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Growth And Development In Infants > Child Health

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Total Questions : 4

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Question 1:

A nurse at a clinic is preparing the immunizations for a 6-month-old baby. The mother says, “My baby is afraid of strangers and afraid of separating from me. My mother-in-law is upset and thinks I am

causing it.” Which response by the nurse is most appropriate?

A. “Give your baby to strangers while you are present, so your baby gets used to strangers.” B. “Your mother-in-law is correct; you need to include her more in your baby’s needs.” C. “Separation anxiety is an important component of a parent-child attachment.” D. “Just let your baby cry for a while; your baby will get used to being separated from you.”

Answer and Explanation

Choice A:

“Give your baby to strangers while you are present, so your baby gets used to strangers.” Forcing interaction with strangers can increase distress and erode trust. Instead, gradual exposure in a calm environment with caregiver support is more appropriate.

Choice B:

“Your mother-in-law is correct; you need to include her more in your baby’s needs.” This dismisses the mother’s valid observation of normal developmental behavior. The concern is about developmental appropriateness, not family involvement.

Choice C:

Separation anxiety reflects the development of object permanence, the understanding that caregivers exist even when out of sight, a sign of a secure attachment to the primary caregiver. This behavior should not be discouraged, and parents should be supported in responding with empathy and consistency.Rationale for incorrect answers:

Choice D:

“Just let your baby cry for a while; your baby will get used to being separated from you.” Ignoring the baby’s distress may harm the secure attachment process and increase anxiety. Infants at this age need responsive caregiving to feel safe and supported.

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Question 2:

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior?

A. Crying when left with the sitter may indicate difficulty with building trust. B. Stranger anxiety should not occur until toddler-hood; this concern should be investigated. C. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. D. Perhaps the sitter doesn’t meet the infant’s needs; choose a different sitter.

Answer and Explanation

Choice A:

“Crying when left with the sitter may indicate difficulty with building trust.” This misinterprets the behavior. The infant’s distress is not about lack of trust, but rather healthy attachment. Trust is actually forming through strong parent-child bonds.

Choice B:

“Stranger anxiety should not occur until toddler-hood; this concern should be investigated.” Stranger and separation anxiety typically emerge between 6 to 12 months, not toddlerhood. This statement suggests abnormality when the behavior is expected and age-appropriate.

Choice C:

Around 6 to 9 months, infants begin to understand object permanence, the concept that caregivers still exist even when out of sight. This cognitive development brings about separation anxiety, a normal developmental milestone. Crying when left with a caregiver does not signal trauma but rather reflects emotional attachment and growing awareness.Rationale for incorrect answers:

Choice D:

“Perhaps the sitter doesn’t meet the infant’s needs; choose a different sitter.” While caregiver quality is always important, distress during separations at this age is common even with attentive sitters. Changing caregivers may not help and could even disrupt the development of consistent relationships.

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Question 3:

A new graduate nurse is assessing an infant in the pediatric unit. An important milestone in the infant’s life is the development of object permanence. This milestone is represented by which of these statements?

A. The infant smiles at the mother when she talks to him. B. The infant repeatedly flexes and extends his arms and legs when the mother picks him up. C. The infant turns and looks for the mother when she walks out of his view. D. The infant cries when the mother hands him to a babysitter.

Answer and Explanation

Choice A:

The infant smiling at the mother when she talks to him reflects social development and bonding, not object permanence. It shows recognition and responsiveness, usually emerging around 6 weeks of age.

Choice B:

The infant repeatedly flexing and extending his arms and legs when the mother picks him up indicates excitement or physical reaction to familiar handling, not a cognitive understanding of presence or absence.

Choice C:

The infant turning and looking for the mother when she walks out of his view demonstrates object permanence, the understanding that people and objects continue to exist even when out of sight. This milestone typically begins to emerge around 6 to 8 months of age and is a key component of cognitive development during the sensorimotor stage as described by Piaget.Rationale for incorrect answers:

Choice D:

The infant crying when the mother hands him to a babysitter is a sign of separation anxiety, which also develops around 6 to 9 months but is emotionally driven, not a direct measure of object permanence.

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Question 4:

A nurse is assessing an infant for attachment behavior with a parent. Which observations are important in assessing this relationship? Select all that apply

A. The kind of body contact between the parent and infant B. If the parent is holding and cuddling the infant C. The kind of comfort techniques being used by the parent D. The comfort level of the parent while interacting with the baby E. Whether the infant is crying

Answer and Explanation

Choice A:

Physical closeness such as skin-to-skin, rocking, and gentle touch fosters emotional bonding and signals a secure attachment.

Choice B:

Cuddling is a sign of nurturing and emotional connection. This physical closeness helps the infant feel safe, calm, and secure, which is key in attachment.

Choice C:

Observing how the parent soothes a crying or distressed baby reflects sensitivity and responsiveness, which are fundamental components of healthy attachment.

Choice D:

A parent who appears relaxed and confident during interactions is likely forming a positive attachment. Tension or avoidance may suggest bonding difficulties.Rationale for incorrect answer:

Choice E:

Crying alone is not a direct indicator of attachment quality. All infants cry as a form of communication. What’s more important is how the caregiver responds to the crying such as comforting, picking up, and soothing.

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