Chapter 18: The Preschool Child

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Which statement best describes the 3-year-old child?
a. Boisterous, tattles on others ANS: C
b. Aggressive, shows off Three-year-old children are helpful and can assist in simple
c. Helpful, wants to assist with chores household chores.
d. Talkative, inquisitive about the environment
The parents of a 4-year-old boy are concerned because they have
noticed him frequently touching his penis. What knowledge would
act as the basis for the nurse's response?
a. This behavior indicates a normal curiosity about sexuality. ANS: A
b. Masturbation suggests the boy has an excessive fear of cas- Masturbation at this age is common and indicates that the
tration. preschooler has a normal curiosity about sexuality.
c. It is usually a result of discomfort from a penile rash or irritation.
d. The behavior is abnormal and the child should be referred for
counseling.
A preschool child is asked, "Why do trees have leaves?" Which
response would be an example of animism?
ANS: C
a. "So I can have shade over my sandbox."
Animism describes the tendency of preschool children to attribute
b. "Because God made them that way."
human characteristics to nonhuman objects.
c. "To hide behind when they are scared."
d. "For the squirrels to play in."
What tasks would be appropriate to expect of a 5-year-old child?
a. Setting the table with paper plates ANS: A
b. Washing the dirty knives Parents must consider developmental level and safety when ask-
c. Carrying glasses from the table to the sink ing the 5-year-old child to help with chores.
d. Scrubbing out the sink with cleanser
A 3-year-old child, while playing with his favorite toy in the play-
room of the pediatric unit, is approached by another child who
also wants to play with the same toy. What behavior will the nurse
ANS: C
anticipate from this child?
The 3-year-old child is egocentric and likely will become angry
a. Will play well with the other child.
when others attempt to take his or her possessions.
b. Will give the toy up and then not play anymore.
c. Will become angry and a physical response might ensue.
d. Will ignore the toy and go on to something else.
A parent is concerned about her children's reaction should their
grandmother die. What understanding will guide the nurse's re-
sponse?
a. Children are unlikely to notice their grandmother's absence if no
ANS: B
one reminds them.
Between 3 and 4 years of age, the children become curious about
b. Young children often understand that other people die, but do
death and dying. They may realize that others die, but they do not
not equate it with themselves.
relate death to themselves.
c. The children's response will depend entirely on whether they
have been acquainted with death before this.
d. Children can understand the concept of a higher being much
like adults can.
What is the most appropriate intervention when dealing with oc-
casional aggression in a 4-year-old child? ANS: A
a. Have the child take a time-out in the corner for 4 minutes. Time-out periods, usually lasting 1 minute per year of age, with
b. Spank the child at the time of the incident. the child sitting in a chair or corner, are considered an effective
c. Take away television privileges for the day. disciplinary technique.
d. Send the child to his room for 30 minutes.
A father is concerned about how long his preschool-age child will
continue sucking his thumb. What is the most helpful response
from the nurse?
a. "Most children will stop thumb-sucking naturally by school age."
ANS: A
b. "Over-the-counter treatments that give a bad taste can be
Most children give up the habit of thumb-sucking by the time they
placed on the thumb to discourage the practice."
reach school.
c. "Consistently touching the child's fingers whenever he sucks his
thumb is most effective."
d. "Thumb-sucking is detrimental to the eruption of the child's teeth
and must be stopped as soon as possible."
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 Chapter 18: The Preschool Child
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How does the nurse characterize the play of 5-year-old children?
ANS: C
a. Enjoying rough and tumble play
The 5-year-old child wants to play by the rules but cannot accept
b. Playing well-organized games
losing. The rules may be very strict or change as the game pro-
c. Following rules
gresses.
d. Preferring inside activities
The nurse is discussing preschoolers' sexual curiosity with the
parent. What statement by the mother leads the nurse to deter-
mine that the mother understands the information? ANS: C
a. "Make up funny words for body parts." Parents should provide sex education at the time the child asks
b. "Distract the child with a toy if they ask about sex." about sex.
c. "Answer their questions when they ask."
d. "Tell them to ask you again when they are 6 years old."
What type of play is most appropriate when planning care for a
child with moderate intellectual deficiency?
a. Exercise leg and arm muscles. ANS: C
b. Be educationally oriented to make up for lost time. The nurse must consider the child's mental age rather than her
c. Be adjusted to mental age rather than chronological age. chronological age when selecting toys for play.
d. Involve contact sports and aggressive physical activity with
other children.
What is the nurse's best advice to a parent about a preschooler's
"imaginary friend"?
a. Having imaginary friends is a sign that the child has low self-es-
ANS: B
teem.
Imaginary friends are common and normal during the preschool
b. It is common for preschoolers to have imaginary friends.
period and serve many purposes, such as relief from loneliness,
c. Preschoolers invent an imaginary friend when they feel over-
mastery of fears, and acting as a scapegoat.
whelmed.
d. The best approach to dealing with an imaginary friend is to
ignore them.
What intervention might the nurse suggest as helpful for the child
with enuresis?
ANS: C
a. Applying an electric pad that gently shocks the child
If a child is experiencing enuresis, liquids after dinner should be
b. Waking the child several times during the night to urinate
limited and the child should routinely void before going to bed.
c. Decreasing fluid intake after the evening meal
d. Increasing dietary fiber intake
What should the nurse suggest as the most appropriate toy choice
for a 3-year-old?
ANS: C
a. A board game
Large construction sets are suitable toys for the preschool-age
b. A small pet, such as a goldfish
child.
c. A large construction set
d. Push-pull toys
The parent of a -year-old child tells the nurse, "My daughter points
instead of speaking whenever she wants me to get something for
her, but she understands me when I ask her to do something."
ANS: B
Based on the parent's comment, what does the nurse suspect?
An expressive language delay is suspected when the child under-
a. Age-appropriate language development
stands spoken language but is not talking.
b. An expressive language delay
c. A receptive language delay
d. A potential hearing deficit
The parent of a 41/2-year-old child tells the nurse, "Bedtime is
difficult. I can't get my son to go to bed at night." The nurse and
the child's mother discuss options. What intervention is the most
ANS: C
appropriate choice?
Parents should engage the child in quiet activities before bedtime
a. Allow the child to put himself to bed when he is tired.
and establish a ritual that signals readiness for bedtime.
b. Let the child read in his room until he falls asleep.
c. Establish a bedtime routine and use it consistently.
d. Tire him out with physical activity before bedtime.
What fear is unique to the preschool period?
a. Water
b. Animals
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 Chapter 18: The Preschool Child
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ANS: C
c. Bodily harm
The fear of bodily harm, particularly the loss of body parts, is
d. Death
unique to this stage
A 4-year-old child tells the nurse she will not eat peas because
they are green. Of what is this an example? ANS: D
a. Egocentrism The tendency to concentrate on a single outstanding charac-
b. Artificialism teristic of an object while excluding other features is known as
c. Animism centering.
d. Centering
A 4-year-old child insists he has more money with a nickel than
his father has with a dime. What is this perception, as described
ANS: D
in Piaget's theory?
The intuitive stage, as described by Piaget, is prelogical thinking
a. Egocentrism
that is based on the outside appearance of objects. A nickel is
b. Artificialism
larger than a dime and therefore more valuable.
c. Animism
d. Intuition
What will children who are unable to express themselves with
words often do? ANS: D
a. Become reclusive and introspective. Children with delayed communication skills will frequently have
b. Develop other methods of verbal communication. tantrums and act out when they are unable to make their needs
c. Engage in more creative play. known.
d. Have tantrums and act out.
Which is an example of associative play?
a. Two children playing in house, one playing the role of the dad
and the other playing the role of the mom
ANS: A
b. Two children playing in a sand box, one building a wall and the
Associative play allows the preschoolers to use their enlarged
other digging a hole
vocabulary in play with other children to carry on conversations
c. Two children playing with sports-associated items, one with a
and describe scenarios for each to play.
football and the other with a bat
d. Two children playing with a coloring book, one coloring pictures
and the other looking at pictures
The nurse is educating a group of preschool parents about the
importance of safety. Which statement by a parent indicates the ANS: C
need for further education? Children must not play in or around the car or be left alone, even for
a. "I continue to provide a great deal of indirect supervision for my a brief moment, in the car. Preschool children still require a good
child." deal of indirect supervision to protect them from dangers that arise
b. "My stairway is always free of clutter." from their immature judgment or social environment. Stairways
c. "I only leave my child in the car for brief moments." should be free of clutter and medications kept out of reach.
d. "Medications are kept in a locked cabinet."
Parents of a 5-year-old child tell the nurse they are concerned
about their child's speech development by stating, "No one can
understand him but us." What clinical classification of speech
ANS: D
disorder does the nurse suspect?
When parents are the only people to understand their preschool
a. Global language delay
child, an articulation disorder is suspected (see Table 18-3).
b. Expressive language delay
c. Language loss
d. Articulation disorder
What does including play in the plan of care for a 5-year-old allow
the child to do? (Select all that apply.) ANS: A, B, C, E
a. Exercise his imagination. Benefits of play for the preschooler include exercising imagination,
b. Assume a role and act it out. assuming a role and acting it out, offering an emotional outlet, and
c. Offer an emotional outlet. interacting with other children. Play employs the use of magical
d. Avoid magical thinking. thinking.
e. Interact with other children.

What developmental milestone(s) assist the 5-year-old boy toward

ANS: A, D, E
developing his sexual identity? (Select all that apply.)
Children of this age become less focused on the mother as the
a. Begins to be less focused on his mother.
central person and begin to identify with the parent of the same
b. Ignores both parents totally.
sex, forming a romantic attachment to the parent of the opposite
c. Regresses to a more infantile level.

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 Chapter 18: The Preschool Child
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d. Forms a romantic attachment to the mother.
e. Identifies with the parent of the same sex.
Which bedtime preparation rituals are the most appropriate for the
nurse to suggest? (Select all that apply.)
a. Telling a story
b. Placing a favorite toy in bed
c. Placing a glass of water at the bedside
d. Turning on a night-light
e. Playing energetically
The nurse points out what advantage(s) of a nursery school or
preschool experience? (Select all that apply.)
a. Increasing self-confidence
b. Fostering group cooperation
c. Detecting adjustment problems
d. Attainment of toilet training skills
e. Playing experiences with other children
Which major developmental tasks will the nurse expect a child to
accomplish by the end of the preschool years? (Select all that
apply.)
a. Development of parallel play
b. Acceptance of separation
c. Increased communication skills
d. Consistent appetite
e. Control of bodily functions
When planning an activity for a 3-year-old child, the nurse bases
the plan on the average attention span of _____ minutes.
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sex. This little boy might say, "I'm going to marry my mother." A
little girl might say, "I'm going to marry my daddy."
ANS: A, B, C, D
All options are soothing bedtime rituals except energetic playing,
which would be stimulating and counterproductive to sleep.
ANS: A, B, C, E
Nursery school increases self-confidence, group cooperation, so-
cial skills, and cooperative play. Objective observations by a nurs-
ery school instructor can detect early adjustment problems. The
child is usually toilet trained prior to the start of preschool.
ANS: B, C, E
The major tasks of the preschool child include preparation to
enter school, development of a cooperative type of play, control of
body functions, acceptance of separation, and increase in com-
munication skills, memory, and attention span. Appetite remains
inconsistent.
ANS:
15
The average attention span of the preschooler is about 15 min-
utes.