Nokea
At a well-child visit, parents ask the nurse how to know if a daycare facility is a good choice for their infant. Which observation should the nurse stress as especially important to consider when making the selection?
- A. Developmentally appropriate toys
- B. Nutritious snacks served to the children
- C. Handwashing by providers after diaper changes
- D. Certified caregivers for each of the age groups at the facility
Correct Answer: C
Rationale: Health practices should be most important. With the need for diaper changes and assistance with feeding, young children are at increased risk when handwashing and other hygienic measures are not consistently used. Developmentally appropriate toys are important, but hygiene and the prevention of disease transmission take precedence. An infant should not have snacks. This is a concern for an older child. Certified caregivers for each age group may be an indicator of a high-quality facility, but parental observation of good hygiene is a better predictor of care.
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During the 2-month well-child checkup, the nurse expects the infant to respond to sound in which manner?
- A. Respond to name.
- B. React to loud noise with Moro reflex.
- C. Turn his or her head to side when sound is at ear level.
- D. Locate sound by turning his or her head in a curving arc.
Correct Answer: C
Rationale: At 2 months of age, an infant should turn his or her head to the side when a noise is made at ear level. At birth, infants respond to sound with a startle or Moro reflex. An infant responds to his or her name and locates sounds by turning his or her head in a curving arc at age 6 to 9 months.
According to Piaget, a 6-month-old infant should be in which developmental stage?
- A. Use of reflexes
- B. Primary circular reactions
- C. Secondary circular reactions
- D. Coordination of secondary schemata
Correct Answer: C
Rationale: Infants are usually in the secondary circular reaction stage from ages 4 to 8 months. This stage is characterized by a continuation of the primary circular reaction for the response that results. Shaking is performed to hear the noise of the rattle, not just for shaking. The use of reflexes stage is primarily during the first month of life. The primary circular reaction stage marks the replacement of reflexes with voluntary acts. The infant is in this stage from ages 1 to 4 months. The fourth sensorimotor stage is coordination of secondary schemata, which occurs at ages 9 to 12 months. This is a transitional stage in which increasing motor skills enable greater exploration of the environment.
The nurse is interviewing the father of a 10-month-old girl. The child is playing on the floor when she notices an electrical outlet and reaches up to touch it. Her father says no firmly and moves her away from the outlet. The nurse should use this opportunity to teach the father what?
- A. That the child should be given a time-out
- B. That the child is old enough to understand the word no
- C. That the child will learn safety issues better if she is spanked
- D. That the child should already know that electrical outlets are dangerous
Correct Answer: B
Rationale: By age 10 months, children are able to associate meaning with words. The father is using both verbal and physical cues to alert the child to dangerous situations. A time-out is not appropriate. The child is just learning about the environment. Physical discipline should be avoided. The 10-month-old child is too young to understand the purpose of an electrical outlet.
Which characteristic best describes the fine motor skills of an infant at age 5 months?
- A. Neat pincer grasp
- B. Strong grasp reflex
- C. Builds a tower of two cubes
- D. Able to grasp object voluntarily
Correct Answer: D
Rationale: At age 5 months, the infant should be able to voluntarily grasp an object. The grasp reflex is present in the first 2 to 3 months of life. Gradually, the reflex becomes voluntary. The neat pincer grasp is not achieved until age 11 months. At age 12 months, an infant will attempt to build a tower of two cubes but will most likely be unsuccessful.
In terms of gross motor development, what should the nurse expect an infant age 5 months to do?
- A. Sit erect without support.
- B. Roll from the back to the abdomen.
- C. Turn from the abdomen to the back.
- D. Move from a prone to a sitting position.
Correct Answer: C
Rationale: Rolling from the abdomen to the back is developmentally appropriate for a 5-month-old infant. The ability to roll from the back to the abdomen is developmentally appropriate for an infant at age 6 months. Sitting erect without support is a developmental milestone usually achieved by 8 months. A 10-month-old infant can usually move from a prone to a sitting position.