exam 1 332, mallon

when should the posterior fontanelles close?

2-3 months

Approach to and Performing Physical Assessment for infants

If baby is calm, quiet, and comfortable on parent's lap, start by auscultating heart & lungs since they're at state of rest.

Adolescent response to pain

Less vocal protest and more verbalizations, uses expressive words to describe pain experience Use numerical scale, Wong/Baker Faces, or adolescent-specific tools

Communicating with Children

Make communication developmentally appropriate

developmentally appropriate communication for infants:

Nonverbal Crying as communication

Role of the Pediatric Nurse

Therapeutic Relationship Family Advocacy and Caring Disease Prevention and Health Promotion Health Teaching Support and Counseling Coordination and Collaboration Ethical Decision Making

infant growth curve

by 1 year, birth weight triples, birth length increases by 50%, chest and head circumference about equal

which is the most effective means of preventing dental caries in school age children? a. flossing the teeth 3 x a week b. unsupervised brushing of teeth before bedtime c. regular consumption of fluorinated drinking water d. brushing teeth after meals, after snacks and at bedtime

d. brushing teeth after meals, after snacks and at bedtime

which condition manifests as a decreased nutritional need and a diminished appetite during toddlerhood? a. grazing b. ritualism c. regression d. physiologic anorexia

d. physiologic anorexia

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

d. shift of focus to prevention of illness and maintenance of health

Preschoolers response to pain

Loud crying, screaming, may put hand on site or misrepresent actual location of pain, may describe pain but not intensity " "ow", "ouch", uncooperative, anticipates pain and worries about it" Use CRIES, FLACC or Wong-Baker Faces scale

Toddlers response to pain

Loud crying, screaming, verbal expressions of one word, uncooperative, pushes stimulus away before applied, thrashing " "ow", "ouch", uncooperative, anticipates pain and worries about it." Use CRIES or FLACC assessment tools

Infant pain assessment

NIPS (neonatal infant pain scale, first 30 days) FLACC scale -higher score=more pain

infant Vital Signs

Pulse = 85 to 205 , BP = 85 to 104 systolic , Respiratory rate = 30 to 60

Rights of Medication Administration specific to pediatrics

Right developmental approach Right of patient/parent to know purpose of medication and potential adverse effects (education) Right of parent/competent adult patient to refuse medication

Piaget's stages of cognitive development: infant

Sensorimotor

Piaget's stages of cognitive development: toddler

Sensorimotor, preoperational

School-age child response to pain

Stalling behavior ("Wait a minute") Muscle rigidity May use all the behaviors of a young child Use FLACC or Wong-Baker Faces scale for younger school age child Use Wong-Baker Faces Scale or numerical scale for older school age

infant mortality rate

The United States has the highest infant death rate of developed nations. Birth weight (BW) Major determinant of neonatal death in the US Low BW (LBW) < 2500g LWB = higher mortality rate The leading cause of death for those younger than 1 year is congenital anomalies.

Unoccupied behavior

The child does not seem to be playing. Instead, he or she is watching whatever is going on that is most interesting

which parental feeding practice would the nurse recognize as placing a 30 month old at risk? a. feeding the child while the child is in active play b. calling the child from active play 15 minutes before eating c. refraining from giving the child hot dogs, fruit gel snacks, and popcorn d. replacing one of the child's meals with frequent nutritional snacks

a. feeding the child while the child is in active play

which response would the nurse provide when the parent of a 3 month old breastfed infant asks about giving the baby water because it is summer and very warm? a. fluids in addition to breast milk are not needed b. water should be given if the infant seems to nurse longer than usual c. clear juice is better than water for promoting adequate fluid intake d. water once or twice a day will make up for losses caused by environmental temperature

a. fluids in addition to breast milk are not needed

for which reason is low-fat milk not recommended for an infant less than 6 months old? a. low-fat milk is high in sodium b. low-fat milk contains inadequate proteins c. low-fat milk has a high propensity to cause colic d. low-fat milk has a propensity to cause diarrhea e. low-fat milk contains inadequate essential fatty acids

a. low-fat milk is high in sodium e. low-fat milk contains inadequate essential fatty acids

a child is prescribed a transmucosal analgesic for pain relief. how is this administered? a. place between cheeks and gums b. place drug above tongue c. instruct the child to swallow drug d. instruct child to chew drug

a. place between cheeks and gums

which intervention lowers the risk for sudden infant death syndrome (SIDS)? a. placing the infant in the supine position to sleep b. making certain the infant is kept very warm while sleeping c. keeping the window open when anyone is smoking near the infant d. letting the infant sleep with the parents instead of alone in the crib

a. placing the infant in the supine position to sleep

which toddler condition is characterized by refusal to eat anything other than crackers, cheese, and turkey? a. ritualism b. regression c. negativism d. abnormal behavior

a. ritualism

Which phase does piaget classify as the period from birth to 24 months? a. sensorimotor b. separation anxiety c. trust versus mistrust d. separation-individuation

a. sensorimotor

a parent of a 2 month old infant asks the nurse, "how can i calm my baby after the vaccination? they cry a lot and i'm unable to stop them from crying." what is the best response? a. swaddling b. bouncing c. speaking excitedly d. breastfeeding

a. swaddling

which response would the nurse recognize when a toddler begins using baby talk and is aggressive with other children after the birth of a sibling? a. the child is using displacement b. the child is neglected by the parents c. the child is trying to accept the baby d. the child hates or resents the baby

a. the child is using displacement

which evaluation would the nurse make when observing a 5 month old infant who has no head lag when pulled to a sitting position? a. this is an expected finding b. the infant may have a cognitive delay c. the infant is developmentally delayed d. this finding is evidence of child abuse

a. this is an expected finding

erikson theorized that the acquisition of which characteristic is the primary focus in infancy? a. trust b. industry c. initiative d. separation

a. trust

which is the first and most important attribute that must develop for a healthy personality according to erikson? a. trust b. mistrust c. autonomy d. shame and doubt

a. trust

parents of a school-age child with rheumatoid arthritis inform the nurse "my child has stopped interacting with others, refrains from eating, and is unable to sleep because of the pain". Which would be the best nursing intervention to determine the severity of the child's pain? a. use the faces pain scale b. ask the child what the pain feels like c. ask the parents where the pain is located d. confer with the health care provider about the pain

a. use the faces pain scale

Toddler stage of development

age 1-3

Preschool stage of development

age 3-6

erikson's stage of development: toddler

autonomy vs shame and doubt

which vitamin supplement would the nurse recommend for all pregnant women to prevent neural tube defects in infants? a. 16 mg of niacin b. 0.4 mg of folic acid c. 1.2 mg of thiamine d. 90 mg of ascorbic acid

b. 0.4 mg of folic acid

At which age do primitive reflexes begin to fade? a. 2 months b. 3 months c. 4 months d. 5 months

b. 3 months

on world hygiene day, the nurse is conducting a health screening in school. the nurse finds that the student is untidy and has dirt under their nails. which instruction does the nurse give to the child? a. you should trim your nails or you will be prone to infection b. a person can lead a healthier life by maintaining good hygiene c. improper hygiene will make you susceptible to infections d. i would like to talk to your mother about your habits

b. a person can lead a healthier life by maintaining good hygiene

which age group of children has cognitive skills characterized by formal operations? a. toddlers b. adolescents c. early childhood d. middle childhood

b. adolescents

which toddler behavior indicates negativism? a. tolerating separation from the parent b. answering "no" to every parental request c. demonstrating the ability to withstand delayed gratification d. showing the ability to interact with others in a less egocentric manner

b. answering "no" to every parental request

the nurse is ready to begin the physical examination of an 8 month old infant. the child is sitting contently on the mother's lap, chewing on a toy. which action would the nurse do first? a. elicit reflexes b. auscultate the heart and lungs c. examine eyes, ears and mouth d. examine the head and move systematically toward the feet

b. auscultate the heart and lungs b/c baby is quiet

which substance is classified as a macromineral? a. iron b. calcium c. fluoride d, vitamin D

b. calcium

which injection site is contraindicated for an infant? a. deltoid muscle b. dorsogluteal muscle c. ventrogluteal muscle d. anterolateral thigh muscle

b. dorsogluteal muscle

which recommendation would the nurse provide to the parent of a toddler to help cope with the birth of a new sibling? a. explain to the toddler that a new playmate will soon come home b. give the toddler a doll with which they can imitate the parent c. prepare the toddler about 1-2 weeks before the birth of a new sibling d. discourage the toddle from helping with care of the new sibling until the baby is much older

b. give the toddler a doll with which they can imitate the parent

development of which psychosocial task is associated with the preschool period? a. identity b. initiative c. intimacy d. industry

b. initiative

which response would the nurse provide the parent of an 8 month old infant who is concerned that the baby cannot walk but is able to sit without support? a. this may indicate a developmental delay, we should evaluate. b. it is normal for babies this age not to walk. we will recheck in a few months c. have you considered using a walker to encourage your baby to walk? d. we would expect your baby to be cruising, or walking while holding, by this age.

b. it is normal for babies this age not to walk. we will recheck in a few months

which gross motor skill is developmentally appropriate for an 18 month old toddler? a. creeps up stairs b. jumps in place w both feet c. stands on one foot momentarily d. kicks ball forward w/o overbalancing

b. jumps in place w both feet

which condition would the nurse suspect if an infant has thin limbs, protruding abdomen, and a diet rich in carbohydrates and poor in proteins? a. marasmus b. kwashiorkor c. kawasaki disease d. nephrotic syndrome

b. kwashiorkor

which toddler characteristic entails the toddler frequently saying "no" to parental requests? a. ritualism b. negativism c. development of ego d. development of superego

b. negativism

which health condition is associated with using food as a reward for good behavior in toddler? a. rickets b. obesity c. early childhood caries d. iron-deficiency anemia

b. obesity

which education would the nurse provide to the parent of an 18 month old about proper restraint in motor vehicles? a. fit the seat belt snugly over the toddler's abdomen b. place the car seat in the back seat of the car, rear facing c. transition the child to a forward facing seat at 25 pounds d. place the car seat in the front passenger seat if there is an airbag

b. place the car seat in the back seat of the car, rear facing

which technique is the recommended approach to warming frozen breast milk for an infant? a. place the container with frozen expressed milk in a microwave to warm it b. place the container with frozen milk in a lukewarm water bath to warm it c. place the expressed milk in refrigerator overnight and heat it on stove next day d. place the expressed milk in refrigerator overnight and warm it in microwave

b. place the container with frozen milk in a lukewarm water bath to warm it

which measure would a school nurse promote to reduce incidents related to unintentional injuries among school children? a. promote physical exercise b. promote helmets while using bikes c. provide education about the perils of smoking d. encourage swimming alone rather than in groups

b. promote helmets while using bikes

which is the most appropriate nursing intervention for a 16 year old girl who told the school nurse that has not started to menstruate? a. explaining that this is not unusual b. referring the adolescent for an evaluation c. assuming the adolescent is pregnant d. suggesting the adolescent stop exercising

b. referring the adolescent for an evaluation

which recommendation would the nurse provide to the parent of a 6 month old infant about the introduction of solid foods? a. rice cereal may be mixed with whole milk b. rice cereal is a good first food because it is easily digested and low in allergenic potential c. the introduction of solid foods at this age is for growth and development rather than taste d. cream of farina is a good first food because it is easily digested and low in allergenic potential

b. rice cereal is a good first food because it is easily digested and low in allergenic potential

which developmental achievement is characteristic of the motor skills of a 24 month old? a. walks alone but falls easily b. runs well with a wide stance c. stands on one foot momentarily d. grasps small objects but cannot release them at will

b. runs well with a wide stance

which recommendation would the nurse offer the parent of a toddler who is concerned about limited food variety and a strong preference for plastic plates? a. serve the child's favorite food in a ceramic bowl b. serve the child's favorite food on the favorite plate c. plastic plates are contraindicated for toddlers d. serve mixed foods, such as stews, because most children like them.

b. serve the child's favorite food on the favorite plate

which recommendation would the nurse provide to the parent of a toddler who is worried that their child touches their genitalia in public? a. do not allow the child to play with genitalia in public or private places b. teach that genital stimulation in private is acceptable but not in public c. take the toddler to a psychologist or psychiatrist for a health check up d. ignore it because it is a normal phenomenon in psychosocial development

b. teach that genital stimulation in private is acceptable but not in public

which response would the school nurse employ when adolescents disclose that they are gay? a. the nurse would discuss his or her own beliefs about homosexuality b. the nurse would provide a nonthreatening environment for the adolescents to discuss their feelings c. the nurse would say that adolescents are too young to determine their sexual orientation d. the nurse would say that homosexual adolescents have the same health needs as heterosexual adolescents

b. the nurse would provide a nonthreatening environment for the adolescents to discuss their feelings

which is the rationale for the nurse recommending that the parent of a 3 year old sing, tell stories, or talk to the child while the child brushes their teeth? a. to show the importance of teeth cleaning b. to prevent boredom while brushing c. to make the brushing time less traumatizing d. to reduce negativism in the child

b. to prevent boredom while brushing

which is the rationale for the nurse recommending that the parent of a 7 month old infant reduce pacifier use? a. to prevent obesity b. to prevent otitis media c. to prevent conjunctivitis d. to prevent a cerumen impaction

b. to prevent otitis media

which clinical manifestations would the nurse expect when caring for a child with dyssomnias? a. episodes of sleep terrors b. trouble falling asleep at night c. episodes of sleepwalking d. rhythmic movement disorders

b. trouble falling asleep at night

infancy stage of development

birth to age 1

which response would the nurse provide the parents of a 6 month old infant who are concerned that their baby pushes the spoonful of baby food away whenever it is near their mouth? a. it is important not to give in to this kind of controlling behavior b. your baby is old enough to feed themself. try letting them hold the spoon c. maybe you need to try a different type of spoon designed for infants d. just keep offering the spoon to him even though he pushes it away

d. just keep offering the spoon to him even though he pushes it away

which anticipatory guidance would the nurse provide the family of a 6 month old infant being seen for a well baby check-up? a. keep the doors of appliances closed at all times b. never shake baby powder directly on the infant c. install a gate at the top and bottom of stairs d. keep the crib rails raised to full height at all times

d. keep the crib rails raised to full height at all times

a nurse is discussing various development theories at a parenting class. which individual is associated with the moral development theory? a. freud b. fowler c. erikson d. kohlberg

d. kohlberg

for which condition is an infant at risk if the diet has limited protein-based food sources? a. rickets b. pellagra c. marasmus d. kwashiorkor

d. kwashiorkor

which parental statement indicates to the nurse a need for additional education about injury prevention in early childhood? a. we keep all of the medicines out of reach b. we have a fence around the swimming pool c. we have put gates at the top and bottom of our stairs d. our 2 year old toddler takes a bath w his sister while we cook dinner

d. our 2 year old toddler takes a bath w his sister while we cook dinner

which is the best way to prevent poisoning in preschoolers? a. watch the child at all times b. keep ipecac syrup in the home c. teach the child to consume only food and drinks d. store poisonous substances in a locked cabinet

d. store poisonous substances in a locked cabinet

which response would the nurse recommend when a 3 year old child hits their parent and laughs? a. tell the child to stop hitting because hitting hurts others b. tolerate the child's behavior until the hitting stops c. place the child in time-out alone when the hitting occurs d. tell the child to stop hitting is not allowed

d. tell the child to stop hitting is not allowed

a nurse needs to assess a young child's blood pressure. which is a developmentally appropriate way for the nurse to prepare the child for the procedure? a. telling the child: im going to squeeze the bulb really tightly and then release it b. telling the child: you may feel a little pressure in your arm when the cuff inflates c. telling the child: its just a procedure that your doctor ordered. i promise it wont hurt d. telling the child: squeezing the bulb pushes the air into the cuff and makes the silver in the tube go up

d. telling the child: squeezing the bulb pushes the air into the cuff and makes the silver in the tube go up

which behavior would the nurse suspect is contributing to a toddler's malnourishment and dental caries? a. total avoidance of fruit-flavored drinks b. the provision of a cup of fruit on a daily basis c. the provision of lean meats and low-fat cheeses d. the provision of 10 oz of fruit juice per day

d. the provision of 10 oz of fruit juice per day

which is true about the trend in adolescent pregnancy in the US? a. the rate has doubled since 1990 b. the rate has been on the rise since 1990 c. the rate has been the same since 1990 d. the rate has been on a downward trend since 1990

d. the rate has been on a downward trend since 1990

what is the current understanding for nonpharmacologic strategies for pain management work in children? a. they make the pharmacologic strategies less effective b. they work faster than most pharmacologic strategies do c. they convince the children that they are not feeling pain d. they provide coping strategies that help reduce pain perception

d. they provide coping strategies that help reduce pain perception

which recommendation would the nurse make for the family of a 9 month old infant who is worried about a baby's thumb sucking? a. a pacifier should be substituted for the thumb b. sucking should be discouraged after age 12 months c. there is a no need to restrain nonnutritive sucking during infancy d. thumb sucking should be discouraged when permanent teeth begin to erupt

d. thumb sucking should be discouraged when permanent teeth begin to erupt

which parental statement indicates to the nurse that additional education is needed regarding accident prevention for a 2 year old? a. we locked all of the medicine in the medicine chest b. we turned down the temperature on our water heater c. we put gates at the top and bottom of the basement steps d. we make sure we fasten the front seat belt tightly

d. we make sure we fasten the front seat belt tightly

Parallel play

Two children play in same area with others, using like materials, but they play independently. Often the children play back to back and have minimal interaction. Sharing infrequently happens during parallel play

Childhood mortality

Unintentional injuries (accidents) are the leading cause of death after age 1 year through adolescence.

Older infant response to pain

Withdraw from painful stimuli, loud cry Use CRIES or FLACC assessment tools

which type of injury is common in 2 month old infants? a. falls b. poisoning c. aspiration d. suffocation e. motor vehicle accidents

a. , c. , d. , and e.

which response would the nurse provide the parent of a 6 month old infant who develops black stools within 2 days of starting iron supplementation for iron deficiency anemia? a. black stools are one of the common side effects of iron supplements; therefore there is no need to worry b. iron supplements should be stopped immediately and the health care provider should be consulted c. iron supplements may cause bleeding in the upper GI tract and should be investigated further. d. iron supplements may cause bleeding in the lower GI tract and should be investigated further.

a. black stools are one of the common side effects of iron supplements; therefore there is no need to worry

in which way is chronic pain in children differentiated from recurrent pain? a. chronic pain persists for 3 months or more b. chronic pain is episodic and reoccurs c. depression is elevated in children with recurrent pain d. anxiety is elevated in children with chronic pain

a. chronic pain persists for 3 months or more

Approach to and Performing Physical Assessment for children

start with least disturbing to potentially most upsetting. Least invasive/painful to most invasive/painful, start from distal areas first

preschooler: vital signs

temp: Axillary 97.5 - 98.6 F (36.4 - 37 C) HR: 70-110 beats/min Resp: 16-22 breaths/min BP:average, 95/57 mm Hg

adolescent growth rate second to infancy,

the most rapid changes apart from infancy

erikson's stage of development: infancy

trust vs mistrust

which organ is most vulnerable to the adverse effects of excessive oxygenation in preterm infants? a. brain b. heart c. retina d. nerves

c. retina

which response would the nurse provide the parent of a 10 month old infant who is worried that the baby cries and screams whenever being left with the grandparents? a. the infant may be accustomed to being spoiled b. the grandparents may not be responsive to the infant. c. stranger anxiety is common for an infant of this age d. separation anxiety should have disappeared between 4 and 8 months of age

c. stranger anxiety is common for an infant of this age

which condition would the nurse suspect when a 6 month old infant demonstrates increased drooling, finger sucking, and biting on objects? a. illness b. cavities c. teething d. viral illness

c. teething

which is a cause of temper tantrums in toddlers? a. a spoiled child b. a pathologic conditions c. the child's desire for independence d. the child's ability to control their emotions

c. the child's desire for independence

what is the appropriate action when the route of morphine administration is changed from intravenous to oral? a. the oral morphine dosage must be equal to the intravenous dosage to be effective b. the oral morphine dosage must be one-half of the intravenous dosage to be effective c. the oral morphine dosage must be larger than the intravenous dosage to be effective d. the oral morphine dosage must be one-quarter of the intravenous dosage to be effective

c. the oral morphine dosage must be larger than the intravenous dosage to be effective

which characteristic may be observed in latchkey children? a. they are braver than their peers b. they may bully other children c. they feel more lonely or isolated d. they have confidence compared with peers

c. they feel more lonely or isolated

for which reason would the nurse advise a family to avoid giving honey to their baby until the child is 1 year old? a. to reduce the risk for tetanus b. to reduce the risk for diarrhea c. to reduce the risk for botulism d. to reduce the risk for allergy

c. to reduce the risk for botulism

which vitamin would the nurse anticipate being prescribed for an exclusively breastfed 4 month old infant? a. vitamin b b. vitamin c c. vitamin d d. vitamin k

c. vitamin d

which developmental task would the nurse expect a 24 month old to perform? a. walking alone without support b. jumping w both feet c. walking up and down stairs d. standing on one foot

c. walking up and down stairs

which response would the nurse provide to the parent of an 18 month old child who asks whether hot dogs may be included in the child's diet? a. yes, but only organic b. only occasionally because they can cause childhood caries c. yes but make sure to cut them into small pieces d. no, the child will not be able to chew them properly

c. yes but make sure to cut them into small pieces

at which age does puberty generally begin for girls and boys? a. 8 years for girls, 10 years for boys b. 9 for girls, 11 for boys c. 12 for girls, 10 for boys d. 10 for girls, 12 for boys

d. 10 for girls, 12 for boys

which is the basal energy requirement of a newborn in kcal per kilogram of body weight? a. 102 b. 104 c. 106 d. 108

d. 108

adolescent stage of development

Adolescence is the period from ages 13 to 19. Some experts now consider the period of adolescence from ages 10 to 25 due to recent research on brain development.

preschool gross motor skills

Alternate feet on stairs 2. Hops on one foot (4 years) 3. Throws and catches ball (5 years) 4. Jumps rope

which statement characterizes the eating behavior of toddlers? a. they become fussy eaters b. they have increased appetites c. they have few food preferences d. their table manners are predictable

a. they become fussy eaters

which observation made by the nurse is included under the developmental history for genetic consultation? a. observation for hereditary diseases b. observation for behavioral diseases c. observation for neurologic conditions d. observation for growth abnormalities

b. observation for behavioral diseases

according to sigmund freud, which age period do children usually undergo maturation of the reproductive system and develop sex hormones? a. 1-3 years b. 3-6 years c. 6-12 years d. 12-18 years

d. 12-18 years

how long after the appearance of the first pubescent changes does menarche or the first menstruation occur? a. 3 years b. 15 months c. 18 months d. 2 years

d. 2 years

which best describes the origin of a cow's milk allergy? a. a result of infant colic b. a gastrointestinal underresponse to dairy c. a complication of chronic GERD d. a multifaceted disorder causing systemic and local reactions

d. a multifaceted disorder causing systemic and local reactions

decision making regarding the care of older children and adolescents would include the patient's assent as well as the parent's consent. which is the meaning of assent in this situation? a. assent is the capability of making an intelligent decision b. assent means that the adolescent acknowledges the parent's authority to make informed health decisions. c. assent applies to one who is legally under the age of maturity but is recognized as having the legal capacity of an adult d. assent means that the adolescent has been informed about the proposed treatment, procedure, or research and is willing to permit a health care provider to perform it

d. assent means that the adolescent has been informed about the proposed treatment, procedure, or research and is willing to permit a health care provider to perform it

which description is characteristic preoperational thought in toddlers? a. considering all possible alternatives b. being able to see the event or object from another perspective c. being able to understand that something can be different d. believing that their thoughts are all-powerful and caused the event that occurred

d. believing that their thoughts are all-powerful and caused the event that occurred

how is bulimia characterized? a. binge eating b. avoidance or restriction of food intake c. refusal to maintain a minimally normal body weight and by severe weight loss in the absence of obvious physical causes d. binge eating followed by inappropriate compensatory behaviors such as fasting, excessive exercise, medications, or self-induced vomiting

d. binge eating followed by inappropriate compensatory behaviors such as fasting, excessive exercise, medications, or self-induced vomiting

which recommendation would the nurse include when teaching a parent of a toddler about oral hygiene? a. flossing is not recommended at this age b. toddlers are old enough to brush their teeth effectively c. the toddler's toothbrush should be small and have hard, rounded, nylon bristles d. brush the toddler's teeth with plain water if the child does not like toothpaste

d. brush the toddler's teeth with plain water if the child does not like toothpaste

which description would the nurse provide the parent of an infant with colic? a. colic is often a result of inadequate bonding b. colic causes periods of abdominal pain accompanied by weight loss c. colid primarily affects infants over 6 months with frequent episodes of abdominal pain and crying d. colic causes paroxysmal abdominal pain or cramping marked by episodes of loud crying

d. colic causes paroxysmal abdominal pain or cramping marked by episodes of loud crying

a nurse is delivering a lecture on oral health for children. which is the most common dental condition in children that the nurse would specifically address? a. gingivitis b. periodontitis c. oral candidiasis d. dental caries

d. dental caries

for which condition would the nurse evaluate when caring for a 12 month old infant who is unable to pull up to a standing position? a. lordosis b. kyphosis c. osteogenesis imperfecta d. development dysplasia of the hip

d. development dysplasia of the hip

which type of maltreatment is when the child appears to have had plenty of food and has been kept clean but has not been held or given any attention? a. physical abuse b. physical neglect c. emotional abuse d. emotional neglect

d. emotional neglect

which intervention would the nurse recommend to foster a toddler's achievement of autonomy? a. helping the toddler complete tasks b. helping the toddler learn the difference between right and wrong c. providing opportunities for the toddler to play with other children d. encouraging toddlers to do things for themselves when capable

d. encouraging toddlers to do things for themselves when capable

which recommendation would the nurse provide the mother of 8 month old infant who wishes to discontinue breastfeeding? a. offer whole cow's milk b. feed organic skim milk c. avoid commercial canned formulas d. feed commercial iron-fortified formula

d. feed commercial iron-fortified formula

which is the most important factor in determining the degree of fit between an infant's temperament and the interactions between the child and parents? a. a child and parent with similar temperaments b. a child and parent with different temperaments c. infant behavior that is consistently outside the parent's expectations d. harmony between the parent's expectations and the child's actual temperament

d. harmony between the parent's expectations and the child's actual temperament

which response would the nurse provide the parent of 12 month old who says "I can't let him feed himself because he makes too much of a mess"? a. it's important not to give in to this kind of temper tantrum at this age b. it's important to let him make a mess. just don't worry about it so much c. maybe you need to try a different type of spoon, one designed for infants d. he's at the age when he should begin to feed himself. let's think of ways to make the mess more tolerable.

d. he's at the age when he should begin to feed himself. let's think of ways to make the mess more tolerable.

which task does erikson describe as the primary focus of psychosocial development in school-age children? a. autonomy b. trust c. initiative d. industry

d. industry

according to erikson, which developmental task does the nurse recognize as the primary psychosocial task of the preschool period? a. identity b. industry c. intimacy d. initiative

d. initiative

adolescent pain assessment

numerical rating visual analog scale include cultural considerations (pain=weakness)

school age stage of development

refers to children ages 6 to 12. Early: 6 to 10 years old Late: 10 to 12 years old

Toddler gross motor skills

running, climbing, jumping, pushing or pulling a toy, throwing a ball, and pedaling a tricycle

Preschool fine motor skills

Handedness obvious by five years 2. Ties shoes by five years 3. Copies X or O by 3-4 years

adolescent vital signs

-12 to 18 years -60-100 bpm -12-20 breaths -100 to 120 -98.6

Piaget's stages of cognitive development: preschool

Preoperational

erikson's stage of development: adolescence

identity vs role confusion

Infant and toddler order of VS assessment

(1) Assess comfort level (2) Respirations first (so you don't disturb them) (3) Count the apical heart rate (4) Measure BP (if applicable) (5) Temperature last

infant fine motor skills

- *palmar grasp*: 6 months - *pincer grasp*: 9 months - *brings objects to mouth*: 4 months - *transfers objects from hand to hand*: 6-8 months

infant gross motor skills

- *sitting up without support*: 6-8 months - *rolling over*: 6 months - *standing without support*: 10-12 months - *first steps*: 12 months

toddler vital signs

-1-2 years -HR: 90-140 -RR: 20-30 -systolic: 80-90 -temp: 96.8-99.6

Issues affecting childhood health

-Obesity -Type 2 diabetes -Violence -Developmental stage-related injuries -Substance abuse -Mental Health problems

toddler fine motor skills

-Progresses from holding and pinching -Manages utensils -Holds crayon -Strings a bead -Works a puzzle -Uses a touch screen

school age gross motor skills

-coordination, balance, & rhythm improve -able to ride a bike -jump rope dance -participates in variety of sports -strength & endurance increase

adolescent gross motor skills

-endurance & concentration increase -can follow complicated instructions -speed & accuracy increase -become more competitive

school age fine motor skills

-eye hand coordination & balance improve -able to write, print, sew, or build models -exhibit manipulative skills -take pride in activities that require dexterity

adolescent fine motor skills

-increased ability to manipulate objects -handwriting is neat -refines dexterity skills -develops precise eye-hand coordination & finger dexterity

when should the anterior fontanelles close?

12-18 months

Family-centered care

3 key components of family-centered care are respect, collaboration, and support.

Pain in neonates

Can only be based on physiologic and behavioral responses Use CRIES or PIPP

Associative play

Children interact and engage in a common activity. Materials are exchanged. The play is not organized, although the children may attempt to control or limit participation. The children do not have a common goal

Piaget's stages of cognitive development: school age

Concrete operational

developmentally appropriate communication for

Honesty will help gain the trust of an adolescent. Be aware of privacy needs; allow time for the patient to speak without parents in the room Plan for developmental regression during times of stress An adolescent who is ill may act younger than his or her actual age; an adolescent who is in pain may act much younger May require a detailed explanation, maintain privacy, importance of peers.

developmentally appropriate communication for school age:

Explain what, how, and why (using concrete terms) Anticipate questions, allow them to see equipment, therapeutic play may be helpful

toddler pain assessment

FLACC scale (react to painful procedures the same way as painless procedures)

developmentally appropriate communication for toddlers and preschoolers:

Focus on the child in your communication Use words he or she will recognize Be consistent (e.g., do not smile when doing painful procedures) Involve the parent if possible Allow children to touch medical equipment Repeat information in simple, consistent terms

Piaget's stages of cognitive development: adolescent

Formal operational

Young infant response to pain

Generalized response of rigidity and thrashing, loud cry, and facial expression, such as grimace Use CRIES or FLACC assessment tools

School aged vital signs

HR: 85-100 R: 18-20 BP: 90-108/60-68 mmHg

Cooperative or organized supplemental play

Play with a recognized group goal, often directed by 1 or 2 players and characterized by sets of different roles. Members control entry

onlooker play

The child focuses on play activity of others and remains close by but does not participate

Solitary independent play

The child plays alone, using different materials from other children in the vicinity. The child makes no effort to interact with others. Considered intellectually advanced type of play across childhood and should be encouraged.

at what age would the nurse expect an infant to be able to say mama and dada with meaning? a. 4 months b. 6 months c. 10 months d. 12 months

c. 10 months

at which age would the nurse expect an infant's anterior fontanel to close? a. 6 weeks b. 8 weeks c. 14 months d. 24 months

c. 14 months

Which play type involves objects in the environment that attract a child's attention? a. Skill play b. Dramatic play c. Sense-pleasure play d. Social-affective play

c. Sense-pleasure play

the nurse finds that a 2 month old infant is not gaining weight despite receiving expressed breast milk. the mother works for 8 hours and expresses milk once during this time. which recommendation would the nurse make to the mother? a. advise the mother to quit her job and breastfeed the baby b. advise the mother to take the baby to work if possible c. advise the mother to express milk at least q 3-4 hours d. advise the mother to switch to infant formula milk for the baby

c. advise the mother to express milk at least q 3-4 hours

which condition is associated with prolonged bottle-feeding? a. sleep disruption b. iron-deficiency anemia c. early childhood caries d. delayed language development

c. early childhood caries

which recommendation would the nurse provide the parent of an infant experiencing teeth pain? a. rub the gums with aspirin b. apply hydrogen peroxide to the gums c. give the child a cold teething ring d. have the child chew on a warm teething ring to encourage tooth eruption.

c. give the child a cold teething ring

which type of development is a 3 year old child demonstrating when riding a tricycle? a. cognition skills b. fine motor skills c. gross motor skills d. socialization skills

c. gross motor skills

which response would the nurse provide to the parent of a toddler who reports coating the child's pacifier with honey? a. honey is a good source of vitamin A b. honey is an effective appetite stimulant c. honey-coated pacifiers increase the risk for caries d. honey should be avoided until 2 years of age

c. honey-coated pacifiers increase the risk for caries

which recommendation would the nurse provide to the parent of a toddler who started using a bottle instead of a cup and demands to play with the same toys as her newborn sibling? a. teach the toddler new skills for further development b. take the toddle to a psychologist for behavioral therapy c. ignore this behavior and praise appropriate behavior d. refer the toddler to an experience psychiatrist for a check-up

c. ignore this behavior and praise appropriate behavior

which action would the nurse take when the parents of a 12 month old express concern that their infant is still sucking the thumb and ask how to stop this annoying behavior? a. report the parents' concerns to the proper authorities b. ignore the parents' concerns because the behavior is normal c. investigate the parents' feelings regarding their child's behavior d. reassure that the parents that their child's thumb sucking is not their fault

c. investigate the parents' feelings regarding their child's behavior

which recommendation would the nurse include when educating a parent about infant safety and injury prevention? a. refer to medication as candy to encourage cooperation b. provide mobile walkers to promote coordination and prevent falls c. maintain one hand on the infant at all times during bathing d. keep the infant's play area free of rugs, mats, and large objects

c. maintain one hand on the infant at all times during bathing

which parental statement indicates a potential developmental delay in a 4 month old infant? a. our baby is drooling all the time. b. our baby is mouthing everything. c. our baby mostly coos and laughs, but not a lot of sounds otherwise d. our baby seems to really enjoy people and when they talk to him

c. our baby mostly coos and laughs, but not a lot of sounds otherwise

the nurse is caring for a comatose child with multiple injuries. which statement would the nurse recognize? a. pain cannot occur if the child is comatose b. pain may occur if the child regains consciousness c. pain requires astute nursing assessment and management d. pain is best assessed by family members who are familiar with the child

c. pain requires astute nursing assessment and management

which type of play is characteristic of toddlers? a. tactile b. solitary c. parallel d. cooperative

c. parallel

a nurse is caring for a 7 year-old child who has undergone surgery for severe wounds and multiple fractures sustained in an MVA. Which is the priority nursing intervention in managing this child's pain? a. treating the child's pain with nonpharmacologic measures b. increasing the dose of analgesic until the child is sedated c. planning an around-the-clock schedule of preventative pain medication d. giving the child a clock and explaining when the child may have the next dose of pain medication

c. planning an around-the-clock schedule of preventative pain medication

which is a way to increase a 6-year-old child's intake when the child has no appetite? a. hold the child while feeding b. scold the child for not eating c. provide carbonated drinks and ice pops d. leave the child alone to feed him or herself

c. provide carbonated drinks and ice pops

the nurse observes a toddler playing with other children, then coming to the parents to be held, then returning to play with others. which developmental task would the nurse recognize this toddler to be demonstrating? a. tactile play b. parallel play c. rapprochement d. separation anxiety

c. rapprochement

erikson's stage of development: school age

industry vs inferiority

erikson's stage of development: preschool

initiative vs guilt