ch. 27
A nurse is caring for a 4-year-old child. The parents indicate that their child often reports that objects in the house are his friends. The parents are concerned because the child says that the grandfather clock in the hallway smiles and sings to him. Which response by the nurse is best?
"Attributing lifelike qualities to inanimate objects is quite normal at this age." (p.985)
The caregiver of a 6-year-old expresses concern that the child cannot yet print her first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be mostappropriate?
"By the age of 6, most children can print some letters and maybe their first name." (p.987)
The nurse is conducting a well-child exam of a 4-year-old boy. Which statement would alert the nurse that the child is at risk for iron deficiency?
"He loves milk and drinks it every time he is thirsty." (p.999)
The mother of a 4-year-old reports using time-outs as a means for disciplining the child. Which statement by the mother would require the nurse to provide additional teaching?
"I usually have him in time-out for about 10 minutes." (p.1001-1002)
The father of a 4½-year-old boy has contacted the nurse because he is concerned that his son is frequently touching his genitals. The nurse explains that this is normal during the preschool years. Which statement by the father would indicate a need for further teaching?
"I will need to find an appropriate punishment for him if this continues." (p.1002-1003)
A school nurse has completed an educational program for parents of preschool children. Which statement by a participant indicates a need for further education?
"My 5-year-old son still needs me to dress and undress him." (p.987)
The nurse is preparing a safety presentation for a health fair for families. Which instruction should the nurse prioritize when illustrating car safety and the family?
"Set a good example. Wear your own seat belt every time you drive." (p.997-998)
The nurse is providing teaching to the mother of a 4-year-old girl about bike safety. Which statement by the mother indicates a need for further teaching?
"She can ride on the street if I am riding with her." (p.997)
The nurse has completed an education program on normal communication abilities in the preschool-age child. Which statement by a participant indicates a need for further education?
"Stating his name and address is too hard for my 5-year-old child; it will be another year before he can do that." (p.988-989)
The parent of a 4-year-old child tells the nurse about being frustrated because all the parent seems to do lately is fight with the child over what the child wants to eat and wear. The parent notes sometimes wanting to spank the child for always disagreeing. What would be the bestsuggestion for the nurse to make to this parent?
"Use the time-out technique for discipline." (p.1001-1002)
A nurse is preparing a presentation for a health fair discussing various aspects of toddlers. Which example should the nurse use to best illustrate dramatic play?
Acting out a troubling or stressful situation (p.992)
A nurse is caring for a 4-year-old child who will be undergoing a procedure to remove a mass from the abdomen. In order to help the child remain calm in preparation for getting an IV catheter placed, what intervention might the nurse implement?
Allow the child to play with a procedure doll. (p.995)
The nurse is assessing a 4-year-old child. The child tells the nurse about her friend, Nancy, who lives in her room at home. The mother tells the nurse that Nancy is not a real person. The nurse would use which term when documenting this assessment finding?
imaginary friend (p.985)
The nurse is assessing a 3-year-old at a well-child visit and the child appears to be progressing well. Which activity will the nurse ask the child to attempt to appropriately assess the fine motor skills of this preschooler?
Button clothes. (p.995)
A nurse is developing a plan of care for a 4-year-old client with cystic fibrosis who has frequent hospitalizations related to his illness. Which would be the most appropriate nursing diagnosis for this client?
Delayed growth and development related to frequent illness (p.992)
A bilingual family tells the nurse their desire for their child to learn both languages. One language is spoken predominantly in the home. The parents ask the nurse when is the best time to teach the child the other language. What time period would the nurse respond?
During the preschool years (p.961)
A 3½-year-old child hits another child in prekindergarten and pushes her down. The mother calls the clinic to ask why her child is so aggressive and asks what to do. The nurse's advice would include which suggestion?
Explain that aggression is a common behavior for a child this age but the child must understand that hurting someone is not acceptable. (p.996)
The nurse is caring for a child who is described as being an inquisitive learner, loves to learn new things, and feels a sense of accomplishment when succeeding in activities. The nurse understands that this child is in which of Erikson's stages of development?
Initiative versus guilt (p.985)
The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which fruits contains the most calcium?
Orange (p.998)
A preschool-age child tells the nurse about an imaginary friend. The parents are concerned because the child refuses to do anything without the friend's help. Which nursing diagnosis is most applicable for the family?
Parental anxiety related to lack of understanding of childhood development (p.985)
The nurse is caring for a preschool-age child in the hospital with severe developmental delays. The parents have three other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highestpriority in regard to the parents at this time?
Risk for caregiver role strain (p.992)
The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers?
Snacks throughout the day help the child meet nutritional requirements (p.999)
What suggestions regarding the evaluation of a childcare center would the nurse share with a preschooler's mother?
Specific program goals to be accomplished should be available. (p.994-995)
A 4-year-old is going to finger paint for the first time. What is the best action for the adult supervisor of this activity?
Support whatever the child paints. (p.995)
In teaching caregivers of preschool children, the nurse would reinforce that which activity would be most important for this age group?
The preschool child should be properly restrained when riding in a vehicle. (p.997)
The nurse is providing anticipatory guidance and education to the parents of child entering into the preschool age group. What information would the nurse include in the teaching?
The preschool-age child's physical growth will slow compared to previous years. (p.994)
When collecting data on a preschool-aged child during a well-child visit, the nurse discovers the child has gained 12 lb (5.4 kg) and grown 2.5 inches (6.3 cm) in the last year. The nurse interprets these findings to indicate which situation?
Weight is above an expected range and height is within an expected range. (p.984)
The nurse is watching a 4-year-old child play with another preschool child. The children are playing a game with rules. The nurse notes that the child is demonstrating what type of play?
cooperative play (p.994)
The nurse is evaluating statistics of dental care of preschool-age children in the community. Which should the nurse focus on as having the greatest overall impact?
fluoridated water system in the community (p.1001)
Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:
having the child wear a personal flotation device whenever near or on the water. (p.998)
Parents tell the nurse their 3-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?
iron deficiency (p.999)
The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation?
presence of 10 deciduous teeth (p.984)
The nurse is caring for a 4-year-old girl following an appendectomy. The girl becomes fearful and starts to cry as soon as the nurse walks into the room. When the nurse asks about the crying, the girl says, "Nurses who wear shirts with flowers give shots." The nurse understands that this statement is an example of:
transduction (p.985)
The nurse has completed an educational program on normal growth and development in children. Which statement by a participant would indicate a need for further education?
"I am so glad I can get rid of all of those bath toys because they take up so much room." (p.1001)
If the child is gaining weight at an expected rate, a child who weighs 36 lb (16.3 kg) at 3 years of age would weigh what amount at age 5?
44 to 46 lb (20 to 21 kg) (p.984)
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in?
Pretending to be mommies and daddies in the playhouse (p.994-995)
A nurse is evaluating a 5-year-old client in the clinic. Which finding would indicate to the nurse that the client is not meeting Erikson's stages of psychosocial development?
The client asks permission to play. (p.985)
When assessing the growth and development of a 4-year-old, which would the nurse note as being appropriate?
tells a fantasy story about a bear and a car (p.985)
During an assessment, a preschool-aged child tells the nurse about having 12 siblings. The nurse is aware that the child has two older brothers. What would be the nurse's best response?
"That is a good pretend answer but tell me the names of the brothers you really have." (p.988)
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to:
testing and identification of group role. (p.995-996)
The nurse is providing health-promotion teaching to a group of parents of preschoolers at a local day care. What information would the nurse include in this education session? Select all that apply.
- Encourage children to select their own clothing to wear each day. - Parents will need to supervise tooth-brushing and be responsible for flossing. - Treat any toileting accidents in a matter-of-fact manner and assist the child in getting dry (p.1001)
The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. What points should the nurse make?
- The back seat remains the safest place for children to ride. - Many car seats are installed improperly, making them unsafe. - Children who weigh less than 40 pounds should use a car seat with harness and top tether. - Booster seats should be used with both a shoulder and lap belt. (p.996)
A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include?
- "Do not refer to medicines as candy." - "Do not allow your child to approach strange dogs." - "Role-model bicycle safety by wearing a helmet too." - "Have your child hold hands with a grown-up in parking lots." (p.997)
During an admission assessment the nurse is discussing the developmental level of the child with the parents. Which comments by the parents demonstrate a good understanding of developmental expectations of the preschool-aged child?
- "We think it is important to have play dates with our friend's preschool children." - "Our child attends a wonderful preschool 3 times per week." - "We have been talking about enrolling in a morning preschool program since this is our only child." (p.996)
The mother of a 3-year-old tells the nurse that she is concerned that her child is not developing motor skills quickly enough. She states that, "My son can't skip and cannot stand on one foot for any length of time while playing." How should the nurse respond?
"Your child is not expected to be able to perform those activities at 3 years of age." (p.987)
The father of a 4-year-old is concerned his child is not telling the truth and blaming others for things that have happened. Which response should the nurse prioritize after the father shares that the child is blaming someone named "Andrew" for a broken tool, and they have no idea who this is?
"Your son may have a friend named Andrew, but it could be an imaginary friend." (p.985)
Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful?
- "Avoid having your child watch frightening shows on TV before bedtime." - "Set up some familiar bedtime rituals for your child." - "Try using a night light in the child's room." - "Try reading a favorite story before bedtime." (p.1000)
A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching?
- Urge your children to report others who are bullying. - Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. - Teach your children to say "no" to anyone whose touching makes them feel uncomfortable. - Urge children never to talk to or accept a ride from a stranger. (p.1002-1003)
A parent tells a nurse that the child has recently established some friendships for the first time. In which age group do you expect this child to be?
Preschool (p.990)
