Pediatric Growth and Development 23-27 & 42
Ensure that the child brushes his teeth after each meal and snacks.
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?
4 stages of substance abuse
1. experimental- learning the mood swing 2. more regular use with noticeable changes in schoolwork, friendships, and dress. Seeking the mood swing. 3. Preoccupation with the mood swing, dramatic behavior changes, truancy, lost job. 4. Using to feel normal. Dependency with deterioration in health
grasps rattle by its handle
10 month fine motor skills
holds hands in an open position, grasp reflex fading
2 month fine motor skills
lifts head off mattress when prone
2 month gross motor skills
-No longer has grasp reflex -Keeps hands loosely open
3 month fine motor skills
play lawn mower
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?
Why does that red train keep crashing into all of the other trains?
A nurse is conducting a mental status examination with a 5-year-old boy who is playing with trains and blocks of different colors. He repeats the same actions with the trains over and over again throughout the examination. Which of the following questions would be most appropriate?
rattles, soft stuffed toys, teething toys, nesting toys, playing pat-a-cake, playing with balls, reading books, mirrors, brightly colored toys, playing with blocks
Age appropriate activities for a infant
"Does the baby go to bed with a bottle of formula each night?"
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?
Allow the child choices when asking questions, such as "Do you want to wear the red or the blue top?"
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?
14-15 hrs daily and 9-11 hrs at night around age 4 mos
How much sleep is needed for an infant?
• Anterior fontanels close by 18 months of age. • Weight - At 30 months of age, toddlers should weigh four times their birth weights. • Height - Toddlers grow about 7.5 cm (3 in) per year. • Head circumference and chest circumference are usually equal by 1 to 2 years of age
Identify all physical development that occurs in toddlers
Piaget: Preoperational Stage Erikson: Autonomy vs. shame and doubt
Identify the developmental stage 2-6
The child may have a fear of being separated from her mother.
In collecting data on a 7-year-old-child with a possible diagnosis of school phobia, the nurse directs questions related to the following topics. Which of the following would most likely be a cause of the child having school phobia?
Preschooler, 3-6 years Erikson's third stage in which the child finds independence in planning, playing and other activities
Initiative vs. Guilt
1. Small objects (grapes, coins, candy) that can become lodged in the throat should be avoided. 2. Toys that have small parts should be kept out of reach. 3. Age-appropriate toys should be provided. 4. Clothing should be checked for safety hazards (loose buttons). 5. Balloons should be kept away from toddlers. 6. Parents should know emergency procedures for choking.
Injury Prevention: Aspiration of foreign objects 1-3
Takes in new information at a rapid rate and asks "why" and "how"
The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur?
form vases from blocks of clay
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?
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.
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?
33-35 cm or 13-14 inches
a infants head circumference is?
9-10 months
comprehends the word "NO" by what age?
Adolescent, 12-18 years Erikson's stage during which teenagers and young adults search for and become their true selves
identity vs. role confusion
The ability to recognize and use symbols
what happens in mental representation
mistrust develops if needs are inadequately or inconsistently met, or if needs are continuously met before being vocalized by the infant.
what happens in mistrust of the infant?
has a strong grasp reflex
1 month fine motor skills
demonstrates head lag
1 month gross motor skill
Changes from a prone to a sitting position
10 month gross motor skills
Places objects into a container; neat pincer grasp
11 month fine motor skills
cruises or walks while holding onto something
11 month gross motor skill
Tries to build a two-block tower without success Can turn pages in a book
12 month fine motor skills
Sits down from a standing position without assistance walks with one hand held
12 month gross motor skills
Raises head and shoulders off mattress when prone and only slight head lag
3 month gross motor skills
vocalizes with cooing noises by 3-4 months 3 mon: shows considerable interest with environment Turns head to sound of rattle by 3mon. Laughs and squeals by 4 mon. Consonants are added by 3-4 mon.
3-4 Months:
grasps objects with both hands
4 month fine motor skills
rolls from back to side
4 month gross motor skills
uses palmar grasp dominantly
5 month fine motor skills
rolls from front to back
5 month gross motor skills
holds bottle
6 month fine motor skills
rolls from back to front
6 month gross motor skills
CRAFFT
6-item screen for alcohol or drugs in adolescents, 14-18 (C=car, R=relax, A=alone, F=forget, F= family or friends, T= trouble)
moves objects from hand to hand
7 month fine motor skills
Bears full weight on feet Sits, leaning forward on both hands
7 month gross motor skills
begins using pincer grasp
8 month fine motor skills
sits unsupported
8 month gross motor skills
Has a crude pincer grasp
9 month fine motor skills
Pulls to a standing position Creeps on hands and knees
9 month gross motor skills
"Have you explored with your child if something is causing her to be afraid to go to school?"
A 10 year-old girl has a pattern of school success, solid peer relationships, and a healthy family life. The girl's caregiver reports for the past 3 weeks the child has reported abdominal pain with vomiting and diarrhea, and tells the caregiver lets her stay home, she is fine by mid-morning. She is also fine on weekends. which question should the nurse prioritize to this caregiver?
C. Keep all medications locked up and out of reach for the child. D. Turn the hot water heater temperature down to 120°F (48.9°F). E. Never allow the child to ride in the car unless secured in a car seat.
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 recommendation(s) would the nurse make to the family to help ensure the child's health? Select all that apply.
"Wet dreams are not the result of anything you are doing but are simply the body's way of ridding itself of excess semen."
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 sense of trust and identity
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?
Offer small portions of 1 to 2 teaspoons to the child. Mealtime for a toddler should not exceed 20 minutes. Do not use sweets as a reward for cleaning their plate.
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.
Remain calm and ignore the tantrum Stay nearby to ensure the child's safety without giving in to the child's desires
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.
Nonorganic failure to thrive
A 6-month-old infant presents at the pediatric clinic with his/her mother. The child is very thin, less than 5% on the growth chart, irritable, listless, unresponsive to the nurse, and has poor muscle control. The child has no history of serious illness. When the infant begins to cry, the mother is very slow to respond and the child is not comforted by the mother. The nurse is concerned about the infant, because these are signs of:
swayed back
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?
Weight is within expected range and height is above expected range.
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 grown 5 in (12.70 cm) over the past year. The nurse determines this child is within which parameters?
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.
A breastfeeding 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?
"Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."
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?
Tooth eruption is often genetically based, with some families having babies with early tooth eruption, while others have late tooth eruption.
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?
"The baby needs to learn how to swallow, so catch the food and offer it again until the baby learns this."
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?
"Remain calm, pick the child up, and move to a quiet and neutral place until the child gains self-control; don't give in to the child's demands."
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?
-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°F (48.9°C).
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.
Red meat, poultry, and fish
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?
"I am almost 15 now, so that means I could possibly get this disease."
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?
Inform the mother that her toddler's growth is within normal limits and there is nothing to be worried about
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 the child's last visit a year ago. How should the nurse respond to this mother's concerns?
Read the child a book in bed and take time to calm the child down before turning out the lights.
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?
Use the crib for sleeping only, not for play activities
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?
The toddler cannot stand upright without support.
A nurse is assessing a 15-month-old toddler. Which of the following findings should the nurse report to the provider?
Inability to raise head when in prone position A 3-month-old infant should be able to raise her head and shoulders from prone position. (should be able to sit without support at 8 months; should be able to grasp objects w fingers at 6 months; should be able to bring objects to her mouth at 4 months)
A nurse is assessing a 3-month-old infant. Which of the following findings should the nurse report to the provider?
Closed posterior fontanel posterior fontanel should close by about 8 weeks of age. (A 9-month-old infant should be able to use his thumb and index fingers in a crude pincer grasp; develop upper lateral incisors between 9 and 13 months of age and lower lateral incisors at 10 to 16 months; 8-month-old infant should be able to sit without support)
A nurse is assessing a 6-month-old infant at a well-child visit. Which of the following findings should the nurse expect?
Toy hammer and pounding board.
A nurse is caring for a 2-year-old who is hospitalized and throws a tantrum when his parents leave. Which of the following toys should the nurse provide to alleviate the child's stress?
Putting a large-piece puzzle together
A nurse is planning care for a 4-year-old child who requires airborne precautions. Which of the following activities should the nurse plan for the child?
Acting out a troubling or stressful situation
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?
Impulsivity Inattention Distractibility Hyperactivity
A nurse is preparing a teaching session for a group of parents with children newly diagnosed with ADHD. When explaining this disorder to the parents, what would the nurse include as being involved? Select all that apply.
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 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.
0.5 to 1 lb (0.27 to 0.45 kg)
A nurse is providing care to an adolescent being treated for anorexia as an outpatient. The nurse is evaluating the adolescent's weight gain over the past week. The nurse determines that the adolescent is achieving the expected outcome when the adolescent shows a gain of how much for the week?
"It's okay to let my toddler take bubble baths and play in the bubbles."
A nurse is reviewing important concepts related to bathing and tub baths with a parent of a toddler. Which statement by the parent indicates the need for additional teaching?
"Temper tantrums are the toddler's attempt to gain control of a situation."
A nurse is teaching the parents of a toddler about temper tantrums. Which of the following statements should the nurse include in the teaching?
Learning to act on one's own
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?
"Does your child interact with you when playing?"
A parent expresses concern that the child has an autism spectrum disorder. The nurse obtains a health history of the symptoms to understand the parent's concern. Which question would the nurse ask first?
Ignore the temper tantrums.
A parent of a toddler asks a nurse how the child's frequent temper tantrums can best be handled. Which of the following actions should the nurse suggest to the parent?
Follow the child's home routines as much as possible while in the hospital
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?
Toddler, 1-3 years Erikson's stage in which a toddler learns to exercise will and to do things independently; failure to do so causes shame and doubt
Autonomy vs. Shame and Doubt
1) Trust vs mistrust 2) Autonomy vs shame and doubt 3) Initiative vs guilt 4) Industry vs inferiority 5) Identity vs role confusion
Correct order of Erikson's developmental theory
True
Depressive disorder-findings must be present for 1 year to diagnose in children and adolescents
"Children of this age may stutter while they search for just the right word."
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?
Trust vs mistrust
Eriksons level of development: NB-1
120 degrees or below
Hot water heaters should be set to what temp?
■12 to 15 months - Inactivated poliovirus (IPV) (third dose between 6 to 18 months); Haemophilus influenzae type B (Hib); pneumococcal vaccine (PCV); measles, mumps, and rubella (MMR); and varicella ■12 to 23 months - Hepatitis A (Hep A), given in two doses at least 6 months apart ■15 to 18 months - Diphtheria and tetanus toxoids and pertussis (DTaP) ■12 to 36 months - Yearly seasonal trivalent inactivated influenza vaccine (TIV); live, attenuated influenza vaccine (LAIV) by nasal spray (at 2 years of age)
Immunizations
Failure to Thrive (FTT)
Inadequate growth resulting from inability to obtain or use calories required for growth. •Infant or child who falls below the fifth percentile for weight (and possibly height) or persistent weight loss •Inadequate caloric intake •Inadequate absorption •Increased metabolism •Defective utilization RISK FACTORS: •premature birth •low birth weight •IUGR •Neglect •Lack of parental knowledge •Disturbed maternal-child attachment •Poverty •Family Stress •Feeding resistance Clinical manifestations and diagnosis: •less than fifth percentile on growth chart for weight •malnourished appearance •poor muscle tone •no fear of strangers •minimal smiling •decreased activity level •developmental delay •withdrawal behavior
School age, 6-12 years Erikson's stage when the child learns to be productive
Industry vs. Inferiority
1. Sharp objects should be kept out of reach. 2. Firearms should be kept in locked boxes or cabinets. 3. Toddlers should not be left unattended with any animals present. 4. Toddlers should be taught stranger safety.
Injury Prevention: Bodily harm 1-3
1. The temperature of bath water should be checked. 2. Thermostats on hot water heaters should be turned down to 49° C (120° F) or below. 3. Working smoke detectors should be kept in the home. 4. Pot handles should be turned toward the back of the stove. 5. Electrical outlets should be covered. 6. Toddlers should wear sunscreen when outside.
Injury Prevention: Burns 1-3
1. Toddlers should not be left unattended in bathtubs. 2. Toilet lids should be kept closed. 3. Toddlers should be closely supervised when near pools or any other body of water. 4. Toddlers should be taught to swim.
Injury Prevention: Drowning 1-3
1. Doors and windows should be kept locked. 2. Crib mattresses should be kept in the lowest position with the rails all the way up. 3. Safety gates should be used across the top and bottom of stairs.
Injury Prevention: Falls 1-3
1. Infants and toddlers remain in a rear-facing car seat until the age of 2 years or the height recommended by the manufacturer. 2. Toddlers over the age of 2 years, or who exceed the height recommendations for rear-facing car seats, are moved to a forward-facing car seat. 3. Safest area for infants and children is the backseat of the car. 4. Do not place rear-facing car seats in the front seat of vehicles with deployable passenger airbags.
Injury Prevention: Motor-vehicle injuries 1-3
1. Exposure to lead paint should be avoided. 2. Safety locks should be placed on cabinets that contain cleaners and other chemicals. 3. The phone number for a poison control center should be kept near the phone. 4. Medications should be kept in childproof containers, away from the reach of toddlers. 5. A working carbon monoxide detector should be placed in the home.
Injury Prevention: Poisoning 1-3
1. Plastic bags should be avoided. 2. Crib mattresses should fit tightly. 3. Crib slats should be no farther apart than 6 cm (2.375 in). 4. Pillows should be kept out of cribs. 5. Drawstrings should be removed from jackets and other clothing.
Injury Prevention: Suffocation 1-3
Language increases to about 50- 300 words by the age of 2 years. 1 year - three-to-five-word vocab. understands simple commands 2-3 years - use multiword sentences by combining two to three words. Imitates animal sounds, refers to self by name, begins to use verbs in past tense.
Language Development: Toddlers 1-3 years
crying is 1st form of communication, vocalizes by cooing noises by 3-4 months, laugh and squeals by 4 months
Language development
Babbles one-syllable sounds
Nurse is assessing a 7-month-old infant. Which of the following indicates a need for further evaluation?
Large building blocks
Nurse is caring for a 12-month-old toddler who is hospitalized and confined to a room with contact precautions. Which of the following toys should the nurse recommend in order to meet the developmental needs of the client?
"It is expected for children who are hospitalized to regress. The toileting skills will return when your child is feeling better."
Nurse is caring for a 4-year-old child who has croup and wet the bed overnight. When the parents visit the next day, the nurse explains the situation and one of the parents says, "she never wets the bed at home. I am so embarrassed." Which of the following responses should the nurse make?
Arrange for a teacher to provide lesson plans.
Nurse is planning care for a 10-year-old who will be hospitalized for an extended period of time. Which of the following actions should the nurse include in the plan of care to meet client's psychosocial needs according to Erikson?
Wrap the arm of the child's doll or toy prior to the procedure.
Nurse is preparing to assist with applying a cast to a preschooler's arm. Which of the following actions should the nurse take?
Toddlers begin developing taste preferences, and are generally picky eaters who repeatedly request their favorite foods. Physiologic anorexia occurs, resulting in toddlers becoming fussy eaters because of a decreased appetite. Toddlers should consume 24 to 30 oz of milk per day, and may switch from drinking whole milk to drinking low-fat milk after 2 years of age. Juice consumption should be limited to 4 to 6 oz per day. Trans fatty acids and saturated fats should be avoided. Diet should include 1 cup of fruit daily. Food serving size should be 1 tbsp for each year of age, or ¼ to 1/3 of an adult portion. Toddlers generally prefer finger foods because of increasing autonomy. Regular meal times and nutritious snacks best meet nutrient needs. Snacks or desserts that are high in sugar, fat, or sodium should be avoided. Foods that are potential choking hazards (nuts, grapes, hot dogs, peanut butter, raw carrots, tough meats, popcorn) should be avoided. Adult supervision should always be provided during snack and mealtimes. Foods should be cut into small, bite-size pieces to make them easier to swallow and to prevent choking. Toddlers should not be allowed to engage in drinking or eat
Nutrition: Toddlers
"He wants to accompany me to the bathroom but I prefer to go alone."
Parents are beginning to potty train 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?
sensorimotor- separation, object permanence, and mental representation accomplished this stage
Piaget stage of development- 0-2
• The sensorimotor stage transitions to the preoperational stage around 2 years. • The concept of object permanence increases. • Toddlers have and demonstrate memories of events that relate to them. • Domestic mimicry (playing house) is evident. • Preoperational thought does not allow for toddlers to understand other viewpoints, but it does allow them to symbolize objects and people to imitate previously seen activities.
Piaget- Identify the cognitive development that occurs in toddlers:
■ Independence is paramount for toddlers, who are attempting to do everything for themselves. ■ Toddlers often use negativism, or negative responses, as they begin to express their independence. ■ Ritualism, or maintaining routines and reliability, provides a sense of comfort for toddlers as they begin to explore the environment beyond those most familiar to them.
Psychosocial Development: Erikson- Autonomy versus Shame and Doubt: 1-3 years
He spends time alone and shows little interest in making friends.
Samuel is a 6-year-old boy who has been diagnosed with autism. Which of the following symptoms would you expect Samuel to display?
Behavioral theory
Susan's parents have begun a program of therapy that includes giving Susan a token each time she follows directions. The following theoretical framework provides the background for such a program:
Set up some playdates that include projects or activities in which the child can be successful.
The 6-year-old at a well-child office visit tells the nurse, "I can't 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?
"Food jags are common in this age. This probably won't last long."
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?
Mowing the lawn with a toy lawnmower
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?
Play peek-a-boo with the child when happy
The caregivers of an infant state that their child cries when her mother leaves for even a short amount of time. What might the nurse suggest as a way to console the infant and develop a sense of security when the child's primary caregiver is out of sight?
Inability to relate to others Inability to communicate with others Obviously limited activities and interests.
The characteristics of the child with autism fall into three categories. What are these three categories?
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.
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?
"Your son may have a friend named Andrew, but it could be an imaginary friend."
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. cheese and crackers C. whole grain granola with yogurt E. turkey sandwich
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.
"Children this age sometimes can't distinguish between fantasy and reality."
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?
"If he cannot see you, he thinks you are gone and that is frightening."
The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her infant son crying. Which is the best response from the nurse to help this mother?
Vegetarian diets can be healthy; ensure she includes whole-grain products, legumes, nuts, seeds, and soy dairy substitutes.
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?
"Bottles given at bedtime can cause erosion of the enamel on the teeth."
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?
102 pounds
The nurse does a weight measurement on an adolescent girl who should weigh 120 pounds according to the expected weight for her age and height. The adolescent is found to weigh exactly the weight that would indicate to the nurse that this adolescent fits the criteria for anorexia nervosa. Which of the following amounts does the girl weigh?
162 pounds
The nurse does a weight measurement on an adolescent girl whose ideal weigh is 135 pounds according to the expected weight for her age and height. The adolescent is found to weigh exactly the lowest weight that would indicate to the nurse that this adolescent fits the criteria for obesity. Which of the following amounts does the girl weigh?
Pretending to be mommies and daddies in the playhouse
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 14-month old whose reaction to his caregiver leaving him is to calmly repeat the statement, "Bye bye, Will. Bye bye, Will.
The nurse has gathered the following data on four different children. Which child will likely be further assessed and tested for autism?
Attention deficit hyperactive disorder (ADHD)
The nurse in the well-child clinic observes a 5-year-old child in the waiting room is having trouble using a crayon to color. During the visit, the same child climbs off the table several times even after the nurse has asked him to stay on the table. Each time the nurse reminds him he says, " Oh yeah." and happily climbs back up. The nurse suspects that the child has:
9:00 p.m.
The nurse is addressing a caregiver's 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?
24 pounds (10.8 kg) and 30 inches (75 cm)
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 reflecting height/weight would the nurse expect to document for this visit?
Smiles at significant others
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?
"You're following expected patterns of growth."
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?
eye coordination
The nurse is assessing a 3-year-old at a routine well-child visit. Which assessment should the nurse prioritize in the vision check?
Button clothes
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?
Hop on one foot
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?
slightly overweight
The nurse is assessing a 9-year-old girl during her well-child checkup 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?
Trust
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?
"Do you have oral, anal, or vaginal sex?"
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?
is eating cereal using the thumb and index finger
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?
He stares at a rotating wheel on his crib mobile.
The nurse is caring for a 12-month-old with autism spectrum disorder (ASD). What description would you expect to elicit from his mother on history-taking?
The child plays and sleeps quietly for long periods of time without fussing.
The nurse is caring for a 6-month-old infant diagnosed with nonorganic failure to thrive. Which of the following would the nurse most likely have noted with this child?
Correct fluid and electrolyte imbalances
The nurse is caring for a child with an eating disorder. Which is the priority treatment for the disorder?
insists on doing a new skill and then asking for help
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?
The child is of normal weight for her height according to the growth charts.
The nurse is collecting data on a 16-year-old girl with the diagnosis of bulimia. What would the nurse most likely note in this child?
cottage cheese
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 foods 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?
milk dry beans juice bread eggs
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?
at 15 months and at least annually thereafter
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?
The nurse should teach and support the caregiver
The nurse is developing a plan of care for the child hospitalized with nonorganic failure to thrive. The following nursing interventions would be included in this plan. Which nursing intervention would be the highest priority for this child
A classroom with a plan of study that is followed each day.
The nurse is discussing the treatment for a child with attention deficit hyperactivity disorder (ADHD) with a group of school nurses. What would be an appropriate learning setting for a child with ADHD?
68 in (172.72 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?
-Dried fruits -Peanuts -Hard boiled eggs
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?
Being honest and straightforward with teenagers will encourage them to ask about subjects like sexuality.
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?
Let them choose their hairstyle, even though it may not look the best for them.
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?
"It is important to let the infant set the pace for weaning, no matter what age they are."
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?
The infant sleeps 10 to 12 hours at night and can take two to three naps during the day.
The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care. The group will be helping the parents with infant care. Which instruction should the nurse prioritize with this group?
The child can use food to manipulate others' behavior
The nurse is meeting with a group of young parents to discuss nutrition and theirreschooler. Which response should the nurse prioritize when asked if using desserts as a reward for good behavior is an appropriate idea?
painting pictures in the art corner of the room
The nurse is monitoring a playgroup of children on the pediatric unit. The nurse predicts the school-age child will most likely be participating in which activity?
pushing toy cars around on a large rug with roads
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?
They are building a house for their dolls with blocks in the room.
The nurse is observing 4-year-old twins during their well-child appointment. Which observation by the nurse would indicate the children are demonstrating cooperative play?
While the other children are eating a snack, the child walks around the room feeling the walls and ignores the caregiver who offers him a snack.
The nurse is observing a group of 2- and 3- year olds in a play group. Which behavior noted in one of the children indicates to the nurse that the child may have autism spectrum disorder (ASD)?
Split fingernails Eroded dental enamel
The nurse is performing the physical examination of a child with bulimia. What findings would the nurse identify as supporting this disorder? Select all that apply.
increased attention span and interest in an activity for a long length of time
The nurse is preparing a care plan for a school-age child to address the child's hospitalization. Which factor should the nurse incorporate into this plan?
Caregivers should maintain consistent rules and expectations
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?
The first tooth usually erupts by 6 months
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?
Plan time for the primary caregiver to focus on the toddler while the secondary caregiver focuses on the infant.
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?
Boys grow at a slower, steadier rate than do girls.
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?
"Set a good example. Wear your own seat belt every time you drive."
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?
will work on a picture until it is finished
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?
32 lbs (14.54 kg) and 27 in (68.58 cm) tall
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?
Teens are busy developing their own personal identity.
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?
bland
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?
Playing in an organized group with each other
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 independently and are side by side
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?
"Food is so expensive, we always make our children eat everything on their plates."
The nurse is presenting information about school-aged children at a community event. Which statement from the group should the nurse prioritize to address with further teaching and more information?
Snacks throughout the day help the child meet nutritional requirements
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers?
Iron
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?
Playing with the plastic vacuum cleaner and pushing it around the room
The nurse is supervising a play group of children on the unit. The nurse expects the toddlers will most likely be involved in which activity?
Promotion of normal development Learning Social interaction Specific language development
The nurse is talking with the parents of a child diagnosed with autism. Together, they set specific goals of care for the child. Which goals may be included? Select all that apply.
Soybean curd
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?
"When she watches TV and hears a commercial, she repeats one word from the commercial but doesn't seem to understand what she is saying."
The nurse is working with a group caregivers of children who are diagnosed with autism. Which statement made by the parents shows an example of echolalia
Rearranging a group of coins first into a circle, then a triangle and then a square
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?
hierarchical arrangement
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?
Compulsive overeating
The nurse recognizes in working with children that the child who has polyphagia will likely exhibit which of the following?
"This is a common reaction. Give your child acetaminophen, cuddle him, and apply a cool compress to the injection site."
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?
Two of the cuspid teeth have erupted
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?
observing without participating
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?
The beginning of puberty
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?
Needs 10 to 12 hours of sleep per night
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?
Promises to quit or attempts to quit
The nursing instructor is teaching a group of pediatric nursing students about the stages of substance abuse in children. Which of the following behaviors is associated with Stage 3 - Preoccupation with the mood swing?
weighing a pound of oranges and a pound of bricks and counting how many of each make a pound
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?
"The diet excludes red meat and possibly poultry."
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?
"Keep a night light on in your child's room."
The parent of a 4-year-old child tells a nurse that the child believes there are monsters hiding in the closet at bedtime. Which one of the following statements should the nurse make?
"Has your child had their hearing tested?"
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?
The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along.
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?
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.
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?
"This is normal for this age group. It's referred to as solitary independent play."
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?
Grows and develops skills more rapidly than at any other time in their life.
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?
tries to sweep up spilled cereal but cries when can't do well
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?
"I feel better knowing that her curiosity is normal."
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?
It may increase slightly in size the first few months of life
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?
safely store all chemical substances
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?
has first permanent molars
The school nurse is assessing a 6-year-old child's dentition. Which assessment should the nurse prioritize for this child?
"Adolescents need to know how to use condoms correctly to avoid sexually transmitted infections."
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?
"I always cook foods that are low in fat."
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?
Encourage activities that will increase his physical activity.
The school nurse is meeting with a 10-year-boy who is concerned about his weight. He reports he doesn't eat much candy but loves fruit, pasta, potatoes, and bread. Which suggestion should the nurse prioritize to help him maintain a healthy weight?
"You have lots of hormone changes going on right now."
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?
vision and hearing
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?
Dairy products, meat, poultry, fish, and eggs
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?
Use a repetitive series of movements.
To feed lunch to a child with autism spectrum disorder (ASD), which action would it be most important for the nurse to take?
Filling and emptying containers Playing with blocks Looking at books Push-pull toys Tossing balls Finger paints Large-piece puzzles Thick crayons
What are age-appropriate activities for toddlers?
Weight is above an expected range and height is within an expected range
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?
126 pounds
When weighing and measuring an adolescent whose ideal body weight is 105 pounds, the nurse would identify the child as obese if the child weighs which of the following?
Diabetes Mellitus
Which disorder is a concern in adulthood as well as in childhood for the person who is overweight or obese during childhood?
"I will be back after you eat your dinner and SpongeBob goes off."
Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital?
2 months
a infants speaks single vowel sounds by?
doubles
a infants wt ________________ by 6 mos
triples
a infants wt _______________by 12 mos
3-5
an infants speaks how many words by age 1?
Born - 1 year Erikson's stage in which infants decide whether the world is friendly or hostile. They decide depending on whether they can trust that their basic needs will be met. If successful, the result is trust and hopefulness.
trust vs mistrust stage
infants learn that an object still exists when out of view happens about 9-10 mos
what happens in object permanence
infants learn to separate themselves from other objects in the environment
what happens in separation
trust is developed by meeting comfort, feeding stimulation, and caring needs.
what happens in trust of the infant?
dtap, rotavirus (RV), inactivated polio (IVP), Hib, pneumococcal (PCV), and hep b
what immunizations does a baby get at 2 months?
DTaP, RV, IPV, Hib, PCV
what immunizations does a baby get at 4 months?
DTaP, IPV, Hep B, PCV
what immunizations does a baby get at 6 months?
Hep B
what immunizations does a baby get at birth?
seasonal influenza
what immunizations does a baby get from 6-12 months?
RV, Hib
what immunizations does a baby get from 6-18 mos?
