Peds 26,27,28,31,32,33

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The parents of a toddler express frustration to the nurse because their child is a "fussy eater." The nurse's BEST response is: "You should provide larger servings of different foods. "Provide more bland food varieties as toddlers have few food preferences." "Table manners will improve if you provide finger foods." "Becoming a fussy eater is expected during the toddler years."

"Becoming a fussy eater is expected during the toddler years." Toddlers have a decrease in appetite. They have strong taste preferences. Use of finger foods contributes to unpredictable table manners. Toddlers have physiologic anorexia that contributes to fussy eating.

The parent of a 12-month-old infant says to the nurse, "He pushes the teaspoon right out of my hand when I feed him. I cannot let him feed himself; he makes too much of a mess." The nurse's BESTresponse is: "It is important not to give into this kind of temper tantrum at this age. Simply ignore the behavior and the mess." "You need to try different types of utensils, bowls, and plates. Some are specifically designed for young children." "It is important to let him make a mess. Just try not to worry about it so much." "Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable."

"Feeding himself will help foster his growth and development. Perhaps we can discuss ways to make the messes more tolerable." The child is developmentally ready for self-feeding. Ignoring the behavior and not allowing the child to self-feed is not fostering the child's development. The child is developmentally ready for self-feeding. The parent should not force the use of the spoon but should substitute finger foods. This response minimizes the parent's concerns about the mess created by self-feeding. At 12 months the child should be self-feeding. Since children this age eat primarily finger foods, it is useful to offer the parent suggestions for keeping the mess to a minimum.

The nurse should provide further teaching about sudden infant death syndrome (SIDS) prevention when hearing the mother of an 8 week old make which statement? (Select all that apply.) Select all that apply. "I only smoke in the kitchen." "I put my baby to sleep on her back." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night."

"I only smoke in the kitchen." "I have my baby sleep with me instead of alone in the crib." "I make sure my baby wears a flannel sleeper and has two blankets to keep warm in her crib." "I always leave my baby's favorite stuffed bunny rabbit in the crib to keep her from crying at night." Maternal smoking increases the risk of SIDS. Smoking anywhere in the home with an infant present is not recommended. The "Back to Sleep" Campaign is given credit for reducing the rate of SIDS in the United States. Co-sleeping increases the risk of SIDS. Overheating increases the risk of SIDS. Leaving a stuffed animal in the crib is a suffocation risk but still needs to be addressed as a safety hazard.

A Mexican American adolescent states to the nurse, "I have cancer because it is God's will. It will make me stronger." The MOST appropriate response by the nurse is: "You are too young to think that way. You still have many years to live." "Tell me how you feel about the treatment plan." "I will move your family into the waiting area to give you some quiet time." "I will contact the hospital chaplain for you."

"Tell me how you feel about the treatment plan." It is very common in the Mexican American culture for patients to feel that health is controlled by environment, fate, and will of God. Asking the patient an open-ended question to assess how the patient feels about the treatment plan will provide the nurse with more information about what the patient understands about the illness and exactly what treatment measures the patient desires. The nurse should not provide false reassurance. Family and strong kinship is important in this culture. Separating a family member is not the most appropriate action. The nurse should ask about religious preferences first before assuming the patient would like to speak with a chaplain.

A parent has a 2 year old in the clinic for a well-child checkup. Which statement by the parent would indicate to the nurse that the parent needs more instruction regarding accident prevention? "We locked all the medicines in the bathroom cabinet." "We turned the thermostat down on our hot water heater." "We placed gates at the top and bottom of the basement steps." "We stopped using the car seat now that my child is older."

"We stopped using the car seat now that my child is older." These are appropriate actions. A car seat should be used until child weighs 40 lbs, at approximately 4 years of age.

A 4-month-old infant is brought to the clinic by his parents for a well-baby checkup. What should the nurse include at this time concerning injury prevention? "Never shake baby powder directly on your infant because it can be aspirated into his lungs." "Do not permit your child to chew paint from window ledges because he might absorb too much lead." "When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." "Keep doors of appliances closed at all times."

"When your baby learns to roll over, you must supervise him whenever he is on a surface from which he might fall." This is appropriate guidance for a first-month appointment. This information should be included at the 9-month visit when the infant is beginning to crawl and pull to a stand. Rolling over from abdomen to back occurs between 4 and 7 months. This is the appropriate anticipatory guidance for this age. This information should be included at the 9-month visit when the infant is beginning to crawl and pull to a stand.

At what age would the nurse advise parents to expect their infant to be able to say "mama" and "dada" with meaning? 4 months 6 months 10 months 14 months

10 months Consonants are added to infant vocalizations. Babbling resembles one-syllable sounds. At this age infants say sounds with meaning. This is late for the development of sounds with meaning.

The nurse would expect that most children would be using sentences of 6 to 8 words by age: 18 months. 24 months. 3 years. 5 years.

5 years. This age child has a vocabulary of only 10 words. A child of this age uses 2- to 3-word phrases. A child this age uses 3- to 4-word sentences. Children can make sentences of 6 to 8 words at this age

Place the following steps of the nursing process in the proper order of completion when the nurse is caring for a child with pneumonia. (Place the answer options in the correct order. Separate each answer by a comma.) (Select all that apply.) 1. Identify the problem of impaired gas exchange. 2. Establish therapeutic goals and prioritize health care provider orders. 3. Determine whether antibiotic therapy has been effective by reviewing white blood cell count. 4. Administer antibiotics as ordered. 5. Listen to the child's breath sounds and monitor vital signs.

5. Listen to the child's breath sounds and monitor vital signs. 1. Identify the problem of impaired gas exchange. 2. Establish therapeutic goals and prioritize health care provider orders. 4. Administer antibiotics as ordered. 3. Determine whether antibiotic therapy has been effective by reviewing white blood cell count. The correct steps in the nursing process are: Assessment: Listening to breath sounds, Diagnosis: Identifying patient problems, Planning: Establish goals and prioritize, Implementation: Administer antibiotics, Evaluate: Determine effectiveness of interventions

The nurse expects which characteristic of fine motor skills in a 5-month-old infant? Strong grasp reflex Neat pincer grasp Able to build a tower of two cubes Able to grasp object voluntarily

Able to grasp object voluntarily A strong grasp reflect is characteristic of a 1-month-old infant. A neat pincer grasp is characteristic of a 10-month-old infant. The ability to build a tower of 2 cubes is characteristic of a 15-month-old infant. The ability to grasp objects voluntarily is appropriate for a 5-month-old infant.

What has had the greatest impact on reducing infant mortality in the United States? Access to high-quality prenatal care Decreased incidence of congenital abnormalities Better maternal nutrition Improved funding for health care

Access to high-quality prenatal care Access to and the use of high-quality prenatal care is a promising preventive strategy to decrease early delivery and infant mortality. The improvements in perinatal care, in particular respiratory care and care of the mother-baby dyad before delivery, have had the greatest impact. There has been a decrease in some congenital anomalies such as spina bifida, but this is not the greatest impact. Better maternal nutrition has had a positive influence but not the greatest overall impact. Changes in funding have not had the greatest impact.

The nurse should expect to possibly incorporate which religious and cultural practices into the plan of care when caring for a 35-year-old Jewish mother who just gave birth to a healthy baby boy? (Select all that apply.) Select all that apply. Circumcision in hospital Ordering house diet lunch tray of roasted pork with mashed potatoes Allowing family, friends, and rabbi to visit patient often Ask males to remove shawl and yarmulke while visiting Ordering house diet with the exception of shellfish

Allowing family, friends, and rabbi to visit patient often Ordering house diet with the exception of shellfish Ritual circumcision of male infants is custom on the eighth day and performed by a mohel. Jews generally are prohibited from eating pork or shellfish. Family, friends, and rabbi should be allowed to visit. Asking males to remove shawls or yarmulkes is not necessary while visiting.

The parents of a 5-month-old girl complain to the nurse that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. What should the nurse suggest to help them deal with this problem? Putting her in parents' bed to cuddle. Beginning to put her to bed while still awake. Letting her cry herself back to sleep. Giving her a bottle of formula instead of breastfeeding her so often at night.

Beginning to put her to bed while still awake. The nurse needs to discuss the issue of co-sleeping with parents. Having the infant in bed with them may still interfere with their sleep. Parents need to develop bedtime rituals that involve putting the child in bed when awake. If the child is put in bed awake, she will be able to return to sleep more easily if she awakens at night. Providing formula at night contributes to bottle-mouth caries.

Which strategy might be recommended for an infant with failure-to-thrive to increase caloric intake? Using developmental stimulation by a specialist during feedings Avoiding solids until after the bottle is well accepted Being persistent through 10 to 15 minutes of food refusal Varying schedule of routine activities on a daily basis

Being persistent through 10 to 15 minutes of food refusal Feeding times should have a nonstimulating environment so the focus is on the meal. Solids should be introduced slowly to decrease dependence on the bottle. Calm perseverance is important. Parents often fail to persist through the child's refusals. Daily schedule should be structured to provide consistency for the child.

The nurse is teaching the parent of a 2-year-old child how to care for the child's teeth. Which of the following should be included? Flossing is not recommended at this age. The child is old enough to brush teeth effectively. Brush teeth with plain water if child does not like toothpaste. Toothbrush should be small and have hard, rounded, nylon bristles.

Brush teeth with plain water if child does not like toothpaste. Flossing should be done after brushing. Two year olds cannot effectively brush their own teeth; parental assistance is necessary. Some children do not like the flavor of toothpaste or the foam; water alone can be used. Soft, multitufted, bristled toothbrushes are recommended.

Apnea of infancy has been diagnosed in an infant who will soon be discharged with home monitoring. When teaching the parents about the infant's care, what is the most important information the nurse should include in the discharge teaching plan? Cardiopulmonary resuscitation (CPR) Administration of intravenous (IV) fluids Reassurance that the infant cannot be electrocuted during monitoring Advice that the infant not be left with other caretakers such as baby-sitters

Cardiopulmonary resuscitation (CPR) Cardiopulmonary resuscitation (CPR) is essential for parent and caregivers to know. Most likely the child will not have venous access; thus home intravenous (IV) therapy is not necessary. The monitor is insulated and grounded. The parents should arrange for other caregivers to help out. All need to be taught how to use the monitoring equipment and how to perform CPR.

A camp nurse is assessing a group of children attending summer camp. Based on the nurse's knowledge of special parenting situations, which group of children is at risk for a sense of belonging? Children adopted as infants Children recently placed in foster care Children whose parents recently divorced Children who recently gained a stepparent

Children recently placed in foster care Children placed in foster care are at greater risk to have problems perceiving a sense of belonging. Children adopted at birth have fewer problems with acceptance when parents follow preadoption counseling about disclosure. Children of divorced parents often fear abandonment. Children who gain a stepparent are at risk for having trust problems with the new parent.

The nurse is caring for a Vietnamese child and observes various marks on the child s body. When completing a thorough assessment, the nurse should keep which applicable cultural practices in mind? (Select all that apply.) Select all that apply. Coining Cupping Forced kneeling Topical garlic application Burning

Coining Cupping Burning Cultural practices possibly considered abusive by the dominant culture are:Coining: A Vietnamese practice that may produce welt-like lesions on the child s back when the edge of a coin is repeatedly rubbed lengthwise on the oiled skin to rid the body of disease.Cupping: An Old World practice (also practiced by the Vietnamese) of placing a container (e.g., tumbler, bottle, jar) containing steam against the skin surface to draw out the poison or other evil element. When the heated air within the container cools, a vacuum is created that produces a bruise-like blemish on the skin directly beneath the mouth of the container.Burning: A practice of some Southeast Asian groups whereby small areas of skin are burned to treat enuresis and temper tantrums.Forced kneeling: A child discipline measure of some Caribbean groups in which a child is forced to kneel for a long time.Topical garlic application: A practice of Yemenite Jews in which crushed garlic cloves or garlic petroleum jelly plaster is applied to the wrists to treat infectious disease. The practice can result in blisters or garlic burns.

Which health promotion teaching points should a nurse include in a dental teaching plan to help prevent dental caries? (Select all that apply.) Select all that apply. Drink fluoridated water. Begin dental hygiene after eruption of both front teeth. Schedule regular dental appointments after age 2. Dates and locations of free dental clinics. Dental caries are preventable.

Drink fluoridated water. Dates and locations of free dental clinics. Dental caries are preventable. Dental caries is the single most common chronic disease of childhood. The most common form of early dental disease is early childhood caries, which may begin before the first birthday and progress to pain and infection within the first 2 years of life. Preschoolers of low-income families are twice as likely to develop tooth decay and only half as likely to visit the dentist as other children. Early childhood caries is a preventable disease, and nurses play an essential role in educating children and parents about practicing dental hygiene beginning with the first tooth eruption; drinking fluoridated water, including bottled water; and instituting early dental preventive care.

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy? Help the toddler complete tasks. Provide opportunities for the toddler to play with other children. Help the toddler learn the difference between right and wrong. Encourage the toddler to do things for himself or herself when he or she is capable of doing them.

Encourage the toddler to do things for himself or herself when he or she is capable of doing them. Toddlers have an increased ability to control their bodies, themselves, and the environment. Autonomy develops when children complete tasks of which they are capable. To successfully achieve autonomy, the toddler needs to have a sense of accomplishment. This does not occur if parents complete tasks. Children at this age engage in parallel play. This will not foster autonomy. This concept is too advanced for toddlers and will not contribute to autonomy.

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age-group? (Select all that apply.) Select all that apply. Falls Drowning Poisoning Sports injuries Tricycle and bicycle accidents

Falls Drowning Poisoning Tricycle and bicycle accidents Falls occur frequently in preschoolers. Closely monitor playground activities such as climbing a jungle-gym. Closely supervise around any water and ensure swimming pools are securely fenced to prevent near drowning. Place all medications and poisons out of reach and in locked cabinets. Administer medications as a drug, not "candy." Keep poison control phone number by telephone. When riding tricycles and bicycles, children often forget not to ride in the streets. Sports injuries occur in older children.

What is appropriate advice for parents who are preparing to tell their children about their decision to divorce? Avoid crying in front of children. Avoid discussing the reason for the divorce. Give reassurance that the divorce is not the children's fault. Give reassurance that the divorce will not affect most aspects of the children's lives.

Give reassurance that the divorce is not the children's fault. Parents can cry in front of children; it may give the children permission to do the same. Parents should provide the reasons for the divorce in a manner the children will understand. If parents are able, they should hold and touch children and reassure them that they are not the cause of the divorce. This would most likely be false reassurance because many aspects will change.

What should the nurse recommend to help a toddler cope with the birth of a new sibling? Give the toddler a doll on which he or she can imitate parenting. Discourage the toddler from helping with care of new sibling. Prepare the toddler for upcoming changes about 1 to 2 weeks before birth of the sibling. Explain to the toddler that a new playmate will soon come home.

Give the toddler a doll on which he or she can imitate parenting. The toddler can participate in the activity of caring for a new family member. The child should be encouraged to participate in accordance with his or her abilities. Preparation should begin as soon as changes in the mother's physical appearance and the home setting occur. This will establish unrealistic expectations.

Which statement about early childhood caries (ECC) is correct? The syndrome is distinguished by protruding upper front teeth, resulting from sucking on a hard nipple. Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. The syndrome can be prevented by breastfeeding. Giving the child juice in the bottle instead of milk at bedtime prevents this syndrome.

Giving a bottle of milk or juice at naptime or bedtime predisposes the child to this syndrome. This may result from pacifier use or thumb-sucking. Sweet liquids pooling in the mouth during sleep cause dental caries. Frequent breastfeeding before sleep can also cause bottle-mouth caries. Juice in bottles before sleep contributes to bottle-mouth caries.

Nurses play an important role in current issues and trends in health care. Which is a current trend in pediatric nursing and health care today? The patient is the unit of care for the health care provider. Discharge planning begins when the physician writes the order. Health promotion resources enable children to achieve their full potential. The focus of pediatric health care is trending toward acute hospital care.

Health promotion resources enable children to achieve their full potential. Health promotion provides opportunities to reduce differences in current health status among members of different groups and provides a better chance to achieve the fullest health potential. The patient and family is the unit of care for the health care provider. Discharge planning begins when the patient is admitted. The focus of pediatric health care is trending away from acute hospital settings.

The nurse notices that a toddler is more cooperative when taking medicine from a small cup rather than from a large cup. This is an example of which characteristic of preoperational thought? Egocentrism Irreversibility Inability to conserve Transductive reasoning

Inability to conserve The inability to see situations from other perspectives does not facilitate medication administration. The inability to reverse actions physically initiated does not facilitate medication administration. The smaller cup makes it look like less medicine. Focusing on particulars does not explain the cooperation with the smaller medication cup.

The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.) Select all that apply. Large blocks Alphabet flash cards 100-Piece puzzles Dolls Hand puppets

Large blocks Alphabet flash cards Dolls Hand puppets Manipulative, constructive, creative, and educational toys provide for quiet activities, fine motor development, and self-expression. Easy construction sets, large blocks of various sizes and shapes, a counting frame, alphabet or number flash cards, paints, crayons, simple carpentry tools, musical toys, illustrated books, simple sewing or handicraft sets, large puzzles, and clay are suitable. Probably the most characteristic and pervasive preschool activity is imitative, imaginative, and dramatic play. Dress-up clothes, dolls, housekeeping toys, dollhouses, play store toys, telephones, farm animals and equipment, village sets, trains, trucks, cars, planes, hand puppets, and medical kits provide hours of self-expression toys. Large puzzles are appropriate for preschoolers, but 100-piece puzzles are likely too small and may cause frustration for the preschooler.

A 4-year-old female child is afraid of dogs. What should the nurse recommend to her parents to help her with this fear? Keep her away from dogs Buy her a stuffed dog toy Force her to touch a dog briefly Let her watch other children play with a dog

Let her watch other children play with a dog These actions avoid the object of fear rather than approaching it and finding solutions. These actions avoid the object of fear rather than approaching it and finding solutions. Forcing the child to interact with the dog may increase the level of fear. The parents should actively seek ways to deal with fear. By observing other children at play with dogs, the child can learn to adapt.

The nurse is providing education to a parent of a 10-month-old infant receiving iron supplements. What will be included in the teaching? (Select all that apply.) Select all that apply. Administer iron with meals. Place iron toward the back side of the mouth with a dropper. Mix iron with milk for greater absorption. Report black, tarry stools to health care provider. Apply barrier ointment if needed to buttocks.

Place iron toward the back side of the mouth with a dropper. Apply barrier ointment if needed to buttocks. Administration of Iron Supplements includes:Ideally iron supplements should be administered between meals for greater absorption.Liquid iron supplements may stain the teeth, therefore administer with a dropper toward the back of the mouth (side). In older children, administer liquid iron supplements through a straw or rinse mouth thoroughly after ingestion.Avoid administration of liquid iron supplements with whole cow's milk or milk products as these bind free iron and prevent absorption.Educate parents that iron supplements will turn stools black or tarry green.Iron supplements may cause transient constipation. Caution parents not to switch to a low-iron containing formula or whole milk, which are poor sources of iron and may lead to iron deficiency anemia (see Iron Deficiency Anemia, Chapter 43).In older children, follow liquid iron supplement with a citrus fruit or juice drink (no more than 3 to 4 ounces).Avoid administration of iron supplements with food or drinks that bind iron and prevent absorption.

As part of their teaching function at discharge, nurses should tell parents that the baby's respiratory status should be protected by the following procedures: (Select all that apply.) Select all that apply. Prevent exposure to people with upper respiratory tract infections Keep the infant away from secondhand smoke Avoid loose bedding, waterbeds, and beanbag chairs Do not let the infant sleep on his or her back Keep a bulb suction available at home.

Prevent exposure to people with upper respiratory tract infections Keep the infant away from secondhand smoke Avoid loose bedding, waterbeds, and beanbag chairs Keep a bulb suction available at home. Infants are vulnerable to respiratory infections; infected people must be kept away. Secondhand smoke can damage lungs. Infants can suffocate in loose bedding and furniture that can trap them. The infant should be laid down to sleep on his or her back for better breathing and to prevent sudden infant death syndrome. A bulb syringe will be useful if the baby needs suctioning of the mouth and nose at home to protect the airway.

The nurse teaching parents of an adolescent about nutrition will include which important information? Adolescents are usually mature enough to make healthy food choices. Resources to assist lower income families about obtaining enough protein. Behavior problems in this age-group are not related to nutritional deficiencies. Parental influence has the greatest impact on food choices at this age.

Resources to assist lower income families about obtaining enough protein. Lower income families may need resources and information about how to obtain assistance in getting expensive foods such as meats to get enough protein intake. During adolescence, parental influence diminishes and the adolescent makes food choices related to peer acceptability and sociability. Occasionally these choices are detrimental to adolescents with chronic illnesses, such as diabetes, obesity, chronic lung disease, hypertension, cardiovascular risk factors, and renal disease. Families that struggle with lower incomes, homelessness, and migrant status generally lack the resources to provide their children with adequate food intake; nutritious foods, such as fresh fruits and vegetables; and appropriate protein intake. The result is nutritional deficiencies with subsequent growth and developmental delays, depression, and behavior problems. Behavior problems can indeed be related to nutritional deficiencies.

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? Send the child to his or her room. If the child cries, refuses, or is more disruptive, try another approach. Select an area that is safe and nonstimulating, such as a hallway. 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 becomes quiet. The general rule is 1 minute per year. An hour per year is excessive.

What is the most appropriate teaching point to include in a health promotion teaching plan for parents of children age 5 to 14? Causes of mechanical suffocation Keeping all medications out of childrens' reach Storing firearms in locked cabinets Warning signs of violent crimes

Storing firearms in locked cabinets Improper use of firearms is the fourth leading cause of death from injury in children 5 to 14. Mechanical suffocation is the leading cause of death from injury in infants. Homicide is the second leading cause of death in 15 to 19 year olds. Poisoning causes a considerable number of injuries in children under 4 years of age.

The parents of a toddler ask the nurse how to handle their child's increasing number of temper tantrums. The nurse should include which positive reinforcement methods of reducing the number of tantrums? (Select all that apply.) Select all that apply. Suggest that parents provide the child an "all or none" position. Suggest that parents ignore the behavior as long as child is not harming self. Encourage the parents to provide comfort once the child has calmed down. Ask parents to praise the child for positive behavior when not having a tantrum. Tell parents not to give in to the original request that started the temper tantrum.

Suggest that parents ignore the behavior as long as child is not harming self. Encourage the parents to provide comfort once the child has calmed down. Ask parents to praise the child for positive behavior when not having a tantrum. Tell parents not to give in to the original request that started the temper tantrum. During tantrums ignore the behavior, provided the behavior is not injurious to the child. During periods of no tantrums, practice developmentally appropriate positive reinforcement. Other suggestions for handling tantrums include:Offering the child options instead of an "all or none" positionPicking one's battles carefully and ignoring small skirmishes over unimportant issues.Giving comfort once the child is able to control emotions but not giving in to the original request.Praising the child for positive behavior when he or she is not having a tantrum.

A hospitalized toddler clings to a worn, tattered blanket. She screams when anyone tries to take it away. What is the nurse's BEST explanation to the parents for the child's attachment to the blanket? The blanket encourages immature behavior. The blanket is an important transitional object. She has not mastered the developmental task of individuation-separation. She has not bonded adequately with her mother.

The blanket is an important transitional object. Transitional objects are important to help toddlers separate. The blanket is an important transitional object that provides security when the child is separated from parents. Transitional objects are helpful when the child is experiencing an increased stress situation such as hospitalization. This does not reflect bonding behavior.

A child is brought to the emergency department after falling down the basement stairs. On assessment, what findings may cause the nurse to suspect child maltreatment? (Select all that apply.) Select all that apply. The child's bruises are located only on the right arm and leg. The child is brought to the emergency department by an unrelated adult. The child has a history of a broken arm last year from falling off a swing. The child's caregiver is anxious that the child get immediate medical attention. The child has red, green, and yellow bruises on more than one plane of the body.

The child is brought to the emergency department by an unrelated adult. The child has red, green, and yellow bruises on more than one plane of the body. A child brought to a health care provider for a trauma or suspicious injury by an unrelated adult or if the primary care provider is totally unavailable is a warning sign of abuse. Varying degrees of healing of bruises in more than one plane of the body is a warning of abuse. Falling down stairs can be an unintentional injury. A child with an isolated documented injury is not a warning sign of abuse. Multiple fractures of differing ages are a warning sign of abuse. An anxious caregiver is a normal response for an injured child. A delay in seeking care is a warning sign of abuse.

The nurse preparing a nutritional teaching plan for the parents of a preschool child should include which information? The quality of the food consumed is more important than the quantity. Nutrition requirements for preschoolers are very different from requirements for toddlers. Requirement for calories per unit of body weight increases slightly during the preschool period. Average daily intake of preschoolers should be about 3000 calories.

The quality of the food consumed is more important than the quantity. It is essential that the child eat a balanced diet with essential nutrients. Requirements are similar. Caloric requirement decreases slightly. Average intake is about 1800 calories each day.

With regard to umbilical cord care, nurses should be aware that: the stump can easily become infected. a nurse noting bleeding from the vessels of the cord should immediately call for assistance. the cord clamp is removed at cord separation. the average cord separation time is 5 to 7 days.

The stump can easily become infected. The cord stump is an excellent medium for bacterial growth. The nurse should first check the clamp (or tie) and apply a second one. If the bleeding does not stop, then the nurse calls for assistance. The cord clamp is removed after 24 hours when it is dry. The average cord separation time is 10 to 14 days.

The nurse is teaching the parents of a 24-month-old about motor skill development. The nurse should include which statement in the teaching? The toddler walks alone but falls easily. The toddler's activities begin to produce purposeful results. The toddler is able to grasp small objects but cannot release them at will. The toddler's motor skills are fully developed but occur in isolation from the environment.

The toddler's activities begin to produce purposeful results. The child is able to walk up and down stairs at this age. Gross and fine motor mastery occur with other activities. This is a task of infancy. Interaction with the environment is essential at this age.

The parents of a 9-month-old infant tell the nurse that they are worried about their baby's thumb-sucking. What is the nurse's BEST reply? A pacifier should be substituted for the thumb. Thumb-sucking should be discouraged by age 12 months. Thumb-sucking should be discouraged when the teeth begin to erupt. There is no need to restrain nonnutritive sucking during infancy.

There is no need to restrain nonnutritive sucking during infancy. Evidence is inconclusive regarding whether a pacifier or thumb is better for satisfying sucking needs. Thumb-sucking and the use of pacifier should be stopped after 4 years of age. Thumb-sucking and the use of pacifier should be stopped after 4 years of age. Nonnutritive sucking reaches its peak at about 18 to 20 months of age.

Which statement is true concerning folk remedies? They may be used to reinforce the treatment plan. They are incompatible with modern medical regimens. They are a leading cause of death in some cultural groups. They are not a part of the culture in large, developed countries.

They may be used to reinforce the treatment plan. Whenever they are compatible, folk remedies should be used to reinforce the treatment plan. This will assist in establishing a caring environment. Depending on the remedy, they may not be incompatible. These circumstances vary with the remedy. These circumstances vary with the remedy.

Which statement is correct about young children who report sexual abuse? They may exhibit various behavioral manifestations. In most cases the child has fabricated the story. Their stories are not believed unless other evidence is apparent. They should be able to retell the story the same way to another person.

They may exhibit various behavioral manifestations. There is no diagnostic profile of the child who is being sexually abused. Many different behavioral manifestations may be exhibited. Adults are reluctant to believe children, and sexual abuse goes unreported. The physical examination is normal in 80% of the abused children. The child will usually try to protect parents and may accept responsibility for the act.

The nurse in the pediatric clinic identifies which infants at risk for developing vitamin D-deficient rickets? Lacto-ovo vegetarians Those using yogurt as primary source of milk Those who are breastfed exclusively Those exposed to daily sunlight

Those using yogurt as primary source of milk Individuals who follow this diet include milk and its products in their diet. Breast milk has sufficient vitamin D if the mother is not deficient in this vitamin. Yogurt may not be supplemented with vitamin D. Lack of sunlight contributes to vitamin D-deficient rickets.

Parents of a 10-year-old child are concerned that their child has recently been showing signs of loneliness and abandonment. What should the nurse consider when discussing this issue with the parents? Changing self-esteem is difficult after about age 5. Self-esteem is the objective judgment of one's worthiness. Transitory periods of loneliness and abandonment are expected developmentally. High self-esteem develops when parents show adequate love for the child.

Transitory periods of loneliness and abandonment are expected developmentally. Self-esteem is influenced throughout adolescence. One aspect of self-esteem is a subjective judgment of one's worthiness. Self-esteem changes with development. Transient changes are expected and with positive encouragement and support are only temporary. Self-esteem is based on several components: competence, sense of control, moral worth, and worthiness of love and acceptance.

The parents of a toddler state their child is having trouble sleeping. What is the nurse's BEST suggestion to improve sleep habits? Using a transitional object. Varying the bedtime ritual. Restricting stimulating activities during the day. Explaining away fears.

Using a transitional object. A transitional object may help the child ease anxiety and facilitate sleep. A consistent ritual will facilitate sleep. The child should have stimulating physical activity during the daytime. Verbal explanations are not understood by a child this age.

A mother is bringing her 4-month-old infant into the clinic for a routine well-baby check. The mother is exclusively breastfeeding. There are no other liquids given to the infant. What vitamin does the nurse anticipate the provider will prescribe for this infant? Vitamin B Vitamin D Vitamin C Vitamin K

Vitamin D The American Academy of Pediatrics recommends that infants who are exclusively breast-fed receive 400 international units (IU) of vitamin D daily in the first few days of life and continued daily supplementation to decrease vitamin D deficiency. Vitamin B is not needed. Vitamin C is not needed. Vitamin K is not needed.

The signs and symptoms in a nursing diagnosis describe: projected changes in an individual's health status, clinical conditions, or behavior. an individual's response to health pattern deficits in the child, family, or community. a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems. physiologic, situational, and maturational factors that cause the problem or influence its development.

a cluster of cues and/or defining characteristics that are derived from patient assessment and indicate actual health problems. These are the outcomes or goals that are established. This is the definition of the problem statement, the first component of the nursing diagnosis. This is the third part of the nursing diagnosis, the signs and symptoms. This is the definition of etiology, the second component of the nursing diagnosis.

The nurse is planning care for a patient with cultural background different from that of the nurse. An appropriate goal is to: strive to keep cultural background from influencing health needs. encourage continuation of cultural practices in the hospital setting. attempt in a nonjudgmental way to change cultural beliefs. adapt as necessary cultural practices to health needs.

adapt as necessary cultural practices to health needs. The cultural background is part of the individual; it would be very difficult to eliminate its influence. The cultural practices need to be evaluated within the context of the health care setting to determine whether they are conflicting. The cultural background is part of the individual; it would be very difficult to eliminate its influence. Whenever possible, nursing care should facilitate the integration of cultural practices into health needs.

The primary goals in the nutritional management of children with failure to thrive (FTT) are: (Select all that apply.) Select all that apply. allow for catch-up growth. correct nutritional deficiencies. achieve ideal weight for height. restore optimum body composition. educate the parents or primary caregivers on child's nutritional requirements. educate the parents or primary caregivers that the child will need tube feedings first.

allow for catch-up growth. correct nutritional deficiencies. achieve ideal weight for height. restore optimum body composition. educate the parents or primary caregivers on child's nutritional requirements. The goal is to provide sufficient calories to support "catch-up" growth, which is a rate of growth greater than the expected rate for age. Correction of nutritional deficiencies is another goal that may require multivitamin supplements and dietary supplements with high-calorie foods and drinks in addition to treating any coexisting medical problems.Accurate assessment of the child's initial weight and height are important, as well as the daily recording of weight, food intake, and feeding behavior. Correction of nutritional deficiencies is another goal that may require multivitamin supplements and dietary supplements with high-calorie foods and drinks in addition to treating coexisting medical problems to optimize body composition. A goal is to provide education to the parents or primary caregiver of the child's nutritional requirements along with appropriate feeding methods.

A 3-month-old bottle-fed infant is allergic to cow's milk. The nurse's BESToption for a substitute is: goat's milk. soy-based formula. skim milk diluted with water. amino acid formula.

amino acid formula. The milk protein in goat's milk cross-reacts with cow's milk protein. This is avoided because of the cross-reaction with soy. The cow's milk protein is also found in skim milk. The milk protein is broken down in these formulas.

A 3.8-kg infant was delivered vaginally at 39 weeks after a 30-minute second stage. There was a nuchal cord. After birth the infant is noted to have petechiae over the face and upper back. Information given to the infant's parents should be based on the knowledge that petechiae: are benign if they disappear within 48 hours of birth. result from increased blood volume. should always be further investigated. usually occur with forceps delivery.

are benign if they disappear within 48 hours of birth. Petechiae, or pinpoint hemorrhagic areas, acquired during birth may extend over the upper portion of the trunk and face. These lesions are benign if they disappear within 2 days of birth and no new lesions appear. Petechiae may result from decreased platelet formation. In this situation the presence of petechiae is most likely a soft-tissue injury resulting from the nuchal cord at birth. Unless they do not dissipate in 2 days, there is no reason to alarm the family. Petechiae usually occur with a breech presentation vaginal birth.

Before transporting a 16-year-old American Indian female for a magnetic resonance imaging (MRI) scan, the nurse notices the girl is wearing a decorated amulet necklace. The nurse's next BEST action is to: remove the necklace and place it at the nurse's station. explain the risks of wearing the necklace during the MRI. ask the patient if there is a special reason for wearing the necklace. place tape around the neck covering the necklace.

ask the patient if there is a special reason for wearing the necklace. The nurse should first ask the patient the purpose of wearing the necklace. The amulet may be worn as a religious ritual or simply as an accessory. After assessing why the necklace is worn, the nurse could then explain the reason for having to remove the necklace for the procedure. The first step though is to assess. Placing tape around the neck is not an appropriate action and could be unsafe. The necklace should be left with family members if possible or in a locked cabinet, rather than at the nurse's station.

One of the major tasks of toddlerhood is toilet training. In teaching the parents about a child's readiness for toilet training, it is important for the nurse to emphasize that: nighttime bladder control develops first, so parents should focus on that in the initial teaching with their toddler. bowel control is accomplished before bladder control, so the parent should focus on bowel training first. the toddler must have the gross motor skill to climb up to the adult toilet before training is begun. the universal age for toilet training to begin is 2 years, and the universal age for completion is 4 years.

bowel control is accomplished before bladder control, so the parent should focus on bowel training first. Bowel training is usually accomplished before bladder training because of its greater regularity and predictability. The sensation to defecate is stronger than that of urination. The completion of bowel training will give the toddler a sense of accomplishment that can be carried onto bladder training. Nighttime bladder control normally takes several months to years after daytime training; therefore, this should not be the initial focus of toilet training with a toddler. There is no universal right age to begin toilet training or an absolute deadline to complete training. One of the nurse's most important responsibilities is to help parents identify the readiness signs in their child.

The nurse is assessing a preschool age child who is stuttering when answering the nurse's questions. The nurse should offer alternate methods of responding to the stuttering when observing the parent: completing the child's sentences. listening attentively. encouraging the child to speak slowly. helping the child relax.

completing the child's sentences. The National Institute on Deafness and Other Communication Disorders NIDCD encourages parents and caregivers of children who stutter to speak slowly and relaxed, refrain from criticizing the child's speech, resist completing the child's sentences, and take time to listen attentively.

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse's knowledge of growth and development, the nurse recognizes that this is: unsafe play that should be discouraged. creative play that should be encouraged. suggestive of limited family resources. suggestive of limited adult supervision.

creative play that should be encouraged. This type of play should be encouraged. After children create something new, they can then transfer it to other situations. There should be some supervision to prevent injury or accidents. As long as the play is supervised, it should be encouraged. This is not considered unsafe play. There is no indication of limited resources. There is no indication of limited adult supervision.

The nurse is assessing a 6-month-old infant who smiles, coos, and has a strong head lag. The nurse should recognize that: this assessment is normal. the child is probably cognitively impaired. developmental/neurologic evaluation is needed. the parent needs to work with the infant to stop head lag.

developmental/neurologic evaluation is needed. A 6-month-old infant should have social interaction beyond smiling and cooing. The child requires evaluation. The head lag should be almost gone by 4 months of age. This child requires evaluation. The child requires evaluation before interventions can be determined.

When completing the health assessment for a 2-year-old child, the nurse should expect the child to: engage in parallel play. fully dress self with supervision. have a vocabulary of at least 500 words. be one third of the adult height.

engage in parallel play. Two year olds typically play alongside each other. The child still needs help with clothing at 2 years of age. A vocabulary of 300 words is expected at this age. The child typically has grown to one half of adult height.

A 2-year-old child has recently started having temper tantrums during which she holds her breath and sometimes faints. The nurse should: refer the child for respiratory evaluation. refer the child for psychologic evaluation. explain to the parent that this is not harmful. explain to the parent that the child is spoiled.

explain to the parent that this is not harmful. This is not a respiratory issue. Temper tantrums are part of this developmental stage; if they persist, an evaluation may be indicated. The rising carbon dioxide levels in the child will automatically restart the breathing process. No data have been shown to support this.

When caring for a preschool-age child, the nurse should incorporate knowledge that body image has developed to include: a well-defined body boundary. knowledge about his or her internal anatomy. fear of intrusive procedures. anxiety and fear of separation.

fear of intrusive procedures. Preschoolers have poorly defined body images. Preschoolers have little or no knowledge of their internal anatomy. Preschoolers fear that their insides will come out with intrusive procedures. Preschoolers are able to separate.

The mother of a 3-month-old breastfed infant asks about giving her baby water since it is summer and very warm. The nurse should recommend that: fluids in addition to breast milk are not needed. water should be given if the infant seems to nurse longer than usual. water once or twice a day will make up for losses caused by environmental temperature. clear juices would be better than water to promote adequate fluid intake.

fluids in addition to breast milk are not needed. The child will nurse according to needs. Additional fluids are not necessary for the breastfed baby. Supplemental water should not be given. It may cause water intoxication. Supplemental water should not be given. It may cause water intoxication. Clear juices do not provide sufficient caloric or nutrient intake and may interfere with breastfeeding.

The MOST appropriate recommendation for relief of teething pain is to instruct the parents to: rub gums with aspirin to relieve inflammation. apply hydrogen peroxide to gums to relieve irritation. give child a frozen teething ring to relieve inflammation. have child chew on a warm teething ring to encourage tooth eruption.

give child a frozen teething ring to relieve inflammation. Gums should not be rubbed with aspirin. It can be dangerous if the child aspirates aspirin. Hydrogen peroxide would not be effective. Cold reduces inflammation and should be used for relief of teething irritation. Cold, not warmth, reduces inflammation.

The parents of a 4-year-old girl are worried because she has an imaginary playmate. The nurse's BEST response is to tell the parents: a psychosocial evaluation is indicated. an evaluation of possible parent-child conflict is indicated. having imaginary playmates is normal and useful at this age. having imaginary playmates is abnormal after about age 2 years.

having imaginary playmates is normal and useful at this age. Since an imaginary playmate is part of normal development, an evaluation is not necessary. Since an imaginary playmate is part of normal development, an evaluation is not necessary. Imaginary playmates are a part of normal development at this age. The peak incidence of imaginary playmates occurs at 2.5 to 3 years of age. These "playmates" usually are not present once school starts.

The nurse is giving anticipatory guidance to the parent of a 5 year old. In this guidance, it is MOST important to: prepare the parent for increased aggression. encourage the parent to offer the child choices. inform the parent to expect a more tranquil period at this age. advise parents that this is the age when stuttering may develop.

inform the parent to expect a more tranquil period at this age. The end of preschool/beginning of school age is a more tranquil period.This indicates age 4 anticipatory guidance. These actions are indicative of age 3 anticipatory guidance. These actions are indicative of age 3 anticipatory guidance.

When preparing to administer Hepatitis B vaccine to a newborn, the nurse should: (Select all that apply.) Select all that apply. initiate an immunization record. confirm the hepatitis B status of the newborn's mother. obtain a syringe with a 25-gauge, 5/8-inch needle. assess the dorsogluteal muscle as the preferred site for injection. confirm that the newborn's mother has signed the informed consent.

initiate an immunization record. confirm the hepatitis B status of the newborn's mother. obtain a syringe with a 25-gauge, 5/8-inch needle. confirm that the newborn's mother has signed the informed consent. An immunization record is important for the nurse to initiate and give to the mother so that a continuous record of immunizations is maintained. Hepatitis B vaccine is the primary prevention for the disease. If the mother is positive for the hepatitis B virus, the newborn will need to receive the hepatitis B immunoglobulin (HBIG) in addition to the hepatitis B vaccine. The dose of hepatitis B vaccine is 0.5 mL, to be given with a 25-gauge, 5/8-inch needle, intramuscularly (IM) in the newborn. Signed informed consent must be obtained from the mother before administration of the vaccine. The only safe intramuscular injection site for the newborn is the vastus lateralis muscle.

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of: identity. intimacy. initiative. industry.

initiative. Preschoolers focus on developing initiative. Identity is the stage associated with adolescence. Intimacy is an adult stage. The stage is known as initiative versus guilt. Industry is an adult stage.

The practice of cultural humility is continual and an important concept in the nursing process. Nurses can facilitate this process by: (Select all that apply.) Select all that apply. integrating cultural knowledge. recognizing cultural differences. acting in a culturally appropriate manner. being aware of their own beliefs and practices. helping the family adapt to the health care practices.

integrating cultural knowledge. recognizing cultural differences. acting in a culturally appropriate manner. being aware of their own beliefs and practices. Integrating cultural knowledge is essential to providing care to families and the community. Recognizing cultural difference is a component of cultural awareness, humility, and competence. Acting culturally appropriate is essential in understanding and being able to deal effectively with families in a multicultural community. Nurses must be aware of their own beliefs and practices before they can begin to understand the varied and numerous cultural influences on the life of children and family. It is essential that nurses make an effort to adapt health care practices to the family's health needs rather the attempting to change longstanding beliefs.

When teaching an adolescent mother about risk factors for neonatal death, the most important factor is? low birth weight (LBW). injuries to the mother during pregnancy. newborn obesity. chronic illness of the mother.

low birth weight (LBW). Low birth weight (LBW), which is closely related to early gestational age, is considered the leading cause of neonatal death in the United States. Injuries are the leading cause of death in children over age 1 year, with the majority being motor vehicle accident (MVA) injuries. Injuries to the mother and chronic illness are not the major causes of neonatal death.

While caring for hospitalized adolescents, the nurse observes that sometimes they are skeptical of their parents' religious beliefs/practices. The nurse should recognize that this is: normal in spiritual development. abnormal in spiritual development. related to illness and occurs only at times of crisis. related to the inability of parents to explain adequately their beliefs/practices.

normal in spiritual development. This describes stage 4 in spiritual development. Adolescents attempt to determine which of their parental standards and beliefs to incorporate into their own.

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: order the child a meatless tray. tell the parent to take any meat off the child's meal tray. ask the parent if they would like to have a Buddhist priest visit. explain to the parent 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.

When preparing parents to teach their preschool child about human sexuality, the nurse should emphasize that: a parent's words may have a greater influence on the child's understanding than the parent's actions. parents should determine exactly what the child wants to know before answering a question about sex. parents should avoid using correct anatomic terms because they are confusing to the preschooler. parents should allow children to satisfy their sexual curiosity by playing "doctor."

parents should determine exactly what the child wants to know before answering a question about sex. The actions may have a greater influence because language is not fully developed. It is important that the parent answer the question that the child is asking. Using correct terminology lays the foundation for later discussion. Parents should encourage the asking of questions to resolve curiosity without undue investigation on the child's part.

During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. His birthday is close to the cutoff date, and he has not attended preschool. The nurse's BEST recommendation is to: start kindergarten. perform developmental screening. observe a kindergarten class. postpone kindergarten and go to preschool.

perform developmental screening. This does not address the father's concern about readiness. A developmental screening will provide the necessary information to help the family determine readiness. Observing will provide information about kindergarten but not whether the child is ready. If the child is ready for kindergarten, preschool may lead to boredom.

The nurse's BEST approach for effective communication with a preschool-age child is through: speech. play. drawing. actions.

play. Language is not specific for children. Play is the child's way to learn to understand and adjust to situations. Drawing is not developed at this age. Actions are not effective for communication.

Evidence-based practice, a current health care trend, is best described as: gathering evidence of mortality and morbidity in children. meeting physical and psychosocial needs of the child and family in all areas of practice. using a professional code of ethics as a means for professional self-regulation. questioning why something is effective and whether there is a better approach.

questioning why something is effective and whether there is a better approach. This will assist the nurse in determining areas of concern and potential involvement. It is not possible to meet all needs of the family and child in all areas of practice. The nurse is an advocate for the family. This is part of the professional role and licensure. Evidence-based practice helps to focus on measurable outcomes and the use of demonstrated, effective interventions, and questions whether there is a better approach.

A 4-year-old boy has been having increasingly more frequent angry outbursts in preschool. He is very aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. The MOST appropriate intervention is to: explain that this is normal in preschoolers, especially boys. refer the child for professional help. talk to the preschool teacher to obtain validation for the behavior the parent reports. encourage the parent to try more consistent and firm discipline.

refer the child for professional help. This is not normal behavior. This is not expected behavior; the child should be referred to a competent professional to deal with his aggression. The validation will be helpful for the referral, but the referral is the priority action. This may be recommended by the professional.

The role of the pediatric nurse is influenced by trends in health care. The greatest trend in health care is: primary focus on treatment of disease or disability. national health care planning on a distributive or episodic basis. accountability to professional codes and international standards. shift of focus to prevention of illness and maintenance of health.

shift of focus to prevention of illness and maintenance of health. Traditionally, this is the role of the physician. This is not a major trend. This is an established responsibility, not a trend. Prevention is the current focus of health care, one in which nursing plays a major role.

The MOST overwhelming adverse influence on health is: race. customs. socioeconomic status. genetic constitution.

socioeconomic status. Although children of different racial groups have differing health issues, socioeconomic status is a key predictor. Customs do not usually have an adverse effect on health. A higher percentage of lower-class individuals have some health problem at any one time than other individuals in different classes. There is a high correlation between poverty and poor nutrition. On a population basis, genetic constitution is not an overwhelming adverse influence.

Characteristics of physical development of a 30-month-old child are the: (Select all that apply.) Select all that apply. anterior fontanel is open. birth weight has doubled. genital fondling is noted. sphincter control is achieved. primary dentition is complete.

sphincter control is achieved. primary dentition is complete. Sphincter control in preparation for bowel and bladder control is usually achieved by 30 months of age. Primary dentition is usually completed by 30 months of age. The anterior fontanel closes between 12 and 18 months of age. Birth weight should double at 5 to 6 months of age and quadruple by 2½ years of age. Genital fondling is not a characteristic of physical development of this age-group. This is part of the development of gender identity.

Poisoning in toddlers can best be prevented by: consistently using safety caps. storing poisonous substances in a locked cabinet. keeping ipecac syrup in the home. storing poisonous substances out of reach.

storing poisonous substances in a locked cabinet. Not all poisonous substances have safety caps. This is an appropriate action. Ipecac does not prevent poisoning and is not recommended. Toddlers can climb; therefore little is out of reach.

The exhausted parents of a 2-month-old infant with colic ask the nurse what is the best method to promote comfort and sleep for the infant. The nurse's initialaction is to: advise the mother to follow a milk-free diet for 3 to 5 days. take a thorough, detailed history of usual daily events. administer simethicone drops to provide relief from gas pains. explain that the parents need to stay calm so the infant will remain calm.

take a thorough, detailed history of usual daily events. The initial step in managing colic is to take a thorough, detailed history of the usual daily events including: diet, time of day when child cries, presence of family members, type of cry, etc. Before suggesting formula changes or medications to relieve symptoms, a detailed history is needed. It is important that the nurse convey an empathetic and compassionate attitude and reassure the parents that they are not doing anything wrong.

The nurse is caring for a dying boy whose religion is Islam (Muslim/Moslem). An important nursing consideration related to his impending death and religion is that: there are no special rites. there are specific practices to be followed. the family is expected to "wait" away from the dying person. baptism should be performed if it has not been done previously.

there are specific practices to be followed. The nurse should contact someone from the person's mosque to assist. Islam has specific rituals for bathing and wrapping the body in cloth before it is to be moved. Family may be present. No baptism is performed at this time.

A parent of an 8-month-old infant tells the nurse that the baby cries and screams whenever he or she is left with the grandparents. The nurse's reply should be based on knowledge that: the infant is most likely spoiled. this is a normal reaction for this age. this is an abnormal reaction for this age. grandparents are not responsive to that infant.

this is a normal reaction for this age. These are developmentally appropriate. The infant is experiencing stranger anxiety, which is expected for this age child. These are developmentally appropriate. No data have been shown to support this.

The nurse educator instructs a nursing student that according to Erikson, infancy is concerned with acquiring a sense of: trust. industry. initiative. separation.

trust. The task of infancy is the development of trust. Industry versus inferiority is the developmental task of school-age children. Initiative versus guilt is the developmental task of preschoolers. Separation occurs during the sensorimotor stage as described by Piaget.

Newborns are at high risk for injury if appropriate safety precautions are not implemented. Parents should be taught to: place the newborn on the abdomen (prone) after feeding and for sleep. avoid use of pacifiers. use a rear-facing car seat. use a crib with side rail slats that are no more than 3 inches apart.

use a rear-facing car seat. The prone position is no longer recommended since it may interfere with chest expansion and lead to sudden infant death syndrome. Approved pacifiers are safe to use and fulfill a newborn's need to suck. If the newborn is breastfed, the use of pacifiers should be delayed until breastfeeding is well established to avoid the development of nipple confusion. Your baby should be in a rear-facing infant car safety seat from birth until age 2 years or until exceeding the car seat's limits for height and weight. Slats in a crib should be no more than 2 inches apart.


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