Chapter 27: Growth and Development of the Preschooler - ML6

Correct response: testing and identification of group role. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 995-996.

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: playing in an even-number group of children (four). regression. preschoolers having a harder time sharing than toddlers. testing and identification of group role.

Correct response: "Children of this age may stutter while they search for just the right word." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and De

During a well-child visit, the caregiver expresses concern that the 3-year-old child often stutters when speaking. Which response should the nurse prioritize to best assist this family? "Children of this age may stutter while they search for just the right word." "Stuttering is common in young children because they are not physically capable of forming all the sounds." "Difficulties with speaking generally indicate that the adults in the child's life are not reading to the child enough." "Stuttering is usually indicative of a hearing loss."

Correct response: egocentricity. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

During the health history, the nurse asks a 4-year-old about objects he is viewing. One of the objects is a car. The child tells the nurse that the car is "what mommy uses to take me to school." The nurse interprets this statement as indicating: play. fantasy. initiative. egocentricity.

Correct response: 44 to 46 lb (20 to 21 kg) Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PHYSICAL GROWTH, p. 984. Explanation: The preschool age child gains about 4 to 5 lb (1.8 to 2.3 kg) each year and grows about 2.5 to 3 in (6.3 to 7.6 cm). So a 36 lb (16.3 kg) child at 3 years gaining 4 to 5 lb (1.8 to 2.3 kg) per year would be 44 to 46 lb (36 lb + 8 lb = 44 lb; 36 lb + 10 lb = 46 lb).

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? 38 lb to 40 (17.2 to 18.1 kg) 58 to 60 lb (26.3 to 27.2 kg) 44 to 46 lb (20 to 21 kg) 50 to 52 lb (22.7 to 23.6 kg)

Correct response: "By the age of 6, most children can print some letters and maybe their first name." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TABLE 27.2 Motor Skill Development, p. 987.

The caregiver of a 6-year-old expresses concern that the child cannot yet print her first and last name. The caregiver is wondering if this is normal. Which response by the nurse would be most appropriate? "Some children this age cannot hold a pencil or crayon well enough to write legibly." "Usually by the age of 6, most children can write numbers up to nine, but no letters." "It is not unusual for children of this age to be writing their first name in cursive." "By the age of 6, most children can print some letters and maybe their first name."

Correct response: "Talk to your son's new teacher and schedule a tour with him." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 996.

The nurse is conducting a health screening of a 5-year-old boy as required for kindergarten. The boy is fearful about going to a new school. The mother asks for the nurse's advice. Which response by the nurse is best? "Remind him that kindergarten will be a lot of fun and he'll make new friends." "Be aware that he may have difficulty adjusting being away from home 5 days a week." "Kindergarten is a big step for a child. Be patient with him." "Talk to your son's new teacher and schedule a tour with him."

Correct response: "He loves milk and drinks it every time he is thirsty." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 999

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." "He eats a well-balanced diet." "He does not like spinach, but he does like chicken and beef." "He enjoys eggs and fortified cereal for breakfast."

Correct response: The child can hop on one foot. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TABLE 27.2 Motor Skill Development, p. 987.

Which gross motor skill would the 4-year-old child have most recently attained? The child can hop on one foot. The child can tie his/her shoelaces. The child can button his/her clothes. The child can cut his/her food.

Correct response: dressing in the mother's coat to play house Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 994.

Which type of play should the nurse encourage for a preschool-age child who is hospitalized? playing an electronic handheld game dressing in the mother's coat to play house turning out the lights to play hide and seek planting flower bulbs that can be watched growing next spring

Correct response: Introduce new food gradually and include variety. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 999.

Which would be a nutritional goal for a preschool client? Reduce messiness and spills. Let the child eat only what the child wants. Introduce new food gradually and include variety. Eat everything on the plate.

Correct response: opening drawers in the room, pulling out supplies, and examining them Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 969.

A father and his 4-year-old son are waiting in an exam room when the nurse enters and greets them. Which activity that the nurse observes the boy doing would best demonstrate the primary developmental task of the preschool-age child, according to Erikson? roughhousing with his father opening drawers in the room, pulling out supplies, and examining them singing a song he learned at preschool reading a book

Correct response: The child is able to draw shapes such as circles and squares. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TABLE 27.2 Motor Skill Development, p. 987.

A 4-year-old child is drawing with crayons. Which creation by the child would most be reflective of the anticipated skill level of this age? The child draws random lines on the paper and reports it is a person. The child draws a person with 6 body parts. The child is able to draw shapes such as circles and squares. The child is able to proficiently draw several letters of the alphabet.

Correct response: Do not start the car until seat belts are in place. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 996.

A parent tells the nurse about being frustrated because the preschool-aged child screams every time the parent attempts to buckle the child's seat belt. What advice should the nurse give this parent? Do not start the car until seat belts are in place. Arrange for a babysitter to avoid taking the child in the car. Tell the child that you will give a treat for buckling up. Warn the child of punishment for not buckling up and then follow through.

Correct response: iron deficiency Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 999

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? dental caries iron deficiency interference with growth obesity

Correct response: Parental anxiety related to lack of understanding of childhood development Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

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? Social isolation related to unwillingness to relate except through imaginary friend Compromised family coping related to abnormal behavior of child Parental anxiety related to lack of understanding of childhood development Disturbed thought processes related to deep-set psychological need

Correct response: "That is a good pretend answer but tell me the names of the brothers you really have." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TABLE 27.3, p. 988.

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? "I guess you don't know much about counting yet." "Don't lie to me. That's never a nice thing to do to someone." "That is a good pretend answer but tell me the names of the brothers you really have." "Does it make you feel more important when you add on brothers?"

Correct response: Preoperational thought Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget? Preoperational thought Tertiary circular reaction Primary circular reaction Coordination of secondary schema

Correct response: having the child wear a personal flotation device whenever near or on the water. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 998.

Parents of a 3½-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize: adults learning infant/child cardiopulmonary resuscitation (CPR). enrolling the child in swimming lessons. having the child wear a personal flotation device whenever near or on the water. using and renewing sunscreen regularly.

Correct response: When discussing improper behavior, call the behavior "bad" or "naughty," not the child. Anticipate situations likely to cause misbehavior and redirect the child to another activity. Books and stories can help preschoolers master proper behavior. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 1001-1002.

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? Select all that apply. Spank with an open hand only and never with an object. A time-out of about 8 minutes would be appropriate for intentional misbehavior. Anticipate situations likely to cause misbehavior and redirect the child to another activity. When discussing improper behavior, call the behavior "bad" or "naughty," not the child. Books and stories can help preschoolers master proper behavior.

Correct response: "Try using a night light in the child's room." "Set up some familiar bedtime rituals for your child." "Avoid having your child watch frightening shows on TV before bedtime." "Try reading a favorite story before bedtime." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TEACHING GUIDELINES 27.1 Bedtime Routines, p. 1000.

Parents of a preschooler tell the nurse that their child often refuses to go to sleep at night. Which suggestion by the nurse would be helpful? Select all that apply. "Try reading a favorite story before bedtime." "Set up some familiar bedtime rituals for your child." "Avoid having your child watch frightening shows on TV before bedtime." "Try using a night light in the child's room." "Keep the door closed and the lights off so that your child can fall asleep faster."

Correct response: Parent knows the misbehavior was intentional. Warn the child there will be a time-out if the behavior does not stop. Move the preschool-age child to a boring spot. Set a timer for no more than 4 minutes. If the child gets up, return the child to the time-out location and restart the time. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1002.

Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order. Click an option, hold and drag it to the desired position, or click an option to highlight it and move it up or down in the order using the arrows to the left. 1If the child gets up, return the child to the time-out location and restart the time. 2Parent knows the misbehavior was intentional. 3Move the preschool-age child to a boring spot. 4Warn the child there will be a time-out if the behavior does not stop. 5Set a timer for no more than 4 minutes.

Correct response: height and weight Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PHYSICAL GROWTH, p. 984.

The clinic nurse is collecting vital signs on a 4-year-old client being seen for a yearly well check-up. Which measurements should the nurse collect? height, weight, and abdominal girth height and weight height, weight, abdominal girth, and head circumference height, weight, and head circumference

Correct response: tells a fantasy story about a bear and a car Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, 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 has best friends at preschool and sleepovers scribbles with no discernable pictures/letters begins to show logical thought processes

Correct response: imagination in a 3-year-old is at its peak. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 993-994

When planning how to respond to a 3-year-old child about telling stories ("tall tales"), the nurse would base the statement on the fact that: preschoolers have a limited vocabulary. a 3-year-old knows the word two but not the concept of two. a preschooler is in an insecure period. imagination in a 3-year-old is at its peak.

Correct response: asking the girl to slow down and to think before she talks Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COMMUNICATION AND LANGUAGE DEVELOPMENT, p. 988.

A 4-year-old girl has begun stuttering. Which practice by the parents will the nurse discourage? asking the girl to slow down and to think before she talks giving the child opportunity to speak and finish her ideas looking at the child while she is speaking enunciating clearly and slowing down parental speech

Correct response: Support whatever the child paints. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, BOX 27.1 Appropriate Toys for Preschoolers, p. 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? Draw a picture first for the child to see how to do it. Support whatever the child paints. Tell the child that it will be fun but that he or she should not make a mess. Make a model for the child to follow so it will be easy to copy.

Correct response: "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 994-995.

A 5-year-old girl is pretending to be a crocodile during a physical examination. Her mother just smiles and rolls her eyes at the nurse. What would be the best response for the nurse to give the child? "What happened to my client? Did you eat her?" "Oh no! I have a crocodile in my room. Please don't bite me!" "What a wonderful imagination you have! I've never seen anyone who was so good at pretending to be a crocodile." "My dear, you are a girl, not a crocodile. Now sit still so that I can examine you."

Correct response: "It's best to answer his questions using accurate anatomical names and keep your answers simple." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 990.

A father tells the nurse that his son has been asking questions about his genitals. The father states that he is unsure how to answer the questions of a 4-year-old. How should the nurse respond? "It's best to answer his questions using accurate anatomical names and keep your answers simple." "That is a difficult subject to address. I'm not sure what is the best way to answer that question." "I would suggest getting books with pictures to help explain the differences between male and female genitalia." "You should answer his questions by whatever feels most comfortable to you."

Correct response: "Attributing lifelike qualities to inanimate objects is quite normal at this age." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

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." "Is there any family history of mental health disorders?" "Your child is demonstrating animism, which is common." "Has your child suffered any type of physical trauma lately?"

Correct response: Weight is above an expected range and height is within an expected range. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PHYSICAL GROWTH, p. 984.

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. Weight and height are within expected patterns of growth. Weight is below an expected range and height is above an expected range. Weight falls within an expected range and height is less than what would be expected.

Correct response: imagination Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

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

Correct response: "Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, p. 978.

During an extended stay in a hospital the nurse has observed a 5-year-old having several temper tantrums. How should the nurse address this behavior with the parents? "We don't allow children of this age to throw tantrums so you will need to manage your child's behavior." "I am concerned that your child may have a developmental delay since most children of this age don't throw temper tantrums." "I think we need to plan how to discipline your child when acting out this way." "Is it common for your child to throw temper tantrums at home? We have observed this behavior several times here."

Correct response: "I will need to find an appropriate punishment for him if this continues." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, pp. 1002-1003.

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? "This is probably a good time to talk about safety and who can touch him." "I should teach him certain rules about this activity." "I will need to find an appropriate punishment for him if this continues." "I have heard that both boys and girls often touch themselves at this age."

Correct response: Allowing the child to spread soft cheese on crackers Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 998.

What would be most effective in helping promote initiative and nutritional health for a preschooler? Allowing the child to spread soft cheese on crackers

Correct response: not to ride in a car with strangers. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 990.

The most important safety precaution for parents to teach preschoolers is: not to ride in a car with strangers. to chew bites of food three times. not to begin formal dance classes. not to watch their father mow the lawn.

Correct response: "Both your son's height and rate of growth are within normal limits for his age." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PHYSICAL GROWTH, p. 984.

The father of a preschool boy reports concerns about the short stature of his son. The nurse reviews the child's history and notes the child is 4 years old and is presently 41 in (104 cm) tall and has grown 2.5 in (6.35 cm) in the past year. Which response by the nurse is most appropriate? "Your son is slightly below the normal height for his age group but may still grow to be a normal height in the coming year." "Your son is slightly below the normal height for his age but he had demonstrated a normal growth rate this year." "Both your son's height and rate of growth are within normal limits for his age." "Is there a reason you are concerned about your child's height?"

Correct response: "Do not refer to medicines as candy." "Do not allow your child to approach strange dogs." "Have your child hold hands with a grown-up in parking lots." "Role-model bicycle safety by wearing a helmet too." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 997.

A nurse is teaching a group of parents of preschoolers about safety. Which information would the nurse include? Select all that apply. "Do not allow your child to approach strange dogs." "Do not refer to medicines as candy." "Have your child hold hands with a grown-up in parking lots." "Allow your child to ride in the front seat of the car." "Role-model bicycle safety by wearing a helmet too."

Correct response: imitative play Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT -FIGURE 27.9, p. 994.

A nurse observes a 3-year-old child playing with an older sibling. In which type of play would the nurse expect to see the siblings engaged? parallel play imitative play nonverbal play hand regard

Correct response: Meet with the child and parents and discuss if cultural food preferences may be hindering the amount being eaten at lunch. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, CULTURAL INFLUENCES ON GROWTH AND DEVELOPMENT, pp. 990-991.

A family from India has recently moved to the United States. Their 5-year-old child often visits the school nurse after lunch reporting a "stomachache." The lunch staff tell the nurse that the child eats very little for lunch. What is the best action by the nurse? Meet with the child and parents and discuss if cultural food preferences may be hindering the amount being eaten at lunch. Explain to the child that the reason for the stomachache is that not enough is being eaten during lunch. Speak to the child and parents to discuss the repercussions of visiting the nurse so frequently. Talk with the child and encourage that lunches be brought from home so that nutrient needs are met.

Correct response: Delayed growth and development related to frequent illness Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, CULTURAL INFLUENCES ON GROWTH AND DEVELOPMENT, p. 992.

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 Health-seeking behaviors Risk for imbalance nutrition, more than body requirements Parental anxiety related to lack of understanding

Correct response: Urge children never to talk to or accept a ride from a stranger. Encourage children to tell you or another trusted adult if someone asks them to keep a secret about anything uncomfortable. Urge your children to report others who are bullying. Teach your children to say "no" to anyone whose touching makes them feel uncomfortable. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, ADDRESSING COMMON DEVELOPMENTAL CONCERNS, pp. 1002-1003.

A nurse is developing a teaching plan for parents of preschoolers about how to address the issue of strangers and safety. Which would the nurse expect to include in the teaching? Select all that apply. Wait until children are old enough to tell them how to call for help in an emergency. 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. Urge your children to report others who are bullying.

Correct response: A child pretends to be a teacher and asked another child to be the pretend student in "class." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 994-995.

A nurse is observing a group of 4-year-old children in a play area. What action, when observed by the nurse, would alert the nurse to typical play for this age group? A child pretends to be a teacher and asked another child to be the pretend student in "class." A group of children play a board game involving matching colored cards to shapes. A child plays alone, with a set of children's kitchen utensils, pots and pans. A child plays with a toy while another child sits next to him and plays with a different toy.

Correct response: swimming lessons stranger awareness gun safety bicycle safety Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, CULTURAL INFLUENCES ON GROWTH AND DEVELOPMENT, p. 991. Explanation: It is in the preschool years that children often begin to feel comfortable in water. It is important for parents to teach beginning swimming to reduce the risk for accidental drowning. Parents should teach preschoolers that not all people are friends and to be aware of anyone that the child does not know. Bicycle safety is important at a young age and includes helmet safety and crossing streets.

A nurse is providing an anticipatory guidance class on safety for parents of preschool-age children. Which interventions are important for the nurse to address during the class? Select all that apply. stranger awareness drug awareness swimming lessons bicycle safety gun safety

Placing the child is an approved car seat. Explanation: The leading cause of death in the preschool group is automobile accidents, followed by poisonings and falls. Placing the child in an approved car seat is a safety precaution to help prevent serious injury and even death. All safety measures help keep children safe. Putting latches on the lower cabinets and using a baby gate at the top of the stairs are important to prevent poisonings and to prevent falls which could cause head injuries and fractures. Many infectious diseases are preventable as a result of health promotion and illness prevention techniques.

A nurse realizes safety teaching has been successful when the parents identify which action to help prevent the leading cause of death in preschoolers? Putting latches on lower cabinets Placing the child in an approved car seat Using gates at the top of the stairs Washing hands after using the bathroom

Correct response: Preschool Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 990.

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 Adolescence Toddler School age

Correct response: follow a routine and set a bedtime. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TEACHING GUIDELINES 27.1, p. 1000.

The nurse and a client are discussing the client's preschool child. The client states, "When I tell my child it's time for bed, he/she screams and cries for almost an hour each night before going to sleep." The client and the nurse decide that the next course of action is: let the child fall asleep wherever he/she wants and then carry the child to bed. promise the child a new toy in the morning for good behavior. follow a routine and set a bedtime. let the child set the time to go to bed.

Correct response: "Tell me about your child's exposure to tobacco smoke." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 997.

The nurse is conducting a physical examination of a young preschooler and detects the odor of tobacco smoke on the parents' hair and clothing. How should the nurse respond? "You should stop smoking around your child." "Tobacco smoke is linked with an increased number of ear infections." "Are you aware that exposure to tobacco smoke can be associated with behavioral difficulties?" "Tell me about your child's exposure to tobacco smoke."

Correct response: "We just got him a new bike he can grow into." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 997.

The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed? "He never rides in the street." "Our son always wears a helmet." "We just got him a new bike he can grow into." "He is able to ride without training wheels."

Correct response: Explain to the parent her child likely does not have the needed motor skills to achieve this task at his current age. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, MOTOR SKILL DEVELOPMENT, p. 987.

The mother of a 4-year-old child reports she has been trying in vain to teach her son to tie his shoelaces. She states she fears he may be "slow". Which action by the nurse is most appropriate? Ask to assess the child's fine motor skills for developmental delays in light of her reports. Explain that she may need to change the way she is instructing him to do this. Demonstrate a few methods for the parent to use to teach this skill to her child. Explain to the parent her child likely does not have the needed motor skills to achieve this task at his current age.

Correct response: "Stating his name and address is too hard for my 5-year-old child; it will be another year before he can do that." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COMMUNICATION AND LANGUAGE DEVELOPMENT, pp. 988-989.

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." "When my child counts numbers, it is only to 10 and we are slowing working on counting higher." "My child is finally talking in a way that most of my friends can understand her speech." "I am glad to know that my 4-year-old child asking so many questions is normal."

Correct response: "I am so glad I can get rid of all of those bath toys because they take up so much room." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1001.

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 will add some crayons, chalk and finger paints to my three-year-old's birthday gifts." "My four-year-old will be getting a tricycle for her birthday. I'm glad it's a good gift for her." "It is okay for my four-year-old to still play in his sandbox." "I am so glad I can get rid of all of those bath toys because they take up so much room."

Correct response: Button clothes. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, BOX 27.1 Appropriate Toys for Preschoolers, p. 995.

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? Use scissors. Button clothes. Tie shoelaces. Print a few letters.

Correct response: imaginary friend Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

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? magical thinking imaginary friend animism preoperational thought

Correct response: transduction. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985.

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: beginning empathy. magical thinking. transduction. animism.

Correct response: Initiative versus guilt Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PSYCHOSOCIAL DEVELOPMENT, p. 985.

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? Trust versus mistrust Autonomy versus shame and doubt Initiative versus guilt Industry versus inferiority

Correct response: Risk for caregiver role strain Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, CULTURAL INFLUENCES ON GROWTH AND DEVELOPMENT, p. 992.

The nurse is caring for a preschool-age child in the hospital with severe developmental delays. The parents have three other younger children at home and both parents work full-time outside the home. The family has just moved to this area. Which nursing diagnosis would be the highest priority in regard to the parents at this time? Readiness for enhanced parenting Risk for caregiver role strain Interrupted family processes Imbalanced nutrition, less than body requirements

Correct response: Takes in new information at a rapid rate and asks "why" and "how" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TABLE 27.3, p. 988.

The nurse is caring for several clients on the pediatric unit. When interacting with the preschool-age child, which action does the nurse predict will occur? Insists doing something and the next moment reverts to being dependent Grows and develops skills more rapidly than at any other time in their life Takes in new information at a rapid rate and asks "why" and "how" Increased attention span and can be interested in an activity for a long length of time

Correct response: "The school is quite structured and advocates corporal punishment." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 996.

The nurse is conducting a health screening for a 3-year-old boy as required by his new preschool. Which statement by the parents warrants further discussion and intervention? "The school has a loose environment, which is a good match for his temperament." "There is a very low student-teacher ratio, and they do a lot of hands-on projects." "The school requires processed foods and high sugar foods be avoided." "The school is quite structured and advocates corporal punishment."

Correct response: presence of 10 deciduous teeth Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PHYSIOLOGIC CHANGES, p. 984.

The nurse is conducting a well-child assessment of a 4-year-old. Which assessment finding warrants further investigation? presence of 20 deciduous teeth presence of 19 deciduous teeth absence of dental caries presence of 10 deciduous teeth

Correct response: "My child is so picky and eats the same thing every day for days on end!" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 998-999. Explanation: The preschooler's appetite is erratic. At one sitting the preschooler may devour everything on the plate, and at the next meal he or she may be satisfied with just a few bites. Food jags, such as eating the same thing for days on end, are common in the toddler, not the preschooler. Preschooler's are picky eaters. They may eat only a limited variety of foods or foods prepared in only one way. Portions for preschoolers are smaller than adult-sized portions, so the child may need to have meals supplemented with nutritious snacks. Giving the child non-nutritious snacks may cause the child not to eat at mealtimes. The child eating as much as the adolescent sibling is being set up for obesity.

The nurse is discussing nutritional issues and concerns with the caregivers of preschoolers. Which statement made by a caregiver best indicates a common aspect of the diet and nutrition of the preschool child? "Our child gets into food jags where he will only eat one food all day long." "My spouse is insistent that our 5-year-old not eat any snacks so that he will eat all of his meal at mealtime." "My 4-year-old eats as much as my teenager does every day." "My child is so picky and eats the same thing every day for days on end!"

Correct response: "Our family rule is that all children 'clean their plates' at each meal, and we feed them a lot." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 999.

The nurse is doing a well-child exam of a 5½-year-old girl. Which statement by the mother would alert the nurse that further teaching is needed about healthy eating habits? "She enjoys planning meals and helping me in the kitchen." "I try to set a good example and eat a variety of fruits and vegetables." "We eat fast food less than once a month." "Her serving sizes are about half the size of ours." "Our family rule is that all children 'clean their plates' at each meal, and we feed them a lot."

Correct response: They are building a house for their dolls with blocks in the room. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 994.

The nurse is observing 4-year-old twins during their well-child appointment. Which observation by the nurse would indicate the children are demonstrating cooperative play? They sit on the floor, near each other, and look at different picture books. They competitively stack blocks and keep score of who stacks the highest number of blocks. They play with dollhouse furniture, each with different room furnishings. They are building a house for their dolls with blocks in the room.

Drawing a 6-part man Lacing one's shoes Explanation: A 5 year old can draw a 6-part man and lace his or her own shoes. The ability to draw a cross and stand on one foot is characteristic of a 3 year old. Jumping is characteristic of a 4 year old.

The nurse is observing a group of 5-year-olds playing in the playroom. Which developmental milestones does the nurse identify as newly acquired skills since turning 5 years old? Select all that apply. Drawing a cross Lacing one's shoes Standing on one foot Jumping Drawing a 6-part man

Correct response: "Look! I am a nurse, and I am helping people feel better!" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, EMOTIONAL AND SOCIAL DEVELOPMENT, p. 989.

The nurse is observing several children interacting during a community health event. Which observed behavior would be indicative of a 4-year-old child? "I told the other child no, when he asked me to cheat at the game." "I lost the game because I did not play good, and I am sad." "I ran the race better than my best friend because he was slow." "Look! I am a nurse, and I am helping people feel better!"

Correct response: Playing in an organized group with each other. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 995.

The nurse is presenting an in-service on the types of playing that children may engage in. The nurse determines the session is successful when the attending nurses correctly choose which example as representing cooperative play? Playing independently and are side-by-side. Playing apart from others without being part of a group. Playing in an organized group with each other. Playing together in an activity without organization.

Correct response: Snacks throughout the day help the child meet nutritional requirements Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 999.

The nurse is presenting nutritional information at a community health fair. Which suggestion should the nurse prioritize when illustrating proper nutrition for preschoolers? Need three big meals a day due to rapid growth Need extra calcium for proper muscle growth Should drink at least 4 cups of milk each day Snacks throughout the day help the child meet nutritional requirements

Correct response: "My 4-year-old should be ingesting at least 700 mg of calcium through food daily to promote good bone health." "I generally give my child choices about foods within each food category, ensuring all food groups are represented." "We very rarely feed our child fast food and when we do we try to keep it as healthy as possible with no soda." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 998-99.

The nurse is providing an in-service for parents of preschoolers regarding nutrition. Which comments by the parents demonstrate successful learning following the in-service? Select all that apply. "We very rarely feed our child fast food and when we do we try to keep it as healthy as possible with no soda." "I generally give my child choices about foods within each food category, ensuring all food groups are represented." "The only way I can get my child to consume sources of vitamin C is through fruit juices. I guess it's better than not at all." "My 4-year-old is above normal in weight but I'm sure it's just baby fat and will be lost with age." "My 4-year-old should be ingesting at least 700 mg of calcium through food daily to promote good bone health."

Correct response: 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 clothing. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 1001.

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. Preschoolers are capable of taking a bath independently. 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 clothing. Encourage children to select their own clothing to wear each day. Preschoolers only need to wear bicycle helmets if they are going on long rides.

Correct response: Orange Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 998

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of these fruits contains the most calcium? Banana Peach Orange Apple

Correct response: "She can ride on the street if I am riding with her." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 997.

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 should always ride on the sidewalk." "She can ride on the street if I am riding with her." "The balls of her feet should reach both pedals while sitting." "Pedal back brakes are better for her age group."

Correct response: "It's just as important to establish a morning wake-up time as it is as establishing a bedtime. Children tend to do better when they have a normal routine to follow." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, TEACHING GUIDELINES 27.1, p. 1000.

The nurse is speaking to a parent of a 4-year-old. The parent states that she has trouble getting her child to go to bed at night. Which is the best response by the nurse? "Sometimes your child needs to burn off excess energy before bed. I would suggest allowing them to run around house for 10 to 15 minutes before bedtime." "Children need dark to sleep. It's important not to use a nightlight even if your child is afraid of the dark." "It's just as important to establish a morning wake-up time as it is as establishing a bedtime. Children tend to do better when they have a normal routine to follow." "It's okay to let your child fall asleep while watching television in their room. This often helps if your child is afraid of the dark."

Correct response: "When we go to the park, my child never wants to play with the other children." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 994.

The nurse is speaking with the parent of a 4-year-old child. Which statement by the parent would suggest a need for further investigation? "When we go to the park, my child never wants to play with the other children." "My child loves to play dress-up with friends at day care." "I think it is so cute when my child wants to help my spouse with yardwork." "Sometimes I wish my child would play with a toy in the way it was intended. My child is constantly pretending it is something else." "My son loves to follow around his older sister."

Correct response: cooperative play Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 994.

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? dramatic play parallel play cooperative play associative play

Correct response: centering. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COGNITIVE DEVELOPMENT, p. 985. Explanation: At age 3 years, cognitive development is still preoperational. Although children during this period do enter a second phase called intuitional thought, they lack insight to view themselves as others see them or put themselves in another's place. This is called centering. Because preschoolers cannot make this kind of mental substitution, they feel that they are always right and causes them to argue. Conservation is reflected in the child's ability to distinguish that two items of equal size are the same despite a change in form. Initiative is the developmental task of preschoolers and is reflected in the child's learning as much as possible about the world around them by trying new activities or having new experiences. Guilt occurs if children are punished or criticized for attempts at initiative.

The parent of 3 1/2-year-old preschooler tells the nurse that the child argues quite a bit and says that the child is always right. The nurse interprets this information as indicating: guilt. initiative. conservation. centering.

Correct response: "Use the time-out technique for discipline." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, pp. 1001-1002.

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 best suggestion for the nurse to make to this parent? "Spank lightly to get the child's attention." "It is not normal to feel that way." "Take some toys away when the child acts like that." "Use the time-out technique for discipline."

Correct response: "Has your child had their hearing tested?" Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, SENSORY DEVELOPMENT, pp. 987-988.

The parent of a 4-year-old is expressing concern that this child is not talking as much—or as well—as her other children did at that age. Which question should the nurse prioritize when assessing this preschooler for this concern? "Does your child have opportunities to have conversations with other people?" "Do you praise and give your child encouragement when the child tries to talk with you?" "How often do you or a family member read to your child?" "Has your child had their hearing tested?"

Correct response: The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along. Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, PROMOTING HEALTHY GROWTH AND DEVELOPMENT, p. 997.

The parents of 5-year-old boy are concerned about the how a recent motorcycle accident to his father will affect the child. Although the father has fully recovered, the child is very concerned if the father is away longer than expected; the child is not as talkative but appears withdrawn and quiet. The nurse should point out the child's behavior is likely related to which factor? The child is imitating the adults' behavior and just trying to be nice to everyone. The child is afraid of losing his father and trying show how much he loves him. The boy believes he caused the accident by telling his father he "hoped he crashed" when the boy couldn't go along. The boy is afraid of being hurt himself and thinks being "especially good" will protect him from accidents.

Correct response: "She screams and thrashes when we try to touch her." Explanation: Reference: Ricci, S. S., Kyle, T., & Carman, S., Maternity and Pediatric Nursing, 4th ed., Philadelphia, Wolters Kluwer, 2021, Chapter 27: Growth and Development of the Preschooler, COMPARISON CHART 27.1 Nightmares Versus Night Terrors, pp. 1000-1001.

The parents of a 4-year-old girl tell the nurse that their daughter is having frequent nightmares. Which statement indicates that the girl is having night terrors instead of nightmares? "She comes and wakes us up after she awakens." "She screams and thrashes when we try to touch her." "She has a hard time going back to sleep." "She is scared after she wakes up."