Ch 3 – growth and development of the newborn and infant – Flashcards
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Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
a) Sitting independently
b) Turning a doorknob
c) Building a tower of four cubes
d) Walking independently
answer
Sitting independently
Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.
question
Two parents who have financial issues ask the nurse if a borrowed crib would be okay to use for their new twin boys. Which response should the nurse use in educating the parents?
a) "You should just buy a new crib to be on the safe side."
b) "You can use any crib that you want."
c) "You can use the crib, but there are guidelines to follow."
d) "No, you cannot use a borrowed crib."
answer
"You can use the crib, but there are guidelines to follow."
The nurse would educate the parents on the latest guidelines for using baby cribs and provide them with available safety and information pamphlets. All cribs made after 1973 have specific safety guidelines and standards. The other responses do not provide the correct available information or educate the parents on safety standards.
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The nurse is reinforcing teaching related to the nutritional needs of the infant with a group of caregivers. One caregiver asks why her 6-month-old infant needs to have solid foods when breast milk is such a good source of nutrition. What would be the best response by the nurse?
a) "The extrusion reflex must be developed and feeding solid foods will help the child to develop this reflex."
b) "Milk does not provide adequate amounts of iron, which are found in solid foods."
c) "Breastfeeding will become painful when the child gets more teeth, so the infant needs to eat solid foods."
d) "By this age your child is ready to try new skills such as eating solid foods."
answer
"Milk does not provide adequate amounts of iron, which are found in solid foods."
At about four to six months of age, the infant's milk consumption alone is not likely to be sufficient to meet caloric, protein, mineral, and vitamin needs. In particular, the infant's iron supply becomes low, and supplements of iron-rich foods are needed.
question
The nurse is helping the mother of a 5-month-old boy understand the importance of developmentally appropriate play. Which one of the toys best meets the needs of this child?
a) Brightly colored stacking toy
b) A push-pull toy
c) A yellow rubber duck for the bath
d) Pots and pans from the kitchen cupboard
answer
A yellow rubber duck for the bath
The rubber duck is most appropriate. It is safe, visually stimulating while bobbing on the water, and adds pleasure to bath time. A push-pull toy promotes skill for a walking infant. Pots and pans from the kitchen cupboard are played with successfully after sitting is mastered. A 5-month-old does not have the fine motor coordination to use stacking toys.
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A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl just demonstrated?
a) Object permanence
b) Primary circular reaction
c) Secondary circular reaction
d) Binocular vision
answer
Secondary circular reaction
By the third month of life, a child enters a cognitive stage identified by Piaget as primary circular reaction. During this time, the infant explores objects by grasping them with the hands or by mouthing them. Infants appear to be unaware of what actions they can cause or what actions occur independently, however. At about 6 months of age infants pass into a stage Piaget called secondary circular reaction. Now when infants reach for an object, hit it, and watch it move, they realize it was their hand that initiated the motion, and so they hit it again. By 10 months, infants discover object permanence. Infants are ready for peek-a-boo once they have gained this concept. They know their parent still exists even when hiding behind a hand or blanket and wait excitedly for the parent to reappear. Binocular vision, which is the ability to fuse two images into one, is demonstrated by 2-month-olds when the follow moving objects with their eyes, although not past the midline.
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The parents of a 4-day-old infant report concern about his weight loss. What is the best response by the nurse?
a) "Babies will begin to rapidly regain weight and will double birth weight around 6 months of age."
b) "With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks."
c) "Weight loss after birth is normal."
d) "Babies may lose up to 10% of their body weight in the first month of life."
answer
"With appropriate nutrition weight gain will commence with a return to the birth weight within 2 weeks."
The average newborn weighs 7 lb 8 oz (3,400 g) at birth. Newborns lose up to 10% of their body weight over the first week of life. The average newborn then gains about 30 g per day and regains his or her birth weight by 10 to 14 days of age. Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old.
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A mother is discussing her 10-month-old boy with the nurse. Which comment indicates a need for teaching?
a) "I wipe my son's teeth every day with a fresh washcloth."
b) "He loves being in his walker and 'zips' around the house."
c) "He gets a few sips of apple juice each day from a regular cup, not a sippy cup."
d) "We have safety gates at the top and bottom of our stairs."
answer
"He loves being in his walker and 'zips' around the house."
Walkers are safety hazards and not recommended by the American Academy of Pediatrics. They cause falls plus promote the ability to reach items on surfaces otherwise inaccessible. The other comments are age appropriate and acceptable practice.
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Which statements regarding infant safety are accurate? Select all that apply.
a) Only small pillows should be used in cribs
b) Car seats should be placed in back seats
c) A safe temperature for hot water heaters in households with infants is 120 degrees
d) Crib and playpen bars should be no more than 2 3/8 inches apart
e) Bottle should only be propped for infants 8 months or older
answer
• Crib and playpen bars should be no more than 2 3/8 inches apart
• Car seats should be placed in back seats
• A safe temperature for hot water heaters in households with infants is 120 degrees
Crib and playpen bars should be no more than 2 3/8 inches apart so the infant can be safe from getting body parts caught between the bars. Car seats are placed in the back seat and manufacturers' instructions are followed regarding forward or backward facing depending on the age and size of the child. Water heaters should be set no higher then 120 degrees to prevent potential burns. Bottles should never be propped and pillows are not placed in cribs of infants
question
The nurse pulls the 5-month-old to sitting position from supine and notes head lag. The nurse's response is to:
a) consider this a normal response for the age.
b) refer the infant for developmental and/or neurologic evaluation.
c) conclude the earlier assessments carried out fatigued the infant.
d) suggest more awake tummy time for the child.
answer
refer the infant for developmental and/or neurologic evaluation.
There should be no head lag by 4 months. Head lag in the 5-month-old may indicate motor or neurologic problems and needs immediate follow-up. All other nursing actions indicate failure to recognize the problem.
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A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child?
a) The infant says "da-da" when looking at her father
b) The infant squeals with pleasure
c) The infant coos, babbles, and gurgles
d) The infant imitates her father's cough
answer
The infant says "da-da" when looking at her father
By 9 months, an infant usually speaks a first word: "da-da" or "ba-ba." The other answers refer to earlier milestones in language development. In response to a nodding, smiling face, or a friendly tone of voice, a 3-month-old infant will squeal with pleasure or laugh out loud. By 4 months, infants are very "talkative," cooing, babbling, and gurgling when spoken to. At 6 months, infants learn the art of imitating. They may imitate a parent's cough, for example, or say "Oh!" as a way of attracting attention.
question
The nurse is caring for a 5-week-old infant who is spitting up "all the time." This is the mother's first child. What should be the priority nursing intervention?
a) Describe the capacity of a 5-week-old infant's stomach.
b) Offer assurance that spitting up is normal.
c) Observe the mother while she feeds and burps her infant.
d) Recommend the mother offer smaller and more frequent feedings.
answer
Observe the mother while she feeds and burps her infant.
Assessing the mother's feeding and burping technique is the first nursing action needed. The mother may be overfeeding or inadequately burping the child. Recommending smaller and more frequent feedings would be determined by the assessment. Assuring the mother that some spitting up is normal and describing the capacity of the infant's stomach is helpful information but not the priority.
question
What action shows an example of Erik Erikson's developmental task for the infant?
a) The infant cries and the caregiver picks the child up.
b) The infant cries when he has a wet diaper.
c) The infant plays the game peek-a-boo.
d) The infant smiles as people walk past the crib.
answer
The infant cries and the caregiver picks the child up.
Erikson's psychosocial developmental task for the infant is to develop a sense of trust. The development of trust occurs when the infant has a need and that need is met consistently.
question
Infant development is best described by which statement?
a) Development proceeds from fine to gross.
b) Development is not sequential but predictable.
c) Development proceeds cephalocaudally.
d) Development varies greatly from infant to infant.
answer
Development proceeds cephalocaudally.
Growth and development both proceed from head to toe, or in a cephalocaudal sequence.
question
The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:
a) when weaning is complete.
b) as soon as the first tooth erupts.
c) as soon as he begins to eat fruit.
d) by 12 months of age.
answer
as soon as the first tooth erupts.
Toothbrushing should begin with the eruption of the first tooth.
question
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?
a) If she is safe, they lie her down and leave.
b) The child has a regular, scheduled bedtime.
c) They put her to bed when she falls asleep.
d) They sing to her before she goes to sleep.
answer
They put her to bed when she falls asleep.
If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.
question
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:
a) The weight assessment is blatantly inaccurate.
b) The child weighs more than expected for age.
c) The child weighs less than expected for age.
d) The child weighs the expected amount for age.
answer
The child weighs less than expected for age.
Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.
question
A frustrated mother comes to a 9-month well-baby check-up because her son is refusing all of the solid food she gives him. When talking with this mother, the nurse discovers that she has struggled all her life with a weight problem. She attributes this problem to being forced to eat all of the food she was served as a child, even when she was full. Because she doesn't want to cause the same problem in her child, she tells the nurse that each time her son pushes food away with his tongue she believes that he doesn't want it. Which statement would be most appropriate for the nurse to say to this mother?
a) "The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
b) "Because your baby is a fussy eater, have more than one food available at each feeding so he can choose a food he likes."
c) "The baby might be allergic to the particular foods you offered, so try different kinds of food."
d) "The baby might not be ready for solid food, so wait a month or so and try again."
answer
"The baby needs to learn how to move the food to the back of the mouth for swallowing, so catch the food and offer it again until the baby learns this."
The infant knows only one way to take food: namely to thrust the tongue forward as if to suck. This is called the extrusion (protrusion) reflex and has the effect of pushing solid food out of the infant's mouth. The process of transferring food from the front of the mouth to the throat for swallowing is a complicated skill that must be learned. If the food is pushed out, the caregiver must catch it and offer it again. The baby soon learns to manipulate the tongue and comes to enjoy this novel way of eating.
question
A 12-month-old seen at a walk-in clinic weighed 8 pounds 4 ounces (3.75 kg) at birth. Weight now is 20 pounds 8 ounces (9.3 kg). The nurse determines:
a) The child weighs more than expected for age.
b) The child weighs the expected amount for age.
c) The weight assessment is blatantly inaccurate.
d) The child weighs less than expected for age.
answer
The child weighs less than expected for age.
Birth weight should triple by 12 months. The child should weigh near 24 pounds 12 ounces (11.25 kg). The child is underweight for age.
question
The nurse enters her client's room to find the new mom crying softly. The nurse asks what is wrong. The mom says, "I had my heart set on breast-feeding and now my baby has a cleft lip. My dreams of breast-feeding him are destroyed." What should the nurse tell her client about breast-feeding an infant with this diagnosis?
a) "I am so sorry, looks like bottle-feeding for you."
b) "I am so sorry your infant has that problem, maybe next time."
c) "Sometimes dreams do not come true."
d) " You can still attempt breast-feeding; let me call a lactation consultant for you."
answer
" You can still attempt breast-feeding; let me call a lactation consultant for you."
The nurse should be therapeutic in her response and reassure the mother that breast-feeding may still be an option. Infants with cleft lips may still successfully breast-feed. The infant's feeding must be assessed, their weight monitored, and the feeding may be slower. The other responses are not therapeutic and supportive to the new mother.
question
The nurse is conducting a physical examination of a 5-month-old boy. Which observation may be cause for concern about the infant's neurologic development?
a) His toes hyperextend when the bottom of the foot is stroked.
b) The infant grasps a finger when it is placed in his palm.
c) The infant displays an asymmetric tonic neck reflex (fencing reflex).
d) The anterior fontanel is open and easily palpated
answer
The infant displays an asymmetric tonic neck reflex (fencing reflex).
The tonic neck reflex normally disappears by age 4 months, the palmar grasp reflex by age 6 months, and the Babinski reflex (fanning of toes when sole of foot stroked) by 12 months. Retaining these primitive reflexes may indicate a neurologic abnormality. The anterior fontanel, which remains open for brain growth, closes between 12 and 18 months of age.
question
A new mother reports that she is exhausted and that the little sleep she gets is determined by her baby's daytime naps and the few hours the baby sleeps during the night. The nurse discusses with this mother the importance of helping the infant establish healthy sleeping patterns. What would be most helpful for this mother to do to encourage healthy sleeping patterns?
a) Wake the baby from afternoon naps after 1 hour to ensure she is sleepy by nighttime.
b) Put the baby to bed at various times of the evening.
c) Use the crib for sleeping only, not for play activities.
d) Let the baby cry during the night and she will eventually fall back to sleep.
answer
Use the crib for sleeping only, not for play activities.
A consistent bedtime routine is usually helpful in establishing healthy sleeping patterns and in preventing sleep problems. Using the crib for sleeping only helps the child associate the bed with sleep. Depriving the baby of sleep during the afternoon or evening will make the baby over-tired and less able to establish a healthy sleeping pattern. While letting a baby cry for a while is acceptable, this does not promote consistency in the baby's sleeping pattern.
question
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:
a) the newborn's stomach can hold between one-half and 1 ounce.
b) the best feeding schedule offers food every 4 to 6 hours.
c) most newborns need to eat about 4 times per day.
d) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.
answer
the newborn's stomach can hold between one-half and 1 ounce.
The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1½ to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.
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Question: Put the following developmental milestones related to an infant's hearing in correct chronological order:
1. Locate & turn toward sound in any direction
2. Turn head to locate sound
3. Locate sounds made above
4. Stop activity in response to spoken word
5. Locate sounds downward and to side
6. Recognize name when spoken
answer
Stop activity in response to spoken word
Turn head to locate sound
Locate sounds downward and to side
Locate sounds made above
Recognize name when spoken
Locate & turn toward sound in any direction
That an infant can hear can be demonstrated at birth by the way a newborn quiets momentarily at a distinctive sound such as a bell or a squeaky rubber toy. By 1 month, this reaction is even more marked. Hearing awareness becomes so acute by 2 months of age infants will stop an activity at the sound of spoken words. Many 3-month-old infants turn their heads to attempt to locate a sound. At 4 months of age, when infants hear a distinctive sound they turn and look in that direction. By 5 months of age, infants demonstrate they can localize sounds downward and to the side, by turning their head and looking down. Six-month-olds have progressed to being able to locate sounds made above them. By 10 months, infants can recognize their name and listen acutely when spoken to. By 12 months, infants can easily locate sound in any direction and turn toward it.
question
The nurse comes into an infant's room on the pediatric floor. The nurse wants to try to feed the infant for the first time since her surgery. How does the nurse know what infant state the child is in by what the mother says and that it is okay to try and feed the infant?
a) "She is so quiet today, that is not like her."
b) "She has been a chatterbox and smiles just like her brother."
c) "She has been crying every time someone picks her up."
d) "She is still sleeping, I guess she is worn out."
answer
"She has been a chatterbox and smiles just like her brother."
The best time to feed an infant is when the child is in the active alert state. This infant is talking and smiling, which shows she is calm and actively awake. In the active alert state the infant has normal respirations, limited movement, and eyes that are bright and shiny and attentive. The other choices put the infant in a crying state, quiet alert or deep sleep, or drowsing. These stages are not optimal for interacting with the child.
question
The nurse is preparing a list of abilities of 10-month-olds to use in teaching a parenting group. Which ability should appear at this age?
a) Feeds self with spoon (but spills)
b) Cruises around furniture
c) Uses two or three words with meaning
d) Sits from standing position
answer
Cruises around furniture
At 10 months, this ability appears and is practiced often in preparation for later independent walking. All the rest of the skills take an additional 2 months to develop and appear around age 1 year.
question
The nurse at a family health clinic is teaching a group of parents about normal infant development. What patterns of communication should the nurse tell parents to expect from an infant at age 1?
a) Understands "no" and other simple commands
b) Uses speech-like rhythm when talking with an adult
c) Uses multisyllabic babbling
d) Squeals and makes pleasure sound
answer
Understands "no" and other simple commands
At age 1, most babies understand the word "no" and other simple commands. Children at this age also learn one or two other words. Babies squeal, make pleasure sounds, and use multisyllabic babbling at age 6 months. Using speech-like rhythm when talking with an adult usually occurs between ages 9 to 12 months.
question
The nurse is examining a 6-month-old girl who was born 8 weeks early. Which finding is cause for concern?
a) Head size has increased 5 in (12 cm) since birth.
b) The child weighs 10 lb 2 oz (4.6 kg).
c) The child measures 21 in (53 cm) in length.
d) The child exhibits palmar grasp reflex.
answer
Head size has increased 5 in (12 cm) since birth.
The child's head size is large for his adjusted age of 4 months, which would be cause for concern. Normal growth would be 3.6 in (9 cm). At 10 lb, 2 oz (12 cm), the child is the right weight for a 4-month-old adjusted age. Palmar grasp reflex disappears between 4 and 6 months adjusted age, so this would not be a concern yet. The child is of average weight for a 4-month-old adjusted age.
question
The nurse is examining an 8-month-old girl for appropriate development during a regular check-up. Which observation points to a developmental risk?
a) Uses only the left hand to grasp
b) Crawls with stomach down
c) Cannot pull self to standing
d) Picks up small objects using entire hand
answer
Uses only the left hand to grasp
Favoring one hand over the other may be a warning sign that proper motor development is not occurring in the other arm or hand. Grasping small objects with the entire hand is common at 8 months and precedes the pincer grasp, which is used about 2 months later. Crawling with stomach down and being unable to pull to standing are abilities that may not occur for another 4 to 8 weeks.
question
The nurse is assessing the sleeping practices of the parents of a 4-month-old girl who wakes repeatedly during the night. Which parent comment might reveal a cause for the night waking?
a) They sing to her before she goes to sleep.
b) If she is safe, they lie her down and leave.
c) The child has a regular, scheduled bedtime.
d) They put her to bed when she falls asleep.
answer
They put her to bed when she falls asleep.
If the parents are keeping the child up until she falls asleep, they are not creating a bedtime routine for her. Infants need a transition to sleep at this age. If the parents are singing to her before she goes to bed, if she has a regular, scheduled bedtime, and if they check on her safety when she wakes at night, then lie her down and leave, they are using good sleep practices.
question
A 6-month-old arrives for a well-baby visit with a case of diaper rash. The baby's mother tells the nurse she is not concerned and believes this to be normal. She reports that she changes the baby's diaper when he wakes up and before she puts him in his crib for naps or bedtime. It would be important to teach this mother that she should start checking his diaper to see if it needs changing every
a) 1/2 hour
b) 5 hours
c) 1-1 1/2 hours
d) 2-4 hours
answer
2-4 hours
To prevent diaper rash, soiled diapers should be changed frequently. Check every 2-4 hours while the infant is awake to see if the diaper is soiled. Waking the baby to change the diaper is not necessary.
question
When teaching an infant's mother about bathing her, it would be important to instruct her that:
a) bath time provides an opportunity for play.
b) she should never use soap on a baby's hair.
c) infants need a daily bath.
d) soap lubricates and oils an infant's skin.
answer
bath time provides an opportunity for play.
Infants do not need a daily bath as long as the diaper area is washed with diaper changes. Soap is actually drying to an infant's skin. Washing the hair with soap can help remove excess oil.
question
The infant measures 21 ½ inches (54.6 cm) at birth. If the infant is following a normal pattern of growth, what would be an expected height for this child at the age of six months?
a) 32 inches (81.3 cm)
b) 27 ½ inches (69.9 cm)
c) 30 ½ inches (77.5 cm)
d) 29 inches (73.7 cm)
answer
27 ½ inches (69.9 cm)
Most infants double their birth weight by 4 months of age and triple their birth weight by the time they are 1 year old. By 12 months of age, the infant's length has increased by 50 percent.
question
A teen mom asks the discharge nurse if it is okay to sleep in bed with her baby. She says her mom always did it with her siblings and it seemed okay. How should the nurse respond?
a) "Bed sharing is okay, just make sure the infant is between two people."
b) "Sure, you can do whatever you want, it is your baby."
c) "Bed sharing has positive effects on babies, let me get you information."
d) "Sure, you can, make sure you use a soft mattress for support."
answer
"Bed sharing has positive effects on babies, let me get you information."
The nurse should enforce that bed sharing is sometimes a positive experience if the parents are safe and responsible. When done properly, the effect can be positive on infant nutrition and physiology. The other responses do not promote safety or educate the teen.
question
Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?
a) Building a tower of four cubes
b) Turning a doorknob
c) Sitting independently
d) Walking independently
answer
Sitting independently
Infants typically sit independently, without support, by age 8 months. Walking independently may be accomplished as late as age 15 months and still be within the normal range. Few infants walk independently by age 11 months. Building a tower of three or four blocks is a milestone of an 18-month-old. Turning a doorknob is a milestone of a 24-month-old.
question
Which milestone would you expect an infant to accomplish by 8 months of age?
a) Creeping on all fours
b) Sitting without support
c) Being able to sit from a standing position
d) Pulling self to a standing position
answer
Sitting without support
Most babies sit steadily at 8 months, creep at 9 months, and pull to standing at 10 months.
question
The nurse goes in to check on a new mother to see how breast-feeding is going with her new son. The nurse observes the infant is on the mother's lap with the blanket unwrapped, and the mother is washing his face, and gently stroking the baby. The mother has had trouble breastfeeding the last few times. What is the appropriate response from the nurse?
a) "That is not how you get him to eat."
b) "You are doing a wonderful job attempting to waken the baby."
c) "You will never get him to eat all unwrapped like that."
d) "Maybe you should watch the breastfeeding video again."
answer
"You are doing a wonderful job attempting to waken the baby."
The nurse should be emotionally supportive to the new mom. The mom's techniques are commonly used in breastfed infants who are sleeping. The encouragement from the nurse will support the mom through this learning period. The other responses do not emotionally support the mom or contribute to a positive learning environment.
question
The nurse is reviewing topics to be discussed with caregivers related to caring for infants. Which statement would be the most appropriate statement for the nurse to make to this group of caregivers?
a) The infant should be dressed more warmly than older children and caregivers
b) The infant should wear hard-soled shoes in order to protect their feet from injury
c) The infant sleeps 10-12 hours at night and take 2-3 naps during the day
d) The infant should be sound asleep before being put into the crib for sleeping
answer
The infant sleeps 10-12 hours at night and take 2-3 naps during the day
Most infants sleep 10-12 hours at night and take 2-3 naps. 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.
question
The nurse is teaching healthy eating habits to the parents of a 7-month-old girl. Which recommendation is the most valuable advice?
a) Serve new foods several times
b) Actively urge the child to eat new foods
c) Let the child eat only the foods she prefers
d) Provide small portions that must be eaten
answer
Serve new foods several times
When introducing a new food to an infant, it may take multiple attempts before the child will accept it. Parents must demonstrate patience. Letting the child eat only the foods she prefers, forcing her to eat foods she does not want, or actively urging the child to eat new foods can negatively affect eating patterns.
question
The nurse is caring for the family with a 2-month-old boy with colic. The mother reports feeling very stressed by the baby's constant crying. Which intervention would provide the most help in the short term?
a) Assessing the parents' care and feeding skills
b) Urging the baby's mother to take time for herself away from the child
c) Watching how the parents respond to the child
d) Educating the parents about when colic stops
answer
Urging the baby's mother to take time for herself away from the child
Urging the parents to get time away from the child would be most helpful in the short term, particularly if the parents are stressed. Educating the parents about when colic stops would help them see an end to the stress. Observing how the parents respond to the child helps to determine if the parent/ child relationship was altered. Assessing the parents' care and feeding skills may identify other causes for the crying.
question
The nurse is assessing the oral cavity of a 4-month-old infant. Which finding is consistent with a child of this age?
a) No teeth
b) 1 upper tooth
c) 1 to 2 lower teeth
d) 1 to 3 natal teeth
answer
No teeth
Normally infants are not born with teeth. Occasionally there are one or more teeth at birth. These are termed natal teeth and are often associated with anomalies. The first primary teeth typically erupt between the ages of 6 and 8 months.
question
When weighing and measuring a child at her 1-year well-baby checkup, the nurse would expect to see that over the previous 6 months a baby who weighed 8 pounds and was 20 inches long at birth would have gained about
a) 8 pounds and grown 4-6 inches.
b) 8 pounds and grown 2-3 inches.
c) 16 pounds and grown 2-3 inches.
d) 16 pounds and grown 4-6 inches.
answer
8 pounds and grown 4-6 inches.
During the first 6 months, an infant's birth weight doubles and his or her height increases by about 6 inches. Growth slows slightly during the second 6 months but is still rapid. By 1 year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.
question
The infant weighs 7 lbs. 4 oz. (3.3 kg) at birth. If the infant is following a normal pattern of growth, what would be the expected weight for this child at the age of 12 months?
a) 28 lbs. 4 oz. (12.8 kg)
b) 14 lbs. 8 oz. (6.6 kg)
c) 21 lbs. 12 oz. (9.9 kg)
d) 25 lbs. (11.3 kg)
answer
21 lbs. 12 oz. (9.9 kg)
By one year of age, the infant has tripled his or her birth weight and has grown 10 to 12 inches.
question
The nurse conducting a 6-month well-baby check-up assesses for the presence/absence of the asymmetric tonic neck reflex. At this age the reflex:
a) is a protective reflex and retained for life.
b) should be pronounced and easy to elicit.
c) should have disappeared.
d) is expected to appear within 1 month.
answer
should have disappeared.
This primitive (not protective) reflex should be present at birth and disappear around age 4 months.
question
The mother of a 3-month-old is concerned because her daughter does not yet sit by herself. Which statement best reflects average sitting ability?
a) Most babies sit steadily at 3 months; she is slightly delayed.
b) Most babies do not sit steadily until 8 months; she is normal.
c) Most babies sit steadily at 4 months; she is normal.
d) Sitting ability and the age of first tooth eruption are correlated.
answer
Most babies do not sit steadily until 8 months; she is normal.
Many infants sit steadily by 8 months of age.
question
A parent asks the nurse if her 2-month-old could have bananas yet. The nurse would respond and educate the parent on the nutrition stages of infants by which of these responses?
a) "When did you feed your other child bananas?
b) "In one month you can try bananas if you think she is ready."
c) "Sure, if you feel she is ready to have bananas."
d) "In two months you can try bananas if you think she is ready."
answer
"In two months you can try bananas if you think she is ready."
The nurse should choose this response because no solid foods are recommended for infants until 3 months of age. The age of 4 to 6 months is the age recommended to introduce solid foods. The other responses are the incorrect age or are letting the parent decide the appropriate answer.
question
A new mother asks for advice from the nurse about bathing her infant. Which of the following should the nurse tell her?
a) Be sure to give the baby a complete bath every day
b) Be sure to brush the scalp with a soft toothbrush during the bath to prevent seborrhea
c) Be sure to oil the scalp with mineral oil and leave it on overnight before bathing the infant the next day
d) Be sure to wash the infant's face, hands, and diaper area daily
answer
Be sure to wash the infant's face, hands, and diaper area daily
Except in very hot weather, an infant does not need a bath every day. If a parent is tired and would not enjoy bath time or if some days are just too rushed, a complete bath can be omitted, with only the infant's face, hands, and diaper area washed. Some infants do need their head and scalp washed frequently (every day or every other day) to prevent seborrhea, a scaly scalp condition often called cradle cap. If seborrhea lesions do develop, they adhere to the scalp in yellow, crusty patches. The skin beneath them may be slightly erythematous. The patches can be softened by oiling the scalp with mineral oil or petroleum jelly and leaving it on overnight. The crusts can then be removed by shampooing the hair the next morning. A soft toothbrush or fine-toothed comb can be used to help remove them.
question
In working with an infant, the nurse recognizes what as a characteristic of the infant?
a) The child insists they can "do it," the next moment they revert to being dependent.
b) The child has an increased attention span and can be interested in an activity for a long length of time.
c) The child takes in new information at a rapid rate and asks "why" and "how".
d) The child grows and develops skills more rapidly than at any other time in their life.
answer
The child grows and develops skills more rapidly than at any other time in their life.
The infant grows and develops skills more rapidly than she ever will again. The toddler insists she can do things one minute and then becomes dependent the next minute. The preschool age child soaks in information and asks "why" and "how" over and over. The school-age child has a longer attention span and can become absorbed in a craft or activity for several hours.
question
The nurse is teaching the mother of a 2-month-old girl about the social and emotional developments that will occur in the next 8 weeks. Which behavior is most likely to occur?
a) Mimicking mother's facial expressions
b) Becoming clingy around strangers
c) Participating in a game of peek-a-boo
d) Crying when the mother is out of sight
answer
Mimicking mother's facial expressions
Infants will mimic the facial expressions of their parents when they are 3 to 4 months old. Becoming clingy around strangers probably won't occur until the child reaches 6 months. Engaging in peek-a-boo becomes fun between 6 and 8 months. Crying when the mother is out of sight indicates separation anxiety and is common after 6 to 8 months of age.
question
The infant weighs 6 lbs., 8 oz. (2.95 kg) at birth. If the infant is following a normal pattern of growth, what would be an expected weight for this child at the age of four months?
a) 15 lbs. 4 oz. (6.92 kg)
b) 16 lbs. (7.26 kg)
c) 10 lbs. 8 oz. (4.76 kg)
d) 13 lbs. (5.9 kg)
answer
13 lbs. (5.9 kg)
Most infants double their birthweight by 4 months of age and triple their birthweight by the time they are 1 year old.
question
Anticipatory guidance for an infant for the 4th month should include the fact that she probably will:
a) be able to turn over onto the back.
b) insist on things being done her way.
c) have many "blue" or moody periods.
d) develop a fear of strangers.
answer
be able to turn over onto the back.
Infants typically turn over front to back at 4 months, enlarging the area of the house that needs to be childproofed.
question
The mother of a 1-month-old infant voices concern about her baby's respirations. She states they are rapid and irregular. Which information should the nurse provide?
a) The irregularity of the infant's respirations are concerning; I will notify the physician.
b) The normal respiratory rate for an infant at this age is between 20 and 30 breaths per minute.
c) An infant at this age should have regular respirations.
d) The respirations of a 1-month-old infant are normally irregular and periodically pause.
answer
The respirations of a 1-month-old infant are normally irregular and periodically pause.
The normal respiratory rate for a 1-month-old infant is 30 to 60 breaths per minute. By 1 year of age the rate will be 20 to 30 breaths per minute. The respiratory patterns of the 1-month-old infant are irregular. There may normally be periodic pauses in the rhythm.
question
A 5-month-old infant being assessed was born at 32 weeks. The nurse doing the well-child check-up should compare the baby to what norms?
a) The development of a 3-month-old
b) The development of a 10-week-old
c) The growth of a 5-month-old
d) The growth of a 2-month-old
answer
The development of a 3-month-old
The infant was born 8 weeks early. Two months are subtracted from the present age of 5 months. Both growth and development should be assessed using 3-month norms.
question
The nurse is educating the mother of a 6-month-old boy about the symptoms for teething. Which symptom would the nurse identify?
a) Running a mild fever or vomiting
b) Choosing soft foods over hard foods
c) Increased biting and sucking
d) Frequent loose stools
answer
Increased biting and sucking
The nurse would advise the mother to watch for increased biting and sucking. Mild fever, vomiting, and diarrhea are signs of infection. The child would more likely seek out hard foods or objects to bite on
question
The best way for an infant's father to help his child complete the developmental task of the first year is to:
a) expose her to many caregivers to help her learn variability.
b) keep her stimulated with many toys.
c) talk to her at a special time each day.
d) respond to her consistently.
answer
respond to her consistently.
A sense of trust is difficult to learn if things are constantly changing. Consistently responding to an infant's needs helps to build a sense of trust.
question
A 2-month-old body has inconsolable crying, is gassy, and constantly draws his legs up. It has been determined that the boy has colic. What is the best intervention to treat colic?
a) He needs to try a different formula to assess for sensitivity.
b) His parents should sing and play music to comfort him.
c) He is hungry so his mom should feed him more.
d) His mom should have a regular diet.
answer
He needs to try a different formula to assess for sensitivity.
Colic peaks between 3 weeks and 6 months of age. Treatment is a restful, soothing environment. Changing an infant's formula or having a breastfeeding mom decrease her intake of gassy foods may alleviate the symptoms.
question
The mother of an infant asks you when to begin brushing her son's teeth. Your best response would be:
a) as soon as he begins to eat fruit.
b) as soon as the first tooth erupts.
c) when weaning is complete.
d) by 12 months of age.
answer
as soon as the first tooth erupts.
Toothbrushing should begin with the eruption of the first tooth.
question
The nurse is educating the mother of a newborn about feeding practices. The nurse correctly advises the mother that:
a) the newborn's stomach can hold between one-half and 1 ounce.
b) demand scheduled feeding is associated with increased difficulty getting the baby to sleep through the night.
c) most newborns need to eat about 4 times per day.
d) the best feeding schedule offers food every 4 to 6 hours.
answer
the newborn's stomach can hold between one-half and 1 ounce.
The capacity of the normal newborn's stomach is between one-half and one ounce. The recommended feeding plan is to use a demand schedule. Newborns may eat as often as 1½ to 3 hours. Demand scheduled feedings are not associated with problems sleeping at night.
