NCLEX-PN › Pediatric Care and Development
By what age should an infant have doubled it's birth weight?
6 months
12 months
3 months
9 months
An infant should have doubled it's birth weight by the age of six months, and tripled it's birth weight by the age of 12 months. Children who fail to reach these markers may be underweight due to a variety of factors such as underfeeding, metabolic disorder, or failure to thrive.
By what age should an infant be able to pull itself up to standing?
9 months
12 months
6 months
18 months
An infant should have the ability to pull itself up to standing by the age of 9 months. If standing is not seen after 12 months the child should be evaluated for any type of physical developmental disabilities or delays.
At what age does the posterior fontanelle close?
8 weeks
12 weeks
16 weeks
4 weeks
The posterior fontanelle, which is the cartilaginous gap at the junction of the lambdoid suture and the sagittal suture, closes at eight weeks of age.
Which of the following is not part of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) diagnostic criteria for autism spectrum disorder (ASD)?
Hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for the person’s developmental level
Stereotyped or repetitive motor movements, use of objects, or speech
Highly restricted, fixated interests that are abnormal in intensity or focus
Hyper- or hyporeactivity to sensory input or unusual interests in sensory aspects of the environment
All of the behaviors listed are part of the diagnostic criteria for autism spectrum disorder except for disruptive hyperactivity-impulsivity present for a period of greater than six months, which is part of the DSM-5's diagnostic criteria for attention deficit hyperactivity disorder (ADHD), not for autism spectrum disorder (ASD).
A mother brings her seven year old daughter into the emergency room after she fell while riding her bike. She was not wearing a helmet and she hit her head on the asphalt.
Which of the following is not a sign of late-stage increased intracranial pressure (ICP) in a pediatric patient?
Dilated scalp veins
Bradycardia
Fixed, dilated pupils
Diminished level of consciousness
Diminished level of consciousness, bradycardia, and fixed and dilated pupils are all signs of later-stage intracranial pressure (ICP). Dilated scalp veins may be present with ICP, but will be seen in the early stages of the condition.
A nurse is instructing a parent on proper care for their seven-year-old son who has recently been diagnosed with a seizure disorder. In regards to care during a seizure, the nurse should advise the parent to do all of the following except __________.
Place a padded tongue blade in the child's mouth
Move furniture away
Note the length of the seizure
Stay with the child for the duration of the episode
A parent of a child with a seizure disorder should be instructed to stay with the child through the duration of the seizure, to move any nearby furniture out of the way of the child to prevent trauma, and to note and record the length of the seizure. No object should ever be put into the mouth of a child who is having a seizure.
Which of the following would increase suspicion of strabismus in a pediatric patient?
The child consistently squints or tilts head to see
The child complains of frequent nausea
The child does not respond to loud or sudden noises
Difficulty holding eye contact or responding to social cues
Strabismus is a misalignment of the eyes that results in one eye becoming dominant over the other. It does not affect hearing or ability to connect to others socially. This condition should not result in nausea.
An audible click when the examiner slips the femoral head forward is considered positive for what sign?
Ortolani sign
Babinski sign
Brudzinski sign
Scarf sign
An audible click when the examiner slips the femoral head forward is considered a positive Ortolani sign. This finding suggests congenital hip dysplasia. Babinski sign is the presence of the Babinski reflex, which is normal in infants. Scarf sign is used to assess developmental age and muscle tone in neonates. Brudzinski sign is not related to the musculoskeletal system but is part of a physical examination in cases of suspected meningitis.
At what age can an infant begin eating solid foods?
6 months
3 months
4 months
9 months
Solid foods should not be introduced into an infant's diet before 6 months of age. Earlier introduction may trigger specific food allergies, as well as reducing breastmilk production in a breastfeeding mother.
The nurse cares for a 2-year-old boy whose mother is worried that he is not fully toilet trained yet. The mother is worried because he is not yet able to hold his urine for more than a couple hours, but is proud that he can use the toilet for bowel movements. How should the nurse reply to the mother?
“Bladder control is usually achieved after bowel control, so toilet training can take anywhere from 2 to 3 years to fully achieve.”
“Your child could be developmentally delayed and should have achieved full toilet training by now. Let me refer you to a pediatric psychologist.”
“Bladder control is usually achieved before bowel control, but he is on track to become fully potty trained.”
“You should tell your son ‘no’ every time he wets himself. That is the only way he will learn that his behavior is not acceptable.”
“Bladder control is usually achieved after bowel control, but he should be fully potty trained by this age.”
Toilet training may be achieved anywhere from 24 months to 36 months, and may sometimes take longer for boys than girls. Bladder control usually occurs after bowel control. Parents should not be concerned if their children take the full 36 months to become toilet trained or if they have difficulty holding their urine longer than a few hours due to the small size of their bladders. Toilet training that takes longer than 3 years may be caused by psychological factors, but this child is not in need of the assessment of a child psychologist at his age. The nurse should not encourage the mother to tell the child that his behavior is unacceptable because it is not expected of him to achieve full toilet training for another year.