Nokea
A 4-year-old child tells the nurse that she doesnt want another blood sample drawn because I need all of my insides and I dont want anyone taking them out. What is the nurses best interpretation of this?
- A. The child is being overly dramatic.
- B. The child has a disturbed body image.
- C. Preschoolers have poorly defined body boundaries.
- D. Preschoolers normally have a good understanding of their bodies.
Correct Answer: C
Rationale: Preschoolers have little understanding of body boundaries, which leads to fears of mutilation. The child is not capable of being dramatic at this age. She truly has fear. Body image is just developing in school-age children. Preschoolers do not have good understanding of their bodies.
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The nurse is caring for a hospitalized 4-year-old boy. His parents tell the nurse they will be back to visit at 6 PM. When he asks the nurse when his parents are coming, what would the nurses best response be?
- 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.
Correct Answer: B
Rationale: A 4-year-old child understands time in relation to events such as meals. Children perceive soon as a very short time. The nurse may lose the childs trust if his parents do not return in the time he perceives as soon. Children cannot read or use a clock for practical purposes until age 7 years. I will tell you every time I see you how much longer it will be assumes the child understands the concepts of hours and minutes, which does not occur until age 5 or 6 years.
What signals the resolution of the Oedipus or Electra complex?
- A. Learns sex differences
- B. Learns sexually appropriate behavior
- C. Identifies with the same-sex parent
- D. Has guilt over feelings toward the father or mother
Correct Answer: C
Rationale: The resolution of the Oedipus or Electra complex is identification with the same-sex parent. Learning sex differences and sexually appropriate behavior is a goal in further differentiation of oneself but does not signal the resolution of the Oedipus or Electra complex. Guilt over feelings toward the father or mother is seen as a stage in the complex, not the resolution.
A boy age 4 1/2 years has been having increasingly frequent angry outbursts in preschool. He is aggressive toward the other children and the teachers. This behavior has been a problem for approximately 8 to 10 weeks. His parent asks the nurse for advice. What is the most appropriate intervention?
- A. Refer the child for a professional psychosocial assessment.
- B. Explain that this is normal in preschoolers, especially boys.
- C. Encourage the parent to try more consistent and firm discipline.
- D. Talk to the preschool teacher to obtain validation for behavior parent reports.
Correct Answer: A
Rationale: The preschool years are a time when children learn socially acceptable behavior. The difference between normal and problematic behavior is not the behavior but the severity, frequency, and duration. This childs behavior meets the definition requiring professional evaluation. Some aggressive behavior is within normal limits, but at 8 to 10 weeks, this behavior has persisted too long. There is no indication that the parent is using inconsistent discipline. A part of the evaluation is to obtain validation for behavior parent reports.
The parent of a 4-year-old boy tells the nurse that the child believes monsters and bogeymen are in his bedroom at night. What is the nurses best suggestion for coping with this problem?
- A. Let the child sleep with his parents.
- B. Keep a night light on in the childs bedroom.
- C. Help the child understand that these fears are illogical.
- D. Tell the child that monsters and bogeymen do not exist.
Correct Answer: B
Rationale: Involve the child in problem solving. A night light shows a child that imaginary creatures do not lurk in the darkness. Letting the child sleep with his parents will not get rid of the fears. A 4-year-old child is in the preconceptual stage and cannot understand logical thought.
The nurse is conducting an assessment of fine motor development in a 3-year-old child. Which is the expected drawing skill for this age?
- A. Can draw a complete stick figure
- B. Holds the instrument with the fist
- C. Can copy a triangle and diamond
- D. Can copy a circle and imitate a cross
Correct Answer: D
Rationale: A 3-year-old child copies a circle and imitates a cross and vertical and horizontal lines. He or she holds the writing instrument with the fingers rather than the fist. A 3-year-old is not able to draw a complete stick figure but draws a circle, later adds facial features, and by age 5 or 6 years can draw several parts (head, arms, legs, body, and facial features). Copying a triangle and diamond are mastered sometime between ages 5 and 6 years.