PEDS HESI PRACTICE QUESTIONS
According to Erikson, what should the nurse anticipate when assessing an adolescent? a. Being engaged in tasks b. Questioning sexual identity c. Having highly imaginative thoughts d. Wanting to participate in organized activities
b
What is the expected average weight for a 6-month-old child? a. 680 g (1.5 lb) b. 7.26 kg (16 lb) c. 11.34 kg (25 lb) d. 9.75 kg (21.5 lb)
b The average weight of a 6-month-old child is 7.26 kg (16 lb). The average weight gain in an infant is 680 g (1.5 lb) per month until age 5 months, when the birth weight has at least doubled. The average weight of a 6-month-old child is not as high as 11.34 kg (25 lb). The average weight of a 1-year-old child is 9.75 kg (21.5 lb).
When does the anterior fontanel of an infant close? a. At 4 to 10 months b. At 8 to 12 months c. At 12 to 18 months d. At 18 to 26 months
c
Which stage describes the Oedipus complex, according to Freud's theory? a. Stage 2 b. Stage 3 c. Stage 4 d. Stage 5
b According to Freud's theory, there are five stages in a child's development. Stage 3 is the Oedipal stage, which is also known as the phallic stage. Stage 2 is the anal stage. Stage 4 is the latency stage. Stage 5 is the genital stage
Which is an inborn error of metabolism that affects growth and development? a. Cystic fibrosis b. Achondroplasia c. Turner syndrome d. Hunter syndrome
d Hunter syndrome is an inborn error of metabolism that hinders development and results in altered physical appearance and impaired mental development. Cystic fibrosis is a genetic disorder that results in accumulation of mucus in the lungs and pancreas. Achondroplasia is a congenital disorder that is a common cause for the structural defect called dwarfism. Turner syndrome is a chromosomal abnormality associated with webbed neck and low-set ears
Which stage of Lawrence Kohlberg's theory of moral development is associated with a person following a law even if it is discriminatory to a racial group? a. Social contract orientation b. Society-maintaining orientation c. Instrumental relativist orientation d. Universal ethical principle orientation
a A person in the social contract orientation stage follows laws even if they are not fair to a certain racial group. During the society-maintaining orientation stage, an individual expands his or her focus from a relationship with others to societal concerns. During the instrumental relativist orientation stage, the decision to do something morally right is based on satisfying one's own needs and occasionally the needs of others. An individual in the universal ethical principle orientation stage may not follow a law if it does not seem fair to a particular racial group
Which school-age client should the nurse assess for symptoms related to burnout? a. 7-year-old b. 8-year-old c. 9-year-old d. 10-year-old
d The school-age client between the ages of 10 to 12 years often becomes overinvolved with activities leading to burnout; therefore, the nurse should assess the 10-year-old client for clinical manifestations associated with burnout. The other school-age clients (7 years, 8 years, and 9 years) do not often become overinvolved in activities leading to burnout.
How many days is the neonatal period?
the first 28 days of life
Which age should the nurse teach the parents of a school-age client to expect mandibular second molars to erupt? a. 7 to 8 years b. 9 to 10 years c. 10 to 12 years d. 11 to 13 years
d Mandibular second molars often erupt between 11 and 13 years of age. The maxillary central incisor is expected to erupt between 7 and 8 years of age. The mandibular cuspids are expected to erupt between 9 and 10 years of age. The mandibular second bicuspids are expected to erupt between 11 to 12 years of age.
Which stage of Kohlberg's theory is an individual in if he or she wants to modify a law if it is not fair to a particular group? a. Social contract orientation b. Society-maintaining orientation c. Instrument relativist orientation d. Universal ethical principle orientation
d The universal ethical principle orientation stage is associated with a person who wants to modify a law if it does not seem just. According to the social contract orientation stage, a person tends to follow a law even if it is not fair. During the society-maintaining stage, an individual shows concerns for his or her society and makes decisions in accordance to his or her society. During the instrument relativist orientation stage, a child recognizes that there is more than one correct vie
Who should the nurse include as the authority when providing education to the parents of a 7-year-old client related to moral development? a. The school-age child b. The school-age child's peers c. Any higher power the child believes in d. Any adult with authority over the child
d When a school-age child and an adult differ in judging an act, the adult is right. The school-age child, the child's peers, and a higher power that the child believes in are not authorities to moral development of the school-age client.
According to Freud's theory, in what order do the stages of child development occur? 1.Oral 2.Anal 3.Genital 4.Oedipal 5.Latency
1. oral 2. anal 3. oedipal 4. latency 5. genital
What is the correct order of the stages according to Kohlberg's theory of moral development? 1.Social contract orientation 2.Good boy-nice girl orientation 3.Society-maintaining orientation 4.Instrumental relativist orientation 5.Universal ethical principle orientation 6.Punishment and obedience orientation
1. punishment and obedience orientation 2. instrumental relativist orientation 3. good boy-nice girl orientation 4. society-maintaining orientation 5. social contract orientation 6. universal ethical principle orientation
Who completes the developmental questionnaire for a pediatric client who is being assessed using the Developmental (ASQ-3) screening? a. Child b. Parent c. Nurse d. Physician
b The parent completes the questionnaire portion of the Development (ASQ-3) assessment. A health care professional, such as the nurse or physician, scores the assessment. The child's stage of development is assessed using this process.
How many hours of sleep should the nurse recommend for the 11-year-old client? a. 9 b. 8 c. 11 d. 12
a A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client. A 5-year-old school-age client requires 11.5 hours of sleep per night; however, 11 and 12 hours of sleep is not recommended for an 11-year-old school-age client
Which statement describes stage 2 of Kohlberg's theory? a. The child recognizes that there is more than one correct view. b. An adolescent chooses to avoid a party where they know beer will be served. c. An individual wants to win the approval of and maintain the expectations of one's immediate group. d. A child's response to a moral dilemma is in terms of absolute obedience to authority and rules.
a According to stage 2 of Kohlberg's theory, a child recognizes that there is more than one correct view. An adolescent who chooses not to attend a party where beer will be served because they know this is wrong is acting according to stage 4. Stage 3 states that an individual wants to win the approval of and maintain the expectations of one's immediate group. During stage 1, a child's response to a moral dilemma is in terms of absolute obedience to authority and rules.
The nurse is assessing an 8-month-old child's gross motor development. Which action by the child indicates late development? a. The child is unable to stand by holding onto furniture. b. The child cannot change from a prone to a sitting position. c. The child cannot sit down from a standing position without help. d. The child cannot sit steadily on the floor for a prolonged period of time.
a At 8 months of age the child should be able to stand by holding onto furniture, because the child readily bears weight on the legs when supported. When a child is 10 months old, the child can change from a prone to a sitting position. When a child is 12 months old, the child is able to sit down from a standing position without any help. When a child is at least 9 months old, the child can sit steadily on the floor for a prolonged period of time.
What is true about the instrumental relativist orientation stage? a. An individual recognizes that there is more than one correct point of view. b. An individual finds a balance between societal rules and basic human rights and obligations. c. An individual response to a moral dilemma is in terms of absolute obedience to authority and rules. d. An individual sees moral reasoning based on own personal internalization of societal and other's expectations.
a During the instrumental relativist orientation stage, an individual finds that there is more than one correct point of view. During the postconventional reasoning stage, a person finds a balance between societal rules and basic human rights and obligations. During the punishment and obedience orientation stage, a child's response to a moral dilemma is in terms of absolute obedience to authority and rules. During the conventional reasoning stage, the person sees moral reasoning based on his or her own personal internalization of societal and other's expectations.
Which theory states that a child's growth pattern is related to gene activity? a. Gesell's theory b. Piaget's theory c. Erikson's theory d. Havinghurst's theory
a Gesell's theory of development states that each child's pattern of growth is unique and that this pattern is directed by gene activity. Piaget's theory of cognitive development comprises four periods related to age: sensorimotor, preoperational, concrete operations, and formal operations. Erikson's theory of psychosocial development states that an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Havinghurst's theory of stage crisis is based on developmental tasks. This theory incorporates three primary sources for developmental tasks: tasks that surface because of physical maturation, tasks that evolve from personal values, and tasks that are a result of pressures from society.
How much does the head circumference increase per month from 4 to 6 months of age? a. 1 cm (0.4 inch) b. 2 cm (0.75 inch) c. 0.5 cm (0.2 inch) d. 3.5 cm (1.38 inch)
a Head circumference increases approximately 1 cm (0.4 inch) per month from 4 to 6 months of age. Head circumference increases approximately 2 cm (0.75 inch) per month from birth to 3 months of age. It increases approximately 0.5 cm (0.2 inch) per month during the second 6 months. It does not increase as fast as by 3.5 cm (1.38 inch) at any time during infancy.
Which formula is most preferable for a child who has lactose intolerance? a. Soy-based formula b. Whey hydrolysate formula c. Cow's milk-based formula d. Amino acid-based formula
a Soy-based formula is a commercially available formula that has a high amount of protein but does not contain lactose. Amino acid-based formula is preferable for a child who has food allergies. However, it is not the most preferable formula for the child with lactose intolerance. Whey hydrolysate formula and cow's milk-based formula contain high amounts of lactose.
Which fine motor skill should the nurse expect when assessing the development of an infant between 10 and 12 months of age? a. Holds a crayon b. Walks with assistance c. Stands independently d. Sits from a standing position
a The ability to hold a crayon is a fine motor skill that the nurse should expect when conducting a developmental assessment for an infant between 10 to 12 months of age. Walking with assistance, standing alone, and sitting from a standing position are all gross motor skills the nurse would anticipate for this infant.
The nurse assesses a client and determines that she has achieved thelarche. What clinical finding prompted the nurse's report? a. Appearance of breast buds b. Occurrence of gynecomastia c. Growth of hair on mons pubis d. Occurrence of menstrual cycle
a The appearance of breast buds is considered to be an initial indication of puberty and is known as thelarche. A few months after thelarche, growth of pubic hair on the mons pubis occurs. This is known as adrenarche. The occurrence of the first menstrual cycle is known as menarche. Temporary gynecomastia is seen in some boys during mid-puberty.
At which stage of Kohlberg's theory does an individual want to fulfill the expectations of one's immediate group? a. Good boy-nice girl orientation b. Society-maintaining orientation c. Instrumental relativist orientation d. Universal ethical principle orientation
a The good boy-good girl orientation stage involves an individual who wants to win the approval and maintain the expectations of one's immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. The instrumental relativist orientation stage involves a child who wants to follow his or her parent's rules. The universal ethical principle orientation stage defines "right" by the decision of conscience according to self-chosen ethical principles.
From which client does the nurse expect dramatic physical growth and marked development? a. 9-month-old infant b. 24-month-old toddler c. 4-year-old preschool-age child d. 10-year-old school-age child
a The nurse can anticipate the infant to have both dramatic physical growth and marked development. The toddler, preschool-age, and school-age children will all continue to experience physical growth and development; however, these age groups do not experience growth and development as rapid as that of the infant.
Which stage is a part of postconventional reasoning? a. Social contract orientation b. Society-maintaining orientation c. Instrumental relativist orientation d. Punishment and obedience orientation
a The social contract orientation stage is a part of postconventional reasoning. Society-maintaining orientation is part of the conventional/role conformity reasoning level. The instrumental relativist orientation stage and the punishment and obedience orientation stage are parts of the preconventional reasoning level.
The nurse is using Piaget's theory to assess the cognitive development in a child. What is most likely to be the age of the child who has reached a developmental milestone by grasping the concept of conservation of numbers for the first time? a. 5 years b. 7 years c. 9 years d. 12 years
a There appears to be a developmental sequence in children's capacity to conserve matter. Children usually grasp conservation of numbers between the ages of 5 and 6 years. So, in this scenario, the child who is most likely to have grasped the concept of conservation of numbers for the first time is likely to 5 years old. Conservation of liquids, mass, and length usually is accomplished at about ages 6 to 7 years old. Conservation of weight is understood sometime later, around ages 9 to 10 years old. The child begins to understand conservation of volume or displacement last, between ages 9 and 12 years old.
A child has been diagnosed with hemophilia type A after experiencing excessive bleeding from a minor trauma. The mother states that the toddler being seen for the trauma is very active and is difficult, constantly saying no. What would be an appropriate response? a. "Toddlers are curious, trying to make decisions and be independent." b. "Saying no at this stage is a signal that the child may need some therapy." c. "You must show the child from a young age that you are the boss and in charge." d. "Responsible parenting means you must protect the child from all future injuries."
a Toddlers are curious, trying to make decisions and being independent, and learning autonomy, which is a normal developmental stage for this age group. Saying no is the toddler's means of developing independence rather than a need for therapy. The developmental task according to Erikson is autonomy verses shame, so caregivers need to allow some independence. No person can protect absolutely another individual from all injuries.
During which stage of development should the nurse anticipate sibling relationships that fluctuate between open bickering and supportive relationships? a. Preschool b. Early school-age c. Late adolescence d. Middle school-age
d
During testing of the neurologic reflexes of an infant, which reflex should the nurse expect to appear at 3 months and persist until 24 to 36 months of age? a. Neck righting b. Body righting c. Otolith righting d. Labyrinth righting
a While the infant is supine, if the head is turned to one side, the shoulder, trunk, and finally pelvis will turn toward that side. This reflex appears at 3 months, and persists until 24 to 36 months of age. Body righting is a modification of the neck-righting reflex in which turning hips and shoulders to one side causes all other body parts to follow; it appears at 6 months, and persists until 24 to 36 months of age. When the body of an erect infant is tilted, the head is returned to an upright, erect position; this is known as otolith righting, which appears at 7 to 12 months of age, and persists indefinitely. When an infant in prone or supine position is able to raise head, it is known as labyrinth righting. It appears at 2 months, and is strongest at 10 months of age.
What should the nurse anticipate, according to Erikson, when assessing a school-age child? Select all that apply. a. Being engaged in tasks b. Questioning sexual identity c. Having highly imaginative thoughts d. Wanting to participate in organized activities e. Struggling with self-control and independence
a d The nurse would anticipate that the school-age child would want to be engaged in tasks and participate in organized activities. Questioning sexual identity is expected for the adolescent. The nurse would anticipate that a preschool-age child would have highly imaginative thoughts, according to Erikson. Struggling with self-control and independence is expected for the toddler-age child
At which stage of Kohlberg's theory is the child afraid of punishment? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
a According to Kohlberg's theory of moral development, at stage 1 a child is afraid of punishment. At stage 2, the child recognizes that there is more than one correct viewpoint. At stage 3, an individual seeks the approval of and maintains the expectations of one's immediate group. At stage 4, an individual expands focus from a relationship with others to societal concerns
Which behaviors should the nurse anticipate when conducting a developmental assessment for a newborn? Select all that apply. a. Sucking on a pacifier b. Grasping a parents finger c. Discovering hands and feet d. Swallowing while breastfeeding e. Rooting when the cheek is stroked
a, b, d, e Developmental behaviors for a newborn are mostly reflective, including sucking, grasping, swallowing, and rooting. The nurse would not anticipate hands and feet to be discovered until 1 to 4 months of age
Which symptoms present in a child indicate Turner syndrome? Select all that apply. a. Webbed neck b. Impaired language c. Tall stature with long legs d. Low position of posterior hairline e. Shield-shaped chest with wide space between the nipples
a, d, e Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.
Which of these age groups has the highest incidence of lead poisoning? a. Adult b. Toddler c. Adolescent d. School-age child
b
According to the Piaget's theory, which behavior does a nine-year-old child show? a. Logical reasoning b. Concrete thinking c. Object permanence d. Imaginary audience
b A child of nine years of age will exhibit concrete thinking. Logical reasoning is observed in individuals starting from the age of 11. Object permanence is observed in children between birth and two years old. The idea of being constantly observed by an imaginary audience is observed in individuals starting from the age of 11.
According to Piaget's theory, which of these statements about the period of concrete operations is true? a. A child develops a scheme for dealing with the environment. b. A child is able to describe a process without actually doing it. c. A child has the capacity to reason with respect to possibilities. d. A child believes that everyone experiences the world exactly as he or she does.
b According to Piaget's theory, a child is able to describe a process without actually carrying it out in the concrete operations period. A child develops a scheme for dealing with the environment during the sensorimotor period. A child gains the capacity to reason with respect to possibilities during the formal operations period. A child believes that everyone experiences the world exactly as he or she does during the preoperational period.
What should the nurse teach the parent of an infant who is at risk for infections? a. "You must avoid placing the infant in bright sunlight." b. "Breast-feeding will provide protection against bacteria." c. "Use soy-based infant formulas to help prevent infection." d. "The infant will be less susceptible to infections later in life."
b Breast milk contains immunoglobulin G (IgG) that protects the infant against many bacteria, such as Escherichia coli. The nurse instructs the parent to avoid placing the infant in bright sunlight for a long period of time to prevent burns, but not to prevent infections. Soy-based infant formulas are used only if the infant is allergic to lactose in the breast milk and is not used to prevent the risk for infections. Later, susceptibility would be dependent on multiple factors, including nutrition and exposure to infections
According to Piaget, which statement describes the concrete operation stage? a. During this stage, children have egocentric thoughts. b. During this stage, children are able to perform mental operations. c. During this stage, children learn to think with the use of symbols and mental images. d. During this stage, children develop an action pattern for dealing with the environment.
b During the concrete operation stage, children are able to perform mental operations. During the formal operations stage, there is prevalence of egocentric thoughts. During the preoperational stage, children learn to think with the use of symbols and mental images. During the sensorimotor stage, children develop an action pattern for dealing with the environment
Which statement describes the latency stage of Freud's psychoanalytic model of personality development? a. During this stage, genital organs are the focus of pleasure. b. During this stage, sexual urges are repressed and channeled into productive activities. c. During this stage, an infant begins to think that his or her parent is separate from the self. d. During this stage, sexual urges reawaken and are directed to an individual outside the family circle.
b During the latency stage, Freud believed that sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable. During the phallic stage, the genital organs are the focus of pleasure. During the oral stage, infants begin to think that the parent is something separate from the self. During the genital stage, sexual urges reawaken and are directed to an individual outside the family circle.
According to Piaget's theory, which period describes a child's stage of egocentrism? a. Sensorimotor b. Preoperational c. Formal operations d. Concrete operations
b During the preoperational period, children learn to think with the use of symbols and mental images. They exhibit egocentrism where they see all objects and persons as their own. The sensorimotor period occurs between birth and two years. During this period, infants develop an action pattern for dealing with the environment. The formal operations period lasts from 11 years of age into adulthood. During this period, the person is self-conscious and thinks he or she is invulnerable and tends to show risk-taking behaviors. The concrete operations period occurs between seven to 11 years of age. During this period, children are able to perform mental operations
Which of these statements about the transition from intrauterine to extrauterine life is true? a. Hyperthermia is observed in the newborn. b. Newborns are susceptible to heat loss and cold stress. c. Apgar assessments are conducted 5 and 10 minutes after birth. d. Physiological changes in the newborn occur during the first 12 hours of life.
b During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.
According to Kohlberg's theory of moral development, which stage is a part of conventional reasoning? a. Social contract orientation b. Society-maintaining orientation c. Instrument relativist orientation d. Universal ethical principle orientation
b In Kohlberg's theory, the society-maintaining orientation is stage 4 of conventional reasoning. Social contract orientation is stage 5 of postconventional reasoning. Instrument relativist orientation is stage 2 of preconventional reasoning. Universal ethical principle orientation is stage 6 of postconventional reasoning
In which stage of Kohlberg's theory of moral development does the nurse anticipate a client to realize there is more than one right point of view? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
b Level I, preconventional reasoning, stage 2, is when the nurse anticipates that the client will realize there is more than one right view. In level I, stage 1, the nurse would anticipate absolute obedience to authority and rules. In level II, conventional reasoning, stage 3, the child wants to win approval and maintain expectations of his or her immediate group. Level II, stage 4, is when the client expands focus from the relationship with others to societal concerns.
The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF). Which parental statement indicates the need for further education related to the potential for poor growth? a. "My child's diagnosis causes delayed bone growth." b. "My child will have a poor appetite, which will lead to poor growth." c. "My child will have increased oxygen demands, which will lead to poor growth." d. "My child will have a decreased ability to absorb nutrients, which will cause poor growth."
b Pediatric clients who are diagnosed with CF experience poor growth despite a healthy appetite and diet; therefore, the parental statement indicates that the infant's poor appetite will lead to poor growth indicates the need for further education. Pediatric clients diagnosed with CF experience poor growth due to delayed bone growth, increased oxygen demands, and a decreased ability to absorb nutrients.
Which is a common attribute that the nurse assesses in an "easy" child? a. Passive resistance b. Predictable habits c. Intense mood expressions d. Slow adaptation to change
b The nurse anticipates that the "easy" child will have predictable habits. Passive resistance is a trait assessed in the "slow to warm up" child. Intense mood expressions and slow adaptation to change are characteristics of the "difficult" child
What does the nurse anticipate the primary healthcare provider to advise the parents of a child newly diagnosed with a mitochondrial disorder? a. There is no risk of recurrence of this disease in the next child. b. You may need to use a donor egg for future children. c. There are more chances of miscarriage in the next pregnancy. d. You can find more information about this disease on the internet.
b The nurse anticipates that the healthcare provider will advise the parents about alternative options for starting the next pregnancy, such as using a donor egg or sperm. This is because there is a high increased risk for mitochondrial disorder in their future children. Although the mitochondrial DNA organelle itself is inherited through the mother's egg, mitochondrial disorder is complex and can be transmitted to offspring by maternal inheritance and/or mutations in nuclear DNA that follow autosomal dominant or recessive inheritance patterns, which can be inherited from either or both parents. The exact nature of how the disorder occurs for this couple will need to be explored further in a genetics clinic. The diagnosis of mitochondrial disorder in this child does not carry an increased chance of miscarriage for the mother in future pregnancies. It is not a good idea to encourage the parents to look for additional information on the internet, because some information may be inaccurate.
The nurse is discussing the neurologic reflexes seen in an infant with the parents. Which reflex will the nurse state as being present indefinitely? a. Landau b. Parachute c. Body righting d. Neck righting
b The parachute reflex appears at 7 to 9 months and persists indefinitely. The Landau reflex appears at 6 to 8 months and lasts until 12 to 24 months. Body righting appears at 6 months and lasts until 24 to 36 months. Neck righting appears at 3 months and lasts until 24 to 36 months
Which safeguards should the school nurse teach parents to assess for prior to allowing school-age clients to participate in athletic programs? Select all that apply. a. A life-long enjoyment of fitness b. The use of appropriate equipment c. The development of basic motor skills d. A physical examination every two years e. Participation in warm-up exercises prior to physical activity
b, d, e Safeguards prior to participation in athletic programs include a physical examination every two years, the use of appropriate equipment, and participating in warm-up exercise prior to physical activity. A life-long enjoyment of fitness and the development of basic motor skills are goals related to the participation in athletic programs, not safeguards.
Which school-age client does the nurse anticipate will experience sibling rivalry as a source of stress? a. A 9-year-old male b. A 7-year-old male c. A 6-year-old female d. An 8-year-old female
c
Which of these skills should be present in a six to eight month old child? a. The child pulls himself or herself to stand or sit. b. The child is able to pick small objects. c. The child can sit alone without support. d. The child can place objects into containers.
c A child of six to eight months of age should be able to sit alone without support. A child after 8 months of age should be able to pick up small objects, place objects in containers, and pull himself or herself up to stand or sit.
The nurse is providing care to the family of a preschool-age child who is diagnosed with sickle cell disease. Which statement made by the sibling would initiate a teaching session with the parents regarding discipline? a. "I really wish my brother wasn't sick all the time." b. "I am afraid that I caused my brother to get sick again because I was mad at him." c. "When I lied to my parents, I was punished for a week and my brother never gets punished." d. "I never get to go over to my friends' houses because we are always taking my brother to the doctor."
c A critical component of any child's development is discipline. Applying appropriate discipline to the child who is chronically ill or disabled can also limit the resentment and hostility that can develop among siblings if parents apply different standards to each child. The nurse's responsibility is to help parents learn successful methods of guiding the child. The statements regarding wishing that the brother wasn't sick, fears of having caused the illness, and missing play dates may require further assessment and family teaching, but the teaching would not be related to discipline.
Which period of Piaget's theory covers the prevalence of egocentrism in adolescents? a. Sensorimotor b. Preoperational c. Formal operations d. Concrete operations
c Formal operations is the fourth period of Piaget's theory. During this period, there is a prevalence of egocentric thought. This egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self-consciousness. The sensorimotor period is the first period of Piaget's theory. In this period, infants develop a schema or action pattern for dealing with the environment. The preoperational period is the second period. During this time, children learn to think with the use of symbols and mental images. Concrete operations is the third period of Piaget's theory. During this period, children are able to coordinate two concrete perspectives in social and scientific thinking.
What type of development is described under Freud's theory? a. Cognition development b. Psychosocial development c. Psychosexual development d. Moral reasoning development
c Freud's psychoanalytic model of personality development sets forth five stages of psychosexual development. Each stage is characterized by sexual pleasure in a part of the body: the mouth, the anus, and the genitals. Piaget's theory of cognitive development includes four periods that are related to age and demonstrate specific categories of knowing and understanding. According to Erikson's theory of psychosocial development, an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Kohlberg's theory of moral development expands on Piaget's cognitive theory.
Which should the nurse anticipate, according to Erikson, when assessing a preschool-age child? a. Being engaged in tasks b. Questioning sexual identity c. Having highly imaginative thoughts d. Wanting to participate in organized activities
c The nurse would anticipate that a preschool-age child would have highly imaginative thoughts, according to Erikson. Being engaged in tasks and wanting to participate in organized activities is expected for the school-age child. Questioning sexual identity is expected for the adolescent.
A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate? a. Domestic mimicry b. Causal relationship c. Spatial relationship d. Object permanence
c The toddler's ability to recognize the shapes of objects and fit smaller boxes in larger boxes indicates awareness of spatial relationships. If the toddler is acutely aware of others' actions and attempts to copy them in gestures and words, it indicates domestic mimicry. When the toddler explores an object each time it appears in a new place, it indicates an awareness of causal relationships. If the toddler understands that objects continue to exist even when they cannot be observed in the same place, it indicates an awareness of object permanence
A child wants to be on time for a family dinner. According to Kohlberg's theory, what stage of development is the child going through? a. Good boy-nice girl orientation b. Society-maintaining orientation c. Instrumental relativist orientation d. Universal ethical principle orientation
c When a child wants to be on time for a family dinner, this thought exemplified the instrumental relativist orientation stage. A child at this stage follows his or her parent's rules. During the good boy-nice girl orientation stage, a child wants to win the approval of and maintain the expectations of one's immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. During the universal ethical principle orientation stage, the concept of "rightness" is defined by self-chosen ethical principles
The nurse is learning about the shift in total body fluid that occurs from infancy to adulthood. What percentage of body weight is the weight of extracellular fluid (ECF) in an infant at term? a. 10% b. 20% c. 44% d. 78%
c he amount of ECF is 44% of the body weight at term. The initial birth weight of a term newborn can decrease by 10% in the first 5 days of life due to ECF compartment contraction, enhanced renal tubular function, and rapidly increasing glomerular filtration rate. The amount of ECF is 20% in adulthood. At birth, 78% of the infant's body weight is water—ECF occupies a significant part of it.
Which statement is true about Piaget's theory of cognitive development? a. Piaget's theory includes five periods that are related to age. b. In the late preoperational stage, the children experience animism. c. In the preoperational stage, children are able to perform mental operations. d. During the sensorimotor stage, infants develop an action pattern for dealing with their environment.
d According to Piaget's theory, during the sensorimotor stage, infants develop a schema or action pattern for dealing with the environment. Piaget's theory includes four periods which are related to age. In the early preoperational stage, children experience animism. During the concrete operations stage, children are able to perform mental operations.
Which client may have concerns related to sexuality when hospitalized with a chronic illness? a. An 8-year-old b. A 10-year-old c. A 12-year-old d. An 18-year-old
d An 18-year-old client is an adolescent, which is the stage of development where concerns about sexuality may occur when hospitalized with a chronic illness. The other clients are not developmentally characterized as adolescents; therefore, the nurse would not anticipate an 8-year-old, 10-year-old, or 12-year-old to have this concern.
While performing the physical assessment of an infant, the nurse notices the infant has developed a color preference for red and yellow. What is most likely to be the age of the infant? a. 4 weeks b. 8 weeks c. 15 weeks d. 20 weeks
d An infant develops a color preference for yellow and red between 20 to 28 weeks of age. At 4 weeks, the infant can follow a range of 90 degrees. Between 6 to 12 weeks of age, the infant develops peripheral vision to 180 degrees. Between 12 to 20 weeks of age, the infant is able to accommodate to near objects.
The parents of a preschooler tell the nurse that they try to inculcate good eating habits by asking the child to be at the table until the "plate is clean." What condition is the child at risk for? a. Anorexia b. Depression c. Aggression d. Poor eating habits
d Asking the child to be at the table until the "plate is clean" results in overeating and develops poor eating habits later in life. Anorexia is seen if the child does not consume the required amount of food. Depression may be seen in a child if there are any psychological issues. Aggression occurs from sociocultural and familial influences on the child.
According to Erikson's stages of life, what is the stage when a child begins walking, feeding, and using the toilet? a. Trust versus mistrust b. Initiative versus guilt c. Identity versus role confusion d. Autonomy versus sense of shame and doubt
d At one to three years of age, the child starts walking, feeding, and using the toilet on his or her own. This stage is one of autonomy versus sense of shame and doubt. The stage from birth to one year when the infant develops trust toward parents or the caregiver is known as the trust versus mistrust stage. The initiative versus guilt stage is marked by the child's fantasies and imaginations motivating the child to explore the environment. The identity versus role confusion stage begins after adolescence. During this stage, an individual tries to find out his or her own identity.
What is the reason for calculating a body mass index (BMI)-for-age during a health maintenance assessment for school-age clients? a. Assessing for bulimia nervosa b. Monitoring for failure to thrive c. Monitoring for anorexia nervosa d. Assessing for obesity or overweight
d Due to the increasing number of overweight children in the United States, the BMI charts are a critical component of children's physical assessment. BMI-for-age may be used to identify children and adolescents at the upper end of the distribution who are either overweight (at or above 95th percentile) or at risk for being overweight (at or above the 85th percentile and below the 95th percentile). Assessing for bulimia nervosa and anorexia nervosa is more appropriate for an adolescent versus a school-age child. Assessing for failure to thrive (FTT) is more appropriate for the infant, toddler, and preschool-age child.
In which stage of Kohlberg's theory of moral development does the nurse anticipate a client to expand focus from relationships with others to societal concerns? a. Stage 1 b. Stage 2 c. Stage 3 d. Stage 4
d Level II, conventional reasoning, stage 4 is when the nurse anticipates a client will expand focus from the relationship with others to societal concerns. In level I, preconventional reasoning, stage 1, the nurse anticipates absolute obedience to authority and rules. In level I, preconventional reasoning stage 2, the nurse anticipates that the client will realize there is more than one right view. In level II, preconventional reasoning stage 3, the client wants to win approval and maintain expectations of his or her immediate group.
A community health nurse makes a home visit to a disabled 13-year-old client who has a 6-month-old infant sister. The infant lies quietly in her crib and rarely smiles or vocalizes; it appears that the infant barely has her basic needs met. What is the nurse's most appropriate intervention? a. Advise the parent that the infant will be retarded if not stimulated. b. Ask the disabled client to spend more time playing with the sister. c. Encourage purchasing toys that are appropriate for the infant's age level. d. Determine whether there is anyone who can help with chores and the infant's care.
d Recruiting someone to help with chores and infant care will allow the parent time to rest and will provide the infant with care and attention. Making the parent feel guilty is not therapeutic and will increase anxiety. The disabled sibling requires attention, and this responsibility may cause jealousy, rivalry, and resentment. Toys need not be employed for sensory stimulation; household objects and quality human contact can serve as well.
Which should the nurse encourage for the adolescent client diagnosed with a chronic illness to achieve independence from family? a. Using coping skills b. Wearing make-up c. Buying stylish clothes d. Socializing with peers
d Socialization with peers should be encouraged for adolescent clients diagnosed with a chronic illness to achieve independence from family. Use of coping skills helps the adolescent develop a personal identity. Wearing make-up and buying stylish clothes allows the adolescent to learn through abstract thinking
The parents of a preschooler are worried, because the child is often seen talking to imaginary friends. The parents admit that they often scold the child for such behavior. Of what does the nurse inform the parents? a. "The child may develop severe psychological problems." b. "You must involve the child in some spiritual activities." c. "There may be some neurologic or developmental issue." d. "The behavior is normal at this age and it will help counter loneliness."
d Sometimes children create imaginary friends to help counter the feelings of loneliness. Therefore the nurse should tell the parents that it is a normal behavior. Speaking to imaginary friends is a habit that children overcome later in life and, therefore, there is no risk for developing any psychological problems. It is not necessary to involve the child in any spiritual activity if the parents do not desire to do so. A neurologic problem is suspected if the child exhibits jerking movements or experiences fainting spells.
Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action? a. Highly active in childhood b. Absent around the umbilicus c. Widely distributed throughout the body d. Grow in conjunction with axillary hair follicles
d The apocrine sweat glands secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action. These glands grow in conjunction with hair follicles around the axillae. The apocrine glands are inactive during childhood and reach their secretory potential at the time of puberty. The apocrine glands are situated around the umbilicus. They have limited distribution and are found only around the axillae, areolae, external auditory canal, and anal and genital regions. Eccrine sweat glands, not the apocrine glands, have wide distribution throughout the body.
A child who is recently admitted to school is introverted and prefers being alone at the school. What is the temperament of the child according to Stella Chess and Alexander Thomas's longitudinal study? a. The easy child b. The difficult child c. The hyperactive child d. The slow to warm-up child
d The child will be categorized as a slow to warm-up child. These children are uneasy or cautious in new situations or with unfamiliar people. They react negatively with mild intensity to new stimuli. An easy child is open and adaptable to change and displays a mild-to-moderately intense mood that is typically positive. A difficult child adapts slowly to new routines, people, or situations. This type of child has intense mood expressions with negative behavior. A hyperactive child usually has problems concentrating and paying attention.
The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics and hypogenitalism. Which chromosomal notation is associated with the child's condition? a. 45,XO b. 47,XXX c. 47,XYY d. 48,XXXY
d The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.
Which nursing action is most accurate when assessing the chest circumference of a newborn during the initial physical assessment? a. Measuring during expiration only b. Taking three measurements and recording the average c. Measuring during inspiration and plotting this data on the growth chart d. Placing the measuring tape around the rib cage at the nipple line
d The most accurate nursing action when assessing the chest circumference of a newborn during the initial physical assessment is to place the measuring tape round the rib cage at the nipple line. Two measurements should be performed, one during inspiration and one during expiration. The average of these two measurements is then plotted on the growth chart.
