Question 1

A school nurse is planning to assess the visual acuity of the preschool students at the school.Which of the following tests would be used?

Accepted Answer

Early detection requires regular screening with standardized tests such as the Denver Eye Screening Test or the Snellen Screening Test.The Snellen Screening Test, when administered under standardized procedures, has the advantage of rendering a reliable estimate of actual visual acuity.The Denver Eye Screening Test was designed for preschool children and includes detection of the commonly occurring visual problems, such as refractive errors, strabismus (crossing of the eyes), and amblyopia.The Snellen E chart is designed for preschool children.For visual acuity, Snelling is the instrument of choice.The Denver Eye is designed to pick up pathology of the eye.The Ishihara is a test for color blindness and the cover tests pick up amblyopia.

Question 2

Which of the following foods will a 5-year-old child need help eating?

Accepted Answer

The preschooler will need help with the chicken.In the later preschool years, most children need help cutting meats.

Question 3

Which of the following is a hallmark of Piaget's preconceptual substage?

Accepted Answer

The hallmark of Piaget's preconceptual substage is using language to function symbolically.The preschool child demonstrates increased symbolic functioning during the intuitive substage, from age 4 to 7 years.The predominant feature of this and the following period is the concrete thought process, as compared with adult abstract thinking.As they experience symbolic mental representations, preschoolers process mental symbols as though they were actually participating in the event.

Question 4

A nurse is working with a local day care center to develop appropriate outdoor play activities for 5-year-old children at the center.Which of the following activities would the nurse most likely recommend?

Accepted Answer

Preschoolers' physical abilities include balancing on one foot, jumping, and running.Generally, preschoolers appreciate an audience, enjoy practicing new skills, and demonstrate mastered skills to others.Appropriate outdoor play for a 5-year-old child includes playing on age-appropriate playground equipment while being supervised by day care personnel.At the age of 5, the child is still not proficient at controlling a bike in the streets.Swimming in a pool is hazardous unless the child has been previously taught to swim and is also being closely supervised on a one-to-one basis-neither of which is practical for a day care setting.Drawing with easels and crayons/chalk is not a good use of outdoor time.It is a sedentary activity, which can be easily done indoors at the day care center during indoor time.

Question 5

During a well-child visit, a father tells the nurse that the preschool-aged child has been enjoying their "road trips" that they take together.On such occasions, the child gets to sit in the front seat of the car with him.Which of the following actions should the nurse take next?

Accepted Answer

Federal investigations concluded that children younger than age 13 should ride in the back seat of a motor vehicle, particularly because of potential injury or death from a passenger seat airbag that could inflate in a severe car accident.Although parents may know that infants should be placed in the back seat, they do not always know that children in the front seat of a motor vehicle face danger, even if they are using a restraint system.Educating the father regarding the rationale for the recommendation, (i.e., the hazard of small children riding in the front seat), may improve his compliance.Reporting the behavior to authorities will likely set up an adversarial relationship between the father and the nurse and thus will not be productive.

Question 6

A preschooler and her school-age brother both have received the same swimming tube as a gift.The brother accidentally took his sister's swimming tube.The sister protested that she needed her swimming tube to go swimming.Which of the following is being demonstrated by this behavior by the sister?

Accepted Answer

As they experience symbolic mental representations, preschoolers process mental symbols as though they were actually participating in the event.At this stage, mental abstraction, such as skipping from one part of an operation to another, reversing the operation mentally, or thinking of the whole in relation to the parts, is not feasible.The behavior is indicative of concrete thinking.Children can only concentrate on their own perspective.Also, the preschooler is not able to consider more than one factor at a time when solving problems.She knows only that her tube has been taken.She is not able to grasp that the two tubes are identical; thus she could easily use her brother's tube, which has been left behind.

Question 7

Autism disorder is common and is invariably encountered by nurses providing care for children.Which of the following statements is correct concerning this disorder?

Accepted Answer

Autism disorder is considered as a genetically determined disorder and is only rarely associated with non-genetic risk factors, such as maternal valproic acid use during pregnancy, congenital rubella, and cerebral palsy.Currently, multiple studies have linked autism spectrum disorders with atypical birth weight (high or low), low Apgar scores, hemolytic disease, hyperbilirubinemia (jaundice), respiratory distress, advanced parental age, length of gestation, and environmental factors (viruses), all of which may be subtle and complicated by the genetic influence.While frequently reported in the lay press, there has been no scientifically sound study which has linked autism with child vaccines.The disorder is believed to be associated with genetic factors.

Question 8

A nurse is reviewing the chart of a preschool child who has been diagnosed with Asperger's syndrome.Which of the following findings is the nurse most likely to discover?

Accepted Answer

Asperger's syndrome is a form of autism.Manifestations of autism spectrum disorders vary considerably.However, these children usually have a variety of problems including failure to attain motor skill developmental milestones.Such findings are signs that warrant further assessment.A failure to crawl by 10 months of age is a failure to attain a normal milestone of motor skill development.The other choices do not suggest abnormal findings.

Question 9

A 5-year-old is consuming a daily caloric intake of 1400 calories.Approximately what portion of the diet should be comprised of carbohydrates?

Accepted Answer

Preschoolers should consume approximately half of their diet in carbohydrates.Children aged 3 to 5 years old should receive 1200 to 1600 calories per day depending on their activity level and gender.

Question 10

A 4-year-old girl asks her mother for a second cup of yogurt before starting to eat the first cup she was given.What will the child most likely do with the extra helping?

Accepted Answer

The extra helping is likely for the child's imaginary friend.Preschoolers may have one or more imaginary companions.They are usually another child.Preschoolers eat, play, and sleep with their imaginary companions.

Question 11

A 4-year-old boy had an episode of enuresis.Which of the following actions should be taken by the parents?

Accepted Answer

They should be responsible for changing their own clothes and reminded gently and encouragingly of ways to avoid problems in the future.The parents should have the child change his own pajamas before returning to bed after the episode of enuresis.Preschoolers should not be ridiculed nor punished.For this reason, choices "B," "C," and "D" are inappropriate.

Question 12

A mother comments to the school nurse that her child has poor hygiene habits and asks the nurse for suggestions as to how to teach her child to improve on his hygiene.Which of the following recommendations would the nurse give the mother?

Accepted Answer

Although preschoolers are not completely responsible for their own health management, they certainly contribute by brushing their teeth, taking medication, wearing appropriate clothing for inclement weather, and performing other actions.Reinforcement of health-promotion activities, which occurs in the home and child care environments, helps to instill behaviors that affect self-esteem, safety, and an individual's overall balance with life.For example, family support for active lifestyles provides one way for parents to assume a positive role to model for children.The best way for a parent to teach a child good hygiene is to model the behavior at home.Reinforcement of health-promotion activities helps to instill behaviors.Additionally, preschoolers like to imitate adults.

Question 13

Which sleep ritual is age appropriate for a preschooler?

Accepted Answer

An age-appropriate sleep ritual for a preschooler is to say good night to all 20 stuffed animals in the room before going to sleep.Preschoolers have longer, more rigid bedtime rituals than toddlers.They prolong bedtime routines, which for them generally last about 30 minutes.Reasonable rituals should be honored.Unreasonable rituals such as choices "A" and "D" are not appropriately implemented.Choice "C" is not a bedtime ritual.

Question 14

A nurse is determining caloric needs for a preschooler who weighs 18 kg.Which of the following represents the daily caloric needs for this child?

Accepted Answer

The approximate number of calories required by an 18-kg preschooler is 1620.Preschoolers need approximately 90 kcal/kg of body weight per day for health maintenance, activity, and growth.

Question 15

A 2-year-old child has hives.Of the following items ingested, which is most likely to have caused the allergic reaction?

Accepted Answer

Oatmeal-peanut cookies are most likely to have caused the allergic reaction.Nuts, and especially peanuts, are a food that is commonly associated with allergic reactions.

Question 16

A nurse is discussing genetic disorders with a local community group.Which of the following statements would the nurse make during the presentation?

Accepted Answer

The genetic problems most likely to appear during the preschool years are cystic fibrosis, Duchenne muscular dystrophy, fragile X syndrome, Williams syndrome, and autism.

Question 17

A 4-year-old child tells the school nurse that he invented a new song.Which of the following would be the best response by the nurse?

Accepted Answer

During the preschool years, basic self-concept emerges from the child's personal struggle for autonomy.As children develop beyond the toddler years, they refine their sense of self through both task-oriented and socially oriented experiences.By reinforcing skills and successfully accomplishing tasks, preschoolers build self-esteem, enhancing overall health.The nurse's best response is to congratulate the child on a job well done.Reinforcement of behaviors and praising are methods that help develop self-concept.

Question 18

A nurse is using primary prevention strategies to prevent child abuse in the community.Which of the following interventions would the nurse implement?

Accepted Answer

Educating the public about violence and the potential for abuse is a form of primary prevention.Nurses provide primary prevention for violence by promoting awareness and providing anticipatory guidance.Primary prevention is used before violence actually occurs.Choices "B," "C," and "D" deal with child abuse after it has already manifested and thus would not be consistent with strategies for primary prevention.

Question 19

The nurse is about to administer prescribed medication to a 4 year old.The medication is renally excreted.Which of the following statements is correct concerning this scenario?

Accepted Answer

Kidneys reach full maturity by the end of infancy and early toddler years.As a result, medications that are renally excreted can be given at the recommended doses.

Question 20

During a well-child visit, a parent tells the nurse that their preschooler occasionally wakes up during the middle of the night and tells them about "scary things." He is fully awake when the parents enter the room.The child often recalls the incident the following morning.Based on growth and development, which of the following would be the most common reason for the preschooler to wake up?

Accepted Answer

Nightmares are a common reason for nighttime awakenings.Nightmares fully waken the child and give them a feeling of fearfulness and helplessness.Consolation is readily provided by the parent.Night terrors are a more extreme manifestation typically resulting in a child who is not fully awake and is inconsolable for 10 minutes.Night terrors may "cause the child to sit up in bed, scream, stare at an imaginary object, breathe heavily, perspire, and appear in obvious distress … In most cases the child does not recall the dream and in the morning does not remember the incident." Enuresis typically does not wake the child; children with adequate food intake during the day and evening would not have a problem with night-time wakening due to hunger.

Quiz 19: Preschool Child