Chapter 21 - Developmental Concepts

Applying the principles of growth and development, place the following body parts in the correct sequence as they would develop from first to last.

Brain Heart Intestine Legs Feet

A nurse is assessing a 7-month old infant. When applying Piaget's theory of cognitive development, which developmental task would the nurse expect the infant to have achieved? Select all that apply.

Demonstrating basic reflexes such as sucking Performing repetitive behaviors such as smiling Relating behavior to a change in the environment

The Super Ego

Freud; "moral watchdog"; governs behavior by reality and morality, often taught by parents, church and/or community; standards develop through interaction; conscience; ego ideal

Freud

Psychoanalytic theory, psychosexual stages *Conscious : Super Ego (moral) *Con/Uncon: Ego (trying to gratify booth) *Unconscious: ID (Instant gratification)

A nurse is caring for a client who is has a history of drug dependency. The nurse understands which of the following components of Sigmund Freud's theory is responsible for relapses into drug dependency?

The id

preoperational stage

in Piaget's theory, the stage (from about 2 to 6 or 7 years of age) during which a child learns to use language but does not yet comprehend the mental operations of concrete logic

Erik Erikson

neo-Freudian, humanistic; 8 psychosocial stages of development: theory shows how people evolve through the life span. Each stage is marked by a psychological crisis that involves confronting "Who am I?"

Oral Stage (0-1 year)

Freud's first stage of psychosexual development during which pleasure is centered in the mouth * Developmental - feeding= trust * Adult Fixation - smoke, bite fingers, talkative

What is considered to be a time when specific environmental or biologic events must occur for development to proceed normally?

Critical period

A nurse is working in the pediatric clinic. The nurse is seeing Janet Brent and her 10-year-old daughter, who is here for a well-child checkup. Janet asks what the common health problems are for this age. The nurse's correct reply includes which of the following?

Scoliosis

During a health history, a middle-aged man tells the nurse, "I will always take care of my children because my parents took care of me." Based on Kohlberg's theory, what level of moral development is the man demonstrating?

conventional

formal operational stage

in Piaget's theory, the stage of cognitive development (normally beginning about age 12) during which people begin to think logically about abstract concepts

Genital Stage (puberty on)

maturation of sexual interests focused on genitals * Developmental - sexual maturity * Adult Fixation - mentally healthy

Kohlberg

moral development

Latent Stage (6-puberty)

the quieting of the libido * Developmental - social and communication skills (friends, hobbies) * Adult Fixation - none

A nurse is caring for a 6-year-old boy who is hospitalized for observation following a motor vehicle accident. Based on Havighurst's developmental tasks, what would be the best choice for a diversional activity for this client?

Reading a storybook

Donald, a newly graduated nurse is applying for a position in a pediatric clinic. In preparation, he studies about growth and development. He learns that which of the following are considered milestones within a developmental level? Choose all that apply.

Roll over Crawl Walk

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?

Sensorimotor

The nurse assesses that a toddler begins to smile, wave his arms and legs, and vocalize when he sees his mother setting up the high chair for lunch. The nurse determines this action as an indicator of progress in which of Piaget's cognitive stages?

Sensorimotor

A nurse is conducting an in-service education program for a group of nurses transitioning to the pediatric unit of the facility. The nurse is describing the various theories of growth and development. The nurse determines that the teaching was successful when the group identifies the stages of cognitive devleopment by Piaget. Place the stages listed below in the correct sequence from first to last that would demonstrate the group's learning.

Sensorimotor Pre-operational Concrete operational Formal operational

A nurse assesses the effect of the environment and nutrition on clients visiting a walk-in clinic in a low-income community. Which statements accurately describe these effects? Select all that apply.

Substance use by a pregnant woman increases the risk for congenital anomalies in the developing fetus. Use of alcohol and drugs is more prevalent in teenagers who have poor family relationships. An increased incidence of teenage pregnancy can be linked to substance use by adolescents.

A parent of a preschooler brings the child to the health center for a visit. During the visit, the parent says, "It's just one question after another. Why does this happen? How does it happen? I'm at a loss as to what to say to my child." When providing anticipatory guidance to this parent, which information would the nurse incorporate?

The child is taking the initiative in learning to achieve initiative.

A nurse is assessing children using Kohlberg's theory of moral development. What milestones are achieved in the preconventional level of this theory? Select all that apply.

The child learns to follow parents' rules. The child is motivated by punishment for not conforming to rules. The child develops a perception of goodness or badness.

Frued

id, ego, superego

A nurse is reviewing the medical records of several children who come to the health center for care. When applying Piaget's theory, which child would the nurse anticipate as being able to think abstractly and use deductive reasoning?

13-year-old

According to Piaget, the individual assimilates and accommodates new information during this period.

Adaptation

An older adult has come to the clinic for a follow up visit. During the visit, the client tells the nurse, "I've really had a good life. I've been successful in my work and I have a wonderful family. My grandchildren bring me so much joy." The nurse interprets this statement as indicating achievement of which developmental task?

Ego integrity

A nurse is searching the Internet for information about theorists associated with moral development. The search reveals several theorists. Which result would the nurse identify as being associated with women and morality?

Giligan

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?

Phallic Stage

Gould

theory based on specific beliefs and developmental phases

Fowler

theory of faith 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 experiencing the Electra complex which is normal at this age.

According to Havighurst, learning behaviors are based upon developmental tasks. In assessing an adult patient, the nurse is aware that a common developmental task of middle adulthood includes:

assisting children to become responsible adults.

A nurse is talking with the parents of an 8-year-old who was admitted to the pediatric unit for treatment of an asthma exacerbation. Which suggestion would be most appropriate for a nurse to give to the parents to foster industry?

"Be sure to congratulate him on his accomplishments."

A nurse is providing anticipatory guidance to the parents of a 2 1/2-year-old girl. To foster the development of autonomy, which instruction would the nurse include?

"Encourage the child to dress herself."

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 do not trust anyone." "I am not good at anything." "I really don't have many friends, nobody likes me."

A 4-year-old client was admitted for treatment of severe pneumonia. The parents report that the child has been toilet-trained for two years, but the client has been incontinent of urine and stool twice since admission. How should the nurse explain this to the parents?

"Many children regress in their developmental stages when seriously sick."

This theory deals with perception and thinking.

Cognitive theory

A nurse is caring for a child who states: "I don't like the taste of this medicine, but my parents told me it will help me get better, so I'll take it." This example best exemplifies which stage of Piaget's cognitive development theory?

Concrete operational stage

The nurse is providing prenatal education for a group of pregnant teenagers. The nurse talks about substance use during pregnancy and relates that use to which possible newborn consequences? Select all that apply.

Congenital anomalies Low birth weight Premature birth

A nurse is reviewing the history of a pregnant woman and notes that the woman has a history of substance use. When teaching the woman about the possible effects of substance use on her baby, the nurse would identify that the fetus is at higher risk for which condition? Select all that apply.

Congenital anomalies Low birth weight Prematurity

A 10-year-old girl is excited when she receives the "most improved player" award on her softball team. Although she was not the strongest player on the team, she always tried to perform at her best level and never gave up on practicing her skills. What stage of psychosocial development according to Erik Erikson is this child demonstrating?

Industry versus inferiority

A nurse is assessing the psychosocial development of children in a day care center. Which child would the nurse expect to be experiencing the most intense period of speech development?

A 4-year-old

A nurse is caring for a child who stated, "Nobody likes me! I don't have any friends." According to Erik Erikson's Theories of Psychosocial Development, which of the following stages is the child at risk for not achieving?

Industry vs Inferiority

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?

Accidents

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 normal finding for a client at this stage of development.

A child who learns that he must sit quietly during story hour in kindergarten, thereby integrating this new experience into his existing schemata, is applying the process of:

Assimilation

A nurse is working with a child on a pediatric unit. Based on the age of the child, the nurse understands the child should be in Piaget's Concrete Operational stage. Which of the following activities should the nurse plan to include in the plan of care to evaluate if the child has achieved this stage?

Classifying and sorting coins

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' heights and weights as they file through the station, observing that there is a large variation in physical size and emotional maturity. Which of the following factors may affect emotional growth of children? Choose all that apply.

Development of trust Praise for doing well Loving caregivers

A nurse is caring for an elderly client in a long term care facility. The resident is reminiscing about his life and his achievements. The nurse understands the client is in which of the following stages of Erik Erikson's Psychosocial Development theory?

Ego Integrity

The nurse is caring for a man 79 years of age who was admitted for a hip replacement. He visits with the nurse every chance he gets; he seems lonely. He tells the nurse his wife died two years ago. He has children in nearby cities and has nine grandchildren. He says his life has been good and he is content, even though he misses his wife. The nurse assesses him for developmental issues and knows that he fits well into which of Erikson's stages of development?

Ego integrity versus despair

A nurse is observing interactions between a new mother and her newborn. The nurse observes the mother not responding to her newborn's cries. Which of the following growth and development theories does the nurse understand this observation addresses?

Erik Erikson's Trust vs Mistrust stage

Which developmental theorist created the psychosocial theory of development?

Erikson

The nurse sees a client age 4 years and her mother at the pediatric clinic. The client is here for immunizations. She is bubbly and talkative, and tells you about her dance lessons and her new baby brother. Her mother tells you she encourages her daughter to try new experiences and enjoy life. You know that according to Erikson's developmental theory, the client is well on the way to achieving which of the following?

Initiative

Anal Stage (1-3 years)

Freud's pychosexual period during which a child learns to control his bodily excretions centered on anus * Developmental - Toilet training (control and independence) * Adult Fixation - orderliness and messiness

A nurse is reviewing developmental theories for class discussion. The nurse knows that Freud's theory emphasizes the effect of instinctual human drives on behavior. He identified the underlying stimulus for human behavior as sexuality, which he called libido. Freud defined libido as which of the following?

General pleasure-seeking instincts

A nurse observes individuals who are volunteering in a community free health clinic. Which of the following stages of Erikson's Psychosocial Development theory describes these individuals?

Generativity vs stagnation

What are the two factors that drive growth and development?

Genetics and environment

Donald, a newly graduated nurse, is working in a pediatric clinic. Today he sees Karen, a 1-month-old infant, and her single mother. The mother is estranged from Karen's father but is marrying her high school sweetheart next week. Donald remembers from nursing school that which of the following will affect an infant's growth and development? Choose all that apply.

Genetics of mother Environment of infant Mother's prenatal nutrition

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?

Growth

According to Freud's theory, what factor is concerned with self-gratification?

Id

The nurse observes a hospitalized 15-year-old male refuse his meal tray and state: "I usually eat pizza at home. I can't eat the food in here." This type of rebellious behavior is characteristic of which of Erik Erikson's stages of psychosocial development?

Identity versus role confusion

A nurse is reading a journal article about Erikson's developmental theory. The nurse demonstrates understanding of the information by identifying the stages listed below. Place the stages in the proper order from earliest to latest that would demonstrate the nurse's understanding.

Identity versus role confusion Intimacy versus isolation Generativity versus stagnation Ego integrity versus despair

A nurse is reviewing information about Fowler's theory of faith development. The nurse demonstrates understanding of this theory by identifying the six stages. Place the stages listed below in the proper sequence from first to last that would demonstrate the nurse's understanding.

Intuitive-predictive faith Mythic-literal faith Synthetic-conventional faith Individuative-reflective faith Conjunctive faith Universalizing faith

The parents of a 4-year-old girl bring the child to the clinic for the first time. During the assessment, the nurse asks the parents about any religious beliefs. The parents tell the nurse that they are Christian. The mother says, "We take her to church with us. She's really well-behaved. She even tries to imitate what we do, standing, kneeling, folding her hands, and such." The nurse interprets this behavior as reflecting which stage of faith development?

Intuitive-projective faith

The nurse is counseling a woman who states: "I'm never going to find a husband; every time I start dating I end up getting hurt. I'm not even going to try anymore." This woman is in what stage of Carol Gilligan's theory of moral development?

Level 1—selfishness

The nurse is caring for a woman 40 years of age, who is admitted for fixation of an ankle fracture related to a rollerblading accident. She comments to the nurse that she plans to give up rollerblading because her balance and reflexes are not as good as they once were. She sounds accepting of this. According to Robert Havighurst, in which of the following developmental stages is this client?

Middle adulthood

A nurse is conducting an in-service education program on moral development for a group of staff nurses. The nurse describes the theories of Kohlberg and Gilligan. The nurse determines that the teaching was successful when the group identifies which area as being associated with women and morality?

Needs of others

A nurse is reading a journal article about Freud's Theory of Psychoanalytic Development and the stages associated with it. Place the stages listed below in the sequence that would demonstrate the nurse's understanding of the information in the article.

Oral stage Anal stage Phallic stage Latency stage Genital stage

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?

Oral; anal

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?

Organization

A nurse is preparing to assess the growth and development of a child who has come to the clinic for a routine well-child visit. When assessing the child's growth and development, which concept would be important for the nurse to integrate? Select all that apply.

Patterns and levels of development are highly individualized. Trends in growth and development are relatively regular and predictable. Previous learned abilities form the foundation for newly learned abilities.

A nursing student is visiting a day care to observe growth and development in action. The nursing student completes screening assessments on preschoolers who are learning to feed, dress, and toilet themselves, as well as expanding their motor and verbal abilities. According to Piaget, in what development stage are they?

Preoperational

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

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?

Sensorimotor stage

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

Sexuality

A school nurse is using Havighurst's developmental theory to teach parents of adolescents what to expect at this developmental stage. Which behaviors are typical of adolescents? Select all that apply.

The adolescent accepts his or her body and uses it effectively. The adolescent achieves emotional independence from parents. The adolescent acquires an ethical system as a guide to behavior.

A nurse is teaching parents of preschoolers about growth and development of their children. Which teaching point would the nurse include?

The pace of growth and development is specific for each person.

A nurse wants to teach children about the importance of oral health with brushing and flossing. Based on Piaget's theory, to what age group would it be most appropriate to teach this topic?

Third- and fourth-graders

The Ego

the largely conscious, "executive" part of personality that, according to Freud, mediates among the demands of the id, superego, and reality. The ego operates on the reality principle, satisfying the id's desires in ways that will realistically bring pleasure rather than pain.

Havighurst

theory based on developmental tasks

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?

Woman's own needs

Based on Havighurst's theory, the nurse recognizes that one of the developmental tasks of middle adulthood is:

adjusting to physical changes.

Gilligan

conception of morality from the female viewpoint

The ID

contains a reservoir of unconscious psychic energy that, according to Freud, strives to satisfy basic sexual and aggressive drives. The id operates on the pleasure principle, demanding immediate gratification

senorimotor stage

in Piaget's theory, the stage (from birth to about 2 years of age) during which infants know the world mostly in terms of their sensory impressions and motor activities

concrete operational stage

in Piaget's theory, the stage of cognitive development (from about 6 or 7 to 11 years of age) during which children gain the mental operations that enable them to think logically about concrete events

Based on Piaget's theory of cognitive development, what type of activities would a nurse recommend to parents of children in the preoperational stage?

play activities

Phallic Stage (3-6 years)

psychosexual stage that focuses on the genitals * Developmental - oedipus/Electra complex (identification) * Adult Fixation - sexual disfunction

Erickson

psychosocial development

Piaget

stages of cognitive development

Levinson

theory based on the organizing concepts of individual life structure

A nurse is working with young adults and assessing their moral development. The nurse relates which of the following theorists who developed the Theory of Moral Development?

Lawrence Kohlberg

A nurse is providing care to a pregnant woman who has come to the clinic for a visit. Assessment reveals that the woman is single, 38 years old, and pregnant for the first time. This is her first prenatal visit. The fetus is estimated to be at 30 weeks' gestation. The woman reports that since the date of her last menstrual period, she has gained about 7 lb (3 kg). The nurse determines that fetal development may be at risk based on which factor? Select all that apply.

Maternal age of 38 years Inadequate prenatal care Questionable maternal nutrition status

The nurse is caring for a woman 68 years of age who is admitted for fixation of an ankle fracture related to a fall at home. The client states that she is thinking of selling her home and moving to a smaller place. Her husband died six months ago and she is unable to physically maintain her home without him. She sounds accepting of this. According to Robert Havighurst, in which of the following developmental stages is the client?

Later Maturity

The school nurse is teaching growth and development in a health class. What should the nurse teach the students about development?

It is the process of ongoing change