Peds Midterm
posterior fontanel closes when?
~2mo
Normal BP for adolescent?
112-127/66-80
Normal RR in adolescents?
12-16
pediatric pt is at high risk for....
airway obstruction obligate nose breather small, flexible airway chest wall
When are deciduous teeth shed?
starts at 6 yo thru 12ish (school age)
What is anticipatory guidance?
teaching based on child's dev'tal stage; educate caregiver about stages child will reach in the near future and related care; safety=potential injury r/t child's dev'tal stage and ways to prevent injury.
What should the nurse suggest when parents ask what to do about their preschooler's stuttering? 1 Speak clearly and do not complete the child's sentences. 2 Avoid looking at the child when he experiences difficulty forming words. 3 Help the child by supplying the correct word when he experiences a block. 4 Stop the conversation and tell the child to speak slowly when starting again.
1 Speak clearly and do not complete the child's sentences. During the preschool years speech dysfluency is a typical characteristic of language development; it will resolve if the child is spoken to clearly and is not corrected. Avoiding eye contact, supplying the correct word, or drawing attention to the stuttering is demeaning; it may decrease the child's self-esteem and worsen the stuttering.
Themes of coping/stress in children include...
negativism temper tantrums regression transitional objects toys, pretend play rituals
tips for communicating with children...
non-verbal cues very important approach child slowly indirect talk get at child's level
Factors that make child's resp system diff't from adults?
obligate nose breathers large head, weak neck muscles other structural differences
What type of play is the most prominent for toddler age kids (1-3yrs)?
parallel play
Cognitive issues of magical thinking, less egocentric, unable to conceptualize time are present at what age group?
preschool 3-5 yrs
"toddler" age range
1 - 3 yrs
Normal HR in neonate?
100-180 (asleep 80-160)
When do we expect crawling?
9 mo
Normal RR in preschoolers?
22-34
Average newborn length?
50cm / 20in
What does POS stand for?
Point Of Service plans
What does PPO stand for?
Preferred Provider Organizations Groups of health care providers who agree to provide health services to a specific group of clients at a discounted cost.
When does walking progress to running?
Toddler age (1-3 yrs)
"Newborn" age range
birth to 1 month
Things to consider when examining the school age child
inquisitive - what will happen? body integrity is a major concern privacy is important early health teaching
Kids are talking in 2-3 word sentences when?
2 yrs old
Normal RR in toddlers?
24-40
A 15-month-old child is hospitalized after ingesting toilet bowl cleaner. The mother confides that she feels guilty about leaving the cleaner where her child could get it. What is the best response by the nurse? 1 "Anyone could make a mistake. Don't dwell on it." 2 "Let's not worry about the past. Your child is going to get better." 3 "It was an accident, but you should consider special locks on your closets." 4 "That was careless of you. Please make sure that you poison-proof your house."
3 "It was an accident, but you should consider special locks on your closets." Describing the incident as an accident and recommending locks on closets accepts the mother's statement and helps the mother express her guilt while providing directions to safeguard her child. Poisoning is not an everyday occurrence; teaching should be incorporated to protect the child. Telling the mother that the child will get better is false reassurance; the child's condition is still in question. Calling the mother careless only increases the mother's guilt and provides nothing more than a vague suggestion of how to remedy the problem.
The nurse finds that a 2-year-old child has impaired fine motor skills. The nurse recommends toys that will be beneficial for the child. Which statement by the child's parents needs correction? 1 "I should provide musical toys." 2 "I should provide straddle trucks." 3 "I should provide battery-operated cars." 4 "I should provide thick crayons and finger paints."
3 "I should provide battery-operated cars." Passive toys such as battery-operated cars should not be provided as they do not stimulate musculoskeletal development. Musical toys can improve coordination. Straddle trucks improve locomotive skills. Thick crayons and finger paints improve fine motor skills.
The nurse is assessing a newborn and anticipates that the newborn has renal impairment. Which finding supports the nurse's conclusion? 1 The newborn has colorless urine. 2 The newborn has odorless urine. 3 The newborn first voids after 76 hours. 4 The newborn's urine has specific gravity of 1.020.
3 The newborn first voids after 76 hours. A newborn should void within 24 hours. However, in this case, the newborn first voids after 76 hours, indicating renal impairment. The urine should be colorless and odorless. This indicates that the urine is normal and the child has normal renal function. Normally the specific gravity of urine is 1.020.
The parents of a 4-month-old infant with a diagnosis of acute otitis media and fever ask the nurse about the use of antibiotics to treat this condition. What is the best response by the nurse? 1 "Antiinflammatory medications are recommended for this condition." 2 "Typically antiviral medications are given to treat acute otitis media." 3 "Current practice is to wait 72 hours to see whether the condition resolves." 4 "Antibiotics are recommended for infants under 6 months with acute otitis media."
4 "Antibiotics are recommended for infants under 6 months with acute otitis media." All cases of acute otitis media (AOM) in infants younger than 6 months should be treated with antibiotics because of the children's immature immune systems and the potential for infection with bacteria. Current literature indicates that waiting up to 72 hours for spontaneous resolution is safe and appropriate management of AOM in healthy infants older than 6 months and children. However, the watchful waiting approach is not recommended for children younger than 2 years of age who have persistent acute symptoms of fever and severe ear pain. Antiviral or antiinflammatory medications would not be recommended in an acute case of otitis media.
How does the US rank internationally when it comes to infant mortality rate?
46th out of the 223 countries that reported. As in the rate was higher than the first 45 countries. One of the major reasons for the poor US showing is the large racial disparity.
respiratory illness accounts for ____% of childhood MORBIDITY
50%
"school age" range
6 - 11 or 12 yrs
When do adult teeth erupt?
6 yrs old, accompanied by loss of primary teeth.
When does stranger anxiety start?
6-8 months
Normal HR in adolescent?
60-90 (asleep 50-90)
When does a child say their first word?
8-9 months or later Sounds become more meaningful and specific by 9 to 15 months. By age 1, usually has vocab of several words.
Normal HR in toddler?
80-110 (asleep 60-90)
Normal BP for 6mo (infant)?
87-105/53-66
Normal BP for toddler (2r)?
95-105/53-66
Normal BP for school-age (7yr)?
97-112/57-71
When is object permanence established?
9mo
A 6-week old infant grasps a rattle placed in the hand. The mother is impressed with this skill. The nurse should explain that this is: A) Atypical behavior and further evaluation is required B) The palmar grasp reflex and is expected at this age C) Voluntary behavior usually is observed in an older infant D) The pincer grasp, which should disappear in 3-4 months of age
B) The palmar grasp reflex and is expected at this age
The student nurse is classifying four infants according to their gestational age. Which infant's information requires correction? Infant 1: 33 weeks = preterm Infant 2: 40 weeks = Full term Infant 3: 38 weeks = late preterm Infant 4: 43 weeks = post-term A Infant 1 B Infant 2 C Infant 3 D Infant 4
C Infant 3 Infants who are born at 34 0/7 and 36 6/7 weeks of gestation are known as late-preterm infants, not infants who are born at 38 weeks of gestational age. An infant who is born before completion of 37 weeks of gestational age is known as a preterm infant. An infant who is born between 38 and 42 weeks of gestational age is known as a full-term infant. An infant who is born after 42 weeks of gestational age is known as a postterm infant.
body image, moody, sexuality, emancipation are themes of what stage of adolescence?
early adolescence
example of concrete thinking?
you're gonna get a stick in the arm "you're gonna stab me with a stick from a tree in my arm? wtf?"
Major issues include associative play, strong imagination, fears (i.e. boogie man)
preschool 3-5 yrs
When can dev't of gross and fine motor skills like drawing and skipping be expected?
preschool 3-5 yrs
When is the toddler potbelly lost?
preschool age 3-5 yrs become leaner
Things to consider when approaching toddler/preschooler for examination
they are egocentric - focus exam on what they will FEEL Separation anxiety is HIGH; interact with parent FIRST and examine child with parent nearby
Common issues regarding injury prevention in children?
vehicle safety (proper use of car seats), falls, burns, aspiration, newfound mobility, curiosity w/o cognitive skills
How much does baby weight increase in first 6 months?
weight should double in first 6 mo
How much does baby weight increase in first year?
weight should triple by 1 yr of age
Nursing care of children involves nursing care of the ____________ and requires skill in dealing with both.
whole family
at what age does binocular vision begin?
~3-4 months
When is vision acuity 20/20 achieved?
~6yrs
common cause of mortality among children 1-19 yrs old?
accidents
Major issues of __________________ include imaginary audience, personal fable
adolescence (13-20 yrs)
For what age range are all of these themes relevant? personal fable / risk taking car / bike safety substance abuse suicide
adolescent safety issues
After first 2 yrs backward-facing carseat, what is next for car safety?
after 2 yrs, upright and forward facing, booster seat until at least 8 yrs old, minimum height 4'9". Need to be both, over 8 and 4'9".
The nurse recognizes that behaviors frequently first exhibited in an 8-month-old infant include: A)Drinking from a cup, saying "mama" and "dada", standing alone B) Smiling spontaneously, clasping hands, and keeping the head steady when smiling C) Being shy with strangers, playing peek-a-boo, and standing by holding on to furniture D) Removing some clothing, building a tower of two cubes, and stopping to pick up toys
C) Being shy with strangers, playing peek-a-boo, and standing by holding on to furniture
What can a nurse say to parents that might reduce parental anxiety about an ill child in the hospital?
"Your child is in the best place possible here at the hospital. You brought him in at just the right time so that we an help him."
At 2 yrs of age, children are ~______ their adult height
1/2 their adult height
Normal HR in Infant (6mo)?
100-160 (asleep 75-160)
Normal RR in school-age kids?
18-30
When does birth weight triple and cruising +/- walking occur?
1yr
An adolescent who has had type 1 diabetes for 5 years stops adhering to the therapeutic regimen. In light of the client's developmental level, the nurse concludes that the behavior is a reflection of a: 1 Need for attention 2 Struggle for identity 3 Denial of the diabetes 4 Regression related to the illness
2 Struggle for identity Striving to attain identity and independence are tasks of the adolescent, and rebellion against established norms may be exhibited. Nonadherence to a regimen is not a bid for attention; rather, it is an attempt to establish an identity, which is a developmental task of adolescence. Although the adolescent may be using denial, denial is not developmentally related to adolescence. Noncompliance is not a sign of regression; it is an attempt to attain identity through rebellion against established norms.
"Preschool" age range
3 - 6 yrs
An infant has been admitted for dehydration as a result of acute gastroenteritis and vomiting, and the nurse administers lactated Ringer's solution intravenously. The nurse concludes that the treatment has been effective after noting: 1 Tenting turgor 2 Pink mucous membranes 3 Three wet diapers in 24 hours 4 Capillary refill greater than 2 seconds
3 Three wet diapers in 24 hours Three or more wet diapers in 24 hours indicates that fluid balance is improving and that the kidneys are functioning. Capillary refill of more than 2 seconds, fewer than three wet diapers in a day, and tenting turgor are all signs of dehydration, not of improvement.
Average newborn weight?
3.4kg / 7.5lbs
A nurse at the well-child clinic determines a 1-year-old infant's length to be below what is expected. The current height is 28 inches, and the birth length was 20 inches. What should this infant's current length be? Record your answer using a whole number. ___ inches
30 inches This infant is 2 inches shorter than expected. At 1 year of age an infant should have increased the birth length by 50%; 50% of 20 inches is 10 inches; 10 inches added to the birth length of 20 inches equals 30 inches.
Normal RR in infant?
30-60
Average newborn head circumference?
32-38cm / 13-15in
Normal HR in preschooler?
70-110 (asleep 60-90)
A nurse is assessing a 1-month-old infant with suspected hypertrophic pyloric stenosis (HPS). Referring to the figure, what area of abdo should the nurse expect to palpate an olive-shaped mass? A) Upper midline B) LUQ C) LLQ D) RUQ
D) RUQ HPS occurs when the circumferential muscle of the pyloric sphincter of the stomach becomes thickened. This thickening may be palpated as an olive-like mass in the upper right quadrant to the right of the umbilicus. This area is over the cardiac sphincter where the esophagus and stomach are connected, which is unrelated to HPS. This area is over the spleen, which is unrelated to HPS. The olive-like mass of HPS is on the right, not left, side of the umbilicus.
Etiology and symptoms of URI's (aka colds)?
Etiology: viral Symptoms: rhinitis, cough, fever, irritability, anorexia, V/D
Nursing care for child with URI/cold?
HOB elevated saline nose drops or warm water suction (olive tip?) monitor fever, SOB, cough encourage fluids hygiene - handwashing
What does HMO stand for?
Health Maintenance Organizations. Provide relatively comprehensive health services for ppl enrolled in the org for a set fee or premium.
How does the US rank globally in infant mortality rates? (from powerpoint)
US ranked 34th globally
Components of pediatric pulmonary physical exam?
color LOC resp effort/pattern position breath sounds eval of oxygenation
Leading cause of mortality among children under 1 yr of age?
congenital, LBW
Medical Tx of cold/URI?
fever control possible contraindications in use of decongestants/cough suppressants; do NOT give to young infants, and may not be helpful in older children
Common foreign body aspiration culprits?
hot dogs, round candy, peanuts, grapes, latex balloons, buttons, toy parts
future thinking, less egocentric are themes of what state of adolescence?
late adolescence
Things to consider when interacting with toddler/preschooler
let child play w/ exam equip concrete thinking - use simple and familiar words keep invasive objects out of sight toddler is more challenging, while preschooler is more cooperative
rebellion, peer groups are themes of what stage of adolescence?
middle adolescence
separation anxiety peaks when?
toddler age 1-3 yrs
Fluid requirements in pediatrics
higher per kg due to: greater insensible loss higher metabolic rate child at greater risk of dehydration/fluid overload
When does puberty begin in boys?
~11.6 yrs testicular size 1st sign
A 6-month-old infant weighing 15 lb is admitted with a diagnosis of dehydration. A prescription for oral rehydration therapy 4 mL/kg Pedialyte over 4 hours is made. What is the approximate amount of fluid that the infant should ingest during the 4 hours? A) 28 mL B) 32 mL C) 38 mL D) 42 mL
A) 28 mL At 15 lb the infant weighs about 7 kg; 4 mL × 7 kg is 28 mL. The other amounts (32 mL, 38 mL, 42 mL) are too much.
Approx what age is a kid around 40 lbs?
4 yrs old
When do we expect first words?
1yr
After returning from surgery an infant suddenly becomes cyanotic. What is the nurse's priority intervention? 1 Checking vital signs 2 Administering oxygen 3 Suctioning the nasopharynx 4 Placing the infant in the side-lying position
3 Suctioning the nasopharynx The most likely cause of cyanosis is secretions in the airway. The airway must be cleared of secretions for effective air exchange. Taking vital signs is unsafe because valuable time is lost while the infant's brain is deprived of oxygen. Oxygenation is ineffective if secretions are not first cleared from the airway. The side-lying position helps promote drainage of secretions, but this intervention should be undertaken only after the airway is cleared.
An infant with diarrhea requires contact precautions. What is the most effective nursing action to control the spread of this infant's pathogens? 1 Wearing a gown, mask, and gloves during care 2 Allowing only registered nurses to give direct care 3 Restricting visitors to the infant's immediate family 4 Washing hands before and after contact with the infant
4 Washing hands before and after contact with the infant The most effective method of preventing the spread of infection is handwashing not only before and after care but also before and after using gloves. A mask is not required for contact precautions. The level of education of the caregiver does not guarantee the correct technique for preventing the spread of infection. The risk for spread of infection is not in the number of visitors but the aseptic technique practiced by these visitors.
When does separation anxiety start?
4-8 months
Leading cause of death in ages 1 to 4?
unintentional injury (8.5 per 100,000 deaths)
On child/adult over 3 yrs of age, how do you pull ear for examination?
up and back
Sudden onset of coughing or choking, inspiratory stridor, hoarse cry/voice, suprasternal retractions sounds like _____________?
upper airway obstruction
"infant" age range
1 mo - 1 yr
When does puberty begin in girls?
~11yrs breast buds first sign, menses
anterior fontanel closes when?
~12-18mo
When does the anterior fontanel close?
~18mo
what is visual acuity at 3 yrs?
~20/50
A nurse is teaching parenting to a group of teenage mothers. After a discussion of child safety, the young mothers provide feedback. Which comment indicates the need for additional information? 1 "My baby could drown if I leave her alone in water higher than her waist." 2 "My baby could swallow any item small enough for him to put in his mouth." 3 "My baby will be safest in the car if I put the car seat in the middle of the back seat." 4 "My baby will touch everything when she starts to crawl, so I'll cover all of the electrical outlets."
1 "My baby could drown if I leave her alone in water higher than her waist." Drowning can occur in even a minimal amount of water because the infant does not have the body control to move out of the water. Babies can swallow any small item left in their reach. The middle of the back seat is the best location for the car seat. Before the infant becomes mobile, the mother will need to take precautions to prevent electrical injury.
A 16-year-old single mother of a 1-month-old infant and the infant's grandmother bring the baby to the emergency department and report that the infant accidentally fell down the stairs. The nurse knows that a consent form for treatment should be signed. Who has the responsibility for signing the consent? 1 The mother, despite her age 2 No one, because this is an emergency 3 The grandmother, because she is a relative 4 Family court, because the mother is a minor
1 The mother, despite her age The client is an emancipated minor, meaning that she has adult status. In most states the age of majority is 18 years; however, parents younger than 18 years are considered emancipated minors and may sign consents for themselves and their children. Consent always is needed when a parent is present and capable of providing it. The grandmother does not have the legal right to give consent. Family court is unnecessary.
Why does the nurse recommend that parents give their child food rich in vitamin A? 1 To help the child improve visual acuity 2 To help the child improve language skills 3 To help the child develop gross motor skills 4 To help the child improve concentration levels
1 To help the child improve visual acuity Eating vitamin A-rich food improves the child's vision. Engaging the child in conversation will help improve language skills. Activities like jumping, running, and climbing will promote physical growth and improve gross motor skills. Vitamin A is not associated with concentration levels. *Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.*
A nurse teaches a mother about appropriate play for an 8-month-old infant. Which of the mother's suggestions indicate that the teaching has been understood? *Select all that apply.* 1 Textured book 2 Modeling clay 3 Stuffed animal 4 Play telephone 5 Hanging mobile
1, 3, 5 Textured book, Stuffed animal, Hanging mobile A textured book promotes tactile stimulation and touch discrimination. A stuffed animal promotes manipulative play. A hanging mobile promotes visual stimulation. Modeling clay is an unsafe toy for an 8-month-old infant because an infant of this age explores the environment by placing objects in the mouth. An 8-month-old infant is too young for a play telephone; it is an appropriate toy for a toddler to promote imitative play.
Children under 3 are prone to otitis media - why?
eustachian tube more horizontal
Body surface area of children
greater BSA:body mass ratio lose more heat and water through evaporation
Parent teaching regarding a newborn and carseats?
infant seat rear-facing until 2 yrs of age
Which screening report will help the nurse determine skeletal growth in a child? 1 Electroencephalogram reports 2 Radiographs of the hand and wrist 3 Magnetic resonance imaging (MRI) 4 Denver Developmental Screening Test
2 Radiographs of the hand and wrist Skeletal growth in a child can be determined from the ossification centers. At 5-6 months, the capitate and hamate bones in the wrist are the earliest centers. Therefore, radiographs of the hand and wrist will help determine skeletal growth in the child. Electroencephalogram reports will help assess a child's brain activity.MRI is used to scan the internal structures of a patient. The Denver Developmental Screening Test is used to understand developmental issues of a child.
A 10-year-old child who has sickle cell anemia is admitted to the hospital with a vaso-occlusive painful episode. The nurse manager plans to place the child in the same room as a child with the diagnosis of: 1 Pneumonia 2 Thalassemia 3 Acute pharyngitis 4 Chronic osteomyelitis
2 Thalassemia Rationale: Thalassemia is a hemolytic anemia that is not communicable. Roommates with infectious diseases should be avoided because a child with sickle cell anemia is susceptible to infections. These childrens' spleens become infarcted and are gradually replaced by fibrous tissue by 5 years of age. The spleen filters bacteria, thereby triggering phagocytosis; without a functioning spleen and therefore this trigger, these children are prone to infection. The child with sickle cell anemia is susceptible to infection; pneumonia (lungs), pharyngitis (upper respiratory tract), and chronic osteomyelitis (bone) are all types of infections.
Which instruction does the nurse give to the parents to help their child get accustomed to a new babysitter? 1 "Ask the babysitter to stand very close to the child." 2 "Ask the babysitter to hold out arms and smile broadly." 3 "Stay close and allow the child to observe the babysitter." 4 "Discourage the child from clinging in front of the babysitter."
3 "Stay close and allow the child to observe the babysitter." Children need to explore and get used to babysitters or any stranger at their own rate. Therefore, the parents should stay close to the child and allow the child to observe the babysitter. The babysitter needs to maintain a safe distance from the infant so that the infant is not scared. The stranger needs to talk softly and avoid sudden gestures, such as smiling broadly or holding out arms, which may scare the infant. The parents should not discourage the child from clinging, as it is necessary for the child's optimal emotional development.
While assessing an 18-month-old child a nurse observes that the toddler can crawl up stairs but needs assistance when climbing the stairs upright. What does this indicate to the nurse? 1 Presence of talipes equinovarus 2 Presence of neurologic damage 3 Expected behavior in a toddler of this age 4 Existence of developmental dysplasia of the hip
3 Expected behavior in a toddler of this age Rationale It is not until 2 years of age that toddlers are able to use their feet to walk up stairs instead of crawling. Talipes equinovarus is identified with the use of other criteria. At 18 months of age the inability of the toddler to use the feet to go up stairs is not a problem; it is expected. Developmental dysplasia of the hip is identified with the use of other criteria.
The nurse is providing dental hygiene to a toddler. Which action does the nurse perform to clean the toddler's back teeth? 1 The nurse tells the toddler a story. 2 The nurse tells the toddler to say "cheese." 3 The nurse tells the toddler to "roar like a lion." 4 The nurse tells the toddler to "tweet like a bird."
3 The nurse tells the toddler to "roar like a lion." The nurse tells the toddler to "roar like a lion" as it helps the nurse access the toddler's back teeth and clean them properly. The nurse tells stories to the toddler to prevent boredom. The nurse tells the toddler to say "cheese" while brushing the toddler's front teeth. The nurse tells the toddler to "tweet like a bird" so that the toddler's mouth opens widely for effective cleaning.
What things should be considered when approaching an infant?
responds to non-verbal interaction stranger anxiety ~6-8mo examine in parent's arms WARM stethoscope! opportunistic examination
When can we expect to see concrete operations (conservation, mental representation; appreciate different points of view)?
school age 6-12 yrs old
The parents of a school-age child tell the nurse, "We evade any questions about sex that our child asks us. It is very embarrassing to discuss such things with our child." What does the nurse inform the parents? 1 "It is right to evade questions now, as the child is still small." 2 "The child will feel depressed if you do not answer all queries." 3 "The child may engage in sexual activities if you explain it now." 4 "The child may speak with peers and get inaccurate information."
4 "The child may speak with peers and get inaccurate information." If the parents refuse to answer any questions related to sex, the child obtains this information from peers who may provide inaccurate information. It is not correct to evade the child's questions related to sexual activity. Instead, the parents should discuss the topic honestly. If the parents do not answer the child's questions, the child will not feel depressed, but will look for information elsewhere. Providing information about sex will not encourage the child to engage in sexual activity. Rather, it will minimize the feelings of embarrassment and uncertainty that accompany puberty.
An infant with hydrocephalus has a ventriculoperitoneal shunt surgically inserted. What nursing care is essential during the first 24 hours after this procedure? 1 Medicating the infant for pain 2 Placing the infant in a high Fowler position 3 Positioning the infant on the side that has the shunt 4 Monitoring the infant for increasing intracranial pressure
4 Monitoring the infant for increasing intracranial pressure The shunt may become obstructed, leading to an accumulation of cerebrospinal fluid and increased intracranial pressure. Although providing pain relief for the infant is an important part of postsurgical care, monitoring for potentially severe complications such as increased intracranial pressure takes precedence. Positioning the infant flat helps prevent complications that may result from a too-rapid reduction of intracranial fluid. The infant is positioned off the shunt to prevent pressure on the valve and incision area.
Normal HR in school-age child?
65-110 (asleep 60-90)
When does birth wt double, teeth erupt, sitting occur?
6mo
The nurse must administer an IM medication to a 2-year-old whose parent is not present. The most therapeutic approach should be to: A) Avoid telling the child beforehand, give the injection, and then cuddle the child B) Demonstrate how an injection is given, tell why it is needed, and then gather the equipment C) Warn the child about the "hurt" just before giving the injection, say it is OK to cry, and then comfort the child D) Give a doll the injection, encourage the child to give the doll an injection, and then give the child the injection
C) Warn the child about the "hurt" just before giving the injection, say it is OK to cry, and then comfort the child
To examine ear, how do you pull ear in child?
under 3 yrs of age, pull ear down and back
A nurse is obtaining a health history from the mother of a 2-month-old infant with a diagnosis of hypertrophic pyloric stenosis (HPS). What is the most significant finding about the cause of the infant's HPS? 1 A first cousin underwent surgery for HPS. 2 The birth was preterm and the birthweight was 4 lb. 3 An older brother had idiopathic vomiting during infancy. 4 The older sister experienced an intestinal obstruction during early infancy.
1 A first cousin underwent surgery for HPS. The higher incidence of HPS among first-degree relatives seems to indicate a hereditary cause. Full-term infants are more likely to be affected than preterm infants. HPS is not related to other gastrointestinal disorders, even among close relatives.
A nurse who works in a fertility clinic is discussing the inheritance pattern of sickle cell disease with the parents of a school-aged child with the disease. The parents are planning to have a second child. The nurse knows that the parental genotypic makeup is: 1 Father heterozygous (sickle trait), mother heterozygous (sickle trait) 2 Mother homozygous (no sickle trait), father heterozygous (sickle trait) 3 Father homozygous (no sickle trait), mother heterozygous (sickle trait) 4 Mother homozygous (has sickle cell disease), father is homozygous (no sickle trait)
1 Father heterozygous (sickle trait), mother heterozygous (sickle trait) Sickle cell disease is an autosomal recessive disorder; each parent contributes one affected gene. All children with a mother who is homozygous (has sickle cell disease) and a father who is homozygous (no sickle trait) will have the sickle cell trait but not sickle cell disease. There is a 50% chance that a child with a homozygous mother/heterozygous father, homozygous father/heterozygous mother, or homozygous mother/homozygous father will have the sickle cell trait, not sickle cell disease.
Which solid food can be given to a 6-month-old infant? 1 Raw pieces of fruit 2 Crackers or Zwieback 3 Firmly cooked vegetable 4 Well-cooked table foods
2 Crackers or Zwieback A 6-month-old infant is able to digest crackers or Zwieback. A 6-month-old infant cannot digest raw pieces of fruit or firmly cooked vegetables. Well-cooked table foods can be effectively digested by a 12-month-old child, but not a 6-month-old infant.
During discharge planning the parents of an infant with spina bifida express concern about skin care and ask the nurse what can be done to avoid problems. What is the best response by the nurse? 1 Diapers should be changed at least every 4 hours. 2 Frequent diaper changes with cleansing are needed. 3 Medicated ointment should be applied six times a day. 4 Powder may be used in the perineal area when it becomes wet.
2 Frequent diaper changes with cleansing are needed. Infants with spina bifida often exhibit dribbling of urine; they need meticulous skin care and frequent diaper changes to prevent skin breakdown. Changing diapers every 4 hours is insufficient and may result in skin breakdown. Medicated ointments are unnecessary; if a skin irritation develops and an ointment becomes necessary, it should be prescribed by the health care provider. Powder will not keep the skin dry; when powder mixes with urine, it forms a pastelike substance that promotes skin breakdown. Also, powder is toxic if inhaled and should be avoided.
During a follow-up visit, the nurse observes that a toddler still has improper bone development, even after proper nutritional counseling to the mother. Which foods, when omitted, are responsible for this condition in the infant? *Select all that apply.* 1 Fish 2 Waffles 3 Dried fruits 4 Red meats 5 Orange juice
2, 5 Waffles, Orange juice Calcium plays an important role in bone development in the body. Foods such as waffles and orange juice are rich in calcium sources. Therefore, the mother should feed the child these foods to help the development of the skeletal system. Fish, dried fruits, and red meats are not rich sources of calcium; therefore, these foods do not aid in bone development. Instead, they aid in preventing iron-deficiency anemia in the body.
Which finding indicates that a newborn has vernix caseosa? 1 Brown hair on the skin 2 Rosy to yellowish skin 3 Cheese-like substance on the skin 4 Light-pink to reddish-brown skin
3 Cheese-like substance on the skin Sebum and desquamating cells on the newborn's skin give it a white, cheesy appearance, which is called vernix caseosa. Brown hair on a newborn's skin is called lanugo. Newborns of Asian descent will have rosy to yellowish skin. Light-pink to reddish-brown skin indicates that the newborn is of Native American descent.
When do baby teeth erupt?
6-8 months most children have 20 teeth by 2.5 yrs old
What is the rate of infant mortality in the US?
6.1 deaths per 1,000 live births
The factor that is most significant for the nurse working with the family of an infant born with a genetic disorder is their: 1 Willingness to give physical care to their infant 2 Understanding of the factors causing the infant's disorder 3 Response to the reactions of significant others to their infant 4 Readiness to talk about problems their infant may have in the future
errrr probably 4?
What physical/social factors increase morbidity in children?
poverty, homelessness, LBW, chronic illness
Leading cause of death in ages 5 to 14 years?
unintentional injury (4.1 per 100,000 deaths)
The nurse is assessing a newborn immediately after birth. Which finding indicates normal development in a newborn? 1 A body weight of 3500 g 2 A core body temperature of 96° F 3 Blood pressure of 70/60 mm Hg 4 Head circumference is 3 cm less than chest circumference
1 A body weight of 3500 g The newborn has a body weight of 3500 g, which is within the normal range of 2700 to 4000 g. Therefore, this indicates normal development. The core body temperature of the newborn is 96° F, which is lower than the normal range of 97.7° F to 99.7° F. Therefore, the core body temperature of 96°F indicates hypothermia. The normal blood pressure of a newborn on the first day of birth is 65/45 mm Hg. A blood pressure finding of 70/60 mm Hg indicates very high blood pressure. The head circumference of the newborn is less than the chest circumference, which indicates that the newborn may have microcephaly.
The nurse is applying skin ointment to acne lesions on a patient who has recently reached puberty. What does the nurse anticipate as the cause for the extensive acne? 1 Highly active sebaceous glands in "flush areas" of the body 2 Increased subcutaneous fat prior to a skeletal growth spurt 3 Thelarche as the first indication of puberty 4 Influence of gonadal and adrenal androgens
1 Highly active sebaceous glands in "flush areas" of the body Acne is a common skin problem seen in patients of pubertal age. The pathogenesis of pubertal acne is linked with the hormonal influences on the skin and its appendages. The "flush areas" of the body include the face and neck, shoulders, back and chest. The sebaceous glands in these "flush areas" become very active and secrete excessive sebum under the influence of hormones at the time of puberty. This hyperactivity of the sebaceous glands results in the development of puberty-related acne. In boys, just before the skeletal growth spurt, there is a transient increase in subcutaneous fat. Girls in whom thelarche is the first indication of puberty exhibit an early onset of menstruation and higher body fat. The hair at sites related to secondary sex characteristics becomes coarser, darker, and longer because of the influence of gonadal and adrenal androgens.
A specimen for arterial blood gases is obtained from a severely dehydrated 3-month-old infant with a history of diarrhea. The pH is 7.30, Pco2 is 35 mm Hg, and HCO3- is 17 mEq/L. What complication does the nurse conclude has developed? 1 Metabolic acidosis 2 Metabolic alkalosis 3 Respiratory acidosis 4 Respiratory alkalosis
1 Metabolic acidosis The blood pH indicates acidosis; the bicarbonate (HCO3-) level is further from the expected range than is the partial pressure of carbon dioxide (Pco2), indicating a metabolic origin (losses from diarrhea). The blood pH indicates acidosis, not alkalosis. The HCO3- level is farther from the expected range than the Pco2 level, indicating a metabolic, not a respiratory, origin of the acidosis. The blood pH indicates an acidic, not an alkalotic, state; also, it is of metabolic origin.
A school-age child often steals money from home to buy chocolate. Upon being confronted by the parents, the child lies about stealing. The parents are worried that such behavior will steer the child towards criminal activities later in life. What is the best response from the nurse? 1 "It is a normal behavior and the child will grow out of it later." 2 "Use admonition and ask the child to return the stolen money." 3 "Catch the child in the act of stealing and ask for an explanation." 4 "Inform all the family members and teachers about this behavior."
2 "Use admonition and ask the child to return the stolen money." The nurse should tell the parents that it is not necessary to attach any deep meaning to the child's stealing habits. With admonition and appropriate punishment the child will grow out of it. Simple punishment, like asking the child to return the stolen money, will help the child develop respect for other people's property. Stealing is not a normal behavior, and the nurse needs to instruct the parents that the behavior will be altered only if corrective measures are implemented. Catching the child in the act of stealing is not effective, as the child will refuse to accept responsibility for the act. Informing all the family members or teachers about this behavior will not help in curtailing this habit; rather, it will make the child feel ashamed.
Methylphenidate (Ritalin SR) is ordered for a 6-year-old boy with the diagnosis of attention deficit-hyperactivity disorder (ADHD). The nurse teaches the father about the safe administration of the medication and concludes that the instructions have been understood when the father says that he should administer it: 1 At bedtime 2 After breakfast 3 When the child gets hungry 4 When the child's behavior is out of control
2 After breakfast Methylphenidate (Ritalin SR) may cause nausea, anorexia, and dry mouth, which interfere with appetite and adequate food intake; therefore it should be administered after the child has eaten breakfast. Methylphenidate is a cerebral stimulant that can interfere with sleep; it should not be administered within 6 hours of bedtime. It should be taken exactly as prescribed, not on an as-needed basis.
A 3-month-old infant has been hospitalized with respiratory syncytial virus (RSV). What is the priority intervention? 1 Administering an antiviral agent 2 Clustering care to conserve energy 3 Offering oral fluids to promote hydration 4 Providing an antitussive agent whenever necessary
2 Clustering care to conserve energy Often the infant will have a decreased pulmonary reserve, and the clustering of care is essential to provide for periods of rest. Antiviral therapy is controversial for this age group and is not given unless complications ensue. Intravenous fluids are given during the acute phase to prevent dehydration. Antitussive agents are not used; nasal secretions are aspirated with the use of a bulb syringe whenever necessary.
Which assessment findings of a child would indicate a need for genetic consultation? *Select all that apply.* 1 Fetal alcohol syndrome 2 Visual or hearing problems 3 Family history of mental illness 4 Development and speech delays 5 Excessive bleeding or excessive clotting
2 Visual or hearing problems 3 Family history of mental illness 4 Development and speech delays 5 Excessive bleeding or excessive clotting Visual or hearing problems may indicate a genetic disorder and should be assessed thoroughly. Mental illness is a hereditary disorder that can be transmitted through genes to the child. Therefore, a family history of any mental illness indicates a need for genetic consultation so that preventive measures and treatment can be initiated. Development and speech delays may indicate a genetic disorder, like autism or another behavioral disorder. Bleeding disorders like sickle cell anemia are also inherited and need genetic consultation. Fetal alcohol syndrome is not inherited, but caused by maternal consumption of alcohol during pregnancy.
What are the different stages of cognitive development in an infant as described by Piaget? *Select all that apply.* 1 Narcissism 2 Separation 3 Attachment 4 Using symbols 5 Object permanence
2, 4, 5 Separation, Using symbols, Object permanence The first stage of cognitive development is separation, in which infants learn that they are separate from the objects in their environment. Using symbols or mental representation to think of an object without actually experiencing it is the last stage of intellectual development and occurs at 12 months of age. In the object permanence stage the infant understands that the objects exist even after they are outside the visual field. Narcissism refers to total control for oneself, which is seen in infants at the first stage of psychosocial development. Attachment is a development of the social aspects in a child, and is not a stage of cognitive development.
The preoperative nurse is reviewing a child's history and physical before repair of a ventricular septal defect. Which assessment finding should the nurse expect? 1 Severe cyanosis 2 High hemoglobin and hematocrit levels 3 Bilateral lung sounds with rales and rhonchi 4 High blood pressure in the arms and low blood pressure in the legs
3 Bilateral lung sounds with rales and rhonchi Defects that allow blood flow from the higher-pressure left side of the heart to the lower-pressure right side (left-to-right shunt) result in increased pulmonary blood flow and cause heart failure. A child with a ventricular septal defect would exhibit bilateral lung sounds with rales and rhonchi. In a right-to-left shunt, desaturated blood moves from right to left, causing desaturation in the left side of the heart and in the systemic circulation. Clinically these patients have polycythemia (high hemoglobin and hematocrit levels) and hypoxemia, and they usually appear cyanotic. Tetralogy of Fallot and tricuspid atresia are the most common defects in this group. Coarctation of the aorta involves localized narrowing near the insertion of the ductus arteriosus, which results in increased pressure proximal to the defect (head and upper extremities) and decreased pressure distal to the obstruction (body and lower extremities). The blood pressure is high in the arms and low in the legs.
A 4-month-old infant is being treated for talipes equinovarus (clubfoot). The infant has a cast change every 2 to 3 weeks. When the infant is brought to the well-baby clinic for a routine visit, a nurse evaluates the foot in the cast. Which assessments should the nurse include? *Select all that apply.* 1 Pedal pulses of both feet 2 Range of motion of the foot in the cast 3 Color of the toes of the foot in the cast 4 Movement of the toes of the foot in the cast 5 Knee flexion and extension of the affected leg
3 Color of the toes of the foot in the cast 4 Movement of the toes of the foot in the cast Skin color will indicate adequate (e.g., same color as the rest of the body's skin) or impaired (e.g., dusky, cyanotic) circulation in the foot in a cast. Movement will indicate unimpaired neural transmission in the foot. Pedal pulses will not be accessible on the foot in a cast. A foot cannot be put through its full range of motion with a cast in place. Knee flexion and extension are irrelevant; the knee is not involved with a foot in a cast.
The nurse observes dental caries in an 8-month-old infant. Which action of the parents is likely responsible for this condition? 1 Giving the infant canned fruit 2 Giving the infant 960 mL of milk daily 3 Giving the infant fruit juice with a bottle 4 Giving cheese as a finger food
3 Giving the infant fruit juice with a bottle Giving an infant fruit juice with a bottle can result in dental caries. Giving an infant canned fruits and vegetables can result in lead poisoning, not dental caries. Giving an 8-month-old infant 960 mL of milk is appropriate and does not result in dental caries. Cheese can be given as a finger food to an 8-month-old infant and may not result in dental caries.
A nurse is reviewing the clinical records of infants and children with cardiac disorders in whom heart failure developed. What does the nurse identify as the last sign of heart failure? 1 Tachypnea 2 Tachycardia 3 Peripheral edema 4 Periorbital edema
3 Peripheral edema Heart failure is characterized by a decrease in blood flow to the kidneys, causing sodium and water reabsorption and resulting in peripheral edema. The peripheral edema indicates severe cardiac decompensation. Tachypnea and tachycardia constitute an early attempt by the body to compensate for decreased cardiac output. Periorbital edema occurs most noticeably in children with acute poststreptococcal glomerulonephritis, not heart failure.
A child who has persistent inattentive behavior is prescribed methylphenidate hydrochloride. Which behavior indicates that the child needs further treatment? 1 The child remains attentive during long classes while seated at a desk. 2 The child follows instructions given by teachers on a regular basis. 3 The child experiences difficulty keeping school supplies organized. 4 When instructed to wait, the child sits in one place without complaint.
3 The child experiences difficulty keeping school supplies organized. The child has persistent inattentive behavior and is on methylphenidate hydrochloride therapy, which indicates that the child has attention deficit hyperactivity disorder (ADHD). A child with ADHD will have difficulty organizing belongings and tasks. Therefore, the child who has difficulty organizing school supplies even after treatment with methylphenidate hydrochloride will require further treatment. After successful treatment of ADHD, the child will be able to remain attentive for prolonged periods of time. Successful treatment with methylphenidate hydrochloride makes the child more attentive to instructions. The child with ADHD is hyperactive, so he or she does not stay quiet. If the child is obedient and stays quiet, the treatment has been effective.
The parents of a preschooler are worried, as the child is often seen talking to imaginary friends. The parents admit that they often scold the child for such behavior. What does the nurse inform the parents? 1 "The child may develop severe psychological problems." 2 "You must involve the child in some spiritual activities." 3 "There may be some neurological or developmental issue." 4 "The behavior is normal at this age and it will help counter loneliness."
4 "The behavior is normal at this age and it will help counter loneliness." Sometimes children create imaginary friends to help counter the feelings of loneliness. Therefore, the nurse should tell the parents that it is a normal behavior. Speaking to imaginary friends is a habit that children overcome later in life and, therefore, there is no risk for developing any psychological problems. It is not necessary to involve the child in any spiritual activity if the parents do not desire to do so. A neurological problem is seen if the child exhibits jerking moments or experiences fainting spells.
The parents of a 7-year-old child who has acute glomerulonephritis (AGN) are fearful their other child may contract the illness. What should the nurse explain to them about the disorder? 1 The cause of acute glomerulonephritis is unknown, so it is difficult to know how to prevent it. 2 Acute glomerulonephritis is inherited as a sex-linked recessive trait that usually occurs only in males. 3 The cause of acute glomerulonephritis is the formation of a clot in the renal tubules resulting from a systemic infection. 4 Acute glomerulonephritis is caused by an antigen-antibody response that is usually associated with Streptococcus infection.
4 Acute glomerulonephritis is caused by an antigen-antibody response that is usually associated with Streptococcus infection. AGN is usually the sequela of a β-hemolytic streptococcal infection; it is not contagious. The cause is known; prevention depends on treating individuals who contract a streptococcal infection with antibiotics to eliminate the organism. AGN is an acquired, not an inherited, disorder, although incidence in males outnumbers that in females 2:1. The precipitating streptococcal infection is usually a localized pharyngitis, and clots do not form in the small renal tubules.
A 3-year-old child feels a sense of rivalry with his father and wants him to die. Shortly after these feelings emerge, the child's father dies in a road accident. The child then begins to feel intense guilt, believing that he caused the death. What is the best nursing intervention in this situation? 1 Teach relaxation techniques to the child. 2 Encourage the child to play with his siblings. 3 Suggest that the child's uncle spend time with him. 4 Explain to the child that wishes do not make things happen.
4 Explain to the child that wishes do not make things happen. The nurse should clarify the child's thoughts and help reduce feelings of guilt by explaining that wishes do not make events occur. Relaxation techniques help to reduce anxiety but do not reduce the feeling of guilt. Playing with siblings or spending time with an uncle may help relieve the child's stress, but they do not address the feelings of guilt. *Test-Taking Tip: Look for answers that focus on the patient or are directed toward feelings.*
The mother of an infant with Down syndrome asks the nurse what causes the disorder. Before responding, the nurse recalls that the genetic factor of Down syndrome results from: 1 An intrauterine infection 2 An X-linked genetic disorder 3 An Autosomal recessive gene 4 Extra chromosomal material
4 Extra chromosomal material Down syndrome (trisomy 21) results from extra chromosomal material on chromosome 21. Down syndrome does not result from a maternal infection. Down syndrome is not related to an X-linked or Y-linked gene. An autosomal recessive gene is not the cause of Down syndrome, although translocation of chromosomes 15 and 21 or 22 is a genetic aberration found in some children with Down syndrome.
Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous due to bacterial action? 1 Highly active in childhood 2 Absent around the umbilicus 3 Widely distributed throughout the body 4 Grow in conjunction with axillary hair follicles
4 Grow in conjunction with axillary hair follicles The apocrine sweat glands secrete a thick substance in response to emotional stimulation and become odoriferous due to bacterial action. These glands grow in conjunction with hair follicles around the axillae. The apocrine glands are inactive during childhood and reach their secretory potential at the time of puberty. The apocrine glands are situated around the umbilicus. They have limited distribution and are found only around the axillae, areolae, external auditory canal, and anal and genital regions. Eccrine sweat glands, not the apocrine glands, have wide distribution throughout the body.
A nurse is teaching the parents of an infant with a cleft lip and palate how to prevent infection. What information should the nurse include about why the infant is predisposed to infection? 1 Waste products accumulate along the defect. 2 Circulation to the defective area is insufficient. 3 Inefficient feeding behaviors result in inadequate nutrition. 4 Mouth breathing dries the oropharyngeal mucous membranes.
4 Mouth breathing dries the oropharyngeal mucous membranes. Infants with cleft lip and palate breathe through their mouths, bypassing the natural humidification and filtration provided by the nose; as a result, the mucous membranes become dry and cracked and are at risk for infection. It is not difficult to keep the area clean by cleansing it with water after a feeding. Circulation to the area is unimpaired. Feeding can be adequate with the use of special equipment and a slow approach.
The nurse finds that a child has developed the qualities of independence, self-control, and self-governance. Which type of development does the nurse anticipate in the toddler? 1 Social development 2 Spiritual development 3 Biologic development 4 Psychosocial development
4 Psychosocial development Psychosocial development is indicated by the child's awareness of the relationship between him- or herself and his or her environment. When the child develops independence, self-control, and self-governance, it indicates that the child has acquired a sense of autonomy, which is a component of psychosocial development. Social development is the ability to establish and maintain rewarding relationships with others. Spiritual development in children is heavily influenced by family members and others close to them; it is not specifically associated with the development of autonomy. Biologic development is the series of changes that occur at different stages of growth.
After assessing a 1-year-old child, the nurse concludes that the child has normal development. Which finding supports the nurse's conclusion? 1 The child's head bends toward the side that the nurse strokes. 2 The child's hips move toward the side that the nurse stimulates. 3 The child abducts his or her arms while flexing the elbows when the nurse makes a loud noise. 4 The child's toes hyperextend when the nurse strokes the heel upward across the foot.
4 The child's toes hyperextend when the nurse strokes the heel upward across the foot. A normal 1-year-old child will exhibit the Babinski reflex. To assess the Babinski reflex, the nurse strokes the heel of the child upward across the foot, which results in hyperextension of the infant's toes. To assess the rooting reflex, the nurse strokes the child's cheek; the child's head bends toward the side being stroked, and the child begins to suck. This reflex disappears at the age of 4 months. To assess trunk incurvation, the nurse strokes the child's spine. In response the child's hips move to the side of stimulation or toward the stroke. This reflex disappears at the age of 6 months. When assessing the child's startle reflex, the nurse makes a sudden loud noise. In response to the noise the child abducts his or her arms while flexing the elbows. The reflex disappears at the age of 3-4 months. Therefore, the appearance of the rooting reflex, trunk incurvation, or startle reflex in a 1-year-old child would indicate abnormal development. *Test-Taking Tip: Do not select answers that contain exceptions to the general rule, controversial material, or degrading responses.*
The nurse observes an infant using his thumb and index finger to hold an object. What does the nurse infer from this? 1 The infant is exhibiting Moro reflex. 2 The infant is showing tonic neck reflex. 3 The infant is exhibiting parachute reflex. 4 The infant is showing crude pincer grasp reflex.
4 The infant is showing crude pincer grasp reflex. An infant using his thumb and index finger to hold an object would indicate that the infant has crude pincer grasp reflex. As the infant is not startled, the nurse does not conclude that the infant is showing Moro reflex. If the infant extends his or her arm and leg to the side where the infant's head is turned, it indicates that the infant has tonic neck reflex. The infant is not showing protective response towards falling. Therefore, the infant does not show parachute reflex.
After assessing a 4-day-old newborn, the nurse anticipates that the newborn has impaired vision. Which finding supports the nurse's conclusion? 1 The newborn has visual acuity of 20/100. 2 The newborn blinks in response to light. 3 The newborn does not produce tears while crying. 4 The newborn has no corneal reflex after a light touch.
4 The newborn has no corneal reflex after a light touch. Corneal reflex in infants is activated by a light touch. Therefore the nurse anticipates that the newborn has impaired vision when there is no corneal reflex after a light touch. Visual acuity of 20/100 in a newborn is a normal finding; it does not indicate that the newborn has impaired vision. A positive blink reflex in response to stimulus is a normal finding; it does not indicate that the newborn has impaired vision. The tear glands begin functioning 2-4 weeks after birth. The absence of tears while crying is a normal finding in newborns and does not indicate that the newborn has impaired vision.
The nurse is caring for a child who has attention deficit hyperactivity disorder (ADHD). Which changes in the child's classroom will be beneficial? *Select all that apply.* A Providing breaks frequently at regular intervals B Writing instructions on the blackboard after verbalization C Improving the writing skills of the child compared to computer skills D Increasing the number of classroom assignments and homework E Scheduling academic subjects for times when the child is under the effect of medication
A, B, E A Providing breaks frequently at regular intervals B Writing instructions on the blackboard after verbalization E Scheduling academic subjects for times when the child is under the effect of medication A child with attention deficit hyperactivity disorder (ADHD) will not be able to concentrate properly and experiences difficulty sitting in one place for a prolonged time. Therefore, frequent breaks are helpful to improve the child's concentration. Visual representations also help attract attention and improve concentration. Therefore, it is appropriate to write instructions after saying them. The child will have increased concentration under the effect of medication, which is generally in the morning. Therefore, academic subjects should be scheduled for the morning. A child with ADHD will have dysgraphia, or poor handwriting. Therefore, it is appropriate to concentrate on improving the child's computer skills, instead of improving handwriting. It is appropriate to allot more time to take tests and help the child complete tasks rather than giving homework and assignments.
The nurse is teaching a mother about the developmental behaviors of a 7-month-old infant. Which statement by the mother indicates effective learning? *Select all that apply.* A "I should start oral hygiene in my child." B "I should not change my child's diet." C "I should call my child by her name." D "I should not leave the child with an unfamiliar relative." E "I should encourage my child to produce n, k, g, p, and b sounds."
A, C, D A "I should start oral hygiene in my child." C "I should call my child by her name." D "I should not leave the child with an unfamiliar relative." The upper central teeth begin to erupt in a 7-month-old infant; therefore, the mother can buy a toothbrush with soft bristles to maintain oral hygiene. A 7-month-old infant can remember and respond to his or her own name. A 7-month-old infant often has a fear of the strangers, so the mother should not leave the infant with new people. A 7-month-old infant has taste preferences, so the mother can expose the child to different foods. A 7-month-old infant is able to say words such as dada, baba, kaka, etc. Therefore, the parents should encourage the infant to produce these words, not specific sounds like n, k, g, p, and b.
What advice is appropriate for a growing child to prevent obesity? *Select all that apply.* A "You should skip breakfast and eat a healthy lunch and dinner." B "You should put a video game system in your bedroom." C "You should drink fewer sweetened beverages every day." D "You should eat small meals throughout the day." E "You should watch television for less than 2 hours every day."
C, D, E "You should drink fewer sweetened beverages every day." "You should eat small meals throughout the day." "You should watch television for less than 2 hours every day." Sweetened beverages are high in sugar and calories, which increase the risk of obesity. Therefore, the nurse instructs the patient to avoid sweetened beverages. Eating small meals at regular intervals keeps the person feeling full, reduces overeating, and improves metabolism. A sedentary lifestyle also increases the risk of obesity. Playing video games is primarily a sedentary activity. The nurse should instruct the patient to reduce television watching to less than 2 hours a day. Breakfast is a very important meal, and the nurse should instruct the patient to eat a healthy breakfast every day. *Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.*
The infant mortality rate in black community is about ______ times higher than that of white non-hispanic
about two times higher white 5.1 deaths per 1,000 black 11.6 deaths per 1,000
