Health Promotion of the Preschooler and Family

1. Which of the following would the nurse expect of a healthy 3-year-old child? a. Jump rope

b. Ride a two-wheel bicycle
c. Skip on alternate feet
d. Balance on one foot for a few seconds

ANS: D
Three-year-olds are able to accomplish this gross motor skill.

DIF: Cognitive Level: Comprehension REF: Page 444
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

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

Lace shoes and tie shoelaces with a bow
Use scissors to cut pictures, and print a few numbers
Draw a person with seven parts and correctly identify the parts
Draw a circle and name what has been drawn

ANS: D
Three-year-olds are able to accomplish this fine motor skill.

DIF: Cognitive Level: Application REF: Page 444
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

3. According to Piaget, magical thinking is the belief that: a. events have cause and effect.
b. God is like an imaginary friend.
c. thoughts are all-powerful.

d. if the skin is broken, the child’s insides will come out.

ANS: C
Because of their egocentrism and transductive reasoning, preschoolers believe that thoughts are all-powerful.

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DIF: Cognitive Level: Comprehension REF: Page 439
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

4. Which of the following is descriptive of the preschooler’s understanding of time? a. Has no understanding of time
b. Associates time with events
c. Can tell time on a clock

d. Uses terms like “yesterday” appropriately

ANS: B
In a preschooler’s understanding, time has a relation with events such as “We’ll go outside after lunch.”

DIF: Cognitive Level: Comprehension REF: Page 439
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

5. The nurse is caring for a hospitalized 4-year-old boy, Ryan. His parents tell the nurse that they will be back to visit at 6 PM. When Ryan asks the nurse when his parents are coming, the nurse’s best response is which of the following?
a. “They will be here soon.”

b. “They will come after dinner.”
c. “Let me show you on the clock when 6 PM is.”
d. “I will tell you every time I see you how much longer it will be.”

ANS: B
A 4-year-old understands time in relation to events such as meals.

DIF: Cognitive Level: Comprehension REF: Page 439
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

6. A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was “bad.” Which of the following is the nurse’s best interpretation of this comment?
a. Sign of stress

b. Common at this age
c. Suggestive of maladaptation
d. Suggestive of excessive discipline at home

ANS: B

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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.

DIF: Cognitive Level: Comprehension REF: Page 439
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

7. A 4-year-old child tells the nurse that she does not want another blood sample drawn because “I need all of my insides, and I don’t want anyone taking them out.” Which of the following is the nurse’s best interpretation of this?
a. Child is being overly dramatic.

b. Child has a disturbed body image.
c. Preschoolers have poorly defined body boundaries.
d. Preschoolers normally have a good understanding of their bodies.

ANS: C
Preschoolers have little understanding of body boundaries, which leads to fears of mutilation.

DIF: Cognitive Level: Comprehension REF: Page 440
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

8. Which of the following types of play is most typical of the preschool period? a. Solitary

b. Parallel
c. Associative d. Team

ANS: C
Associative play is group play in similar or identical activities but without rigid organization or rules.

DIF: Cognitive Level: Comprehension REF: Page 441
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

9. Imaginary playmates are beneficial to the preschool child because they do which of the following?

a. Take the place of social interactions
b. Take the place of pets and other toys
c. Become friends in times of loneliness
d. Accomplish what the child has already successfully accomplished.

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ANS: C
One purpose of an imaginary friend is to be a friend in time of loneliness.

DIF: Cognitive Level: Analysis REF: Page 442
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

10. Which of the following characteristics best describes the language of a 3-year-old child?

a. Asks meanings of words
b. Follows directional commands
c. Can describe an object according to its composition
d. Talks incessantly regardless of whether anyone is listening

ANS: D
Because of the dramatic vocabulary increase at this age, 3-year-olds are known to talk incessantly regardless of whether anyone is listening.

DIF: Cognitive Level: Comprehension REF: Page 444
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

11. By what age would the nurse expect that most children could obey prepositional phrases such as “under,” “on top of,” “beside,” and “in back of”?
a. 18 months
b. 24 months

c. 3 years d. 4 years

ANS: D
At 4 years, children can understand directional phrases.

DIF: Cognitive Level: Comprehension REF: Page 444
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

12. Which of the following is a useful skill that the nurse should expect a 5-year-old child to be able to master?
a. Tie shoelaces
b. Use knife to cut meat

c. Hammer a nail
d. Make change out of a quarter

ANS: A
Tying shoelaces is a fine motor task of 5-year-olds.

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DIF: Cognitive Level: Comprehension REF: Page 444
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

13. The nurse is guiding parents in selecting a daycare facility for their child. Which of the following is especially important to consider when making the selection?
a. Structured learning environment
b. Socioeconomic status of children

c. Cultural similarities of children
d. Teachers knowledgeable about development

ANS: D
A teacher knowledgeable about development will structure activities for learning.

DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

14. Parents tell the nurse that they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. Which of the following is the most appropriate recommendation the nurse should make?
a. Punish children so this behavior stops.

b. Neither condone nor condemn the curiosity.
c. Allow children unrestricted permission to satisfy this curiosity. d. Get counseling for this unusual and dangerous behavior.

ANS: B
Three-year-olds become aware of anatomic differences and are concerned about how the other “works.” Such exploration should not be condoned or condemned.

DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

15. The parent of a 4-year-old boy tells the nurse that the child believes that monsters and boogeymen are in his bedroom at night. The nurse’s best suggestion for coping with this problem is which of the following?
a. Let the child sleep with his parents.

b. Keep a night-light on in the child’s bedroom.
c. Help the child understand that these fears are illogical.
d. Tell the child frequently that monsters and boogeymen do not exist.

ANS: B
A night-light shows a child that imaginary creatures do not lurk in the darkness.

Page 443

Page 446

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DIF: Cognitive Level: Comprehension REF:
TOP: Integrated Process: Teaching/Learning
MSC: Area of Client Needs: Health Promotion and Maintenance: Prevention and Early Detection of Disease

16. Preschoolers’ fears can best be dealt with by which of the following interventions?

Actively involving them in finding practical methods to deal with the frightening

experience

Forcing them to confront the frightening object or experience in the presence of

their parents

Using logical persuasion to explain away their fears and help them recognize

how unrealistic the fears are

Ridiculing their fears so that they understand that there is no need to be afraid

ANS: A
This is the best way to deal with fears.

DIF: Cognitive Level: Comprehension REF: Page 446
TOP: Integrated Process: Nursing Process: Implementation
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

17. Which of the following accurately describes the speech of the preschool child?
a. Dysfluency in speech patterns is normal.
b. Sentence structure and grammatic usage are limited.
c. By age 5 years, child can be expected to have a vocabulary of about 1000 words. d. Rate of vocabulary acquisition keeps pace with the degree of comprehension of

speech.

ANS: A
Dysfluency includes stuttering and stammering, a normal characteristic of language development.

DIF: Cognitive Level: Comprehension REF: Page 447
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

18. Which one of the following dysfunctional speech patterns is a normal characteristic of the language development of a preschool-age child?
a. Lisp
b. Stammering

c. Echolalia
d. Repetition without meaning

ANS: B
Stammering and stuttering are normal dysfluency patterns in preschool-age children.

Page 446

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DIF: Cognitive Level: Comprehension REF: Page 447
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development

19. During the preschool period, injury prevention efforts should emphasize which of the following?

a. Constant vigilance and protection
b. Punishment for unsafe behaviors
c. Education for safety and potential hazards d. Limitation of physical activities

ANS: C
Education for safety and potential hazards is appropriate for preschoolers because they can begin to understand dangers.

DIF: Cognitive Level: Comprehension REF: Page 450
TOP: Integrated Process: Nursing Process: Assessment
MSC: AreaofClientNeeds:SafeandEffectiveCareEnvironment:Safetyand Infection Control (Injury Prevention)

MULTIPLE RESPONSE

1. In terms of language and cognitive development, a 4-year-old child would be expected to do which of the following? (Select all that apply.)
a. Think in abstract terms.
b. Follow directional commands.

c. Understand conservation of matter.
d. Uses sentences of eight words.
e. Tell exaggerated stories.
f. Comprehend another person’s perspective.

ANS: B, E
Children ages 3 to 4 years can give and follow simple commands and tell exaggerated stories.

DIF: Cognitive Level: Application REF: Page 440
TOP: Integrated Process: Nursing Process: Assessment
MSC: Area of Client Needs: Health Promotion and Maintenance: Growth and Development