Chapter 18: The Preschool Child Nursing School Test Banks

Chapter 18: The Preschool Child

MULTIPLE CHOICE

1. Which statement best describes the 3-year-old child?
a. Boisterous, tattles on others
b. Aggressive, shows off
c. Helpful, wants to assist with chores
d. Talkative, inquisitive about the environment
ANS: C
Three-year-old children are helpful and can assist in simple household chores.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 3
TOP: Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. The parents of a 4-year-old boy are concerned because they have noticed him frequently touching his penis. What knowledge would act as the basis for the nurses response?
a. This behavior indicates a normal curiosity about sexuality.
b. Masturbation suggests the boy has an excessive fear of castration.
c. It is usually a result of discomfort from a penile rash or irritation.
d. The behavior is abnormal and the child should be referred for counseling.
ANS: A
Masturbation at this age is common and indicates that the preschooler has a normal curiosity about sexuality.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 9
TOP: Masturbation KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. A preschool-age child is asked, Why do trees have leaves? Which response would be an example of animism?
a. So I can have shade over my sandbox.
b. Because God made them that way.
c. To hide behind when they are scared.
d. For the squirrels to play in.
ANS: C
Animism describes the tendency of preschool children to attribute human characteristics to nonhuman objects.

DIF: Cognitive Level: Application REF: Page 421 OBJ: 1
TOP: Cognitive Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. What tasks would be appropriate to expect of a 5-year-old?
a. Setting the table with paper plates
b. Washing the dirty knives
c. Carrying glasses from the table to the sink
d. Scrubbing out the sink with cleanser
ANS: A
Parents must consider developmental level and safety when asking the 5-year-old child to help with chores.

DIF: Cognitive Level: Application REF: Page 430 OBJ: 3
TOP: DevelopmentSafety KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

5. A 3-year-old child, while playing with his favorite toy in the playroom of the pediatric unit, is approached by another child who also wants to play with the same toy. What behavior will the nurse anticipate from this child?
a. Will play well with the other child
b. Will give the toy up and then not play anymore
c. Will become angry and a physical response might ensue
d. Will ignore the toy and go on to something else
ANS: C
The 3-year-old child is egocentric and likely will become angry when others attempt to take his or her possessions.

DIF: Cognitive Level: Application REF: Page 425 OBJ: 3
TOP: Display of Aggression KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

6. A parent is concerned about her childrens reaction should their grandmother die. What understanding will guide the nurses response?
a. Children are unlikely to notice their grandmothers absence if no one reminds them.
b. Young children often understand that other people die, but do not equate it with themselves.
c. The childrens response will depend entirely on whether they have been acquainted with death before this.
d. Children can understand the concept of a higher being much like adults can.
ANS: B
Between 3 and 4 years of age, the child becomes curious about death and dying. They may realize that others die, but they do not relate death to themselves.

DIF: Cognitive Level: Comprehension REF: Page 425 OBJ: 7
TOP: Concept of Death KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. What is the most appropriate intervention when dealing with occasional aggression in a 4-year-old child?
a. Have the child take a time-out in the corner for 4 minutes.
b. Spank the child at the time of the incident.
c. Take away television privileges for the day.
d. Send the child to his room for 30 minutes.
ANS: A
Time-out periods, usually lasting 1 minute per year of age, with the child sitting in a chair or corner, are considered an effective disciplinary technique.

DIF: Cognitive Level: Application REF: Page 425 OBJ: 8
TOP: Limit Setting KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

8. A father is concerned about how long his preschool-age child will continue sucking his thumb. What is the most helpful response from the nurse?
a. Most children will stop thumb-sucking naturally by school age.
b. Over-the-counter treatments that give a bad taste can be placed on the thumb to discourage the practice.
c. Consistently touching the childs fingers whenever he sucks his thumb is most effective.
d. Thumb-sucking is detrimental to the eruption of the childs teeth and must be stopped as soon as possible.
ANS: A
Most children give up the habit of thumb-sucking by the time they reach school.

DIF: Cognitive Level: Application REF: Page 428 OBJ: 9
TOP: Thumb-Sucking KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. How does the nurse characterize the play of 5-year-old children?
a. Enjoying rough and tumble play
b. Playing well-organized games
c. Following rules
d. Preferring inside activities
ANS: C
The 5-year-old wants to play by the rules but cannot accept losing. The rules may be very strict or change as the game progresses.

DIF: Cognitive Level: Comprehension REF: Page 422, Table 18-1 | Page 425-426
OBJ: 13 TOP: Play KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. The nurse is discussing preschoolers sexual curiosity with the parent. What statement by the mother leads the nurse to determine that the mother understands the information?
a. Make up funny words for body parts.
b. Distract the child with a toy if they ask about sex.
c. Answer their questions when they ask.
d. Tell them to ask you again when they are 6 year old.
ANS: C
Parents should provide sex education at the time the child asks about sex.

DIF: Cognitive Level: Analysis REF: Page 424 OBJ: 9
TOP: Sexual Curiosity KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

11. What type of play is most appropriate when planning care for a child with moderate intellectual deficiency?
a. Exercise leg and arm muscles.
b. Be educationally oriented to make up for lost time.
c. Be adjusted to mental age rather than chronological age.
d. Involve contact sports and aggressive physical activity with other children.
ANS: C
The nurse must consider the childs mental age rather than her chronological age when selecting toys for play.

DIF: Cognitive Level: Application REF: Page 431 OBJ: 14
TOP: Play KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

12. What is the nurses best advice to a parent about a preschoolers imaginary friend?
a. Having imaginary friends is a sign that the child has low self-esteem.
b. It is common for preschoolers to have imaginary friends.
c. Preschoolers invent an imaginary friend when they feel overwhelmed.
d. The best approach to dealing with an imaginary friend is to ignore them.
ANS: B
Imaginary friends are common and normal during the preschool period and serve many purposes, such as relief from loneliness, mastery of fears, and acting as a scapegoat.

DIF: Cognitive Level: Comprehension REF: Page 431, Nursing Tip
OBJ: 13 TOP: Imaginary Friend
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

13. What intervention might the nurse suggest as helpful for the child with enuresis?
a. Applying an electric pad that gently shocks the child
b. Waking the child several times during the night to urinate
c. Decreasing fluid intake after the evening meal
d. Increasing dietary fiber intake
ANS: C
If a child is experiencing enuresis, liquids after dinner should be limited and the child should routinely void before going to bed.

DIF: Cognitive Level: Application REF: Page 428-429
OBJ: 9 TOP: Enuresis KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

14. What should the nurse suggest as the most appropriate toy choice for a 3-year-old?
a. A board game
b. A small pet, such as a goldfish
c. A large construction set
d. Push-pull toys
ANS: C
Large construction sets are suitable toys for the preschool-age child.

DIF: Cognitive Level: Application REF: Page 431 OBJ: 13
TOP: Play KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

15. The parent of a 3 -year-old child tells the nurse, My daughter points instead of speaking whenever she wants me to get something for her, but she understands me when I ask her to do something. Based on the parents comment, what does the nurse suspect?
a. Age-appropriate language development
b. An expressive language delay
c. A receptive language delay
d. A potential hearing deficit
ANS: B
An expressive language delay is suspected when the child understands spoken language but is not talking.

DIF: Cognitive Level: Application REF: Page 425, Table 18-3
OBJ: 3 TOP: Language Development
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. The parent of a 4 -year-old child tells the nurse, Bedtime is difficult. I cant get my son to go to bed at night. The nurse and the childs mother discuss options. What intervention is the most appropriate choice?
a. Allow the child to put himself to bed when he is tired.
b. Let the child read in his room until he falls asleep.
c. Establish a bedtime routine and use it consistently.
d. Tire him out with physical activity before bedtime.
ANS: C
Parents should engage the child in quiet activities before bedtime and establish a ritual that signals readiness for bedtime.

DIF: Cognitive Level: Application REF: Page 424 OBJ: 6
TOP: Bedtime Habits KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

17. What fear is unique to the preschool period?
a. Water
b. Animals
c. Bodily harm
d. Death
ANS: C
The fear of bodily harm, particularly the loss of body parts, is unique to this stage.

DIF: Cognitive Level: Knowledge REF: Page 425 OBJ: 3
TOP: Fear KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

18. A 4-year-old child tells the nurse she will not eat peas because they are green. Of what is this an example?
a. Egocentrism
b. Artificialism
c. Animism
d. Centering
ANS: D
The tendency to concentrate on a single outstanding characteristic of an object while excluding other features is known as centering.

DIF: Cognitive Level: Application REF: Page 421 OBJ: 3
TOP: Centering KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

19. A 4-year-old child insists he has more money with a nickel than his father has with a dime. What is this perception, as described in Piagets theory?
a. Egocentrism
b. Artificialism
c. Animism
d. Intuition
ANS: D
The intuitive stage, as described by Piaget, is prelogical thinking that is based on the outside appearance of objects. A nickel is larger than a dime and therefore more valuable.

DIF: Cognitive Level: Comprehension REF: Page 421 OBJ: 4
TOP: Cognitive Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

20. What will children who are unable to express themselves with words often do?
a. Become reclusive and introspective
b. Develop other methods of verbal communication
c. Engage in more creative play
d. Have tantrums and act out
ANS: D
Children with delayed communication skills will frequently have tantrums and act out when they are unable to make their needs known.

DIF: Cognitive Level: Comprehension REF: Page 421 OBJ: 5
TOP: Tantrums KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

21. Which is an example of associative play?
a. Two children playing house, one playing the role of the dad and the other playing the mom
b. Two children playing in a sand box, one building a wall and the other digging a hole
c. Two children playing with sports-associated items, one with a football and the other with a bat
d. Two children playing with a coloring book, one coloring pictures and the other looking at pictures
ANS: A
Associative play allows the preschoolers to use their enlarged vocabulary in play with other children to carry on conversations and describe scenarios for each to play.

DIF: Cognitive Level: Analysis REF: Page 424 OBJ: 13
TOP: Associative Play KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

22. The nurse is educating a group of preschool parents about the importance of safety. Which statement by a parent indicates the need for further education?
a. I continue to provide a great deal of indirect supervision for my child.
b. My stairway is always free of clutter.
c. I only leave my child in the car for brief moments.
d. Medications are kept in a locked cabinet.
ANS: C
Children must not play in or around the car or be left alone, even for a brief moment, in the car. Preschool children still require a good deal of indirect supervision to protect them from dangers that arise from their immature judgment or social environment. Stairways should be free of clutter and medications kept out of reach.

DIF: Cognitive Level: Comprehension REF: Page 430 OBJ: 11
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

23. Parents of a 5-year-old child tell the nurse they are concerned about their childs speech development by stating, No one can understand him but us. What clinical classification of speech disorder does the nurse suspect?
a. Global language delay
b. Expressive language delay
c. Language loss
d. Articulation disorder
ANS: D
When parents are the only people to understand their preschool child, an articulation disorder is suspected. (See Table 18-3.)

DIF: Cognitive Level: Application REF: Page 423 OBJ: 5
TOP: Safety KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

MULTIPLE RESPONSE

24. What does including play in the plan of care for a 5-year-old allow the child to do? (Select all that apply.)
a. Exercise his imagination
b. Assume a role and act it out
c. Offers an emotional outlet
d. Avoid magical thinking
e. Interact with other children
ANS: A, B, C, E
Benefits of play for the preschooler include exercising imagination, assuming a role and acting it out, offering an emotional outlet, and interaction with other children. Play employs the use of magical thinking.

DIF: Cognitive Level: Knowledge REF: Page 422, Table 18-1 | Page 425-426
OBJ: 10 TOP: Purpose of Play
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

25. What developmental milestone(s) assist the 5-year-old boy toward developing his sexual identity? (Select all that apply.)
a. Begins to be less focused on his mother
b. Ignores both parents totally
c. Regresses to a more infantile level
d. Forms a romantic attachment to the mother
e. Identifies with the parent of the same sex
ANS: A, D, E
Children of this age become less focused on the mother as the central person and begin to identify with the parent of the same sex, forming a romantic attachment to the parent of the opposite sex. This little boy might say, Im going to marry my mother. A little girl might say, Im going to marry my daddy.

DIF: Cognitive Level: Application REF: Page 425-426
OBJ: 2 TOP: Romantic Attachment to Parent
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

26. Which bedtime preparation rituals are the most appropriate for the nurse to suggest? (Select all that apply.)
a. Telling a story
b. Placing a favorite toy in bed
c. Placing a glass of water at the bedside
d. Turning on a night light
e. Playing energetically
ANS: A, B, C, D
All options are soothing bedtime rituals except energetic playing, which would be stimulating and counterproductive to sleep.

DIF: Cognitive Level: Comprehension REF: Page 424 OBJ: 6
TOP: Bedtime Habits KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

27. The nurse points out what advantage(s) of a nursery school or preschool experience? (Select all that apply.)
a. Increasing self-confidence
b. Fostering group cooperation
c. Detecting adjustment problems
d. Attainment of toilet training skills
e. Playing experiences with other children
ANS: A, B, C, E
Nursery school increases self-confidence, group cooperation, social skills, and cooperative play. Objective observations by a nursery school instructor can detect early adjustment problems. The child is usually toilet trained prior to the start of preschool.

DIF: Cognitive Level: Comprehension REF: Page 429 OBJ: 12
TOP: Advantages of Nursery School KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

28. Which major developmental tasks will the nurse expect a child to accomplish by the end of the preschool years? (Select all that apply.)
a. Development of parallel play
b. Acceptance of separation
c. Increased communication skills
d. Consistent appetite
e. Control of bodily functions
ANS: B, C, E
The major tasks of the preschool child include preparation to enter school, development of a cooperative type of play, control of body functions, acceptance of separation, and increase in communication skills, memory, and attention span. Appetite remains inconsistent.

DIF: Cognitive Level: Comprehension REF: Page 420 OBJ: 2
TOP: Major Developmental Tasks. KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

29. When planning an activity for a 3-year-old, the nurse bases the plan on the average attention span of _____ minutes.

ANS:
15

The average attention span of the preschooler is about 15 minutes.

DIF: Cognitive Level: Comprehension REF: Page 422, Table 18-1
OBJ: 3 TOP: Attention Span of Preschooler
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

30. Play that is designed to retrain muscles or improve eye-hand coordination is considered ____________________ play.

ANS:
therapeutic

Therapeutic play, whether at home or in a clinic or rehab center, is designed to retrain muscles, strengthen muscles, or improve eye-hand coordination

DIF: Cognitive Level: Knowledge REF: Page 432 OBJ: 14
TOP: Therapeutic Play KEY: Nursing Process Step: N/A
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

31. The gradual transfer of behavioral control from the parent to the child is accomplished through _________________.

ANS:
discipline

Through discipline the parent gradually gives up behavior self-control to the child.

DIF: Cognitive Level: Comprehension REF: Page 426 OBJ: 3
TOP: Discipline KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

32. ____________ is a preschoolers idea that the world and all of its contents are created by people.

ANS:
Artificialism

Artificialism is the belief that all things in the world have been created by people.

DIF: Cognitive Level: Knowledge REF: Page 421 OBJ: 1
TOP: Artificialism KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

33. ____________________ _________ is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there.

ANS:
Symbolic functioning

Symbolic functioning is seen in the play of children who pretend that an empty box is a fort; they create a mental image to stand for something that is not there.

DIF: Cognitive Level: Knowledge REF: Page 421 OBJ: 1
TOP: Symbolic Functioning KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

34. Put the stages of separation anxiety in order from first to last. Put a comma and space between each answer choice (a, b, c, d, etc.)
a. Detachment
b. Regression
c. Despair
d. Protest

ANS:
D, C, A, B

The preschool child may feel abandoned by the parents and continues to be subject to separation anxiety. Separation anxiety is manifested by the stages of protest, despair, detachment, and regression.

DIF: Cognitive Level: Comprehension REF: Page 432 OBJ: 3
TOP: Separation Anxiety KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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