MCHN CHAPTER 31 FAMILY WITH INFANT b) .

b) . The infant should not be given any solid foods until this digestive problem is
resolved.
Which statement best describes the infants physical development? c) This is abnormal and requires further investigation.
d) This is normal because of the immaturity of digestive processes at this age.
a) Anterior fontanel closes by age 6 to 10 months.
b) Binocularity is well established by age 8 months. A 3-month-old infant, born at 38 weeks of gestation, will hold a rattle if it is put in her hands;
c) Birth weight doubles by age 5 months and triples by age 1 year. however, she will not voluntarily grasp it. The nurse should interpret this as:
d) Maternal iron stores persist during the first 12 months of life.
a) Normal development
The nurse is assessing a 6-month-old healthy infant who weighed 7 pounds at birth. The b) Significant developmental lag.
nurse should expect the infant to now weigh approximately: c) Slightly delayed development caused by prematurity.
d) Suggestive of a neurologic disorder such as cerebral palsy.
a) 10 pounds.
b) 15 pounds In terms of fine motor development, the infant of 7 months should be able to:
c) 20 pounds
d) 25 pounds a) Transfer objects from one hand to the other.
b) Use thumb and index finger in a crude pincer grasp.
The nurse is doing a routine assessment on a 14-month-old infant and notes that the c) Hold a crayon and make a mark on paper.
anterior fontanel is closed. This should be interpreted as: d) Release cubes into a cup.
a. A normal finding. In terms of gross motor development, what would the nurse expect a 5-month-old infant to
b. A questionable finding the infant should be rechecked in 1 month. do?
c. An abnormal finding indicates the need for immediate referral to a
practitioner a) Roll from abdomen to back.
d. An abnormal finding indicates the need for developmental assessment. b) Roll from back to abdomen
c) Sit erect without support.
By what age does the posterior fontanel usually close? d) Move from prone to sitting position.
a. 6 to 8 weeks At which age can most infants sit steadily unsupported?
b. 10 to 12 weeks
c. 4 to 6 months a. 4 months
d. 8 to 10 months b. 6 months
c. 8 months
The parents of a 9-month-old infant tell the nurse that they have noticed foods such as d. 10 months
peas and corn are not completely digested and can be seen in their infants stool. The
nurse bases her explanation on knowing that: By what age should the nurse expect that an infant will be able to pull to a standing
position?
a) Children should not be given fibrous foods until the digestive tract matures at age
4 years a. 6 months
b. 8 months Sara, age 4 months, was born at 35 weeks gestation. She seems to be developing
c. 9 months normally, but her parents are concerned because she is a more difficult baby than their
d. 11 to 12 months other child, who was term. The nurse should explain that:

According to Piaget, the 6-month-old infant would be in what stage of the sensorimotor a. Infants temperaments are part of their unique characteristics.
phase? b. Infants become less difficult if they are not kept on scheduled feedings and
structured routines.
a. Use of reflexes c. Saras behavior is suggestive of failure to bond completely with her parents.
b. Primary circular reactions d. Saras difficult temperament is the result of painful experiences in the neonatal
c. Secondary circular reactions period.
d. Coordination of secondary schemata
Which information could be given to the parents of a 12-month-old child regarding
Which behavior indicates that an infant has developed object permanence? appropriate play activities for this age?
a. Recognizes familiar face such as the mother a. Give large push-pull toys for kinesthetic stimulation.
b. Recognizes familiar object such as a bottle b. Place cradle gym across crib to facilitate fine motor skills.
c. Actively searches for a hidden object c. Provide child with finger paints to enhance fine motor skills.
d. Secures objects by pulling on a string e. Provide stick horse to develop gross motor coordination.
A parent asks the nurse At what age do most babies begin to fear strangers? The nurse An appropriate play activity for a 7-month-old infant to encourage visual stimulation is:
responds that most infants begin to fear strangers at age:
a. Playing peek-a-boo.
a. 2months. b. Playing pat-a-cake
b. 4 months c. Imitating animal sounds.
c. 6 months. d. Showing how to clap hands.
d. 12 months.
The best play activity to provide tactile stimulation for a 6-month-old infant is to:
The nurse is interviewing the father of 10-month-old Megan. She is playing on the floor
when she notices an electrical outlet and reaches up to touch it. Her father says No firmly a. Allow to splash in bath.
and removes her from near the outlet. The nurse should use this opportunity to teach the b. Give various colored blocks
father that Megan: c. Play music box, tapes, or CDs.
d. Use infant swing or stroller.
a. Is old enough to understand the word No.
b. Is too young to understand the word No. At what age should the nurse expect an infant to begin smiling in response to pleasurable
c. Should already know that electrical outlets are dangerous. stimuli?
d. Will learn safety issues better if she is spanked.
a. 1month
b. 2months
c. 3months
 d. 4months d. When tooth eruption has started

Latasha is a breastfed infant being seen in the clinic for her 6-month checkup. Her mother
tells the nurse that Latasha recently began to suck her thumb. The best nursing intervention
is to:
a. Recommend that the mother substitute a pacifier for Latashas thumb.
b. Assess Latasha for other signs of sensory deprivation.
c. Reassure the mother that this is very normal at this age.
d. Suggest that the mother breastfeed Latasha more often to satisfy sucking needs.
Austin, age 6 months, has six teeth. The nurse should recognize that this is:
The parents of a 4-month-old infant tell the nurse that they are getting a microwave oven
and will be able to heat the babys formula faster. The nurse should recommend:
a. Never heating a bottle in a microwave oven
b. Heating only 10 ounces or more.
c. Always leaving the bottle top uncovered to allow heat to escape.
d. Shaking the bottle vigorously for at least 30 seconds after heating.
Parents tell the nurse that their 1-year-old son often sleeps with them. They seem
unconcerned about this. The nurses response should be based on the knowledge that:

a. Normal tooth eruption. a. Children should not sleep with their parents.
b. Delayed tooth eruption b. Separation from parents should be completed by this age.
c. Unusual and dangerous.. c. Daytime attention should be increased.
d. Earlier-than-normal tooth eruption. d. This is a common and accepted practice, especially in some cultural groups.

The nurse notices that a 10-month-old infant being seen in the clinic is wearing expensive, The parent of 2-week-old Sarah asks the nurse if Sarah needs fluoride supplements
inflexible, hightop shoes. The nurse should explain that: because she is exclusively breastfed. The nurses best response is:

a. Soft and flexible shoes are generally better. a. She needs to begin taking them now.
b. High-top shoes are necessary for support. b. They are not needed if you drink fluoridated water.
c. Inflexible shoes are necessary to prevent in-toeing and out-toeing. c. She may need to begin taking them at age 6 months
d. This type of shoe will encourage the infant to walk sooner. d. She can have infant cereal mixed with fluoridated water instead of supplements.

A mother tells the nurse that she is discontinuing breastfeeding her 5-month-old infant. The A mother tells the nurse that she doesnt want her infant immunized because of the
nurse should recommend that the infant be given: discomfort associated with injections. The nurse should explain that:

a. Skim milk. a. This cannot be prevented.

b. Whole cows milk b. Infants do not feel pain as adults do.
c. Commercial iron-fortified formula.. c. This is not a good reason for refusing immunizations.
d. Commercial formula without iron. d. A topical anesthetic, eutectic mixture of local anesthetic (EMLA), can be
applied before injections are given.
When is the best age for solid food to be introduced into the infants diet?
The parents of a 12-month-old child ask the nurse if the child can eat hot dogs. The nurses
a. 2to 3 months reply should be based on knowing that:
b. 4to 6 months
c. When birth weight has tripled a. The child is too young to digest hot dogs.
 b. The child is too young to eat hot dogs safely. Clinical manifestations of failure to thrive caused by behavioral problems resulting in
c. Hot dogs must be sliced into sections to prevent aspiration. inadequate intake of calories include:
d. Hot dogs must be cut into small, irregular pieces to prevent aspiration.
a. Avoidance of eye contact.
The clinic is lending a federally approved car seat to an infants family. The nurse should b. An associated malabsorption defect.
explain that the safest place to put the car seat is: c. Weight that falls below the 15th percentile.
d. Normal achievement of developmental landmarks.
a. Front facing in back seat.
Which is an important nursing consideration when caring for an infant with failure to thrive?
b. Rear facing in back seat.
a. Establish a structured routine and follow it consistently.
c. Front facing in front seat if an air bag is on the passenger side. b. Maintain a nondistracting environment by not speaking to the infant
during feeding.
d. Rear facing in front seat if an air bag is on the passenger side
c. Place the infant in an infant seat during feedings to prevent
A nurse is teaching parents about prevention and treatment of colic. Which should the overstimulation.
nurse include in the teaching plan? d. Limit sensory stimulation and play activities to alleviate fatigue.

a. Avoid use of pacifiers. An important nursing responsibility when dealing with a family experiencing the loss of an
b. Eliminate all secondhand smoke contact. infant from sudden infant death syndrome (SIDS) is to:
c. Lay infant flat after feeding.
a. Explain how SIDS could have been predicted and prevented.
d. Avoid swaddling the infant.
b. Interview parents in depth concerning the circumstances surrounding the
A parent of an infant with colic tells the nurse, All this baby does is scream at me; it is a infants death.
constant worry. The nurses best action is: c. Discourage parents from making a last visit with the infant.
d. Make a follow-up home visit to parents as soon as possible after the
a. Encourage parent to verbalize feelings. infants death.
b. Encourage parent not to worry so much.
c. Assess parent for other signs of inadequate parenting. Which is the most appropriate action when an infant becomes apneic?
d. Reassure parent that colic rarely lasts past age 9 months.
a. Shake vigorously.
Parent guidelines for relieving colic in an infant include: b. Roll head side to side.
c. Hold by feet upside down with head supported.
a. Avoiding touching the abdomen. d. Gently stimulate trunk by patting or rubbing.
b. Avoiding using a pacifier.
c. Changing the infants position frequently. With the goal of preventing plagiocephaly, the nurse should teach new parents to:
d. Placing the infant where the family cannot hear the crying.
a. Place the infant prone for 30 to 60 minutes per day.
b. Buy a soft mattress.
c. Allow the infant to nap in the car safety seat.
 d. Have the infant sleep with the parents. a. Neonates will be immune the first few months.
b. If the mother has had the disease, the infant will receive passive immunity.
An infant has been pronounced dead from sudden infant death syndrome (SIDS) in the c. Children younger than 1 year seldom contract this disease.
emergency department. Which is an appropriate question to ask the parents? d. Most children are highly susceptible from
a. Did you hear the infant cry out? Pacifiers can be extremely dangerous because of the frequency of use and the intensity of
b. Why didnt you check on the infant earlier? the infants suck. In teaching parents about appropriate pacifier selection, the nurse should
c. What time did you find the infant? explain that a pacifier should have which characteristics (select all that apply)?
d. Was the head buried in a blanket?
a. Easily grasped handle
An infant experienced an apparent life-threatening event and is being placed on home
apnea monitoring. The parents have understood the instructions for use of a home apnea b. One-piece construction
monitor when they state:
c. Ribbon or string to secure to clothing
a. We can adjust the monitor to eliminate false alarms.
b. We should sleep in the same bed as our monitored infant. d. Soft, pliable material
c. We will check the monitor several times a day to be sure the alarm is working. e. Sturdy, flexible material
d. We will place the monitor in the crib with our infant.
In terms of gross motor development, what would the nurse expect a 5-month-old infant to
The parents of a 3-month-old infant report that their infant sleeps supine (face up) but is do(select all that apply)?
often prone (face down) while awake. The nurses response should be based on knowledge
that this is: a. Roll from abdomen to back.

a. Unacceptable because of the risk of sudden infant death syndrome (SIDS). b. Put feet in mouth when supine.
b. Unacceptable because it does not encourage achievement of developmental
milestones. c. Roll from back to abdomen.
c. Unacceptable to encourage fine motor development.
d. Sit erect without support.
d. Acceptable to encourage head control and turning over.
e. Move from prone to sitting position.
The nurse should teach parents that which age is safe to give infants whole milk instead of
commercial infant formula? A nurse is conducting education classes for parents of infants. The nurse plans to discuss
sudden infant death syndrome (SIDS). Which risk factors should the nurse include as
a. 6 months
increasing an infants risk of a SIDS incident(select all that apply)?
b. 9 months
c. 12 months a. Breastfeeding
d. 18 months
b. Low Apgar scores
A parent asks the nurse whether her infant is susceptible to pertussis. The nurses response
should be based on which statement concerning susceptibility to pertussis? c. Male sex
d. Birth weight in the 50th or higher percentile e. We will remove front knobs from the stove.

e. Recent viral illness

Which interventions should the nurse implement when caring for a family of a sudden infant
death syndrome (SIDS) infant (select all that apply)?

a. Allow parents to say goodbye to their infant. b. Once parents leave the hospital, no
further follow-up is required.

c. Arrange for someone to take the parents home from the hospital.

d. Avoid requesting an autopsy of the deceased infant.

e. Conduct a debriefing session with the parents before they leave the hospital

A nurse is preparing to administer routine immunizations to a 4-month-old infant. The infant

is currently up to date on all previously recommended immunizations. Which immunizations
will the nurse prepare to administer (select all that apply)?

a. Measles, mumps, and rubella (MMR)

b. Rotavirus (RV)

c. Diphtheria, tetanus, and acellular pertussis (DTaP)

d. Varicella

e. Haemophilus influenzae type b (HIB) f. Inactivated poliovirus (IPV)

A nurse has completed a teaching session for parents about baby-proofing the home.
Which statements made by the parents indicate an understanding of the teaching (select all
that apply)?

a. We will put plastic fillers in all electrical plugs. b. We will place poisonous substances in a
high cupboard.

c. We will place a gate at the top and bottom of stairways.

d. We will keep our household hot water heater at 130 degrees.