NUR 236 PrepU Chapter 27: Growth and Development of the Preschooler

A 3½-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond?

"Tell me about Boo-ga-loo."

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)

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 most appropriate?

"By the age of 6, most children can print some letters and maybe their first name."

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 mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?

"I usually have him in time-out for about 10 minutes."

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 nurse is providing an in-service for parents of preschoolers regarding nutrition. Which comments by the parents demonstrate successful learning following the in-service? Select all that apply.

"My 4-year-old should be ingesting at least 700 mg of calcium through food daily to promote good bone health." "I generally give my child choices about foods within each food category, ensuring all food groups are represented." "We very rarely feed our child fast food and when we do we try to keep it as healthy as possible with no soda."

The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?

"Set a good example. Wear your own seat belt every time you drive."

A hospitalized 4-year-old child reports having difficulty falling asleep at night due to a fear of monsters. How will the nurse respond?

"You sound scared. I will show you under the bed that there are no monsters."

The nurse is conducting a well-child examination of a 4-year-old and is assessing the child's height. By how much should the nurse expect the child's height to have increased since last year's examination?

2.5 to 3 inches (6.35 to 7.62 cm)

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

Acting out a troubling or stressful situation

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?

Button clothes.

A bilingual family tells the nurse their desire for their child to learn both languages. One language is spoken predominantly in the home. The parents ask the nurse when is the best time to teach the child the other language. What time period would the nurse respond?

During the preschool years

Johnny exhibits the following growth pattern. Which interpretation of the data is accurate? Select all that apply.3 yrs: Ht. 37 inches Wt. 32 pounds4 yrs: Ht. 39 inches Wt. 39 pounds5 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 providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium?

Orange

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?

Playing in an organized group with each other.

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 caring for a preschool-age child in the hospital with severe developmental delays. The parents have three 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

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

imagination

A 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.

Which gross motor skill would the 4-year-old child have most recently attained?

The child can hop on one foot.

A nurse is assessing a 3 year old at a well-child visit. Which developmental milestones would the nurse expect to assess? Select all that apply.

Undresses self without difficulty Stacks a tower of blocks

A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply.

Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable.

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.

The most important safety precaution for parents to teach preschoolers is:

not to ride in a car with strangers.

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?

presence of 10 deciduous teeth

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

tells a fantasy story about a bear and a car

At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to:

testing and identification of group role.

In counseling a group of parents regarding the development of school readiness in preschoolers, it is most important to emphasize:

the home environment.

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.

A 4-year-old female client presents to the clinic with an increased temperature. Based on the assessment findings (above), what does the nurse anticipate the primary health care provider will prescribe for this client?

urinalysis, culture and sensitivity

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

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

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply.

"Try using a night light in the child's room." "Set up some familiar bedtime rituals for your child." "Avoid having your child watch frightening shows on TV before bedtime." "Try reading a favorite story before bedtime."

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

Preschool

The nurse is caring for a 4-year-old child who is hospitalized and in traction. The child talks about an invisible friend to the nurse. Which action by the nurse is indicated?

The nurse should recognize this behavior as normal for the child's developmental age and do nothing.

In teaching caregivers of preschool children, the nurse would reinforce that which activity would be most important for this age group?

The preschool child should be properly restrained when riding in a vehicle.

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.