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What characteristic best describes the language skills of a 3-year-old child?
- A. Asks meanings of words
- B. Follows directional commands
- C. Can describe an object according to its composition
- D. Talks incessantly regardless of whether anyone is listening
Correct Answer: D
Rationale: Because of the dramatic vocabulary increase at this age, 3-year-old children are known to talk incessantly regardless of whether anyone is listening. A 4- to 5-year-old child asks lots of questions and can follow simple directional commands. A 6-year-old child can describe an object according to its composition.
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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.
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.
During a well-child visit, the father of a 4-year-old boy tells the nurse that he is not sure if his son is ready for kindergarten. The boys birthday is close to the cut-off date, and he has not attended preschool. What is the nurses best recommendation?
- A. Start kindergarten.
- B. Talk to other parents about readiness.
- C. Perform a developmental screening.
- D. Postpone kindergarten and go to preschool.
Correct Answer: C
Rationale: A developmental assessment with a screening tool that addresses cognitive, social, and physical milestones can help identify children who may need further assessment. A readiness assessment involves an evaluation of skill acquisition. Stating the child should start kindergarten or go to preschool and postpone kindergarten does not address the fathers concerns about readiness for school. Talking to other parents about readiness does not ascertain if the child is ready and does not address the fathers concerns.
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.
In terms of cognitive development, a 5-year-old child should be expected to do which?
- A. Think abstractly.
- B. Use magical thinking.
- C. Understand conservation of matter.
- D. Understand another persons perspective.
Correct Answer: B
Rationale: Magical thinking is believing that thoughts can cause events. An example is thinking of the death of a parent might cause it to happen. Abstract thought does not develop until the school-age years. The concept of conservation is the cognitive task of school-age children, ages 5 to 7 years. A 5-year-old child cannot understand another persons perspective.