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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.
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The nurse is talking to the parent of a 5-year-old child who refuses to go to sleep at night. What intervention should the nurse suggest in helping the parent to cope with this sleep disturbance?
- A. Establish a consistent punishment if the child does not go to bed when told.
- B. Allow the child to fall asleep in a different room and then gently move the child to his or her bed.
- C. Establish limited rituals that signal readiness for bedtime.
- D. Allow the child to watch television until almost asleep.
Correct Answer: C
Rationale: An appropriate intervention for a child who resists going to bed is to establish limited rituals such as a bath or story that signal readiness for bed and consistently follow through with the ritual. Punishing the child will not alleviate the resistance problem and may only add to the frustration. Allowing the child to fall asleep in a different room and to watch television to fall asleep are not recommended approaches to sleep resistance.
Which type of play is most typical of the preschool period?
- A. Team
- B. Parallel
- C. Solitary
- D. Associative
Correct Answer: D
Rationale: Associative play is group play in similar or identical activities but without rigid organization or rules. School-age children play in teams. Parallel play is that of toddlers. Solitary play is that of infants.
At a seminar for parents with preschool-age children, the nurse has discussed anticipatory tasks during the preschool years. Which statement by a parent should indicate a correct understanding of the teaching?
- A. I should be worried if my 4-year-old child has an increase in sexual curiosity because this is a sign of sexual abuse.
- B. I should expect my 5-year-old to change from a tranquil child to an aggressive child when school starts.
- C. I should be concerned if my 4-year-old child starts telling exaggerated stories and has an imaginary playmate, since these could be signs of stress.
- D. I should expect my 3-year-old child to have a more stable appetite and an increase in food selections.
Correct Answer: D
Rationale: A 3-year-old child exhibits a more stable appetite than during the toddler years and is more willing to try different foods. A 4-year-old child is imaginative and indulges in telling tall tales and may have an imaginary playmate; these are normal findings, not signs of stress. Also a 4-year-old child has an increasing curiosity in sexuality, which is not a sign of child abuse. A 5-year-old child is usually tranquil, not aggressive like a 4-year-old child.
Parents tell the nurse they found their 3-year-old daughter and a male cousin of the same age inspecting each other closely as they used the bathroom. What is the most appropriate recommendation for the nurse to make?
- A. Punish the children so this behavior stops.
- B. Neither condone nor condemn the curiosity.
- C. Get counseling for this unusual and dangerous behavior.
- D. Allow the children unrestricted permission to satisfy this curiosity.
Correct Answer: B
Rationale: Three-year-old children become aware of anatomic differences and are concerned about how the other sex works. Such exploration should not be condoned or condemned. Children should not be punished for this normal exploration. This is age appropriate and not dangerous behavior. Encouraging the children to ask their parents questions and redirecting their activity is more appropriate than giving permission.
A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was bad. What is the nurses best interpretation of this comment?
- A. Sign of stress
- B. Common at this age
- C. Suggestive of maladaptation
- D. Suggestive of excessive discipline at home
Correct Answer: B
Rationale: Preschoolers cannot understand the cause and effect of illness. Their egocentrism makes them think they are directly responsible for events, making them feel guilt for things outside of their control. Children of this age react to stress by regressing developmentally or acting out. Maladaptation is unlikely. This comment does not imply excessive discipline at home.