Peds Book ?s Exam 1
The nurse is playing with the 8-month-old infant. The nurse hides the toy to assess cognitive function of the infant. The infant tries to find the toy. This demonstrates what characteristic of Piaget's stages of cognitive development? a. Concept of causality b. Object permanence c. Primary circular reactions d. Prelogical reasoning
b
A nurse is assessing a 15 month old at a well-child visit. Which actions demonstrate that the child is achieving milestones? Select all that apply. a. Walks up the stairs by holding on to rail b. Uses 4 to 6 words when speaking c. Scribbles with a crayon d. Understands and follows simple commands e. Climbs down from chair independently
b c d
The nurse is planning an educational seminar for community members that focuses on the 2020 National Health Goals to promote health during the infant year. What should the nurse include in this seminar? Select all that apply. a. Introducing solid food by age 6 months b. Continuing breast-feeding for 6 months c. Using infant car seats d. Placing infants on back to sleep e. Receiving immunizations after the age of 1
b c d
Many researchers have theories relating to the stages of growth and development. Which stage(s) of accepted theories relates to the preschool-aged child from ages 4 to 6 years? Select all that apply. a. Formal operational phase b. Erikson's stage of initiative vs. guilt c. Piaget's preoperational phase d. Freud's phallic stage e. Kohlberg's pre-conventional level stage 1 f. Freud's oral stage
b c d e
The nursing instructor is preparing a class discussion covering the theories of Erikson and the growth and development of infants and children. Which example would best illustrate the phase referred to as initiative by Erikson? a. Learning to trust when needs are met after crying b. Knowing the rules, enjoys being good, being independent, and receiving approval c. Interacting and competing with others d. Performing a task by oneself, even if it takes a long time
b
What action shows an example of Erik Erikson's developmental task for the infant? a. The infant cries when he or she has a wet diaper. b. The infant cries and the caregiver picks the child up. c. The infant smiles as people walk past the crib. d. The infant plays the game peek-a-boo.
b
When the nurse discharges a new mom and infant, the nurses notices that the car seat is in the front seat of the car. What is the appropriate response for the nurse to make regarding the car seat? a. "I see you have a car seat. That is great." b. "Let me go over car seat safety with you, so you can install your car seat properly." c. "With the car seat in front, you can keep an eye on your baby." d. "You should never put the car seat in the front."
b
Which theorist believes that the child progresses from making decisions with no moral sensitivity to making decisions based on personal standards and values? a. Piaget b. Kohlberg c. Freud d. Erikson
b
A 2-year-old wants to feed herself and becomes agitated when the nurse attempts to feed her. What does the nurse understand is the developmental age of this child according to Erikson? a. Autonomy vs. doubt and shame b. Initiative vs. guilt c. Industry vs. inferiority d. Trust vs. mistrust
a
A child gains weight and becomes taller each year. What is this process called? a. Growth b. Development c. Progression d. Orderly change
a
A father mentioned to the nurse that his usually smiling, happy 8-month-old boy was clingy and intensely serious when his grandmother visited from a distant city. The nurse explained the child was experiencing: a. Stranger anxiety b. Cephalocaudal development c. Changes in temperament d. Colic e. Separation anxiety
a
A mother brings a 15-month-old child to the clinic for a routine health maintenance visit. Which immunization should the nurse prepare to administer to this child? a. MMR b. Polio c. Rinne Test d. Hep A
a
A mother confides in a nurse that her preschool daughter only wants to play with her father as soon as he comes home from work in the evenings and does not seem to have any interest in spending time with the mother. This phenomenon is an example of: a. Electra complex. b. genu valgum. c. Oedipus complex. d. centering
a
A parent is comparing a child's development on the growth chart with those of another child and is concerned that her child is not in the "normal" range. What can the nurse inform the parent to alleviate her anxiety? a. "Growth charts are just a standard measurement. If your child doesn't fall into the 'normal' range, it doesn't indicate something is wrong." b. "I can certainly understand your fear. If your child is not falling into the 'normal' range, it can indicate that there may be some developmental delays." c. "Maybe the other child is advanced and your child is growing slower. We will keep a close eye or your baby to make sure nothing is wrong." d. "Everyone is scared that their child will not be normal. Let's just wait and see what will happen with your child."
a
A staff nurse is talking about Piaget's theory with a nursing student. Infants are in the sensorimotor stage of cognitive development during which object permanence is mastered. An example of an infant displaying this ability is: a. looking for a toy in her crib at the last place she saw it. b. shaking a rattle to enjoy the sound. c. pushing a spoon from her high chair tray to the floor. d. smiling at herself in the mirror.
a
According to Piaget, one basic concept that a child will learn during the first year is that: a. he is separate from his parents. b. he cannot be fooled by changing shapes. c. most procedures can be reversed. d. his parents are not perfect.
a
At a physical examination, a nurse asks the father of a 4-year-old how the boy is developing socially. The father sighs deeply and explains that his son has become increasingly argumentative when playing with his regular group of three friends. The nurse recognizes that this phenomenon is most likely due to: a. testing and identification of group role. b. preschoolers having a harder time sharing than toddlers. c. regression d. playing in an even-number group of children (four).
a
Infant development is best described by which statement? a. Development proceeds cephalocaudally. b. Development proceeds from fine to gross. c. Development varies greatly from infant to infant. d. Development is not sequential but predictable.
a
The developmental task of preschoolers is to achieve a sense of: a. initiative versus guilt. b. accomplishment versus inefficiency. c. autonomy versus shame and doubt. d. cognition versus attitude.
a
The mother of a 6-month-old infant asks the nurse at a community health center what she should do about her baby, who always wants to put everything in his mouth. What would be an appropriate response by the nurse, based on Freud's theory? a. "Babies at this age explore and enjoy their world with their mouths." b. "I don't know if that is normal or not, but I will check on it." c. "This usually does not happen until babies are 2 years old." d. "There must be something wrong...your baby should not be doing that."
a
The mother of a toddler observes the child play next to another child but not with the child. What should the nurse explain to the mother about this type of play behavior? a. This is parallel play and is expected. b. This is peer play and is abnormal. c. This is premature play and should be stopped. d. This is adjacent play and is only seen in school-age children.
a
The nurse enters her client's room and finds the infant on a pillow with a bottle propped up while the mother is dressing. What statement should the nurse make? a. "You should always hold your baby for feedings instead of propping the bottles." b. "Are you almost ready to be discharged?" c. "Is she almost done feeding?" d. "Look how cute she is."
a
The nurse has brought a group of preschoolers to the playroom to play. Which activity would the nurse predict the children to become involved in? a. Pretending to be mommies and daddies in the playhouse b. Playing a board game c. Painting pictures in the art corner of the room d. Watching a movie with other children their age
a
The nurse is assessing an 6-month-old infant at a well-baby visit and is answering questions from the new mother. Which response should the nurse prioritize when addressing the mother's question concerning what the infant should be learning at this point in life? a. Trust b. Fear c. Love d. Anger
a
The nurse is providing parental anticipatory guidance to promote healthy emotional development in a 12-month-old boy. Which statement best accomplishes this? a. A regular routine and rituals will provide stability and security. b. Aggressive behaviors such as hitting and biting are common in toddlers. c. A sense of control can be provided through offering limited choices. d. Emotions of a 12-month-old are labile. He can move from calm to a temper tantrum rapidly.
a
The nursing student is preparing a presentation which will illustrate the various stages of growth and development starting with a newborn. Which example should the student point out will best illustrate cephalocaudal growth pattern? a. Controlling the head and neck before being able to control the arms and legs b. Walking for several steps, stopping, and then running for several steps c. Using the fingers to pick up an object and put it back down d. Grasping the foot and pulling it to the mouth
a
When caring for a child with a cognitive impairment, what is a primary factor for the nurse to consider regarding the approach for interaction with the child? a. The developmental stage is based on developmental tasks achieved. b. The developmental stage is based on the chronological age. c. The developmental stage is based on the parent's report of level of functioning. d. The developmental stage is based on the gestational age.
a
When observing a group of toddlers playing in a child care setting, it is noted that the toddlers are all playing with buckets and shovels but are not playing with each other. This type of play is referred to as: a. Parallel play b. Solitary play c. Onlooker play d. Associative play
a
Which behavior by a 3 year-old child does not validate Erikson's developmental task for preschoolers? a. Compares his soccer abilities with his peers. b. Dresses up and pretends to be a superhero. c. "Cooks" a meal on the toy stove. d. Asks the parent "why" about everything that happens.
a
A nurse is preparing to administer vaccines to a child who is entering kindergarten. Which vaccines should the nurse anticipate administering to this child? Select all that apply. a. poliomyelitis (inactivated) b. diphtheria, pertussis, and tetanus (DTaP) c. varicella d. hepatitis B e. measles, mumps, and rubella (MMR)
a b c e
Parents of a toddler are expressing concern about their child's extreme negativism. Every question is answered with a forceful, "no." Which information would be most appropriate for the nurse to share with this couple about their toddler's negativity? Select all that apply. a. This is not only normal for toddlers but demonstrates a positive stage of development. b. Rather than ask, "Do you want to come to dinner now?" instead state, "It's dinner time. Do you want to drink milk or water with your dinner?" c. After one warning, place the child in time-out if they say "no" again in response to questions. d. With regards to bath time, ask the child "Will you please go get ready to take your bath?" e. This is a step in the child's development toward independence and to take care of his or her own needs.
a b e
The nurse is assessing the psychosocial development of a preschooler. What are normal activities characteristic of the preschooler? Select all that apply. a. Acts out roles of other people b. Plans activities and makes up games c. Classifies or groups objects by their common elements d. Engages in parallel play with peers e. Initiates activities with others f. Understands relationships among objects
a b e
The nurse is observing a group of 5-year-olds playing in the playroom. Which developmental milestones does the nurse identify as newly acquired skills since turning 5 years old? Select all that apply. a. Drawing a 6-part man b. Jumping c. Standing on one foot d. Lacing one's shoes e. Drawing a cross
a d
A 2-month-old infant has inconsolable crying, is gassy, and constantly draws the legs up. It has been determined that the infant has colic. What intervention should the nurse recommend to treat colic? a. The infant is hungry, so the parent should feed more. b. The infant is bottle fed, so the parent needs to try a different formula to assess for sensitivity. c. The infant is breastfed so the mother should eat more broccoli. d. The parents should play music continuously to comfort the infant.
b
A 2-year-old with pneumonia has recently been hospitalized. When the lunch tray arrives to the floor, the nurse caring for the patient sets up the tray and allows the child to self-feed with a spoon despite the mess. What is the nurse's best reason for these actions? a. to foster trust b. to foster autonomy c. to foster industry d. to foster initiative
b
A breast-feeding infant will gaze intently into his or her mother's eyes, grasp her finger, and smell and taste the milk. This use of the senses is attributed to a phase of development that is part of which theory? a. Kohlberg's theory b. Piaget's theory c. Erikson's theory d. Freud's theory
b
A grandmother who is the primary caregiver of a 2-year-old is expressing concern about how to best handle the temper tantrums that can occur two or three times a day, often in public places. She explains she spanked her own children for this but she is worried this is not the best way to handle the situation. Which response from the nurse will best address this concern? a. "Spanking is controversial but sometimes necessary, so use it if it works." b. "Remain calm, pick the child up, and move to a quiet and neutral place until she gains self-control; don't give in to her demands." c. "Remind the child that she is in a public place and ask her to respect those around her; reward her if she responds by calming herself." d. "Warn the child that she will be punished when she is back at home then follow through with the punishment."
b
A hospitalized 2-year-old is toilet training and excited to show the nurse the product created in the toilet. What stage does the nurse recognize this child is in according to Freud? a. Oral stage b. Anal stage c. Phallic stage d. Oedipal stage
b
A nurse is talking to and making facial expressions at a 9-month-old baby girl during a routine office visit. What is the most advanced milestone of language development that the nurse should expect to see in this child? a. The infant coos, babbles, and gurgles b. The infant says "da-da" when looking at her father c. The infant squeals with pleasure d. The infant imitates her father's cough
b
A nurse notices that a 4-month-old infant has an asymmetric head, with the back of the skull flattened. Which of the following should she recommend to the parents to correct this condition? a. Consult a pediatric surgeon about surgically reshaping the skull b. Place the infant on her stomach during play time each day c. Place the infant on her stomach to sleep each night d. Increase the infant's sleep time each day
b
A nurse places a toy car in front of a 6-month-old girl. She swats at it, and the car flies across the examination table and lands on the floor. She squeals with surprise and delight. When the nurse puts the toy car in front of her again, she immediately swats it again and laughs as it rolls across the table and falls to the floor again. What has the girl demonstrated? a. Object permanence b. Secondary circular reaction c. Binocular vision d. Primary circular reaction
b
A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks? a. Maturation b. Developmental c. Cephalocaudal d. Proximodistal
b
A pediatric nurse observes an infant holding a rattle. Upon dropping the rattle, the baby cannot pick it up with his fingers on his own. The nurse correctly identifies this to be an example of which type of growth? a. abnormal development b. Proximodistal c. abnormal growth d. cephalocaudal
b
Genetics have an influence on many aspects of growth and development. The genetic influence that has to do with the way a person thinks, behaves, and reacts is referred to as: a. Growth b. Temperament c. Maturation d. Development
b
The nurse and a client are discussing the client's preschool child. The client states, "When I tell my child it's time for bed, he/she screams and cries for almost an hour each night before going to sleep." The client and the nurse decide that the next course of action is: a. let the child set the time to go to bed. b. follow a routine and set a bedtime. c. let the child fall asleep wherever he/she wants and then carry the child to bed. d. promise the child a new toy in the morning for good behavior.
b
The nurse is caring for a newborn client following hospitalization for an infection. Which condition should the nurse prioritize in the plan of care at this time? a. Lack of age-appropriate toys and activities related b. Delayed growth and development after hospitalization c. Parent exhibits knowledge deficit regarding dietary protein requirements d. Parent inquire about the child's expected growth and development
b
A family has recently moved into the area and is bringing their 18-month-old son in to the office for his first visit. The father is in dusty work clothes and explains that they are in the process of restoring the house they recently moved into, which was built in the 1920s and which had been vacant for many years. The nurse urges the father to have a blood test done on the son. Which of the following is the best rationale for this intervention? a. Risk for ingestion of cleaning products they may have been left out due to the renovation b. Risk for developing tetanus due to all of the construction going on c. Risk for lead paint poisoning due to the age of the house d. Risk for development of diabetes due to all of the high-calorie fast foods the family is consuming while their kitchen is under construction
c
A mother calls the hospital nursing hotline and asks, "My 8-week-old daughter cries 8 hours a day, and she is hard to console. Is that normal?" What should the nurse's response be to this mother? a. "Yes, maybe she is just tired." b. "No, call your doctor." c. "Let me ask you some more questions to see if there are symptoms of colic." d. "Yes, infants cry all the time at that age."
c
A mother reports to the nurse that her 4-year-old does everything that she does. She says she is becoming somewhat frustrated with these actions. What would be the best response by the nurse to this mother? a. "This is not normal behavior. I am going to get the doctor's advice." b. "I can imagine that it would be very irritating." c. "Preschoolers' imitating is a healthy behavior. It is part of their imagination and normal growth and development." d. "I am sure there are ways to get your daughter to stop imitating you."
c
A nurse at a pediatric clinic is assessing a young client at a well-child visit. After the assessment, the nurse determines the child is in Erikson's autonomy stage based on which finding? a. They want to know the rules and enjoy being good and getting approval. b. Learning to trust that needs are met when they cry c. Will perform tasks by themselves, even when it takes a long time d. Will interact with others and like to compete
c
A nurse is observing a 3-year-old preschooler engaged in play. What behavior would the nurse most likely expect to observe? a. Group play b. Parallel play c. Imitative play d. Solitary play
c
A nursing instructor asks the class to describe growth and development using only one word. Which of the following would be the best choice? a. simple b. slow c. individualized d. unorderly
c
A parent brings her 3-year-old child in for a sick visit for the third time this year. The child, who attends a preschool program, continues to develop upper respiratory infections. The parent is frustrated with the situation and asks the nurse for advice. What would be the best recommendation for the nurse to give to the parent in this situation? a. Send the child to preschool with a healthy snack each day. b. Teach the child to cover the mouth when sneezing. c. Make sure that frequent handwashing is being stressed at the preschool. d. Withdraw the child from preschool and keep him/her at home.
c
As the fetus develops, certain growth and development trends are regular and predictable. The first trend is cephalocaudal growth. What does this mean? a. Both sides of the body develop first equally. b. Gross motor skills are learned last. c. Head and brain develop first. d. Legs and feet develop first.
c
During their school-aged years, children understand concepts best if they can see the concept illustrated. This type of thinking is termed a. school-aged rhetoric. b. formal thought. c. concrete thought. d. black-and-white reasoning.
c
Parents of an 18-month-old tell the nurse that the child eats very little during meals but is constantly asking for snacks. Which recommendation should the nurse make? a. Provide a firm explanation to the child. b. Offers rewards with meals to increase eating. c. Give nutritious snacks throughout the day. d. Avoid snacks to increase mealtime hunger.
c
The 18-month-old toddler has most likely attained which gross motor skill? a. The ability to balance on one foot. b. The ability to pedal a tricycle. c. The ability to walk independently. d. The ability to walk up stairs alone.
c
The nurse is explaining to parents that the preschooler's developmental task is focused on the development of initiative rather than guilt. What is a priority intervention the nurse might recommend for parents of preschoolers to stimulate initiative? a. As a parent, decide how and with whom the child will play. b. Do not set limits on the preschooler's behavior as this results in low self-esteem. c. Reward the child for initiative in order to build self-esteem. d. Change the routine of the preschooler often to stimulate initiative.
c
The nurse is teaching a new mother about the development of sensory skills in her newborn. What would alert the mother to a sensory deficit in her child? a. The newborn's eyes focus on near objects. b. The newborn's eyes wander and occasionally are crossed. c. The newborn does not respond to a loud noise. d. The newborn becomes more alert with stroking when drowsy.
c
What information would the nurse include when teaching the parents of an infant about colic? a. The infant will need future follow-up for a "nervous" bowel. b. Formula intake should be doubled to keep the infant from losing weight. c. Colic symptoms will probably fade at 3 months of age. d. Symptoms will decrease if the infant is laid on the back after feedings.
c
Which activity would the nurse expect to find in an 18-month-old? a. Pedaling a tricycle b. Standing on tiptoes c. Climbing stairs with assistance d. Carrying a large toy while walking
c
Which gross motor developmental milestone is least likely for a 2-year-old? a. Jumps in place b. Climbing stairs with assistance c. Rides a tricycle d. Stands on one foot with help
c
The parents are asking their health care provider to give them some advice on how to start toilet training their toddler. Which information is most appropriate to share with this family? Select all that apply. a. Flush bowel movements right away to keep the child from playing with the stool. b. Begin training with urination since this is the most frequent and costly part of potty training. c. Praise the child every time the child sits on the potty chair and tries to defecate. d. Don't let the child use the potty chair as a place to sit at the play table since it might confuse the child of its purpose. e. Allow the child to sit on the potty chair for up to 30 minutes until the child actually defecates or urinates.
c d
A first-time father calls the pediatric nurse stating he is concerned that his 4-year-old daughter still wets the bed almost every night. Remembering his own experience of being punished for wetting the bed at 4 years old, he is not sure punishment is the best approach to address this. Which nursing instruction is the most appropriate? a. "Disciplining is not likely to be effective, but if the child keeps wetting the bed it may be necessary." b. "Nightly bedwetting up to age 12 is developmentally typical, so you will need to practice patience with your daughter." c. "Setting rules is a parent's job to help the child have acceptable social behavior, so take away a privilege each time she wets the bed." d. "Bedwetting is not uncommon in young children. Try to calmly change the bed without showing your frustration."
d
A nurse is teaching a 7-year old diabetic child who is in Piaget's concrete operational stage about insulin injections. Based on Piaget's theory, what would be the nurse's best method of preparation for this child? a. Show the child a video about diabetes and insulin. b. Explain the procedure to the child in detail. c. Give the child a pamphlet on diabetes to read. d. Demonstrate the procedure on a teddy bear.
d
A nurse observes a child engaged in parallel play in a nursery. What is an example of parallel play? a. Two boys playing cooperatively with stuffed animals, pretending that the toys are fighting each other b. A group of children playing hide and seek on the playground c. A girl sitting by herself and alternating between playing with a doll for a time and then with a toy truck for a time d. A boy sitting beside a girl in the floor, each playing independently with a separate set of blocks
d
According to Kohlberg, which of the following considerations is central to human development? a. Safety b. Agency c. Influence d. Morality
d
In discussing their 2-year-old's behavior with the nurse, which of the parents' statements suggests the child may be ready for toilet teaching? a. The child often removes her shoes and socks. b. The child frequently repeats words parents just said. c. The toddler walks with a wide, swaying gait. d. The child hides behind her bedroom door when defecating.
d
Many different factors affect growth and development. For example, why does Mary have blonde hair and blue eyes while John has brown hair and green eyes? a. maternal nutrition b. childhood illnesses c. prenatal influences d. genetic inheritance
d
Nursing students are reviewing information about the cognitive development of preschoolers. The students demonstrate understanding of the information when they identify that a 3-year-old is in what stage as identified by Piaget? a. Tertiary circular reaction b. Primary circular reaction c. Coordination of secondary schema d. Preoperational thought
d
Parents and their nearly 3-year-old child have returned to the clinic for a follow-up appointment. Which of the findings may signal a speech delay? a. Half of speech understood by outsider b. Asks "why" often c. Talks about a past event d. Uses two-word sentences or phrases
d
The nurse is assessing the development of a 15-month-old girl during a well-child visit. Which skill would the nurse expect to see? a. Points to her nose and mouth b. Runs to her mother c. Feeds herself with a spoon d. Stands alone
d
The nursing instructor is conducting a class on the development of an infant. The instructor determines the class is successful when the students correctly illustrate which as the proximodistal development in an infant? a. Imitate speech-like sounds, then learns to speak a language b. Roll over, then learns to follow an object with the eyes c. Walk for several steps, then learns to run d. Kick and to wave the arms, then learns to grasp the foot and pull it to the mouth
d
The parents of a toddler are concerned their child is not developing correctly and are questioning the nurse concerning the child's lack of effort to join other children in a group activity. Which response should the nurse prioritize in answering the parents? a. "Perhaps getting your child interested in sports will improve their other play habits." b. "Your child is involved with others, just indirectly. See how they sit next to the other children and play with the same toys?" c. "You should try to get your child involved in a local Boys and Girls club to encourage more interaction." d. "This is normal for this age group. It's referred to as solitary independent play."
d
The parents of an 8-month-old hospitalized child tell the nurse they are not going to visit as often since the child screams and is upset when they leave. Select the best response by the nurse: a. I know it is difficult to leave but the crying stops in a few minutes. b. Every parent should stay in the hospital with a child at all times. c. The child is spoiled and should be distracted when parents leave. d. This is normal behavior and is called separation anxiety.
d
What position is the infant placed in for "tummy time"? a. The infant is placed in the bath on their tummy. b. The infant is placed on the bed on their tummy. c. The infant is placed on mommy's lap on their tummy. d. The infant is placed on the floor on their tummy.
d
What should the nurse instruct a parent to help a child complete Erikson's developmental task during the infant period? a. Keep the child stimulated with many toys. b. Expose the child to many caregivers to help learn variability. c. Talk to the child at a special time each day. d. Respond to the child's needs consistently.
d
When assessing a toddler's language development, what is the standard against which you measure language in a 2-year-old toddler? a. The toddler should be able to count out loud to 20. b. The toddler should say 20 nouns and 4 pronouns. c. The toddler should say two words plus "ma-ma" and "da-da." d. The toddler should speak in two-word sentences ("Me go").
d
Which of the following is a biological factor that has influence on growth and development? a. Illicit drugs b. Poor diet c. Illness d. Genetics
d
The nurse is reviewing growth and development for infants. Place the following developmental milestones in the correct order, from first to last for the growing and developing infant. Use all options. a. Infant sits independently, unsupported b. Infant rolls over from back to front or front to back c. Infant crawls d. Infant pulls to standing position e. Infant turns head when lying in prone position
e b a c d
