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Flashcards in Chapter 13 Deck (14):
1

A mother tells the nurse that her daughter's favorite toy is a large, empty box that contained a stove. She plays "house" in it with her toddler brother. Based on the nurse’s knowledge of growth and development, the nurse recognizes that this is
a. unsafe play that should be discouraged.
b. creative play that should be encouraged.
c. suggestive of limited family resources.
d. suggestive of limited adult supervision.

Ans: B
This type of play should be encouraged. After children create something new, they can then transfer it to other situations. There should be some supervision to prevent injury or accidents.
As long as the play is supervised, it should be encouraged. This is not considered unsafe play.
There is no indication of limited resources.
There is no indication of limited adult supervision.

2

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of
a. identity.
b. intimacy.
c. initiative.
d. industry.

Ans: C
Preschoolers focus on developing initiative. The stage is known as initiative versus guilt.
Identity versus role confusion is associated with adolescence.
Intimacy versus isolation is associated with young adulthood.
Industry versus inferiority is associated with the school-aged child.

3

The best approach for effective communication with a preschooler is through
a. speech.
b. play.
c. drawing.
d. actions.

Ans: B
Preschoolers' most effective means of communication is through play. Play allows preschoolers to understand, adjust to, and work out life's experiences through their imagination and ability to invent and imitate.
Speech is not effective, because preschoolers assume that everyone thinks as they do and that a brief explanation of their thinking makes them understood by others, which is often not true. Also, preschoolers often do not understand the meaning of words and often take statements literally.
Drawing is still being developed as a fine motor skill; therefore, it is not the most effective means of communication.
Actions are not an appropriate means of communication for a preschooler.

4

The preschooler's body image has developed to include
a. a well-defined body boundary.
b. knowledge about his or her internal anatomy.
c. fear of intrusive procedures.
d. fear of looking different from his or her friends.

Ans: C
Preschoolers fear that their insides will come out with intrusive procedures.
Preschoolers have poorly defined body images.
Preschoolers have little or no knowledge of their internal anatomy.
The fear of looking different is a concept that occurs in later school-aged children and adolescents.

5

The parents of a 4½-year-old girl are worried because she has an imaginary playmate. Based on the nurse’s knowledge of the preschooler, the most appropriate response is
a. a psychosocial evaluation is indicated.
b. an evaluation of possible parent-child conflict is indicated.
c. having imaginary playmates is normal and useful at this age.
d. having imaginary playmates is abnormal after age 2 years.

Ans: C
Imaginary playmates are a part of normal development at this age and serve many purposes, including being a friend in times of loneliness, accomplishing what the preschooler is still attempting, and experiencing what the preschooler wants to forget or remember.
Because an imaginary playmate is part of normal development, a psychosocial evaluation is not warranted.
Because an imaginary playmate is part of normal development, an evaluation of the parent-child relationship is not warranted.
Imaginary playmates are commonly present during the preschool years; therefore, they are not abnormal after the age of 2 years.

6

By what age would the nurse expect most children to use sentences of four or five words?
a. 18 months
b. 24 months
c. 3 years
d. 4½ years

Ans: D
Children ages 4 to 5 years use sentences of four or five words.
An 18-month-old child has a vocabulary of approximately 10 words.
A 24-month-old child uses two- or three-word phrases.
A 3-year-old child uses sentences of three or four complete words.

7

During a well-child visit, the father of a 4-year-old child tells the nurse that he is not certain if his child is ready for kindergarten. The child's birthday is close to the cutoff date, and the child has not attended preschool. The most appropriate recommendation by the nurse is to
a. Encourage the father to have the child start kindergarten
b. Recommend to the father that he postpone kindergarten and send the child to preschool
c. Refer the child for developmental screening and make a recommendation based on the results
d. Have the father observe a kindergarten class and then decide if his child would enjoy the experience

Ans: C
A developmental screening will provide the necessary information to help the family determine readiness.
Encouraging the father to have the child start kindergarten does not address the father's concern about readiness and suggests that his concerns are not warranted.
Recommending to the father that he postpone kindergarten and send the child to preschool assumes that the child is not ready for kindergarten, but the recommendation is not based on any data or facts. Recommending to the father that he simply place his child in preschool may lead to the child's boredom with school.
Having the father observe a kindergarten class and then decide if the child would enjoy the experience will provide information about kindergarten but not about whether his child is ready to begin and thrive there.

8

When preparing parents to teach their preschool child about human sexuality, what should the nurse emphasize?
a. A parent's words may have a greater influence on the child's understanding than the parent's actions.
b. Parents should determine exactly what the child wants to know before answering a question about sexuality.
c. Parents should avoid using correct anatomic terms because they are confusing to the preschooler.
d. Parents should encourage preschoolers to satisfy their sexual curiosity by playing "doctor."

Ans: B
It is important that the parent answer the question that the child is asking.
Actions may have a greater influence because language is not fully developed in the preschool years.
Using correct terminology lays the foundation for later discussion of human sexuality.
Parents should encourage children to ask questions to provide accurate information at their cognitive level.

9

Ashley, age 4½ years, is afraid of dogs. What should the nurse recommend to her parents to help her with this fear?
a. Keep her away from dogs.
b. Buy her a stuffed dog toy.
c. Force her to touch a dog briefly.
d. Let her watch other children play with a dog.

Ans: D
The parents should actively seek ways to deal with fear. By observing other children at play with dogs, the child can adapt.
Keeping their child away from dogs avoids the object of fear rather than addressing the fear and finding solutions.
Buying a child a stuffed dog toy avoids the object of fear rather than addressing the fear and finding solutions.
Forcing the child to touch a dog without working up to it may increase the level of fear.

10

A 4½-year-old boy has been having increasingly frequent angry outbursts in preschool for approximately 8 to 10 weeks. In addition, he is aggressive toward the other children and teachers. His parents ask the nurse for advice. The most appropriate nursing intervention is to
a. explain that this is normal in preschoolers, especially boys.
b. refer the child for counseling.
c. talk to the preschool teacher to obtain validation for the behavior the parent reports.
d. encourage the parent to try more consistent and firm discipline.

Ans: B
This is not expected behavior. The child should be referred to a competent professional to deal with his aggression so that an accurate assessment can be made and a care plan determined.
Outward aggression to others is not normal behavior and should be evaluated.
The validation will be helpful for the referral, but the referral is the priority action.
This may be recommended by the professional once an accurate assessment is made.

11

Which is descriptive of the nutritional requirements of preschool children?
a. The quality of the food consumed is more important than the quantity.
b. Nutritional requirements for preschoolers are different from requirements for toddlers.
c. The requirement for calories per unit of body weight increases slightly during the preschool period.
d. The average daily intake of preschoolers should be about 3000 calories.

Ans: A
It is essential that the child eat a balanced diet with essential nutrients; the amount of food is less important than the quality of the food.
Requirements are similar for both toddlers and preschoolers.
The caloric requirement decreases slightly for preschoolers.
The average intake is about 1800 calories each day for preschoolers.

12

Kimberly, age 4 years, sometimes wakes her parents up at night, screaming, thrashing, sweating, and apparently frightened. Yet she is not aware of her parents' presence when they check on her. She lies down and sleeps without any parental intervention. This most likely scenario is
a. nightmares.
b. sleep terrors.
c. seizure activity.
d. sleep apnea.

Ans: B
In sleep terrors, the child is only partially aroused; therefore, she does not remember her parents' presence.
A nightmare is a frightening dream followed by full awakening; therefore, the child would realize that her parents are present.
The description of the child's experience does not indicate the presence of seizure activity.
Sleep apnea is a cessation of breathing during sleep.

13

The nurse is giving anticipatory guidance to the parent of a 5-year-old. What is the most appropriate information to include?
a. Prepare the parent for increased aggression.
b. Encourage the parent to offer the child choices.
c. Inform the parent that he or she can expect a more tranquil period at this age.
d. Advise the parent that this is the age when stuttering may develop.

Ans: C
The end of preschool and the beginning of school age is a more tranquil period.
Preparing the parent for increased aggression is anticipatory guidance for 4-year-old children.
Encouraging the parent to offer the child choices is anticipatory guidance for 3-year-old children.
Advising the parent that this is the age when stuttering may develop is anticipatory guidance for 3-year-old children.

14

A nurse is presenting a class on injury prevention to parents of preschoolers. Which injuries should the nurse identify as occurring in this age group? (Select all that apply.)
a. Falls
b. Drowning
c. Poisoning
d. Sports injuries
e. Tricycle and bicycle accidents

Ans: A, B, C, E