Chapter 31, The Infant and Family: Growth and Development of the Neonate and Infant—Sherpath

Question 1 of 15

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A weight gain of 1.49 lb (0.68 kg) per month is expected from birth until which month?

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  • 6 monthsAn infant is expected to gain 1.49 lb (0.68 kg) per month from birth until 6 months.
• • 8 monthsA weight gain of 1.49 lb (0.68 kg) per month is not expected from birth until 8 months.
• • 10 monthsAn infant is not expected to gain 1.49 lb (0.68 kg) per month from birth until 10 months.
• • 12 monthsA weight gain of 1.49 lb (0.68 kg) per month is not expected from birth until 12 months.

Question 2 of 15

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At which age should infants achieve proper eye coordination?

• • Infants should achieve proper eye coordination by 2 weeks to 1 month.Two weeks of age is not the time that proper eye coordination can be expected to occur. At this age there will be little coordination and the eyes will appear to wander.
• • Infants should achieve proper eye coordination by 1-2 months.At 1-2 months, an infant lacks eye coordination and the eyes may seem to wander or appear crossed.
• • Infants should achieve proper eye coordination by 2 to 4 months.At this age the infant’s nerves and muscles are still underdeveloped, therefore the infant lacks eye coordination and the eyes may seem to wander or appear crossed.
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  • Infants should achieve proper eye coordination by 4 to 6 months.Infants under 3-4 months of age often lack eye coordination and alignment but should achieve proper coordination by 4 to 6 months. By 3 months infants should be able to track and reach for objects as their eye-hand coordination begins to develop.

Question 3 of 15

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A mother of a 10-month-old comes to the nurse concerned that her child has had two upper respiratory infections in one month and asks if something is wrong with her child. How can the nurse respond?

• • To prevent infection the infant will need prophylactic antibiotics.Offering prophylactic antibiotics will not be the best way to respond to the parent. The parent should be reassured that this can be normal for a child who is this age.
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  • Infants have an immature immune system, which makes them susceptible to infections.Telling the parent that the child has an immature immune system, making them more susceptible to infection, will be the best explanation for the nurse to give the parent. The nurse can explain to the parent that the airways are small and collapsible, making it easier for pathogens to cause an infection.
• • An infant’s immune system should be developed by 6 months and so the child needs further evaluation.Suggesting the child should have a fully developed immune system by 6 months is not accurate and therefore it is not the best explanation to give the parent.
• • The infant’s infections are a sign that the child will develop asthma.Telling the parent that the infections are a sign that the child will develop asthma is not accurate and therefore this is not the best response to give the parent.

Question 4 of 15

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The mother of a newborn child enquires about having her child’s hearing checked. What is the best response by the nurse?

• • All newborns should be screened before 1 year of age.Suggesting all newborns be screened before 1 year of age is not the correct advice, therefore this is not the response the nurse should give.
• • At 6 months you can return and we will screen your infant.Telling the mother to return at 6 months is not the appropriate advice to give and therefore should not be the response made by the nurse.
• • Your newborn will be screened at the four-month well-baby visit.Suggesting the mother have her baby screened at 4 months is not accurate and therefore not the best response.
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  • All newborns should be screened for hearing before one month of age.Stating that the child will be screened for hearing before one month of age is accurate and therefore this is the best response for the nurse to make.

Question 5 of 15

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Which series of activities best reflects the motor development of an infant from 1 month of age to 4 months?

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  • At 4 months, the rooting reflex disappears.There are several primitive reflexes that disappear after the first year of life. The Moro reflex and the rooting reflex will disappear by 4 months of age.
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  • At 1 month, the child will hold a fist tightly clenched.At one month the child will keep the hand clenched and this will start to change by 2 months of age.
• • At 3 months the child will be able to crawl a minimal distance.This motor development will not usually be seen between 1 and 4 months of age. Crawling is more likely to be seen by 6 months of age.
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  • At 3 months the child will be able to lift the head 90 degrees from a prone position.The muscle strength in the baby’s head by 3 months of age will allow for lifting to 90 degrees in a prone position.
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  • At 4 months the child can hold the head steadily erect in a sitting position.At four months a child has motor development sufficient enough to hold the head erect in the sitting position.

Question 6 of 15

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Which important anticipatory guidance would parents need to learn prior to the development of the infant’s pincer grasp (around 9 months of age)?

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  • Electrical outlets should be covered with socket safety panels.Six-month-old infants grasp objects with all their fingers in a raking motion, but 9-month-olds use their thumbs and forefingers which allows them to grab potentially harmful things, putting them at risk for electrical injury.
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  • Parents should place stove pot handles away from the child’s reach.This would be good anticipatory guidance to give a parent with a child who is 9 months old since the child will be reaching for dangerous objects when in the kitchen.
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  • Parents should keep unsafe objects locked out of reach of the infant.Infants will need to be watched closely, and since they are growing in both cognitive development and motor development, this ability provides them with a wider view of the world and creates new ways to play, but this may put them in danger.
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  • The infant’s food items should be cut into small, manageable pieces.Nine-month-olds use their thumbs and forefingers in a fine motor skill called the pincer grasp, which allows them to grab potentially harmful things and place them in their mouth, which creates a choking hazard.
• • Parents should place hand protectors on the child to help protect them from injury.This is not a realistic suggestion to offer parents and therefore this advice will not be given for anticipatory guidance on the pincer grasp.

Question 7 of 15

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A mother has brought in her infant for the infant’s 6-month well-child checkup. You notice the infant’s left eye intermittently not aligning with the right eye and an inability to focus both eyes on the same spot. What is the appropriate response?

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  • Ensure the infant’s “red reflex” is normal.This is an important part of any pediatric eye exam.
• • Place the infant in isolation as this can be a sign of conjunctivitis.Eye alignment and movement coordination is usually not affected by infections. The child mentioned above should not be put into isolation and the provider should be contacted.
• • Do nothing, as infants do not gain extraocular eye coordination until 9 months of age.The infant’s provider will need to be notified and this child will need further evaluation. By three months infants should be able to track and reach for objects and they will achieve proper coordination shortly after.
• • Stress the importance of eye exercises to help prevent worsening of the condition.This is not the appropriate response for eye misalignment and lack of eye coordination in a pediatric patient. Eye exercises are not going to be advised by the nurse.
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  • Notify the child’s provider, as extraocular eye alignment should be achieved by 6 months of age.Infants under 3 to 4 months of age often lack eye coordination and alignment but should achieve proper coordination by age 4 to 6 months. By 3 months, infants should be able to track and reach for objects as their eye-hand coordination begins to develop.

Question 8 of 15

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A mother of a 3-month-old infant is requesting information on the motor milestones she can expect to see in her child. The nurse can tell the parent to expect to see which activities at 3 months?

• • Puts foot in mouthBy 3 months the child will not place foot in mouth, but rather this activity will be seen at 5 months.
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  • Places hand in mouthThe nurse can tell the parent that at 3 months the child will attempt to place their hand in the mouth.
• • Turns from back to abdomenThe child will not be able to turn from back to abdomen at 3 months. This activity will be seen at around 6 months of age.
• • Turns from abdomen to backBy 3 months the child will not yet be able to turn from abdomen to back. This activity will be seen by 4 and 5 months of age.
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  • Can lift head off bed in prone position.By 3 months the infant should be able to lift the head off a bed in prone position, so the nurse can tell the parent to expect this activity.

Question 9 of 15

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What consequences may result if an infant’s needs are ignored by the parent?

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  • Feelings of insecurityIf the infant’s needs are not met, the child will develop feelings of insecurity at an early age, which can continue throughout life, along with a feeling of dissatisfaction.
• • Emotional resilienceIf the child’s needs are ignored, this can have an impact on the child’s growth and development. This will not help the child develop emotional resilience.
• • An early development of independenceThe infant will not develop a level of independence if the needs are ignored. Later in childhood development is when the child will start to develop some autonomy but even then the child’s needs cannot be ignored.
• • Inappropriate survival mechanism developmentThe infant does not have an innate survival mechanism and will need the love and care of the parent in order to survive and develop a secure relationship with the parent.

Question 10 of 15

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The nurse is observing a mother who is interacting with her infant and notices the infant trying to imitate the sounds that the mother is making. The nurse knows that the child must be at least what age?

• • 3-4 monthsA child at 3-4 months will not be imitating sounds that the mother is making. The infant will be making mostly babbling sounds to self.
• • 4-6 monthsAt 4-6 months the child may repeat sounds to self but at this age will not be imitating sounds.
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  • 6-8 monthsAn infant who is 6-8 months of age will be able to imitate the sounds the mother is making and therefore the nurse knows the patient must be at least this age.
• • 1-3 monthsWhen a child is 1-3 months old they will enjoy making sounds and will respond to voices but will not be imitating the mother’s sounds.

Question 11 of 15

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A mother brings her 5-month-old infant to the clinic and is concerned that the child does not seem to smile as much as her niece, who is the same age. How will the nurse respond?

• • This is normal as you can expect to see a smile at 6 months of age.Suggesting the child should start to smile at 6 months is not accurate and therefore this is not how the nurse should respond to the parent.
• • All children start to smile at a different age, so be patient. There is no need to worry.Telling the parent that all children begin smiling at different ages is not the appropriate response. There are social milestones that parents can expect to see through infancy.
• • This is a concern since the child should be showing a social smile by no later than 1 month of age.Suggesting that the child should be smiling by 1 month is not the correct information and therefore is not how the nurse should respond to the parent.
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  • This is a concern since the child should be showing a social smile by no later than 3 months of age.Since the child should be showing a social smile by no later than 3 months, this is the correct response that the nurse should make to this parent.

Question 12 of 15

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A new mother at the clinic asks at what age her baby will be able to actively participate in a game of pat-a-cake with her. Which would be the correct response from the nurse?

• • 4 monthsA 4-month-old will not likely play a clapping game with the parent. The child would more likely watch a mother and smile as she clapped.
• • 6 monthsAt 6 months, a mother can begin to engage the child in pat-a-cake, but the child will more likely reach for the mother’s hand rather than clap the hand and participate actively.
• • 9 monthsAt 9 months, the child will want to reach and touch the mother’s hand but will not likely engage in a clapping game.
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  • 12 monthsAt 12 months the child is likely to participate in pat-a-cake with the mother. This is considered a critical developmental milestone.

Question 13 of 15

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Parent–infant attachment is the most important association for which type of development?

• • BiologicalThe innate or biological development is going to depend on the parent-infant attachment but is not the most important factor involved.
• • PhysiologicalParent-infant attachment will influence physiological development but the parent-infant attachment will influence a more important aspect of the child’s development.
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  • PsychosocialPsychosocial development needs to be reinforced in the infant’s life. This is one of the most important aspects in the development of parent-infant attachment.
• • SocioculturalParent-infant attachment will have an influence on a child’s social development, but this attachment will have a stronger effect on another, more important aspect of infant development.

Question 14 of 15

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How can the parent-infant attachment be strengthened immediately after birth?

• • The mother needs to have time alone to ensure she does not overwhelm the child.Instead of spending time alone, the mother or parent should be encouraged to shower the infant with love to ensure a strong parent-infant attachment.
• • A mother should cuddle with the baby but allow the child to cry alone if the baby is upset.This action does not describe what is expected between the parent and the child. If the baby begins to cry, the mother should respond promptly and be sure to answer the baby’s cries.
• • The mother should give the infant some space to allow for natural biological development.If the mother gives the infant space after birth, this will not encourage or strengthen the parent-infant attachment.
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  • Reciprocal interactions that include holding the child, touching the child, and speaking gently to the child.This is an example of how the parent-infant interaction can be strengthened after birth and therefore a lot of positive physical and emotional interactions between the parent and child should be encouraged.

Question 15 of 15

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Which statement can the nurse use to educate the parent on leaving a child who shows emotional distress when having to leave the parent?

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  • Separations should be accomplished swiftly without dwelling on the separation.This statement suggesting the parent leave swiftly, yet with care, would help the parent-child interaction where the child is upset at leaving the mother.
• • The mother should reciprocate and show the child that she too is emotionally a bit upset.If the mother shows this type of behavior, it can make the child a bit more emotionally upset.
• • Separations should not be done too fast as this can create emotional turmoil in the child.Suggesting this type of departure can create more emotional distress in a child experiencing some separation anxiety, therefore this suggestion would not be helpful.
• • Separations should be accomplished swiftly, and with repeated emphasis on reassuring the child that the mother will return shortly.This statement should not be mentioned to the parent as an emphasis on reassuring the child at separation can create a stronger emotional response.