Deck 11: Developmental Management of Early Childhood

Question 1

The primary care pediatric nurse practitioner performs a developmental assessment on a 32-month-old child. The child's parent reports that about 70% of the child's speech is intelligible. The pediatric nurse practitioner observes that the child has difficulty pronouncing "t," "d," "k," and "g" sounds. Which action is correct?

A) Evaluate the child's cognitive abilities.
B) Obtain a hearing evaluation.
C) Reassure the parent that this is normal.
D) Refer the child to a speech therapist.

Answer 1

C

Question 2

The mother of a 3-year-old child takes the child to a play group once a week. She expresses concern that the child plays with toys but does not interact with the other toddlers. What will the primary care pediatric nurse practitioner counsel the mother?

A) The child probably is very shy but will outgrow this tendency with repeated exposure to other children.
B) The toddler may have a language delay that interferes with socialization with other children.
C) Toddlers may be interested in other children but usually do not engage in interactive play.
D) Toddlers need more structured play to encourage interaction and socialization with others.

Answer 2

C

Question 3

The primary care pediatric nurse practitioner learns that the mother of a 3-year-old child has been treated for depression for over 5 years. Which aspect of this child's development will be of the most concern to the nurse practitioner?

A) Fine motor
B) Gross motor
C) Social/emotional
D) Speech and language

Answer 3

C

Question 4

The primary care pediatric nurse practitioner is offering anticipatory guidance to the parents of a 12-month-old child. The parents are bilingual in Spanish and English and have many Spanish-speaking relatives nearby. They are resisting exposing the child to Spanish out of concern that the child will not learn English well. What will the pediatric nurse practitioner tell the parents?

A) Children who learn two languages simultaneously often confuse them in conversation.
B) Children with multi-language proficiency do not understand that others cannot do this.
C) Learning two languages at an early age prevents children from developing a dominant language.
D) Most bilingual children are able to shift from one language to another when appropriate.

Question 5

The parents of a 3-year-old child are concerned that the child has begun refusing usual foods and wants to eat mashed potatoes and chicken strips at every meal and snack. The child's rate of weight has slowed, but the child remains at the same percentile for weight on a growth chart. What will the primary care pediatric nurse practitioner tell the parents to do?

A) Allow the child to choose foods for meals to improve caloric intake.
B) Place a variety of nutritious foods on the child's plate at each meal.
C) Prepare mashed potatoes and chicken strips for the child at mealtimes.
D) Suggest cutting out snacks to improve the child's appetite at mealtimes.

Question 6

The primary care pediatric nurse practitioner (PNP) is evaluating health literacy in the mother of a new preschool-age child. How will the nurse practitioner assess this?

A) Ask the child how many books he has at home.
B) Ask the mother about her highest grade in school.
C) Ask the mother to determine the correct dose of a drug from a label.
D) Ask the mother to read a health information handout aloud.

Question 7

The parent of a 24-month-old child asks the primary care pediatric nurse practitioner when toilet training should begin. How will the pediatric nurse practitioner respond?

A) "Begin by reading to your child about toileting."
B) "Most children are capable by age 2 years."
C) "Tell me about your child's daily habits."
D) "We should assess your child's motor skills."

Question 8

During a well child assessment of an 18-month-old child, the primary care pediatric nurse practitioner observes the child point to a picture of a dog and say, "Want puppy!" The nurse practitioner recognizes this as an example of what type of speech?

A) Holophrastic
B) Receptive
C) Semantic
D) Telegraphic

Question 9

The primary care pediatric nurse practitioner is counseling the parents of a toddler about appropriate discipline. The parents report that the child is very active and curious, and they are worried about the potential for injury. What will the pediatric nurse practitioner recommend?

A) Allow the child to explore and experiment while providing appropriate limits.
B) Be present while the child plays to continually teach the child what is appropriate.
C) Let the child experiment at will and to make mistakes in order to learn.
D) Say "no" whenever the child does something that is not acceptable.

Question 10

The primary care pediatric nurse practitioner is evaluating a 2-year-old with a documented speech delay. Screenings to assess motor skills and cognition are normal, and the child passed a recent hearing test. What will the pediatric nurse practitioner do next?

A) Ask the child's parents whether they read to the child.
B) Give parents educational materials to encourage speech.
C) Refer the child to an early intervention program.
D) Suggest that they purchase age-appropriate music videos.

Question 11

The primary care pediatric nurse practitioner performs a physical examination on a 9-month-old infant and notes two central incisors on the lower gums. The parent states that the infant nurses, takes solid foods three times daily, and occasionally takes water from a cup. What will the pediatric nurse practitioner counsel the parent to promote optimum dental health?

A) To begin brushing the infant's teeth with toothpaste
B) To consider weaning the infant from breastfeeding
C) To discontinue giving fluoride supplements
D) To make an appointment for an initial dental examination