Test Bank CURRENT Diagnosis and Treatment Pediatrics 24th Edition Hay Levin

Test Bank CURRENT Diagnosis and Treatment Pediatrics 24th Edition Hay Levin Chapter 1 The Newborn Infant 1. Which milestone is developmentally appropriate for a 2-month-old infant when the nurse pulls the infant to a sitting position? a. Head lag is present when the infants trunk is lifted. b. The infant is able to support the head when the trunk is lifted. c. The infant is briefly able to hold the head erect. d. The infant is fully able to support and hold the head in a straight line. ANS: C A 2-month-old infant is able to hold the head erect only briefly and continues to have some head lag. It is not until 4 months of age that the infant can keep his or her head in a straight line when pulled to a sitting position. 2. Approximately what should a newborn weigh at 1 year of age if the newborns birth weight was 7 pounds 6 ounces? a. 14 3/4 pounds b. 22 1/8 pounds c. 29 1/2 pounds d. Unable to estimate weight at 1 year ANS: B An infant triples the birth weight by 1 year of age. An infant doubles the birth weight by 6 months of age. An infant quadruples the birth weight by 2 years of age. Weight at 6 months, 1 year, and 2 years of age can be estimated from the birth weight. 3. Which statement made by a parent would be consistent with a developmental delay? a. I have noticed that my 9-month-old infant responds consistently to the sound of his name. b. I have noticed that my 12-month-old child does not get herself to a sitting position or pull to stand. c. I am so happy when my 1 1/2-month-old infant smiles at me. 1 | P a g ed. My 5-month-old infant is not rolling over in both directions yet. ANS: B Critical developmental milestones for gross motor development in a 12 month old include standing briefly without support, getting to a sitting position, and pulling to stand. If a 12- month- old child does not perform these activities, it may be indicative of a developmental delay. An infant who responds to his name at 9 months of age is demonstrating abilities to both hear and interpret sound. A social smile is present by 2 months of age. Rolling over in both directions is not a critical milestone for gross motor development until the child reaches 6 months of age. 4. At a healthy 2-month-old infants well-child clinic visit, the nurse should give which immunizations? a. DTaP, IPV, HepB, Hib, PCV, rotavirus b. MMR, DTaP, PVC, and IPV c. Hib, DTaP, rotavirus, and OPV d. Hib and MMR, IPV, and rotavirus ANS: A DTaP, IPV, HepB, Hib, PCV, and rotavirus are the appropriate sequence of immunizations for a healthy 2-month-old infant. MMR is given at or after 12 months of age. Oral polio vaccine (OPV) is no longer administered in the U.S. 5. The nurse advises the mother of a 3-month-old infant, exclusively breast-fed, to: a. start giving the infant a vitamin D supplement. b. start using an infant feeder and add rice cereal to the formula. c. start feeding the infant rice cereal with a spoon at the evening feeding. d. continue breast-feeding without any supplements. ANS: A Breast milk does not provide an adequate amount of dietary vitamin D. Infants who are exclusively breast-fed need vitamin D supplements to prevent rickets. An infant feeder is an 2 | P a g einappropriate method of providing the infant with caloric intake. Solid foods and rice cereal are not recommended for a 3-month-old infant. Solid feedings do not typically begin before 4 to 6 months of age. Because breast milk is not an adequate source of fluoride, infants need to be given a fluoride supplement. 6. At from view. a. 4 b. 6 c. 9 d. 20 ANS: C By 9 months of age an infant will actively search for an object that is out of sight. Four-month- old infants are not cognitively capable of searching out objects hidden from their view. Infants at this developmental level do not pursue hidden objects. Six-month-old infants have not developed the ability to perceive objects as permanent and do not search out objects hidden from their view. Twenty-month-old infants actively pursue objects not in their view and are capable of recalling the location of an object not in their view. They first look for hidden objects around the age of 9 months. 7. The parents of a newborn infant state, We will probably not have our baby immunized because we are concerned about the risk of our child being injured. Which is the best response for the nurse to make? a. It is your decision. b. Have you talked with your parents about this? They can probably help you think about this decision. c. The risks of not immunizing your baby are greater than the risks from the immunizations. d. You are making a mistake. ANS: C Although immunizations have been documented to have a negative effect in a small number of 3 | P a g e months of age, an infant should first be expected to locate an object hiddencases, an unimmunized infant is at greater risk for development of complications from childhood diseases than from the vaccines. It is the parents decision not to immunize the child; however, the nurse has a responsibility to inform parents about the risks to infants who are not immunized. Grandparents can be supportive but are not the primary decision makers for the infant. Telling parents that they are making a mistake is an inappropriate response. 8. The mother of a 9-month-old infant is concerned because the infant cries when she leaves him. Which is the best response for the nurse to make to the mother? a. You could consider leaving the infant more often so he can adjust. b. You might consider taking him to the doctor because he may be ill. c. Have you noticed whether the baby is teething? d. This can be a healthy sign of attachment. ANS: D Healthy attachment is manifested by stranger anxiety in late infancy. An infant who manifests stranger anxiety can be supported by the mother leaving the infant for only short periods of time. Assessing developmental needs is appropriate before taking an infant to a physician. Pain from teething expressed by the infants cries would not occur only when the mother left the room. 9. Which statement concerning physiological factors of infancy is true? a. The infant has a slower metabolic rate than an adult. b. An infant is not able to digest protein and lactase. c. Infants have a slower circulatory response than adults. d. The kidneys of an infant are less efficient in concentrating urine than an adults kidneys. ANS: D The infants kidneys are not as effective at concentrating urine compared with an adults kidneys because of immaturity of the renal system and a slower glomerular filtration rates. The infants metabolic rate is faster, not slower, than an adults. Although the newborn infants gastrointestinal system is immature, it is capable of digesting protein and lactase, but the ability to digest and absorb fat does not reach adult levels until approximately 6 to 9 months of age. 4 | P a g e10. Which is a priority in counseling parents of a 6-month-old infant? a. Increased appetite from secondary growth spurt b. Allowing the infant to self-feed c. Securing a developmentally safe environment for the infant d. Strategies to teach infants to sit up ANS: C Safety is a primary concern as an infant becomes increasingly mobile. The infants appetite and growth velocity decrease in the second half of infancy. Fine motor development, which is refined in the second half of infancy, is necessary before the infant can self-feed. Unless the infant has a neuromuscular deficit, strategies for teaching a normally developing infant to sit up are not necessary. 11. A mother of a 2-month-old infant tells the nurse, My child doesnt sleep as much as his older brother did at the same age. What is the best response for the nurse? a. Have you tried to feed the baby more often? b. Infant sleep patterns vary widely, with some infants sleeping only 2 to 3 hours at a time. c. It is helpful to keep a record of your babys eating, waking, sleeping, and elimination patterns and to come back in a week to discuss them. d. This infant is difficult. It is important for you to identify what is bothering the baby. ANS: B Newborn infants may sleep as much as 17 to 20 hours per day. Sleep patterns vary widely, with some infants sleeping only 2 to 3 hours at a time. Infants typically do not need more caloric intake to improve sleep behaviors. Keeping intake, output, waking, and sleeping data is not typically helpful in discussing differences among infants behaviors. Identifying an infant as difficult without identifying helpful actions is not a therapeutic response for a parent concerned about sleep. 12. The mother of a 10-month-old infant tells the nurse that her infant really likes cows 5 | P a g emilk. Which is the best response