Question 1

In terms of gross motor development,what would the nurse expect a 5-month-old infant to do?

Accepted Answer

Rolling from abdomen to back is developmentally appropriate for a 5-month-old infant. The ability to roll from back to abdomen usually occurs at 6 months old. Sitting erect without support is a developmental milestone usually achieved by 8 months. The 10-month-old infant can usually move from a prone to a sitting position.

Question 2

Which statement best describes the infant's physical development?

Accepted Answer

Growth is very rapid during the first year of life. The birth weight has approximately doubled by age 5 to 6 months and triples by age 1 year. The anterior fontanel closes at age 12 to 18 months. Binocularity is not established until age 15 months. Maternal iron stores are usually depleted by age 6 months.

Question 3

An appropriate play activity for a 7-month-old infant to encourage visual stimulation is:

Accepted Answer

Because object permanence is a new achievement,peek-a-boo is an excellent activity to practice this new skill for visual stimulation. Playing pat-a-cake and showing how to clap hands will help with kinetic stimulations. Imitating animal sounds will help with auditory stimulation.

Question 4

The parents of a 9-month-old infant tell the nurse that they have noticed foods such as peas and corn are not completely digested and can be seen in their infant's stool. The nurse bases her explanation on knowing that:

Accepted Answer

The immaturity of the digestive tract is evident in the appearance of the stools. Solid foods are passed incompletely broken down in the feces. An excess quantity of fiber predisposes the child to large,bulky stools. This is a normal part of the maturational process,and no further investigation is necessary.

Question 5

The nurse is doing a routine assessment on a 14-month-old infant and notes that the anterior fontanel is closed. This should be interpreted as:

Accepted Answer

Because the anterior fontanel normally closes between ages 12 and 18 months,this is a normal finding,and no further intervention is required.

Question 6

What behavior indicates that an infant has developed object permanence?

Accepted Answer

During the first 6 months of life infants believe that objects exist only as long as they can see them. When infants search for an object that is out of sight,this signals the attainment of object permanence,whereby an infant knows that an object exists even when it is not visible. Between ages 8 and 12 weeks infants begin to respond differentially to the mother. They cry,smile,vocalize,and show distinct preference for the mother. This preference is one of the stages that influence the attachment process,but it is too early for object permanence. Recognizing familiar objects is an important transition for the infant,but it does not signal object permanence. The ability to understand cause and effect is part of secondary schema development.

Question 7

Most infants begin to fear strangers at age:

Accepted Answer

Between ages 6 and 8 months fear of strangers and stranger anxiety become prominent and are related to the infant's ability to discriminate between familiar and nonfamiliar people. At age 2 months infants are just beginning to respond differentially to the mother. At age 4 months the infant is beginning the process of separation individuation when the infant begins to recognize self and mother as separate beings. Twelve months is too late and requires referral for evaluation if the child does not fear strangers at this age.

Question 8

At what age should the nurse expect an infant to begin smiling in response to pleasurable stimuli?

Accepted Answer

At age 2 months the infant has a social,responsive smile. A reflex smile is usually present at age 1 month. The 3-month-old can recognize familiar faces. At age 4 months the infant can enjoy social interactions.

Question 9

The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The nurse should expect the infant to now weigh approximately:

Accepted Answer

Birth weight doubles at about age 5 to 6 months. At 6 months a child who weighed 7 pounds at birth would weigh approximately 15 pounds. Ten pounds is too little. The infant would have gone from the 50th percentile at birth to below the 5th percentile. Twenty pounds or more is too much. The infant would have tripled the birth weight at 6 months.

Question 10

At which age can most infants sit steadily unsupported?

Accepted Answer

Sitting erect without support is a developmental milestone usually achieved by 8 months. At age 4 months an infant can sit with support. At age 6 months,the infant will maintain a sitting position if propped. By 10 months the infant can maneuver from a prone to a sitting position.

Question 11

According to Piaget,the 6-month-old infant would be in what stage of the sensorimotor phase?

Accepted Answer

Infants are usually in the secondary circular reaction stage from age 4 months to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. Shaking is performed to hear the noise of the rattle,not just for shaking. The use of reflexes is primarily during the first month of life. Primary circular reaction stage marks the replacement of reflexes with voluntary acts. The infant is in this stage from age 1 month to 4 months. The fourth sensorimotor stage is coordination of secondary schemata. This is a transitional stage in which increasing motor skills enable greater exploration of the environment.

Question 12

Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother tells the nurse that she recently began to suck her thumb. The best nursing intervention is to:

Accepted Answer

Sucking is an infant's chief pleasure,and she may not be satisfied by bottle-feeding or breastfeeding alone. During infancy and early childhood there is no need to restrict nonnutritive sucking. Dental damage does not appear to occur unless the use of the pacifier or finger persists after age 4 to 6 years. The nurse should explore with the mother her feelings about pacifier vs. thumb. This is a normal behavior to meet nonnutritive sucking needs. No data support that Latasha has sensory deprivation.

Question 13

In terms of fine motor development,the infant of 7 months should be able to:

Accepted Answer

By age 7 months infants can transfer objects from one hand to the other,crossing the midline. The crude pincer grasp is apparent at about age 9 months. The child can scribble spontaneously at age 15 months. At age 12 months the child can release cubes into a cup.

Question 14

The best play activity for a 6-month-old infant to provide tactile stimulation is to:

Accepted Answer

The feel of the water while the infant is splashing provides tactile stimulation. Various colored blocks provide visual stimulation for a 4- to 6-month-old. Music box,tapes,and CDs provide auditory stimulation. Swings and strollers provide kinesthetic stimulation.

Question 15

The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says "No" firmly and removes her from near the outlet. The nurse should use this opportunity to teach the father that Megan:

Accepted Answer

By age 10 months children are able to associate meaning with words. The father is using both verbal and physical cues to alert the child to dangerous situations. The child should be old enough to understand the word "No."
 The 10-month-old is too young to understand the purpose of an electric outlet. The father is using both verbal and physical cues to teach safety measures. Physical discipline should be avoided.

Question 16

Sara,age 4 months,was born at 35 weeks' gestation. She seems to be developing normally,but her parents are concerned because she is a "more difficult" baby than their other child,who was term. The nurse should explain that:

Accepted Answer

Infant temperament has a strong biologic component. Together with interactions with the environment,primarily the family,the biologic component contributes to the infant's unique temperament. Children perceived as difficult may respond better to scheduled feedings and structured caregiving routines than to demand feedings and frequent changes in routines. Sara's temperament has been created by both biologic and environmental factors. The nurse should provide guidance in parenting techniques that are best suited to Sara's temperament.

Question 17

By what age does the posterior fontanel usually close?

Accepted Answer

The bones surrounding the posterior fontanel fuse and close by age 6 to 8 weeks. Ten weeks or longer is too late.

Question 18

By what age should the nurse expect that an infant will be able to pull to a standing position?

Accepted Answer

Most infants can pull themselves to a standing position at age 9 months. Infants who are not able to pull themselves to standing by age 11 to 12 months should be further evaluated for developmental dysplasia of the hip. At 6 months the infant has just obtained coordination of arms and legs. By age 8 months infants can bear full weight on their legs. Any infant who cannot pull to a standing position by age 1 year should be referred for further evaluation.

Question 19

What information could be given to the parents of a 12-month-old child regarding appropriate play activities for this age?

Accepted Answer

The 12-month-old child is able to pull to a stand and walk holding on or independently. Appropriate toys for this age child include large pull toys for kinesthetic stimulation. A cradle gym should not be placed across the crib. Finger paints are appropriate for older children. A 12-month-old child does not have the stability to use a stick horse.

Question 20

A 3-month-old infant,born at 38 weeks of gestation,will hold a rattle if it is put in her hands,but she will not voluntarily grasp it. The nurse should interpret this as:

Accepted Answer

This indicates normal development. Reflexive grasping occurs during the first 2 to 3 months and then gradually becomes voluntary. No evidence of neurologic dysfunction is present.

Quiz 36: The Infant and Family