A preschool-aged child got into the cookie jar and ate several ...

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A preschool-aged child got into the cookie jar and ate several cookies before dinner. When confronted by the parent, the child responds, My pet horse ate them. What does the nurse teach the parents about this response?
 
  a. It is normal for children to have imaginary friends at this age.
  b. This vivid imagination will lead the child to misbehave later on.
  c. Lying is disobedient and should be punished consistently.
  d. The child is obviously afraid of the parents' response.

Question 2

The parents of a 4-year-old express concern that the child is wearing the same size clothing as she did last year. What action by the nurse is most appropriate?
 
  a. Weigh and measure the child and compare with last visit.
  b. Reassure parents that their child is growing normally.
  c. Assess the child's eating and activity patterns.
  d. Encourage the parents to provide the child a multivitamin.

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Answer to Question 1

ANS: A
It is common for toddlers to have imaginary friends. They are especially important in allowing the child to express something unpleasant. The other responses are not appropriate.

Answer to Question 2

ANS: A
Physical growth slows during the preschool years, with most children only gaining about 5 lb and to 3 inches a year. The nurse should weigh and measure the child and compare the readings to those taken at the last visit. Showing the parents these results and educating them on expected growth will reassure them. Simply telling the parents their child is normal does not provide objective information and is dismissive of their concern. The nurse should assess each child's eating and activity habits. The child may or may not need a vitamin. This can be discussed with the provider.