Peds Exam 3 Unit 9 (31,32,33,34,35)

In terms of language and cognitive development, which behavior is expected of a 4-year-old child? (Preschool 3-5 years)

• Stuttering, disfluency

• Intuitive behavior

• Shift from egocentric to social awareness and the ability to consider others’ viewpoints

• Egocentric communication

• Play, which becomes children’s way of understanding, adjusting to, and working out life’s experiences

• Magical thinking,

Acyclovir is given to children with chickenpox for what purpose? (Preschool 3-5 years)

• Shorten the duration of illness

• Reduce viral shedding

• Decrease the severity of symptoms

• Prevent complications in high-risk groups

Parents tell the nurse that they found their 3-year-old daughter and a male cousin inspecting each other.. Which is the most appropriate recommendation? (Preschool 3-5 years)

• Remain calm and avoid overreacting or scolding the children

• Gently redirect to another activity

• Explain to the parents that this behavior is normal for 3-year-olds

• Encourage the parents to answer any questions the children may have about body differences in a simple, age-appropriate manner

• Suggest the parents teach children about privacy and personal boundaries

Which accomplishment would the nurse expect of a healthy 3-year-old child?(Preschool 3-5 years)

• Gross motor Skills

  • Ride a tricycle

  • Walk on tiptoes

  • Balance on one foot for a few seconds

  • Do a broad Jump

• Fine Motor Skills

  • Shoe increased skillful manipulation in drawing and dressing

• Language skills

  • Use sentences of about 3-4 words

  • ask many questions

  • use plurals, correct pronouns, and the past tense of verbs

  • Name of familiar objects, animals, body parts, and relatives

• Cognitive Skills

  • Know their age and gender

  • Count three objects correctly

• Social and emotional skills

  • Express feelings verbally rather than acting them out

  • Engage in more complex pretend play

A 4-year-old says, “ I need all my insides.” How should the nurse interpret this? (Preschool 3-5 years)

• Normal expression of anxiety about medical procedures

• Indication that the child needs reassurance and an age-appropriate explanation

• Sign that the child is developing body awareness, but still has magical thinking

• An opportunity to provide gentle education about the body’s ability to heal and remain whole

• Utilize concrete explanations, reassure the child that they will remain whole.

Why are imaginary playmates beneficial to the preschool child? (Preschool 3-5 years)

• Companionship — Provide Friendship during times of loneliness

• Skill development — Allow children to practice and accomplish tasks they are still learning

• Emotional processing — Imaginary friends help children experience or work through events they want to remember or forget

• Safe exploration of roles — Children can play out different scenarios, including assuming parental roles, in a safe environment

• Coping mechanisms — They can serve as a way for children to deal with various situations or emotions

• Creativity and imagination — having imaginary friends fosters imaginative thinking and creative play

• Cognitive Development — Play helps children differentiate between make-believe and reality

• Emotional Regulation — Children may use imaginary friends to express feelings or work through conflicts

Hospitalized 4-year-old asks, “When are my parents coming?” Best nurse response? (Preschool 3-5 years)

• “ Your parents will be here after lunch. Let’s look at the clock together. When the big hand reaches 12 and the little hand is at 1, that’s when they’ll arrive. Would you like to make a special picture for them while we wait?”

  • Provide a specific time frame for the child to understand

  • Use visual aids to help the child conceptualize time

  • Offer distraction activities that also serve as preparation for the parents return

  • Help the child feel more in control of the situation

Identify the most accurate statement about moral development in the 9-year-old child? School-Age (6–12 yrs)

That they can judge and act by the intentions that promoted it rather than just its consequences. At this age, children begin to move beyond simply evaluating actions based on rewards or punishments. They start to understand that the reason behind an action matters, not just the outcome. This represents a significant shift from younger children who tend to view rules as absolute and judge actions solely on their results or wheart they break established rules

Which behavior by parents/teachers best assists the child in negotiating industry? School-Age (6–12 yrs)

• Providing opportunities for real achievement and offering positive reinforcement. Including;

  • Allowing the child to engage in meaningful tasks they can complete

  • Recognize and praise their efforts and accomplishments

  • Encourage independence and exploration

  • Offer age appropriate challenges that build skills

  • Provide supportive guidance without taking over

  • Help children learn from their failures without feeling inferior

  • Create balance between work and play

  • Acknowledging individual differences in abilities and interests

Which statement by parents indicates understanding about helping first graders adapt to school? School-Age (6–12 yrs)

• We plan to introduce our child to the teacher and the facility before school starts, and we'll provide the school with detailed information about our child's home routines, favorite activities, and personal habits to help them feel more comfortable in the new environment."

• Sharing familiar information helps the child feel more comfortable in new surroundings.

• It bridges the gap between home and school environments.

• It shows awareness of the child's individual needs during this transition.

• It aids teachers in creating a more personalized and supportive environment for the child.

• It's a proactive step that can significantly ease the child's adjustment to school.

• This strategy aligns with best practices for reducing separation anxiety and facilitating a smooth transition into the school setting for young children

9- to 10-year-old boys form a “Boys-Only” skateboard club. How should this be interpreted? School-Age (6–12 yrs)

• is a typical and developmentally appropriate behavior for children in middle childhood.

• Exclusivity can be a concern; it's generally a normal part of development at this stage. Adults should monitor to ensure the club doesn't promote harmful behaviors or excessive exclusion.

Which Characteristic of dishonest behavior in 8-10 year olds? School-Age (6–12 yrs)

• Understand the concept of property rights more fully

• Are more likely to take responsibility for their dishonest actions

• May still engage in lying or stealing, but with a greater awareness of its wrongness

• Can distinguish between fantasy and reality more clearly

• Are less likely to cheat impulsively compared to younger children

• May lie to meet expectations they feel unable to achieve otherwise

• Are quick to report dishonest behavior in their peers

• Can better comprehend the consequences of their dishonest actions

Which statement accurately describes physical development in school-age years? School-Age (6–12 yrs)

• Gradual steady growth, increase strength and physical capabilities, shedding deciduous teeth, and acquisition of permeant teeth

The ability to understand 1+3=4 and 4-3+1 occurs in which stage of cognitive development?School-Age (6–12 yrs)

• Concrete operations stage of cognitive development

• Occurs around age 7 and extends through early adolescence

Parents ask how many hours a 12-year-old should sleep per night? School-Age (6–12 yrs)

9-11 hours

9-year-old with stomach pain, aggressive, stubborn-possible trigger? School-Age (6–12 yrs)

-       Stress

In addition to stress, school-age children experience a wide variety of fears, including fear of the dark, excessive worry about past behavior, self-consciousness, social withdrawal, and an excessive need for reassurance. These fears are considered normal for children this age.

What should be included in injury prevention teaching for school-age years? School-Age (6–12 yrs)

MVA: -       Educate child on proper use of seat belts while a passenger in a vehicle. -       Maintain discipline while the child is a passenger in a vehicle (e.g., ensure that children keep arms inside, do not lean against doors, and do not interfere with driver). -       Remind parents and children that no one should ride in the bed of a pickup truck. -       Emphasize safe pedestrian behavior. -       Insist on child wearing safety apparel (e.g., helmet) when applicable, such as while riding bicycle, motorcycle, moped, or ATV   Drowning: -       Teach child to swim. -       Teach basic rules of water safety. -       Select safe and supervised places to swim. -       Check sufficient water depth for diving. -       Caution child to swim with a companion. -       Ensure that child uses an approved flotation device in water or boat. -       Advocate for legislation requiring fencing around pools. -       Learn cardiopulmonary resuscitation. Burns -       Make certain home has smoke detectors. -       Set water heaters to 48.9°C (120°F) to avoid scald burns. -       Instruct child on behavior in areas involving contact with potential burn hazards (e.g., gasoline, matches, bonfires or barbecues, lighter fluid, firecrackers, cigarette lighters, cooking utensils, chemistry sets). -       Instruct child to avoid climbing or flying kite around high-tension wires. -       Instruct child in proper behavior in the event of fire (e.g., fire drills at home and school). -       Teach child safe cooking (use low heat; avoid any frying; be careful of steam burns, scalds, or exploding foods, especially from microwaving). Poisoning -       Educate child on hazards of taking nonprescription drugs and chemicals, including aspirin and alcohol. -       Teach child to say “no” if offered illegal or dangerous drugs or alcohol. -       Keep potentially dangerous products in properly labeled receptacles, preferably out of reach.

Best Medium to transport an avulsed tooth?School-Age (6–12 yrs)

• Hank’s balanced Salt Solution- Ideal

• Milk

• Saliva — In container

• Saline Solution

  • If none are available, water can be used as a last resort, but it is not optimal as it can damage the tooth’s root cells.

What is the earliest age puberty begins?School-Age (6–12 yrs)

Girls

• Caucasian Girls — Before 7 is considered precocious puberty

• African American Girls - Before 6 is considered precocious puberty

  Boys

• Before 9 is considered precocious puberty

What describes moral development in younger school-age children? School-Age (6–12 yrs)?

• Understanding rules and expected behaviors, but not the reasons behind them

• Judging actions based on rewards and punishments

• Viewing "bad acts" as those that break rules or cause harm

• Believing that what others tell them to do is right, while their own thoughts may be wrong

• Interpreting accidents or misfortunes as punishment for "bad" acts

• Having a concrete sense of justice and fairness

• Directing actions towards satisfying their own needs, and less frequently, the needs of others

Which assessment finding indicates appropriate cognitive development in older school-age children? School-Age (6–12 yrs)

• The ability to understand and apply the concept of conservation. This is a key cognitive milestone in Piaget's concrete operational stage, typically occurring between ages 7-11.

• Conservation refers to the understanding that certain properties of an object remain the same despite changes in its appearance or arrangement. For example:

  • Recognizing that the amount of liquid remains the same when poured from a short, wide glass into a tall, narrow one

  • Understanding that the number of objects in a group doesn't change when they're spread out or clustered together

  • Grasping that the mass of clay doesn't change when it's reshaped

A Father of a 12-year-old is concerned about BMI at the 60th percentile. What is the best nursing action? School-Age (6–12 yrs)

• Reassure the father that a BMI at the 60th percentile is within the normal range for a 12 year old

What should be the foundation of 5th-grade sex education teaching? School-Age (6–12 yrs)

• Treating sex as a normal part of growth and development

• Providing honest, accurate information at the child's level of understanding

• Differentiating between sex and sexuality

• Explaining anatomy and physiological aspects in simple terms

• Addressing common myths and misconceptions

• Discussing puberty and expected changes

• Clarifying values and identifying positive role models

• Developing problem-solving skills and practicing responsibility

• Presenting basic information about pregnancy, contraceptives, and sexually transmitted infections in age-appropriate terms

• Creating a safe environment for questions and open dialogue

• Encouraging effective communication with parents about sexual topics

• Addressing media influences and information from jokes or peers

• Teaching respect for diverse cultural and societal values related to sexuality

8-Year-old with cancer says, “ God is punishing me.” How should nurses interpret this? School-Age (6–12 yrs)

• The child is seeking to understand their illness and diagnosis. Associated with learning and developing spiritual beliefs and feelings

• Listen without judging, acknowledge children’s feelings, Explore their understanding

Which activity best develops fine motor skills in school-age children? School-Age (6–12 yrs)

• Drawing, Writing, handicrafts, playing musical instruments, Building blocks, Puzzles, painting and coloring

The mean age of menarche in the United States is? Adolescence (12-18 yrs)

• 12 years, 8 months for non-Hispanic white girls,

• 12 years, 2 months for African American girls.

• The average age range for menarche is between 10½ to 15 years, with most girls experiencing their first menstruation around 12 years of age

Weight loss in anorexia nervosa is often triggered by what event? Adolescence (12-18 yrs)

Dieting.

Which statement is most descriptive of bulimia during adolescence? Adolescence (12-18 yrs)

Secret, uncontrolled binge eating alternating with methods to prevent weight gain, such as self-induced vomiting, laxative use, strict dieting, or excessive exercise.

How may anorexia nervosa best be described? Adolescence (12-18 yrs)

• An eating disorder characterized by a refusal to maintain a minimally normal body weight and by severe weight loss in the absence of obvious physical causes. It is a disorder with social, psychological, behavioral, cultural, and physiologic components that result in significant morbidity and mortality.

Which aspect of cognition develops during adolescence? Adolescence (12-18 yrs)

• Formal operational thought develops

• Abstract thinking

When planning care for adolescents, which intervention should the nurse consider?Adolescence (12-18 yrs)

• interventions that promote autonomy and independence

• Helping adolescents articulate their needs

• Involving them in developing their own care plans

• Encouraging them to express how others can best assist them

• Providing opportunities for decision-making

• Respecting their individuality

• Offering flexible routines and activities

Allowing access to age-appropriate technology and socialization

Nurse caring for adolescent with acute cocaine toxicity- Initial Data collection focus? Adolescence (12-18 yrs)

• ABCS then Neuro assessment

• Then Temperature, Cardiac assessment and then history

• Cocaine can cause Hyperthermia, Stroke, MI, Respiratory distress

• Vital signs: HR, BP, temperature, respiratory rate and pattern

• Neurological assessment: level of consciousness, pupil dilation, presence of agitation or seizure activity

• Cardiovascular assessment: dysrhythmias, signs of MI

• Physical symptoms: N/V, headache, flushing of the face

• Recent drug use history: amount and route, time since last use, any other substances

17-year-old not having sex, “Because parents would be mad’ Indicates a lag in which area? Adolescence (12-18 yrs)

• lag in moral development may indicate a need for guidance in developing more autonomous decision-making skills and a personal ethical framework

A 14-year-old always eating through weight is appropriate. Best explanation?Adolescence (12-18 yrs)

• Accelerated growth and development during puberty.

• EX; Increasing energy needs, Hormonal changes, Muscle mass increase, Higher physical activity, Fast metabolism.

Parents are concerned that 15-year-old spends to much time in the mirror. Nurses’ best response? Adolescence (12-18 yrs)

• Reassure parent that this is normal for the development of their body image and self-concept

• Encourage communication with the child and parent/HCP.

• Avoid criticizing their mirror habits. Promote positive self-image with supportive language

Most common cause of death in adolescence? Adolescence (12-18 yrs)

• MVC, Other accidental injuries

• Homicide

• Suicide

At what age should concerns about pubertal delay be considered in boys? Adolescence (12-18 yrs)

• 14 years of age without scrotal and testicular changes. Hormonal imbalance, underlying health conditions

Which statement best describes Tanner staging? Adolescence (12-18 yrs)

• Standardized method for assessing and categorizing the physical development of secondary sex characteristics during puberty. 5 stages

• Girls – Breast Development and pubic hair growth

• Boys – Genitalia development: Testicular and penile growth