newborn/infant growth and development

A 12-month-old infant was born full-term without any difficulties. The infant weighed 8 lb at birth. Which assessment findings would the nurse expect for this infant? (Select four items.) -Current weight is 24 lb. -Anterior fontanel is closed. -Posterior fontanel is slightly open. -The infant is now walking. -The infant tries to build a two-block tower. -The infant says 10 words with meaning.

-current weight is 24 lb -anterior fontanel is closed -the infant is now walking -the infant tries to build two-block towers

The nurse is reviewing the medical record of an infant who is being seen for the 12-month well-child visit. Which finding(s) is normal for this infant? Select all that apply. A. infant walks independently B. heart rate 101 beats/min C. infant has moderate head lag D. respiratory rate 28 breaths/min E. temperature 100.6°F (38.1°C)

A, B, D

The nurse is teaching the parent of a 5-month-old child who is concerned about thumb sucking. What should be included in the teaching plan? Select all that apply. A. Informing the parent that thumb sucking occurs more often during periods of stress B. Telling the parent this behavior usually decreases by 6 to 9 months of age C. Assuring the parent this behavior won't cause malocclusion D. Advising the parent this behavior is a form of self-comfort

ALL

The nurse is assessing the newborn. Which would the nurse assess to be an abnormal finding? A. The neck is short, thick and mobile B. The newborn startles to loud sounds C. Natal teeth noted in the mouth that are loose D. Gluteal folds are present and symmetrical

Natal teeth noted in the mouth that are loose Explanation: The presence of 1 or 2 teeth at birth (natal teeth) is a finding that may be benign or may point to other congenital abnormalities.

Parents report to the nurse that their young infant breastfeeds and sleeps well on their abdomen on a soft mattress, with a light blanket covering them. The nurse determines the infant is at risk for ____ related to _____ and ______. Blank 1: Shaken baby syndrome (SBS) Sudden infant death syndrome (SIDS) Gastroesophageal reflux disease (GERD) Blanks 2 and 3: Prone sleeping Supine sleeping Soft crib mattress Breastfeeding

SIDS related to soft crib mattress and prone sleeping

A 9-month-old infant's parent is questioning why cow's milk is not recommended in the first year of life as it is much cheaper than formula. What rationale does the nurse include in the response? A. It is permissible to substitute cow's milk for formula at this age as the infant is so close to 1 year old. B. Cow's milk is poor in iron and does not provide the proper balance of nutrients for the infant. C. As long as the parent provides whole milk, rather than skim, they can start cow's milk in infancy. D. If the parent cannot afford the infant formula, they should dilute it to make it last longer.

B

The nurse assesses a 4-month-old child during a well-child visit (above). Which assessment finding should the nurse report to the health care provider? A. waking 3 times per night to feed B. not smiling or tracking faces C. not rolling over D. occasionally spitting up after breastfeeding

B

The parent of a 1-month-old infant voices concern about the infant's respirations. The parent states the respirations are rapid and irregular. Which information should the nurse provide? A. The irregularity of the infant's respirations is concerning; I will notify the health care provider. B. The respirations of a 1-month-old infant are normally irregular and periodically pause. C. The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute. D. An infant at this age should have regular respirations.

B

The parent of a 2-month-old infant is expressing concern that the infant may be getting spoiled. What is the nurse's best response? A. "The baby just needs love and attention. Don't worry; the baby's too young to spoil." B. "Consistently meeting the infant's needs helps promote a sense of trust." C. "Infants need to be fed and cleaned; if you are sure those needs are met, just let your baby cry." D. "Consistency in meeting needs is important, but you are right, holding the infant too much will spoil the baby."

B

five basic assessment during physical exam

vital signs head circumference length + weight fontanels neuro/reflex

A 9-month-old has been brought to the clinic for a well-child visit. The parent reports their child was born 6 weeks prematurely. During the data collection, the child's parent reports their child seems to be a few months "behind" what they recall from their older children. What is the best response by the nurse? A. "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." B. "All children mature and develop at different rates so it is unwise to compare them in this way." C. "Delays are normal when a child is premature." D. "You should talk with the health care provider about getting your child tested"

"Delays are normal when a child is premature." Explanation: When infants are born prematurely delays may be noted. When assessing the growth and development of a premature infant,

The parent of a 6-week-old infant voices concerns about their child's stooling. They further share that their child grunts and cries when having a bowel movement. What response by the nurse is most appropriate? A. "What does their stool look like?" B. "Grunting is normal with infant stool formation." C. "Are they in pain?" D. "We will need to collect a stool specimen for analysis."

"What does their stool look like?" Explanation: Grunting, crying and straining during bowel movements by infants and newborns is normal. This is due to the immaturity of the gastrointestinal system. The most important thing to do initially is to determine the appearance of the stool.

The nurse is providing a nutrition workshop for the parents of infants. The nurse understands that further instruction is required when hearing which comments from the parents? Select all that apply. A. "Food is so expensive. I can't afford for my child to leave any food on the plate." B. "I have tried at least 10 times with every green vegetable and I can't get my child to like them." C. "I try to eat healthy in front of my child so they will hopefully pick up good eating habits." D. "I let my child eat whatever they want right now so that we don't argue about food. Hopefully they will like healthy foods when they grow up." E. "I plan on encouraging my child to cook with me when they are old enough so that they will enjoy a variety of foods and learn how to cook too."

-"Food is so expensive. I can't afford for my child to leave any food on the plate." -"I have tried at least 10 times with every green vegetable and I can't get my child to like them." -"I let my child eat whatever they want right now so that we don't argue about food. Hopefully they will like healthy foods when they grow up."

The nurse is educating the parents of a newborn prior to discharge home. The parents demonstrate teaching was successful when making which statement(s)? Select all that apply. A. "I will not be concerned if my newborn has stools that begin to have a yellowish color to them." B. "We should get some rest in about 1 month when the newborn starts sleeping through the night." C. "I plan to add a little rice cereal to my breast milk so my newborn will sleep longer at night." D. "I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." E. "My newborn can see up-close things, like our faces, better than things at a distance."

-"I will not be concerned if my newborn has stools that begin to have a yellowish color to them." -"I understand it is normal for newborns to lose 5% to 10% of their bodyweight after birth." -"My newborn can see up-close things, like our faces, better than things at a distance."

height increases by _____ inch per month for ______ 6 months

1 inch for the first 6 months

The infant weighs 7 lb 4 oz (3300 g) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months? A. 14 lb 8 oz (6.6 kg) B. 21 lb 12 oz (9.9 kg) C. 25 lb (11.3 kg) D. 28 lb 4 oz (12.8 kg)

21 lb 12 oz (9.9 kg)

The infant measures 21.5 in (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for the infant at the age of 6 months? A. 27.5 in (70 cm) B. 29 in (74 cm) C. 30.5 in (77.5 cm) D. 32 in (81 cm)

27.5 in (70 cm) Explanation: Infants gain about 0.5 to 1 in (1.25 to 2.5 cm) in length for each of the first 6 months of life.

Infant developmental milestones

3mo = social smile 4-5mo = recognize people 6-9mo = sit alone 7-9mo = stranger anxiety by 15mo = walk, separation anxiety, few words reflexes that disappear in 1st year: moro (spread limbs when startled) rooting, palmar, Babinski

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. should have disappeared. B. should be pronounced and easy to elicit. C. is expected to appear within 1 month. D. is a protective reflex and retained for life.

A

The parent of an infant asks the nurse when to begin brushing the infant's teeth. What would be the nurse's best response? A. as soon as the first tooth erupts B. by 12 months of age C. when weaning is complete D. as soon as the infant begins to eat fruit

A

The postpartum nurse observes new parents as they put their newborns in the bassinet to sleep. Which action(s) by a new parent require further instruction from the nurse? Select all that apply. A. A parent places a newborn on its side after falling asleep. B. A parent states all of their children like sleeping on their abdomen and this newborn likes it too. C. A parent places the comforter the grandparent made over the newborn's body. D. A parent tells their spouse to be sure to place the newborn on their back when putting the newborn in the bassinet. E. A parent states their newborn looks too warm, so they are moving the bassinet in front of the air conditioner to cool off the newborn.

A B C E

The nurse establishes the following plan of care based on the nursing diagnosis: Caregiver role strain related to infant crying throughout night as manifested by parents stating, "We are exhausted." Which nursing interventions are included in the plan of care? Select all that apply. A. Establish a quieting ritual for infant before bed. B. During night awakening, keep interactions minimal. C. Add rice cereal to the evening bottle to prevent hunger and awakening. D. At bedtime, ensure the child is in a deep sleep then place in crib. E. Having one parent awake at a time with infant

A B E

A nurse is caring for an 8-month-old infant admitted for respiratory distress. The infant's caregiver asks why their infant is admitted for a respiratory issue, whereas the caregiver has similar symptoms and can manage those symptoms at home. Which statement(s) should the nurse include? Select all that apply. A. "The infant's nasal passages are narrower compared to an adult." B. "The infant's chest wall is more rigid compared to an adult." C. "The infant's tongue occupies a smaller space compared to an adult." D. "The infant has less immunoglobulin A compared to an adult." E. "The infant's bronchi and bronchioles are shorter compared to an adult."

A C D The respiratory system continues to mature over the first year of life. In comparison to the adult, the infant's nasal passages are more narrow, the trachea and chest wall are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel shaped, the tongue is larger, and there is less immunoglobulin A in the mucosal lining of the upper respiratory tract.

A 9-month-old has been brought to the clinic for a well-child visit. The parent reports their child was born 6 weeks prematurely. During the data collection, the child's parent reports their child seems to be a few months "behind" what they recall from their older children. What is the best response by the nurse? A. "We will need to check this out since any delays related to prematurity should be resolved by the time a child is 6 months old." B. "All children mature and develop at different rates so it is unwise to compare them in this way." C. "Delays are normal when a child is premature." D. "You should talk with the health care provider about getting your child tested."

C

Parents of an 8-month-old infant express concern that the infant cries when left with the babysitter. How does the nurse best explain this behavior? A. "Crying when left with the sitter may indicate difficulty with building trust." B. "Stranger anxiety should not occur until toddlerhood; this concern should be investigated." C. "Separation anxiety is normal at this age; the infant recognizes parents as separate beings." D. "Perhaps the sitter doesn't meet the infant's needs; choose a different sitter."

C

The nurse is providing anticipatory guidance to the parent of a 6-month-old infant. What is the best instruction by the nurse in relation to the infant's oral health? A. "Start brushing the teeth after all the baby teeth come in." B. "Use a washcloth with toothpaste to clean the mouth." C. "Clean your baby's gums, then new teeth, with a washcloth." D. "Rinse your baby's mouth with water after every feeding."

C

An infant is breastfed. When assessing the stools, which findings would be typical? A. Harder stools than those of bottle-fed infants B. Fewer stools than bottle-fed infants C. Less constipation than bottle-fed infants D. A strong odor

C. Less constipation than bottle-fed infants The stools of breastfed infants tend to be yellow-tan. They are looser in texture and appear "seedy." The stool of a bottle-fed infant has the consistency of peanut butter. The stools of breastfed babies generally have no odor since all milk is digested. Some babies will have a bowel movement with every feeding but it is small. Bottle-fed babies have less stools each day but they are larger and more likely to have an associated odor.

What information would the nurse include when teaching the parents of an infant about colic? A. Colic symptoms will probably fade at 3 months of age. B. The infant will need future follow-up for a "nervous" bowel. C. Formula intake should be doubled to keep the infant from losing weight. D. Symptoms will decrease if the infant is laid on the back after feedings.

Colic symptoms will probably fade at 3 months of age. Explanation: Colic is defined as inconsolable crying that lasts 3 hours or longer per day and which it has no physical cause. Colic symptoms typically fade around 3 months of age.

The parent of a 3-month-old infant asks the nurse about starting solid foods. What is the most appropriate response by the nurse? A. "It's okay to start puréed solids at this age if fed via the bottle." B. "Infants don't require solid food until 12 months of age." C. "Solid foods should be delayed until age 6 months, when the infant can handle a spoon on their own." D. "The tongue extrusion reflex disappears at age 4 to 6 months, making it a good time to start solid foods."

D

The parents of an 8-month-old infant voice concern to the nurse that their infant is not developing motor skills as they should. What question should the nurse ask to help determine if their fears are warranted? A. "Does your infant move a toy back and forth from one hand to the other when you give it to them?" B. "Does your infant place toys into a box or container and take them out?" C. "Is your infant able to drink with a cup by themselves?" D. "Is your infant able to hold a pencil and scribble on paper?"

Does your infant move a toy back and forth from one hand to the other when you give it to them?" Explanation: Transferring an object from one hand to the other is expected at 7 months of age, so this ability would be expected of an 8-month-old.

The nurse is providing education about nutrition and feeding to the parents of a healthy 10-month-old child. What foods, if reported by the parents, indicate the need for further education? Select all that apply. A. pureed beef B. rice cereal C. whole grapes D. cooked peas E. honey

whole grapes honey

Which milestone would the nurse expect an infant to accomplish by 8 months of age? A. Sitting without support B. Creeping on all fours C. Pulling self to a standing position d. Being able to sit from a standing position

Sitting without support Explanation: Physical development of infants occurs in a cephalocaudal fashion. That means they must learn to control and lift their heads first. This is followed by the ability to turn over. Once this occurs the remainder of development occurs quickly. Most infants are able to sit unsupported by 8 months. They are able to creep at 9 months and pull to a standing position by 10 months. At 12 months the infant is able to sit from a standing position and is learning to walk.

The nurse in a community clinic is assessing a 2-month-old infant. The parent asks if the infant is developing normally. The nurse refers to which finding as suggestive of normal development in infants from birth to 2 months of age? A. The infant transfers objects from one hand to the other. B. The infant stays seated in the tripod position. C. The infant raises head and chest while on stomach. D. The infant laughs aloud and responds to name.

The infant raises head and chest while on stomach. Explanation: Infants have gained some neck control and can independently raise head and chest by 2 months of age. Transferring objects from one hand to another is expected at 7 months of age. Laughing aloud and responding to their name is expected between 4 to 5 months of age. Sitting in the tripod position is not expected until 6 months of age

The parent of a 1-month-old infant voices concern about the infant's respirations. The parent states the respirations 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 is concerning; I will notify the health care provider.

The respirations of a 1-month-old infant are normally irregular and periodically pause. Explanation: The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age, the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.

The nurse is assessing the sleeping practices of the parents of a 4-month-old child who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking? A. They sing to them before they go to sleep. B. They put them to bed when they fall asleep. C. If they are safe, they lie them down and leave. D. The child has a regular, scheduled bedtime.

They put them to bed when they fall asleep. Explanation: If the parents are keeping the child up until they fall asleep, they are not creating a bedtime routine for them. Infants need a transition to sleep at this age.

The best way for an infant's parent to help the child complete the developmental task of the first year is to: A. expose the infant to many caregivers to help the infant learn variability. B. talk to the infant at a special time each day. C. respond to the infant consistently. D. keep the infant stimulated with many toys.

respond to the infant consistently.

When performing neurological reflexes on the infant, which primitive reflex will be present longest? A. Moro B. Babinski C. rooting D. step

babinski

infant gross motor skills

newborn- turns head from side to side when prone 3 months- minimal head lag 4 months- rolls front to back 6 months- sits leaning forward 8 months- sits unsupported 9 months- pulls self to standing 10-11 months - cruises, may stand alone, can sit from standing 12 months- walks holding someones hand

The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to: A. refer the infant for developmental and/or neurologic evaluation. B. conclude the earlier assessments carried out fatigued the infant. 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. Explanation: 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.