NE 105 Test 2 Study Guide - Preschooler & School Age

Summer 2025 | 100 Questions | 6 Hours of Content

Test Overview

• Total Questions: 100
• Content Areas: Preschool (2 hours) + School Age (12 hours)
• Question Distribution: Focus on developmental concepts, safety, nutrition, communication
• Cognitive Levels: Remember (R), Understand (U), Apply (AP), Analyze (A), Evaluate (E), Create (C)

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PRESCHOOLER SECTION (54 Questions Total)

Developmental Concepts (25 Questions) - PRIORITY AREA

Key Theorists & Stages

Erikson: Initiative vs. Guilt (Ages 3-6)

• Task: Retain initiative without impinging on others' rights
• Guilt occurs when children overstep their ability limits
• Children learn to balance self-direction with social boundaries

Piaget: Preoperational Stage

• Preconceptual Phase (2-4 years)
• Intuitive Phase (4-7 years)
• Bridge from self-satisfying behavior to rudimentary socialized behavior

Key Characteristics with Examples:

Time - Incompletely Understood:

• Example: Child says "I went to grandma's house yesterday" when it was actually last week
• Nursing Application: Avoid saying "Take medicine tomorrow" - instead say "after you wake up and eat breakfast"
• What NOT to say: "Yesterday, tomorrow, next week, Tuesday"
• What TO say: "After lunch," "when daddy comes home," "before bedtime"

Egocentrism - Think only in terms of their own perception:

• Example: 3-year-old covers their own eyes and thinks you can't see them
• Example: Child thinks everyone sees what they see and feels what they feel
• Nursing Application: Explain procedures from THEIR perspective, not yours
• Note: Lessens as child approaches age 4

Attention Span - Short:

• Example: Can only focus on one activity for 5-10 minutes max
• Nursing Application: Keep teaching sessions brief, use multiple short interactions
• Example: Will start coloring but quickly move to blocks, then to pretend play

Learning - Through Observing and Imitating:

• Example: Copies how parents brush teeth, talk on phone, cook
• Example: "Playing doctor" after hospital visits
• Nursing Application: Model proper hand washing, medication taking
• Example: Child pretends to give shots to dolls after receiving immunizations

Animism - Life-like qualities to inanimate objects:

• Example: "The chair is mad because I bumped into it"
• Example: Talking to stuffed animals as if they're alive
• Example: "The car is tired and needs to sleep in the garage"
• Nursing Application: Child may think medical equipment is "alive" and scary

Centration - Focus on one aspect only:

• Example: 4-year-old asked to sort blocks focuses ONLY on color, ignoring shape or size
• Example: When shown two glasses (one tall/thin, one short/wide) with same amount of water, thinks tall glass has "more"
• Nursing Application: Child may focus only on the needle, not the helpful medicine

Magical Thinking:

• Example: "I got sick because I was bad"
• Example: "If I wish hard enough, my broken toy will fix itself"
• Example: "Monsters live under my bed"
• Nursing Application: Reassure that illness/procedures are NOT punishment for being "bad"

Intuitive - Know right/wrong but can't explain why:

• Example: "Hitting is wrong" but can't explain why beyond "because mommy said so"
• Example: Knows stealing is bad but reasoning is "because you go to jail" not moral understanding
• Nursing Application: Give simple, concrete explanations rather than complex reasoning

Inability to Conserve:

• Example: Thinks flattened play-doh ball has less clay than round ball
• Example: Believes cut sandwich has more food than whole sandwich
• Clinical Example: May think liquid medicine "disappears" if poured into different shaped cup

Irreversibility - Cannot mentally reverse actions:

• Example: Cannot understand that 2+3=5 means 5-3=2
• Example: If you pour water from short wide cup to tall thin cup, cannot mentally "pour it back"
• Nursing Application: Cannot understand "if we take the medicine away, you'll feel sick again"

Global Organization - See things as wholes:

• Example: Draws people as stick figures with all body parts attached to head
• Example: Cannot break down complex tasks into steps
• Nursing Application: Give one simple instruction at a time, not multi-step directions

Kohlberg: Preconventional Morality

• Most basic level of moral judgment
• Requires parental intervention to prevent inappropriate behavior

Complete Growth & Motor Development by Age

3 Years Old:

• Weight: 32 lbs, Height: 37 inches
• Growth Pattern: 2.5-3 inches/year, 5 lbs/year
• Physical Changes: Loss of "baby fat," gain in muscle = stronger, more mature appearance
• Skull Growth: In the jaw, widening for emergence of permanent teeth (about age 6)

Gross Motor Skills:

1. Walking, running, climbing, jumping are well established
2. Rides a tricycle
3. Walks on tiptoes
4. Balances on one foot for a few seconds
5. Alternate stairs, broad jump

Fine Motor Skills:

1. Can stack 9-10 cubes
2. Draws circles
3. CANNOT draw stick figures

Dressing Abilities:

1. Dresses almost completely, but needs help with buttons and shoes
2. Cannot distinguish between right and left
3. Can slip on shoes, but CANNOT tie laces

Vocabulary/Speech:

1. Talks incessantly
2. 900 word vocabulary
3. Age 3-4: form sentences of 3-4 words, include only essential words (telegraphic speech)

Socialization:

1. Eager to please
2. Still some parallel play, but also associative now

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4 Years Old:

• Weight: 36¾ lbs (average gain 5 lbs/year for all preschoolers 3,4,5)
• Growth: Same 2.5-3 inches/year pattern

Gross Motor Skills:

1. Skips & hops well on one foot
2. Catches ball reliably
3. Throws overhead
4. Can walk downstairs with alternating feet

Vocabulary/Speech:

1. 1500 word vocabulary
2. Sentences of 3-4 words (but start to lengthen)
3. Tell exaggerated stories
4. Start using prepositions
5. Prime time for the use of profanity, especially if hanging around older kids

Socialization:

1. Associative play
2. Imaginary playmates
3. Dramatic & imaginative
4. Imitative play
5. May rebel if too much is expected

Play Characteristics: Should be manipulative, constructive, creative and educational

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5 Years Old:

• Weight: 41 lbs
• Growth: 2½-3 inches in height each year (all preschoolers)
• Physical Changes: Most height from elongation of legs (not trunk)
• Appearance: Starting to look more slender, rather than "potbellied toddler"

Gross Motor Skills:

1. Skips and hops on alternate feet
2. Throws and catches well
3. Jumps rope
4. Skates with good balance
5. Backward heel-to-toe walking

Fine Motor Skills:

1. Muscles still developing
2. Can copy diamond, square, triangle
3. Can tie shoelaces
4. Can print name

Vocabulary/Speech:

1. Vocabulary of 2100 words
2. By now, sentences are from 6-8 words long
3. Use all parts of speech correctly
4. Can define things and name opposites

Socialization:

1. Definitely doing associative play
2. Tries to follow rules, but may cheat to win
3. Eager to please again, but now has peer influence and may question parents (difference between parents and peers)

Safety (9 Questions)

Safety Examples - Age-Specific Concerns:

No Longer in Oral Stage:

• What this means: Not putting everything in mouth like toddlers
• Example: Less worry about small objects being swallowed
• But still need: Supervision with small parts that could cause choking

Better at Following Directions:

• Example: Can understand and follow "Stop at the corner and wait for me"
• Example: Will remember "Don't touch the hot stove"
• Nursing Application: Can give simple safety instructions they'll remember

Set the Example:

• Bike Helmet Example: If parents always wear helmets, children will too
• Seatbelt Example: "Mommy buckles up, so I buckle up too"
• Hand Washing Example: Children copy proper technique when adults model it

Prevention PLUS Education Needed:

• Prevention Example: Childproof locks on cabinets with cleaning supplies
• Education Example: Teaching "These are poison - never touch"
• Combined Approach: Lock up matches AND teach "fire is dangerous"

Immunization Readiness:

• School Entry Requirements: Need specific vaccines before kindergarten
• Developmental Readiness: Better able to understand "medicine to keep you healthy"
• Cooperation: Can follow instructions like "hold still" and "count to ten"

Communication (7 Questions)

Communication Examples by Age:

3-Year-Old Telegraphic Speech:

• Characteristic: Only essential words, like old-style telegrams
• Examples:
  • "Me go store" (instead of "I want to go to the store")
  • "Daddy work" (instead of "Daddy went to work")
  • "Want cookie now" (instead of "I would like a cookie now please")
• Nursing Application: Understand their meaning even with incomplete sentences

4-Year-Old Language:

• Prepositions: "The toy is UNDER the bed," "Put it ON the table"
• Exaggerated Stories: "I saw a dinosaur in my backyard and it was THIS big!"
• Profanity Stage: May repeat "bad words" without understanding - testing boundaries
• Example Conversation: "I went to the park and there were a MILLION kids there and we played FOREVER!"

5-Year-Old Advanced Speech:

• Complete Sentences: "I would like to go outside and play on the swings after I finish my lunch"
• Definitions: Can explain "A dog is an animal that barks and has four legs"
• Opposites: "Hot and cold," "big and small," "happy and sad"
• All Parts of Speech: Uses nouns, verbs, adjectives, adverbs correctly

Speech Difficulties - What's Normal:

• Age 5 Trouble Sounds:
  • "Wabbit" instead of "rabbit" (R sound)
  • "Dat" instead of "that" (TH sound)
  • "Wion" instead of "lion" (L sound)
  • "Ship" instead of "ship" (SH sound)
• Stuttering: "I-I-I want to go p-p-play" - normal between ages 2-4

Nutrition (5 Questions)

Nutritional Examples - Real-World Applications:

Quality Over Quantity:

• Good Example: Small portion of chicken, vegetables, and whole grain bread
• Poor Example: Large portion of chicken nuggets and fries
• Nursing Teaching: "A few bites of healthy food is better than a full plate of junk food"

Food Fads and Preferences:

• Examples:
  • "I only eat foods that are white" (milk, bread, rice, bananas)
  • "Everything must be separate - food cannot touch on the plate"
  • "I will only eat triangular sandwiches, not rectangular"
• Nursing Response: Normal behavior, don't make it a power struggle

Picky Eater Strategies:

• What NOT to do: Force eating, bribe with dessert, make separate meals
• What TO do: Offer variety, eat together as family, stay calm
• Example Approach: "Here's dinner. You choose how much to eat. Kitchen closes after dinner."

Age 5 Improvement:

• Example: Child who refused all vegetables at age 3-4 suddenly tries carrots
• Why: More mature taste buds and decreased need for control
• Nursing Teaching: Reassure parents this phase will pass

Dealing with Power Struggles:

• Scenario: Child refuses to eat anything but crackers
• Wrong Response: "You'll sit here until you finish your vegetables!"
• Right Response: Offer healthy options, let child choose amounts, remove food calmly if refused

Activity/Mobility (5 Questions)

Play Development with Examples:

Associative Play - Key Characteristics:

• Definition: Group play in similar activities but without rigid rules or organization
• Example: Three children all playing with blocks in same area, talking to each other, but each building their own tower
• Example: Children at water table - all playing with water toys, sharing space, but each doing own activity
• Difference from Parallel: Children interact and communicate but don't work toward common goal
• Difference from Cooperative: No shared rules, leadership, or group objectives

Specific Play Examples by Age:

3 Years:

• Associative Play Begins: Still some parallel (playing side-by-side independently) but starting to interact
• Example: Two children with puzzles, occasionally commenting "I found a red piece!" but working on separate puzzles

4 Years:

• Imaginary Playmates: "My friend Sarah is invisible but she's sitting right there"
• Dramatic/Imaginative: Full elaborate scenarios - "I'm the mommy, you're the baby, and we're going to the store"
• Imitative Play: Copying adult behaviors - playing house, doctor, teacher
• Example: Group of children "playing restaurant" - one is chef, one is waiter, but rules change constantly

5 Years:

• Rule-Following: Tries to follow rules but may cheat to win
• Example: Playing board game but secretly moves extra spaces when others aren't looking
• Peer Influence: "But Tommy's mom lets him stay up until 9!"
• Example: Group playing "Red Light, Green Light" - understands rules but disputes calls

Rest & Sleep (2 Questions)

Sleep Needs:

• 12 hours per night
• Naps are now often a thing of the past
• Establish a routine to allow high-energy kids to unwind
• Don't let them stay up late or come to parents' bed

Nightmares vs. Night Terrors - KNOW THE DIFFERENCES:

Additional Important Systems & Needs

Elimination:

• The preschooler may have achieved nighttime control of bowel and bladder by age three
• May be potty trained by age four (or not...)

Cardiovascular Changes (Oxygen):

• Heart rate decreases with advancing age
• Blood pressure increases with advancing age
• A heart murmur may be heard (can be normal)

Self-Actualization & Self-Esteem:

• Parents are usually the primary influence for preschooler's value system
• Modeling can be good OR bad
• Preschool institutions can provide valuable socialization and exposure to diversity

Sexuality:

• Be honest with age-appropriate information
• Masturbation is common and normal
• Answer "what do they know and what do they think?" with honesty

What to Look for in Preschool/Daycare Selection:

• Valuable socialization opportunities
• Exposure to diversity
• Age-appropriate activities and environment

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SCHOOL AGE SECTION (46 Questions Total)

Developmental Concepts (24 Questions) - PRIORITY AREA

Key Areas to Study:

• Cognitive development stages
• Social development milestones
• Moral development progression
• Identity formation processes

Safety (5 Questions)

Focus Areas:

• Age-appropriate safety concerns
• Injury prevention strategies
• Environmental safety assessment

Nutrition (4 Questions)

Nutritional Assessment:

• Caloric needs for age group
• Nutritional deficiency identification
• Healthy eating promotion

Communication (5 Questions)

Communication Development:

• Language milestone assessment
• Social communication skills
• Peer interaction patterns

Behavior (4 Questions)

Behavioral Assessment:

• Normal vs. concerning behaviors
• Discipline strategies
• Social skill development

Sexuality (3 Questions)

Age-Appropriate Education:

• Developmental understanding
• Honest, age-appropriate responses
• Normal sexual development

Activity/Mobility (1 Question)

Physical Activity Needs:

• Motor skill development
• Exercise requirements
• Activity safety

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NURSING PROCESS APPLICATION

Assessment (Focus for ALL topics)

• Developmental milestone evaluation
• Growth parameter measurement
• Safety risk identification
• Nutritional status assessment
• Communication skill evaluation

Planning & Implementation

• Goals/Outcomes: Age-appropriate, measurable
• Interventions: Evidence-based, family-centered
• Implementation: Consider developmental stage

Evaluation

• Monitor progress toward developmental milestones
• Assess intervention effectiveness
• Modify plans based on outcomes

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STUDENT LEARNING OUTCOMES

Provider of Care

• Deliver developmentally appropriate nursing care
• Recognize normal vs. abnormal findings

Aware of Behavior

• Understand developmental behaviors
• Identify concerning behavioral patterns

Communicator

• Use age-appropriate communication
• Educate families effectively

Collaborator

• Work with families and healthcare team
• Coordinate care across settings

Legal/Ethical Guides

• Apply ethical principles to pediatric care
• Understand consent and assent issues

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KEY STUDY TIPS

1. Focus on Developmental Questions (49 total) - largest category
2. Remember age-specific milestones for 3, 4, and 5-year-olds
3. Safety is critical - know prevention strategies
4. Communication development follows predictable patterns
5. Assessment skills are tested across all content areas
6. Apply nursing process to each scenario
7. Consider family-centered care in all responses

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COMPLETE MILESTONE REFERENCE CHART

Universal Preschool Patterns:

• Growth: 2.5-3 inches/year, 5 lbs/year
• Physical Changes: Loss of "baby fat," muscle gain, leg elongation (not trunk), more slender appearance
• Dental: 20 teeth by preschool, permanent teeth emerge by age 6, jaw widens
• Sleep: 12 hours/night, naps often discontinued
• Nutrition: 1800 calories/day, quality over quantity, decrease fat intake