PrepU Chapter 21 Developmental Concepts

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The nurse is assessing a 15-year-old who was involved in a fight at school. Which client statements would the nurse see as evidence that this child is delayed in Erickson's developmental stages? Select all that apply. "I am strong and I want to protect people." "I do not trust anyone." "I want to decide what I do with my life." "I really don't have many friends, nobody likes me." "I am not good at anything."

"I do not trust anyone." "I really don't have many friends, nobody likes me." "I am not good at anything." Learning to trust occurs in infanthood. Ability to trust should be established by adolescence. Learning to feel adequate is a task of toddlerhood. Feeling of adequacy should be addressed in the school-age child. In adolescence the child tries on new roles (protector in this case) and decides what direction to take in life.

A client says, "I thought my period was late because I was drinking heavily and did cocaine a couple of times lately. But my pregnancy test is positive and I am scared about what I may have done to the infant." What information should the nurse provide about the possible effects of substance use on the infant? Select all that apply. "The medical care you get now can reverse any damage." "There is a risk for birth defects in the infant." "There is a risk the infant will be born with a low birth weight." "As long as you were eating well, the infant is probably fine." "Your infant may be born prematurely."

"There is a risk for birth defects in the infant." "There is a risk the infant will be born with a low birth weight." "Your infant may be born prematurely." Substance use increases the risk for congenital anomalies, low birth weight, and prematurity. Good nutrition will not protect the infant from these effects. Medical care cannot reverse damage already done, but may help prevent further damage. làm tăng nguy cơ dị tật bẩm sinh, nhẹ cân và sinh non.

A nurse is providing care to several children at the local clinic. When assessing each child, in which child would the nurse expect to find the ability to think abstractly and use deductive reasoning? 3-year-old male 13-year-old female 5-year-old female 8-year-old male

13-year-old female The formal operations stage, typical of children between the ages of 11 or 12 to 14 or 15 years, is characterized by the use of abstract thinking and deductive reasoning. A 3-year-old and a 5-year-old are in the preoperational stage of cognitive development, which is characterized by the beginning use of symbols. An 8-year-old would be in the concrete operational stage, which involves learning by manipulating concrete or tangible objects and classifying articles according to two or more characteristics. This stage is also characterized by the development of logical thinking.

A nurse is working in a pediatric clinic. The parent has brought in the 2-year-old toddler for a well-child checkup. The parent asks what the common health problems are common for this age. The nurse's correct reply includes which of the following? Lice infestation Accidents Scoliosis Food allergies

Accidents Accidents are a major health concern for toddlers due to their mobility and exploration of their environment. Food allergies are a common health concern during infancy. Scoliosis and lice infestation are more commonly seen in school-age children.

Which developmental theorist created the psychosocial theory of development? Piaget Erikson Freud Maslow

Erikson Erikson's psychosocial theory of development encompassed social and cultural influences.

What are the two factors that drive growth and development? Environment and fertility Healthcare and perception Genetics and environment Nutrition and exercise

Genetics and environment Two primary factors drive growth and development: genetics and environment.

A nurse is reading a journal article about growth and development. The article goes on to describe the concept of transformation. The nurse demonstrates understanding of the information by identifying which theorist as being identified with this concept? Erikson Havighurst Gould Piaget

Gould Gould (1978), a psychiatrist trained in a psychoanalytic perspective, studied men and women between the ages of 16 and 60 years, labeling the central theme for the adult years as transformation, with specific beliefs and developmental phases. Havighurst believed that living and growing were based on learning and that a person must continuously learn to adjust to changing conditions. Piaget believed that learning occurred as a result of the internal organization of an event. Erikson believed that development was a continuous process made up of distinct stages characterized by the achievement of developmental goals affected by the social environment and significant others.

The nurse is seeing 6-year-old Patrick in the clinic. As the nurse is measuring height and weight for Patrick, his mother comments on how much he has grown since his last checkup. The nurse knows that this increase in size is which of the following? Development Growth Prepubescent Cephalocaudal

Growth Explanation: Growth is an increase in body size, or changes in body cell structure, function, and complexity. Development is an orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning. Cephalocaudal means proceeding from head to tail. Pubescence is the time when secondary sex characteristics continue to develop, and ova and sperm begin to be produced by the reproductive organs.

The nurse is caring for a mother of a healthy infant age six months. The mother expresses concern about the child putting everything in his mouth. The nurse uses Freud's theory to teach the mother which of the following about this behavior? It shows early neuromuscular control. It allows the infant to gain trust. It is abnormal for this age. It is a way that the infant explores.

It is a way that the infant explores. Freud's theory includes the oral stage, in which the infant uses his or her mouth as the major source of gratification and exploration. It is normal for this age. Early neuromuscular control is related to Freud's second stage. Gaining trust has to do with Erikson's theory of development.

As a nursing student is visiting a day care to observe growth and development in action. The nursing student completes assessments on infants and toddlers who are learning to walk, talk, and control elimination. According to Freud, in what developmental stage are they? Phallic; genital Oral; anal Relationships and events Trust versus mistrust

Oral; anal During the oral stage, Freud indicates that the infant uses his or her mouth as the major source of gratification and exploration. Pleasure is experienced from eating, biting, chewing, and sucking. Freud goes on to say that toilet training is a crucial issue, requiring delayed gratification as the child compromises between enjoyment of bowel function and limits set by social expectations. Trust versus mistrust is Erikson's theory. The Phallic stage is Freud's preschool theory. The relationships and events theory belongs to Piaget.

Cognitive development theory states that human nature is essentially rational and that the individual's basic goal is to learn to master the environment. Which of the following cognitive processes involve the rearranging and structuring of one's knowledge and thoughts? Assimilation Adaptation Organization Accommodation

Organization Explanation: The rearranging and structuring of one's knowledge and thoughts is called organization. Assimilation is the ongoing process of organizing new information into existing knowledge. Adaptation is the process of assimilating and accommodating new information. Accommodation is the process of resolving the disequilibrium resulting from the modifications needed in thought processes to incorporate new data.

A student nurse is enrolled in a growth and development class. Which of the following Freudian stages should the student nurse recognize in a child with an increase in gender difference awareness? Anal Stage Phallic Stage Oral Stage Latency Stage

Phallic Stage The Phallic Stage is the stage in which a child develops an increased awareness of gender differences. The Oral Stage is when the infant uses his or her mouth as a major source of satisfaction. The Anal Stage is when toilet training is taking place with the child. The Latency Stage involves identification with the same sex parent.

Newborns are capable of activities such as grasping objects and displaying basic reflexes. To which of the following of Piaget's cognitive developmental stages do the newborns belong? Preoperational Sensorimotor Formal operational Concrete operational

Sensorimotor Newborns belong to the sensorimotor stage of cognitive development, characterized by activities such as grasping and displaying basic reflexes. The preoperational stage is characterized by assigning meaning or identity to an object governed by own perceptions. The concrete operational stage is characterized by concrete thinking and using more logic. The formal operational stage emerges around 12 years of age and is characterized by the ability to think abstractly.

A mother, 13 years of age, delivers a low-birth-weight neonate. The neonate is transferred to the neonatal intensive care unit. The mother reports receiving occasional prenatal care and has a history of excessive alcohol consumption. The growth and development of this neonate has been influenced by which of the following? Prenatal factors Spiritual factors Caregiver factors Individual factors

Prenatal factors Fetal development can be altered by prenatal factors such as maternal age (with risk greater in those under age 15 and over age 35), maternal substance use, inadequate prenatal care, and inadequate maternal nutrition. Individual factors might result in altered development from birth through adolescence and may include congenital or genetic disorders, brain damage from accidents, or abuse, sensory impairments, and substance use. Caregiver factors that negatively affect development are neglect and abuse, mental illness, intellectual disability, or a severe learning disability. Spiritual factors, such as religious beliefs, are not a factor in this situation.

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' height and weight as they file through her station, where she observes that there is a large variation in physical size and emotional maturity. Which of the following factors may affect physical growth of children? Choose all that apply. Prenatal nutrition Availability of books Physical activity Heredity Colorful toys

Prenatal nutrition Physical activity Heredity Many different factors influence both growth and development. Growth and development might be facilitated or delayed by genetic heredity; prenatal, individual, and caregiver factors; and environment and nutrition. Colorful toys and books help create a stimulating environment, but probably do not contribute to physical growth.

Genomic information can identify gene mutations and environmental influences that can impact a pregnancy. What are the implications for nursing practice related to this advancement? Provision of appropriate health teaching Counsel clients to stop smoking Promote no EtOH intake during pregnancy Advise clients of need for better nutrition

Provision of appropriate health teaching Regarding the ongoing genomic research, nurses need the knowledge base to be able to answer questions, provide appropriate health teaching, and counsel or direct patients at risk to available resources. The other choices are all good interventions for nurses to include for pregnant patients, but not necessarily related to genomic research.

The nurse is seeing a male client 6 years of age in the clinic. As the nurse is measuring height and weight for the client, his mother comments on how coordinated he is becoming. The nurse knows that this increase in coordination is which of the following? A reflex Part of being prepubescent Related to development Due to growth

Related to development Growth is an increase in body size, or changes in body cell structure, function, and complexity. Development is an orderly pattern of changes in structure, thoughts, feelings, or behaviors resulting from maturation, experiences, and learning. Pubescence is the time when secondary sex characteristics continue to develop, and ova and sperm begin to be produced by the reproductive organs. Developing coordination is not a reflex.

A nurse is observing a child pick up a rattler and shake it to hear a sound. The nurse understands that the child is considered to be in which of the following of Piaget's Cognitive Development stages? Formal Operational stage Preoperational stage Sensorimotor stage Concrete Operational stage

Sensorimotor stage A child who picks up a rattler to shake it is considered to be in Piaget's Sensorimotor stage. This shows the child relating his or her own behavior to the environment. In the Preoperational stage the child uses symbols and pictures to represent themselves. In the Concrete Operational stage the child can manipulate objects. With formal Operational stage the child uses abstract thinking.

According to Freud, which of the following influences is the primary force that drives an individual's development? Autonomy Faith Sexuality Security

Sexuality According to Sigmund Freud, the stages of development are based on sexual motivation. Sexuality supersedes security and autonomy, though both are highly significant and are influenced by sexual motivation. Faith is not a central construct in Freud's theory of development.

During a well-child visit, the nurse observes a 3-year-old girl who climbs up into her father's lap and says, "I am going to marry you when I grow up, Daddy." What determination does the nurse make about this observation? This child is in the latency stage of Freud's theory of the mind. This child is developing an unhealthy attachment to her father. This child is experiencing the Electra complex which is normal at this age. This is a strong clue that this child may be being sexually abused.

This child is experiencing the Electra complex which is normal at this age. The Electra complex is based on feelings of intimate sexual possessiveness for the opposite-sex parent. It is normal during the phallic stage of development and will likely resolve. The latencystage does not begin until much later in childhood (age 7). There is no indication that this child is being sexually abused by the father or has an unhealthy attachment to him.

A nurse is presenting a workshop for a group of young women. Part of the workshop focuses on the moral development of women. The nurse integrates information about Gilligan's theory into the presentation, describing the various levels that a woman goes through as morality develops. When describing level 1, the nurse would focus on which area? Acceptance by others Woman's own needs Move from selfishness to responsibility Adoption of social values

Woman's own needs Explanation: In level 1, the focus is on the girl's or woman's own needs. Should and would are the same. The transition that follows this level is characterized by the move from selfishness to responsibility—a move that integrates the responsibility to care for oneself with the desire to care for others. In level 2, moral judgment is based on shared norms and expectations, and societal values are adopted. Acceptance by others becomes critical, and the ability to protect and care for others becomes the defining characteristic of female goodness.

According to Havighurst, learning behaviors are based upon developmental tasks. In assessing an adult client, the nurse is aware that a common developmental task of middle adulthood includes: adjusting to retirement and reduced income. learning to live with a marriage partner. assisting children to become responsible adults. preparing for a career.

assisting children to become responsible adults. Assisting children to become responsible adults is a developmental task of middle adulthood. Preparing for a career is a task of adolescence. Learning to live with a marriage partner is a developmental task of young adulthood. Adjusting to retirement and reduced income is a developmental task of later maturity.

The nurse assesses that a child is in Piaget's preoperational stage of cognitive development. The nurse anticipates which behaviors from Erikson's psychosocial stages in this child? Select all that apply. Development of sense of self Development of purpose Beginning interpersonal skills Development of competence Exploration of personal identity

Beginning interpersonal skills Development of purpose Piaget's preoperational stage of cognitive development and Erikson's psychosocial stage of initiative versus guilt both occur during preschool to early school years. Initiative versus guilt is characterized by the development of interpersonal skills through activities with others and the development of purpose. Development of competence occurs in industry vs. inferiority. Exploration of personal identity and sense of self occur in identity vs. role confusion.

A 25-year-old client is a college graduate and is married with one child. During a wellness visit, the client confides, "I just feel like something is missing from my life. Maybe I need to make a career change." How would the nurse familiar with Levenson and associates' theory of development interpret this statement? As a danger sign that the client is about to undergo a damaging transformation. As indicating this client is advanced in thinking through life development. As indication that the client is lagging in developmental tasks. As a normal finding for a client at this stage of development.

As a normal finding for a client at this stage of development. Levinson and associates' stage of "entering the adult world" occurs around ages 22 to 28. People are building on past decision and choices but may feel something is "missing" from their lives. Decisions are made to either find a new direction in life or to make a stronger commitment to previous choices. There is no indication that this transformation will be damaging.


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