Growth and Development CH 26-29 (E1)
A 10-year-old child tells the school nurse that she is embarrassed that she is afraid of the dark. Which is the best response by the nurse? A) "It is normal for a 10-year-old to be afraid of the dark so there is no need to be embarrassed. Would you like to talk about it?" B) "Are you afraid that something is going to happen to you or that something or someone may be outside that you can't see?" C) "That is so horrible that you are afraid of the dark. Can you sleep at night at all?" D) "I was afraid of the dark at your age. You will grow out of that fear soon."
A
A mother brings her 6-year-old son in for a check-up because the child is reporting stomachaches. It is the beginning of the school year. What might the mother also mention? A) The child cries before going to school B) The child made friends the first day of school C) The child fights with siblings more often D) The child loves the crowds in the lunchroom
A
A teacher refers a student to the school nurse because the student is frequently falling asleep during class. After talking with the student, the nurse is most concerned by which statement by the student? A) "I get 7 hours of sleep every night so I don't know why I am so tired." B) "I guess I need to be more careful about my curfew on school nights." C) "My mom keeps telling me to turn off my television when I go to bed." D) "I just can't seem to stay awake during that class because it's boring."
A
Parents and their 35-month-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? A) Uses two-word sentences or phrases B) Half of speech understood by outsider C) Asks "why" often D) Talks about a past event
A
The healthcare provider has made a notation in the medical record of a 17-year-old adolescent that the client is not demonstrating successful completion of the Erikson stage of development. What behavior would be consistent with this assessment? A) The adolescent is uncertain and frequently unable to make decisions. B) The adolescent is distrustful of others. C) The adolescent is sexually promiscuous. D) The adolescent is anxious to move away from the parent's home.
A
The nurse is caring for a premature baby in the NICU. The mother reports that the infant's normally happy and outgoing 5-year-old sister is acting sad and withdrawn. The nurse understands that due to her developmental stage, the girl is at risk of what happening? A) Viewing her baby sister's illness as her fault B) Harming the baby C) Experiencing clinical depression D) Creating an imaginary friend to cope with the situation
A
The nurse is examining a 2-year-old child for speech and language development. Which finding would suggest a delay in speech development? A) The child does not use the names of familiar objects. B) The child repeats what the parents say out of context and at random moments. C) The child puts together sentences of two words. D) The child does not speak clearly but shows understanding of what is said.
A
The nurse is examining a 3-year-old child during a regular visit. Which finding would disclose a developmental delay in this child? A) The child demonstrates separation anxiety. B) The child copies a circle on a piece of paper. C) The child imitates the nurse in use of a stethoscope. D) The child follows directions when made one at a time.
A
The nurse is performing an annual check-up for an 8-year-old child. Compared to the previous assessment of this child, which characteristic would most likely be observed? A) Breathing is diaphragmatic B) Pulse rate is increased C) Secondary sex characteristics are present D) Blood pressure has reached adult level
A
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old child. Which statement best accomplishes this? A) A regular routine and rituals will provide stability and security. B) A sense of control can be provided through offering limited choices. C) Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly. D) Aggressive behaviors such as hitting and biting are common in toddlers.
A
The nurse is watching toddlers at play. Which normal behavior would the nurse observe? A) Parallel play B) Solitary play C) Cooperative play D) Do not play outside the home
A
The nurse knows that the school-age child is in Erikson's stage of industry versus inferiority. Which best exemplifies a school-ager working toward accomplishing this developmental task? A) Signs up for after-school activities B) Performs his bedtime preparations autonomously C) Becomes aware of the opposite sex D) Developing a conscience
A
The nurse teaches parents of adolescents that adolescents need the support of parents and nurses to facilitate healthy lifestyles. What should be a priority focus of this guidance? A) Reducing risk-taking behavior B) Promoting adequate physical growth C) Maximizing learning potential D) Teaching personal hygiene routines
A
When observing a group of preschoolers at play in the clinic waiting room, which type of play would the nurse be least likely to note? A) Parallel play B) Cooperative play C) Dramatic play D) Fantasy play
A
While treating a minor playground injury for an 8-year-old child, the school nurse discovers that the injury was the result of bullying. What should be the nurse's first action? A) Assess the situation with the help of the school staff and parents. B) Immediately call the bullied child's parents. C) Determine if there have been other playground bullying incidents. D) Question those responsible for the bullying.
A
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? SELECT ALL THAT APPLY A) Plans activities and makes up games B) Initiates activities with others C) Acts out roles of other people D) Engages in parallel play with peers E) Classifies or groups objects by their common elements F) Understands relationships among others
A, B, C
The parent of an 11-year-old child is worried that the child spends too much time watching TV. What information should the nurse share with this parent? SELECT ALL THAT APPLY A) Establish guidelines on when a child can watch TV. B) Watch programs together and discuss subject matter with the child. C) The American Academy of Pediatrics recommends 2 hours or less of TV daily. D) Use video games that are more active to offset sedentary TV viewing. E) Limit TV time by using it as a reward.
A, B, C
The school nurse is preparing a presentation for a group of teachers about teen suicide. When discussing risk factors for this occurrence which should be included? SELECT ALL THAT APPLY A) History of mental illness B) Substance use disorder C) Homosexuality D) Sexual promiscuity E) Family history of depression
A, B, C
The nurse is caring for preschoolers in a day care center. For this age group, of what developmental milestones should the nurse be aware? SELECT ALL THAT APPLY A) Counting 10 or more objects B) Correctly naming at least four colors C) Understanding the concept of time D) Knowing everyday objects E) Understanding the differences of others F) Forming concepts as logical as an adult's
A, B, C, D
For what reasons do nurses work to prevent tobacco use by teens? SELECT ALL THAT APPLY A) Tobacco use is addicting (nicotine). B) Teens who smoke are more likely to use alcohol and drugs. C) Smokeless tobacco damages gums and teeth. D) Smoking is associated with fighting and unprotected sex. E) Smoking damages the respiratory system.
A, B, C, D, E
A parent describes the 4-year-old child's eating habits as "picky" and goes on to describe using, coaxing, and threatening measures to get the child to eat. The nurse determines the child is growing normally. What interventions will the nurse suggest? SELECT ALL THAT APPLY A) Focus on quality, not quantity. B) Allow the child to decide how much the child will eat. C) Approach mealtime matter-of-factly. D) Offer a variety of healthy foods including those liked and refused. E) Ignore the pickiness. F) Offer only nutritious between-meal snacks.
A, B, C, D, E, F
The parent of a toddler half-jokingly states: "I am so tired of hearing 'NO!' I wish he would stop!" What suggestions will the nurse offer to reduce toddler negativism? SELECT ALL THAT APPLY A) Make statements: "It is time for lunch." B) Offer simple choices: "Blue shirt or red one?" C) Avoid "yes" and "no" questions. D) Use humor to make "no" funny: "Do cows bark?" E) Emphasize what is not to be done: "Don't sit there." F) Avoid ending a request with "Okay?"
A, B, C, D, F
Parents ask for disciplinary guidance for their 4-year-old. The nurse suggests which of these actions? SELECT ALL THAT APPLY A) When discussing improper behavior, call the behavior "bad" or "naughty," not the child. B) Anticipate situations likely to cause misbehavior and redirect the child to another activity. C) Spank with an open hand only and never with an object. D) A time-out of about 8 minutes would be appropriate for intentional misbehavior. E) Books and stories can help preschoolers master proper behavior.
A, B, E
The parent of a preschooler reports that the child seems to believe in magic. The parent voices concern that this "fantasy world" may become a problem. What response by the nurse is indicated? SELECT ALL THAT APPLY A) "Your child is engaging in what we call magical thinking." B) "This type of imagination is not normally seen until a child is school aged." C) "Fantasy play is most often seen in lonely children in an attempt to occupy themselves." D) "While imagination is normal, this type of fantasy world can cause problems for your child and should be discouraged." E) "This type of thought process allows your child to begin to observe the differences in the world."
A, E
A 4-year-old child has begun stuttering. Which practice by the parents will the nurse discourage? A) Giving the child opportunity to speak and finish ideas B) Asking the child to slow down and to think before talking C) Looking at the child while the child is speaking D) Enunciating clearly and slowing down parental speech
B
An 11-year-old child is continually late for the bus, resulting in asking if it's okay to stay home that day from school. The parents ask the school nurse for advice on what they should do. What is the best response by the nurse? A) "It is best if you make him get on the bus whether he is ready or not in order to let him know you are in control." B) "Could both of you and your child come in for a conference so we can discuss this situation?" C) "I am sure he has school phobia. We will need to speak with the school counselor." D) "Is there anything happening at home that is making him want to stay there instead of school?"
B
Based on Erikson's developmental theory, what is the major developmental task of the adolescent? A) Gaining independence B) Finding an identiy C) Coordinating information D) Mastering motor skills
B
During an annual visit of a 6-year-old child, the nurse observes dental caries on two of the child's primary teeth. Which response by the parents suggests more education is needed regarding the importance of primary teeth? A) "I guess we better look for a pediatric dentist for our child." B) "These are only baby teeth so we are not worried." C) "I guess we will need to supervise our child while brushing." D) "I see now we need to use a fluoride toothpaste for our child."
B
Parents of a toddler describe how they handled their child's temper tantrum in a shopping mall. What action of the parents indicates need for additional teaching? A) Remained relatively calm even though embarrassed B) Reasoned with the child to stop the behavior C) Made sure the child was rested and not hungry before going to the mall D) Tried to refocus the child's attention as tantrum behavioral cues appeared
B
The nurse at an elementary school is explaining the concept of industry versus inferiority to a group of nursing students. What is part of this stage of Erikson's theory? A) The conventional stage of development B) A sense of competence, mastery, and worth C) Lack of the ability to think abstractly D) The principle of conservation
B
The nurse is assessing a 2-year-old boy who has missed some developmental milestones. Which finding will point to the cause of motor skill delays? A) Mother is suffering from depression B) Homeless and has no toys C) Inadequate diet D) Unperturbed by a loud noise
B
The nurse is observing a 24-month-old boy in a day care center. Which finding suggests delayed motor development? A) Trouble undressing himself B) Unable to push a toy lawnmower C) Unable to unscrew a jar lid D) Falls when he bends over
B
The nurse is playing a game with a toddler in the hospital room. What is the most important benefit of this nurse--client interaction? A) Utilizing clinical time when the unit is not busy B) Developing a trusting relationship with the nurse C) Occupying the toddler's time while the parents are meeting with the health care provider D) Distracting the toddler from expending too much energy with active playing
B
The nurse is providing teaching about preventing poisoning. Which statement by the parent would warrant further discussion? A) "I never transfer cleaning products out of their original containers." B) "All medicine in our bathroom is in childproof containers." C) "We have the poison control number located near our phone." D) "We keep our lawn and garden products on a high shelf in the garage."
B
The nurse is talking with a chatty 7-year-old girl during her regular check-up. Which behaviors would the child also be expected to exhibit? A) Showing no interest in what the nurse sees in her ears B) Explaining what is right and what is wrong C) Demonstrating independence from her mother D) Showing no concern when the nurse hurts her own finger
B
The nurse is talking with a school-aged child about interests. In which interest do most school-aged children place the most focus? A) Family B) School C) Church D) Pets
B
The nurse is teaching parents how to avoid a power struggle with their 2-year-old child. Which comment indicates that more teaching is needed? A) "Both of us, as parents, will agree on and consistently enforce the limits we set." B) "We will make sure our child shares toys with cousins of this age." C) "We will give our child a choice whenever possible." D) "Childproofing our home will make it less necessary to say 'No!'"
B
The nurse is teaching the parents of a 12-year-old boy about appropriate approaches when raising an adolescent. Which comment should be included in the discussion? A) "Find out if his friends are worthy of him." B) "Try to be open to his views." C) "Maintain a firm set of rules." D) "Remind him that he is still your little boy."
B
The nurse is teaching the parents of a 2-year-old toddler methods of dealing with their child's "negativism." Based on Erikson's theory of development, what would be an appropriate intervention for this child? A) Discourage solitary play; encourage playing with other children B) Encourage the child to pick out his own clothes C) Use "time-outs" whenever the child says "no" inappropriately D) Encourage the child to take turns when playing games
B
The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by A) Learning from repeating tasks B) Developing a sense of worth and competence C) Using fantasy and magical thinking to cope with problems D) Developing a sense of trust
B
To gain cooperation from a toddler, what is the best approach by the nurse? A) Immediately pick the toddler up from the mother's lap. B) Kneel in front of the toddler while he or she is on the mother's lap. C) Do the nursing tasks quickly so the toddler can play. D) Ask the toddler if it is okay if you begin the needed task.
B
What finding would the nurse most likely discover in a 10-year-old child in the period of concrete operational thought? A) Participation in abstract thinking B) Ability to classify similar objects C) Problem solving via the scientific method D) Ability to make independent decisions
B
When instructing the parents of a toddler about appropriate nutrition, what would the nurse recommend? A) 12-16 oz fruit juice per day B) 16-24 oz milk per day C) Fat intake of 30%-40% of total calories D) 10-12 g fiber per day
B
While observing a group of 9-year-old children at school the nurse is concerned that one of the children is not cognitively developing according the Piaget's stage of concrete-operational thought processes. With which activity is the nurse concerned? A) Arrives to class late from recess and apologizes to the teacher B) The child does not understand the phrase "slow as molasses" when used by the teacher C) Believed that not turning in homework on time was acceptable, but has since decided it is not acceptable D) Enjoys math instruction and decides to join the math club
B
The nurse is preparing a care plan for a 7-year-old child on the pediatric unit newly diagnosed with asthma. One of the child's parents is employed as a family practice physician and the other as a lawyer. The child has two older siblings and two younger siblings. Which nursing diagnoses would apply to this situation? SELECT ALL THAT APPLY A) Impaired mobility B) Risk for infection C) Risk for caregiver role strain D) Knowledge deficit regarding disease process E) Knowledge deficit regarding use of inhaler medication for asthma
B, C, D, E
The nurse is assessing a 2-year-old toddler. Which observations would alert the nurse that the child may be developmentally delayed? SELECT ALL THAT APPLY A) The child is unable to stack one block on top of another. B) The child's vocabulary consists of the words "ball," "dada," "mum," "drink" and "up." C) The child claps hands in response the nurse clapping hands. D) The child will not pick up a toy or touch the nose when directed by the nurse. E) The child pushes and pulls the play vacuum cleaner in the toy room.
B, D
The nurse is assessing the gross motor skills of an 8-year-old boy. Which interview question would facilitate this assessment? A) "Do you like puzzles?" B) "Do you play any instruments?" C) "Do you participate in any sports?" D) "Do you like to construct models?"
C
The nurse is counseling the parents of a 10-year-old child who was caught stealing at school. Which topic should the nurse cover? A) Having the child return the property in front of the class B) Discussing ways for the child to save face C) Finding out what is currently going on at home D) Reminding the child daily that stealing is wrong
C
The nurse is discussing ways to promote discipline with parents who are becoming increasingly frustrated with their teenager. What would the nurse identify as most important? A) Establish rules an expectations B) Collaborate to determine consequence C) Make your responses consistent D) Explain the rules to the adolescent
C
The nurse is testing the sensory development of a toddler brought to the clinic for a well visit. What might alert the nurse to a potential problem with the child's sensory development? A) Places the nurse's stethoscope in his mouth B) Vision tests at 20/50 in both eyes C) Does not respond to commands whispered in his ear D) Taste discrimination is not at adult levels
C
The nurse is visiting a day care center and watches two toddlers at play. What best describes the play observed? A) Playing for significant stretches of time in one activity B) Sharing stuffed animals C) Playing alongside one another D) Sitting quietly with several toys
C
The pediatric nurse is planning quiet activities for a hospitalized 18-month-old. What would be an appropriate activity for a child of this age group? A) Painting by number B) Putting shapes into appropriate holes C) Stacking blocks D) Using crayons to color in a coloring book
C
What activity would the nurse expect to find in an 18-month-old? A) Standing on tiptoes B) Pedaling a tricycle C) Climbing stairs with assistance D) Carrying a large toy while walking
C
When considering the psychosocial development of a school-aged child, which is the primary developmental task? A) Establishing trust in friends outside the home family unit B) Reflecting on recent activities of accomplishment C) Establishing a social network D) Planning for future events
C
The nurse is providing information to the parents of a 6-year-old child who has been caught lying at home and at school. Which would the nurse share with the parents? SELECT ALL THAT APPLY A) Recommend the use of immediate and firm punishment. B) Indicate that the child is probably lying to impress friends. C) Suggest reading a story with the child about the consequences of lying. D) Explain that children this age typically lie to avoid punishment. E) Notify the healthcare provider to check for underlying problems.
C, D
Parents comment that their child seemed more coordinated on the basketball floor at 12 years than now at 14. The nurse can include what information in the response? A) Hand--eye coordination is affected negatively by puberty. B) It is more difficult to keep focused at 14 years than at 12. C) This may be a reaction to adult authority. D) Rapid and uneven growth of early adolescence (11 to 14 years) can interfere with coordination.
D
Parents of an 11-year-old child are bewildered that their child was caught stealing. Which reason for this behavior would the nurse suggest? A) This is one way for the child to increase self-esteem. B) The child has not attained the ability to understand ownership and property rights. C) The child was attempting to escape punishment. D) The child had a strong desire to own the item.
D
Parents say they have been using measures to lessen the struggle of getting their preschooler to bed at night and to sleep. Which practice will the nurse suggest they discontinue? A) Eliminating caffeine sources beginning late afternoon B) Providing a nightlight C) Taking the TV set out of the child's room D) Allowing the preschooler to fall asleep wherever and whenever the child is tired enough
D
The nurse is caring for a toddler who is in Piaget's senosrimotor stage of cognitive development. Which task would the nurse expect the toddler to be able to perform? A) Completing puzzles with four pieces B) Winding up a mechanical toy C) Playing make-believe with dolls D) Knowing which are his or her toys
D
The nurse is designing a nursing care plan for a toddler with lymphoma, who is hospitalized for treatment. What is a priority intervention that the nurse should include in this child's nursing plan? A) Limiting visitors to scheduled hours B) Planning physical therapy C) Introducing to other toddlers D) Monitoring for developmental delays
D
The nurse is discussing proper discipline with the parent of a 15-month-old child. Which statement is most important? A) Rules and limits should be simple and few. B) Toddlers are unable to learn rules easily. C) Use praise when the child is doing something right. D) Never spank the child for any reason.
D
The nurse is promoting language and cognitive development to the parents of a 3-year-old child. Which guidance about reading with their child will be most helpful? A) Read a different book if he knows the story. B) Have the child sit still during the story. C) Keep story time a reward for being good. D) Ask the child questions as you read.
D
The nurse is teaching the parent of a 2-year-old child about age-appropriate toys. Which would be of most interest plus stimulating to the growth and development of this child? A) Providing a brightly colored plastic bucket and shovel B) Offering the child a variety of large stuffed toys C) Giving the child a toy vacuum cleaner D) Giving the child bowls, pot, pans, and large spoons
D
The nurse teaching safety to teens knows that which of these is the leading cause of death among adolescents? A) Drowning B) Poisoning C) Diseases D) Unintentional injuries
D
The school nurse is performing a vision screening for a 7-year-old child. Which finding should trigger a referral? A) Visual acuity of 20/20 in both eyes B) Peripheral vision similar to that of the school nurse C) Ability to color discriminate D) Slight misalignment of the eyes
D
Corporal punishment (increases/decreases) learning capacity.
Decreases
T/F: Many families use appropriate car seat and seat belt safety with their children.
False
Drinking excess amounts of milk may lead to what?
Iron deficiency
Teens who have parents who are actively involved in their lives are (more/less) likely to drink alcohol.
Less
Toddlers younger than 18 months should never be spanked due to an increased risk of what?
Physical injury
T/F: Maternal depression is a risk factor for poor cognitive development.
True
