10&11&12 pedi
A 4-year-old child is admitted to the hospital with a diagnosis of leukemia. The mother is very upset and tells the nurse that the child has not wet the bed in 18 months. She asks the nurse why all of a sudden the child is wetting the bed. What is the best explanation for this behavior by the nurse to the mother?
"A child's behavior may go backward to an earlier stage of development during an acute illness."
During the annual physical examination, a teenage client tells the nurse that she is anxious as well as frustrated because of the acne on her face. Which is the best response for the nurse?
"This is one of the most common physical changes during adolescence."
A client arrives at a healthcare facility complaining that her daughter frequently sucks her thumb. The client wants to know about the adverse effect of thumb sucking. What would be the best response from the nurse to the client?
"Thumb sucking in children may cause permanent damage to the child's mouth structure."
The nurse is caring for an elderly woman and notices that she is not using her cane properly. Which of the following statements by the nurse would most likely elicit a positive response from the patient?
"You use the cane the way I did before I was shown a way to keep from tripping over it; do you mind if I show you?"
A 55-year-old middle-aged professor is contemplating retirement from teaching because of a wonderful buyout offer being presented to potential candidates by the university. The client shares this information with the nurse who is collecting data and vital signs as a follow-up visit to the primary care provider for hypertension. What suggestions should the nurse provide to the client at this time? 1Encourage development of hobbies and interests in the community. 2. Make sure to explore possibilities for part-time work. 3. Spend money on an extended vacation before retirement. 4. Maintain current home and buy a condo in a warmer winter climate.
1,2
A teenage client who has lived on a college campus in the late teen and early adult years has been surrounded by similar aged and like-minded individuals. As the client has moved away from college and left the family of origin, the client tells the nurse of being lonely. The client asks the nurse about relationships at this time in life. What should the nurse tell the client about relationships? 1.Encourage relationships that include coworkers 2.Encourage male and female housemates 3.Discourage homosexual relationships 4.Discourage religious orders
1,2
A gentleman that is being assessed for high blood pressure tells the nurse that he is worried about his teenage son who has started using drugs and alcohol and does not listen to him. What should the nurse suggest to the client to help his son overcome peer pressure? 1. Model safe habits and practices. 2.Promote a safe home environment where the son receives appropriate responses. 3. Give information about the hazards of risk taking. 4. Acknowledge inappropriate practices that the son participates.
1,2,3
A nurse educator is explaining cognitive development in children to a group of nursing students, with the help of Piaget's theory of cognitive development. The nursing instructor asks the group of nursing students to identify the characteristics of cognition at the level of concrete operations. Based on this information, what would be the correct characteristics identified by the nursing students at the concrete operations level of Piaget's theory? 1. Reversibility 2. Seriation 3. Conservation of matter 4. Complex problem solving
1,2,3
A middle-aged female client has recently lost her spouse to pancreatic cancer. The client shares with the student nurse that she does not anticipate being able to achieve all the professional goals before retiring or dying. Based on this information, the student nurse is preparing a postclinical summary on the consequences of an adult's failure in resolving a midlife crisis. What topics should the student nurse plan to include in the report? 1. Brooding 2. Physical illness 3. Criminal tendencies 4. Chemical dependency
1,2,4
During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend, but does not know much about sex. Why is it important that the nurse assist in providing sex education to teenagers? 1. Adolescents will seek answers elsewhere. 2. Unwholesome attitudes may develop from information from peers. 3. Repetition of correct beliefs that they receive from older adolescents is critical. 4. Premature and unsafe sexual activities could occur.
1,2,4
During a routine checkup, a 33-year-old unmarried client reveals that she is anxious to start a family and have a baby. What challenge should the nurse discuss with the client about this concern?
1,3
A gentleman that is being assessed for high blood pressure tells the nurse that he is worried about his teenage son who has started using drugs and alcohol and does not listen to him. Why do adolescents take risks with their health and relationships? 1. Define their identity 2. Exert their interdependence 3. Prove to peers that they are maturing 4. Peer pressure
1,3,4
During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend, but does not know much about sex. Why does the nurse need to counsel this potentially sexually active adolescent? 1. Sexual activity at younger ages is increasing. 2. Young girls use birth control pills more when they are available. 3. Incidence of sexually transmitted infections is on the rise. 4. Condom use helps prevent sexually transmitted infections.
1,3,4
The nurse is collecting data about a baby in the well-baby clinic. The nurse reads in the electronic medical record that cephalocaudal direction movements are present. What are examples of cephalocaudal direction movements? 1. Lift head before sitting 2. Sit before walking 3.Roll over before grasping objects Make sounds 4.before being able to walk
1,4
According to Erikson, developmental challenges are influenced by a variety of issues confronting the individual. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, what expectations should the nurse review with the client that will greatly influence romantic relationships and their forms? 1. Individual characteristics 2. Cultural patterns 3. Societal expectations
2,3
During the annual physical examination of an adolescent girl, the adolescent reveals to the nurse that she is interested in having an intimate relationship with her boyfriend but does not know much about sex. How can the nurse help this client form a healthy sexual attitude? 1. Tell her that she should have no questions about sexual preferences. 2. Review pubertal changes that occur in the body. 3. Provide information about sex. 4. Review that sexual activity at younger ages is decreasing.
2,3
According to Erikson's theory, at each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. The student nurse is preparing a short report for a postclinical conference during the pediatric rotation. The student nurse is doing a case study report on the assigned child and family for which she cared during the clinical experience. The family consists of an infant, school-aged child, teenager, mother, and father. What individuals in this family exert the most lasting influence on the ongoing development of the infant? 1. School-aged child 2. Teenager 3. Mother 4. Father
3,4
student nurse is preparing a report about the stages of development in early adulthood. Based on integrating concepts on the theories of early adulthood, which is the correct sequence that the student nurse should review of the stages of development? 1. Reappraising commitments 2. Establishing adult relationships 3. Starting a family 4. Choosing a career
4, 2, 3, 1
Play is important to child development. Children learn about the world through play. Infant and toddler play is usually an interaction among children, the family, and simple toys. The nurse asks the mother of a toddler how long the child plays with one toy or with the family dog. The nurse is collecting this information during an admission interview. What answer by the mother would best be considered a normal finding to the nurse of the attention span of a toddler?
5-10 minutes
There are characteristics and a normal sequence of human growth and development. A cousin who is a nurse is watching the niece's children while the niece attends calling hours for their uncle. The youngest child continuously smiles, babbles, follows the light in the funeral home, and reacts to the noises in the environment. Based on this information, the nurse knows that this child is most likely approximately what age?
6 weeks
When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on Erikson's theory of psychosocial development, which should the nurse identify as the major priority challenge faced by adolescents?
Achieving their own identity
A client expresses anxiety regarding the 20-year-old daughter's ability to handle effectively the pressures of a career as a social worker. What factor is of highest priority in the daughter's ability to adapt to adverse circumstances in career that the nurse should address with the client at this time?
Adjustments made by her throughout childhood and adolescence
nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
After age 12 children can think in the abstract including complex problem solving.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the formal operations level of cognitive development?
After age 12 children can think in the abstract, including complex problem solving.
When the nurse views the family as context, the primary focus is on the health and develop- ment of an individual member existing within a specific environment (i.e., the patient's fam- ily). Although the focus is on the individual's health status, the nurse should
Assess how much the family provides the patient's basic needs.
The nurse is interviewing a patient who is being admitted to the hospital. The patient's family went home before the nurse's interview. The nurse asks the patient, "Who decides where to go on vacation?" In asking this, what is the nurse trying to do?
Assess the family structure.
A couple with young children asks the nurse about the factors that contribute to a strong family unit. What instruction is of highest priority for the nurse to provide to the parents?
Authority, provider, and protector of the family reside with the father.
Parents ask the nurse how they will know when their daughter has reached puberty. Which is the best response by the nurse?
By age 14, many girls have the physical appearance of a young woman."
When focusing on older adults, the nurse must be aware that
Caregivers may be spouses or middle-age children.
Social scientists have identified four threats facing the family in today's American society. Of the choices below, what are the four threats? (Select all that apply.)
Changing economic status Homelessness Family violence Presence of illness
The nurse is collecting data from a 4-year-old client and mother. What are the normal cognitive and motor development expectations that should be observed by a nurse in a 4- year-old child?
Children can state their full name and age.
A nurse is explaining cognitive development in children to a client, with the help of Piaget's theory of cognitive development. What would be the best explanation by the nurse about the preoperational level of cognitive development?
Children from ages 2 to 7 years investigate and explore the environment and look at things from their own point of view
A 23-year-old recent college graduate is confused about the next steps to take in life. During a visit to the primary care office for an influenza immunization, the client asks the nurse what to do next in life. Based on the information from this young adult, what should the nurse encourage as the best avenue for the client at this time?
Choosing a occupation
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients will have the highest incidence of experiencing nocturnal emissions?
Clients in the age group of 12 to 20 years
A teenage female client, when being assessed by the nurse for a minor injury, is curious to know what can be identified as the greatest challenges she will face in early adulthood. What would be the best response by the nurse at this time?
Completing education and choosing an occupation
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, what is the best explanation of Erikson's theory of psychosocial development during the early adult period?
Confronting choices about occupation, education, relationships, living environment, and independence
The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of the pubescence stage?
Desire for independence
There are characteristics and a normal sequence of human growth and development. The nurse sees a 2-month-old child in the pediatrician's office. This is the first child for a new mother. One day after the child was born, the mother asks the nurse to describe what the expectations are for the child during the first 3 months. Based on the mother's question to the nurse, what would be the best explanation by the nurse about the major level of cognitive development for a 2-month-old child?
Develop preferred sleeping position and cry to signal needs
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, what is the best example of psychosocial development during the middle adult period?
Developing the intellectual self by working on advance degrees and reading extensively
A client with a 3-year-old son wants to know the impact of her child failing to meet a challenge in the developmental process. Based on the data collected the nurse knows that what would occur if Erikson's theory of psychosocial development is applied?
Difficulty achieving the next level of development
When discussing the growth and development of an infant with a client, the nurse refers to various theories and phases of development. The nurse is reviewing the major points of Erikson's theory with a client. What would be the best explanation of this theory to the client by the nurse?
Each stage of development contains a psychosocial challenge or critical period during which the person must deal with a major life change.
A nurse is taking care of a teenager who complains about involuntary discharge of semen while sleeping. The nurse observes that the client is confused and does not know about the pubertal changes that are taking place in his body. Based on this information, what is the highest priority area that should be reviewed with the client?
Educate the client about the changes that occur during adolescence
A teenage boy, while being assessed for fever, reveals to the nurse that he is interested in having an intimate relationship, but is afraid of sexually transmitted infections (STIs). How can the nurse best help this client?
Educate the client to use condoms.
A career woman working in a nonprofit organization tells the nurse that she is considering divorcing her husband. She wants a better life for herself and four children. Based on this information, which was provided during a visit to the primary c
Encourage the client to carefully review the possible risk of financial instability that could occur.
The father of a 15-year-old boy is worried because he wants to discipline his son in an age-appropriate manner. While the boy is being assessed for diabetes, the father reveals this concern to the nurse. How should the nurse best help the client?
Explain the importance of adult respect toward adolescents.
During an assessment, a 40-year-old client who is a fireman discusses retirement concerns with the nurse and asks for suggestions. The client owns three homes and is single at the present time. Which is the highest priority suggestion for the nurse to give the client?
Explore possible outside interests from career with the client.
The nurse is caring for an elderly patient who has no apparent family. When questioned about his family and his definition of family, the patient states, "I have no family. They're all gone." When asked, "Who prepares your meals?" he states, "I do, or I go out." Given the three differ- ent approaches to family nursing practice, which would be most appropriate for this patient?
Family as context
Different approaches may be taken to family nursing practice. When the nurse is caring for a patient who needs constant care in the home setting and for whom most of the care is provided by the patient's family, what is the best approach for the nurse to take?
Family as system
The nurse is caring for a patient in hospice. As she observes the family dynamics, she notes that the patient is getting adequate care, but the wife is not sleeping well and needs rest. The nurse also assesses the need for better family nutrition and meals assistance. The nurse dis- cusses these assessments with the patient and his family and formulates a plan of care with them to address these issues. The nurse is utilizing which approach to family nursing practice?
Family as system
It is essential for family members to realize that a family's beliefs, values, and practices strongly influence the health-promoting behaviors of its members, and to understand that
Family environment in early life has a strong influence on later health practices.
Although the family as a whole differs from individual members, the measure of family health is more than a summary of the health of all members. Of the following, what areas are unique to family assessment? (Select all that apply.)
Family form Family structure Family function Family health
Balancing employment and family life creates a variety of challenges in terms of child care and household work for both parents. This has major implications in health care because?
Fathers now participate more fully in day-to-day parenting responsibilities.
The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of middle adolescence stage?
Fluctuations in self-assurance
A young homosexual adult explains to the nurse during an office visit that he has recently decided to inform his friends about his relationship and would like to know about the major challenges that he might face. Which should the nurse identify as the highest priority challenge for the client?
Gathering social support
The student nurse is preparing a short oral report for postclinical discussion on adolescent stages of growth and development. Based on the information that adolescence can be divided into stages, what would be the best explanation of the main characteristics of late adolescence stage?
Grapple with every day issues
The nurse is providing discharge teaching for an older adult woman who will need dressing changes at home. Her husband, who is also elderly, is her only source of care. The husband states that he will not be able to perform the dressing changes. What does the nurse need to ar- range for?
Home care service referrals
A nurse is reviewing the data collection of a middle-aged client. When reviewing the status of a middle-aged client's psychosocial development, which activity is the highest priority for the nurse to explore further with the client?
How the client balances the needs of others
There are characteristics and a normal sequence of human growth and development. The nurse sees a 3-month-old child in the pediatrician's office. The mother asks the nurse what the normal level of cognitive development should be for a 3-month-old child. Based on this information, what would the nurse teach the client's mother as being the major level of cognitive development for a 3-month-old child?
Laughs, squeals, and looks at objects for several seconds, and reaches for and grasps snall objects
The student nurse has been assigned to four clients. The student nurse has to prepare care plans for the client assignment and incorporate Erikson's psychosocial development concepts. Which client should the student nurse recognize as most likely to be in the phase of stagnation?
Middle-aged adult client
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, which is the best explanation by the nurse of generativity?
Occurs in middle adulthood when individuals decide to pass on learning and share skills with younger generations
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, which is the best explanation by the nurse of stagnation?
Occurs in middle adulthood when individuals focus on individual pursuits and interests
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, which is the best explanation by the nurse of intimacy?
Occurs in young adulthood when individuals choose to establish relationships
When discussing the growth and development of an adult, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adult client. Based on this information, which is the best explanation by the nurse of isolation?
Occurs in young adulthood when individuals choose to remain detached from others
A nurse is addressing a group of schoolteachers on the importance of sex education for children. What should the nurse emphasize as the highest primary source of sex education information for adolescents?
Parents
According to Erikson's theory, at each stage of development, a significant person or group exerts a lasting influence on the ongoing development of the child. The student nurse is preparing a short report for a postclinical conference during the pediatric rotation. The student nurse is doing a case study report on the assigned child and family the nurse care for during the clinical experience. The family consists of an infant, school- age child, teenager, mother, and father. Which individual exerts the most lasting influence on the ongoing development of the adolescent?
Peer group
A student nurse is reviewing counseling techniques and has come to the nurse instructor for some assistance with the preparation of a report. During the conference, the student nurse asks the nurse instructor about factors that could have a major influence on decisions made by adults in each period of development. What should the nurse instructor's guidance to the student nurse include in the discussion?
Previous experiences
A client tells the nurse that she has noticed an increase in weight and fat deposits during the past year. The nurse reviews the client's chart and recognizes that the client is most likely going through puberty. Which nursing action is most appropriate at this time?
Provide reassurance that these are normal changes.
A nurse is assessing a teenage client who had an accident in a car race. The client's father reveals that the client has also started drinking and using drugs. The nurse can best categorize the client in which developmental phase?
Psychosocial development
Parents of a son ask the nurse when they will know that their son has reached puberty. What is the best response by the nurse?
Puberty occurs when the person becomes able to reproduce sexually."
A husband brings his children in to visit their mother in the hospital. The nurse asks how the family is getting along at home without their mom around. The husband states, "None of her jobs are getting done, and I don't do those jobs, so the house and the kids are falling apart." The nurse suspects that this family structure is
Quite rigid.
The nurse is caring for a male patient newly diagnosed with type 1 diabetes mellitus. The pa- tient is not adjusting well to the diagnosis and is refusing to learn how to self-inject insulin. The patient's wife is critical of the patient's refusal to learn; a small argument ensues, and the wife leaves, stating, "I'll be back later when I cool off." What should the nurse do?
Realize that the wife will be an important part of therapy.
When initiating the care of families, one factor that helps organize the family approach to the nursing process is that the nurse
Realizes that individuals have an impact on families.
The nurse is collecting data about a baby in the well-baby clinic. The nurse reads in the electronic medical record that proximodistal direction movements are present. What is the best interaction for this description in the record?
Roll over before grasping objects
A mother has just delivered her first baby and asks the nurse about routines at home. Based on this question, what information should the nurse teach the new mother about establishing routines with an infant?
Routines establish trust along with learning to expect
When discussing the growth and development of an adolescent, the nurse refers to various theories and phases of development. A nurse is discussing Erikson's theory of psychological development with an adolescent client. Based on this information, what is the best explanation of Erikson's theory of psychosocial development during the adolescence period?
The adolescent faces many different decisions during the teen years concerning the future and the adult world.
The nurse is collecting data from the parents of a 2-year-old child. While attempting to get information from the parents, the child starts to cry, scream, and lash out every time the nurse tries to pick up the child from the mother's arms. Based on this observation, what conclusion would best be considered by the nursing about this 2-year-old child?
The nurse recognizes that the child is displaying normal toddler development
A recently married 28-year-old client has come to the nurse for his physical assessment. During the assessment, he reveals to the nurse that he is worried about achieving a level of social and civic responsibility, because his current workload does not allow him to do so. What would be the best response by the nurse at this time?
The nurse should indicate that many persons his age are considering building a family.
When documenting the medical history of a young client with a mouth ulcer, the nurse finds that the client is homosexual and is scared of revealing this to his family. Which is the most appropriate nursing intervention when assessing this client?
The nurse should inquire about the symptoms.
A nurse is helping a father understand expected behaviors of his 8-year-old son. The nurse is teaching the father that, by this age, the boy is in the concrete operations stage of development. What are the most common characteristics that the nurse can tell the father that are displayed by children at this level according to Piaget's theory of cognitive development?
They have the ability to understand quantities, such as weight and volume.
The nurse is educating the family regarding normal behavior for their 2-year-old daughter. Why is it important for the nurse to understand normal behavior in a child?
To distinguish between normal and abnormal behavior
While taking care of a teenager in the late adolescence stage, what client behavior will the nurse most likely observe during data collection for an annual physical examination?
True attitude of maturity
A client tells the nurse that her 14-year-old daughter does not eat proper food and seems to be fond of eating at local fast food restaurants with her peers. Based on this information, what should the nurse tell the client about how eating disorders occur in adolescent girls?
Very concerned about their appearance
According to Piaget's theory of cognitive development, children from ages 2 to 7 are in the preoperational major level of cognitive development. The nurse is collecting data from parents of a 4-year-old child. Which would be an appropriate example given by the parents to the nurse of children in the preoperational stage?
Wishing the dog would quit eating their blocks and now feeling responsible because the dog has ran away
A mother tells the nurse that her child has been able to recognize a quart of milk whether it is in the milk container or poured into a plastic jug as the same amount. Based on this information that the nurse collected about the child's current cognitive development, this skill most likely is an example of what concrete operation characteristic of Piaget's theory of cognitive development?
conservation of matter
The family is a central institution in American society; however, the concept, structure, and functioning of the family unit continue to change over time. The uniqueness of each family is referred to as family
diversity
A nurse is discussing feeding practices with the mother of a 3-month-old infant. The mother describes propping the bottle on a blanket in the crib. Which is the highest priority consequence of this practice that the nurse should monitor when caring for the infant?
erosion of tooth enamel
Growth and development, which is considered a single process, continues throughout childhood and into adulthood. Most children are able to perform certain tasks at about the same age, although normal variations exist. A mother asks the nurse what is the first solid food that can be given to the infant. Based on the fact that most children are able to perform certain tasks at about the same age, what would be the best food for the nurse to tell the mother to introduce first to the infant?
iron fortified cereal
Play is important to child development. Children learn about the world through play. The parents of a preschooler tell the nurse that the child frequently plays with other children side by side with the same type of toys but rarely interacts with the other children's toys. Based on the data collected by the nurse, the nurse would most likely contribute this finding to what type of play by the preschooler?
parallel play
Play is important to child development. Children learn about the world through play.The parents of a young girl tell the nurse that the child frequently plays alone with her own toys in the same area as other children, but never interacts with the other children. The parents are worried that something is wrong developmentally with the child. Based on the data collected by the nurse, the nurse best explanation to the parents would be that this is best described as what type of normal play by the child?
solitary play
