Pediatric Nursing Growth and Development

A mother of a 7-year-old child complains to the nurse that her child wets the bed at night. Upon interaction with the child, the nurse learns that the child is afraid of the dark. What does the nurse recommend to the mother? Select all that apply.

"Allow your child to keep a light on in the bedroom at night" "Encourage your child to copy his siblings who sleep alone in their room."

The nurse is educating the mother of an 8-year-old female about the sequences of maturational changes. Which response by the mother indicates effective learning?

"Appearance of breast buds is an initial indication of puberty."

While interacting with a preschooler, the nurse asks the child about the loss of a grandparent. Which statement made by the child should the nurse document in the records?

"I know Superman can get my grandma back soon."

Upon interacting with the parent of an 8-month-old infant, the nurse anticipates that the infant is at risk of childhood obesity. Which statement from the parent supports the nurse's assumption?

"I often give my child potato chips."

A worried parent informs the nurse, "My 6-year-old is otherwise healthy but still wets the bed at night." The nurse is teaching the parent necessary steps to manage the child's nocturnal enuresis. Which statement made by the parent indicates effective learning? Select all that apply.

"I should avoid giving my child fruit juice after 4:00 pm." "I should encourage my child to drink lots of water during the day." "I should wake my child at the same time every night to use the bathroom."

The nurse is caring for an infant who has been prescribed nystatin (Mycostatin). The nurse teaches the mother how to prevent aggravation of oral thrush. Which statements by the mother indicate the need for further teaching? Select all that apply.

"I should boil the pacifier for at least 20 minutes on alternate days." "I should apply the medication at least 20 minutes before feeding." "I should boil the reusable nipples for at least 5 minutes after washing."

The nurse finds that a 2-year-old child has impaired fine motor skills. The nurse recommends toys that will be beneficial for the child. Which statement by the child's parents needs correction?

"I should provide battery-operated cars."

The registered nurse is teaching a student nurse about adhesives to be used for preterm infants. Which statement by the student nurse indicates effective learning?

"I should secure pulse oximeter probes with elasticized dressing material."

The nurse is teaching a mother about the developmental behaviors of a 7-month-old infant. Which statement by the mother indicates effective learning? Select all that apply.

"I should start oral hygiene in my child." "I should call my child by her name." "I should not leave the child with an unfamiliar relative."

The parents tell the nurse that their preschooler often awakes from sleep, screaming in the middle of the night. The preschooler is not easily comforted and screams if the parents try to restrain the child. What does the nurse instruct the parents?

"Intervene only if necessary to protect the child from injury."

The parents of a child often try to persuade their preschooler to touch their pet dog because they want to reduce the child's fear of dogs. Instead, the child's fears and anxiety increase. What does the nurse suggest the parents do to help overcome their child's fear?

"Let the child watch other children playing with dogs."

The parents of a toddler ask the nurse about the importance of play for a child. What is the best answer by the nurse?

"Play activities will help release the child's surplus of energy."

The parents of a preschooler are worried, as the child is often seen talking to imaginary friends. The parents admit that they often scold the child for such behavior. What does the nurse inform the parents?

"The behavior is normal at this age and it will help counter loneliness."

A school-age child is mostly at home after school and gets engrossed in video games. Once a week, the child engages in swimming activity. The child's family also often orders fast food from restaurants. What does the nurse need to inform the parents about the child?

"The child is at risk for childhood obesity."

The parents inform the nurse that their child is often seen daydreaming. What does the nurse inform the parents?

"The child is exhibiting normal behavior seen in children."

The parents of a school-age child tell the nurse that their child is tall, broad, and very active in sports, and so they are planning to enroll the child for strenuous competitive athletics. What is the best response from the nurse?

"The child is not ready for strenuous activities."

The mother of a 2-year-old girl expresses concern that her daughter's growth rate has slowed. What should the nurse explain to the mother about the growth of toddlers?

"This growth pattern is typical at this age."

The nurse is teaching a group of adolescents about the calendar method of contraception. Which statement made by an adolescent indicates effective learning?

"This type of contraception requires a regular menstrual cycle."

A school-age child often steals money from home to buy chocolate. Upon being confronted by the parents, the child lies about stealing. The parents are worried that such behavior will steer the child towards criminal activities later in life. What is the best response from the nurse?

"Use admonition and ask the child to return the stolen money."

What does the nurse expect the primary health care provider (PCP) to advise the parents after their child is diagnosed with a mitochondrial disorder?

"You may need to use a donor egg or sperm for future children."

The nurse is assessing an 8-year-old child who suffers from encopresis. Which advice given by the nurse provides effective treatment for the child? Select all that apply.

"You should include cereals in your diet." "You should drink lots of fluids." "You should eat fresh fruit for breakfast."

The nurse is teaching safe transportation techniques to the parents of a baby who are from a low economic background. Which advice given by the nurse is appropriate?

"You should place the baby's car seat in the rear-facing position in the back seat."

The nurse is teaching growth and development activities to the parents of a 3-month-old infant. Which statements does the nurse include in the teaching plan? Select all that apply.

"Your child should be able to coo, babble, and chuckle." "Your child should be able to pull at blankets or clothes." "Your child's head can come up to a 45- to 90-degree angle from the table."

Which image depicts caput succedaneum in an infant?

1

The nurse is examining a teenage patient who has a gawky, long-legged appearance. What is the sequence of growth changes that lead to this characteristic early adolescent appearance?

1. Growth of the neck, hands, and legs in length 2. Increase in the breadth of the hips and chest 3. Increase in the width of the shoulders 4. Increase in the length of the trunk 5. Increase in the depth of the chest

What birth weight of a neonate indicates a very low birth weight (VLBW) infant?

1300 g

The nurse administers a second dose of inactivated polio vaccine (IPV) to a 4-month-old child. When does the child receive the third dose of IPV?

14 to 18 months of age

How many teeth does a 10-month-old infant usually have? Record your answer using a whole number.

4

After assessing a newborn infant, the nurse finds that the infant has a heart rate of 90 beats/minute, irregular respirations with a weak cry, limp extremities, sneezing reflex, and a completely pink body. What would be the Apgar score of the child? Record your answer using a whole number. ______

6

The nurse is teaching an adolescent about the different methods of contraception. Which statement made by the adolescent indicates a need for further teaching?

A diaphragm is a soft rubber dome with a firm but pliable rim.

While assessing the development of a child, the nurse finds that the child is imitating the actions of her elders. Which stage, according to Erickson's developmental theory, does the nurse expect the child is in?

Autonomy versus shame and doubt

The nurse is caring for an infant undergoing laser therapy for port-wine stain. Which instruction does the nurse give to the infant's parents?

Avoid any trauma to the lesion by not picking at the scab during the therapy.

During assessment, the nurse asks a patient about developmental milestones such as the age at which thelarche and menarche occurred. The nurse determines that the patient experienced pubertal delay. Which finding in the patient supports the nurse's conclusion?

Breast development occurred by 15 years of age.

During a clinical assessment, what secondary sex characteristics does the nurse observe in a teenage patient? Select all that apply.

Change in voice Development of facial hair

The nurse is explaining to the mother of two teenage children why her daughter's height is comparatively less than her son's height. What is the reason for lower overall height in girls compared to boys?

Closure of epiphyses due to estrogen secretion

Which solid food can be given to a 6-month-old infant?

Crackers or Zwieback

The nurse observes bleeding into the subgaleal compartment upon reviewing a child's magnetic resonance imaging (MRI) results. What other conditions should the nurse evaluate in the child? Select all that apply.

Decreased platelet levels Decreased hematocrit levels

A community health nurse makes a home visit to a disabled 13-year-old client who has a 6-month-old infant sister. The infant lies quietly in her crib and rarely smiles or vocalizes; it appears that the infant barely has her basic needs met. What is the nurse's most appropriate intervention?

Determine if there is anyone who can help with chores and the infant's care.

After assessing a neonate who was delivered using forceps immediately after birth, the nurse confirms facial paralysis. Which information does the nurse provide to the mother?

Don't panic; it will resolve within a few days.

Which of the following are congenital anomalies or birth defects seen in children? Select all that apply.

Dysplasias Disruptions Deformations Malformations

While caring for a pregnant patient with body mass index of 32 during labor, the nurse observes that the second stage of labor lasts for about 11 minutes. The nurse also finds that the expected birth weight of the fetus is around 4200 g. Which complication does the nurse anticipate in the neonate after birth?

Erb palsy

A 3-year-old child feels a sense of rivalry with his father and wants him to die. Shortly after these feelings emerge, the child's father dies in a road accident. The child then begins to feel intense guilt, believing that he caused the death. What is the best nursing intervention in this situation?

Explain to the child that wishes do not make things happen.

The nurse teaches a mother about the dietary measures to be followed for her 5-month-old infant. During the follow-up visit, the nurse finds that the child has indigestion. Which action by the mother is responsible for this situation?

Feeding mashed sweet potatoes to the child

The nurse is counseling the parents of an adolescent child on the benefits of social development in the child's maturation process. Which statement by the nurse needs correction to convey an appropriate message to the parents?

Feelings of immortality in the child are undesirable and should be condemned.

Which is an inborn error of metabolism that affects growth and development?

Hunter syndrome

Which medication is prescribed to an infant with congenital syphilis?

IV penicillin (Pfizerpen)

The nurse is preparing to bathe a neonate born at 30 weeks gestation. Which practices by the nurse ensure the infant's safety? Select all that apply.

Immerses the neonate fully (except the head) in the tub Measures the body temperature within 2 to 4 hours before giving the bath Uses cleansing agents with neutral pH and minimal dyes while giving the bath

What growth changes are observed in a male patient during adolescence? Select all that apply.

Increase in length of vocal cords by 0.4 inch Uncontrollable shifting of the voice from deep to high tones

While assessing a term infant a few hours after birth, the nurse finds a body temperature of 95.5° F. What does the nurse do in this situation?

Keep the infant in a double-walled incubator for a few hours.

The nurse is teaching hygiene practices to a 16-year-old patient who has recently had her first menstrual flow. Under which phase of development does the nurse classify the patient?

Middle adolescence

The primary health care provider instructs the nurse to apply an emollient to an infant. During assessment, the nurse finds that the neonate is preterm and has a body weight of 900 g. Which is the appropriate nursing intervention in this situation?

Monitor for coagulase-negative staphylococcus infection.

Which aspects of the "self" do children assess while forming an evaluation of their self-esteem? Select all that apply.

Moral worth Competence Sense of control Worthiness of love

The nurse is assessing newborns 24 hours after birth in a pediatric health care setting. Which neonate requires priority action from the nurse?

Neonate 3

The nurse is assessing the Apgar scores of four different newborns in a pediatric ward. Which child does the nurse anticipate is experiencing severe distress?

Newborn A

When assessing a child's reflexes, the nurse places the child in the prone position and presses a thumb along the child's spine from sacrum to neck. The nurse finds that the child starts crying and urinates while flexing the extremities. Which reflex is the nurse assessing in the child?

Perez reflex

The parents of a preschooler tell the nurse that they try to inculcate good eating habits by asking the child to be at the table until the "plate is clean." What condition is the child at risk for?

Poor eating habits

What are the different patterns of physical development and maturation of neuromuscular functions in a child? Select all that apply.

Proximodistal Cephalocaudal Differentiation

A toddler wearing a diaper is impatient with the wet diaper and shows a desire to have it changed. Which toilet training readiness does this behavior indicate?

Psychological readiness

The nurse finds that a child has developed the qualities of independence, self-control, and self-governance. Which type of development does the nurse anticipate in the toddler?

Psychosocial development

Which physiologic functions decrease in response to certain pubertal changes? Select all that apply.

Pulse rate Basal heat production

Which screening report will help the nurse determine skeletal growth in a child?

Radiographs of the hand and wrist

The nurse finds that an adolescent has a tattoo on the neck and piercings on the ear and eyebrow. During the next visit, the nurse finds that the adolescent has an additional tattoo on right upper arm and another piercing on the nose. What are the priority nursing interventions in this situation? Select all that apply.

Screen the adolescent for human immunodeficiency virus (HIV). Schedule an appointment for administering the hepatitis vaccine.

What are the different stages of cognitive development in an infant as described by Piaget? Select all that apply.

Separation Using symbols Object permanence

The nurse is teaching the mother of 24-month-old child effective ways of cleaning the toddler's teeth. Which actions facilitate access to the child's mouth and help stabilize the child's head for comfort? Select all that apply.

Sitting on a couch or bed with the child's head resting in the mother's lap Using one hand to hold the child's chin and the other to brush the teeth Sitting on the floor or a stool with the child's head resting between her thighs

Which formula is most preferable for a child who has lactose intolerance?

Soy-based formula

The nurse instructs parents to avoid placing their infant in a prone position while sleeping. Which risk does the nurse seek to prevent with this instruction?

Sudden infant death syndrome

After assessing the behavior of a 3-year-old child, the nurse concludes that the child is slow to warm up. Which behavior helps the nurse reach this conclusion?

The child adapts gradually to a new environment with repeated contact.

A child who has persistent inattentive behavior is prescribed methylphenidate hydrochloride. Which behavior indicates that the child needs further treatment?

The child experiences difficulty keeping school supplies organized.

The nurse observes that a child fails to make eye contact and has poor impulse control. Upon further assessment, the nurse finds that the parent is an alcoholic and often neglects the child. What can be said about the child?

The child has developed reactive attachment disorder (RAD).

A worried mother reports that her teenage child wears unusual clothes and makeup and refuses to wear the clothes the mother buys. What does the nurse suspect as the cause for this behavior?

The child is displaying group identity in order to develop a personal identity.

Which behavior of a 3-year-old child indicates delayed development? Select all that apply.

The child is unable to feed himself. The child is unable to climb the stairs.

The nurse is assessing an 8-month-old child's gross motor development. Which action by the child indicates late development?

The child is unable to stand by holding onto furniture.

While assessing the moral development of a child according to Kohlberg's theory, the nurse determines that the child is at the preconventional level of moral development. Which behavior led the nurse to this conclusion?

The child is very obedient and tries to avoid punishment from parents and teachers.

When assessing the cognitive development of a 2-year-old-child, the nurse finds that the toddler exhibits global organization. Which behavior of the child supports the nurse's conclusion?

The child refuses to sleep in his or her room because the location of the bed has changed.

After assessing a 1-year-old child, the nurse concludes that the child has normal development. Which finding supports the nurse's conclusion?

The child's toes hyperextend when the nurse strokes the heel upward across the foot.

The nurse is assessing a female preterm neonate after delivery. Which assessment findings does the nurse document in the hospital reports of the infant? Select all that apply.

The infant has a prominent clitoris. The hair of the infant is fine and feathery. The infant shows no resistance to the heel-to-ear maneuver.

The nurse observes an infant using his thumb and index finger to hold an object. What does the nurse infer from this?

The infant is showing crude pincer grasp reflex.

After assessing a 4-day-old newborn, the nurse anticipates that the newborn has impaired vision. Which finding supports the nurse's conclusion?

The newborn has no corneal reflex after a light touch.

The nurse is providing dental hygiene to a toddler. Which action does the nurse perform to clean the toddler's back teeth?

The nurse tells the toddler to "roar like a lion."

A child has been diagnosed with hemophilia type A after experiencing excessive bleeding from a minor trauma. The mother states that the toddler being seen for the trauma is very active and is difficult, constantly saying no. An appropriate response would be:

Toddlers are curious, trying to make decisions and be independent.

The site of choice for administration of an intramuscular (IM) medication to an infant is:

Vastus lateralis

Which assessment findings of a child would indicate a need for genetic consultation? Select all that apply.

Visual or hearing problems Family history of mental illness Development and speech delays Excessive bleeding or excessive clotting

During a follow-up visit, the nurse observes that a toddler still has improper bone development, even after proper nutritional counseling to the mother. Which foods, when omitted, are responsible for this condition in the infant? Select all that apply.

Waffles Orange juice

Which symptoms present in a child indicate Turner syndrome? Select all that apply.

Webbed neck Low position of posterior hairline Shield-shaped chest with wide space between the nipples