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In terms of fine motor development, what should the 3-year-old child be expected to do?
- A. Tie shoelaces.
- B. Copy (draw) a circle.
- C. Use scissors or a pencil very well.
- D. Draw a person with seven to nine parts.
Correct Answer: B
Rationale: Three-year-old children are able to accomplish the fine motor skill of copying (drawing) a circle. The ability to tie shoelaces, to use scissors or a pencil very well, and to draw a person with seven to nine parts are fine motor skills of 5-year-old children.
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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.
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 planning to bring a preschool child a toy from the playroom. What toy is appropriate for this age group?
- A. Building blocks
- B. A 500-piece puzzle
- C. Paint by number picture
- D. Farm animals and equipment
Correct Answer: D
Rationale: The most characteristic and pervasive preschooler activity is imitative, imaginative, and dramatic play. Farm animals and equipment would provide hours of self-expression. Building blocks are appropriate for older infants and toddlers. A 500-piece puzzle or a paint by number picture would be appropriate for a school-age child.
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.
The nurse has just given a subcutaneous injection to a preschool child, and the child asks for a Band-Aid over the site. Which action should the nurse implement?
- A. Place a Band-Aid over the site.
- B. Massage the injection site with an alcohol swab.
- C. Show the child there is no bleeding from the site.
- D. Explain that a Band-Aid is not needed after a subcutaneous injection.
Correct Answer: A
Rationale: Despite the advances in body image development, preschoolers have poorly defined body boundaries and little knowledge of their internal anatomy. Intrusive experiences are frightening, especially those that disrupt the integrity of the skin (e.g., injections and surgery). They fear that all their blood and insides can leak out if the skin is broken. Therefore, preschoolers may believe it is critical to use bandages after an injury. The nurse should place a Band-Aid over the site.