Which self-care skill would the nurse expect a 4-year-old child to be capable of performing?

What are the primary goals in the nutritional management of children with failure to thrive (FTT)? Select all that apply.

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• Which self care skill with a nurse expect a four
• Which source of stress would the nurse anticipate in a 4 year old child?
• Which developmental language milestone would the nurse expect in a 4 year old child?
• What skill that the nurse should expect a 5

A. allow for catch-up growth.
B. correct nutritional deficiencies.
C. achieve ideal weight for height.
D. restore optimum body composition.
E. educate the parents or primary caregivers on child's nutritional requirements

The goal is to provide sufficient calories to support "catch-up" growth, which is a rate of growth greater than the expected rate for age. Accurate assessment of the child's initial weight and height is important, as well as the daily recording of weight, food intake, and feeding behavior. Correction of nutritional deficiencies is another goal that may require multivitamin supplements and dietary supplements with high-calorie foods and drinks in addition to treating coexisting medical problems to optimize body composition. A goal is to provide education to the parents or primary caregiver of the child's nutritional requirements along with appropriate feeding methods.

The nurse has prepared feeding guidelines for an infant with failure to thrive (FTT). The nurse instructs the student nurse to feed the infant. Which guidelines should the nurse explain to the student nurse before feeding? Select all that apply.

"Continue to talk to the infant while providing the feeding."
"Provide a quiet, unstimulating atmosphere to the infant."
"Maintain a calm, even temperament throughout the meal."

The nurse should instruct the student nurse that an infant with FTT is very distractible, so the nurse should be able to refocus the infant's attention on feeding. The student nurse should give positive reinforcement to the infant during the feeding. Therefore the nurse should talk to the infant throughout the feeding. The nurse should provide a quiet, unstimulating atmosphere to the infant because the infant with failure to thrive (FTT) is very distractible and his or her attention is diverted with minimal stimuli. The nurse should maintain calm, even temperament throughout the meal because negative outbursts may be common in this infant. The student nurse should maintain face-to-face contact with the infant while eating. This provides a positive environment that the infant can start related to feeding time. New foods need to be introduced slowly because infants with FTT are often exclusively bottle-fed and may be reluctant about other types of food.

A 6-year-old child with attention deficit hyperactivity disorder (ADHD) is brought to the hospital with reports of weight loss and loss of appetite. The child has been on the psychostimulant methylphenidate (Ritalin) for the past few months. The child has shown improvement in school since taking the medication. What is the most appropriate instruction given to the parents?

Give the medication with a meal.

Loss of appetite and weight loss are possible side effects of psychostimulant medication administration. Parents should be advised to give the medication with or after a meal to help relieve these symptoms. It is not recommended to stop the drug immediately because the child shows improvement after the administration of the drug. Reducing the dose would deprive the child of the therapeutic effect of the drug. Parents should also be advised to give a nutritious snack to the child in the evening, when the drug's effect is decreasing.

A child is diagnosed with attention deficit hyperactivity disorder (ADHD). What symptoms in the child support the diagnosis? Select all that apply.

The child cannot remember instructions given

The child refuses to work on a jigsaw puzzle.

The child squirms when sitting in a seat.

Children with attention deficit hyperactivity disorder (ADHD) have three major symptoms: inattentiveness, hyperactivity, and impulsiveness. The children squirm when seated, which signifies hyperactivity. Children with ADHD dislike engaging in activities that require concentration and a lot of mental effort. Therefore putting together a jigsaw puzzle would be difficult for a child with ADHD to perform. Children with ADHD tend to forget things very easily because they have difficulty paying attention to the directions given. Children tend to talk too much when they are hyperactive. This is a sign of ADHD. Children with ADHD show less interest in activities that keep them quiet or that are time consuming.

A 10-year-old child is diagnosed with an autism spectrum disorder (ASD). The parents ask the nurse about the cause of the disorder. Which answer given by the nurse is most appropriate?

"The exact cause of autism spectrum disorders is unknown.

Although the exact cause of ASD is not known, the nurse should always help parents understand that they are not responsible for the child's condition. There are many theories about the cause of ASD, but nothing is definitive. High intake of proteins is necessary during pregnancy because it promotes proper growth and development of the fetus. Vaccines containing thimerosal are not associated with ASD. Thimerosal is a preservative found in some vaccines. Consumption of alcohol during pregnancy leads to fetal alcohol syndrome, not autism.

The nurse is assessing growth and development in an infant and suspects the child has infantile autism. What observations led the nurse to come to this conclusion?

Unresponsiveness to sounds

Functional hearing loss is associated with infantile autism. The child has central auditory imperceptions and is unresponsive to sounds as a result of hearing loss. The child may have reduced development and reduced increase in height and weight relative to other children. The presence of bowed legs can be caused by vitamin D deficiency but is not an indication of autism

Autism is a complex developmental disorder. Diagnostic criteria for autism include delayed or abnormal functioning in which area(s) before 3 years of age? Select all that apply.

Social interaction

Inability to maintain eye contact

Language as used in social communication

Children diagnosed with autism show delayed or abnormal functioning in social interactions. A hallmark characteristic of autism is the child's inability to make and maintain eye contact. A characteristic of autism is the child's delay of language at an early age or the sudden deterioration in extant expressive speech. Parallel play is not an area in which autistic children may show delay. When interacting with other children in other forms of play, they display functional limitations. Gross motor development is not an area in which autistic children show delayed or abnormal functioning.

The nurse is assessing a newborn with Down syndrome. The newborn's parent tells the nurse, "We are having a hard time holding our baby. We didn't have this hard of a time with our other children." What would be the nurse's best response?

Children with Down syndrome have lower muscle tone.

Newborns with Down syndrome have joint hyperflexibility and low muscle tone. This can make it difficult to hold the newborn because he or she can go limp like a rag doll. This makes it difficult for the parents to embrace and provide warmth to their newborn. This may make parents feel that the newborn is not bonding with them, but difficulty holding the child does not indicate impaired bonding between the child and parents. Inability to understand the child's needs and nonverbal communication indicates undeveloped bonding. Asking the parents whether they are more apprehensive does not answer their question. It is also a closed-ended question, which is not therapeutic communication. Telling the parents they need to see a counselor is not appropriate. They just need support and teaching.

A week-old newborn is assessed for body weight, birth marks, and height. The birth weight is lower than what it should be for height. Which physical feature of the newborn makes the nurse conclude that the newborn is affected by Down syndrome?

Short and broad neck

One of the characteristics of Down syndrome is a short, broad neck. These children have an impaired immune system and are at risk for spinal cord compression. Physical features such as long and thin fingers, short and thin lips, and broad and long nose are all common in a normal child and do not indicate any abnormality.

A child with cerebral palsy (CP) is experiencing repeated muscle contractures. What advice does the nurse convey to the family to prevent this condition? Select all that apply.

Use assistive devices, such as wrist splits and ankle-foot orthoses

"Perform stretching exercises on the affected muscles of the child.

The family members of the child and the child's parents should be well aware of the different stretching exercises for the affected muscles. It ensures that the child does not have muscle contractures. Assistive devices, such as wrist splints and ankle-foot orthoses, are excellent to prevent muscle contracture. However, it is essential that such devices be used according to the specification of the primary health care provider and at a safety level appropriate for the child's age. ADLs and self-help skills should be promoted so the child becomes self-dependent. This is not done to prevent muscle contracture. The technique of jaw control during and after feeding is used to prevent choking, and it assists in the mobilization of the food. The family of the child is advised to remove thick carpeting to prevent injuries during mobilization in home.

What do the major goals of therapy for children with cerebral palsy include?

Recognizing the disorder early and promoting optimal development

Because cerebral palsy is currently a permanent disorder, the goal of therapy is to promote optimal development. This is done through early recognition and beginning of therapy. It is very difficult to reverse degenerative processes. The underlying defect cannot be cured. Cerebral palsy is not contagious.

The nurse is educating a group of parents about safety promotion and injury prevention in the infant. Which statement made by a parent indicates effective teaching?

"Diaper pins should be kept closed and away from the infant.

Which activity of a 10-month-old infant indicates the development of object permanence?

Looking for a hidden object that the infant had seen earlier

At the age of 9 to 10 months, object permanence is developed in infants. This means that they will look for the object that they had seen before and is now hidden. It indicates cognitive development in the infant. Grasping the feet and pulling them to the mouth, picking up a toy and putting it into the mouth, and transferring the objects from one hand to the other indicate development of fine motor skill in the infant.

A hospitalized toddler clings to a worn, tattered blanket. She screams when anyone tries to take it away. What is the nurse's best explanation to the parents for the child's attachment to the blanket?

The blanket is an important transitional object

The blanket is an important transitional object that provides security when the child is separated from parents. Transitional objects are helpful when the child is experiencing an increased stress situation, such as hospitalization. It is not immature at this age. This does not reflect bonding behavior. This is not related to the developmental task of individuation-separation.

The nurse is discussing toddler development with a parent. Which intervention will foster the achievement of autonomy?

Encourage the toddler to do things for himself or herself when he or she is capable of doing them

Toddlers have an increased ability to control their bodies, themselves, and the environment. Autonomy develops when children complete tasks of which they are capable. To successfully achieve autonomy, the toddler needs to have a sense of accomplishment. This does not occur if parents complete tasks. Children at this age engage in parallel play, which does not foster autonomy. Helping the toddler learn the difference between right and wrong is too advanced for toddlers and does not contribute to autonomy.

The nurse is assessing a 4-year-old child. What age-appropriate language skills should the nurse expect in this child? Select all that apply.

The child at this age has a vocabulary of 1500 words

The child uses complete sentences of 3 to 4 words

A nurse should be aware of the normal age appropriate developmental skills including language skills. A 4-year-old child should have a vocabulary of 1500 words and should be able to complete sentences of 3 to 4 words. A child of 5 years has a vocabulary of 2100 words, can follow three commands in succession, and can use sentences of 6 to 8 words with all parts of speech.

The parents of a 3-year-old child are worried as their child seems to have imaginary friends. They report that their child talks to friends who do not exist. What should the nurse tell the parents?

The child's behavior is normal for a girl her age.

The nurse is teaching a student nurse about the growth and development in school-age children. The nurse states that there are few prominent changes that can be found in the school-age child as compared to a preschooler. Which statement should the nurse include in the teaching? Select all that apply.

Leg length increases in relation to the child's height.

Head circumference decreases in relation to height

Permanent teeth appear too large for the face

During the school-age period, children's height rapidly increases to meet their physical needs. As a result, the head circumference of a school-age child is smaller when compared to overall height. Due to the loss of baby teeth, early deciduous teeth are lost and secondary teeth start to appear in the school-age child. These secondary permanent teeth may appear too large for the child's face. The child's leg increases when compared to increase in the height. Therefore the school-age child has long legs. The school-age child appears to be thinner when compared to the preschooler due to the excessive physical activity. The fat gets distributed evenly, and the child does not have a bulky appearance. The caloric needs of the child gradually decrease in the school-age child as compared to the preschooler. However, the parents must be informed to give a balanced diet to children for proper physical growth.

The nurse plans to use tasks based on the concept of conservation to assess the cognitive development of a 5-year-old child. What is the appropriate method used by the nurse?

Asking the child to compare two differently sized glasses of water

According to Piaget, the school-age child uses thought processes to experience events and actions. They understand the concept of conservation and differentiate things based on their volume, size, and area. To assess the cognitive development in the child, the nurse can ask the child to compare two different sized glasses of water to determine which has more. Only a 9- to 10-year-old child will be able to understand the concept of conservation related to weight, area, and volume occupied by the objects. Therefore these concepts cannot be tested in a 5-year-old child.

The nurse assesses an adolescent girl and finds stage 2 development of the breasts. What changes in the girl support the observations?

Enlargement of the areolar diameter and small area of elevation around the papilla

he physical changes of puberty are primarily the result of hormonal activity. The initial indication of puberty is the appearance of breast buds. Nurses should assess physical and psychological changes as part of routine health checkups. Stage 2 is the breast bud stage, characterized by a small area of elevation around the papilla and enlargement of the areolar diameter. Stage 4 includes projection of areola and papilla to form a secondary mound, with increased breast size and elevation. In stage 3, the breast begins to appear more elevated, without separation of the contours. In stage 5, the breast reaches final adult size, and projection of the papilla only is caused by recession of the areola into the general contour.

Which self care skill with a nurse expect a four

What self-care skill does the nurse expect 4-year-olds to be capable of performing? Four-year-old children can put on a shirt and can fasten it if the buttons are large. Four-year-olds will be able to comb, but not part, their hair.

Which source of stress would the nurse anticipate in a 4 year old child?

Attention, insecurity, and activity level are sources of stress in four-year-old children.

Which developmental language milestone would the nurse expect in a 4 year old child?

Because of developing cognitive abilities, 4-year-old children can form six- to eight-word sentences. Because of expanded experiences and developing cognitive ability, the 4-year-old should have a vocabulary of approximately 150 to 200 words. The use of appropriate grammar does not develop until 9 to 12 years of age.

What skill that the nurse should expect a 5

A useful skill that the nurse should expect a 5-year-old child to be able to master is to: Tie shoelaces. The nurse is guiding parents in selecting a day care facility for their child.

Which self care skill would the nurse expect a 4

Which psychosocial developmental skill would the nurse anticipate in a 4

What skill that the nurse should expect a 5

Which response would the nurse have when a 4