CH11: Infancy Through Adolescence - Fundamentals

The sperm and ovum each contain ______ unpaired chromosomes.

23 Each sperm and ovum contains 23 unpaired chromosomes, which become 46 chromosomes at fertilization.

A school nurse suspects that a 7-year-old child at the school is being physically abused. The nurse should: a. interview the child about possible abuse. b. notify the principal. c. call the parent about her concern. d. report the suspected abuse to the authorities

ANS: D Most states require health workers to report child abuse to the authorities.

The nurse reminds parents that infants who have developed trust by the age of 6 months will be able to: a. tolerate short separations from parents. b. learn to speak at an earlier age. c. attempt walking around 8 months of age. d. seldom cry.

ANS: A Trustful infants can tolerate parental separations for short periods of time and will have confidence to explore new situations.

The school nurse is alert to the behavior of a child who has extremely permissive parents, because this sort of parenting style produces children who are: a. mistrusting. b. depressed. c. anxious. d. impulsive.

ANS: D Permissive parenting produces children who are impulsive, aggressive, and lacking in self-control.

The nurse uses a diagram to show that the fetal prenatal period begins after the _______ week.

8th

A 9-year-old has returned to the pediatric unit from the recovery room after having his appendix removed. He has an intravenous solution running into a vein and a dressing covering the operative site. His parents went home briefly. When he becomes upset and starts crying, the nurse should: a. help the child recall the event day, explaining that his mother will be back later in the morning. b. recognize his need for family by calling his mother on the telephone and telling her to come back and stay with her son. c. appeal to his gender identity by telling him he is a big boy, and big boys don't cry. d. be aware that the child cannot reliably tell the nurse about pain at this age and call the care provider for an order for a pain medication or sedative.

ANS: A A 9-year-old can use cognitive abilities to understand the nurse's explanation. He can also tell about pain.

When a 3-year-old toddler repeatedly tries to reach some cookies on top of a counter and then, after several failures to do so, drags a chair over to the counter and climbs on the chair to get the cookies, she is exhibiting: a. adaptation as described by Piaget. b. egocentricity as described by Freud. c. sensorimotor motivation as described by Piaget. d. preconventional reasoning as described by Kohlberg.

ANS: A Adaptation as described by Piaget outlines that a child can adjust thinking patterns as the child discovers new information.

When the clinic nurse speaks to the 3-year-old child and says, "You can get dressed now and put your shirt and pants back on," she is promoting his sense of: a. autonomy. b. industry. c. initiative. d. trust.

ANS: A Autonomy is the sense of independence—"I can do it myself." It is accomplished in the toddler stage as evidenced by toilet training, self-feeding, and self-dressing. Industry is a school age task, initiative is a 4- to 6-year-old task (preschool), and trust is a task of infancy

An 11-year-old who obeys all the rules set down by the teacher to avoid guilt or disapproval is acting out Kohlberg's theory of: a. conventional reasoning. b. preconventional reasoning. c. postconventional reasoning. d. concrete operations.

ANS: A During the conventional reasoning level of moral development, children obey rules to avoid guilt and disapproval. Moral values are not internalized. Most children are at this stage at about age 9 or 10 years of age.

The pediatric nurse identifies egocentrism in: a. a 2-year-old who hits playmates and takes all the toys. b. a 5-year-old who prefers to read or be read to instead of playing kickball. c. a 12-year-old who is failing school and in frequent fights with his peers. d. a 15-year-old who is a volunteer at the local hospital.

ANS: A Egocentric behavior is generally seen in the toddler and teenage groups. It is characterized by an intense focus on self, with little awareness of others or their needs.

The nurse encourages the parent to allow the toddler to dress himself and feed himself and make simple choices about clothing or food in order to follow the theory of: a. Erik Erikson. b. Jean Piaget. c. Lawrence Kohlberg. d. Sigmund Freud.

ANS: A Erik Erikson's theory of psychosocial stages encourages the toddler toward autonomy by allowing the child to begin to become independent.

A child who can draw pictures of objects not in evidence in the room is exhibiting Piaget's: a. preoperational stage. b. sensorimotor stage. c. concrete operations. d. formal operations.

ANS: A Jean Piaget's cognitive development theory includes the preoperational stage, which occurs from 2 to 7 years of age. During this stage, a child can draw and think about objects that are not in evidence in the immediate environment.

A new parent with her first child tells the nurse that her mother has advised her to feed the baby on a schedule and let the baby cry between feedings so that he does not get spoiled. Based on Erikson's growth and development theory, the nurse's most informative response would be: a. a sense of trust is developed in infancy when a child's needs are met by warm, loving people. b. an infant who learns to adapt to uncomfortable situations and to comfort himself will develop autonomy and independence. c. the infant learns cause and effect at this stage and will learn he can't cry and get his own way. d. in the first year, crying and learning to wait have positive outcomes for both the mother and the baby

ANS: A Meeting the crying baby's needs fosters trust; it does not "spoil" a child. Crying inconsolably is not a positive outcome for a baby when he fails to have his needs met.

The nurse would anticipate that the child who prefers onlooker play would be: a. 1 year old. b. 3 years old. c. 4 years old. d. 5 years old.

ANS: A Onlooker play is a type of play in which a child watches others playing but does not interact. Children younger than the age of 2 engage normally in this type of play.

The nurse reminds parents that social competence can be recognized in their child if the child: a. learns to cope with minor stressors. b. develops a sense of humor. c. finishes jobs and chores they start. d. develops a talent.

ANS: A Persons with social competence can handle minor stressors and are aware of how their behavior influences others and how they may appear to others.

The school nurse recognizes that the adolescent most at risk for a problem relative to body image would be the 15-year-old: a. girl with severe acne. b. boy with a broken leg from a motorcycle accident. c. boy with thinning hair. d. girl who is 2 inches taller than classmates.

ANS: A Severe acne will have the most impact on body image because it alters the appearance of the face. Adolescents are very concerned about their appearance.

The nurse emphasizes the influences that help maintain a healthy pregnancy, which are: (Select all that apply.) a. early prenatal care. b. health of the mother. c. socioeconomic status. d. mother's age. e. age when menses began. f. emotional stress.

ANS: A, B, D, F Adequate prenatal care, health and age of the mother, good nutrition, and emotional status all influence the health of a pregnancy. Socioeconomics and the age of menarche are not direct influences.

Parents of a 5-month-old ask the nurse what they can feed their infant besides breast milk. The nurse would appropriately suggest: (Select all that apply.) a. baby cereals. b. strained fruits. c. any food eaten by the parents. d. small pieces of sausage. e. grapes. f. strained vegetables.

ANS: A, B, F Baby cereals and strained fruits and vegetables are appropriate foods to introduce at this age. Pieces of sausage, grapes, and some foods eaten by parents may be too small and may be aspirated.

The risk for poisoning is most likely in a situation in which: a. a caretaker with an infant with a high fever has been instructed by the clinic nurse to give a liquid fever reducer (antipyretic). b. a toddler is staying with his grandparents for a week while his mother is in the hospital. c. a 7-year-old has asthma and uses daily medications for it. d. a 12-year-old is home alone after school until his parents return from work.

ANS: B A toddler staying with grandparents for an extended emergency visit is at risk for poisoning related to the grandparents' home not being "toddler proof."

As a nurse working in an adolescent mental health clinic, sees many young people struggle with sexual orientation issues. Which of the following is true according to the 2013 National Health Interview Survey? a. 3.6% of the population is homosexual. b. 0.7% of the population is bisexual. c. 30% of the population is gay, lesbian, bisexual, or transgender. d. 0.8% of the population identified themselves as gay, lesbian, bisexual, or transgender.

ANS: B According to the 2013 National Health Interview Survey, studies estimate that 1.6% of the population is homosexual and 0.7% is bisexual. However, according to 2015 Gallup polls, Americans who were surveyed estimated that 23% of the population is gay, lesbian, bisexual, or transgender, which is substantially higher than the 3.8% of the population who identified themselves in the early results of the survey.

The nurse tells a parent of adolescents that teenage pregnancies, although on the decline, often result in the baby having: a. learning difficulties at a later age. b. a low birth weight. c. a congenital deformity. d. retarded development.

ANS: B Because the teenage mother is still growing, the babies from a teen pregnancy are frequently of low birth weight. None of the other options are a direct result of teenage pregnancy.

A nurse encourages the father of a newborn infant to hold the baby close, talk softly, stroke the baby's fingers, and make eye contact in order to: a. assist the father's confidence in holding the baby. b. promote bonding, which in turn promotes a sense of trust in infancy. c. generate a sense of parenting. d. accustom the baby to being handled by different caregivers.

ANS: B Bonding is an important feature of the parent-child relationship that must be supported and facilitated in the first weeks of life (a teachable moment)

The school nurse reminds the eighth grade boys' physical education classes to make time for warm-up exercises and stretching before strenuous physical activity because: a. warm-up exercises allow for a more proficient performance. b. bones are growing faster than muscles and tendons and may result in injury. c. the body's circulating blood needs warm-up time to perfuse larger frames. d. warm-ups give an opportunity for perspiration to cool overheated muscles.

ANS: B Bones are growing faster than muscles or tendons. Heavy physical activity without warm up exercises could cause injury.

A nurse would expect a child of 2 years to communicate in: a. squeals and pointing. b. two word sentences. c. three word sentences. d. four word sentences.

ANS: B Children should be using two word sentences by the age of 2 years. Precocious children may be able to communicate with sentences of greater length.

The anxious father to be asks the nurse when the sex of the fetus can be determined. The nurse's answer is based on the knowledge that the external genitalia appear in the: a. second month. b. third month. c. fourth month. d. fifth month.

ANS: B External genitalia can be visualized on ultrasound in the third month.

The nurse explains that the Denver Developmental Screening Test (DDST) evaluated gross motor skills by observing the child's ability to: a. stack a pile of blocks. b. hop on one foot. c. draw a detailed figure of a person. d. use different colors when drawing a house.

ANS: B Gross motor skills evaluated by the DDST are walking, jumping, using a tricycle, throwing and catching a ball, and hopping or standing on one foot.

The school nurse is teaching parents of fifth graders (10 year olds) about the physical changes of puberty that they can expect in their children, such as: a. boys begin to change physically before girls. b. there will be children in different stages of puberty throughout the next several years. c. the physical changes of puberty occur gradually, and children adjust without difficulty. d. most boys and girls will begin the physical changes of puberty by seventh grade (12 years old). If this has not happened, the child should be evaluated by a care provider.

ANS: B In general, girls begin to develop 2 to 3 years ahead of boys. A child may have great difficulty with body changes, especially if he is very much ahead of or behind his peers. Many boys do not begin to develop until the high school years and continue their growth into their 20s.

The nurse recognizes that the parenting style in which a parent is firm, in control, and has a warm encouraging relationship with the child is: a. authoritarian. b. authoritative. c. autocratic. d. absolute.

ANS: B In the authoritative parenting style, a parent has a firm approach, is in control, and has a warm, loving, and encouraging relationship with their children.

The nurse instructs the parents that emotional intelligence can be supported in a child by the parents: a. insisting on IQ testing. b. talking to the child about his or her feelings. c. allowing the child to bring friends into their home. d. encouraging the child to read.

ANS: B Parents can assist their children in developing emotional intelligence by talking to their children about their feelings, taking their children's feelings seriously, and helping them find ways to cope with their feelings.

A 15-year-old girl reports to the school nurse that she feels she does not fit in and feels near tears all the time. She states her grades are declining. The nurse's best approach to this situation would be: a. "Everyone has 'downtimes.' Let's get you signed up with a tutor." b. "I think I better refer you to the school psychologist to help you." c. "Don't be silly...of course you fit in. You have many friends." d. "Come back again next week and we can talk some more about this problem."

ANS: B The feelings of not fitting in and being close to tears all of the time in addition to declining grades are indicators of depression. Any adolescent who exhibits signs of depression should be evaluated by a mental health professional rather than being treated by the school nurse. The other options belittle the girl's feelings.

A mother of an 11-month-old is concerned about her baby not walking and states that his older brother was walking at 10 months. The nurse's response, based on knowledge of normal development, should be: a. "Your son may be somewhat slow developmentally. You might have him evaluated by a neurologist." b. "The rate of development can be very different from one child to another, even among brothers and sisters." c. "Don't worry. Children can be perfectly normal and not walk until they are 2 years of age." d. "It's hard to predict when a child will walk. Some walk before they are able to crawl or sit alone."

ANS: B Development follows a pattern (sit before creep, creep before walk) but varies in normal children. Eleven months is not developmentally slow, but children normally do walk before 2 years of age.

A 4-year-old attends a preschool group three mornings a week. He has been treated kindly and lovingly at home. At school, according to Kohlberg's theory of moral development, he is likely to: a. treat his peers and siblings in a loving and kind manner, because he has internalized the value of treating others as he has been treated. b. conform to social standards and rules to avoid feeling guilty or risking social disapproval. c. follow the rules regarding peer interactions to avoid punishment. d. be developmentally advanced and have a conscience that is based on an innate sense of justice and duty.

ANS: C According to Kohlberg, the child's behavior at preschool will be preconventional reasoning, governed by fear of punishment. This stage lasts until about the age of 9 years.

A distressed mother confides in the school nurse that she witnessed her 15-year-old son and a 15-year-old friend masturbating in her son's bedroom. The nurse's best response would be: a. "Perhaps you should ask your homosexual feelings toward his friend." b. "The fact that they were doing this secretly indicates that they feel guilty about the experience." c. "Many kids have a homosexual encounter, but it does not mean they are homosexual." d. "Mutual masturbation is frequently the initial experience of a person who is actively homosexual."

ANS: C Approximately 8% of adolescents experience a homosexual encounter. This does not mean they are homosexual.

An anxious father to be tells the nurse that his wife's due date was 5 days ago and there are still no signs of labor. The nurse's most helpful response would be: a. "I think you should contact your wife's doctor about this concern." b. "Just be patient...babies come when they are ready." c. "Any time 2 weeks on either side of the due date is considered normal." d. "Sometimes estimated due dates have been off by as much as 6 weeks."

ANS: C Births occurring 2 weeks on either side of the estimated due date are considered normal

A school nurse is planning an education course for high school students on the effects of early sexual activity. Which of the following topical points, from the CDC would she include? a. 35% of US high school students had experienced intercourse. b. 89% of US high school students, who had experienced intercourse, used a condom. c. Adolescent students may have difficulty with the emotional aspects of sexual activity. d. Poor risk of sexually transmitted infections.

ANS: C Centers for Disease Control and Prevention (CDC) reported in 2013 that 47% of US high school students had experienced intercourse, and 41% had not used a condom the last time they had sex (CDC, 2015). Although the body is capable of intercourse in adolescence, many young people are not prepared for the emotional aspects of sexual activity. Early sexual activity is associated with high risk of sexually transmitted infections, pregnancy, and emotional pain (Wisnieski and Matzo, 2013).

A nurse assessing a 13-year-old female is aware that the presence of axillary and pubic hair indicates the presence of: a. progesterone. b. insulin. c. estradiol. d. cortisol

ANS: C Estradiol is an estrogen secreted by the ovaries that is responsible for the appearance of secondary sex characteristics.

When asked, the nurse explains that the superego described in Sigmund Freud's theory influences human behavior by playing the part of the: a. reality tester. b. seeker of pleasure. c. moral dictator. d. primitive urges.

ANS: C Freud's theory describes three parts of the personality: identity, ego, and superego. The superego represents the moral component of the personality.

The nurse clarifies that growth differs from development in that growth: a. is the same for all siblings in a family. b. is solely dependent on heredity. c. progresses in an orderly, predictable way. d. continues throughout life.

ANS: C Growth progresses in an orderly and predictable way. Its patterns and stages can be anticipated. Growth potential is hereditary, but many things such as nutrition and illness can affect growth.

When a 4-year-old boy announces that he is going to marry his mother, the nurse recognizes that this statement is an indicator that he is in the Freudian stage of: a. oral. b. anal. c. phallic. d. latency.

ANS: C In the Freud's phallic or Oedipal stage, children identify with the parent of the same sex. The little boy is imitating his father by declaring his desire to marry his mother.

The well child clinic nurse reminds the parents of a 2-year-old that the primary environmental influence for physical development is: a. play. b. nurturing parents. c. nutrition. d. frequent checkups.

ANS: C Nutrition is the primary environmental influence on physical development.

The school nurse suspects a 14-year-old of having anorexia nervosa because the nurse has observed that the adolescent: a. is binging on rich foods. b. has early onset of sexual development. c. uses frequent enemas and laxatives. d. is doing excessive rigorous exercises.

ANS: D Anorexics control their weight by reducing nutritional intake and engaging in rigorous exercise. The body becomes emaciated and sexual development is delayed.

In planning anticipatory guidance for the parents of an 18-month-old child at a well child clinic, the nurse should include information about the: a. child's need for and ability to participate in quiet activities such as reading stories and watching television and movies on a phone or computer for long periods of time. b. advantages of having the child begin to attend day care to develop his social interactions and group play skills with other children. c. need for close supervision and making the environment safe related to poisons, motor vehicles, stairs, and electrical hazards. d. need for increased nutritional intake to maintain the continued rapid growth of infancy into this stage.

ANS: C Parents with a child at 18 months of age need to be guided in how to protect their child from his own curiosity and dangers. An 18-month-old is not capable of sitting still for stories for long periods, and at this age, children engage in parallel play rather than group play. His nutrition needs to be balanced but will probably decline in amount because growth is not as rapid as in infancy. The American Academy of Pediatrics guidelines recommend no television, smart phones, or computers for children under 2 years, and less than 2 hours of screen time per day for children and teens. These activities have been linked to an increase in attention problems, development of unhealthy eating habits, higher body mass index, and obesity.

The nurse is assessing 6-month-old infant. The infant was born at 38 weeks gestation, weighed 4 pounds at birth, and was 18 inches long. Which of the following statements by the mother indicates that further parental education is needed? a. My baby should weigh at least, 12 pounds today. b. My baby is considered a preterm baby. c. My baby is considered a small for date baby. d. My baby should be at least 28 inches long.

ANS: C The average newborn weighs 7 to 7 1/2 lb and is 20 to 21 inches long. Less than 5.5 pounds is considered low birth weight and more than 8.8 pounds is considered high birth weight. There are two categories of low-birth-weight babies. The first is preterm babies, who are born before 37 weeks of gestation and weigh less than 5 pounds. The second category is small-for-dates babies. These infants are born at term but weigh less than 90% of what they should weigh. All babies should double their birth weight at 5 to 6 months and triple it by 1 year. They should also grow 1/2 to 1 inch per month the first 6 months and 3/8 inch per month from 6 to 12 months. At well baby visits the baby's growth is measured and documented on standard growth charts.

The mother of a 13-year-old girl tells the school nurse that her daughter will appear one day neatly dressed and groomed and the next will have on tattered jeans and a T-shirt and untidy hair. The nurse realizes that these are 'trials' to find: a. initiative. b. industry. c. identity. d. social approval.

ANS: C The major developmental task of Erik Erikson's theory is that of discovery of one's identity. The changing of clothing and behaviors indicate trying for a "fit."

A group of fifth grade boys play together at school and after school are seen in each other's company. The school nurse is aware that this sort of group is representative of Freud's: a. anal stage. b. oral stage. c. latency stage. d. phallic stage.

ANS: C The major developmental tasks of Sigmund Freud's latency stage of psychosexual development include a focus on relationships with same sex peers.

A parent asks the nurse about how to discipline her 2-year-old who has become uncooperative and negative and is having temper tantrums. The most helpful suggestion made by the nurse would be for the parent to deal with this normal behavior by: a. scolding the child sternly to discourage this behavior. b. taking away a favorite toy until behavior improves. c. using a "time-out" (a quiet time without toys). d. asking the child to "help Mama" by not being naughty.

ANS: C This is a normal 2-year-old behavior; the mother needs to learn the use of "time-out" or nonpunitive, less authoritarian ways of dealing with the 2-year-old that are not so likely to provoke "no."

A parent asks how long she should enforce a "time-out" for her 4-year-old, who frequently hits her younger brother and takes his toys. The nurse recommends: a. 2 minutes. b. 3 minutes. c. 4 minutes. d. 5 minutes

ANS: C Time-outs are effective in this stage as a consequence for undesired behavior. A general guideline is that the length of time of the time-out should match the age (number of minutes = age).

The nurse reminds a parent that a major milestone for a 2- to 3-year-old child is to learn to: a. play team games with others his age. b. speak clearly and fluently. c. use the toilet for bladder and bowel functions. d. tie shoelaces.

ANS: C Toilet training is usually accomplished in the second or third year. Team games are a young school age phenomenon, as is tying shoelaces. Speaking clearly and fluently does not occur until after the toddler stage.

A woman in her first trimester of pregnancy asks the nurse how much weight she can expect to gain by the time of EDD (estimated delivery date). The nurse correctly responds approximately by informing her: a. 5 to 10 pounds. b. 15 to 20 pounds. c. 25 to 30 pounds. d. 35 to 40 pounds.

ANS: D A woman beginning pregnancy at a healthy weight should expect to gain approximately 30 pounds.

A middle school female student is evaluated for depression. During the assessment, it was evident that she was a victim of cyberbullying. According to The Cyberbullying Research Center, which of the following will promote a positive outcome for this patient? a. She is not alone, 26% of middle school at high school students have been the victim of cyberbullying. b. She is not alone, 16% of middle school at high school students have been involved in bullying. c. She is at risk for substance abuse. d. She has a group of loving, supportive adults in her family.

ANS: D According to The Cyberbullying Research Center, 26% of middle school and high school students have been victims of cyberbullying, and 16% have been involved in bullying. Studies demonstrate decreased substance use and mental health problems when youth view the family as a resource for support and advice (Ackley et al., 2014).

The nurse instructs the caregiver of a newborn that newborns should double their birth weight by: a. 2 to 3 months. b. 3 to 4 months. c. 4 to 5 months. d. 5 to 6 months.

ANS: D All babies should double their birth weight by 5 to 6 months, and triple it by 1 year.

The well baby clinic nurse suggests that the most important aspect parents should consider when selecting a day care facility for their preschooler would be the: a. cost and convenience of the facility. b. educational qualifications of the teachers and the aides. c. cleanliness and provision of healthy snacks. d. facility's approach to discipline and a nurturing atmosphere.

ANS: D Although all aspects listed may be important, the atmosphere of nurturing and the level of discipline should be the major consideration in selecting a day care facility.

A woman who has just given birth expresses concern about the cheesy, waxy substance that is covering her neonate. The nurse accurately responds: a. "This material develops in the absence of adequate subcutaneous fat." b. "This material is often seen on infants who have experienced intrauterine stress." c. "This substance will be absorbed and used as a nutrient by your infant." d. "This is a normal finding and is called vernix caseosa."

ANS: D At birth, the skin and scalp are often covered with vernix caseosa (a cheesy, waxy substance that protects the skin in fetal life). This wears off in a day or two.

The nurse points out that an infant who pulls at a drawer handle to open a drawer that holds a toy that is out of view is exhibiting: a. industry. b. initiative. c. concrete operations. d. object permanence.

ANS: D By the time babies are about 8 months old, they realize that an object still exists even when they cannot see it. This is called object permanence. It is demonstrated when an infant is shown an object that is then hidden, and the baby looks for it.

The nurse is aware that according to Piaget's theory, the child's cognitive development is: a. present at birth as a genetic imprint that will begin to unfold in the first year, independent of the child's environment. b. a series of psychosocial tasks to be accomplished at various stages throughout life, such as developing a sense of identity in adolescence. c. the physical increase in size that occurs in the brain of the child, with most of the growth completed by the age of adolescence. d. occurring in stages, which allows a child to organize knowledge and adapt to the environment in increasingly complex ways.

ANS: D Cognitive refers to intellectual aspects. It is strongly influenced by environment and is more than just physical development of the brain. Piaget theorized stages a child goes through in organizing knowledge and adapting to the environment.

A nurse arranges for cooperative play in a pediatric unit by: a. coloring a picture in a coloring book with a 6-year-old patient. b. arranging for two 3 year olds to play with their dolls at the same table. c. showing an 11-year-old how to do a crossword puzzle. d. organizing a checkers game between two 10 year olds.

ANS: D Cooperative play is a type of play in which children play together. Games have rules and goals that are accepted and followed.

The home health nurse reminds parents that dental care for a child should begin: a. when the child has all his permanent teeth. b. when the child has all his deciduous teeth. c. at approximately the age of 4 or 5 years, when the child can cooperate with a dentist. d. with tooth brushing and flossing of the first teeth by a parent or caregiver.

ANS: D Dental care properly starts when the child first cuts teeth and the caregiver cleans them. Toddlers quickly learn to imitate adult behaviors and can brush their own teeth with supervision before all teeth have erupted.

During the first trimester of pregnancy, the most important teaching a nurse can provide the expectant mother is: a. avoiding very strenuous exercises or activities. b. eating large high caloric meals to provide for the growing fetus. c. preparing self-physically and mentally for the work of labor. d. acquiring adequate prenatal care.

ANS: D Early prenatal care is the most important factor in a healthy pregnancy outcome.

An 8-year-old's mother asked the child to set the table, but then remarked that it was not very neat and then reset the table herself. According to Erikson, this sort of behavior on the part of the mother will cause the child to feel: a. mistrustful. b. ashamed. c. guilty d. inferior.

ANS: D Erik Erikson's psychosocial development theory includes the stage industry vs. inferiority, which is characterized by a child not being recognized for his or her industry.

Based on the theory of Erikson, the nurse advises that the best discipline for an adolescent would be to: a. make him get a job. b. increase his household chores. c. implement a long period of "time-out." d. "ground" him and deprive him of contact with friends.

ANS: D Erik Erikson's psychosocial development theory includes the stage of identity vs. identity confusion. This age values association with peers above everything else, so depriving the child from contacting his friends would have the most impact.

A 4-year-old child tells other children that last night he flew to the moon and walked around with his friend Sam. He says that he is the only one who can see Sam. The nurse should: a. warn the child's mother that he may be developing emotional problems. b. interrupt the conversation with a comment that children can't fly to the moon. c. take the child aside and tell him gently that he should stop telling such stories or people will not trust him. d. recognize that imaginary friends and fantasy are normal at this age.

ANS: D Fantasy and imaginary friends are normal in this age group.

A 10-year-old girl has recently grown 3 inches and gained 20 pounds. She began having menstrual periods and is embarrassed about her breast development. The parents are concerned about her complaints of fatigue. The most helpful response from the nurse would be to suggest: a. having her evaluated for a physical problem. b. minimizing her feelings of embarrasment c. enrolling in a health club for exercise. d. helping the child recognize bodily self-consciousness and fatigue as a normal part of maturation.

ANS: D Fatigue is a common teen complaint associated with rapid growth and change. Self-consciousness about body changes is also common.

A nurse instructing a group of adolescents about development includes in her remarks that the presence of follicle-stimulating hormone (FSH) will cause boys to: a. have a significant growth spurt. b. grow a beard. c. maintain an erection. d. produce sperm.

ANS: D Follicle-stimulating hormone (FSH) stimulates the testes to begin producing sperm.

A nurse teaches a woman who is considering pregnancy that her intake of folic acid to help prevent congenital abnormalities should be: a. 100 mcg/day. b. 200 mcg/day. c. 300 mcg/day. d. 400 mcg/day.

ANS: D If planning to become pregnant, a woman should be certain her intake of folic acid is at least 400 mcg/day to assist in preventing neural tubal defects.

A person who demonstrates the ability to logically manipulate abstract and unobservable concepts is in which stage of Jean Piaget's cognitive development theory? a. Preoperational stage b. Sensorimotor stage c. Concrete operations d. Formal operations

ANS: D Jean Piaget's cognitive development theory includes the formal operations stage, which occurs from 11 years of age to death. During this stage, a person demonstrates the ability to logically manipulate abstract and unobservable concepts.

A dejected 8-year-old has brought home an art project that was finished at school that didn't get put up on the bulletin board with some better projects. The best way to support the child's sense of industry would be for the parents to: a. remind the child that not all kids are artistic. b. point out the areas in the project that could have been improved. c. request that the teacher allows the project to be posted on the bulletin board. d. post the project on the front of the refrigerator.

ANS: D Posting the project in a prominent place and remarking on the positive aspects of it like color selection or composition will boost the child's sense of industry.

When the nurse makes a loud noise near the infant, the infant reacts by arching his back and assuming a typical posture with flexion and adduction of the extremities, and his fingers fan initially. This is called the: a. stepping reflex. b. grasping reflex. c. Babinski reflex. d. Moro reflex.

ANS: D The Moro reflex (startle response) can be elicited by making a loud noise near the baby, who will react by arching his back and assuming a typical posture with flexion and adduction of the extremities and fingers fanned initially.

The nurse confirms that in the embryonic stage of prenatal development (third to eighth week), the embryo's: a. growth slows. b. organs begin to function. c. limbs move. d. heart begins to beat.

ANS: D The embryo's heart begins to beat at 3.5 weeks.

The nurse instructs the mother of an infant about infant safety factors. The nurse would assess the need for further instruction if the caregiver states: a. "I will place my infant on her back for sleep." b. "I will place my infant in a car seat when driving." c. "I will not leave my infant alone in a house or a car." d. "I will place my infant on her stomach for sleep."

ANS: D The infant should be restrained in a car seat in the back seat of the automobile whenever the vehicle is in motion. The infant should be placed on his back for sleep, with propping slightly on one side or the other for variation. No infant should be placed on the stomach to sleep. An infant should never be left alone in a house or car.

A nurse assessing a 13-year-old girl observes that she has begun her menstruation cycle. The nurse is aware the hormone responsible for this change is: a. parathyroid hormone (PTH). b. thyroid-stimulating hormone (TSH). c. adrenocorticotropic hormone (ACTH). d. follicle-stimulating hormone (FSH).

ANS: D The pituitary hormone follicle-stimulating hormone (FSH) stimulates the ovaries to begin producing estrogen hormones that initiate menses.

The nurse advises the young mother that most pediatricians recommend feeding newborns using _______ ______.

breast milk

The nurse explains that babies can lift their heads before they can lift their chests, control their shoulders before they control their arms and fingers, sit before they stand, and crawl before they walk. This is a result of ________ development.

cephalocaudal