Engage Fundamentals (Psychosocial Concepts for Nursing Practice): Human Growth and Development
During a wellness visit for a 4-year-old preschooler, a parent explains that their child enjoys playing games on a computer and asks the nurse about an acceptable amount of screen time for their child. Which of the following responses should the nurse make?
"An acceptable amount of screen time is 1 hour per day." Rationale: Screen time for preschoolers should be limited to no more than 1 hr per day of programming at home, school, or afterschool care.
A nurse is caring for a client during a prenatal visit. The client states, "Now that I'm pregnant, I drink wine with dinner. I've given up hard alcohol." Which of the following responses should the nurse make?
"Avoiding alcohol, even wine, is advised during pregnancy since it can cause harm to your baby." Rationale: Scientists have not yet determined if there is a safe amount of alcohol to drink during pregnancy. Therefore, clients who are pregnant are advised to abstain from drinking alcohol during pregnancy altogether.
A nurse is caring for adolescents in a school-based health clinic. Which of the following client statements should the nurse recognize as an indication that the client is experiencing Erikson's stage of identity versus role confusion?
"I think I might be gay." Rationale: Identity vs. Role Confusion is the stage of Erikson's theory related to adolescence that involves forming an identity and answering the central question of "Who am I?" Questions about sexuality, developing a sense of identity, and finding their place in society are issues the adolescent addresses during this stage.
A nurse is caring for a 10-year-old child who is newly diagnosed with diabetes mellitus. Which of the following actions by the child should the nurse recognize as characteristic of Erikson's stage of industry versus inferiority?
Expresses confidence in their ability to self-administer insulin Rationale: Industry vs. Inferiority is Erikson's stage of development occurring during the school-age years. During this stage, children work at learning complex skills, problem-solving, and gaining a sense of self. Successes in these areas, along with support from those around them, promotes a sense of accomplishment and confidence in their endeavors.
A school nurse asks a first grader about rules at school. The child responds, "We need to wash our hands before lunch, be respectful to the teacher, and pay attention in class. If we don't, we'll get into big trouble." The nurse should recognize that the child is in which of the following of Kohlberg's stages of moral development?
Punishment and Obedience Rationale: The Punishment and Obedience stage is a part of the first level of Kohlberg's moral development theory, referred to as the preconventional reasoning level, and occurs in children between the ages of 4 and 10 years. During the Punishment and Obedience stage, rules are viewed in terms of positive or negative consequences to action. In the punishment and obedience stage, rules are obeyed to avoid punishment. A child who is in the first grade would be in this stage.
A nurse is discussing climacteric changes that occur during middle adulthood with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the concept? (Select all that apply.)
Rationale: "Both males and females experience a change of life referred to as climacteric," is correct. Climacteric occurs in both sexes and results in changes to the sex organs and hormones. "Climacteric in females is referred to as menopause," is correct. Climacteric changes in females mark the cessation of menses and a progressive decrease in the hormones estrogen and progesterone, otherwise known as menopause. "Climacteric changes in males occur gradually, over a number of years," is correct. Both females and males experience climacteric. In males, the changes are more gradual when compared to those in females. The biologic changes experienced by males include a slow decline in levels of testosterone and sperm. In addition, the male can experience a delay in the ability to achieve and maintain an erection. "Climacteric in females can manifest as heart palpitations," is correct. Climacteric in females can produce a number of physical manifestations including hot flashes, night sweats, vaginal dryness, and heart palpitations.
A nurse is providing an educational session on cognitive development at a community event. Which of the following statements by the nurse are consistent with Piaget's theory of cognitive development? (Select all that apply.)
Rationale: "Individuals acquire knowledge, intellect, and cognition over time," is correct. Piaget believed that cognitive development is based on how an individual acquires knowledge, intellect, and cognition over time. "Intelligence is a natural ability that develops as a child grows and adapts to their environment," is correct. Piaget believed that intelligence is an inborn, natural ability that develops as a child grows and adapts to their environment. "Children construct knowledge that evolves and changes over time," is correct. Piaget believed that children construct knowledge that evolves and changes over time. "Children construct knowledge in new ways at critical points during development," is correct. Piaget believed that children construct knowledge in new ways at critical points during development.
A nurse is planning an educational session about human growth and development for a group of clients who are pregnant. Which of the following universal principles should the nurse include in the discussion? (Select all that apply.)
Rationale: Cephalocaudal principle is correct. Human development follows a head-to-toe progression. Infants gain control over their neck and head before their extremities. Simple to complex is correct. Human development occurs in an orderly pattern from simple to complex. Infants learn head control before crawling. Continuous process is correct. Human development is a continuous process characterized by periods of growth spurts and periods of slow and steady growth. Individualized rates is correct. Human development varies from individual to individual. Each has their own growth timetable and rate of development.
A nurse is preparing an educational session about school-age children to a group of caregivers. Which of the following characteristics should the nurse include in the teaching? (Select all that apply.)
Rationale: Egocentrism decreases is correct. Egocentrism, or a characteristic in which the child views themselves as the center of the universe, is common in preschool-age children aged 2 to 6 years. It is part of the preoperational stage of Piaget's stages of cognitive development. By the time the child becomes school-age, egocentrism begins to wane as children have more life experiences and more exposure to other ways of thinking. At this age, children begin to realize that events can be interpreted in different ways and other people may have different opinions than they do. Begins to understand reversibility is correct. School-age children begin to develop thinking beyond concrete or literal thinking that is common in the preoperational stage. Reversibility is the concept that some objects that have been changed, such as water into ice, can return back to their original form and is a concept understood by children at this age. Other concepts that the school-age child can grasp include spatiality and conservation. Understands events can be interpreted in different ways is correct. Children who are school-age (6 to 12 years old) are in what Piaget referred to as the stage of concrete operational thinking. In this stage, children have experiences interacting with a wider range of people and come to realize that events can be interpreted differently by others.
A nurse is assessing an adolescent who reports feeling "very depressed." The nurse should recognize that which of the following are signs of increased risk for suicide? (Select all that apply.)
Rationale: Expressing feelings of gloom and helplessness is correct. Expressing feelings of gloom and helplessness is a sign of potential suicide. Expressing loss of interest in activities once considered important is correct. Expressing loss of interest in activities once considered important is a sign of potential suicide. Making threats of self-harm is correct. Making threats of self-harm is a sign of potential suicide. Having access to weapons is correct. It is a potential sign of suicide when individuals who have depression refer to having access to weapons.
A nurse is providing prenatal education to a client who is in the first trimester of pregnancy. Which of the following teratogens should the nurse instruct the client to avoid during pregnancy due to the risk to fetal development? (Select all that apply.)
Rationale: Hyperthermia is correct. Hyperthermia is an example of a physical agent that can cause harm to fetal development. It is a teratogen and should be avoided. Teratogens are classified into four types: physical agents, metabolic conditions, infections, and drugs. Uncontrolled glucose levels is correct. Uncontrolled glucose levels are an example of a metabolic condition that can cause harm to fetal development. It is a teratogen and should be avoided. Teratogens are classified into four types: physical agents, metabolic conditions, infection, and drugs. Rubella is correct. Rubella is an infection that can cause harm to fetal development. It is a teratogen and can be prevented with a vaccine. Teratogens are classified into four types: physical agents, metabolic conditions, infection, and drugs. Smoking is correct. Smoking can cause harm to fetal development. It is a teratogen and should be avoided. Teratogens are classified into four types: physical agents, metabolic conditions, infection, and drugs.
A nurse is providing discharge teaching to parents of a preschooler who was admitted due to a severe asthma exacerbation. Which of the following instructions should the nurse include? (Select all that apply.)
Rationale: Instruct on the use of the metered-dose inhaler (MDI) is correct. Asthma can be a life-threatening condition. Proper management of asthma includes taking steps to avoid or limit exacerbations, self-monitoring, assessment of manifestations, and how to properly use the prescribed medications. Improper use of an MDI can result in a failure to control asthma manifestations and is an important part of the discharge teaching when preparing the child's parents for home care following discharge. Have family members smoke tobacco products outside of the house is correct. Asthma can be a life-threatening condition. Proper management of asthma includes taking steps to avoid or limit exacerbations which can include exposure to triggers such as dust mites, pollen, mold, pet dander, and second-hand smoke. Instructing family members and any visitors on the importance of restricting smoking tobacco products to outside the child's home is an important part of the discharge teaching when preparing the child's parents for home care following discharge. Make changes in the home environment to reduce dust mites is correct. Asthma can be a life-threatening condition. Proper management of asthma includes taking steps to avoid or limit exacerbations which can include exposure to triggers such as pollen, mold, pet dander, and dust mites. Instructing the family members on the importance of decreasing the presence of dust-mites is an important part of the discharge teaching. Share the plan for managing an asthma attack with the child's preschool teachers is correct. Asthma can be a life-threatening condition. It is important for caregivers including family members, teachers and others who have contact with the child to be aware of the child's diagnosis of asthma as well as the manifestations of exacerbations and the treatment measures should an exacerbation occur. Providing the parents with information to be shared with the child's preschool teacher is an important part of the discharge teaching.
A home health nurse is planning care for an older adult client who has hypertension and is living alone. Which of the following health promotion topics should the nurse include in the client's plan of care? (Select all that apply.)
Rationale: Maintaining functional capacity is correct. As a part of the aging process, a variety of physiological change occur including decreases in cardiac output, physical strength, and motor function. Maintaining functional capacity is a health promotion focus for late adulthood. Encouraging the use of free-weight exercises is correct. Osteoporosis is common in late adulthood and exercise helps to preserve bone density. Weight-bearing exercises, such as free-weights or weight machines, are examples of this type of exercise. Participating in social functions is correct. Loneliness and social isolation are factors frequently associated with aging. Participating in social functions is a health promotion focus for late adulthood. Installing grab bars in the shower is correct. As a part of the aging process, a variety of physiological change occur including decreases in physical strength and motor function and increased risk for falls. Taking measures to ensure client safety in the home including installing grab bars in the shower will facilitate the client's ability to be able to safely shower independently and should be included as a topic for health promotion.
A nurse is planning a health class at a local middle school about puberty during adolescence. Which of the following pieces of information should the nurse include in the discussion? (Select all that apply.)
Rationale: Primary sex organs mature during puberty is correct. The primary sex organs of both sexes, the penis and testes in males and the vagina and ovaries in females, begin to mature during puberty when hormonal changes are triggered by the hypothalamus in the brain. Puberty begins with a growth spurt in height and weight is correct. Although differences in height and weight vary among children based upon a number of factors, the changes from middle childhood to puberty are identified by a growth spurt and the initial development of secondary sex characteristics. The child becomes taller and has an increase in weight. Onset of puberty is influenced by genetics, environmental factors, and gender is correct. The timing of the onset of puberty differs among children and is dependent upon various factors such as the child's genetic makeup; for instance, did the child's parents have an early or late puberty? Other factors include environmental factors such as nutrition, health care access, and other social determinants of health. Finally, gender plays a factor in the onset of puberty with females beginning to mature earlier than their male counterparts. Secondary sex characteristics emerge during puberty is correct. Secondary sex characteristics involve changes in fat distribution in females along with the development of breast tissue as well as axillary and pubic hair. Secondary sex characteristics in males involve the development of facial, axillary, and pubic hair along with a deepening of the voice. Both sexes experience an increase in sebaceous glands, which can result in acne. The development of secondary sex characteristics in both sexes occurs over the course of puberty.
A nurse is planning discharge teaching for a client who is newly diagnosed with type 2 diabetes mellitus. Which of the following topics should the nurse include in the teaching? (Select all that apply.)
Rationale: Weight management is correct. Clients who are overweight or obese are at increased risk for complications associated with diabetes mellitus. Weight control through exercise, diet selection, and portion control are important factors that should be a part of the discharge teaching. Glucose testing is correct. Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. Monitoring glucose levels and taking measures to maintain blood glucose within a specified range can reduce the risk for complications of the disorder, such as neuropathy, kidney disease, heart disease, and vision loss and is an important factor that should be a part of the discharge teaching. Daily exercise is correct. Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. Exercise can help manage hyperglycemia and delay or prevent the onset of diabetes mellitus-related complications. Foot care is correct. Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia. The elevated glucose levels result in damage to the blood vessels placing the client at risk for delayed wound healing and damage to the neurologic system resulting in neuropathy and altered sensation to areas such as hands and feet. Attention to foot care can help prevent complications such as nonhealing sores and should be a part of the discharge teaching.
