Chapter 25 Growth and Development of the Newborn and Infant Maternity and Pediatric
Nursing
1. The nurse is examining a 10-month-old boy who was born 10 weeks early. Which of the following
findings is cause for concern?
A) The child has doubled his birthweight.
B) The child exhibits plantar grasp reflex.
C) The child's head circumference is 19.5 inches.
D) No primary teeth have erupted yet.
C) The child's head circumference is 19.5 inches.
Ans: C
Feedback:
The child's head size is large for his adjusted age (7.5 months), which would be cause for concern. Birth
weight doubles by about 6 months of age. Plantar grasp reflex does not disappear until 9 months
adjusted age. Primary teeth may not erupt until 8 months adjusted age.
Page and Header: 887, Head and Chest Circumference
2. The nurse is teaching a new mother about the drastic growth and developmental changes her infant
will experience in the first year of life. Which of the following describes a developmental milestone
occurring in infancy?
A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth.
B) Most infants triple their birthweight by 4 to 6 months of age and quadruple their birthweight by the
time they are 1 year old.
C) The head circumference increases rapidly during the first 6 months: the average increase is about 1
inch per month.
D) The heart triples in size over the first year of life; the average pulse rate decreases from 120 to 140 in
the newborn to about 100 in the 1-year-old.
,A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth.
Ans: A
Feedback:
By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth. Most infants double their birthweight by 4 to 6 months of age and
triple their birthweight by the time they are 1 year old. The head circumference increases rapidly during
the first 6 months: the average increase is about 0.6 inch (1.5 cm) per month. The heart doubles in size
over the first year of life. As the cardiovascular system matures, the average pulse rate decreases from
120 to 140 in the newborn to about 100 in the 1-year-old.
Page and Header: 886, Growth and Development Overview
3. The nurse measures the head circumference of a 6-month-old infant. Which measurement would the
nurse interpret as most appropriate?
A) 33 cm
B) 35 cm
C) 43.5 cm
D) 47 cm
C) 43.5 cm
Ans: C
Feedback:
Head circumference increases rapidly during the first 6 months. In a 6-month-old it is typically 42 to 44.5
cm (16.5 to 17.5 in); at birth it is usually 33 to 35 cm (13 to 14 in); and at 1 year of age it is usually 45 to
47.5 cm (17.7 to 18.7 in).
Page and Header: 887, Head and Chest Circumference
,4. The nurse is helping a new mother prepare for breastfeeding her infant. During which of the following
newborn states of consciousness would the nurse recommended attempting the feeding?
A) Light sleep
B) Drowsiness
C) Quiet alert state
D) Active alert state
C) Quiet alert state
Ans: C
Feedback:
A normal newborn will ordinarily move through six states of consciousness: (1) deep sleep: the infant
lies quietly without movement; (2) light sleep: the infant may move a little while sleeping and may
startle to noises; (3) drowsiness: eyes may close; the infant may be dozing; (4) quiet alert state: the
infant's eyes are open wide and the body is calm; (5) active alert state: the infant's face and body move
actively; and (6) crying: the infant cries or screams and the body moves in a disorganized fashion. The
quiet alert state is the optimal state in which to breastfeed an infant.
Page and Header: 887, States of Consciousness
5. The nurse is assessing the respiratory system of a newborn. Which of the following anatomic
differences place the infant at risk for respiratory compromise? Select all answers that apply.
A) The nasal passages are narrower.
B) The trachea and chest wall are less compliant.
C) The bronchi and bronchioles are shorter and wider.
D) The larynx is more funnel shaped.
E) The tongue is smaller.
F) There are significantly fewer alveoli.
, A) The nasal passages are narrower.
D) The larynx is more funnel shaped.
F) There are significantly fewer alveoli.
Ans: A, D, F
Feedback:
In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall
are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel
shaped, the tongue is larger, and there are significantly fewer alveoli. These anatomic differences place
the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels
of maturity until about 7 years of age.
Page and Header: 892, Respiratory System
6. A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm.
How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex."
B) "This is a primitive reflex known as the palmar grasp."
Ans: B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present
at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski.
During the palmar grasp, the infant reflexively grasps when the palm is touched. The plantar grasp
occurs when the infant reflexively grasps with the bottom of the foot when pressure is applied to the
Nursing
1. The nurse is examining a 10-month-old boy who was born 10 weeks early. Which of the following
findings is cause for concern?
A) The child has doubled his birthweight.
B) The child exhibits plantar grasp reflex.
C) The child's head circumference is 19.5 inches.
D) No primary teeth have erupted yet.
C) The child's head circumference is 19.5 inches.
Ans: C
Feedback:
The child's head size is large for his adjusted age (7.5 months), which would be cause for concern. Birth
weight doubles by about 6 months of age. Plantar grasp reflex does not disappear until 9 months
adjusted age. Primary teeth may not erupt until 8 months adjusted age.
Page and Header: 887, Head and Chest Circumference
2. The nurse is teaching a new mother about the drastic growth and developmental changes her infant
will experience in the first year of life. Which of the following describes a developmental milestone
occurring in infancy?
A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth.
B) Most infants triple their birthweight by 4 to 6 months of age and quadruple their birthweight by the
time they are 1 year old.
C) The head circumference increases rapidly during the first 6 months: the average increase is about 1
inch per month.
D) The heart triples in size over the first year of life; the average pulse rate decreases from 120 to 140 in
the newborn to about 100 in the 1-year-old.
,A) By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth.
Ans: A
Feedback:
By 6 months of age the infant's brain weighs half that of the adult brain; at age 12 months, the brain
weighs 2.5 times what it did at birth. Most infants double their birthweight by 4 to 6 months of age and
triple their birthweight by the time they are 1 year old. The head circumference increases rapidly during
the first 6 months: the average increase is about 0.6 inch (1.5 cm) per month. The heart doubles in size
over the first year of life. As the cardiovascular system matures, the average pulse rate decreases from
120 to 140 in the newborn to about 100 in the 1-year-old.
Page and Header: 886, Growth and Development Overview
3. The nurse measures the head circumference of a 6-month-old infant. Which measurement would the
nurse interpret as most appropriate?
A) 33 cm
B) 35 cm
C) 43.5 cm
D) 47 cm
C) 43.5 cm
Ans: C
Feedback:
Head circumference increases rapidly during the first 6 months. In a 6-month-old it is typically 42 to 44.5
cm (16.5 to 17.5 in); at birth it is usually 33 to 35 cm (13 to 14 in); and at 1 year of age it is usually 45 to
47.5 cm (17.7 to 18.7 in).
Page and Header: 887, Head and Chest Circumference
,4. The nurse is helping a new mother prepare for breastfeeding her infant. During which of the following
newborn states of consciousness would the nurse recommended attempting the feeding?
A) Light sleep
B) Drowsiness
C) Quiet alert state
D) Active alert state
C) Quiet alert state
Ans: C
Feedback:
A normal newborn will ordinarily move through six states of consciousness: (1) deep sleep: the infant
lies quietly without movement; (2) light sleep: the infant may move a little while sleeping and may
startle to noises; (3) drowsiness: eyes may close; the infant may be dozing; (4) quiet alert state: the
infant's eyes are open wide and the body is calm; (5) active alert state: the infant's face and body move
actively; and (6) crying: the infant cries or screams and the body moves in a disorganized fashion. The
quiet alert state is the optimal state in which to breastfeed an infant.
Page and Header: 887, States of Consciousness
5. The nurse is assessing the respiratory system of a newborn. Which of the following anatomic
differences place the infant at risk for respiratory compromise? Select all answers that apply.
A) The nasal passages are narrower.
B) The trachea and chest wall are less compliant.
C) The bronchi and bronchioles are shorter and wider.
D) The larynx is more funnel shaped.
E) The tongue is smaller.
F) There are significantly fewer alveoli.
, A) The nasal passages are narrower.
D) The larynx is more funnel shaped.
F) There are significantly fewer alveoli.
Ans: A, D, F
Feedback:
In comparison with the adult, in the infant, the nasal passages are narrower, the trachea and chest wall
are more compliant, the bronchi and bronchioles are shorter and narrower, the larynx is more funnel
shaped, the tongue is larger, and there are significantly fewer alveoli. These anatomic differences place
the infant at higher risk for respiratory compromise. The respiratory system does not reach adult levels
of maturity until about 7 years of age.
Page and Header: 892, Respiratory System
6. A new mother shows the nurse that her baby grasps her finger when she touches the baby's palm.
How might the nurse respond to this information?
A) "This is a primitive reflex known as the plantar grasp."
B) "This is a primitive reflex known as the palmar grasp."
C) "This is a protective reflex known as rooting."
D) "This is a protective reflex known as the Moro reflex."
B) "This is a primitive reflex known as the palmar grasp."
Ans: B
Feedback:
Primitive reflexes are subcortical and involve a whole-body response. Selected primitive reflexes present
at birth include Moro, root, suck, asymmetric tonic neck, plantar and palmar grasp, step, and Babinski.
During the palmar grasp, the infant reflexively grasps when the palm is touched. The plantar grasp
occurs when the infant reflexively grasps with the bottom of the foot when pressure is applied to the
