shoes on the wrong feet until finally he is successful. According to Erikson, what developmental task is this child trying to master?
Initiative vs. guilt
The nurse is reveiwing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula?
Iron
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
The infant in the exam room has the following signs and symptoms. Which ones will the nurse attribute to teething? Select all that apply.
Irritability and awakening from sleep
The nurse is talking with parents of a depressed 16-year-old boy. Which question is of the most importance?
Is there a gun in your home?
The parents of a 16-year-old are fearful that their child may be using illegal drugs. They report to the nurse that they have noticed recently that their child seems much more focused when doing homework or chores, is losing weight, displays a high level of energy, and becomes agitated easily. The nurse is aware that the teen is displaying symptoms of which type of drug use?
Methamphetamine
The parent of a 3-month-old infant is concerned because the infant does not yet sit by oneself. Which statement best reflects average sitting ability?
Most infants do not sit steadily until 8 months; this infant is normal.
The caregivers of 2 ½-year-old Frances tell the nurse that they are working hard to teach her to share and communicate with other children. The nurse recognizes and acknowledges their devotion, but explains to them that a child this age is probably not at a developmental level to play and share with other children. Of the following activities, which activity would the nurse recommend as the most appropriate activity for a 2 ½-year-old? a) Throwing a baseball sized ball b) Sharing finger paints and painting with the caregiver c) Mowing the lawn with a toy lawnmower d) Looking at large print magazines
Mowing the lawn with a toy lawnmower Correct Explanation: Toddlers enjoy talking on a play telephone. They like pots, pans, and toys such as brooms, dishes, and lawnmowers that help them imitate the adults in their environment and promote socialization. Toys that involve the toddler's new gross motor skills, such as push-pull toys, rocking horses, large blocks, and balls, are popular. Fine motor skills are developed by use of thick crayons, modeling clay, finger paints, wooden puzzles with large pieces, toys with pieces that fit into shaped holes, and cloth books. The toddler will not be interested in sharing toys until the later stage of toddlerhood; adults should not make an issue of sharing at its early stage.
The student nurse is caring for a 2 1/2-week-old in the newborn intensive care unit. Which term is most accurate when discussing this client?
Newborn
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?
No teeth
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age? a) 1 upper tooth b) No teeth c) 1 to 3 natal teeth d) 1 to 2 lower teeth
No teeth
Nurses should provide anticipatory guidance to males to prepare them for what particular pubertal change in late adolescence?
Nocturnal emissions
The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. Which of the following should be the priority nursing intervention?
Observe the mother while she feeds and burps her infant. Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is information helpful to parenting but not the priority.
The parents of a 2-year-old boy report to the nurse because their child is "such a picky eater." Which recommendation would be most helpful for developing healthy eating habits in this child?
Offering a variety of foods along with the foods the child likes
The parents of a 2-year-old boy complain to the nurse because their child is "such a picky eater." Which recommendation would be most helpful for developing healthy eating habits in this child? a) Assuring the parents that food jags are normal, and they can be honored safely b) Offering a variety of foods along with the foods the child likes c) Encouraging the parents to eat a variety of wholesome foods themselves d) Advising the parents to minimize distractions at mealtime
Offering a variety of foods along with the foods the child likes Correct Explanation: Toddlers require fewer calories proportionately than infants, and their appetite decreases (physiologic anorexia). Offering a variety of healthy foods along with foods the child likes will acknowledge preferences while keeping the door open to new foods. Prolonged particular food preferences (food jags) are common. It is also important that mealtime be calm, pleasant, and focused on eating. Toddlers mimic behaviors observed. It is important that parents set a good example with their mealtime behaviors and food choices. All options encourage the development of healthy eating habits, but at this time, variety plus preferred foods will be most helpful
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics?
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
The nurse is observing a play group of children of all ages. The toddlers in the group would most likely be doing which of the following activities? a) Watching a movie with other children their age b) Pretending to be mommies and daddies in the play house c) Playing with the plastic vaccum cleaner pushing it around the room d) Painting pictures in the art corner of the room
Playing with the plastic vaccum cleaner pushing it around the room Correct Explanation: Playtime for the toddler involves imitation of the people around them such as adults, siblings, and other children. Push-pull toys allow them to use their developing gross motor skills. Preschool children have imitative play, pretending to be the mommy, the daddy, a policeman, a cowboy, or other familiar characters. The school-age child enjoys group activities and making things, such as drawings, paintings, and craft projects. The adolescent enjoys activities they can participate in with their peers.
The nurse is supervising a play group of children on the unit. The nurse expect the toddlers will most likely be involved in which activity?
Playing with the plastic vacuum cleaner and pushing it around the room
The nurse is assessing the growth of a premature infant. What would be the appropriate action by the nurse to complete this assessment?
Plot the infant's weight, height, and length on a growth chart.
A mother of a 3-year-old asks the nurse about what kinds of toys would be appropriate. The nurse would suggest which of the following? a) Pounding bench b) 100-piece jigsaw puzzles c) Bicycle with training wheels d) Memory games
Pounding bench Correct Explanation: The 3-year-old child should have a tricycle, large sturdy toys such as big blocks, active toys like a pounding bench, and musical toys that encourage rhythmic movement. The preschooler also likes show-and-tell, guessing games (because his or her memory is improving), and big-pieced jigsaw puzzles. For the 4-year-old, construction toys, jigsaw puzzles, memory games, and fantasy play are favorites.
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? a) Made sure the child was rested and not hungry before going to the mall b) Tried to refocus the child's attention as tantrum behavioral cues appeared c) Reasoned with the child to stop the behavior d) Remained relatively calm even though embarrassed
Reasoned with the child to stop the behavior Correct Explanation: The child having a tantrum is out of control, making reasoning impossible. Calmly bear hugging the child provides control, especially in a public place. The other actions are helpful in preventing a tantrum.
A nurse is preparing discharge teaching for a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan? a) Restrain the baby in a car seat. b) Lock all cabinets that contain cleaning supplies. c) Keep all pots and pans in lower cabinets. d) Give warm bottles of formula to the baby.
Restrain the baby in a car seat.
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
The parents of a 2 year old girl are concerned with her behavior. For which behavior would the nurse share their concern?
She frequently babbles to herself when playing
The nurse is assessing the development of a 15-month-old girl during a regular visit. Which of the following skills would the nurse expect to see? a) Runs to her mother b) Stands alone c) Feeds herself with a spoon d) Points to her nose and mouth
Stands alone Explanation: At 15 months, toddlers have mastered standing and walking alone. The child has yet to develop the ability to feed herself with a spoon, point to her nose and mouth, or run to her mother.
A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing:
Stranger anxiety Stranger anxiety occurs around 8 months and manifests as the father described. This behavior indicates the infant sees himself as a separate person. The other options are incorrect and not related to social/emotional development.
Computer use at home and at school has increased adolescents' comfort in gaining access to and using the Internet. This has expanded their exposure to risks. What potential risks are there for an adolescent to be exposed to?
Teens can be exposed to inappropriate materials, harassment, threats, and potential for molestation.
The nurse is assessing the language development of a 3 year old girl. Which finding would suggest a problem?
The child speaks in 2-3 word sentences
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?
The infant says "da-da" when looking at her father
A preschooler who is receiving gastrostomy feedings occasionally vomits following a feeding. When the parent describes the feeding process, what does the nurse note as the likely cause of the vomiting?
The mother does not check gastric residual prior to feedings.
A mother expresses surprise to the nurse that her daughter has begun masturbating. The most important initial nursing response is that:
This is a normal and expected activity best treated matter-of-factly.
A toddler's father is concerned because his son refuses to share. What is your best response concerning this? a) This is normal toddler behavior; sharing is learned later. b) Play time with other children should be cut back until he learns to share. c) His son is probably reacting to some family crisis. d) Behavior modification techniques can change the child's behavior.
This is normal toddler behavior; sharing is learned later. Correct Explanation: Sharing is not usually learned until the preschool period; toddlers play parallel to each other.
The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. What is the most appropriate intervention?
Wake the child up nightly 30 to 45 minutes after going to sleep.
If a medication is being administered by the otic route, it will be administered in which way?
Warmed to room temperature and dropped into the ear
Toward the end of the preschool age, most children begin loosing their deciduous teeth and permanent teeth begin to erupt. Which of the following teeth are usually the first to come out?
central incisors
The school-age child develops the ability to recognize that if a block of clay is in a round ball and then is flattened, the shape changes but not the amount of clay. What understanding has this child developed?
conservation
A nurse is caring for a child who is grimacing but reports having no pain. What might be the rationale for a child being reluctant to express pain?
fearing getting a "shot" to relieve the pain
A nurse is talking with the mother of a 2 ½ -year-old who is starting toilet training. The nurse determines that the child is the stage of toilet learning when the mother states which of the following? Select all that apply.
• 'He says he wants to wear "big-boy" pants" • "He can pull his pants up and down by himself."
The nurse enters her patient's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her patient about breast-feeding an infant with this diagnosis? a) " You can still attempt breast-feeding; let me call a lactation consultant for you." b) "I am so sorry your infant has that problem, maybe next time." c) "I am so sorry, looks like bottle-feeding for you." d) "Sometimes dreams do not come true."
" You can still attempt breast-feeding; let me call a lactation consultant for you."
A teen mom asks the discharge nurse if it is okay to sleep in bed with the baby. She says her mom always did it with her siblings and it seemed okay. The nurse should respond how? a) "Bed sharing has positive effects on babies, let me get you information." b) "Bed sharing is okay, just make sure the infant is between two people." c) "Sure, you can do whatever you want, it is your baby." d) "Sure, you can, make sure you use a soft mattress for support."
"Bed sharing has positive effects on babies, let me get you information."
The caregiver of an infant tells the nurse that her dentist told her not to let the child go to bed with a bottle of milk. The caregiver states she doesn't understand the reason for this since her baby seems to enjoy the bottle. The most appropriate response to this caregiver would be: a) "Giving a bottle of milk when the infant goes to bed can lead to obesity." b) "Giving your baby a pacifier at bedtime will satisfy the need to suck." c) "Bottles given at bedtime can cause erosion of the enamel on the teeth." d) "You could give your baby a bottle of water at bedtime occasionally."
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
A mother is discussing her 10-month-old boy with the nurse. Which comment indicates a need for teaching? a) "He loves being in his walker and 'zips' around the house." b) "He gets a few sips of apple juice each day from a regular cup, not a sippy cup." c) "We have safety gates at the top and bottom of our stairs." d) "I wipe my son's teeth every day with a fresh washcloth."
"He loves being in his walker and 'zips' around the house."
Martha asks the nurse if her 2-month-old could have baby bananas yet. The nurse would respond and educate Martha on the nutrition stages of infants by which of these responses? a) "Sure, if you feel she is ready to have bananas." b) "In one month you can try bananas if you think she is ready." c) "In two months you can try bananas if you think she is ready." d) "When did you feed your other child bananas?
"In two months you can try bananas if you think she is ready."
Debbie asks her nurse what she thinks about giving her baby a pacifier. Debbie is struggling with this issue and is very teary-eyed about making a decision. How should the nurse respond to Debbie? a) "I always gave my kids a pacifier." b) "You should never give babies pacifiers." c) "It is a personal decision, let me give you a pamphlet from the AAP." d) "You should do whatever you want."
"It is a personal decision, let me give you a pamphlet from the AAP."
Patty calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console, is that normal?" What should the nurse's response be to this mother? a) "Yes, maybe she is just tired." b) "Yes, infants cry all the time at that age." c) "No, call your doctor." d) "Let me ask you some more questions to see if there are symptoms of colic."
"Let me ask you some more questions to see if there are symptoms of colic."
When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? a) "Let me go over car seat safety with you, so you can install your car seat properly." b) "You should never put the car seat in the front." c) "With the car seat in front, you can keep an eye on your baby." d) "I see you have a car seat, that is great."
"Let me go over car seat safety with you, so you can install your car seat properly."
The nurse goes in to check on Lilly and how breast-feeding is going with her new son. The nurse observes the infant is on her lap with the blanket unwrapped, and Lilly is washing his face, and gently stroking the baby. Lily has had trouble breast-feeding the last few times. What is the appropriate response from her nurse? a) "Lilly, you are doing a wonderful job attempting to waken the baby." b) "Lilly, you will never get him to eat all unwrapped like that." c) "Lilly, maybe you should watch the breast-feeding video again." d) "Lilly, that is not how you get him to eat."
"Lilly, you are doing a wonderful job attempting to waken the baby."
The nurse comes into infant Lucy's room on the pediatric floor. She is going to try and feed her for the first time since her surgery. How does the nurse know what infant state Lucy is in by what Mom says and that it is okay to try and feed Lucy? a) "Lucy has been crying every time someone picks her up." b) "Lucy is so quiet today, that is not like her." c) "Lucy is still sleeping, I guess she is worn out." d) "Lucy has been a chatterbox and smiles just like her brother."
"Lucy has been a chatterbox and smiles just like her brother."
A frustrated mother comes to a 9-month well-baby checkup complaining to you that her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which of the following statements would be most appropriate for the nurse to say to this mother? a) "The baby might not be ready for solid food, so wait a month or so and try again." b) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." c) "The baby might be allergic to the particular foods you offered, so try different kinds of food." d) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
The mother of an infant questions the nurse about her baby's teething. The nurse provides client education. Which statement by the mother indicates understanding of the information provided? a) "My baby's first tooth will likely appear between 5 and 6 months." b) "The first teeth that will likely appear are the lower incisors." c) "My baby will most likely have his upper middle teeth come in first." d) "By 1 year my baby should have about three teeth."
"The first teeth that will likely appear are the lower incisors."
Nurse Betty is documenting her postpartum mother and baby. She must document the relationship between the mother and infant. Which observation would demonstrate attachment? a) "The mom is talking to the infant while breast-feeding the infant." b) "The infant remains in the nursery most of the day." c) "The father is always holding the infant." d) "The infant is in the crib every time Betty goes into the room."
"The mom is talking to the infant while breast-feeding the infant."
Bob and Nancy have financial issues and ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents? a) "No, you cannot use a borrowed crib." b) "You can use the crib, but there are guidelines to follow." c) "You should just buy a new crib to be on the safe side." d) "You can use any crib that you want."
"You can use the crib, but there are guidelines to follow."
The nurse enters her patient's room and finds the infant on a pillow with a bottle propped up while mom is dressing. What reaction should the nurse make? a) "Are you almost ready to be discharged?" b) "Look how cute she is." c) "Is she almost done feeding?" d) "You should always hold your baby for feedings instead of propping the bottles."
"You should always hold your baby for feedings instead of propping the bottles."
The mother of 1-week-old boy voices concerns about her baby's weight loss since birth. At birth the baby weighed 7 lb (3.2 kg); the baby currently weighs 6 lb 1 oz (2.8 kg). Which response by the nurse is most appropriate? a) "All babies lose a substantial amount of weight after birth." b) "Your baby has lost a bit more than the normal amount." c) "Your baby has lost too much weight and may need to be hospitalized." d) "Your baby's weight loss is well within the expected range."
"Your baby has lost a bit more than the normal amount."
A 6-month-old arrives for a well-baby visit with a case of diaper rash. The baby's mother tells the nurse she is not concerned and believes this to be normal. She reports that she changes the baby's diaper when he wakes up and before she puts him in his crib for naps or bedtime. It would be important to teach this mother that she should start checking his diaper to see if it needs changing every a) 2-4 hours b) 1/2 hour c) 5 hours d) 1-1 1/2 hours
2-4 hours
The infant measures 21 ½ inches at birth. If the infant is following a normal pattern of growth, which of the following would be an expected height for this child at the age of six months? a) 30 ½ inches b) 27 ½ inches c) 29 inches d) 32 inches
27 ½ inches
The infant measured 20 inches at birth. If the infant is following a normal pattern of growth, which of the following ranges would be an expected height for this child at the age of 12 months? a) 36-38 inches b) 26-28 inches c) 30-32 inches d) 40-42 inches
30-32 inches
The 11 year old arrives in the emergency department presenting with the following: nosebleed with no apparent trauma, disoriented, confused, difficulty walking, nausea, and coughing. The nurse should question the child concerning which potential activity? A.) Falling on the playground at school. B.) Experimenting with an inhalant. C.) Eating a food he is allergic to D.) Exposure to a respiratory disease.
B.) Experimenting with an inhalant.
The nurse is assessing a 9 year old girl during her well-child check up and notes the child weighs 86 lb (39 kg). After noting she weighed 9.5 lb (4.30 kg) at birth and her growth has been within normal patterns, the nurse determines this girl is within which category? A.) Slightly underweight. B.) Slightly overweight. C.) Significantly overweight. D.) Significantly underweight.
B.) Slightly overweight.
The school nurse is preparing to conduct routine health screenings of the elementary school students. Which screening will the nurse prioritize for students ages 6 to 8? A.) Signs of scoliosis B.) Vision and hearing C.) Review immunization records D.) Nutritional needs
B.) Vision and hearing
A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her? a) Be sure to wash the infant's face, hands, and diaper area daily b) Be sure to brush the scalp with a soft toothbrush during the bath to prevent seborrhea c) Be sure to oil the scalp with mineral oil and leave it on overnight before bathing the infant the next day d) Be sure to give the baby a complete bath every day
Be sure to wash the infant's face, hands, and diaper area daily
An infant is breastfed. When assessing her stools, which of the following data would be typical? a) Breastfed infants are less likely to be constipated than bottle-fed infants. b) Breastfed infants usually have fewer stools than bottle-fed infants. c) Stools of breastfed infants are usually harder than those of bottle-fed infants. d) Stools of breastfed infants tend to have a strong odor.
Breastfed infants are less likely to be constipated than bottle-fed infants.
The nurse is monitoring a playgroup of children on a pediatric unit. The nurse predicts the school-age child will MOST likely be participating in which activity? A) Pretending to be mommies and daddies in the playhouse. B) Playing with the plastic vacuum cleaner, pushing it around the room. C) Painting pictures in the art corner of the room. D) Watching a movie with other children their age.
C) Painting pictures in the art corner of the room.
The nurse is addressing a caregivers concerns regarding adequate sleep for an 11 year old child who gets up at 6:30 a.m. each morning. The nurse should point out which time as the most appropriate bedtime for this child? A.) 7:30 p.m. B.) 8:00 p.m. C.) 9:30 p.m. D.) 10:00 p.m.
C.) 9:30 p.m.
The school nurse is meeting with a 10 year old boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestions should the nurse prioritize to help him maintain a healthy weight? A.) Encourage portion control at each meal. B.) Change to a very low-fat and no-carbohydrate diet. C.) Encourage activities that will increase his physical activity. D.) Encourage the child not to worry about his weight until he is older.
C.) Encourage activities that will increase his physical activity.
The nurse is preparing a variety of projects for the pediatric clients on the unit to work on in the playroom. in deciding on projects, the nurse determines the 8 year old will be best suited to work on which activity? A.) Stack blocks in a tower B.) Build a sand castle with a water-filled moat. C.) Form vases from blocks of clay. D.) Put together a model plane.
C.) Form vases from blocks of clay.
The 6 year old at a well-child visit tells the nurse, "I cant play on teams because I am not as good at doing things as my big sister is." what suggestion should the nurse point out to the caregiver that will help increase the child's feelings of self confidence? A.) Ask the child's older sibling to compliment her more often. B.) Praise the child for trying when she can't compete in the same activities as the older sibling. C.) Set up some play dates that include projects or activities in which the child can be successful. D.) Start a rock collection with the child to show her that she ca have fun doing activities that don't involve other children.
C.) Set up some play dates that include projects or activities in which the child can be successful.
The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which ability should appear at this age? a) Sits from standing position b) Uses two or three words with meaning c) Cruises around furniture d) Feeds self with spoon (but spills)
Cruises around furniture
The mother of a 6 year old is asking the nurse how to handle the child's lying and fabricated stories when confronted with questionable actions. Which response would be most appropriate by the nurse? A.) "Your child could be in serious trouble in school if he continues to tell lies." B.)"The child should have privileges taken away for several days each time he tells a lie." C.)"Is there any possibility he is telling the truth and you just don't know it is the truth?" D.) "Children this age sometimes can't distinguish between fantasy and reality."
D.) "Children this age sometimes can't distinguish between fantasy and reality."
The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child? a) A yellow rubber duck for the bath b) Brightly colored stacking toy c) Pots and pans from the kitchen cupboard d) A push-pull toy
A yellow rubber duck for the bath
The nurse is preparing a care plan for a school-aged child to address her hospitalization. Which factor should the nurse incorporate into this plan? A) Increased attention span and interested in an activity for a long length of time. B) Can take in new information at a rapid rate and asks "why" and "how" a lot. C) Insists the can "do it" and then revert to being dependent. D) Grows and develops motor skills more rapidly than at any other time in their life.
A) Increased attention span and interested in an activity for a long length of time.
What is a true statement regarding developmental milestones of the 30-month-old? a) Triples birth weight b) Anterior fontanel closes c) Head circumference equals chest circumference d) Full set of primary teeth
Full set of primary teeth
The nurse is teaching a mother of a 1-year old girl about weaning her from the bottle and breast. Which recommendation should be part of the nurse's plan? a) Wean from breast by 18 months of age at the latest. b) Wean from the bottle at 15 months of age. c) Switch the child to a no-spill sippy cup. d) Give the child an iron-fortified cereal.
Give the child an iron-fortified cereal.
Mark is a 2-month-old that has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that Mark has colic. What is the best intervention to treat colic? a) He needs to try a different formula to assess for sensitivity. b) He is hungry so his mom should feed him more. c) His parents should sing and play music to comfort him. d) His mom should have a regular diet.
He needs to try a different formula to assess for sensitivity.
The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern? a) The child measures 21 in (53 cm) in length. b) Head size has increased 5 in (12 cm) since birth. c) The child weighs 10 lb 2 oz (4.6 kg). d) The child exhibits palmar grasp reflex.
Head size has increased 5 in (12 cm) since birth.
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify? a) Increased biting and sucking b) Running a mild fever or vomiting c) Frequent loose stools d) Choosing soft foods over hard foods
Increased biting and sucking
A parent who is feeding his child formula prepared at home using evaporated milk is concerned about whether the child is receiving all necessary nutrients. Which of the following would be important for this parent to add to his child's diet to supplement the formula? a) Calcium b) Vitamins D c) Iron d) Vitamin E
Iron
When leaving a child who has separation anxiety, parents should say goodbye firmly, explain that they will return, and then leave promptly. a) True b) False
True Prolonged goodbyes only lead to more crying. Sneaking out prevents crying and may ease the parents' guilt, but it can strengthen fear of abandonment so should be discouraged.
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life?
Trust
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 chronically ill adolescent is readmitted to the hospital with an infected wound requiring long-term dressing changes. What is the best way the nurse can encourage independence for this client?
Allow the adolescent to choose the time for the dressing change.
The nurse is caring for children on a postoperative unit. Which nursing action promotes the most efficient pain control?
Anticipate when pain will occur and plan interventions to prevent it.
What advice should the nurse provide the parent of a toddler, regarding how to handle temper tantrums?
Appear to ignore the toddler
After the nurse provides education to new parents about appropriate sleeping habits for infants, which statement by a parent would indicate to the nurse that teaching needs to reoccur?
"My husband gave the baby a special bear that I will place in the crib."
A parent brings a 6-year-old to the clinic and informs the nurse that the child is tired all the time even though the child sleeps 7 to 8 hours each night. What is the best response by the nurse?
"Your child should be getting 11 to 12 hours of sleep per night with some quiet time after school."
During a well-child visit, the mother of a preschooler tells the nurse that her daughter is "daddy's girl." She says, "It seems like I don't exist." Which response by the nurse would be most appropriate?
"Your daughter is showing normal behavior for her age."
During a well-child visit, the mother of a preschooler tells the nurse that her daughter is "daddy's girl." She says, "It seems like I don't exist." Which response by the nurse would be mostappropriate?
"Your daughter is showing normal behavior for her age."
A parent calls the health care provider about the 7-year-old child's dental hygiene. The child has had three cavities. The parent does not know what to do and asks the nurse for guidance. How should the nurse respond?
"Are you able to supervise your child's brushing?"
The mother of a 4-year-old girl reports her daughter has episodes of wetting her pants. The nurse questions the mother about the frequency. The nurse determines these episodes occur about once every 1 to 2 weeks. Which response by the nurse is indicated?
"At this age it is helpful to remind children to go to the bathroom."
A 16-year-old girl has arrived for her sports physical with a new piercing in her navel. Which response by the nurse is best?
"Be sure to clean the navel several times a day."
The parents of a 7-year-old girl report concerns about her seemingly low self-esteem. The parents question how self-esteem is developed in a young girl. Which response by the nurse is best?
"Your daughter's self-esteem is influenced by feedback from people they view as authorities at this age."
According to Piaget, children in the sensorimotor stage of cognitive development have
* A limited concept of time * have imaginary playmates * are very egocentric.
An adolescent's parent states not knowing what to do with the adolescent. The parent reports the adolescent is taking two or three showers a day when not that long ago the parent could barely get the adolescent to take a shower at all. What should the nurse's reply be to the parent?
"Reinforce the family rules but also allow the adolescent to develop one's own routine."
Behaviors that reflect the perioperational stage according to Piaget
* Understanding instructions literally * imitating others' behaviors
Age appropriate milestones: Age 5
* draw a person with a body and at least 6 body parts * copy triangles * dress and undress herself * learning to tie shoes
Parallel play
* occurs when children play with similar toys, beside each other, but are not influenced by other children's play activities * characteristic of toddlers
The health care provider has prescribed a rectal temperature for an 11-month-old infant. The thermometer has been lubricated with a water-soluble lubricant. How far into the rectum would the nurse insert the thermometer?
1/4 to 1/2 inch (0.64 to 1.27 cm)
The nurse is preparing to catheterize an 11-year-old child. The nurse correctly recognizes the child's approximate bladder capacity is what amount?
13 ounces
The parents of an overweight 2-year-old boy admit that their child is a bit "chubby," but argue that he is a picky eater who will eat only junk food. Which response by the nurse is best to facilitate a healthier diet?
"Give him more healthy choices with less junk food available."
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 mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother?
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
A mother is discussing her 10-month old boy with the nurse. Which comment indicates a need for teaching?
"He loves being in his walker and 'zips' around the house." Walkers are safety hazards and not recommended by the American Academy of Pediatrics. They cause falls plus promote the ability to reach items on surfaces otherwise inaccessible. The other comments are age appropriate and acceptable practice.
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 nurse is counseling an overweight, sedentary 15-year-old girl. The nurse is assisting her to make appropriate menu choices. Which statement indicates the adolescent understands how to make appropriate dietary selections?
"I need to have 4 servings of fruit each day."
The nurse is evaluating if nutrition counseling for new mothers has been effective. Which comments by the mothers indicate the need for more instruction? Select all that apply.
"It is much healthier if I puree my own baby food and add a very small amount of salt to make it taste better." "No-spill sippy cups are a good way to limit the amount of juice that comes into contact with the baby's teeth."
In working with the toddler, which of the following statements would be most appropriate to say to the toddler to decrease the behavior known as negativism? a) "You love having the same food every day, do you want apples again with lunch?" b) "It is time for lunch, I am going to put your bib on." c) "Do you want help getting into your chair so we can have lunch?" d) "Are you getting hungry and ready for lunch?"
"It is time for lunch, I am going to put your bib on." Correct Explanation: Limiting the number of questions asked of the toddler and making a statement, rather than asking a question or giving a choice, is helpful in decreasing the number of negative responses from the child
The nurse is preparing to assess the internal ear structures of a 3-year-old. The child is resistant to the otoscope. How should the nurse respond?
"Let's see if I can find some puppies or kittens."
Parents asks the nurse why their child with gastroenteritis is rubbing the abdomen. What is the nurse's best response?
"Rubbing the stomach helps distract the brain from feeling pain."
The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what infant state the child is in by what the mother says and that it is okay to try and feed the infant?
"She has been a chatterbox and smiles just like her brother."
The school nurse is meeting with a group of 11-year-old girls to discuss expected puberty changes in their bodies. When one of the girls states, "I just feel like my whole body is changing and I don't know why" what should the nurse point out to this group?
"You have lots of hormone changes going on right now."
During the first visit to the pediatrician's practice the nurse is performing an admission interview and assessment of a 4-week-old infant. The mother states, "I am sure my baby girl knows my smell because she is much more settled in my arms rather than my mother's arms when she is upset." What is an appropriate response by the nurse?
"You may be right since infants can sense their mother's smell as early as 7 days old."
The parents of a 2-year-old girl are frustrated by the frequent confrontations they have with their child. Which is the best anticipatory guidance the nurse can offer to prevent confrontations?
"You need to adhere to various routines."
A nurse is reviewing the physical exam of a child. The nurse notes that the child's deep tendon reflexes were normal, because they were graded as:
2+
The nurse is talking with a group of caregivers of 3-year-old children. One of the parents asks what an appropriate amount of time would be to have the 3-year-old who is being uncooperative and is out of control to sit alone in a "time out" space? The nurse would suggest that an appropriate amount of time would be a) 15-20 minutes b) 10-12 minutes c) 25-30 minutes d) 2-3 minutes
2-3 minutes Correct Explanation: A useful method for dealing with a child who is not cooperating or who is out of control is to send the child to a "time out" space. This should be a place where the child can be alone but may be observed without other distractions. The duration of the isolation should be limited: 1 minute per year of age is usually adequate.
The preschool age grows about _____ inches each year.
2.5 to 3 inches
The infant weighs 7 lbs. 4 oz. at birth. If the infant is following a normal pattern of growth, which of the following would be an expected weight for this child at the age of 12 months? a) 28 lbs. 4 oz. b) 25 lbs. c) 21 lbs. 12 oz. d) 14 lbs. 8 oz.
21 lbs. 12 oz.
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit?
24 pounds (10.8 kg) and 30 inches (75 cm)
A nurse realizes the importance of nutritional assessment during the health history. When doing so, the nurse must assess the quality as well as quantity of food eaten. The best way to assess food intake is to do:
24-hour recall.
The parents of a 30-month-old girl have brought her into the emergency department because she had a seizure. During the health history, the nurse suspects the child had a breath-holding spell. Which of the following parental reports suggests breath-holding? a) The child was lethargic afterward. b) The event took place during a nap. c) The child became unconscious. d) A tantrum preceded the event.
A tantrum preceded the event. Correct Explanation: The fact that there was a precipitating event of frustration and anger points to the likelihood that this is a cyanotic breath-holding spell. Breath-holding spells never occur during sleep, nor do they feature postictal confusion. Unconsciousness is not definitive because it is common to both seizures and breath-holding spells.
The nurse is asessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check?
Eye coordination
The parents of an overweight 2 year old boy admit that their child is a bit "chubby", but argue that he is a picky eater who will eat only junk food. Which is the best response by the nurse to facilitate a healthier diet?
Give him more healthy choices with less junk food available
The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation?
He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.
A 2-month-old boy has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?
He needs to try a different formula to assess for sensitivity.
A nurse is reading a journal article about adolescents and major causes of injuries in this age group. The nurse demonstrates understanding of this information by identifying which situation as the major cause of adolescent injuries?
Motor vehicle crashes
Once a temper tantrums has started, which intervention is appropriate?
Move objects out of the way or move the toddler to prevent injury.
When preparing to administer medication to an infant, the nurse should utilize which device?
Oral syringe without a needle
The nurse is promoting a healthy diet to the mother of a 6-month-old girl. Which of the following would have the most effect on the infant's neurologic development?
Promoting continuation of breastfeeding Continuing to breastfeed ensures the proper level of nutritional fat for myelination of the nervous system. Having adequate dietary iron would help prevent anemia as the stores from fetal development are depleted. Promoting increased intake of solid foods is not necessary at 6 months and may diminish the amount of breast milk consumed. Fruit juice in the diet is not recommended. Fruits provide more nutrition and will soon be gradually added to the infant's diet.
On physical examination, the nurse discovers that a 6-year-old child's palatine tonsils are somewhat enlarged in the back of the throat. What would be the nurse's best action?
Record this as a normal finding in an early school-age child.
The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:
Refer the infant for developmental and/or neurologic evaluation. There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.
The nurse is observing the behavior of a preschool-aged child and becomes concerned. Which observation suggests that the child's thinking is inconsistent with normal preschooler growth and development?
Refusing to play with "real" children
Included in the nursing care plan for the child receiving total parenteral nutrition (TPN) will be which intervention?
Regularly monitoring the child's blood glucose
The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice? a) Provide small portions that must be eaten b) Let the child eat only the foods she prefers c) Serve new foods several times d) Actively urge the child to eat new foods
Serve new foods several times
What are some negative effects that chronic pain can have on the pediatric population?
Sleep disturbances, exhaustion, irritability, mood disturbances, and depression
In working with the infant age child, the nurse recognizes which of the following as a characteristic of the infant. a) The child grows and develops skills more rapidly than at any other time in their life b) The child has an increased attention span and can be interested in an activity for a long length of time c) The child takes in new information at a rapid rate and asks "why" and "how" d) The child insists they can "do it," the next moment they revert to being dependent
The child grows and develops skills more rapidly than at any other time in their life
The nurse is observing a 3 year old boy in a daycare center. Which behavior might suggest an emotional problem?
The child has persistent separation anxiety.
The nurse is observing a 36 month old boy during a well visit. Which motor skill has he most recently acquired?
The child is able to undress himself
A mother expresses surprise to the nurse that her toddler daughter has begun masturbating. The most important initial nursing response is: a) Toilet teaching places much focus on the genitals. b) This is a normal and expected activity best treated matter-of-factly. c) Toddler girls as well as boys will masturbate. d) Check for undue stress in your toddler's life.
This is a normal and expected activity best treated matter-of-factly. Correct Explanation: Masturbation is a normal event to be done in private. Calling attention to the behavior may increase the frequency. Both girls and boys masturbate, and toilet teaching calls attention to the genital area. These two statements are accurate information but not the best first response. Excessive or public masturbation points to stress.
The father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent?
Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.
A father brings his 2-year-old son in for a well visit. The nurse assesses his growth since the last appointment. Which of the following findings should concern the nurse? a) Total weight gain of 15 lb in the past year b) Increase in height of 5 inches in the past year c) Prominent abdomen d) Forward curve of the spine at the sacral area
Total weight gain of 15 lb in the past year Explanation: A child gains only about 5 to 6 lb (2.5 kg) and 5 in (12 cm) a year during the toddler period, much less than the rate of growth during the infant year. Because the weight gain of the boy in this scenario is so much greater than normal, the nurse should be concerned that the boy is overweight or obese. All of the other findings listed are normal for a 2-year-old.
Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases
A toddler's mother tells you that no matter what she asks of her child, he says, "No." A suggestion you might make to help her handle this problem is for her to a) give him secondary, not primary, choices. b) ask no further questions of him. c) pretend she does not hear him. d) tell him never to say, "No" again.
give him secondary, not primary, choices. Correct Explanation: Encouraging toddlers to express their opinion aids in developing a sense of autonomy; allowing secondary choices encourages this without disrupting family life.
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.
Coorination of secondary schema is seen in
infants at age 10 months
Primary circular reaction is seen in
infants of 3 months
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is:
looking for a toy in her crib at the last place she saw it.
During a well-child visit, the nurse observes the child saying "no" to her mother quite frequently. The mother asks the nurse, "How do I deal with her saying no all the time?" Which of the following would be appropriate for the nurse to suggest? Select all that apply. a) "Use timeout every other time she tells you no." b) "Offer her something she would like, such as ice cream, to distract her." c) "Limit the number of questions you ask of her." d) "Offer her two options from which to choose." e) "Make a statement instead of asking a question."
• "Limit the number of questions you ask of her." • "Offer her two options from which to choose." • "Make a statement instead of asking a question." Correct Explanation: A toddler's "no" can best be eliminated by limiting the number of questions asked of the child. In addition, using statements instead of asking questions and keeping the child to a choice between two options are effective. Using timeout is a discipline measure and would be inappropriate to counteract a toddler's negativism. Offering a choice rather than a bribe such as ice cream is more effective and longer lasting for modifying the child's behavior.
The nurse is teaching the mother of a 5-month-old boy who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. a) Telling the mother this behavior usually decreases by 6 to 9 months of age b) Informing the mother that thumb sucking occurs more often during periods of stress c) Advising the mother this behavior is a form of self-comfort d) Assuring the mother this behavior won't cause malocclusion
• Advising the mother this behavior is a form of self-comfort • Assuring the mother this behavior won't cause malocclusion • Informing the mother that thumb sucking occurs more often during periods of stress • Telling the mother this behavior usually decreases by 6 to 9 months of age
The mother of a toddler boy half-jokingly states: "I am so tired of hearing 'NO!' I wish he would stop!" What suggestions will the nurse offer to reduce toddler negativism? Select all that apply.
• Avoid "yes" and "no" questions. • Offer simple choices: "Blue shirt or red one?" • Make statements: "It is time for lunch." • Avoid ending a request with "Okay?" • Use humor to make "no" funny: "Do cows bark?"
The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? Select all that apply.
• Counting 10 or more objects • Correctly naming at least four colors • Understanding the concept of time • Knowing everyday objects
The nurse is helping parents prepare a healthy meal plan for their toddler. Which guidelines for promoting nutrition should be followed when planning meals? Select all that apply.
• Extending breastfeeding into toddlerhood is believed to be beneficial to the child. • Adequate calcium intake and appropriate exercise lay the foundation for proper bone mineralization. • The toddler requires an average intake of 500 mg calcium per day.
Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds
• Johnny is growing slowly in height but rapidly in weight. • Johnny may be at risk for overweight or obesity. • Johnny's height and weight should be plotted on a growth chart.
** The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.
• Plans activities and makes up games • Initiates activities with others • Acts out roles of other people
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply.
• Plans activities and makes up games • Initiates activities with others • Acts out roles of other people
A nurse is presenting a class on toilet training to a group of parents with toddlers. Which information would the nurse include in the class? Select all that apply.
• Putting the child on the potty chair at regular intervals during the day • Using training pants that slide down easily and quickly • Praising the child when he or she urinates or defecates
A nurse is instructing a young mother on how to ensure a safe bath time for her 4-year-old son. Which of the following are important suggestions for the nurse to give to the mother? (Select all that apply.)
• Turn down the temperature of the water heater to under 120°F • Do not leave the child unsupervised in the bath tub • Assist the child in cleaning under fingernails and around ears
The nurse is conducting a physical examination of a 5-month-old boy. Which of the following observations may be cause for concern about the infant's neurologic development?
The infant displays an asymmetric tonic neck reflex (fencing reflex). The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age.
The nurse is assessing development of a 4-month-old boy during a well-child visit. Which of the following observations needs further investigation?
The infant responds to his mother when he sees her but not at other times when she is near.
The nurse is assessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check? A) Visual acuity B) Eye coordination C) Depth perception D) Color perception
B) Eye coordination
Which of the following immunizations would you plan to administer at a preschool health maintenance visit?
DTaP
The nurse is talking to the parent of a 19-month-old toddler about setting limits and supervising activities. In which situation will the nurse recommend letting the toddler do as he or she pleases?
Exploring one's body
The site most often used when administering a medication using the intradermal route is the:
forearm.
A 4-year-old child is being prepared to undergo a bronchoscopy to remove an aspirated pea. The nurse knows that the parents need reteaching based on which statement?
"We will be able to take our child home immediately after the procedure is completed."
The father of a 6-week-old infant voices concerns about his son's stooling. He further shares that his son grunts and cries when having a bowel movement. What response by the nurse is most appropriate?
"What does his stool look like?"
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans? A) Teens are busy developing their own personal identity. B) They want to successfully complete activities. C) Each child is learning to do things on his or her own. D) They understand and respond to discipline.
A) Teens are busy developing their own personal identity.
A mother is concerned because her 14-month-old son, who had a big appetite when breastfeeding a few months ago, seems uninterested in eating solid food. She still breastfeeds him daily, but is thinking of weaning him soon. How should the nurse respond to this mother? a) "It is normal for toddlers to lose their appetites; try weaning him all at once so that he will be more interested in the solid food." b) "It is not normal for toddlers to lose their appetites; have him tested for a gastrointestinal condition." c) "It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate." d) "It is not normal for toddlers to lose their appetites; spoon feed him yourself to make sure he gets proper nutrition."
"It is normal for toddlers to lose their appetites; try starting him with just a tablespoonful of food on his plate." Correct Explanation: Because growth slows abruptly after the first year of life, a toddler's appetite is usually less than an infant's. Children who ate hungrily 2 months earlier now sit and play with their food. It is important to educate parents while the child is still an infant this decline in food intake will occur so they will not be concerned when it happens. Because the actual amount of food eaten daily varies from one child to another, teach parents to place a small amount of food on a plate and allow their child to eat it and ask for more rather than serve a large portion the child cannot finish. One tablespoonful of each food served is a good start. The nurse should recommend that the mother wean her son gradually to avoid confrontation, not all at once. Most toddlers insist on feeding themselves and generally will resist eating if a parent insists on feeding them.
The parents of a 3-year-old boy tell the nurse that they are having another baby in several months. They ask the nurse for suggestions to help their son adapt to the new baby. Which of the following would the nurse suggest? a) "Move the boy to a big boy bed to make him feel like the big brother." b) "Tell the child that your time needs to be spent with the new baby." c) "Be prepared to discipline the child if he does something to make the baby cry." d) "Let the child participate in caring for the new baby."
"Let the child participate in caring for the new baby." Correct Explanation: Young children who are involved in a newborn's care adapt better than those who are not and thus have fewer feelings of sibling rivalry. During this time, it is wise not to introduce any new developmental tasks such as toilet training, weaning from a nighttime bottle, or changing from a crib to a toddler bed. Encourage parents to spend extra alone time with the child to decrease sibling rivalry. If the child does something to make the new baby cry, the parents should investigate the reason behind the action and talk to the child about it, rather than discipline the child.
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? A) Pretending to be mommies and daddies in the playhouse B) Playing a board game C) Painting pictures in the art corner of the room D) Watching a movie with other children their age
A) Pretending to be mommies and daddies in the playhouse
During the toddler years, the child attempts to become autonomous. If the following statements were made by caregivers of 3-year-old children, which observation reflects that the child is developing autonomy? a) "Every night my child follows the same routine at bedtime." b) "My child has temper tantrums when we go to the store." c) "My child uses the potty chair and is dry all day long." d) "When my child falls down, he always wants me to pick him up."
"My child uses the potty chair and is dry all day long." Correct Explanation: Being toilet trained is an example of the toddler developing autonomy or independence.
A 15-year-old female adolescent tells the nurse she would like to get a tattoo. What response by the nurse is most appropriate?
"Tattoos are invasive and there is the potential for disease with their application."
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."
The nurse is caring for a 10-year-old girl and is trying to obtain clues about the child's state of physical, emotional, and moral development. Which question is most likely to elicit the desired information?
"Tell me about your favorite activity at school?"
A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother?
"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
The nurse is caring for a 4-year-old child who requires a venipuncture. To prepare the child for the procedure, which explanation is most appropriate?
"The doctor will look at your blood to see why you are sick."
A nurse is interviewing a parent regarding the 2-year-old child's recent illness. The nurse would like the parent to elaborate about any symptoms of the illness noticed. Which would be the most effective question for the nurse to ask the parent in this situation?
"What symptoms has your child exhibited?"
After teaching a group of parents about language development in toddlers, what if stated by a member of the group indicates successful teaching?
"When my 3-year-old asks 'Why?' all the time, this is completely normal."
A mother asks the nurse where the microwave is so that she can warm up breastmilk to feed her baby. What is the best response by the nurse?
"You should warm the milk under warm water instead."
By which age should the child know his/her own gender? a) 4 b) 2 c) 3 d) 1
3 Explanation: By the age of three, the child should know his or her own gender. The other age ranges are incorrect.
A mother is concerned that her infant is not gaining adequate weight. The baby is 6 weeks old. Birth weight was 7 pounds 8 ounces (3,400 g). The child should weigh about __________________.
9 pounds (4.32 kg) The child should gain about 20 to 30 g daily while making up the common 10% weight loss following birth.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents? A) "This is normal for this age group. It's referred to as solitary independent play." B) "You should try to get your child involved in a local Boy's and Girl's club to encourage more interaction." C) "Perhaps getting your child interested in sports will improve their other play habits." D) "Your child is involved with others, just indirectly. See how they sit next to the other children and play with the same toys?"
A) "This is normal for this age group. It's referred to as solitary independent play."
The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth? A) The first tooth usually erupts between 6 to 8 months. B) The upper incisors are most often the first teeth to erupt. C) Fluoride should not be used on a child's teeth before 4 or 5 years of age. D) Swollen or inflamed gums during teething indicate a serious concern.
A) The first tooth usually erupts between 6 to 8 months.
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? A)Hop on one foot B) Walk backwards with heel to toe C) Throw and catch a ball D) Jump rope
A)Hop on one foot
An 8 year old boy's foster mother is concerned about three recent cavities found in his permanent teeth and reports the child eats a nutritional diet, doesn't eat junk food, and the town water supply is fluoridated. Which suggestion should the nurse prioritize to this mother in regard to the child's dental health? A.) Encourage the child to abstain from eating sugary snacks at school. B.) Accept that the child is genetically predisposed to having more cavities than most children. C.) Ensure that the child brushes his teeth after each meal and snacks. D.) Have the child's teeth professionally cleaned every three months.
C.) Ensure that the child brushes his teeth after each meal and snacks.
The nurse is assessing an adolescent in the clinic at a routine well-visit. Which question should the nurse prioritize to encourage the adolescent to share detailed information? A) "Do you like members of the opposite sex?" B) "Do you go out on dates frequently?" C) "Are you sexually active?" D) "Do you have oral, anal, or vaginal sex?"
D) "Do you have oral, anal, or vaginal sex?"
Which of the following is appropriate with reference to enhancing a child's self-esteem? a) Avoid applauding for unsuccessful attempts. b) Utilize negative criticism as well as positive reinforcement. c) Include the child in activities that interest the adult. d) Utilize belittling techniques as opposed to time-outs.
Include the child in activities that interest the adult. Correct Explanation: Strategies for enhancing self-esteem encompass including the child in activities that interest the adult. Belittling techniques should not be used. Negative criticism should be avoided. Applauding for unsuccessful attempts as well as successes should be reinforced.
The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium?
Orange
A group of nursing students are completing a clinical day at a preschool. Which behaviors would they identify as common in this preschool group? Select all that apply.
Regression Telling of tall tales Imaginary friends Sibling rivalry Difficulty with sharing
In caring for the child with asthma, the nurse recognizes that bronchodilator medications are administered to children with asthma for which reason?
Relief of acute symptoms
A nurse is educating a client being discharged with her newborn baby. What is the highest priority item that must be included in the teaching plan?
Restrain the baby in a car seat.
A family has recently moved into the area and is bringing their 18-month-old son in to the office for his first visit. The father is in dusty work clothes and explains that they are in the process of restoring the house they recently moved into, which was built in the 1920s and which had been vacant for many years. The nurse urges the father to have a blood test done on the son. Which of the following is the best rationale for this intervention? a) Risk for developing tetanus due to all of the construction going on b) Risk for ingestion of cleaning products they may have been left out due to the renovation c) Risk for lead paint poisoning due to the age of the house d) Risk for development of diabetes due to all of the high-calorie fast foods the family is consuming while their kitchen is under construction
Risk for lead paint poisoning due to the age of the house Correct Explanation: The best rationale for the nurse's intervention is the risk for lead paint poisoning due to the age of the house. All children between the ages of 6 months and 6 years who live in communities with buildings built before 1950 should be tested for the presence of too much lead in their body (lead poisoning). Elevated lead levels are caused by eating, chewing, or sucking on objects (such as windowsills, paint chips, or furniture) that are covered with lead-based paint. There is not enough evidence in the scenario to indicate that the child may be at risk for developing tetanus or that he has ingested cleaning products; in any case, the interventions for these would not include a blood test. There is no basis in the scenario for the suspicion of diabetes in the child.
A nurse is administering subcutaneous deferoxamine to a client as a treatment for sickle cell anemia. The nurse should monitor the client for several potential side effects. Which side effect requires the nurse's immediate attention?
Tachycardia
A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client?
Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail.
The nurse is assessing a 3 year old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
Tertiary circular reactions
The nurse is completing a developmental assessment on a 6-month-old infant. Which findings indicate the need for additional follow-up? Select all that apply.
The infant has frequent episodes of crossed eyes. The infant does not pay attention to noises behind him. The infant seems disinterested in the surrounding environment.
Animism is
attributing life-like qualities to inanimate objects.
During a well-child check at the ambulatory clinic, the mother of a 10-year-old boy reports concerns about her son's frequent discussions about death and dying. Based upon knowledge of this age group, the nurse understands that:
preoccupation with death and dying is common in the school-aged child.
When childproofing the home for a toddler, the most important thing her parents should consider is to a) lock downstairs windows. b) put medicine in a locked cupboard. c) keep the child in a playpen while the parents cook. d) teach the child not to tease dogs.
put medicine in a locked cupboard. Correct Explanation: Poisoning is at peak incidence during the toddler period. Special precautions need to be taken against poisoning at this time.
A 2-year-old toddler holds the breath until passing out when the toddler wants something the parent does not want the toddler to have. The nurse would base evaluation of whether these temper tantrums are a form of seizure on the basis that:
seizures are not provoked; temper tantrums are.
A 2-year-old holds his breath until he passes out when he wants something his mother does not want him to have. You would base your evaluation of whether these temper tantrums are a form of seizure on the basis that a) seizures rarely occur in toddlers. b) seizures are not provoked; temper tantrums are. c) with seizures, cyanosis rarely develops. d) seizures typically occur with fever; temper tantrums do not.
seizures are not provoked; temper tantrums are. Correct Explanation: Temper tantrums occur because children are angry or frustrated; seizures occur without respect to provocation.
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex: a) is a protective reflex and retained for life. b) should be pronounced and easy to elicit. c) should have disappeared. d) is expected to appear within 1 month.
should have disappeared.
The grandmother is the primary caregiver of her 2-year-old granddaughter. She expresses her concern that the child has temper tantrums two or three times a day, often in public places. She explains that she spanked her own children when they did this but now she is worried that spanking is not the best way to handle the situation. She asks the nurse for help with ways to deal with the temper tantrums. In answer to her question, the nurse makes the following statements. Which statement is the most appropriate regarding dealing with the child who has a temper tantrum? a) "Remain calm, pick the child up, and move her to a quiet and neutral place until she gains self-control; don't give in to her demands." b) "Remind her that she is in a public place and ask her to respect those around her; reward her if she responds by calming herself." c) "When the child has a tantrum in a public place, warn her that she will be punished when she is back at home then follow through with the punishment." d) "Spanking is controversial but sometimes necessary, so use it if it works."
"Remain calm, pick the child up, and move her to a quiet and neutral place until she gains self-control; don't give in to her demands." Correct Explanation: Remaining calm is a must. It is not easy to handle a small child who drops to the floor screaming and kicking in rage in the middle of the supermarket or the sidewalk, nor are comments from onlookers at all helpful. The best a caregiver can do is pick up the out-of-control child as calmly as possible and carry him or her to a quiet, neutral place to regain self-control. Reasoning, scolding, or punishing during a tantrum is useless. Do not yield the point or give in to the child's whim. That would tell the child that to get whatever one wants, a person need only throw oneself on the floor and scream. The child would have to learn painfully later in life that people cannot be controlled in this manner. Spanking or other physical punishment usually does not work well because the child is merely taught that hitting or other physical violence is acceptable and a child who is spanked frequently becomes immune to it.
The nurse is providing anticipatory guidance to the parents of a 15-year-old who voice concerns with their teenager's sleep habits. They state, "Left to her own devices, I'm sure she'd stay up until 3:00 in the morning on the weekends and sleep until after lunchtime." Which should the nurse explain to the parents?
"That must be hard for you to manage. Perhaps we can explore some strategies with her to establish more predictable sleep patterns."
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 young breastfeeding mother calls the telephone nurse because she is concerned about her 3-month-old's stools. Which statement is of concern?
"The stools are foamy and smell terrible." This may indicate a digestive problem or illness. The physician or nurse practitioner should be contacted. All the other statements describe normal stooling.
A mother brings her 8-year-old daughter into the doctor's office because over the past year her tonsils have increased in size to the point that the mother is concerned that her breathing will be obstructed. The girl has no pain, fever or other symptoms. Following this data collection, which instruction is best?
"This may be normal growth of lymphatic tissue for this age."
The parent of a 4-year-old child tells the nurse about being frustrated because all the parent seems to do lately is fight with the child over what the child wants to eat and wear. The parent notes sometimes wanting to spank the child for always disagreeing. What would be the bestsuggestion for the nurse to make to this parent?
"Use the time-out technique for discipline."
The nurse is showing the student nurse how to flush a pediatric client's peripherally inserted central catheter (PICC) line. The nurse prepares a 3-mL normal saline flush using a 5-mL syringe. The student asks the nurse why the flush was prepared this way. What is the most accurate response by the nurse?
"Using a larger-volume syringe exerts less pressure on the PICC line."
A mother who is returning to work outside the home has found a daycare center close to her office and is eager to have her 15-month-old son placed there so he can be close by. The center will only take children who are potty-trained. The mother asks the nurse for advice about how to persuade her son to use the potty. Which of the following would be the most appropriate response for the nurse to make to this mother? a) "Encourage your son to watch his older siblings use the toilet." b) "Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." c) "Each time you change his diaper, tell your son how important and fun it is to use the potty chair." d) "Get your son a potty chair and have him sit on it for a few minutes each day."
"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." Explanation: To be able to cooperate in toilet training, the child's anal and urethral sphincter muscles must have developed to the stage where the child can control them. Control of the anal sphincter usually develops first. The child also must be able to postpone the urge to defecate or urinate until reaching the toilet or potty and must be able to signal the need before the event. In addition, before toilet training can occur, the child must have a desire to please the caregiver by holding feces and urine rather than satisfying his/her own immediate need for gratification. This level of maturation seldom takes place before the age of 18-24 months.
The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed?
"We just got him a new bike he can grow into."
A group of caregivers of toddlers are discussing the form of discipline in which the child is placed in a "time-out" chair. Which of the following statements made by these caregivers is most appropriate related to this form of discipline? a) "When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to 'time out.'" b) "Our 'time-out' chair is in the master bedroom so she can't see anyone else in the family." c) "We use the 'time-out' chair when our son gets tired but doesn't want to take a nap." d) "She is two years old now and I put her in 'time out' for five to 10 minutes when she misbehaves."
"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to 'time out.'" Correct Explanation: A method for a child who is not cooperating or who is out of control is to send the child to a "time-out" chair. This should be a place where the child can be alone but observed without other distractions. The duration of the isolation should be limited—one minute per year of age is usually adequate. Caregivers should warn the child in advance of this possibility, but only one warning per event is necessary.
A group of caregivers of toddlers are discussing the form of discipline in which the toddler is placed in a "time-out" chair. Which statement made by these caregivers is most appropriate related to this form of discipline?
"When my son starts getting frustrated and aggressive, I remind him that if he throws a fit he will have to go to time out."
The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. What should the nurse say in response?
"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready."
The father of a 2-year-old girl tells the nurse that he and his wife would like to begin toilet training their daughter soon. He asks when the right time is to begin this process. Which of the following should the nurse say in response? a) "The best time to start toilet training is as soon as the child begins walking." b) "It is best to wait a little longer, until she is 3; only then will she be socially developed enough to understand what you are asking her to do." c) "When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." d) "She's well past the age to begin toilet training; most children are ready by age 1, when they have developed the needed nervous control."
"When she starts tugging on a wet or dirty diaper, she is letting you know she's ready." Correct Explanation: The markers of readiness are subtle, but as a rule children are ready for toilet training when they begin to be uncomfortable in wet diapers. They demonstrate this by pulling or tugging at soiled diapers. Because physiologic development is cephalocaudal, the rectal and urethral sphincters are not mature enough for control in most children until at least the end of the first year, when tracts of the spinal cord are myelinated to the anal level. A good way for a parent to know a child's development has reached this point is to wait until the child can walk well independently. Toilet training need not start this early, however, because cognitively and socially, many children do not understand what is being asked of them until they are 2 or even 3 years old.
The nurse is talking with the parents of a newborn who is being discharged following an uneventful delivery. The parents express their excitement about going home but have concerns about what they need to do to help their 2-year-old adjust to the new baby. Which of the following suggestions would be most appropriate for the nurse to offer these parents? a) "You should plan some time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant." b) "It would be good to have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit." c) "It would be helpful to move the toddler to a new bedroom with a "grown-up" bed." d) "You should plan some time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant."
"You should plan some time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant." Correct Explanation: The secondary caregiver can occasionally take over the care of the new baby while the mother or other primary caregiver devotes herself to the toddler. The primary caregiver might also plan special times with the toddler when the new infant is sleeping and the caregiver has no interruptions. This approach helps the toddler feel special. Moving the older child to a larger bed lets the toddler take pride in being "grown up" now, but it should be done some time before the new baby appears.
A mother of a toddler asks the nurse, "How will I know that my daughter is ready for toilet training?" Which response by the nurse would be most appropriate? a) "Most children are ready for toilet training by the time they are 18 months old." b) "You'll probably notice that your daughter is uncomfortable in wet diapers." c) "Don't worry, your daughter will probably give you very definite signals." d) "Your daughter can understand holding urine and stool by about 1 year of age."
"You'll probably notice that your daughter is uncomfortable in wet diapers." Correct Explanation: The markers of readiness for toilet training are subtle, but, as a rule, children are ready for toilet training when they begin to be uncomfortable in wet diapers. Although the rectal and urethral sphincters are mature by the end of the first year, children are not cognitively and socially ready. In fact, many children do not understand what is being asked of them until they are 2 or even 3 years old.
The mother of a newborn reports she does not think her baby likes his formula since he spits up after only taking a small amount. Which response by the nurse is most appropriate?
"Your baby's stomach is small and can only hold about 1/2 to 1 ounce at birth."
The parent of a preschool-aged child reports that the child seems to believe in imaginary things. The parent voices concern that this "fantasy world" may become a problem. What response(s) by the nurse is indicated? Select all that apply.
"Your child is engaging in what we call magical thinking." "This type of thought process allows your child to begin to observe the differences in the world."
The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler? A) Use scissors. B) Button clothes. C) Tie shoelaces. D) Print a few letters.
B) Button clothes.
The school nurse is discussing obesity with a group of caregivers of school-aged children. Which statement by the caregivers best illustrates that they are prepared to help their child prevent obesity? A) "I always cook foods that are low in fat." B) "We eat fast foods only on weekends because we are too busy to cook." C) "Neither my husband nor I have ever had any concerns with weight." D) "I keep lots of snacks on hand because my child eats all day long."
A) "I always cook foods that are low in fat."
The parents of a 30-month-old toddler have brought the toddler into the emergency department because of a seizure. During the health history, the nurse suspects the toddler had a breath-holding spell. Which parental report suggests breath-holding?
A tantrum preceded the event.
The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?
A yellow rubber duck for the bath The rubber duck is most appropriate. It is safe, is visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.
An 8-month-old child is diagnosed with a second ear infection and the father is concerned the infections are being caused by something he is doing or by something in the child's development. Which question should the nurse prioritize to collect more information to answer this father's questions? A) "Does the baby go to bed with a bottle of formula each night?" B) "Does the baby teething appear to be teething?" C) "Are the baby's scalp and hair shampooed often?" D) "Are you supplementing the baby's home-prepared formula with vitamin C?"
A) "Does the baby go to bed with a bottle of formula each night?"
The nutritionist is presenting information about vegetarian diets with a group of nursing students. The nutritionist determines the session is successful when the students correctly choose which factor concerning the semi-vegetarian diet? A) "The diet excludes red meat and possibly poultry." B) "The diet excludes red meat, poultry, and fish." C) "The diet excludes meat, poultry, fish, and eggs." D) "The diet excludes dairy products, meat, poultry, fish, and eggs."
A) "The diet excludes red meat and possibly poultry."
The nurse is conducting a class for new parents of infants. The nurse determines the session is successful when the parents correctly choose which instruction concerning bathing their infant? A) "When I bathe my baby, I shampoo his hair each time as well." B) "Giving my baby a bath every day during cold weather will help her stay warm." C) "My husband uses plain water on our baby's face but I use mild soap." D) "Now that my baby is bigger, she seems to enjoy having powder applied after her bath."
A) "When I bathe my baby, I shampoo his hair each time as well."
A 17-year-old female is meeting with the nurse for an annual well-visit and is asking the nurse questions about how to know when one is in love. The nurse should point out which factor to help decide if both individuals have reached a mutual agreement and are ready for an intimate relationship? A) A sense of trust and identity B) An ability to be autonomous C) A willingness to take initiative D) An understanding of socialization and of isolation
A) A sense of trust and identity
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? A) Allow the child to touch and play with the nebulizer for a few minutes before the treatment. B) Show the child how to use the nebulizer and tell the child how much easier it is to breathe afterward. C) Explain that the child will feel better after the treatment and allow the child to ask questions. D) Use a poster or brochure to illustrate to the child how the machine works.
A) Allow the child to touch and play with the nebulizer for a few minutes before the treatment.
The nurse is preparing a presentation for a local health fair depicting the differences in maturity between preadolescents. Which differing factor should the nurse prioritize in the presentation? A) Boys grow at a slower, steadier rate than do girls. B) Girls grow at a slower, steadier rate than do boys. C) Boys grow at a rapid, sporadic rate. D) Boys and girls grow at the same rate.
A) Boys grow at a slower, steadier rate than do girls.
The mother of a 4-year-old is concerned her child is not eating well. In addressing the concerns of this mother, which foods should the nurse point out are high in protein? Select all that apply. A) Cheese and crackers B) Cookies and juice C) Whole grain granola with yogurt D) Strawberries and bananas E) Turkey sandwich
A) Cheese and crackers C) Whole grain granola with yogurt E) Turkey sandwich
The nurse is conducting a class at the local health department office for new mothers of infants who are in the various stages of weaning. Which alternative food should the nurse prioritize when questioned by a mother whose infant is refusing to drink milk from a cup to ensure the infant is consuming enough calcium? A) Cottage cheese B) Pudding C) Rice cereal D) Bananas
A) Cottage cheese
The nurse is meeting with a group of adolescent athletes to discuss their nutritional needs. The nurse should encourage the adolescents to include which foods in their diet to increase iron intake? Select all that apply. A) Dried fruits B) Peanuts C) Milk shakes D) Grapes E) Hard-boiled eggs F) Cheese sticks
A) Dried fruits
The school nurse is assessing a 6 year old child's dentition. Which assessment should the nurse prioritize for this child? A) Has first permanent molars. B) Has at least six permanent teeth. C) Has two cuspid or canine teeth. D) Has lost all deciduous teeth.
A) Has first permanent molars.
The nurse is conducting a training session for families who are to receive assistance from the Women, Infants, and Children (WIC) supplemental food program. The nurse determines the session is successful after the participants correctly choose which food items they will be able to receive through the program? Select all that apply. A) Milk B) Dry beans C) Peanuts D) Juice E) Bread F) Eggs
A) Milk B) Dry beans D) Juice E) Bread F) Eggs
A 2-year-old child is reported to be a "picky eater" by his father. What pointers could the nurse provide the parent to help minimize stress related to mealtime? Select all that apply. A) Offer small portions of 1 to 2 teaspoons to the child. B) Food jags needs to be addressed and not given in to. C) Mealtime for a toddler should not exceed 20 minutes. D) Do not use sweets as a reward for cleaning their plate. E) Feed the toddler before the rest of the family.
A) Offer small portions of 1 to 2 teaspoons to the child. C) Mealtime for a toddler should not exceed 20 minutes. D) Do not use sweets as a reward for cleaning their plate.
The pediatric nurse is discussing the daily activities of a 4-year-old with the caregiver to assess growth and development status. The nurse would document that the child has reached the initiative stage of development if the caregiver indicates the child participates in which activity? A) Tries to sweep up spilled cereal but cries when can't do well B) Broke a dish but blamed it on some friend the caregivers don't know C) Refuses to hold anyone's hand while crossing the street D) Gets upset when a babysitter is in charge, but will do what is asked by the babysitter
A) Tries to sweep up spilled cereal but cries when can't do well
The mother of an adolescent has called to talk to the pediatric nurse over concern that her daughter is not getting proper nutrition now that she has started following a vegetarian diet. Which response should the nurse prioritize for this mother? A) Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes. B) Lacto-ovo vegetarian diets are acceptable for teens but, until the body's growth cycle is complete, she needs some egg and dairy products for good health. C) Vegetarian diets can be healthy for teens but should be supplemented with protein drinks and megavitamins. D) A vegetarian diet is unhealthy for growing bodies, and teens are too immature to make a healthy decision.
A) Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes.
The mother of a 9-year-old girl calls the physician's office complaining that her daughter continues to vomit soon after being given an oral amoxicillin capsule for her strep throat. The nurse recognizes that the child's vomiting will interfere with which pharmacokinetic process?
Absorption
The nurse is promoting language and cognitive development to the parents of a 3-year-old boy. Which guidance about reading with their child will be most helpful? a) Read a different book if he knows the story. b) Keep story time a reward for being good. c) Ask the child questions as you read. d) Have the child sit still during the story.
Ask the child questions as you read. Correct Explanation: Engage the child by asking him questions as he listens. This gives him a chance to contribute to the story. The child does not have to sit still. He may want to move around or even act out part of the story. Story time should happen regularly and not be just a reward. Even if the child can tell the story, he may wish to hear it read again because he enjoys the repetition and familiarity.
A 14-year-old female has been brought to the pediatric ambulatory care clinic for a "sports physical" by her mother. The teen tells the nurse she does not want to have her mother present during the examination. What action by the nurse is most appropriate?
Ask the teen's mother to wait in a separate area nearby until the physical examination has been completed.
The nurse is preparing a safety program for the parents of children ranging in age from 1 to 4 years. Which of the following would the nurse include as the leading cause of death in this age group?
Automobile accidents
A teenage boy tells the nurse that his parents embarrass him in front of his friends when they kiss him goodbye. The nurse is aware that this teenager is revisiting which stage of development identified by Erikson?
Autonomy
The developmental task of the toddler period, according to Erikson, is achieving a sense of which of the following? a) Initiative b) Autonomy c) Nonstructure d) Leadership
Autonomy Correct Explanation: Achieving a sense of independence or autonomy is the toddler developmental task.
The nurse is assessing a 2-year-old boy during a well child visit. The nurse correctly identifies the child's current stage of Erickson's growth and development as:
Autonomy versus shame and doubt
The nurse is assessing a 2 year old boy during a well child visit. The nurse correctly identifies the child's current stage of Erickson's growth and development as:
Autonomy versus shame and doubt.
The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lbs (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements? A) 24 lbs (10.88 kg) and 26 in (66.04 cm) tall B) 30 lbs (13.60 kg) and 27 in (68.58 cm) tall C) 34 lbs (15.42 kg) and 32 in (81.28 cm) tall D) 36 lbs (16.32 kg) and 33 in (83.82 cm) tall
B) 30 lbs (13.60 kg) and 27 in (68.58 cm) tall
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? A) Playing apart from others without being part of a group B) Acting out a troubling or stressful situation C) Playing a video game with several other children D) Watching television or videos
B) Acting out a troubling or stressful situation
The nurse is meeting with a group of caregivers of adolescents and discussing sex and sexuality, including how to discuss these issues with their children. Which comment should the nurse prioritize with this group of caregivers? A) Teenagers spend so much time with their peers, and that is usually how they find out about sex. B) Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality. C) Most schools have excellent programs to teach adolescents about sex and sexuality. D) Internet resources, movies, and television have the most accurate and current information for your adolescent to learn about sexuality issues.
B) Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality.
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? A) Scold the child for the insult while apologizing for hurting her, and loosen the cuff. B) 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. C) Explain that the cuff will only hurt for minute and ask the child's caregiver to please tell the child not to speak to you that way. D) Ask the child's caregiver to please hold the child on their lap until she calms down.
B) 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 preparing a presentation for a community health fair on the topic of helping school-aged children develop the self-confidence they will need to mature into responsible adults. Which suggestion should the nurse prioritize to caregivers to enable them to help their children in this area? A) Encourage the child to cheer on their friends at games. B) Caregivers should maintain consistent rules and expectations. C) Ensure that the child has the best teacher possible. D) Encourage older siblings to include the child in their activities.
B) Caregivers should maintain consistent rules and expectations.
A nurse is presenting a class on discipline for a group of parents of toddlers. What information would be important for the nurse to teach this group? Select all that apply. A)Toddlers cannot learn self-control until at least 3 to 4 years of age. B) Consistency in the rules is important so the child understands what is expected. C) If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. D) Even at this young age, children need boundaries. E) If a child hits or bites another child, the parents should scold them, saying such things as "You are very naughty for biting Rachel."
B) Consistency in the rules is important so the child understands what is expected. C) If a child does something wrong, the parent must address the behavior immediately so the child understands what they did wrong. D) Even at this young age, children need boundaries.
A group of nursing students are preparing a presentation illustrating basic safety measures which can be utilized for infants. Which measures should the students prioritize in their presentation? Select all that apply. A) Bottle should only be propped for infants 8 months or older. B) Crib and playpen bars should be no more than 2 3/8 inches apart. C) Only small pillows should be used in cribs. D) Car seats should be placed in back seats. E) A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).
B) Crib and playpen bars should be no more than 2 3/8 inches apart. D) Car seats should be placed in back seats. E) A safe temperature for hot water heaters in households with infants is 120°F (48.9°C).
The nurse is assessing a teenage client and notes his lower front teeth are slightly crossed over. The nurse points out to his caregiver that he should see an orthodontist about this to prevent which potential situation? A) Leaving even slightly crooked teeth will lead to more cavities later in life. B) Even slight malocclusions make chewing and jaw function less efficient. C) This could have a lasting effect on his future to include everything from dating to hiring. D) Uncorrected malocclusions lead to infection and ultimately tooth loss.
B) Even slight malocclusions make chewing and jaw function less efficient.
The parents of a 16-year-old male are worried about recent changes in his behavior, ignoring his schoolwork and sports, and spending almost all of his free time interacting with his girlfriend. Which suggestion should the nurse point out would best address this situation? A) He is not developmentally mature enough to make healthy choices about the ways in which he spends his time, so it would be helpful if they would make a schedule for him that includes about a half-hour per day to talk with his girlfriend. B) He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day. C) He is not developmentally mature enough to have an intimate relationship with one girl; they should encourage him to spend time with groups of friends rather than time alone with his girlfriend. D) He has chosen a girl who is overly dependent on him. They should talk to him about making sure he meets his own needs, including doing the schoolwork he enjoys, in any relationship.
B) He has developed his own identity by now; being able to establish close relationships with girls is important preparation for all of his adult relationships. They should honor his need to be with, or talk to, his girlfriend as long as he has completed his schoolwork for the day.
A group of nursing students are preparing sample menus for the lacto-ovo-vegetarian diet. The instructor determines the presentation is successful after noting the students avoided the use of which foods in planning the menus? A) Red meat and possibly poultry B) Red meat, poultry, and fish C) Meat, poultry, fish, and eggs D) Dairy products, meat, poultry, fish, and eggs
B) Red meat, poultry, and fish
A mother brings her 2-year-old child to the pediatrician's office, voicing concerns about her toddler's growth over the last year. According to the child's records, the toddler has gained 6 pounds (2.7 kg) and grown 2.5 in (6.25 cm) since his last visit a year ago. How should the nurse respond to this mother's concerns? A) Tell her that her child's growth is less than is expected and gather a nutritional history on the child. B) Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about. C) Ask the mother if there are other small people in her family. D) Tell the mother that she needs to return to the pediatrician's office in 3 months to re-weigh the child and measure his height for any changes.
B) Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about.
The nurse is assessing the motor skills of an infant who is 9 months old. Which motor skills should the nurse prepare to assess in an infant achieving normal growth and development milestones? A) Startles then cries when hearing a loud noise B) Is eating cereal using the thumb and index finger C) Moves from a prone to sitting to standing position D) Can stand and walk around furniture
B) Is eating cereal using the thumb and index finger
The nurse is meeting with a group of caregivers of adolescents. Which example should the nurse point out is most effective for the caregiver to support the adolescent? A) Leave pamphlets about topics such as drugs and alcohol in their room so they can read them. B) Let them choose their hairstyle, even though it may not look the best for them. C) Discourage spending too much time with school friends since we know they can be a negative influence. D) Our house rules are stricter than their friends but everyone follows the same rules in our home.
B) Let them choose their hairstyle, even though it may not look the best for them.
The nurse is preparing a presentation for a health fair which will illustrate various ways to help introduce siblings to a new member of the family. Which suggestion should the nurse prioritize to help older siblings, especially toddlers, understand the change in the family dynamics? A) Plan time for the secondary caregiver to focus on the toddler while the primary caregiver focuses on the infant. B) Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant. C) Have a grandparent or another special adult in the child's life take the toddler on an errand or a special visit. D) Move the toddler to a new bedroom with a "grown-up-bed."
B) Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
A first-time parent asks the nurse what toys would be appropriate for her son's second birthday next month. What recommendations would be nurse make? A) Dress-up clothing B) Play lawn mower C) Water gun D) Colorful rattle
B) Play lawn mower
The nurse is supervising a play group of children on the unit. The nurse expect the toddlers will most likely be involved in which activity? A) Pretending to be mommies and daddies in the play house B) Playing with the plastic vacuum cleaner and pushing it around the room C) Painting pictures in the art corner of the room D) Watching a movie with other children their age
B) Playing with the plastic vacuum cleaner and pushing it around the room
The nurse is monitoring children playing in the unit's playroom. The nurse notes that some children are involved in associative play by which actions? A) Drawing pictures in the art area B) Pushing toy cars around on a large rug with roads C) Playing a board game with each other D) Several children engrossed in their own tool-and-bench set
B) Pushing toy cars around on a large rug with roads
A mother tells the nurse that her toddler does not want to go to bed at night and keeps getting back up when she is put to bed. What recommendations would the nurse make to this mother to foster sleep in the toddler? A) Place the child in her bed, tell her goodnight, and then lock the door. B) Read the child a book in bed and take time to calm the child down before turning out the lights. C) Instruct the toddler to stay in bed or she will have her favorite stuffed animal taken away from her. D) If she does not want to go to sleep at her normal bedtime, let her stay up for a little while longer.
B) Read the child a book in bed and take time to calm the child down before turning out the lights.
The nurse is working with a group of 8-year-olds who are learning about the concept of conservation of numbers. Which activity will help teach this concept to these school-aged children? A) Stacking blocks in a tower and counting how many can be stacked without falling. B) Rearranging a group of coins first into a circle, then a triangle and then a square. C) Forming vases from blocks of clay that are of various weights. D) Measuring the weight of a handful of popcorn and then the weight of a handful of pennies.
B) Rearranging a group of coins first into a circle, then a triangle and then a square.
A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply. A) Reason with the toddler and explain that the candy is not nutritious for her. B) Remain calm and ignore the tantrum. C) Do not reward the behavior by giving into the toddler's demands and buying the candy. D) Pick the toddler up and take her to the restroom for a spanking. E) Pick the toddler up and move her to a safe environment but do not give in to her desires.
B) Remain calm and ignore the tantrum. C) Do not reward the behavior by giving into the toddler's demands and buying the candy. E) Pick the toddler up and move her to a safe environment but do not give in to her desires.
A 6-year-old male has come to the clinic for a routine well-child visit. The nurse, after noting in the medical record that this child has followed basic growth and development standards, anticipates documenting which common assessment finding? A) Flat abdomen B) Swayed back C) Long legs D) Slender body
B) Swayed back
A 16-year-old client has been hospitalized 100 miles from home for 1 week to repair a fractured patella suffered in a skateboarding accident. She was cheerful and chatty when she first arrived, but the nurse notes in recent days she has become increasingly quiet and seems lonely. Which nursing intervention should the nurse prioritize for this client? A) Call the hospital's mental health unit to see if she can get some counseling. B) Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail. C) Suggest that she read books and magazines from the hospital bookmobile. D) Ask her caregivers to bring her siblings and friends to visit.
B) Take her to the teen lounge so she can meet other teens, use a phone, and check her e-mail.
The nurse is caring for several clients on the pediatric unit. When interacting with the preschooler, which action will the nurse predict to occur? A) Increased attention span and can be interested in an activity for a long length of time B) Takes in new information at a rapid rate and asks "why" and "how" C) Insists doing something and the next moment reverts to being dependent D) Grows and develops skills more rapidly than at any other time in their life
B) Takes in new information at a rapid rate and asks "why" and "how"
The nursing instructor is leading a class discussion on the various aspects of adolescents. The instructors determines the class is successful after the students correctly choose which milestone as the beginning of adolescence? A) The deciduous teeth falling out B) The beginning of puberty C) The child becoming self-supported D) The fine motor skills fully developed
B) The beginning of puberty
A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns? A) You can begin feeding the infant fruits and vegetables now followed by iron-enriched cereal to ensure that he gets enough iron. B) The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron. C) If you give him one or two bottles of juice each day, he should get all the vitamins he needs. You can begin fruits and cereal in 1 month. D) At 6 months, you need to quit breast-feeding because he is not getting enough iron or Vitamin C and D and that should help him transition to solids better.
B) The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron.
The mother has presented to the pediatric clinic with her 1-year-old infant for the next round of immunizations. The nurse would question administering the immunizations if which situation is noted on assessment? A) The infant has had a runny nose for several days. B) The infant is being treated for a case of eczema. C) The infant was given an antipyretic last week. D) The infant has a rash in the perineal area.
B) The infant is being treated for a case of eczema.
A first-time mother calls the pediatrician's office to ask the nurse about her baby's tooth eruption. The baby is 8 months old and still does not have any teeth. What information can the nurse share with this mother that would correctly respond to her anxiety about her baby's dentition? A) A baby's first teeth should erupt by 8 to 10 months of age and are the two lower front teeth. B) Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption. C) If the baby does not have any teeth come in by next month, the mother needs to bring him back for x-rays. D) Look for the baby to start running a fever and develop a stuffy nose and that will indicate his teeth are coming in.
B) Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption
The nurse is preparing an in-service training session on Erikson's theories for the pediatric nurses. Which task should the nurse prioritize as an example for the school-aged child? A) Insists on doing things their way instead of their caregivers. B) Will work on a picture until it is finished. C) Wants to tie their own shoes no matter how long it takes. D) Understands the need for discipline.
B) Will work on a picture until it is finished.
The nurse is admitting a 10 year old for surgery. What action should the nurse prioritize when caring for this child? A.) Offer to help with bathing. B.) Answer questions regarding pain. C.) Encourage the family caregivers to stay with the child. D.) Avoid prolonged discussions about the child's anxiety.
B.) Answer questions regarding pain.
The nurse is providing client education to the parent about bathing the infant. What would be important to instruct the parent?
Bath time provides an opportunity for play
A newborn infant requires skin care that includes bathing. Besides hygiene, what is another reason for bathing an infant?
Bathing is a time for bonding with the parents.
A nurse is instructing the parents of a toddler on the use of an anesthetic cream in advance of an upcoming procedure the child will have. What information should the nurse mention to them?
Be careful not to let your son remove the dressing, as the cream can cause damage to his eyes if he rubs them.
The nurse notes a school-aged child in the pediatric unit playroom is busy sorting through the Legos and putting them in certain groupings. The nurse determines this child is illustrating which developmental concept? A) Conservation of numbers. B) Decentration. C) Reversibility. D) Hierarchical arrangement.
D) Hierarchical arrangement.
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern? A) "Spanking is controversial but sometimes necessary, so use it if it works." B) "Warn her that she will be punished when she is back at home then follow through with the punishment." C) "Remain calm, pick the child up, and move to a quiet and neutral place until she gains self-control; don't give in to her demands." D) "Remind her that she is in a public place and ask her to respect those around her; reward her if she responds by calming herself."
C) "Remain calm, pick the child up, and move to a quiet and neutral place until she gains self-control; don't give in to her demands."
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? A) "Stop the car any time the preschooler unbuckles the restraints." B) "Explain that wearing a seat belt is a law and the police officer will give a ticket if the seat belt is not buckled." C) "Set a good example. Wear your own seat belt every time you drive." D) "Reward the child with candy or some other treat each time the child keeps the seat belt on."
C) "Set a good example. Wear your own seat belt every time you drive."
The nurse takes a call from a concerned mother whose infant received routine immunizations the day before and now has a temperature of 101oF (38.3oC), is fussy and pulling at the injection site. The mother wants to know what she should do. Which is the best response from the nurse to this mother? A) "You need to bring the baby to the emergency department to be sure he is not having an allergic reaction." B) "All babies have similar reactions but you should call back if he is still fussy in 24 hours." C) "This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site." D) "You can give your child ice cold fluids and cover the injection site so that he doesn't scratch the site and get it infected."
C) "This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."
A 15-year-old client tells the nurse he has been having wet dreams and is ashamed and afraid he will get into trouble because he believes his parents think he is too young to understand or know about sex. To which statement would be the most appropriate for the nurse to respond? A) "Since your parents feel you are not ready to talk about sex, you need to honor their wishes and not bother them with this." B) "Don't worry, it is perfectly normal for 15-year-olds to have the kinds of fantasies that lead to wet dreams. You should tell your parents about this." C) "Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen." D) "You don't need to feel ashamed. I will speak to your parents about the importance of allowing you to experiment with and feel good about your sexuality."
C) "Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen."
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? A) "You should punish your son because no child should be telling lies at this age." B) "You need to show your child the broken tool since at this age they must see something in order to understand." C) "Your son may have a friend named Andrew, but it could be an imaginary friend." D) "You should watch this type of behavior closely since most children this age tell the truth."
C) "Your son may have a friend named Andrew, but it could be an imaginary friend."
The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit? A) 16 pounds (7.2 kg) and grown 26 inches (65 cm) B) 20 pounds (9.1 kg) and 28 inches (70 cm) C) 24 pounds (10.8 kg) and 30 inches (75 cm) D) 28 pounds (12.7 kg) and 32 inches (80 cm)
C) 24 pounds (10.8 kg) and 30 inches (75 cm)
The nurse is measuring the height of a 13-year-old girl who was 56 in (142.24 cm) tall at age 9. The nurse predicts the girl will be approximately how tall if following the normal pattern of growth? A) 58 in (147.32 cm) B) 62 in (157.48 cm) C) 68 in (172.72 cm) D) 76 in (193.04 cm)
C) 68 in (172.72 cm)
The nurse is leading a discussion in a health class at the high school on adolescent relationships. The nurse determines the session is successful when the students correctly choose which type of relationship as involving a member of the opposite sex? A) A homosexual relationship B) An unhealthy relationship C) A heterosexual relationship D) A bisexual relationship
C) A heterosexual relationship
The parents of 5-year-old boy are concerned about the how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child's behavior is likely related to which factor? A) Afraid of losing his father and trying show how much he loves him B) Afraid of being hurt himself and thinks being especially good will protect him from accidents C) Believes he caused the accident by telling his father he hoped he crashed when he couldn't go along D) The child is imitating the adults' behavior and just trying to be nice to everyone.
C) Believes he caused the accident by telling his father he hoped he crashed when he couldn't go along
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother? A) Remind them staying in the hospital now will help the child get well quicker and be home soon, but the other children should not be alone. B) Distract the child with a special blanket, stuffed animal, or other "lovey" from home while the mother quietly slips out. C) Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning." D) Tell both the mother and child that the child will be carefully guarded and won't be in as much danger as she might be if she were home exploring her environment.
C) Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
A 6-month-old arrives for a well-baby visit with a case of diaper rash that the parent believes is normal for infants. The parent reports changing the baby's diaper when he wakes up and before naps or bedtime. Which frequency should the nurse point out will better help heal and prevent future incidences of diaper rash? A) Every hour B) Every 1 to 2 hours C) Every 2 to 4 hours D) Every 3 to 5 hours
C) Every 2 to 4 hours
A toddler is hospitalized and the nurse wants to make the transition from home to hospital as easy as possible for him. Which action by the nurse would be most beneficial to assist the toddler in adapting to the hospital? A) Tell the child what is expected of him to help with compliance. B) Instruct the parents to allow the nurse to do everything for the child to aid in attachment. C) Follow the child's home routines as much as possible while in the hospital. D) Allow the child to dictate when and what they want to do and adhere to their requests.
C) Follow the child's home routines as much as possible while in the hospital.
The nurse is caring for a toddler in the pediatric unit and notes the child is responding according to expected developmental stages. Which characteristic will the nurse predict this toddler to exhibit while in the hospital? A) Will be interested in an activity for a long period of time B) Learns new things quickly by asking questions C) Insists on doing a new skill and then asking for help D) Will go home knowing how to do more things
C) Insists on doing a new skill and then asking for help
The nurse is reviewing the diet of an 8-month-old infant with the mother who reveals she has been using evaporated milk to make the formula. Which additional ingredient should the nurse ensure she is including in the formula? A) Vitamin D B) Vitamin E C) Iron D) Calcium
C) Iron
The nurse is teaching parents interventions appropriate to the emotional development of their toddlers. What is a recommended intervention for this age group?
Do not blame toddlers for aggressive behavior; instead, point out the results of their behavior.
A 15-month-old toddler is brought to the pediatrician's office for a well-child checkup and the nurse is reviewing health promotion with the family. What recommendations would the nurse make to the family to help ensure the child's health? Select all that apply. A) Begin dental examinations at age 3 to 4 years. B) Provide foods rich in calories and carbohydrates for the child. C) Keep all medications locked up and out of reach for the child. D) Turn the hot water heater temperature down to 120℉ (48.9℃). E) Never allow the child to ride in the car unless he is secured in a car seat.
C) Keep all medications locked up and out of reach for the child. D) Turn the hot water heater temperature down to 120℉ (48.9℃). E) Never allow the child to ride in the car unless he is secured in a car seat.
A nursing instructor is leading a class discussion exploring the various aspects of Erikson's theories of the developmental tasks of toddlers. The instructor determines the session is successful when the students correctly choose which task as a priority for toddlers? A) Learning to trust B) Learning to speak C) Learning to act on one's own D) Learning to understand and respond to discipline
C) Learning to act on one's own
A parent is giving the toddler a tub bath. What behavior is NOT recommended by healthcare personnel regarding bathing? A) Allow the toddler to have toys in the tub during bath time. B) Never leave the toddler alone in the tub at any time. C) Let the toddler take bubble baths and play in the bubbles. D) Give the toddler his bath every day at the same time.
C) Let the toddler take bubble baths and play in the bubbles.
The pediatric nurse is meeting with a group of young mothers of newborn infants who are questioning the 'soft spot' on the head and when it will close. Which fact should the nurse point out to the mothers? A) Can be expected to close between months 2 and 3 of life B) Will close and the bones hardened by the time the child is 1 year old C) May increase slightly in size the first few months of life D) Decreases in size rapidly during the first month of life
C) May increase slightly in size the first few months of life
The caregiver of a 17-year-old girl is concerned she is not getting enough nutrition since starting a lactovegetarian diet and asking for menu ideas. Which food items should the nurse point out the child is choosing not to eat based on this diet? A) Red meat and possibly poultry B) Red meat, poultry, and fish C) Meat, poultry, fish, and eggs D) Dairy products, meat, poultry, fish, and eggs
C) Meat, poultry, fish, and eggs
The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play? A) Playing apart from others without being part of a group. B) Playing together in an activity without organization. C) Playing in an organized group with each other. D) Playing independently and are side-by-side.
C) Playing in an organized group with each other.
The nursing students working with a group of 8-year-olds have determined they will illustrate the concept of conservation of weight. Which activity would best help these children grasp this concept? A) Weighing and measuring each child and comparing the number of pounds to the number of inches for each person. B) Using a balance scale to weigh a variety of objects and counting how many pennies must be used to balance the scales. C) Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound. D) Measuring the weight of a handful of popcorn and then the weight of a handful of pennies.
C) Weighing a pound of oranges and a pound of bricks and counting how many of each make a pound.
A parent tells the nurse about being frustrated because the preschool-aged child screams every time the parent attempts to buckle the child's seat belt. What advice should the nurse give this parent?
Do not start the car until seat belts are in place.
The nurse is assessing the 10-month-old infant. The nurse notes the anterior fontanel has closed. What initial action by the nurse is indicated?
Document the findings as normal.
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? A) Weight and height are within expected patterns of growth. B) Weight falls within an expected range and height is less than what would be expected. C) Weight is above an expected range and height is within an expected range. D) Weight is below an expected range and height is above an expected range.
C) Weight is above an expected range and height is within an expected range.
The nurse is presenting an inservice training to a group of pediatric nurses on the topic of play. After discussing various types of play, the following examples are given. Which is the best example of parallel play? a) Children are playing apart from others without being part of a group b) Children are playing in an organized group with each other c) Children are playing together in an activity without organization d) Children are playing independently and are side by side
Children are playing independently and are side by side Correct Explanation: Parallel play occurs when the toddler plays alongside other children but not with them. During cooperative play children play in an organized group with each other as in team sports. Associative play occurs when children play together and are engaged in a similar activity but without organization, rules, or a leader, and each child does what she or he wishes. Solitary independent play means playing apart from others without making an effort to be part of the group or group activity.
During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family? A) "Stuttering is common in young children because they are not physically capable of forming all the sounds." B) "Stuttering is usually indicative of a hearing loss." C) "Difficulties with speaking generally indicate that the adults in the child's life are not reading to the child enough." D) "Children of this age may stutter while they search for just the right word."
D) "Children of this age may stutter while they search for just the right word."
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? A) "When I find my son masturbating, I will tell him that is unacceptable." B) "I will tell my daughter that she will have time to explore her body as she gets older." C) "I will encourage my son to ask his father any questions that are sexual in nature." D) "I feel better knowing that her curiosity is normal."
D) "I feel better knowing that her curiosity is normal."
The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her baby crying. Which is the best response from the nurse to help this mother? A) "He knows you are in the next room and he is attempting to get your attention." B) "By ignoring his crying you will help him develop patience." C) "It is important for him to be with you, so you should take him with you." D) "If he cannot see you he thinks you are gone and that is frightening."
D) "If he cannot see you he thinks you are gone and that is frightening."
A mother calls the pediatrician's office upset because her toddler has begun acting out now that the new baby is home. He wants to have a bottle like the newborn and has begun to have accidents in his pants. Which statement by the nurse would best address this problem? A) "Often, the first child is jealous of the new baby. Just ignore his acting out and he will stop." B) "You need to scold him for wetting his pants and have him change his underwear himself." C) "Offer to let him drink some formula in a cup. He will see that being a baby is not so much fun. " D) "Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."
D) "Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."
A frustrated mother with a 9-month-old baby comes to the clinic because her son is refusing all solid food. When talking with this mother, the nurse discovers the mother has struggled with a weight problem all her life, which she attributes to being forced to eat even when she was full. Not wanting to treat her child the same way, each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother? A) "The baby might be allergic to the particular foods you offered, so try different kinds of food." B) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes." C) "The baby might not be ready for solid food, so wait a month or so and try again." D) "The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
D) "The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
The nurse is assessing a 16-year-old girl at an annual well-clinic visit and notes the girl started menses at 13 years of age and grew 1 inch (2.5 cm) over the past year. When questioned by the young lady if this is normal, which answer should the nurse prioritize? A) "Your height is less than expected." B) "You're taller than what would be expected." C) "Your weight is more revealing than your height." D) "You're following expected patterns of growth."
D) "You're following expected patterns of growth."
The nurse is conducting an assessment on a 1-year-old healthy child and commends the parents for maintaining routine visits. When questioned by the parents as to the recommended schedule for future visits, which schedule should the nurse recommend? A) Quarterly until year 2, then every 6 months until the child enters school B) At 15 months, 18 months, then every 6 months until the child enters school C) At 15 months, 24 months, then annually until the child enters school D) At 15 months and at least annually thereafter
D) At 15 months and at least annually thereafter
The nurse is preparing to teach a class to a group of young parents with infants the basics of introducing solid foods into the diet. Which factor about the food should the nurse point out the infants respond to best when introducing solid foods into the diet? A) Well heated B) Thickened C) An interesting texture D) Bland
D) Bland
The father of a 15-year-old daughter is concerned she is not getting adequate nutrition to play high school basketball. Her games are on Friday nights. Which suggestion should the nurse point out will best suit the needs of this adolescent? A) Pasta with a small amount of meat sauce and two slices of bread for dinner on Wednesday and Thursday evenings and again at 2 p.m. on Friday. B) Boiled eggs with bacon or ham and a glass of orange juice for breakfast on Thursday and Friday mornings along with some sliced turkey and a salad at noon on Friday. C) Three daily meals that include choices from each of the food groups with an additional serving of fruit and several extra glasses of water on Friday. D) Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.
D) Three daily meals that include choices from each of the food groups; Friday's lunch eaten around 2 p.m. with a small amount of fat and a somewhat larger than usual portion of complex carbohydrates.
A 7 year old seen in the clinic for a routine well-child visit is noted on assessment to have gained 5 lb (2.26 kg) and grew 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters? A) Weight and height are within expected patterns of growth. B) Weight is within expected range and height is less than expected. C) Weight is above expected range and the height is within an expected range. D) Weight is within expected range and height is above the expected range.
D) Weight is within expected range and height is above the expected range.
While awaiting an appointment at the doctor's office for his 20-month-old daughter, a young father is astonished to see his daughter assume a proper stance and swing a toy golf club in the play area of the waiting room. A nurse also observes the behavior, and the father recalls that his daughter saw him practicing his golf swing in their back yard a few days ago. The nurse explains that this is an instance of which of the following? a) Deferred imitation b) Autonomy c) Parallel play d) Assimilation
Deferred imitation Correct Explanation: Children at this stage are able to remember an action and imitate it later (deferred imitation); they can do such things as pretend to drive a car or put a baby to sleep because they have not seen this just previously but at a past time. Toddlers engage in assimilation when they learn to change a situation (or how they perceive it) because they are not able to change their thoughts to fit the situation, such as shaking a toy hammer as if it were a rattle, because they are more familiar with rattles than hammers. All during the toddler period, children play beside children next to them, not with them. This side-by-side play (called parallel play) is not unfriendly but is a normal developmental sequence that occurs during the toddler period. Autonomy, or independence, is the primary developmental task of the toddler years, according to Erikson. Although this child's act may be a sign of autonomy, it is more specifically an act of deferred imitation.
A 4-year-old tells you he has an imaginary friend. His parents are concerned because he refuses to do anything without his friend's help. Which nursing diagnosis is most applicable for his family?
Deficient knowledge of normal preschool development
The mother of a 2-year-old tells you she is constantly scolding him for having wet pants. She says her son was trained at 12 months, but since he started to walk, he wets all the time. Which nursing diagnosis would be most applicable?
Deficient parental knowledge related to inappropriate method for toilet training
The mother of a 2-year-old tells you she is constantly scolding him for having wet pants. She says her son was trained at 12 months, but since he started to walk, he wets all the time. Which nursing diagnosis would be most applicable? a) Excess fluid volume related to inability to control urination b) Total urinary incontinence related to delayed toilet training c) Ineffective coping related to lack of self-control of 2-year old d) Deficient parental knowledge related to inappropriate method for toilet training
Deficient parental knowledge related to inappropriate method for toilet training Correct Explanation: It is probable that a child toilet trained at 12 months was not truly trained; his mother was trained to remind him or place him on a toilet frequently during the day. When the child begins to play independently, the "training" is no longer effective.
The nurse is providing anticipatory guidance to the parents of an 18 month old girl. Which recommendation will be most helpful to the parents?
Describing proper behavior when she misbehaves
While observing a group of 9-year-old children at school, the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned?
Does not understand the phrase "slow as molasses" when used by the teacher
A single mother with three young children is reluctant to leave her crying and upset 16-month-old daughter overnight in the hospital but needs to go home to care for the other children. Which suggestion from the nurse will best address the fears and concerns of both the child and mother?
Encourage the mother to give the child a personal item of the mother's to hold on to until she returns and to tell the child a specific time she will return, such as "when breakfast comes in the morning."
The mother of a 4-year-old boy reports her son has voiced curiosity about her breasts. She asks the nurse what she should do. Which information is best for the nurse to give the parent?
Encourage the parent to determine what the child's specific questions are and answer them briefly.
The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which of the following is accurate?
Explaining to the mother the risk for infection is high due to the lack of antibodies Attributing frequent infections to a lack of antibodies is accurate. The infant lacks IgA in the mucosal lining of the upper respiratory tract. The infant's respiratory rate drops to 20 to 30 breaths per minute by the end of the first year. Abdominal breathing persists until 6 to 12 years of age. The respiratory system matures by age 7 years.
The nurse is talking to the mother of a 19-month-old girl about setting limits and supervising activities. In which of the following situations will the nurse recommend letting the child do as she pleases? a) Exploring her body b) Playing on the picnic table c) Choosing her own foods d) Deciding her bedtime schedule
Exploring her body Correct Explanation: It is normal for toddlers to explore their genitals when they are undressed. The parent should allow this and not punish the child. Choosing food and deciding bedtimes need to be done by an adult. Likewise, safety dictates that the picnic table is not a safe play area.
The nurse is teaching a mother of a 1 year old girl about weaning her from the bottle and breast. Which recommendation would be part of the nurse's plan?
Give the child an iron-fortified cereal
The nurse is giving discharge instructions to a parent of a 3-month-old infant. What is the best information to give the parent concerning oral medication administration?
Give the medication with a syringe and direct the liquid toward the posterior side of the mouth while holding the infant upright.
A 15-year-old adolescent shows a pattern of gaining weight, not a large amount but a little more each visit. The adolescent is not active in any sports and eat out frequently with parents. What is the best way for the nurse to assess the adolescent's eating pattern?
Have the adolescent keep a food diary for 1 week.
The nurse is discussing sensory development with the mother of a 2 year old boy. Which parental comment suggests the child may have a sensory problem?
He doesn't respond if i wave to him
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old?
He should speak in two-word sentences ("Me go").
The nurse is assessing the vital signs of several toddlers in the pediatric medical unit. Which findings are of most concern to the nurse?
Heart rate 60 beats per minute; respiratory rate 14 breaths per minute
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 school nurse is developing a school wellness program to promote healthy eating habits and regular physical activity. Each class will be engaging in lessons, contests, and goal setting to develop healthy habits. What is the most important element to emphasize to maximize compliance and long-term change?
Include both parents and children in the wellness program.
The nurse is administering 2 puffs of an albuterol sulfate inhaler to a 4-year-old. Which side effect would the nurse instruct the parent to most likely expect?
Increased heart rate and restlessness
Which assessment findings of the speech of a 5-year-old child warrant further follow-up? Select all that apply.
It is difficult for people outside of the household to understand his conversation. The child has a vocabulary of an estimated 1,200 words. The child is unable to provide his address when asked.
The mother of an 18 month old girl voices concerns about her child's social skills. She reports that the child does not play well with others and seems to ignore other children who are playing at the same time. What response by the nurse is indicated?
It is normal for children to engage in play alongside other children at this age
During the physical examination, the nurse notes a positive Kernig and Brudzinski sign. The nurse interprets these findings to suggest which condition?
Meningeal irritation
The nurse is performing an assessment on a 8-month-old infant. The infant's medical history notes that he was born at 32 weeks' gestation. The infant is progressing normally. At what adjusted age should the nurse expect the infant's developmental accomplishments?
The infant will most likely present with developmental skills consistent with a 6-month-old infant.
A 15-year-old girl is in the hospital for surgery and is confined to bed. The nurse can tell that the client is nervous about being in the hospital. She tells the nurse that she feels "gross" and "on display" in her hospital gown. What should the nurse do to encourage a sense of autonomy and dignity related to the girl's body image?
Offer to assist the girl in washing her hair and let her pick the shampoo.
A client questions how long it will take for the oral pain medication administered to begin to take effect. What information can be provided by the nurse?
One to two hours is needed for oral medications to begin to take effect.
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 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
What feeding practice used by the parents of an 8-month-old should the nurse discourage?
Placing all liquids given the child in a "no spill" sippy cup No spill sippy cups promote sucking rather than teach cup drinking. Reserve these for times avoiding spills is essential. The other feeding practices are age appropriate and safe. Soft table and finger foods promote accepting new textures and self-feeding. Reoffering rejected food allows the child to accept it when ready. Including the infant at the family table provides for modeling of eating behaviors and socialization.
The nurse is presenting an in-service training to a group of pediatric nurses on the topic of play. The nurse determines the session is successful when the group correctly chooses which example as best displaying toddlers playing?
Playing independently and are side by side
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 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
Parents of 3-year-old son ask the nurse for suggestions on how to deal with their son's nightmares. Which of the following suggestions would be least effective? a) Try having him sleep with a nightlight on in his room. b) Search the room to show him that there aren't any monsters. c) Talk to him that night about the details of the dreams. d) Try reassuring him that it was a dream and not real.
Talk to him that night about the details of the dreams. Correct Explanation: When the child has an occasional nightmare, parents should reassure the child that it was just a dream and was not real. Giving lots of hugs and words of reassurance can be supportive. The child may want the parent to search the room to reassure that there are no monsters about. Advise parents to wait until the next morning to talk about the details of the dream, at which time the child should be calmer. The parent should try to determine if there was a specific event or stressor that may have triggered the nightmare. In addition, to decrease nightmares, parents should avoid having the child watch television in the hour before bedtime, avoid telling scary bedtime stories, let the child sleep with a nightlight, and examine how to decrease perceived stress in the child's life.
The nurse is preparing to participate in a community discussion on the needs of the adolescents in the local school. The nurse should point out which goal is the primary concern for these young individuals as the committee makes plans?
Teens are busy developing their own personal identity.
The nurse is examining a 2-year-old girl for speech and language development. Which finding would suggest a delay in speech development? a) The child puts together sentences of two words. b) The child does not speak clearly but shows understanding of what is said. c) The child does not use the names of familiar objects. d) The child repeats what the parents say out of context and at random moments.
The child does not use the names of familiar objects. Correct Explanation: By 24 months most children will name objects familiar to them in their daily lives. Not doing so is strong evidence that a speech delay may exist. Repeating words heard or phrases out of context (echolalia) is normal and a way to practice words and incorporate them in the vocabulary. At 2 years, most children understand much more than they can clearly repeat. Using two-word sentences is a developmental expectation at this age.
A 15-month-old boy has been brought to the clinic because he is pale and listless. Iron deficiency anemia is suspected. The nurse interviews the mother about the child's diet. Which of the following would the nurse identify as possible contributing factor?
The child drinks 4 cups of milk per day
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:
The child weighs less than expected for age. Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.
A child has returned to the unit after having a lumbar puncture. Which instructions are important for the nurse to provide the parents and child?
The child will need to remain flat to prevent a headache.
Transduction is
The nurse is caring for a 5-year-old girl post-tonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process?
The nurse is administering a gavage feeding through a nasogastric feeding tube. Which nursing intervention is the highest priority?
The nurse verifies the position of the feeding tube.
The nurse is making a home visit and observes the 7-month-old pulling the family dog's hair and ears. Which parenting skill does the nurse determine is most effective?
The parent tells the child "no" with a stern voice and pulls the child's hand away from the dog
The parents of a 3 year old boy have asked the nurse for advice about a preschool for their child. Which suggestions is most important for the nurse to make?
The staff should be trained in early childhood development
The physician has made a notation in the medical record of a 17-year-old that the teen is not demonstrating successful completion of Erikson's stages of development. What behavior would be consistent with this assessment?
The teen is uncertain and frequently unable to make decisions.
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler?
The toddler should speak in two-word sentences ("Me go").
The nurse of a preschool child is helping parents develop a healthy meal plan for their child. What nutritional requirements for this age group should the nurse consider?
The typical preschooler requires about 85 kcal/kg of body weight. The 3- to 5-year-old requires 500 to 800 mg calcium and 10 mg iron daily. The 3-year-old should consume 19 mg dietary fiber daily, while the 4- to 8-year-old requires 25 mg dietary fiber per day
The nurse is completing an assessment on a 2-year-old child. The nurse notes the presence of a raised reddish purple spot on the back of the child's neck. Which statement about this finding is correct?
These lesions will normally fade as the child ages.
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?
They put her to bed when she falls asleep.
The best way for a parent to handle a temper tantrum by a toddler is to calmly express disapproval and then ignore it. a) True b) False
True Correct Explanation: Probably the best approach is for parents to tell a child simply they disapprove of the tantrum and then ignore it. They might say, "I'll be in the bedroom. When you're done kicking, you come into the bedroom, too." Children who are left alone in a kitchen this way will usually not continue a tantrum but will stop after 1 or 2 minutes and rejoin their parents. Parents should then accept the child warmly and proceed as if the tantrum had not occurred. This same approach works well for nurses caring for hospitalized toddlers
The nurse is discussing the activities of a 20 month old child with his mother. The mother reports the children of her friends seem to have ore advanced speech abilities than her child. After assessing the child, which of the following findings is cause for follow-up?
Understands approximately 75 to 100 words.
A nurse is assessing a 2 year old's language development. Which of the following would the nurse expect to assess? a) Knowledge of full name b) Ability to name one color c) Use of a two-word noun-verb sentence d) Verbalization of 4 to 6 words
Use of a two-word noun-verb sentence Correct Explanation: A 2 year old should be able to say a two-word sentence that consists of a noun and verb. A 15 month old can say 4 to 6 words. A 30 month old knows full name and can name one color.
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which of the following observations points to a developmental risk?
Uses only the left hand to grasp Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for 4 to 8 weeks.
.Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay?
Uses two-word sentences or phrases A child nearly 3 years of age should speak in three- to four-word sentences.
Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a) Asks "why" often b) Half of speech understood by outsider c) Uses two-word sentences or phrases d) Talks about a past event
Uses two-word sentences or phrases Correct Explanation: A child nearly 3 years of age should speak in three to four word sentences. The other findings indicate normal expressive language for the age.
The nurse is preparing to administer an IV antibiotic to a child. After calculating the recommended dose with the child's weight, the nurse discovers the prescribed dose exceeds the safe dose range in a pediatric drug book. The medication has been given to the child at this dose for 3 days. What action should the nurse take next?
Verify the dose with the prescribing health care provider.
The best activity that a preschooler's parents could use to help her achieve the developmental task of the preschool period is to:
allow her to experiment with Play-Doh.
A medical/surgical nurse has been floated to the pediatric unit. Which action by the float nurse would require the pediatric nurse to intervene?
asking the child his or her name prior to giving medications
Anticipatory guidance for an infant for the 4th month should include the fact that the infant will be able to achieve which developmental milestone?
be able to turn over onto the back
Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:
be able to turn over onto the back.
A toddler's parents want to begin toilet training him. As a rule, the best instruction you could give them is a) toilet training is a 12-month process. b) all children should be toilet trained by age 2 years. c) children can remain dry during the night before they can do so during the day. d) bowel training is easier than urine training.
bowel training is easier than urine training. Correct Explanation: Bowel training is often easier than urine training because the substance to be evacuated is so much more tangible.
A new graduate nurse is asking the nurse preceptor about enemas in pediatrics. The preceptor explains that the use of enemas in children is warranted under which circumstances? Select all that apply.
fecal impaction Hirschsprung disease preparation for surgery preparation for a colonoscopy
A child has been admitted to the emergency department with a pneumothorax. Which intravenous medication prescription does the nurse select prior to the insertion of a chest tube in the child?
fentanyl
Centration is
focusing on one aspect of a situation while neglecting others
The four leading causes of unintentional injury in early childhood include
motor vehicle/traffic accidents, drowning, fires, and burn injury and unintentional suffocation
The most important safety precaution for parents to teach preschoolers is:
not to ride in a car with strangers.
The nurse is assessing a 3-year-old child. The nurse notes the child is able to understand that objects hidden from sight still exist. The nurse correctly documents the child is displaying:
object permanence.
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as:
parallel play
A mother is concerned because her 2-year-old daughter is not speaking much. Which of the following should the nurse suggest to the mother? a) Always answer her questions b) Name aloud the objects that she is playing with c) Use baby talk when speaking to her d) Have her watch educational television e) Read books aloud to her f) Use pronouns when speaking to her
• Always answer her questions • Name aloud the objects that she is playing with • Read books aloud to her Correct Explanation: Reading aloud is an effective way to strengthen vocabulary. Also, urge parents to encourage language development by naming objects as they play with their child or when they give their toddler something. This helps children grasp the fact words are not meaningless sounds; they apply to people and objects and have uses. Always answering a child's questions is another good way to do this. Watching television promotes little learning as the activity is passive and it is difficult to discern how language caused the action. The American Academy of Pediatrics recommends television viewing should be severely limited until at least 2 years of age. Because children learn language from imitating what they hear, if they are spoken to in baby talk, their enunciation of words can be poor; if they hear examples of bad grammar, they will not use good grammar. Remind parents pronouns are difficult for children to use correctly; many children are 3½ or 4 years of age before they can separate the different uses of "I," "me," "him," and "her."
A stay-at-home father wants to purchase commercial toddler meals because his 16-month-old girl recently choked on table food. Which food items will the nurse suggest not be given to this child? Select all that apply. a) Round foods such as hot dogs, whole grapes, and cherry tomatoes b) Sticky foods like peanut butter alone, gummy candies, and marshmallows c) Hard foods such as nuts, raw carrots, and popcorn d) Vegetables such as corn, green beans, and peas e) Fruits such as peaches, pears, and kiwi
• Round foods such as hot dogs, whole grapes, and cherry tomatoes • Sticky foods like peanut butter alone, gummy candies, and marshmallows • Hard foods such as nuts, raw carrots, and popcorn Correct Explanation: To offer soft round foods safely, cut hot dogs in uneven pieces and quarter grapes and cherry tomatoes. This prevents food impacting in an airway. Avoid the hard and sticky foods due to aspiration and airway occlusion risks. The cooked vegetables listed are safe as are the soft fruits
A nurse is presenting a class on toilet training to a group of parents with toddlers. Which of the following would the nurse include in the class? Select all that apply. a) Keeping the child on the potty chair for as long as necessary b) Putting the child on the potty chair at regular intervals during the day c) Using training pants that slide down easily and quickly d) Allowing at least 6 weeks to prepare the child psychologically for the training e) Praising the child when he or she urinates or defecates
• Using training pants that slide down easily and quickly • Praising the child when he or she urinates or defecates • Putting the child on the potty chair at regular intervals during the day Explanation: For effective toilet training, parents should allow 1 to 2 weeks to psychologically prepare the child for training, using training pants that slide down easily and quickly, praising the child when he or she urinates or defecates, limiting the time spent on the potty chair to no longer than 10 minutes (or less if the child is resistant), and putting the child on the potty chair at regular intervals during the day.
The nurse is providing helpful feeding tips to the mother of a 2-week-old boy. Which recommendations will best help the child feed effectively? a) Encourage the infant to latch on properly b) Maintain a feed-on-demand approach c) Apply warm compresses to the breast d) Maintain adequate diet and fluid intake
Maintain a feed-on-demand approach
A 3-month-old still has a Moro reflex. Which statement is most true of this reflex? a) A Moro reflex present at 3 months of age requires referral for a neurologic exam. b) Most 3-month-olds still have a Moro reflex. c) It is not important how long the reflex persists, only that it is present at birth. d) A Moro reflex normally lasts until 9 months.
Most 3-month-olds still have a Moro reflex.
The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which of the following statements best reflects average sitting ability? a) Most babies do not sit steadily until 8 months; she is normal. b) Most babies sit steadily at 3 months; she is slightly delayed. c) Sitting ability and the age of first tooth eruption are correlated. d) Most babies sit steadily at 4 months; she is normal.
Most babies do not sit steadily until 8 months; she is normal.
Put the following developmental milestones related to an infant's hearing in correct chronological order: 1 Stop activity in response to spoken word 2 Locate sounds made above 3 Locate & turn toward sound in any direction 4 Turn head to locate sound 5 Recognize name when spoken 6 Locate sounds downward and to side
Stop activity in response to spoken word Turn head to locate sound Locate sounds downward and to side Locate sounds made above Recognize name when spoken Locate & turn toward sound in any direction
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines: a) The weight assessment is blatantly inaccurate. b) The child weighs more than expected for age. c) The child weighs the expected amount for age. d) The child weighs less than expected for age.
The child weighs less than expected for age.
A father asks you what symptoms he can expect with normal teething in his infant. Which of the following would you tell him? a) The child's gum line will be tender. b) The child will not play or eat for 2 days. c) He can expect his child to be constipated for 2 days. d) The child's temperature may go as high as 102°F.
The child's gum line will be tender.
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development? a) His toes hyperextend when the bottom of the foot is stroked. b) The infant grasps a finger when it is placed in his palm. c) The infant displays an asymmetric tonic neck reflex (fencing reflex). d) The anterior fontanel is open and easily palpated.
The infant displays an asymmetric tonic neck reflex (fencing reflex). (Birth-4mos)
The nurse is assessing development of a 4-month-old boy during a well-child visit. Which observation needs further investigation? a) The infant makes babbling sounds, coos, and smiles. b) The infant shows interest in looking at near or high-contrast objects. c) The infant responds to his mother when he sees her but not at other times when she is near. d) The infant turns his head in the direction of a squeak toy.
The infant responds to his mother when he sees her but not at other times when she is near.
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. Which of the following represents the most advanced milestone of language development that the nurse should expect to see in this child? a) The infant says "da-da" when looking at her father b) The infant coos, babbles, and gurgles c) The infant squeals with pleasure d) The infant imitates her father's cough
The infant says "da-da" when looking at her father
The nurse is reviewing topics to be discussed with caregivers related to caring for infants. Which of the following statements would be the most appropriate statement for the nurse to make to this group of caregivers? a) The infant should be dressed more warmly than older children and caregivers b) The infant sleeps 10-12 hours at night and take 2-3 naps during the day c) The infant should wear hard-soled shoes in order to protect their feet from injury d) The infant should be sound asleep before being put into the crib for sleeping
The infant sleeps 10-12 hours at night and take 2-3 naps during the day
Using knowledge of normal growth and development, which of the following would be expected when observing a 12-week-old infant? a) The infant smiles at significant others b) The infant bears weight on legs when held in standing position c) The infant grasps objects and brings them to the mouth d) The infant is able to sit up and can roll over
The infant smiles at significant others
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide? a) The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. b) The respirations of a 1-month-old infant are normally irregular and periodically pause. c) An infant at this age should have regular respirations. d) The irregularity of the infant's respirations are concerning; I will notify the physician.
The respirations of a 1-month-old infant are normally irregular and periodically pause.
The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1? a) Uses speech-like rhythm when talking with an adult b) Understands "no" and other simple commands c) Squeals and makes pleasure sound d) Uses multisyllabic babbling
Understands "no" and other simple commands
The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term? a) Educating the parents about when colic stops b) Assessing the parents' care and feeding skills c) Urging the baby's mother to take time for herself away from the child d) Watching how the parents respond to the child
Urging the baby's mother to take time for herself away from the child
A new mother complains that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. Which of the following would be most helpful for this mother to do to encourage healthy sleeping patterns? The mother should a) Put the baby to bed a various times of the evening b) Let the baby cry during the night and she will eventually fall back to sleep c) Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime d) Use the crib for sleeping only, not for play activities
Use the crib for sleeping only, not for play activities
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a) Picks up small objects using entire hand b) Cannot pull self to standing c) Uses only the left hand to grasp d) Crawls with stomach down
Uses only the left hand to grasp
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk? a) Uses only the left hand to grasp b) Crawls with stomach down c) Picks up small objects using entire hand d) Cannot pull self to standing
Uses only the left hand to grasp
When teaching an infant's mother about bathing her, it would be important to instruct her that a) she should never use soap on a baby's hair. b) soap lubricates and oils an infant's skin. c) bath time provides an opportunity for play. d) infants need a daily bath.
bath time provides an opportunity for play.
Anticipatory guidance for an infant for the 4th month should include the fact that she probably will a) have many "blue" or moody periods. b) develop a fear of strangers. c) insist on things being done her way. d) be able to turn over onto the back.
be able to turn over onto the back.
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a) pushing a spoon from her high chair tray to the floor. b) looking for a toy in her crib at the last place she saw it. c) shaking a rattle to enjoy the sound. d) smiling at herself in the mirror.
looking for a toy in her crib at the last place she saw it.
Which statements regarding infant safety are accurate? Select all that apply. a) Bottle should only be propped for infants 8 months or older b) Crib and playpen bars should be no more than 2 3/8 inches apart c) Only small pillows should be used in cribs d) A safe temperature for hot water heaters in households with infants is 120 degrees e) Car seats should be placed in back seats
• Crib and playpen bars should be no more than 2 3/8 inches apart • Car seats should be placed in back seats • A safe temperature for hot water heaters in households with infants is 120 degrees
The infant in the exam room has these signs and symptoms. Which will the nurse attribute to teething? Select all that apply. a) Fever and diarrhea b) Refusing to eat c) Irritability and awakening from sleep d) Drooling and biting e) Increased sucking on hands
• Refusing to eat • Irritability and awakening from sleep • Drooling and biting • Increased sucking on hands
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved? a) Building a tower of four cubes b) Sitting independently c) Turning a doorknob d) Walking independently
Sitting independently
Which of the following milestones would you expect an infant to accomplish by 8 months of age? a) Sitting without support b) Pulling self to a standing position c) Creeping on all fours d) Being able to sit from a standing position
Sitting without support
The nurse is providing anticipatory guidance regarding the respiratory development of a 4-week-old girl for her mother. Which action is accurate? a) Informing the mother that the respiratory system reaches maturity similar to the adult's by 12 months of age. b) Advising the mother that the infant's usual respiratory rate should slow to about 20 breaths per minute by age 6 months c) Explaining to the mother the risk for infection is high due to the lack of antibodies d) Telling the mother that abdominal breathing disappears by 9 month of age
Explaining to the mother the risk for infection is high due to the lack of antibodies
While evaluating the development of 10-month-old boy, a nurse hides the boy's stuffed animal behind her back. The boy crawls around the examination table to look behind the nurse's back for the stuffed animal. Which developmental phenomena has this infant demonstrated? a) Binocular vision b) Object permanence c) Depth perception d) Hand regard
Object permanence
The nurse is promoting a healthy diet to the mother of a 6-month-old girl. What action would have the most effect on the infant's neurologic development? a) Adding fruit juice daily b) Establishing an adequate level of dietary iron intake c) Requiring more solid foods in the diet d) Promoting continuation of breastfeeding
Promoting continuation of breastfeeding
The nurse is observing a 6-month-old boy for developmental progress. For which typical milestone should the nurse look? a) Puts down a little ball to pick up a stuffed toy b) Enjoys hitting a plastic bowl with a large spoon c) Picks up an object using his thumb and finger tips d) Shifts a toy to his left hand and reaches for another
Puts down a little ball to pick up a stuffed toy
A new mother, when asked by a nurse, explains that her 4-month-old infant has been nursing regularly every 3 to 4 hours but seems satisfied. However, the mother recently introduced solid food in the form of unbuttered popcorn to the baby as a supplement, to "get her used to eating solid food." She felt that the popcorn would be safe because it is soft on the baby's gums. Which of the following should be the primary nursing diagnosis in this situation? a) Readiness for enhanced nutrition, related to the age of the infant b) Imbalanced nutrition, more than body requirements, related to introduction of a high-calorie food c) Imbalanced nutrition, less than body requirements, related to introduction of a low nutritive food d) Risk for aspiration related to feeding the infant an inappropriate food
Risk for aspiration related to feeding the infant an inappropriate food
A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl just demonstrated? a) Binocular vision b) Primary circular reaction c) Secondary circular reaction d) Object permanence
Secondary circular reaction third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline.
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? a) If she is safe, they lie her down and leave. b) They put her to bed when she falls asleep. c) They sing to her before she goes to sleep. d) The child has a regular, scheduled bedtime.
They put her to bed when she falls asleep.
