NUR 1600 Q1
The nurse is reinforcing instructions to the mother of a 2yo regarding dental care. Which statement by the mother indicates the need for further teaching? A. "It is best to substitute sweets or snacks with food items such as cheese." B. "Proper dental care is not necessary for a toddler until the permanent teeth erupt." C. "My child should have the first dental exam at some point after the second birthday." D. "I do not need to be concerned if the child swallows some toothpaste while brushing the teeth."
"Proper dental care is not necessary for toddlers until their permanent teeth erupt."
The nursing instructor asks a nursing student to describe the formal operations stage of Piaget's cognitive developmental theory. The appropriate response by the nursing student is which?
"The child has the ability to think abstractly."
The mother of a 2 yo asks the nurse if it is all right to give the child a bottle at naptime. Which response by the nurse is appropriate? 1."At this age, the child may have a bottle at any time." 2."A bottle may be given if the child isn't taking fluids well during the day." 3."You may give the child a bottle if necessary, but if you do, it should contain water." 4."The child may have a bottle at naptime, but it is best not to give a bottle at bedtime."
"You may give the child a bottle if necessary, but if you do, it should contain water." A child should never be allowed to fall asleep with a bottle because of the risk of bottle-mouth caries. If the bottle is allowed in bed, it should contain only water. The other options are inappropriate responses to the mother.
A mother tells the nurse in a pediatrician's office that she is concerned because her children must let themselves into the house after school each day while she is at work. The nurse explores which suggestion with the mother to decrease the children's sense of isolation and fear? A. Instruct the children never to cook. B. Let the children play in neighborhood homes. C. Find community after-school programs or activities. D. Have the children call the mother at work every hour.
C. Find community after-school programs or activities.
Which action by the nurse demonstrates use of evidence-based practice (EBP)? a. Gathering equipment for a procedure b. Documenting changes in a patient's status c. Questioning the use of daily central line dressing changes d. Clarifying a physician's prescription for morphine
C. Questioning the use of daily central line dressing changes The nurse who questions the daily central line dressing change is ascertaining whether clinical interventions result in positive outcomes for patients. This demonstrates EBP, which implies questioning why something is effective and whether a better approach exists. Gathering equipment for a procedure and documenting changes in a patient's status are practices that follow established guidelines. Clarifying a physician's prescription for morphine constitutes safe nursing care.
Which describes Lawrence Kohlberg's first level of moral development?
Children determine the goodness or badness of an action in terms of the consequences.
A child has sustained an injury and lost a primary tooth. Which priority action should be taken by the nurse at this time? A. Provide comfort measures and assess for bleeding. B. Referral to the dentist for immediate consultation. C. Recover the tooth and prepare for reimplantation. D. If the tooth is dirty, rinse it off and cover in gauze until needed for reimplantation.
Provide comfort measures and assess for bleeding. Avulsed primary teeth are usually not reimplanted. Therefore the nurse should focus on assessment of the site and comfort measures. All of the other options would be indicated if an avulsed tooth were to be reimplanted.
According to Kohlberg's theory of moral development, at the pre-conventional level, moral development is thought to be motivated by which factor?
Punishment & reward
The parents of a toddler ask the nurse for suggestions about discipline. When discussing the use of timeouts, which of the following suggestions should the nurse include? A. Send the child to his or her room. B. If the child cries, refuses, or is more disruptive, try another approach. C. Select an area that is safe and nonstimulating, such as a hallway. D. The general rule for length of time is 1 hour per year of age.
Select an area that is safe and nonstimulating, such as a hallway. The area must be nonstimulating and safe. The child becomes bored in this environment and then changes his or her behavior to rejoin activities. The child's room may have toys and other forms of amusement that may negate the effect of being separated from family activities. When the child engages in this type of behavior, the timeout begins when the child quiets. The general rule is 1 minute per year. An hour per year is excessive.
According to Piaget, at what stage of development do children typically solve problems through trial and error? A. Sensorimotor stage B. Preoperational stage C. Formal operational stage D. Concrete operational stage
Sensorimotor stage During the sensorimotor stage, infants and young toddlers develop a sense of cause and effect. Relational problem solving is characteristic of the preoperational stage. Adolescents, in the formal operations stage, can test hypotheses. Children in the concrete operations stage solve problems in a tangible, systematic fashion.
The parent of a 3 yo tells the nurse that the child is constantly rebelling & having temper tantrums. Which instruction should the nurse reinforce to the parent?
Set limits on the child's behavior
What is an important consideration related to childhood stress? A. Children should be protected from stress. B. Children do not have coping strategies. C. Parents cannot prepare children for stress. D. Some children are more vulnerable to stress than others.
Some children are more vulnerable to stress than others. Children's age, temperament, life situation, and state of health affect their vulnerability, reactions, and ability to handle stress. It is not feasible to protect children from all stress. Children can be taught coping strategies. Supportive interpersonal relationships are essential to the psychological well-being of children. Adults need to recognize signs of stress before they become overwhelming. Providing children with interpersonal security helps them develop coping strategies for dealing with stress.
A mother asks the nurse when her child should have his first dentist visit. The nurse tells the mother: A. Just before beginning kindergarten B. At age 3 C. Soon after the first primary tooth erupts, usually around 1 year of age D. Twelve months after the first primary tooth erupts
Soon after the first primary tooth erupts, usually around 1 year of age
The nurse is assessing a 36 mo old during a wellness visit to the pediatrician. The child weighs 43 pounds & is 41 inches tall. After plotting the measurements on the standardized growth charts for a 36 mo old, which should the nurse do next?
Assess the parents' body shape & stature.
When conducting a class on sex and sexual activities with adolescents, the most appropriate approach by the nurse is to A. use dolls to teach the content. B. present normal body functions in a straightforward manner. C. refer the adolescents to their parents for sexual information. D. delay giving information about pregnancy unless the adolescents are sexually active.
B. present normal body functions in a straightforward manner. The nurse should provide accurate and complete information using correct terminology that is understandable to the adolescent. Dolls are appropriate for teaching a younger age-group of children. Using the correct terminology is more appropriate for a group of adolescents. Parents are important for conveying the morals and values surrounding sexual activities, but nurses may provide adolescents with accurate, complete information. Adolescents should have information before they become sexually active about the potential consequences of sex, including the practice of safe sex to prevent pregnancy and the transmission of sexually transmitted diseases.
A school nurse provides information to the parents of school-age children regarding appropriate dental care. The nurse tells the parents that their children should: A. Brush and floss their teeth every morning and at bedtime B. Brush their teeth every morning and at bedtime and floss the teeth once a day, preferably at bedtime C. Brush their teeth every morning and at bedtime D. Brush and floss their teeth after meals and at bedtime
Brush and floss their teeth after meals and at bedtime
A nurse is discussing various developmental theories at a parenting class. Which individual is associated with the moral development theory? A) Erikson B) Fowler C) Kohlberg D) Freud
C)Kohlberg Rationale:Kohlberg developed the theory of moral development sequence for children. It includes how children acquire moral reasoning and is based on cognitive developmental theory.Erikson developed the theory of psychosocial development.Fowler developed the theory of spiritual development.Freud developed the theory of psychosexual development.
A 6-month-old infant is admitted to the hospital. The nurse weighs the infant and notes that the infant weighs 14 pounds. Which statement by the mother indicates that further teaching is needed? A. "His weight for his age is just right." B. "I am so glad he is gaining the correct amount of weight for his age." C. "I will have to increase his milk intake because he is not gaining enough weight." D. "He weighed 7 pounds when he was born so he is at the correct weight for his age."
C. "I will have to increase his milk intake because he is not gaining enough weight." Rationale:Newborns double their birth weight at 5 to 6 months of age and triple it by 1 year. Therefore, options 1, 2, and 4 are correct statements. Option 3 indicates the need for further teaching.
A mother of a 3 yo is concerned because the child is still insisting on a bottle at nap time & at bedtime. The nurse should make which suggestion to the mother? A. Allow the bottle if it contains juice. B. Allow the bottle if it contains water. C. Do not allow the child to have the bottle. D. Allow the bottle during naps but not at bedtime.
"Allow the bottle if it contains water." A toddler should never be allowed to fall asleep with a bottle containing milk, juice, soda pop, sweetened water, or any other sweet liquid because of the risk of nursing (bottle-mouth) caries. If a bottle is allowed at nap time or bedtime, it should contain only water.
The nurse determines a 5-year-old child is in the expected Erikson's psychosocial stage if the child makes which comment? 1."I like drawing my mommy pictures with my finger paints." 2."My favorite thing to do is having recess at school with my friends." 3."All my friends and I hang around the mall on Saturday mornings." 4."No, mommy, I don't want to take a bath. I don't need to go potty."
1."I like drawing my mommy pictures with my finger paints." A 5-year-old child would be expected to be experiencing Erikson's psychosocial stage of initiative versus guilt (late childhood, 3 to 6 years). A child in this stage enjoys exploring and making art. During Erikson's stage of industry vs. inferiority, which occurs during school age (6 to 12 years), a child spends a great deal of time in school and with friends. Hanging around at the mall describes behaviors that correspond with the stage that occurs during adolescence, identity vs. role confusion. Episodes of negativism best describes Erikson's stage of shame vs. doubt, which occurs during toddlerhood (early childhood, 18 months to 3 years).
During data collection on a child for a well-child visit, a parent tells the nurse "We have a chore chart at our house. When our child does chores without prompting for 3 days in a row, the child gets an extra 30 minutes of screen time. So far, it seems to be working!" The nurse determines the child's behavior corresponds with which stage of Kohlberg's moral development? 1.Pre-conventional: Obtaining rewards 2.Pre-conventional: Avoiding punishment 3.Conventional: Obeying rules and regulations 4.Post-conventional: Making and keeping promises
1.Pre-conventional: Obtaining rewards The child is in the pre-conventional stage, and obtaining rewards is the focus of the child's behavior. There is nothing in the question that mentions avoiding punishment. In the later stages of Kohlberg's moral development, a person obeys rules and regulations, and makes and keeps promises.
In the well-child clinic, the nurse observes an infant, age 10 months, playing with toys, bringing them to his mouth, and passing the toys from one hand to the next. The nurse determines the child is in which Jean Piaget's first developmental stage? 1.Sensorimotor 2.Preoperational 3.Formal operational 4.Concrete operational
1.Sensorimotor Jean Piaget's first stage of cognitive development is the sensorimotor stage (birth to 2 years). The preoperational stage is the second stage (2 to 7 years of age). The concrete operational stage is the third stage (7 to 11 years of age). The formal operational stage is the fourth stage (11 years of age to adulthood).
The nurse is assisting with data collection for a parent and son during a well-child visit. The nurse determines the child is in the phallic stage of Sigmund Freud's theory of personality development if the parent makes which comment? 1."My child is finally toilet trained." 2."I've noticed my child is developing pubic hair." 3."Yesterday my son asked me why he looked different from his sister." 4."My son hangs around other boys, and they've started saying girls have cooties."
3."Yesterday my son asked me why he looked different from his sister." Freud's phallic stage of development includes the recognition of differences between the sexes. Accomplishing toilet training occurs during the Freud's anal stage. Development of pubic hair is characteristic of the genital stage. Freud's latency stage is characterized by same sex friendships and making comments about the other sex.
The nurse is observing a parent and child interacting in the clinic waiting room. The child begins to bounce on the couch. The parent removes the child from the couch stating firmly, "Couches are for sitting, not for jumping." The parent then gives the child a toy to play with on the carpet. The child plays with the toy until called by the nurse. The nurse determines the child is acting within which Kohlberg stage of moral development? 1.Egocentric judgment 2.Law-and-order orientation 3.Punishment-obedience stage 4.Good boy-nice girl orientation
3.Punishment-obedience stage Kohlberg's theory states that individuals move through the six stages of development in a sequential fashion, but not everyone reaches stages 5 and 6 during his or her development of personal morality. The theory provides a framework for understanding how individuals determine a moral code to guide their behavior. It also states that moral development progresses in relation to cognitive development, and a person's ability to make moral judgments develops over a period of time. In stage 1 (ages 2-3 years; punishment-obedience orientation), children cannot reason as mature members of society because they are too young to do so. A child obeys rules to avoid punishment. It is appropriate for a parent to explain limitations, and to provide distractions. In the egocentric stage, an infant has no concept of right or wrong. A child who is in the law-and-order orientation stage obeys laws to maintain social order. In the good boy-nice girl orientation stage, a child behaves in a way to avoid displeasing others
The nurse notes that a 6-year-old child does not recognize that objects exist even when the objects are outside of the visual field. Based on this observation, which action should the nurse take? 1.Move the objects in the child's direct field of vision. 2.Teach the child how to visually scan the environment. 3.Report the observation to the primary health care provider. 4.Provide additional lighting for the child during play activities.
3.Report the observation to the primary health care provider. According to Jean Piaget's theory of cognitive development, it is normal for the infant or toddler not to recognize that objects continue to be in existence, even if out of the visual field; however, this is abnormal for a 6-year-old. If a 6-year-old child does not recognize that objects still exist even when outside the visual field, the child is not progressing normally through the developmental stages. The nurse should report this finding to the health care provider. Options 1, 2, and 4 delay necessary follow-up and treatment.
Based on Piaget's theory of cognitive development, what is one basic concept a child is expected to attain during the first year of life? A) If an object is hidden, that does not mean that it is gone. B) He or she cannot be fooled by changing shapes. C) Parents are not perfect. D) Most procedures can be reversed.
A) If an object is hidden, that does not mean that it is gone. Rationale:Part of learning permanence is learning that although an object is no longer visible, it still exists.At 1 year of age, a child may not be able to understand that an object that changes shape is still the same object. Understanding conservation occurs between ages 7 to 11 years.
Which of the following developmental stages is Jean Piaget's first stage of cognitive development?
Answer: Sensorimotor Rationale:Jean Piaget's first stage of cognitive development is the sensorimotor stage (birth to 2 years). The preoperational stage is the second stage (2 to 7 years of age).
A 6 yo is hospitalized with a fracture of the femur & is placed in traction. In meeting the psychosocial needs of the child, the nurse most appropriately selects which play activity for the child? A. A board game B. A large puzzle C. A finger-painting set D. A coloring book with crayons
A. A board game Rationale:The school-age child becomes organized with more direction with play activities. Such activities include collections, drawing, construction, dolls, pets, guessing games, board and computer games, riddles, hobbies, competitive games, and listening to the radio or television. Options 3 and 4 are appropriate for a preschooler. Option 2 is appropriate for a toddler.
While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs and practices. The nurse should recognize that this is A. normal in spiritual development. B. abnormal in spiritual development. C. related to illness and occurs only at times of crisis. D. related to the parents' inability to adequately explain their beliefs and practices.
A. normal in spiritual development. The behavior described occurs in stage 4 in spiritual development. Adolescents attempt to determine which of their parents' standards and beliefs to incorporate into their own. The behavior described is not abnormal. The behavior described is not applicable only during times of crisis. The behavior described is not related to the parents' inability to explain their beliefs and practices.
According to Erik Erikson's psychosocial developmental theory, the nurse would anticipate a 5-year-old child to be in the stage of:
Answer:Initiative vs. guilt Rationale:A 5-year-old child would be expected to be experiencing Erikson's psychosocial stage of initiative versus guilt (late childhood, 3 to 6 years)
A nurse is conducting parenting classes for parents of adolescents. Which parenting style should the nurse recommend? a. Laissez-faire b. Authoritative c. Disciplinarian d. Confrontational
ANS: B Parents should be guided toward an authoritative style of parenting in which authority is used to guide the adolescent while allowing developmentally appropriate levels of freedom and providing clear, consistent messages regarding expectations. The authoritative style of parenting has been shown to have both immediate and long-term protective effects toward adolescent risk reduction. The laissez-faire method would not give adolescents enough structure. The disciplinarian and confrontational styles would not allow any autonomy or independence.
A nurse is planning a teaching session for a group of adolescents. The nurse understands that by adolescence the individual is in which stage of cognitive development? a. Formal operations b. Concrete operations c. Conventional thought d. Postconventional thought
ANS: A Cognitive thinking culminates with capacity for abstract thinking. This stage, the period of formal operations, is Piaget's fourth and last stage. Concrete operations usually occur between ages 7 and 11 years.Conventional and post conventional thought refers to Kohlberg's stages of moral development.
A nursing instructor asks a nursing student about Kohlberg's theory of moral development. The instructor determines that the student needs to further research this theory if the student states that a component of the theory includes which of the following?
Individuals move through all six stages in a sequential fashion.
The nurse is observing parents playing with their 10-month-old child. Which should the nurse recognize as evidence that the child is developing object permanence? a. Looks for the toy that parents hide under the blanket b. Returns the blocks to the same spot on the table c. Recognizes that a ball of clay is the same when flattened out d. Bangs two cubes held in her hands
ANS: A Object permanence is the realization that items that leave the visual field still exist. When the infant searches for the toy under the blanket, it is an indication that object permanence has developed. Returning the blocks to the same spot on the table is not an example of object permanence. Recognizing that a ball of clay is the same when flattened out is an example of conservation, which occurs during the concrete operations stage from 7 to 11 years. Banging two cubes together is a simple repetitive activity characteristic of developing a sense of cause and effect.
Which statement characterizes moral development in the older school-age child? a. They are able to judge an act by the intentions that prompted it rather than just by the consequences. b. Rules and judgments become more absolute and authoritarian. c. They view rule violations in an isolated context. d. They know the rules but cannot understand the reasons behind them.
ANS: A Older school-age children are able to judge an act by the intentions that prompted the behavior rather than just by the consequences. Rules and judgments become less absolute and authoritarian. Rule violation is likely to be viewed in relation to the total context in which it appears. The situation and the morality of the rule itself influence reactions.
When assessing a family, the nurse determines that the parents exert little or no control over their children. What is this style of parenting called? a. Permissive b. Dictatorial c. Democratic d. Authoritarian
ANS: A Permissive parents avoid imposing their own standards of conduct and allow their children to regulate their own activity as much as possible. The parents exert little or no control over their children's actions. Dictatorial or authoritarian parents attempt to control their children's behavior and attitudes through unquestioned mandates. They establish rules and regulations or standards of conduct that they expect to be followed rigidly and unquestioningly. Democratic parents combine permissive and dictatorial styles. They direct their children's behavior and attitudes by emphasizing the reasons for rules and negatively reinforcing deviations. They respect the child's individual nature.
Which information could be given to the parents of a 12-month-old child regarding appropriate play activities? a. Give large push-pull toys for kinetic stimulation. b. Place cradle gym across crib to facilitate fine motor skills. c. Provide child with finger paints to enhance fine motor skills. d. Provide stick horse to develop gross motor coordination.
ANS: A The 12-month-old child is able to pull to standing and walk holding on or independently. Appropriate toys for a child this age include large pull toys for kinesthetic stimulation. A cradle gym should not be placed across the crib. Finger paints are appropriate for older children. A 12-month-old child does not have the stability to use a stick horse.
The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. How should the nurse interpret this finding? a. Normal finding b. Finding requiring a referral c. Abnormal finding d. Normal finding, but requires rechecking in 1 month
ANS: A This is a normal finding. The anterior fontanel closes between ages 12 and 18 months. No further intervention is required.
In terms of gross motor development, which should the nurse expect a 5- month-old infant to do? (Select all that apply.) a. Roll from abdomen to back. b. Put feet in mouth when supine. c. Roll from back to abdomen. d. Sit erect without support. e. Move from prone to sitting position. f. Adjust posture to reach an object
ANS: A, B Rolling from abdomen and to back and placing the feet in the mouth when supine are developmentally appropriate for a 5-month-old infant. The ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually achieved by 8 months. The 10-month-old infant can usually move from a prone to a sitting position. The 8-month-old infant adjusts posture to reach an object.
The nurse is taking a sexual history on an adolescent girl. Which is the best way to determine whether she is sexually active? a. Ask her, "Are you sexually active?" b. Ask her, "Are you having sex with anyone?" c. Ask her, "Are you having sex with a boyfriend?" d. Ask both the girl and her parent whether she is sexually active.
ANS: B Asking the adolescent girl whether she is having sex with anyone is a direct question that is well understood. The phrase sexually active is broadly defined and may not provide specific information to the nurse to provide necessary care. The word anyone is preferred to using gender-specific terms such as boyfriend or girlfriend. Because homosexual experimentation may occur, it is preferable to use gender-neutral terms. Questioning about sexual activity should occur when the adolescent is alone.
A school nurse notes that school-age children generally obey the rules at school. The nurse recognizes that the children are displaying which stage of moral development? a. Preconventional b. Conventional c. Postconventional d. Undifferentiated
ANS: B Conventional stage of moral development is described as obeying the rules, doing one's duty, showing respect for authority, and maintaining the social order. This stage is characteristic of school-age children's behavior. The preconventional stage is characteristic of the toddler and preschool age. At this stage, the child has no concept of the basic moral order that supports being good or bad. The postconventional level is characteristic of an adolescent and occurs at the formal stage of operation. Undifferentiated describes an infant's understanding of moral development.
What is the most effective way to clean a toddler's teeth? a. Child to brush regularly with a toothpaste of his or her choice b. Parent to stabilize the chin with one hand and brush with the other c. Parent to brush the mandibular occlusive surfaces, leaving the rest for the child d. Parent to brush the front labial surfaces, leaving the rest for the child
ANS: B For young children, the most effective cleaning of teeth is by the parents. Different positions can be used if the child's back is to the adult. The adult should use one hand to stabilize the chin and the other to brush the child's teeth. The child can participate in brushing, but for a thorough cleaning, adult intervention is necessary.
Which is an appropriate recommendation for preventing tooth decay in young children? a. Substitute raisins for candy. b. Substitute sugarless gum for regular gum. c. Use honey or molasses instead of refined sugar. d. When sweets are to be eaten, select a time not during meals.
ANS: B Regular gum has high sugar content. When the child chews gum, the sugar is in prolonged contact with the teeth. Sugarless gum is less cariogenic than regular gum. Raisins, honey, and molasses are highly cariogenic and should be avoided. Sweets should be consumed with meals so that the teeth can be cleaned afterward. This decreases the amount of time that the sugar is in contact with the teeth.
A parent asks the nurse "when will my infant start to teethe?" The nurse responds that the earliest age at which an infant begins teething with eruption of lower central incisors is _____ months. a. 4 b. 6 c. 8 d. 12
ANS: B Teething usually begins at age 6 months with the eruption of the lower central incisors; 4 months is too early for teething. By age 8 months, the infant has the upper and lower central incisors. At age 12 months, the infant has six to eight deciduous teeth.
A nurse is conducting a teaching session on the use of time-out as a discipline measure to parents of toddlers. Which are correct strategies the nurse should include in the teaching session? (Select all that apply.) a. Time-out as a discipline measure cannot be used when in a public place. b. A rule for the length of time-out is 1 minute per year. c. When the child misbehaves, one warning should be given. d. The area for time-out can be in the family room where the child can see the television. e. When the child is quiet for the specified time, he or she can leave the room.
ANS: B, C, E A rule for the length of time-out is 1 minute per year of age; use a kitchen timer with an audible bell to record the time rather than a watch. When the child misbehaves, one warning should be given. When the child is quiet for the duration of the time, he or she can then leave the room. Time-out can be used in public places and the parents should be consistent on the use of time-out. Implement time-out in a public place by selecting a suitable area or explain to children that time-out will be spent immediately on returning home. The time-out should not be spent in an area from which the child can view the television. Select an area for timeout that is safe, convenient, and unstimulating but where the child can be monitored, such as the bathroom, hallway, or laundry room.
At which age should the nurse expect most infants to begin to say "mama" and "dada" with meaning? a.4 months b.6 months c.10 months d.14 months
ANS: C Beginning at about age 10 months, an infant is able to ascribe meaning to the words "mama" and "dada." Four to 6 months is too young for this behavior to develop. At 14 months, the child should be able to attach meaning to these words. By age 1 year, the child can say three to five words with meaning and understand as many as 100 words
Which describes moral development in younger school-age children? a. The standards of behavior now come from within themselves. b. They do not yet experience a sense of guilt when they misbehave. c. They know the rules and behaviors expected of them but do not understand the reasons behind them. d. They no longer interpret accidents and misfortunes as punishment for misdeeds.
ANS: C Children who are ages 6 and 7 years know the rules and behaviors expected of them but do not understand the reasons for these rules and behaviors. Young children do not believe that standards of behavior come from within themselves, but that rules are established and set down by others. Younger school-age children learn standards for acceptable behavior, act according to these standards, and feel guilty when they violate them. Misfortunes and accidents are viewed as punishment for bad acts.
A nurse is conducting a teaching session for parents of infants. The nurse explains that which behavior indicates that an infant has developed object permanence? a. Recognizes familiar face, such as mother b. Recognizes familiar object, such as bottle c. Actively searches for a hidden object d. Secures objects by pulling on a string
ANS: C During the first 6 months of life, infants believe that objects exist only as long as they can see them. When infants search for an object that is out of sight, this signals the attainment of object permanence, whereby an infant knows an object exists even when it is not visible. Between ages 8 and 12 weeks, infants begin to respond differentially to the mother. They cry, smile, vocalize, and show distinct preference for the mother. This preference is one of the stages that influences the attachment process but is too early for object permanence. Recognizing familiar objects is an important transition for the infant, but it does not signal object permanence. The ability to understand cause and effect is part of secondary schemata development.
The parent of a 2-week-old infant, exclusively breastfed, asks the nurse if fluoride supplements are needed. What is the nurse's best response? a. "She needs to begin taking them now." b. "They are not needed if you drink fluoridated water." c. "She may need to begin taking them at age 4 months." d. "She can have infant cereal mixed with fluoridated water instead of supplements."
ANS: C Fluoride supplementation is recommended by the American Academy of Pediatrics beginning at age 4 months if the child is not drinking adequate amounts of fluoridated water. The amount of water that is ingested and the amount of fluoride in the water are taken into account when supplementation is being considered.
A nurse is assessing a 12-month-old infant. Which statement best describes the infant's physical development a nurse should expect to find? a. Anterior fontanel closes by age 6 to 10 months. b. Binocularity is well established by age 8 months. c. Birth weight doubles by age 5 months and triples by age 1 year. d. Maternal iron stores persist during the first 12 months of life.
ANS: C Growth is very rapid during the first year of life. The birth weight has approximately doubled by age 5 to 6 months and triples by age 1 year. The anterior fontanel closes at age 12 to 18 months. Binocularity is not established until age 15 months. Maternal iron stores are usually depleted by age 6 months.
A nurse notes that a 10-month-old infant has a larger head circumference than chest. The nurse interprets this as a normal finding because the head and chest circumference become equal at which age? a. 1 month b. 6 to 9 months c. 1 to 2 years d. to 3 years
ANS: C Head circumference begins larger than chest circumference. Between ages 1 and 2 years, they become approximately equal. Head circumference is larger than chest circumference before age 1. Chest circumference is larger than head circumference at to 3 years
According to Piaget, the 6-month-old infant should be in which developmental stage? a. Use of reflexes b. Primary circular reactions c. Secondary circular reactions d. Coordination of secondary schemata
ANS: C Infants are usually in the secondary circular reaction stage from ages 4 to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. Shaking is performed to hear the noise of the rattle, not just for shaking. The use of reflexes is primarily during the first month of life. Primary circular reaction stage marks the replacement of reflexes with voluntary acts. The infant is in this stage from ages 1 to 4 months. The fourth sensorimotor stage is coordination of secondary schemata. This is a transitional stage in which increasing motor skills enable greater exploration of the environment.
By what age does birth length usually double? a. 1 year b. 2 years c. 4 years d. 6 years
ANS: C Linear growth or height occurs almost entirely as a result of skeletal growth and is considered a stable measurement of general growth. On average, most children have doubled their birth length at age 4 years. One and 2 years are too young for doubling of length. Most children will have achieved the doubling by age 4 years
By which age should the nurse expect an infant to be able to pull to a standing position? a. 6 months b. 8 months c. 11 to 12 months d. 14 to 15 months
ANS: C Most infants can pull themselves to a standing position at age 9 months. Infants who are not able to pull themselves to standing by age 11 to 12 months should be further evaluated for developmental dysplasia of the hip. At 6 months, infants have just obtained coordination of arms and legs. By age 8 months, infants can bear full weight on their legs. Any infant who cannot pull to a standing position by age 1 year should be referred for further evaluation.
In terms of gross motor development, what should the nurse expect an infant age 5 months to do? a.Sit erect without support. b.Roll from the back to the abdomen. c.Turn from the abdomen to the back. d.Move from a prone to a sitting position.
ANS: C Rolling from the abdomen to the back is developmentally appropriate for a 5-month-old infant. The ability to roll from the back to the abdomen is developmentally appropriate for an infant at age 6 months. Sitting erect without support is a developmental milestone usually achieved by 8 months. A 10-month-old infant can usually move from a prone to a sitting position.
During a routine health assessment, the nurse notes that an 8-month-old infant has significant head lag. Which is the nurse's most appropriate action? a. Teach parents appropriate exercises. b. Recheck head control at next visit. c. Refer child for further evaluation. d. Refer child for further evaluation if anterior fontanel is still open.
ANS: C Significant head lag after age 6 months strongly indicates cerebral injury and is referred for further evaluation. Reduction of head lag is part of normal development. Exercises will not be effective. The lack of achievement of this developmental milestone must be evaluated
At what age can most infants sit steadily unsupported? a. 4 months b. 6 months c. 8 months d. 10 months
ANS: C Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months, an infant can sit with support. At age 6 months, the infant will maintain a sitting position if propped. By 10 months, the infant can maneuver from a prone to a sitting position.
At about what age does the Babinski sign disappear? a. 4 months b. 6 months c. 1 year d. 2 years
ANS: C The presence of the Babinski reflex after about age 1 year, when walking begins, is abnormal. Four to 6 months is too young for the disappearance of the Babinski reflex. Persistence of the Babinski reflex requires further evaluation.
An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? a. 14 b. 16 c. 18 d. 21
ANS: D In general, birth weight triples by the end of the first year of life. For an infant who was 7 pounds at birth, 21 pounds would be the anticipated weight at the first birthday; 14, 16, or 18 pounds is below what would be expected for an infant with a birth weight of 7 pounds.
According to Kohlberg, children develop moral reasoning as they mature. Which statement is most characteristic of a preschooler's stage of moral development? a. Obeying the rules of correct behavior is important. b. Showing respect for authority is important behavior. c. Behavior that pleases others is considered good. d. Actions are determined as good or bad in terms of their consequences.
ANS: D Preschoolers are most likely to exhibit characteristics of Kohlberg's preconventional level of moral development. During this stage, they are culturally oriented to labels of good or bad, right or wrong. Children integrate these concepts based on the physical or pleasurable consequences of their actions. Obeying the rules of correct behavior, showing respect for authority, and engaging in behavior that pleases others are characteristics of Kohlberg's conventional level of moral development.
Austin, age 6 months, has six teeth. How should the nurse interpret this finding? a. Normal tooth eruption b. Delayed tooth eruption c. Unusual and dangerous d. Earlier-than-normal tooth eruption
ANS: D Six months is earlier than expected. Most infants at age 6 months have two teeth. Although unusual, it is not dangerous.
At what age should the nurse expect the anterior fontanel to close? a. 2 months b. 2 to 4 months c. 6 to 8 months d. 12 to 18 months
ANS: D The anterior fontanel normally closes between ages 12 and 18 months. Two to 8 months is too early. The expected closure of the anterior fontanel occurs between ages 12 and 18 months; if it closes between ages 2 and 8 months, the child should be referred for further evaluation.
The school nurse has been asked to begin teaching sex education in the fifth grade. What should the nurse recognize about this age group? a. Children in fifth grade are too young for sex education. b. Children should be discouraged from asking too many questions. c. Correct terminology should be reserved for children who are older. d. Sex can be presented as a normal part of growth and development.
ANS: D When sexual information is presented to school-age children, sex should be treated as a normal part of growth and development. Fifth-graders are usually 10 or 11 years old. This age is not too young to speak about physiologic changes in their bodies. They should be encouraged to ask questions. Preadolescents need precise and concrete information
Which is descriptive of the social development of school-age children? A. Identification with peers is minimal B. Children frequently have "best friends" C. Boys and girls play equally with each other D. Peer approval is not yet an influence toward conformity
Children frequently have "best friends" Same-sex peers form relationships that encourage sharing of secrets and jokes and coming to each other's aid. Identification with the peer group is an important milestone for the school-age child to move toward independence from families. During the school-age years, same-sex peer groups are more prevalent; therefore, there is less interaction between boys and girls. Conforming to the rules is an essential part of group membership and, therefore, an important skill for the school-age child to learn in terms of peer relationships.
According to Sigmund Freud's theory of personality development, which statement best describes the phallic stage?
Children recognize differences between males & females.
Which would be the highest expected growth and development occurrence expected at 12 months of age for an infant who has had appropriate growth assessed at each well-child visit? A. Imitates sounds B. Smiles spontaneously C. Sits steadily unsupported D. Walks holding on to someone's hand
D. Walks holding on to someone's hand Rationale:Growth and development are sequential and predictable. One task builds on another. Mastery of a lower level task must occur before higher-level tasks are completed. At 12 months a child can walk holding on to someone's hand. Smiling, imitating sounds, and sitting steadily unsupported begins at 6 months of age.
A nurse performing a physical assessment of a 12-month-old infant notes that the infant's head circumference is the same as the chest circumference. On the basis of this finding, the nurse should: A. Suspect the presence of hydrocephalus B. Tell the mother that the infant is growing faster than expected C. Suggest to the pediatrician that a skull x-ray be performed D. Document these measurements in the infant's health-care record
Document these measurements in the infant's health-care record
The school nurse is discussing dental health with some children in first grade. Which should be included? A. Teach how to floss teeth properly. B. Recommend a toothbrush with hard nylon bristles to get in between the teeth. C. Emphasize the importance of brushing before bedtime. D. Recommend nonfluoridated toothpaste
Emphasize the importance of brushing before bedtime. Children should be taught to brush their teeth after meals and snacks and before bedtime to prevent dental caries. Parents should help with flossing until children develop the dexterity required, when they are in about the third grade. A toothbrush with soft nylon bristles is recommended to prevent damage to the gums. The American Dental Association recommends fluoridated toothpaste for this age-group.
A 4 yo diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should the nurse suggest to alleviate the child's fears? A. Encourage the child's parents to stay with the child. B. Encourage play with other children of the same age. C. Advise the family to visit only during the scheduled visiting hours. D. Provide a private room, allowing the child to bring favorite toys from home.
Encourage the child's parents to stay with the child.
Which action would improve dental health in the school-age child? A. Limiting brushing of teeth to three times a day following meals. B. Encouraging the child to floss. C. Have the parent brush the child's teeth in order to make sure it is done properly. D. Have the child consume fruit juice rather than soda.
Encouraging the child to floss. Flossing is a critical activity that has been shown to improve dental health. Brushing teeth following meals as well as following snacks has also been shown to improve dental health. At this age, the child should be able to brush their own teeth. Whereas soda should be avoided, the use of fruit juice may contribute to dental caries as it is considered to be a sugar source and example of a fermentable carbohydrate. Water as a drink should be promoted to improve dental health.
The mother of a 5-year-old asks the nurse how often her child should undergo a dental examination. The nurse tells the mother that the child should have a dental examination: A. Every 3 months B. Once a yearEvery C. 6 months D. Whenever a new primary tooth erupts
Every 6 months
Which is the most appropriate recommendation for relief of teething pain? A. Rub the gums with aspirin to relieve inflammation. B. Apply hydrogen peroxide to the gums to relieve irritation. C. Give the child a frozen teething ring to relieve inflammation. D. Have the child chew on a warm teething ring to encourage tooth eruption
Give the child a frozen teething ring to relieve inflammation. Cold reduces inflammation and should be used for relief of teething irritation. Aspirin and aspirin products should never be used in infants and children for inflammation or pain relief. Hydrogen peroxide will not be effective and may irritate the gums more. Cold, not warm, reduces inflammation; therefore, heat is not effective for teething pain.
Which statement about bottle-mouth caries should be taught to the parents? A. This syndrome is distinguished by protruding upper front teeth, resulting from sucking on a hard nipple. B. Giving a bottle of milk or juice at nap time or bedtime predisposes the child to this syndrome. C. This syndrome can be completely prevented by breastfeeding. D. Giving the child juice in the bottle instead of milk at bedtime prevents this syndrome
Giving a bottle of milk or juice at nap time or bedtime predisposes the child to this syndrome. Sweet liquids, or the sugars in milk and even breast milk, pooling in a toddler's mouth during sleep increase the incidence of dental caries. Changes in the positioning of the teeth may result from pacifier use or thumb sucking and are not related to bottle-mouth caries. Frequent breastfeeding before sleep can cause bottle-mouth caries, since breast milk does contain lactose, which is present in higher concentrations than in cow's milk-based formula. Juice, which contains varying concentrations of sugar, in bottles before sleep contributes to bottle-mouth caries.
The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. Which instruction should be included? A. Flossing is not recommended at this age. B. Toddlers are old enough to brush their teeth effectively. C. The parent should brush the toddler's teeth with plain water if he or she does not like toothpaste. D. The toddler's toothbrush should be small and have hard, rounded, nylon bristles.
The parent should brush the toddler's teeth with plain water if he or she does not like toothpaste. Some toddlers do not like the flavor of toothpaste, so water can be used for teeth brushing at this age. Flossing should be done after brushing to establish it as part of dental care for the toddler. Two-year-olds cannot effectively brush their own teeth; parental assistance is necessary. Soft multitufted bristled toothbrushes are recommended to avoid damaging a toddler's teeth or gums.
A nurse is caring for a dying child whose religion is Islam (Muslim, or Moslem). Which is an important nursing consideration related to the child's impending death and religion? A. There are no special rites. B. There are specific practices to be followed. C. The family is expected to "wait" away from the dying person D. Baptism should be performed if it has not been done previously
There are specific practices to be followed. Islam (Muslim, or Moslem) religion has specific rituals for bathing and wrapping the body in cloth before it is to be moved. There are special rites. The nurse should contact someone from the person's mosque to assist with the special rites related to death. Family members may be present with the dying child. No baptism is required at this time.
A nurse is teaching the mother of an 11-month-old infant how to clean the infant's teeth. The nurse tells the mother to A. Dip the infant's pacifier in maple syrup so that the infant will suck B. Use diluted fluoride and rub the teeth with a soft washcloth C. Use a small amount of toothpaste and a soft-bristle toothbrush D. Use water and a cotton swab and rub the teeth
Use water and a cotton swab and rub the teeth
Which assessment finding would the nurse expect to see with regard to weight status in an infant who is 1 year of age? A. Weight is doubled that of birth weight. B. Average weight of a 1 year old is stable if found to be 15 pounds. C. Weight is tripled that of birth weight. D. Breastfeeding infants typically will have smaller head circumference than bottle fed infants. E. Weight is quadrupled compared with initial birth weight at age one.
Weight is tripled that of birth weight. Typically at 1 year of age, infant's birth rate is tripled that of initial birth weight. It is doubled at 6 months of age and quadrupled at 2 years of age. Average weight is based on recognition of growth and development tables based on birth weight. Breastfed infants typically have a larger head circumference as compared to bottle fed infants.
The parent of a hospitalized child tells the nurse, "We do not eat meat. We are practicing Buddhists and strict vegetarians." The most appropriate intervention by the nurse is to A. order the child a meatless tray B. tell the parent to take any meat off the child's meal tray C. ask the parent if they would like to have a Buddhist priest visit D. explain that meat provides protein needed to heal their child.
order the child a meatless tray. It is essential for the nurse to respect the religious practices of the child and parent. The nurse is not culturally sensitive to the religious practices of the child and parent and should ensure that nutritionally complete vegetarian meals are prepared by the Dietary department. Asking the parent if they would like a Buddhist priest is not addressing the vegetarian diet and not being respectful of the child and parent's religious beliefs. The nurse should not encourage the child and parent to go against their religious beliefs.
A 6-month-old infant attempts to pick up a toy using his entire hand. This action would be documented as using a A. pincer grasp. B. palmer grasp. C. prehension. D. gross motor development.
palmer grasp. At 6 months of age, one would expect an infant to be able to pick up and transfer objects with his/her whole hand. This is noted as a palmer grasp. Prehension is when the infant uses both fingers and hands to grab objects and is typically seen between 2 and 3 months. Pincer grasp is when the infant uses both the thumb and middle finger is seen after 6 months of age. The behavior described is an example of fine motor development as opposed to gross motor development.
A nurse observes a parent-child interaction in which the parent acts indifferently to the child's continued efforts to play with a water cooler in the clinic's waiting room resulting in a small amount of flooding in the area of the room. Based on this assessment, the nurse would determine that the parent's childrearing style would be noted as: A. authoritarian B. permissive C. authoritative D. directive
permissive. As the parent is not preventing or interacting with the child to stop this behavior which has resulted in damage, this would be seen as permissive parenting. Authoritarian parenting style reflects a stricter approach and authoritative style would use both elements, authoritarian and permissive to arrive at mutually accepted behavioral actions.
