Peds Final Exam

1m 3s A parent is comparing a child's development on the growth chart with those of another child and is concerned that her child is not in the "normal" range. What can the nurse inform the parent to alleviate her anxiety?

"Growth charts are just a standard measurement. If your child doesn't fall into the 'normal' range, it doesn't indicate something is wrong." Explanation: A growth chart is used for comparison only; if a child does not fall into the "normal" range, it does not necessarily indicate that there is something of concern for that child.

14s A nurse is teaching the parents of an infant about oral care. Which of the following would the nurse include as being important for tooth protection and growth? Fluoride Iron Magnesium Potassium

Fluoride Explanation: Fluoride is important for teeth growth and protection. Fluoride is naturally available in most drinking water. If the water source does not contain fluoride than supplements can be given as prescribed by a doctor at 6 months of age. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 510. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 510 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 31

11s The mother of a 6-month-old infant asks the nurse at a community health center what she should do about her baby, who always wants to put everything in his mouth. What would be an appropriate response by the nurse, based on Freud's theory?? "There must be something wrong...your baby should not be doing that." "I don't know if that is normal or not, but I will check on it." "Babies at this age explore and enjoy their world with their mouths." "This usually does not happen until babies are 2 years old."

"Babies at this age explore and enjoy their world with their mouths." Explanation: According to Freud, infants ages 0 to 18 months use their mouths as the major source of gratification and exploration. Pleasure is experienced from eating, biting, chewing, and sucking. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 496. Chapter 22: Principles of Growth and Development - Page 496 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 13

29s The mother of an infant is confused after being told by her dentist not to let her baby go to bed with a bottle of milk. She does not agree with that suggestion. Which response should the nurse prioritize when addressing this situation with the mother? "Giving a bottle of milk when the infant goes to bed can lead to obesity." "Bottles given at bedtime can cause erosion of the enamel on the teeth." "Giving your baby a pacifier at bedtime will satisfy the need to suck." "You could occasionally give your baby a bottle of water at bedtime."

"Bottles given at bedtime can cause erosion of the enamel on the teeth." Explanation: The sugar from formula or sweetened juice coats the infant's teeth for long periods and causes erosion of the enamel on the deciduous teeth. While giving water in a bottle at bedtime is acceptable and a pacifier will satisfy the sucking need, the most appropriate response is to warn of possible enamel erosion. Giving a bottle at bedtime is not a factor that leads to obesity.

9s The mother of several children is amazed that the youngest male child achieved toilet training much earlier than the other children. What should the nurse explain as the reason for this early development?? "He has exceptional intelligence." "He learned by watching your other children." "He needs testing because he is developing too quickly." "He most likely will wet the bed for many years to come."

"He learned by watching your other children." Explanation: Children learn by watching other children so a youngest child who has many examples to watch may excel in skills such as toilet training. The child did not become toilet trained early because of exceptional intelligence. The child is not developing too quickly. There is no way for the nurse to know if the child will wet the bed. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 500. Chapter 22: Principles of Growth and Development - Page 500 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 15

22s The nurse is assessing a 1-year-old at the well-child annual visit and notes the child is meeting the growth parameters. After noting the birth weight was 8 pounds (3.6 kg) and length was 20 inches (50.8 cm) long, which measurements would the nurse prepare to document for this visit?? 16 pounds (7.2 kg) and grown 26 inches (65 cm) 20 pounds (9.1 kg) and 28 inches (70 cm) 24 pounds (10.8 kg) and 30 inches (75 cm) 28 pounds (12.7 kg) and 32 inches (80 cm)

24 pounds (10.8 kg) and 30 inches (75 cm) Explanation: By 1 year of age, the infant should have tripled his or her birth weight and grown 10 to 12 inches (25 to 30 cm). If this infant was 8 pounds (3.6 kg) at birth, at 1 year, this child should weigh 24 pounds (8 x 3 = 24) and grown to 30 to 32 inches (20 + 10 to 12 = 30 to 32 inches). Most of the growing occurs during the first 6 months with the infant's birth weight doubling and height increasing about 6 inches (15 cm). Growth slows slightly during the second 6 months but is still rapid. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 509. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 509 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 23

11s It is nap time and the caregiver of a 2-year-old says to her child, "I will help you put all of your stuffed animals in a row next to your bed just like we do every day." This statement is an example of: ritualism. dawdling. negativism. discipline.

ritualism. Explanation: Ritualism employed by the young child to help develop security involves following routines that make rituals of even simple tasks. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 529. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 529 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 40

1m 16s The nurse is preparing to assess a 2-year-old at a well-child visit and notes the child was 22 lbs (9.98 kg) and 24 in (60.96 cm) tall at 1 year old. The nurse determines the child is following a normal pattern of growth after obtaining which set of current measurements?

30 lbs (13.60 kg) and 27 in (68.58 cm) tall Explanation: Toddlerhood is a time of slowed growth and rapid development. Each year a toddler gains 5 to 10 lbs (2.26 to 4.53 kg) and about 3 in (7.62 cm). A child weighing 22 lbs (9.98 kg) at age 1 year would be expected to now weigh 27 to 32 lbs (12.24 to 14.41 kg). A height of 24 in at age 1 year (60.96 cm) should now be approximately 27 in (68.58 cm). Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 528. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 528 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 47

34s The daughter of a divorced couple is hospitalized for injuries received in an automobile accident. The custodial father is at work when the mother arrives extremely agitated and demanding to see her daughter immediately. Which action will be most appropriate for the nurse to take at this time? ? Tell the mother what room the child is in Check to see who is allowed to have contact with the child Ask the child if she would like to see her mother Ask the mother if she is allowed to see the child

Check to see who is allowed to have contact with the child Explanation: The instructions from the custodial parent or courts should be honored. The nurse should check to find out if the mother is allowed access to the child. Asking the child may cause problems with one or both parents and could inflict fear or guilt on the child. In addition, even when a parent has been hurtful to a child, the child will often desire to have contact with that parent. Asking the mother if she has access to the child is unlikely to produce a truthful answer if that answer is "no". Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22, Principles of Growth and Development, p. 493-494. Chapter 22: Principles of Growth and Development - Page 493-494 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 3

7s Which measure would you suggest an infant's parents use to relieve teething discomfort? Provide her with a fluid diet for 2 days. Offer her Aspergum to chew. Ask her pediatrician for a sedative for her. Give her a cold teething ring to chew.

Give her a cold teething ring to chew. Explanation: Cold can be very soothing for the tender gumlines during teething. A sedative is not necessary for normal teething discomfort. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 510. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 510 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 29

4s A child gains weight and becomes taller each year. What is this process called?? Development Orderly change Progression Growth

Growth Explanation: Growth is an increase in body side or change in body cell structure, function, and complexity. Development is an orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 488. Chapter 22: Principles of Growth and Development - Page 488 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 14

21s The nursing instructor is leading a discussion on the theories of Sigmund Freud with a group of nursing students. The instructor determines the session is successful when the students correctly choose which example as indicating a child is in the anal stage of development?? Finds satisfaction through making noises and crying Recognizes the physical differences between boys and girls Has a desire to mold and control the environment Beginning to develop a sense of moral responsibility

Has a desire to mold and control the environment Explanation: During the anal stage, according to Freud, elimination is one of the child's first experiences of creativity. It represents the beginnings of the desire to mold and control the environment. Finding satisfaction through making noies and crying occurs in the oral stage, in which satisfaction comes through the mouth. Recognizing the physical differences between boys and girls is in the phallic stage, where the child's interest moves to the genital area as a source of pride and curiosity. Beginning to develop a sense of moral responsibility occurs during the latency stage, when the child's sense of moral responsibility (the superego) develops, based on what has been taught through the parents' words and actions. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 496. Chapter 22: Principles of Growth and Development - Page 496 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 8

8s The nurse is preparing to assess a toddler during a routine health maintenance visit. Which assessment will the nurse perform to determine the child's growth milestone? Blood pressure Urine specimen Hemoglobin level Height and weight

Height and weight Explanation: Growth milestones are assessed at every health maintenance visit and are determined by measuring height and weight. Blood pressure does not assess a growth milestone. A urine specimen would be done at specific times. A hemoglobin level would be determined during specific times. Urine specimens and hemoglobin levels do not measure growth milestones. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 528. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 528 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 35

27s The nursing instructor is conducting a class on the development of an infant. The instructor determines the class is successful when the students correctly illustrate which as the proximodistal development in an infant? ? Kick and to wave the arms, then learns to grasp the foot and pull it to the mouth Roll over, then learns to follow an object with the eyes Walk for several steps, then learns to run Imitate speech-like sounds, then learns to speak a language

Kick and to wave the arms, then learns to grasp the foot and pull it to the mouth Explanation: Proximodistal growth starts in the center of the body and progresses toward the periphery; learning progresses from the simple to the complex. Kicking and waving require only gross motor skills originating close to the trunk that move entire limbs, whereas grasping the foot and guiding it to the mouth each require fine control of the extremities. The other examples show other normal growth and development, but not the progression from proximal/gross to distal/fine movements.

9s A child is refusing to use the potty and is having accidents, even though he has achieved toilet training. This is an example of which type of behavior?

Regression Explanation: Regression is a change from present behaviors to past developmental levels of behavior. Positive redirection is verbally guiding the child toward the accepted behavior. Desensitization occurs when a fear is conquered by approaching it little by little. If the fear becomes a phobia, then the health care team must be consulted. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 531. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 531 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 39

15s The parents are trying to promote toddler independence by allowing the child to dress himself. Which types of clothing would be appropriate to suggest? Select all that apply.

Shirts with large neck openings Shoes with Velcro closures Explanation: Clothes should be easy for the child to put on (e.g., shirts with large neck openings and pants made of stretchy fabrics). Velcro closures on shoes and clothes are easier for the young child than buttons, zippers, snaps, and shoelaces. Items that close in the back should be avoided. Also avoid clothes with drawstrings because drawstrings can getcaught on furniture or playground equipment and can lead to strangulation. When drawstrings are present in pants, jackets, and hoods, they should be cut out. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 533. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 533 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 49

9s The mother of a toddler observes the child play next to another child but not with the child. What should the nurse explain to the mother about this type of play behavior?

This is parallel play and is expected. Explanation: All during the toddler period, children play beside children next to them, not with them. This side-by-side play called parallel play is not unfriendly but is a normal developmental sequence that occurs during the toddler period. This is not peer, adjacent, or premature play. This behavior is not abnormal, does not need to be stopped, and is not seen in school-age children. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 530. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 530 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 37

26s The mother of a 3-year-old girl is asking for suggestions for feeding a child who constantly complains there is not enough food on her plate while still not eating the foods provided to her. Which suggestion should the nurse prioritize for this mother?? Use a smaller plate with the same portions of food. Use a larger plate with the same portions of food. Scold the child for her poor behavior. Promise the child more food after she eats what she has.

Use a smaller plate with the same portions of food. Explanation: The same portion of food on a smaller plate will cover more of the surface area of the plate and will thus look to her like more food. By contrast, putting the same portion on a larger plate will make the portion look even smaller. Because she cannot yet see things from another's point of view, your feelings about giving her more will not be important to her. Because her sense of time is not developed yet, a promise of more later is likely to be meaningless to her. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 499. Chapter 22: Principles of Growth and Development - Page 499 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 5

32s A nurse at a pediatric clinic is assessing a young client at a well-child visit. After the assessment, the nurse determines the child is in Erikson's autonomy stage based on which finding?? Learning to trust that needs are met when they cry Will perform tasks by themselves, even when it takes a long time They want to know the rules and enjoy being good and getting approval. Will interact with others and like to compete

Will perform tasks by themselves, even when it takes a long time Explanation: Autonomy occurs when the child feels in control and learns to perform tasks independently. Getting their needs met when crying describes trust that is developed in the infant. The preschool-aged child wants to know the rules; he or she enjoys being good and getting approval when developing initiative. Interacting and competing with others occurs with the development of industry seen in the school-aged child. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, pp. 497-498. Chapter 22: Principles of Growth and Development - Page 497-498 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 9

15s The developmental task of the toddler period, according to Erikson, is achieving a sense of:

autonomy. Explanation: Achieving a sense of independence or autonomy is the toddler developmental task. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 528. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 528 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 43

24s When childproofing the home for a toddler, the most important thing her parents should consider is to: lock downstairs windows. teach the child not to tease dogs. put medicine in a locked cupboard. keep the child in a playpen while the parents cook.

put medicine in a locked cupboard. Explanation: Poisoning is at peak incidence during the toddler period. Special precautions need to be taken against poisoning at this time. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 538. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 538 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 42

19s The nurse is preparing a presentation for a health fair illustrating the major milestones of infants as they grow and develop. Which fact should the nurse point out when illustrating an infant's teeth?? The first tooth usually erupts between 6 to 8 months. The upper incisors are most often the first teeth to erupt. Fluoride should not be used on a child's teeth before 4 or 5 years of age. Swollen or inflamed gums during teething indicate a serious concern.

The first tooth usually erupts between 6 to 8 months. Explanation: The first deciduous teeth, usually the lower central incisors, erupt between 6 to 8 months of age. Swollen or inflamed gums during teething is common. A cold teething ring can help soothe the baby's discomfort. The American Dental Association recommends administration of fluoride to infants and children in areas where the fluoride content of drinking water is inadequate or absent. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 510. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 510 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 24

13s The nurse observes a toddler riding a tricycle and decides that the parents need additional safety education. What did the nurse observe?

Toddler not wearing a helmet Explanation: Toddlers need to wear a helmet as soon as they begin riding a tricycle. Parents are not as conscientious about using helmets as they are for bicycle riding so this is an area where health teaching is necessary. Wearing a helmet would be expected, and the nurse would not need to provide additional safety education for the parents. Long pants and tennis shoes do not pose a safety issue. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 537. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 537 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 36

37s The nurse is completing the growth chart of a 2-month-old infant at the well-child visit. When asked by the mother what purpose this chart serves, which response would be most appropriate by the nurse?? These charts give us a good indication of the child's nutritional status. By plotting height and weight, we get an indication of what the adult measurements will be. Comparing your child with others of the same age and sex gives us statistics about height and weight. We are comparing the child's current measurements with the child's previous measurements.

We are comparing the child's current measurements with the child's previous measurements. Explanation: A growth chart is used for comparison only and is used to plot and monitor a child's growth through the years. Although a weight loss or failure to gain weight might indicate a nutritional issue, this is not the way growth charts are used. Growth charts do not indicate adult measurements. Statistics may be gathered from growth charts but that is not the primary reason they are used. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 489. Chapter 22: Principles of Growth and Development - Page 489 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 12

20s Which statement by a parent would best prepare the toddler for the parent's return if the parent must leave the hospital? "I will be back in the morning. Mommy loves you." "I will be back after you eat your dinner and SpongeBob goes off." "I will be back later this afternoon." "I will come back when it is time for your bath tonight."

"I will be back after you eat your dinner and SpongeBob goes off." Explanation: Toddlers have no real concept of time and equate time to events in their lives. So, the best way for the mother to tell the child when she will be back at the hospital is to relate her arrival to events such as the child's dinner and TV programs the child likes. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 539. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 539 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 46

11s A nurse is teaching the parents of a toddler how to handle the child's temper tantrums. The nurse determines that the teaching was successful when the parents state that an appropriate response to the tantrum would be: "If you stop screaming, you can have a cookie." "I can kick as hard as you do." "I'll give you a hug if you stop right away." "I'll be in the kitchen. When you're done, you can come in, too.

"I'll be in the kitchen. When you're done, you can come in, too. Explanation: The best response is to tell a child simply that the parent disapproves of the tantrum and then ignore it. Telling the child that the parent will be in the kitchen and that he or she can come in when the child is done is such an example. Bribery, such as saying that the child can have a cookie or a hug if the behavior stops, is rarely effective because by accepting the child's wishes, the parent is encouraging the child to have more tantrums because he or she was successful. Telling the child that the parent can kick as hard as the child can reinforces how the child is responding. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 530. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 530 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 41

19s The mother of an 8-month-old infant appears frustrated and shares with the nurse she can't leave the room without her baby crying. Which is the best response from the nurse to help this mother? "He knows you are in the next room and he is attempting to get your attention." "By ignoring his crying you will help him develop patience." "It is important for him to be with you, so you should take him with you." "If he cannot see you he thinks you are gone and that is frightening."

"If he cannot see you he thinks you are gone and that is frightening." Explanation: An infant cannot apply abstract reasoning but understands only through the five senses. As the infant matures enough to recognize the mother or primary caregiver, the infant becomes fearful when this person disappears. To the infant, out of sight means out of existence, and the infant cannot tolerate this. For the infant, self-assurance is necessary to confirm that objects and people do not cease to exist when out of sight. As the infant grows and develops, they will grow out of this stage. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 514. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 514 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 25

12s When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? "Let me go over car seat safety with you, so you can install your car seat properly." "You should never put the car seat in the front." "I see you have a car seat, that is great." "With the car seat in front, you can keep an eye on your baby."

"Let me go over car seat safety with you, so you can install your car seat properly." Explanation: The nurse should notice this is not the proper place for a car seat. The car seat should be rear facing and in the center of the back seat of the car. The nurse would review car seat safety with the mother and have her install the seat properly. The nurse should provide written materials if available. The other responses are not appropriate and do not ensure that proper installation will occur and that infant safety will be maintained. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 522. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 522 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 32

23s The nurse is assessing growth and development in a 24-week-old infant. The mother is concerned that her baby is too fat. The infant currently weighs 14.5 lb (6.59 kg) and weighed 7 lb (3.18 kg) at birth. An appropriate response to the mother would be:

"Normally infants double their birth weight by 6 months of age. It looks like your infant is growing well at this point." Explanation: Infants should double their birth weight by 6 months. Reducing calories for an infant is inappropriate. Telling the mother that the baby should be fat misses an opportunity to educate her about normal infant growth and development. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 509. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 509 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 30

23s A mother calls the pediatrician's office upset because her toddler has begun acting out now that the new baby is home. He wants to have a bottle like the newborn and has begun to have accidents in his pants. Which statement by the nurse would best address this problem? "Often, the first child is jealous of the new baby. Just ignore his acting out and he will stop." "You need to scold him for wetting his pants and have him change his underwear himself." "Offer to let him drink some formula in a cup. He will see that being a baby is not so much fun. " "Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special."

"Set aside time to spend one-on-one with your older child and make him understand that he is still loved and very special." Explanation: When parents have a second child, the firstborn is often jealous and feels pushed aside by the new baby. Parents need to make time for the first child and set aside one-on-one time with them, showing them that they are still loved and that there is enough time and love for both children. Ignoring the jealous behavior will not help the situation, not will scolding him for his accidents. Regression is a commonly seen with the arrival of a new baby. Offering him formula in a cup does not address the underlying problem of jealousy and feeling neglected. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, pp. 531-532. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 531-532 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 38

33s The mother of a 15-month-old son is returning to work and wants to place her son in the day care close to work; however, they will only accept potty-trained children. Which response from the nurse will best address this situation in answering the mother's questions of how best to potty train her son?

"Wait a few more months until your son has more muscle control and shows signs that he's ready to be potty trained." Explanation: To be able to cooperate in toilet training, the child's anal and urethral sphincter muscles must have developed to the stage where the child can control them. Control of the anal sphincter usually develops first. The child also must be able to postpone the urge to defecate or urinate until reaching the toilet or potty and must be able to signal the need before the event. In addition, before toilet training can occur, the child must have a desire to please the caregiver by holding feces and urine rather than satisfying his/her own immediate need for gratification. This level of maturation seldom takes place before the age of 18 to 24 months. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 535. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 535 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 48

19s The nurse enters her client's room and finds the infant on a pillow with a bottle propped up while the mother is dressing. What statement should the nurse make? "Look how cute she is." "Are you almost ready to be discharged?" "You should always hold your baby for feedings instead of propping the bottles." "Is she almost done feeding?"

"You should always hold your baby for feedings instead of propping the bottles." Explanation: The nurse should educate the mother on the risks of propping bottles with infants. Infants are at risk for aspiration of milk and for otitis media. The other choices do not point out the safety risks or educate the mother. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 522. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 522 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 28

7s A mother takes her 4-month-old to the doctor for a visit. She asks the nurse what type of baby cereal she should buy now that her child is starting solid foods. How should the nurse respond?

"You should buy rice cereal." Explanation: The rice cereal should be first. The infant should be monitored for food allergies by following the rice cereal with oats, barley, and wheat. Wheat has the highest allergy reaction in infants. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, Table 23-3, p. 516. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 516 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 33

9s Every time a toddler's mother asks her a question, the response is "No!" regardless of what the mother asks the child. What would the nurse recommend to the mother to help alleviate this behavior? Don't ask the child any questions and just tell her what to do each day. Allow the child choices when asking questions such as "Do you want to wear the red or the blue top?" Ask the child to please quit saying no to everything asked of her. Respond negatively back to the child each tine the child responds to the parent in a negative fashion.

Allow the child choices when asking questions such as "Do you want to wear the red or the blue top?" Explanation: Negativism is commonly seen in toddlers and is an expression of independence, not defiance. The best way to reduce the number of negative responses is to ask fewer questions and be sure that any question asked allows the toddler a choice of behavior or response. Berating the child or telling the toddler what to do all the time will only make matters worse. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 529. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 529 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 44

17s The mother of an 8-year-old is concerned her child is developing too slowly when compared to a cousin. Which activities, based on Piaget's theories, would the nurse predict this child should be active in?? Can classify and organize information about their environment Has developed an understanding of cause and effect Can understand abstract concepts described only in words or symbols Has no concept of quantity; if it looks like more, it is more

Can classify and organize information about their environment Explanation: According to Piaget, the concrete operations phase should occur at the ages of 7 to 11 years. The child develops the ability to begin problem solving in a concrete, systematic way during this stage. Demonstrating an understanding of cause and effect occurs at the ages of 0 to 2 years and occurs in the sensorimotor phase, Between the ages of 12 to 15 years, the formal operations phase occurs and involves understanding abstract concepts which are described only in words or symbols. The preoperational phase is noted at ages 2 to 7 years and this child has no concept of quantity; if it looks like more, it is more. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 499. Chapter 22: Principles of Growth and Development - Page 499 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 11

8s The nursing student is preparing a presentation which will illustrate the various stages of growth and development starting with a newborn. Which example should the student point out will best illustrate cephalocaudal growth pattern?

Controlling the head and neck before being able to control the arms and legs Explanation: Cephalocaudal development starts with the head and moves downward. The child is able to control the head and neck before being able to control the arms and legs. Grasping the foot and pulling it to the mouth and using the fingers to pick up objects shows development of fine motor skills, but not cephalocaudal development. Walking and running show development of gross motor skills. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 489. Chapter 22: Principles of Growth and Development - Page 489 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 7

22s Many researchers have theories relating to the stages of growth and development. Which stage of accepted theories relates to the preschool-aged child from ages 4 to 6 years? Select all that apply.. Freud's phallic stage Erikson's stage of initiative vs. guilt Piaget's preoperational phase Kohlberg's re-conventional level stage 2 Freud's oral stage Formal operational phase

Freud's phallic stage Erikson's stage of initiative vs. guilt Piaget's preoperational phase Kohlberg's re-conventional level stage 2 Explanation: The child who is 4 to 6 years of age is in the phallic stage according to Freud, the stage of initiative versus guilt according to Erikson, the preoperational phase according to Piaget, and the pre-conventional level according to Kohlberg. The infant is in the oral stage, according to Freud. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, Table 22-1, p. 496. Chapter 22: Principles of Growth and Development - Page 496 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 20

23s The nursing instructor is preparing a class discussion covering the theories of Erikson and the growth and development of infants and children. Which example would best illustrate the phase referred to as initiative by Erikson?? Learning to trust when needs are met after crying Performing a task by oneself, even if it takes a long time Knowing the rules, enjoys being good, being independent, and receiving approval Interacting and competing with others

Knowing the rules, enjoys being good, being independent, and receiving approval Explanation: The development of initiative is noted in the preschool-age child as they develop a conscience and accepts punishment for doing wrong. This child wants to know the rules and enjoys being good and independent and likes getting approval from the adults in their life. The infant learns that crying will get their needs met which describes trust that is developed. The toddler who performs tasks by themselves even when it takes a long time begins in the autonomy stage. This occurs when the child feels in control and learns to perform tasks independently. The child interacting and competing with others describes industry seen in the school age child. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, pp. 497-498. Chapter 22: Principles of Growth and Development - Page 497-498 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 10

15s A 2-year-old child is hospitalized for a surgical procedure. Although previously all fluids were taken from a cup, the toddler wants a bottle to suck on. The nurse recognizes this behavior as what?? Totally unacceptable Proof that the child is sick Normal regression Abnormal behavior

Normal regression Explanation: Based on the principles and theories of growth and development, the nurse recognizes possible regression during difficult periods or times of crisis, accepting and supporting a return to a forward progression in development. It is acceptable, normal behavior for the hospitalized toddler. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 504. Chapter 22: Principles of Growth and Development - Page 504 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 16

33s A 2-year-old child is shopping with her mother when she suddenly falls to the ground and begins to scream, "I want it!" over and over regarding a bag of candy. What would the nurse recommend to the mother to deal with this behavior? Select all that apply. Reason with the toddler and explain that the candy is not nutritious for her. Remain calm and ignore the tantrum. Do not reward the behavior by giving into the toddler's demands and buying the candy. Pick the toddler up and take her to the restroom for a spanking. Pick the toddler up and move her to a safe environment but do not give in to her desires.

Remain calm and ignore the tantrum. Do not reward the behavior by giving into the toddler's demands and buying the candy. Pick the toddler up and move her to a safe environment but do not give in to her desires. Explanation: Temper tantrums in toddlers are very common as they try to control their environment and the caregiver's environment. They become frustrated at their inability to do so or to verbalize their desires. If a toddler has a temper tantrum, the best thing for the parent to do is ignore them and protect them from harm. Parents cannot reason with a toddler—they lack the ability to understand or the desire to change their behavior. Never give in to their demands; they will only learn that if you scream loud enough, they get their way. However, spanking is not recommended. The child has just lost control and needs time to regain self-control. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 24: Growth and Development of the Toddler: 1 to 3 Years, p. 530. Chapter 24: Growth and Development of the Toddler: 1 to 3 Years - Page 530 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 45

20s The school nurse is aware that providing proper care involves cooperation from the adolescent. Which techique will the nurse prioritize to develop open communication with the adolescents?

Show interest in the adolescent and develop a rapport before asking questions. Explanation: Adolescents respond positively to individuals who show an interest in them and make an effort to connect with them. Focus the interview on the adolescent rather than the problem. Sharing about friends, hobbies, and activities is a way to connect with the adolescent. Parents may need to be interviewed as well, but the adolescent is the first and primary focus. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 503. Chapter 22: Principles of Growth and Development - Page 503 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 50

17s According to Freud, what is the name given to the part of the mind that represents one's conscience?

Superego Explanation: According to Freud, the superego is the part of the mind that represents one's conscience and develops from the ego, during the first year of life. It represents the internalization of rules and values so that socially acceptable behavior is practiced. The unconscious mind contains memories, motives, fantasies, and fears that directly affect behavior. The id is concerned with self-gratification. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 496. Chapter 22: Principles of Growth and Development - Page 496 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 21

29s The nursing instructor is explaining the various aspects of growth and development to a group of nursing students. The instructor determines the session is successful when the students point out which example best illustrates the concept of development? ? The 5-month-old whose head circumference and chest measurement are the same The 3-year-old who has been toilet trained for 6 months The 5-year-old who is 2 inches taller than she was 4 months ago The 10-year-old who weighs the same amount as his 8-year-old brother

The 3-year-old who has been toilet trained for 6 months Explanation: Development is the progressive change in the child toward maturity. Toilet training in the child shows evidence the child is moving toward maturity. The other choices have to do with physical increase in the body's size and appearance, which relates to the concept of growth. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 489. Chapter 22: Principles of Growth and Development - Page 489 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 6

31s The parents of a 6-year-old boy express frustration and worry that he doesn't seem to be developing a sense of responsibility. For example, he recently drew on the walls of his room and was told he had to clean the walls by dinnertime. Although he agreed and was shown how to do it and was provided cleaning materials, he had not even started when the deadline arrived. What aspect of child development should the nurse prioritize to explain to the parents how best to handle similar situations?

The boy has not yet developed a sense of time Explanation: At 6, this boy is old enough to perform tasks independently and to want to be good and please his parents. Morally, he is becoming aware of the feelings of others and likely wants to live up to his parents' expectations. He accepted the punishment and was willing to perform it. However, his concept of time may not be very well developed yet, so a deadline is unlikely to be meaningful to him. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed. ., Philadelphia: Wolters Kluwer, 2018, Chapter 22, Principles of Growth and Development, p. 498. Chapter 22: Principles of Growth and Development - Page 498 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 4

26s A breast-feeding mother asks the nurse about when she can begin feeding her 5-month-old infant some solids and vitamins. Which information provided by the nurse would most accurately address this mother's concerns?? You can begin feeding the infant fruits and vegetables now followed by iron-enriched cereal to ensure that he gets enough iron. The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron. If you give him one or two bottles of juice each day, he should get all the vitamins he needs. You can begin fruits and cereal in 1 month. At 6 months, you need to quit breast-feeding because he is not getting enough iron or Vitamin C and D and that should help him transition to solids better.

The first food offered to an infant is iron-enriched rice cereal and can be started now. Additionally, the infant needs to receive Vitamin D and iron. Explanation: Breast-feeding is the best method for feeding infants, according The Academy of Pediatrics Committee on Nutrition. However, by 4 to 6 months of age, breast-fed infants need supplements of iron and vitamin D. Solids are introduced at the same age and begins with iron-fortified rice cereal. The infant may also have diluted fruit juice in small portions. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 515. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 515 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 22

27s The nurse is meeting with a group of older siblings of infants to discuss various aspects of infant care. Which instruction should the nurse prioritize with this group? The infant should be dressed more warmly than older children and caregivers. The infant should wear hard-soled shoes in order to protect their feet from injury. The infant sleeps 10 to 12 hours at night and can take two to three naps during the day. The infant should be sound asleep before being put into the crib for sleeping.

The infant sleeps 10 to 12 hours at night and can take two to three naps during the day. Explanation: Most infants sleep 10 to 12 hours at night and take two to three naps during the day. By being put to bed while awake and allowed to fall asleep, the infant learns good sleeping habits. The infant should be dressed in the same amount of clothing the adult finds comfortable. Hard-soled shoes are not needed by infants and may hamper the development of the foot. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 521. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 521 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 27

10s The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life? Trust Feel anger Love Fear

Trust Explanation: Erikson identifies various developmental stages which all children accomplish as they grow and develop into adults. The primary psychosocial developmental task for the infant is learning to trust. This task creates the foundation for the developmental tasks of the next stages of the child's life. If the infant does not receive food, love, attention, and comfort, the infant learns to mistrust the environment and those who are responsible for caring for the child. Learning to feel anger, love, and fear come at later times in development. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year, p. 509. Chapter 23: Growth and Development of the Infant: 28 Days to 1 Year - Page 509 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 34

12s An 8-month-old hospitalized with bronchiolitis is crying in the crib because it is time for a feeding. The parent caring for the child has left the room to eat lunch. If the needs of the child are not met, what phase of the developmental stage will not be achieved according to Erikson?

Trust Explanation: The infant has no way to control the world other than crying for help and hoping for rescue. During the first year, the child learns whether the world can be trusted to give love and concern or only frustration, fear, and despair. The infant fed on demand learns to trust that cries, communicating a need, will be answered. The baby fed according to the nurse's or caregiver's schedule does not understand the importance of routine but only that cries may go unanswered. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 498. Chapter 22: Principles of Growth and Development - Page 498 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 17

6s A group of boys ages 9 to 10 have formed a "boys only" club that is open to neighborhood and school friends who have skateboards. The school nurse should interpret this as which behavior?

characteristics of social development at this age Explanation: During the school age years and into early adolescence, children begin to transition from the family being the primary influence to the importance of friends and social networks. Having a boy's only club is developmentally normal for this age. Reference: Hatfield, N. T., Kincheloe, C. A. (2018). Introductory Maternity & Pediatric Nursing, 4th ed, Philadelphia: Wolters Kluwer, Chapter 22: Principles of Growth and Development, p. 497. Chapter 22: Principles of Growth and Development - Page 497 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 19

8s If a preschooler sees you pour his liquid medicine from a tall, thin glass into a short, wide one, he will probably reason that:

the amount of medicine is less (the glass is not as full). Explanation: The concept of conservation (not being fooled by a change in shape) is not developed until school age. Reference: Hatfield, N. T., Kincheloe, C. A. Introductory Maternity & Pediatric Nursing, 4th ed., Philadelphia: Wolters Kluwer, 2018, Chapter 22: Principles of Growth and Development, p. 499. Chapter 22: Principles of Growth and Development - Page 499 Add a Note ×Close Add Note Save Cancel 500 characters remaining Question 18