PEDS- Chapter 5- "the point review"

The nurse is providing teaching about preventing poisoning. Which of the following statements by the mother would warrant further discussion?

"All medicine in our bathroom is in childproof containers." *The nurse should emphasize that while childproof caps on medications are important, all medications including those with childproof caps should still be kept locked. (Vitamins are medications.)

The nurse is conducting a well-child exam of a 4-year-old boy. Which of the following statements would alert the nurse that the child is at risk for iron deficiency?

"He loves milk and drinks it every time he is thirsty." *This is likely to result in a very high intake of milk. Excess milk drinking may lead to iron deficiency since the calcium in milk blocks iron absorption. The nurse needs to emphasize this fact and suggest an appropriate daily milk intake.

The father of a 4r-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 of the following statements by the father would indicate a need for further teaching?

"I will need to find an appropriate punishment for him if this continues." *The nurse should remind the father that overreaction to this behavior may cause it to occur more frequently. Masturbation at this age should be treated matter-of-factly

The nurse is doing a well-child exam of a 5r-year-old girl. Which of the statements by the mother would alert the nurse that further teaching is needed about healthy eating habits?

"Our family rule is that all children clean up their plates at each meal."

Parents find responding to their preschooler's questions about sexuality uncomfortable. Sequence the points the nurse will discuss.

-Find out what the child is really asking -Determine what the child already knows -Give only the information requested -Avoid long answers; use correct terms -Address additional question as they arise

The nurse is providing teaching about car seat safety for a parents' meeting at the preschool their children attend. Choose the points the nurse should make. Select all that apply.

-Children who weigh less than 40 pounds should use a car seat with harness and top tether. -The back seat remains the safest place for children to ride. -Many car seats are installed improperly, making them unsafe. -Booster seats should be used with both a shoulder and lap belt.

The nurse realizes that the 5-year-old's growth chart and BMI indicate the child is at risk for obesity. What other findings reinforce this risk? Select all that apply.

-Food used as reward or punishment -Television on during meals -Expectations to eat everything on plate -Faher who is overweight

Johnny exhibits the following growth pattern. How should the nurse interpret or manage this data? Select all that apply. 3 yrs: Ht. 37 inches Wt. 32 pounds 4 yrs: Ht. 39 inches Wt. 39 pounds 5 yrs: Ht. 40 inches Wt. 46 pounds

-Johny is growing slowly in height but rapidly in weight -Height and weight should be plottes on a growth chart -may be at risk for overweight or obesity

A mother describes her 4-year-old girl's eating habits as "picky" and goes on to describe using wheedling, coaxing, and threatening measures to get her to eat. The nurse determines the child is growing normally. What interventions will be suggested? Select all that apply.

-Offer only nutritious between-meal snacks. -Allow the child to decide how much she will eat. -Focus on quality, not quantity. -Offer a variety of healthy foods including those liked and refused. -Ignore the pickiness. -Approach mealtime matter-of-factly.

Place the steps for using time-out as a disciplinary measure for a 4-year-old in proper order.

-Parent knows the misbehavior was intentional -Warn the child there will be a time out if the behavior does not stop -Remove the preschooler to a boring spot -Set a timer for no more than 4 minutes -If the child gets up , replace the child and restart the time *Time-out is an extinction method of discipline that avoids reinforcing the unacceptable behavior with attention. One minute per year of age is the appropriate length of a time-out. Five minutes is the recommended maximum length.

Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of the following? Select all that apply.

-When discussing improper behavior, call the behavior "bad" or "naughty," not the child. -Books and stories can help preschoolers master proper behavior. -Anticipate situations likely to cause misbehavior and redirect the child to another activity.

The nurse teaches parents of young children to prevent burns by setting water heater temperature at __________________ or less.

120F

Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue?

Allowing the preschooler to fall asleep wherever and whenever the child is tired enough *Consistent bedtimes and places for sleep promote good sleep habits.

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 *Many preschoolers stutter as thinking races ahead of their ability to articulate ideas. Most of this stuttering, when not made an issue, will resolve on its own. Calling attention to the dysfluency often exacerbates it.

The nurse is organizing an indoor play area for preschoolers. What play materials are least important?

Electronic teaching toys *These are expensive and usually cannot be used in multiple ways or shared with a group of children

In assessing the bilingual 4-year-old's speech and language development, the nurse should find that the child will:

Be able to use each language as a separate system. *The ability to use both languages separately is developed by 4 years. Mixing the two languages occurred during toddlerhood

Parents of a 3r-year-old indicate they spend time with grandparents who live near a lake. The nurse will emphasize:

Having the child wear a personal flotation device whenever near or on the water

Parents tell the nurse their 3r-year-old refuses to eat meat but are pleased she drinks "lots of milk." What risk does the nurse identify?

Iron deficiency *Meat is an important iron source while calcium in milk consumed in large quantities can block iron absorption.

The nurse is providing teaching about good nondairy sources of calcium for preschoolers. Which of the following is the highest calcium-containing fruit?

Orange

A 3r-year-old shouts, "Look out for Boo-ga-loo!" as the nurse enters the exam room. The father explains Boo-ga-loo is his daughter's imaginary friend. How should the nurse respond?

Tell me about Boo-ga-loo." *The imaginary friend serves as a companion and playmate for the preschooler. The child knows this friend is not real, yet is very invested in the imaginary playmate who can be and do anything the child's fantasy life can invent. The nurse should acknowledge this friend, not minimize the friend's importance. "Tell me..." does this

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?

Tell me about your child's exposure to tobacco smoke.

n counseling a group of parents regarding the development of school readiness in preschoolers, the nurse emphasizes:

The home environment *The home environment is the foundation for the child's learning and is the most important element for developing school readiness. Values regarding learning originate at home. Parents are the first teachers and role models. Structure, proper behavior with others, and language skills are all developed at home and are essential for school success

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 the girl is demonstrating which of the following?

Transduction *The nurse identifies transduction. Because the 4-year-old recently received an injection from a nurse in a flowered uniform, the girl believes that all nurses who wear flowered uniforms give shots. Transduction is reasoning by viewing one situation as the basis for another situation even though the two may or may not be causally linked.

The parents of a 5-year-old call the nurse for advice about night terrors. The child has had them nightly for almost 2 weeks. Which of the following is the most appropriate intervention?

Wake the child up nightly 30 to 45 minutes after going to sleep. *Awakening children early in their sleep cycle often interrupts the night terror events and should be continued nightly for about 7 day

The mother and father of a 5-year-old boy are discussing bicycle safety with the nurse. What comment indicates further teaching is needed?

We just got him a new bike he can grow into." *The bicycle should fit the rider. The balls of his feet should reach both pedals while he is sitting on the seat and has both hands on the handlebars.