NUR 431 EXAM QUESTIONS AND
ANSWERS
How long for breast milk/formula? When do you introduce solid foods? Switch to cow's
milk?
When to ween a pacifier? - Answer-§ Breast milk or formula 0 - 6 months, weaned by
12 months, especially bottles, and switch to cows milk at 12 months becuase it does not
have sufficent iron
§ Solid foods 4 - 6 months
•Pacifier - ok 1st 6 months then wean
When does voluntary control of elimination start?
Prerequisites? - Answer-§ Sphincter control: 18 - 24 months
§ Must recognize urge to go, able to stay dry for 2 hours, interest in using the toilet
Toddler Gross motor and fine motor skills
Walk, run, up and down stairs, jump and stand on one foot?
Throw ball, scrobble drawing, complex block towers or 4 and 8 blocks - Answer-§ Gross
motor
· Walks independently with wide stance: 12 - 15 months
· Run but fall: 18 months (2 years)
· Up and down stairs and climbing:2 years
· Jump and stand on one foot: 3 years
· Manual dexterity: 12 - 15 months
· Drop into bottle and scribble drawing: 15 months
· Throw ball: 18 months
· Complex block towers 3 -4 block: 18 months, 8 blocks at 30 months
Toddler word comprehension and word vocabulary?
Telegraphic speech? - Answer-§ Comprehension > spoken words, communicates in
mostly gestures
§ Comprehension of 200 words: 18 months
§ Vocabulary of 40 - 50 words: 2 years
2 - 3 word sentences, asks why
§ Speech: Echolalia, Telegraphic (only say what is need ie. "cup milk")
Piaget phases for a toddler?
Erikson? - Answer-§ Piaget:
· Sensorimotor phase (12 - 24 months)
¨ Tertiary circular reactions - active experimentation to achieve goals. Reasoning and
problem-solving
, ¨ Spatial relationships, advanced object permanence (searching), egocentric
communication "I want"
· Preconceptual phase (2 - 4 years)
¨ Transition between self-satisfying behavior and socialized relationships (communicate
about themselves to others)
¨ Mental symbolization- ie. needle = hurt (don't tell them about the shot until right before
giving)
§ Erikson: "Autonomy" versus "Shame and doubt"
· Development tasks: differentiate self from others, tolerate separation, delay
gratification, control bodily functions, communicate better
· Strong emotions, rapid mood swings, negativism if not getting their way
· Ritualization
Toddler toys and play - Answer-§ Parallel play- playing alone with someone else
§ Imitation- tea parties, push-pull toys
§ Locomotive skills with toys and tactile play (finger paint, thick crayons)
Physiological Anorexia, timing?
When can you give fluoride toothpaste?
When do you wean from bottles and limit sippy cups? - Answer-18 months, slowed
appetite and very picky. Don't need as many calories. Food jags- want only one food
· Limit juice and milk, ensure iron fortified
· Fluoride toothpaste after age 2
· Wean from bottle by 15 months and limit sippy cups to avoid nursing caries
When should a child start smiling? When should a child be laughing? When should a
child play peek-a-boo? - Answer-Smile: 6-8 weeks (<3 months)
Laugh: 4 months
Peek-a-boo: 6 months
§ Piaget: Sensorimotor phase
·Birth - 1 month:
·1 - 4 months:
·4 - 8 months:
6 - 8 months: - Answer-§ Piaget: Sensorimotor phase
· Birth - 1 month: primitive reflexes
· 1 - 4 months: circular reactions (cry -> food)
· 4 - 8 months: secondary circular reactions (grasping rattle to shaking rattle)
6 - 8 months: Object permanence
v Intramuscular Injection Sites and needle sizes - Answer-Ø IM- immunizations. Less
than 7 months vastus laterals. Above 7 months using ventrogluteal. Never dorsal
gluteal. Deltoid in 3+
Vastus lateralis- all
Deltoid- no infants, 1 year+
Ventrogluteal- 7 months + at 0.5ml
ANSWERS
How long for breast milk/formula? When do you introduce solid foods? Switch to cow's
milk?
When to ween a pacifier? - Answer-§ Breast milk or formula 0 - 6 months, weaned by
12 months, especially bottles, and switch to cows milk at 12 months becuase it does not
have sufficent iron
§ Solid foods 4 - 6 months
•Pacifier - ok 1st 6 months then wean
When does voluntary control of elimination start?
Prerequisites? - Answer-§ Sphincter control: 18 - 24 months
§ Must recognize urge to go, able to stay dry for 2 hours, interest in using the toilet
Toddler Gross motor and fine motor skills
Walk, run, up and down stairs, jump and stand on one foot?
Throw ball, scrobble drawing, complex block towers or 4 and 8 blocks - Answer-§ Gross
motor
· Walks independently with wide stance: 12 - 15 months
· Run but fall: 18 months (2 years)
· Up and down stairs and climbing:2 years
· Jump and stand on one foot: 3 years
· Manual dexterity: 12 - 15 months
· Drop into bottle and scribble drawing: 15 months
· Throw ball: 18 months
· Complex block towers 3 -4 block: 18 months, 8 blocks at 30 months
Toddler word comprehension and word vocabulary?
Telegraphic speech? - Answer-§ Comprehension > spoken words, communicates in
mostly gestures
§ Comprehension of 200 words: 18 months
§ Vocabulary of 40 - 50 words: 2 years
2 - 3 word sentences, asks why
§ Speech: Echolalia, Telegraphic (only say what is need ie. "cup milk")
Piaget phases for a toddler?
Erikson? - Answer-§ Piaget:
· Sensorimotor phase (12 - 24 months)
¨ Tertiary circular reactions - active experimentation to achieve goals. Reasoning and
problem-solving
, ¨ Spatial relationships, advanced object permanence (searching), egocentric
communication "I want"
· Preconceptual phase (2 - 4 years)
¨ Transition between self-satisfying behavior and socialized relationships (communicate
about themselves to others)
¨ Mental symbolization- ie. needle = hurt (don't tell them about the shot until right before
giving)
§ Erikson: "Autonomy" versus "Shame and doubt"
· Development tasks: differentiate self from others, tolerate separation, delay
gratification, control bodily functions, communicate better
· Strong emotions, rapid mood swings, negativism if not getting their way
· Ritualization
Toddler toys and play - Answer-§ Parallel play- playing alone with someone else
§ Imitation- tea parties, push-pull toys
§ Locomotive skills with toys and tactile play (finger paint, thick crayons)
Physiological Anorexia, timing?
When can you give fluoride toothpaste?
When do you wean from bottles and limit sippy cups? - Answer-18 months, slowed
appetite and very picky. Don't need as many calories. Food jags- want only one food
· Limit juice and milk, ensure iron fortified
· Fluoride toothpaste after age 2
· Wean from bottle by 15 months and limit sippy cups to avoid nursing caries
When should a child start smiling? When should a child be laughing? When should a
child play peek-a-boo? - Answer-Smile: 6-8 weeks (<3 months)
Laugh: 4 months
Peek-a-boo: 6 months
§ Piaget: Sensorimotor phase
·Birth - 1 month:
·1 - 4 months:
·4 - 8 months:
6 - 8 months: - Answer-§ Piaget: Sensorimotor phase
· Birth - 1 month: primitive reflexes
· 1 - 4 months: circular reactions (cry -> food)
· 4 - 8 months: secondary circular reactions (grasping rattle to shaking rattle)
6 - 8 months: Object permanence
v Intramuscular Injection Sites and needle sizes - Answer-Ø IM- immunizations. Less
than 7 months vastus laterals. Above 7 months using ventrogluteal. Never dorsal
gluteal. Deltoid in 3+
Vastus lateralis- all
Deltoid- no infants, 1 year+
Ventrogluteal- 7 months + at 0.5ml
