Question 1

The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night.What intervention should the nurse suggest in helping the parent to cope with this sleep disturbance?

Accepted Answer

An appropriate intervention for a child who resists going to bed is to establish limited rituals such as a bath or story that signal readiness for bed and consistently follow through with the ritual.Punishing the child will not alleviate the resistance problem and may only add to the frustration.Allowing the child to fall asleep in a different room and to watch television to fall asleep are not recommended approaches to sleep resistance.

Question 2

In terms of fine motor development,what should the 3-year-old child be expected to do?

Accepted Answer

Three-year-old children are able to accomplish the fine motor skill of copying (drawing)a circle.The ability to tie shoelaces,to use scissors or a pencil very well,and to draw a person with seven to nine parts are fine motor skills of 5-year-old children.

Question 3

Which type of play is most typical of the preschool period?

Accepted Answer

Associative play is group play in similar or identical activities but without rigid organization or rules.School-age children play in teams.Parallel play is that of toddlers.Solitary play is that of infants.

Question 4

In terms of cognitive development,a 5-year-old child should be expected to do which?

Accepted Answer

Magical thinking is believing that thoughts can cause events.An example is thinking of the death of a parent might cause it to happen.Abstract thought does not develop until the school-age years.The concept of conservation is the cognitive task of school-age children,ages 5 to 7 years.A 5-year-old child cannot understand another person's perspective.

Question 5

At a seminar for parents with preschool-age children,the nurse has discussed anticipatory tasks during the preschool years.Which statement by a parent should indicate a correct understanding of the teaching?

Accepted Answer

A 3-year-old child exhibits a more stable appetite than during the toddler years and is more willing to try different foods.A 4-year-old child is imaginative and indulges in telling "tall tales" and may have an imaginary playmate; these are normal findings,not signs of stress.Also a 4-year-old child has an increasing curiosity in sexuality,which is not a sign of child abuse.A 5-year-old child is usually tranquil,not aggressive like a 4-year-old child.

Question 6

Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom.What is the most appropriate recommendation for the nurse to make?

Accepted Answer

Three-year-old children become aware of anatomic differences and are concerned about how the other sex "works." Such exploration should not be condoned or condemned.Children should not be punished for this normal exploration.This is age appropriate and not dangerous behavior.Encouraging the children to ask their parents questions and redirecting their activity is more appropriate than giving permission.

Question 7

During a well-child visit,the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten.The boy's birthday is close to the cut-off date,and he has not attended preschool.What is the nurse's best recommendation?

Accepted Answer

A developmental assessment with a screening tool that addresses cognitive,social,and physical milestones can help identify children who may need further assessment.A readiness assessment involves an evaluation of skill acquisition.Stating the child should start kindergarten or go to preschool and postpone kindergarten does not address the father's concerns about readiness for school.Talking to other parents about readiness does not ascertain if the child is ready and does not address the father's concerns.

Question 8

A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool.He is aggressive toward the other children and the teachers.This behavior has been a problem for approximately 8 to 10 weeks.His parent asks the nurse for advice.What is the most appropriate intervention?

Accepted Answer

The preschool years are a time when children learn socially acceptable behavior.The difference between normal and problematic behavior is not the behavior but the severity,frequency,and duration.This child's behavior meets the definition requiring professional evaluation.Some aggressive behavior is within normal limits,but at 8 to 10 weeks,this behavior has persisted too long.There is no indication that the parent is using inconsistent discipline.A part of the evaluation is to obtain validation for behavior parent reports.

Question 9

A 4-year-old child tells the nurse that she doesn't want another blood sample drawn because "I need all of my insides and I don't want anyone taking them out." What is the nurse's best interpretation of this?

Accepted Answer

Preschoolers have little understanding of body boundaries,which leads to fears of mutilation.The child is not capable of being dramatic at this age.She truly has fear.Body image is just developing in school-age children.Preschoolers do not have good understanding of their bodies.

Question 10

The nurse is planning to bring a preschool child a toy from the playroom.What toy is appropriate for this age group?

Accepted Answer

The most characteristic and pervasive preschooler activity is imitative,imaginative,and dramatic play.Farm animals and equipment would provide hours of self-expression.Building blocks are appropriate for older infants and toddlers.A 500-piece puzzle or a paint by number picture would be appropriate for a school-age child.

Question 11

The parent of a 4-year-old boy tells the nurse that the child believes "monsters and bogeymen" are in his bedroom at night.What is the nurse's best suggestion for coping with this problem?

Accepted Answer

Involve the child in problem solving.A night light shows a child that imaginary creatures do not lurk in the darkness.Letting the child sleep with his parents will not get rid of the fears.A 4-year-old child is in the preconceptual stage and cannot understand logical thought.

Question 12

During the preschool period,the emphasis of injury prevention should be placed on what?

Accepted Answer

Education about safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers.Limitation of physical activities is not appropriate.Punishment may make children scared of trying new things.Constant vigilance and protection are not practical at this age because preschoolers are becoming more independent.

Question 13

What characteristic best describes the language skills of a 3-year-old child?

Accepted Answer

Because of the dramatic vocabulary increase at this age,3-year-old children are known to talk incessantly regardless of whether anyone is listening.A 4- to 5-year-old child asks lots of questions and can follow simple directional commands.A 6-year-old child can describe an object according to its composition.

Question 14

The nurse is caring for a hospitalized 4-year-old boy.His parents tell the nurse they will be back to visit at 6 PM.When he asks the nurse when his parents are coming,what would the nurse's best response be?

Accepted Answer

A 4-year-old child understands time in relation to events such as meals.Children perceive "soon" as a very short time.The nurse may lose the child's trust if his parents do not return in the time he perceives as "soon." Children cannot read or use a clock for practical purposes until age 7 years."I will tell you every time I see you how much longer it will be" assumes the child understands the concepts of hours and minutes,which does not occur until age 5 or 6 years.

Question 15

The nurse is explaining average weight gain during the preschool years to a group of parents.Which average weight gain should the nurse suggest to the parents?

Accepted Answer

The average weight gain remains approximately 2 to 3 kg (4.5-6.5 lb)per year during the preschool period.

Question 16

According to Piaget,magical thinking is the belief of which?

Accepted Answer

Because of their egocentrism and transductive reasoning,preschoolers believe that thoughts are all powerful.Believing God is an imaginary friend is an example of concrete thinking in a preschooler's spiritual development.Cause-and-effect implies logical thought,not magical thinking.Believing that if the skin is broken,the insides will come out is an example of concrete thinking in development of body image.

Question 17

What is descriptive of the nutritional requirements of preschool children?

Accepted Answer

Parents need to be reassured that the quality of food eaten is more important than the quantity.Children are able to self-regulate their intake when offered foods high in nutritional value.The average daily caloric intake should be approximately 1800 calories.Toddlers and preschoolers have similar nutritional requirements.There is an overall slight decrease in needed calories and fluids during the preschool period.

Question 18

A 4-year-old boy is hospitalized with a serious bacterial infection.He tells the nurse that he is sick because he was "bad." What is the nurse's best interpretation of this comment?

Accepted Answer

Preschoolers cannot understand the cause and effect of illness.Their egocentrism makes them think they are directly responsible for events,making them feel guilt for things outside of their control.Children of this age react to stress by regressing developmentally or acting out.Maladaptation is unlikely.This comment does not imply excessive discipline at home.

Question 19

A child age 4 1/2 years sometimes wakes her parents up at night screaming,thrashing,sweating,and apparently frightened,yet she is not aware of her parents' presence when they check on her.She lies down and sleeps without any parental intervention.This is most likely what?

Accepted Answer

This is a description of a sleep terror.The child is observed during the episode and not disturbed unless there is a possibility of injury.A child who awakes from a nightmare is distressed.She is aware of and reassured by the parent's presence.This is not the case with sleep apnea.This behavior is not indicative of seizure activity.

Question 20

What dysfunctional speech pattern is a normal characteristic of the language development of a preschool child?

Accepted Answer

Stammering and stuttering are normal dysfluency in preschool-age children.Lisps are not a normal characteristic of language development.Echolalia and repetition are traits of toddlers' language.

Quiz 13: Health Promotion of the Preschooler and Family