Chapter 5 Flashcards
The nurse is conducting a well-child examination of a 5-year-old girl, who was 40 inches tall at her last examination at age 4. Which height measurement would be within the normal range of growth expected for a preschooler? A) 41 inches B) 43 inches C) 45 inches D) 47 inches
Ans:
B
Feedback:
The average preschool-age child will grow 2.5 to 3 inches (6.5 to 7.8 cm) per year. The average 3-year-old is 37 inches tall (96.2 cm), the average 4-year-old is 40.5 inches tall (103.7 cm), and the average 5-year-old is 43 inches tall (118.5 cm).
The nurse is teaching the parents of a 4-year-old boy about the normal maturation of the child’s organs during the preschool years and their effect on body functions. Which statements accurately describe these changes? Select all that apply.
A)
Myelination of the spinal cord allows for bowel and bladder control to be complete in most children by age 3 years.
B)
The respiratory structures are continuing to grow in size, and the number of alveoli continues to increase, reaching the adult number at about 7 years of age.
C)
Heart rate increases and blood pressure decreases slightly during the preschool years; an innocent heart murmur may be heard upon auscultation.
D)
The bones continue to increase in length and the muscles continue to strengthen and mature; however, the musculoskeletal system is still not fully mature.
E)
The small intestine is continuing to grow in length, and stool passage usually occurs once or twice per day in the average preschooler.
F)
The urethra remains long in both boys and girls, making them more susceptible to urinary tract infections than adults.
Ans:
A, B, D, E
Feedback:
Most of the body systems have matured by the preschool years. Myelination of the spinal cord allows for bowel and bladder control to be complete in most children by age 3 years. The respiratory structures are continuing to grow in size, and the number of alveoli continues to increase, reaching the adult number at about 7 years of age. The bones continue to increase in length and the muscles continue to strengthen and mature. However, the musculoskeletal system is still not fully mature. The small intestine is continuing to grow in length, and stool passage usually occurs once or twice per day in the average preschooler. The 4-year-old generally has adequate bowel control. Heart rate decreases and blood pressure increases slightly during the preschool years. An innocent heart murmur may be heard upon auscultation. The urethra remains short in both boys and girls, making them more susceptible to urinary tract infections than adults.
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. A) Plans activities and makes up games B) Initiates activities with others C) Acts out roles of other people D) Engages in parallel play with peers E) Classifies or groups objects by their common elements F) Understands relationships among objects Ans:
A, B, C
Feedback:
The many activities of the preschooler include beginning to plan activities, making up games, initiating activities with others, and acting out the roles of other people (real and imaginary). Toddlers engage in parallel play; preschoolers engage in cooperative play. School-age children classify or group objects by common elements and understand relationships among objects.
The nurse is caring for a 5-year-old girl posttonsillectomy. The girl looks out the window and tells the nurse that it is raining and says, "The sky is crying because it is sad that my throat hurts." The nurse understands that the girl is demonstrating which mental process? A) Magical thinking B) Centration C) Transduction D) Animism
Ans:
A
Feedback:
The nurse understands that the girl is demonstrating magical thinking. Magical thinking is a normal part of preschool development. The preschool-age child believes her thoughts to be all-powerful. Transduction is reasoning by viewing one situation as the basis for another situation whether or not they are truly causally linked. Animism is attributing life-like qualities to inanimate objects. Centration is focusing on one aspect of a situation while neglecting others.
The parents of a 4-year-old ask the nurse when their child will be able to differentiate right from wrong and develop morals. What would be the best response of the nurse?
A)
‘The preschooler has no sense of right and wrong.’
B)
‘The preschooler is developing a conscience.’
C)
‘The preschooler sees morality as internal to self.’
D)
‘The preschooler’s morals are their own, right or wrong.’
Ans:
B
Feedback:
The preschool child can understand the concepts of right and wrong and is developing a conscience. Preschool children see morality as external to themselves; they defer to power (that of the adult). The child’s moral standards are those of their parents or other adults who influence them, not necessarily their own.
Which activity would the nurse least likely include as exemplifying the preconceptual phase of Piaget's preoperational stage? A) Displays of animism B) Use of active imaginations C) Understanding of opposites D) Beginning questioning of parents' values
Ans:
D
Feedback:
In the intuitive phase of Piaget’s preoperational stage, the child begins to question parents’ values. Animism, active imaginations, and an understanding of opposites would characterize the preconceptual phase of Piaget’s preoperational stage.
The nurse is assessing the motor skills of a 5-year-old girl. Which finding would cause the nurse to be concerned?
A)
Can copy a square on another piece of paper
B)
Can dress and undress herself without help
C)
Draws a person with three body parts
D)
Is beginning to tie her own shoelaces
Ans:
C
Feedback:
By the age of 5 years, the child should be able to draw a person with a body and at least six body parts. She should also be able to copy triangles and other geometric patterns and dress and undress herself and should be learning to tie her shoelaces.
The school nurse is helping parents choose books for their preschoolers. What literacy skills present in the preschooler would the nurse consider when making choices? Select all that apply.
A)
Preschoolers enjoy books with pictures that tell stories.
B)
Preschoolers like stories with repeated phrases as they help keep their attention.
C)
Preschoolers like stories that describe experiences different from their own.
D)
Preschoolers demonstrate early literacy skills by reciting stories or portions of books.
E)
Preschoolers may retell the story from the book, pretend to read books, and ask questions about the story.
F)
Preschoolers do not have enough focus and expanded attention to notice when a page is skipped during reading.
Ans:
A, B, D, E
Feedback:
Preschoolers enjoy books with pictures that tell stories. Stories with repeated phrases help to keep the child’s attention. Also, children like stories that describe experiences similar to their own. The preschool child demonstrates early literacy skills by reciting stories or portions of books. He or she also may retell the story from the book, pretend to read books, and ask questions about the story. The preschool child has enough focus and expanded attention to notice when a page is skipped during reading and will call it to the parent’s attention.
The parents of a preschooler ask the nurse to help them choose a preschool for their child. What are recommended guidelines and goals for choosing a preschool? Select all that apply.
A)
The main goal of preschool is to improve reading and writing skills and readiness for entering into grade school.
B)
When selecting a preschool the parent may want to consider the accreditation of the school and the teachers’ qualifications.
C)
The teachers should decide how focused on curriculum the school should be for each individual student.
D)
The parent should observe the classroom, evaluating the environment, noise level, and sanitary practices.
E)
The type of discipline used in the school is also an important factor. Parents should choose a preschool that uses corporal punishment.
F)
The parent should observe the classroom to determine how the children interact with each other and how the teachers interact with the children.
Ans:
B, D, F
Feedback:
When selecting a preschool, the parent may want to consider the accreditation of the school, the teachers’ qualifications, and recommendations of other parents. The parent should observe the classroom, evaluating the environment, noise level, and sanitary practices, as well as how the children interact with each other and how the teachers interact with the children. The main goal of preschool is to foster the child’s social skills and accustom him or her to the group environment. The parents must decide how focused on curriculum they want the school to be. The type of discipline used in the school is also an important factor. Parents should not choose a preschool that uses corporal punishment.
The mother of a 4-year-old boy tells the nurse that her son occasionally wets his pants during the day. How should the nurse respond?
A)
“Is there a family history of diabetes?”
B)
‘Suddenly having accidents can be a sign of diabetes.”
C)
“That’s normal; don’t worry about it.”
D)
“Tell me about the circumstances when this occurs.”
Ans:
D
Feedback:
Bladder control is present in 4- and 5-year-olds, but an occasional accident may occur, particularly in stressful situations or when the child is absorbed in an interesting activity. The nurse needs to ask an open-ended question to determine the circumstances when the child has had accidents. Simply telling the mother that it is normal does not address the mother’s concerns. The nurse does need to gather more information, because accidents in a previously potty-trained child can be a sign of diabetes.
The nurse is explaining to parents that the preschooler’s developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative?
A)
Reward the child for initiative in order to build self-esteem.
B)
Change the routine of the preschooler often to stimulate initiative.
C)
Do not set limits on the preschooler’s behavior as this results in low self-esteem.
D)
As a parent, decide how and with whom the child will play.
Ans:
A
Feedback:
The building of self-esteem continues throughout the preschool period. It is of particular importance during these years, as the preschooler’s developmental task is focused on the development of initiative rather than guilt. A sense of guilt will contribute to low self-esteem, whereas a child who is rewarded for his or her initiative will have increased self-confidence. Routine and ritual continue to be important throughout the preschool years, as they help the child to develop a sense of time as well as provide the structure for the child to feel safe and secure. Also, consistent limits provide the preschooler with expectation and guidance. Giving children opportunities to decide how and with whom they want to play also helps them develop initiative.
The parents of a 5-year-old boy tell the nurse that their son is having frequent episodes of night terrors. Which of the following statements would indicate that the boy is having nightmares instead of night terrors?
A)
“It usually happens about an hour after he falls asleep.”
B)
“He will tell us about what happened in his dream.”
C)
“He is completely unaware that we are there.”
D)
“When we try to comfort him, he screams even more.”
Ans:
B
Feedback:
During a nightmare, a child will have a memory of the occurrence and may remember the dream and talk about it later. With night terrors, the child has no memory of the event. The other statements are indicative of night terrors.
The mother of a 5-year-old boy calls the nurse and seeks advice on how to assist the child with the recent death of his paternal grandfather. The boy keeps asking when his grandpa is coming back. How should the nurse respond?
A)
“It is best to just ignore this and to not respond to his questions.”
B)
“This is normal; children his age do not understand the permanence of death.”
C)
“You have to keep repeating that his grandfather is never coming back.”
D)
“He will eventually figure this out on his own.”
Ans:
B
Feedback:
The nurse needs to remind the mother that preschoolers do not completely understand the concept of death or its permanence. Telling the mother that it is best to ignore the boy’s questions or that the boy will eventually figure this out on his own does not teach. Repeating that the grandfather is not coming back does not consider the developmental stage of the child and is inappropriate.
The nurse is developing a nursing care plan for a hospitalized 6-year-old. Which behavior would warrant nursing intervention?
A)
The child pretends he is talking to an imaginary friend when the nurse addresses the child.
B)
The child states that her fairy godmother is going to come and take her home.
C)
The child starts talking about his grandmother and then quickly changes the subject to a new toy he received.
D)
The child does not want to play games with other children on the hospital ward.
Ans:
D
Feedback:
The preschooler begins to plan activities, make up games, and initiate activities with others. Not wanting to play games with other children is a sign of a developmental delay and nursing intervention is recommended. The preschooler often has an imaginary friend who serves as a creative way for the preschooler to sample different activities and behaviors and practice conversational skills. Through make-believe and magical thinking, preschool children satisfy their curiosity about differences in the world around them. The preschooler uses transduction when reasoning: he or she extrapolates from a particular situation to another, even though the events may be unrelated.
The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? Select all that apply. A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's
Ans:
A, B, C, D
Feedback:
The child in the intuitive phase can count 10 or more objects, correctly name at least four colors, and better understand the concept of time, and he or she knows about things that are used in everyday life, such as appliances, money, and food. The preschooler forms concepts that are not as complete or as logical as the adult’s, and tolerates others’ differences but doesn’t understand them.
