Test 6 Practice Questions HESI

The nurse is providing anticipatory guidance to the parents of a child who has a difficult temperament. Which statement would the nurse include in the teaching session with these parents regarding their child's temperament? Select all that apply. One, some, or all responses may be correct. A. 'Your child will develop predictable habits.' B. 'Your child will benefit from a bedtime routine.' C. 'Your child is open to change and adapts easily.' D. 'Your child is likely to adapt slowly to the new daycare setting.' E. 'Your child will display intense emotions, including those associated with happiness.'

B, D, E. Children who are classified as having a difficult temperament will benefit from a bedtime routine, will likely adapt slowly to a new daycare setting, and will display intense emotions, including those associated with happiness. The child who is classified as easy will develop predictable habits and will be open to change and adapt easily.

How do adolescents establish family identity during psychosocial development? Select all that apply. One, some, or all responses may be correct. A. By achieving marked physical changes B. By acting independently to make his or her own decisions C. By evaluating his or her own health with a feeling of well-being D. By building close peer relationships to achieve acceptance in the society E. By fostering his or her own development within a balanced family structure

B, E. An adolescent establishes family identity by acting independently in making important decisions about self. An adolescent also needs to foster his or her development along with maintaining a balanced family structure. Health identity is associated with the evaluation of one's own health with a feeling of well-being. By building close peer relationships, an adolescent develops a sense of belonging, approval, and the opportunity to learn acceptable behavior. These actions establish an adolescent's group identity. The sound and healthy growth of the adolescent, with marked physical changes, helps build an adolescent's sexual identity.

Which descriptions of play are developmentally normal in preschoolers? Select all that apply. One, some, or all responses may be correct. A. Preschoolers hinder the play of other children. B. Preschoolers follow set rules while playing. C. Preschoolers engage in pretend play. d. Preschoolers get engaged in associative play. e. Preschoolers need a temporary leader to play.

C, D, E. Preschoolers enjoy pretend play, or imaginative, make-believe play that allows them to develop social, emotional, language, and thinking skills. Preschoolers shift from parallel play to associative play; playing helps them learn to understand others and become more creative. Also, they often select a temporary leader for each activity. Preschoolers play with other children in a cooperative manner, rather than hindering their play. However, there is no division of labor or set, rigid organization or rules.

Which education would the nurse provide the family of a preschool- aged child about normal growth patterns? A. 'The rate of physical growth accelerates during this stage of development.' B. 'Muscle and bone development are mature during this stage of development.' C. 'You can expect your child to keep the potbelly appearance during this stage of development.' D. 'Your child's legs will grow in length versus the trunk of the body during this stage of development.'

D. During the preschool stage of development, the legs will grow in length versus the trunk, as seen during the previous stages of development. The rate of physical growth slows and stabilizes during the preschool stage of development. Muscle and bone. development continue to be immature. The potbelly appearance disappears during the preschool stage of development; the preschooler is slender but sturdy, graceful, agile, and posturally erect.

Which changes can be noticed in adolescents during the process of development of emotional autonomy? Select all that apply. A. Adolescents do not run to their parents if they are upset B. Adolescents do not see their parents as an absolute authority C. Adolescents interact with their parents as peers. D. Adolescents have not established emotional bonds with relationships outside the family E. Adolescents seek suggestions from others and critically weigh alternate courses before making a final judgment.

A, B, C, The process of development of emotional autonomy begins early in adolescence. Adolescents show less emotional attachment toward their parents and show more emotional inclination toward their friends. Adolescents tend to not seek out their parents if they are upset, not see their parent as an absolute authority, and interact with their parents as though they are peers. Adolescents create emotional bonds outside of their families. An adolescent who has attained behavioral autonomy will seek suggestions from others and weigh alternate course of actions before coming to a final decision.

Which behavior would the nurse expect in an 11-year-old girl who is experiencing normal growth and development? Select all that apply. One, some, or all responses may be correct. A. Has sleepovers with friends B. Becomes involved in family events C. Texts and talks to friends on phone D. Demonstrates respect to both parents E. Begins to have crushes on boys in class

A, B, C, D, E. School-age girls have an active social life. This includes having sleepovers with friends and spending long periods talking and texting with friends. The child would be family-oriented and demonstrate respect to both parents. The child begins to notice the opposite sex and reports having crushes.

Which task would be considered developmentally appropriate for a 2- year-old to complete? Select all that apply. One, some, or all responses may be correct. A. Putting socks on feet B. Washing and drying hands C. Using fingers to eat food D. Building a tower of four cubes E. Identifying facial body parts

A, B, C, D, E. The Denver Developmental Screening Test is used to determine if a child is meeting appropriate developmental milestones. It incorporates sensorimotor and preoperational phases of growth and development. According to these phases, a 2-year-old child should be able to put socks on feet, wash and dry hands, use fingers to eat food, build a tower of four cubes, and identify facial body parts.

Which considerations would be included in caring for an infant who is failing to thrive (FTT)? Select all that apply. One, some, or all responses may be correct. A. Dietary history B. Signs of malnutrition C. Familial stress factors D. 75th percentile for weight E .Parent and infant interaction F. Sustained growth under 5th percentile

A, B, C, E, F. Dietary history should include type of feedings, because failure to thrive may be a result of an inadequate milk supply in a breast-feeding mother. Signs of malnutrition can affect hair and skin. The infant also may be listless and slow to achieve milestones. Familial stress factors, such as depression and substance abuse, affect the ability of the caregiver to meet the infant's needs. Lack of parent and infant interactions contributes to failure to thrive, because infancy is the time to develop trust or mistrust. Sustained growth under the 5th percentile indicates failure to thrive. It is expected that an infant will double birth weight by 6 months of age. Weight in the 75th percentile indicates thriving.

The nurse is educating the parents of a preschooler about the importance of play in the development of their child. Which statements would the nurse include for adequate teaching? Select all that apply. One, some, or all responses may be correct. A. 'Playing helps the child socialize with others.' B. 'Pretend play allows children to learn to understand others.' C. 'Playing helps the child release frustration.' D. 'If the child fantasizes about imaginary playmates, introduce him or her to reality!' E. 'The child should completely avoid television, video games, and computer programs.'

A, B, C. A child should be encouraged to play because this activity helps the child socialize with others, learn to understand other points of view, develop skills in solving social problems, and release frustration. Imaginary playmates are a sign of health and allow the child to distinguish between reality and fantasy; this type of play should not be discouraged. Television, video games, and computer programs also support development and the learning of basic skills.

Which fears related to growth and development would the nurse plan for a hospitalized pediatric client? Select all that apply. One, some, or all responses may be correct. A. Having limited independence B. Being separated from family C. Falling behind on schoolwork D. Receiving investigational treatment E. Being in an unfamiliar environment

A, B, D, E. Research indicates that pediatric clients fear having limited independence, being separated from family, receiving investigational treatment, and being in an unfamiliar environment during hospitalization. The nurse would plan for these factors when providing care to a hospitalized pediatric client. Falling behind on schoolwork is not a fear about hospitalization that is supported by research.

Which growth and developmental changes indicate increased maturity during the school-age stage of development? Select all that apply. One, some, or all responses may be correct. A. An increase in leg length in relation to height B. A decrease in head circumference in relation to standing height C. The face grows faster in relation to the remainder of the cranium D. Decreased waist circumference in relation to standing height E. Little increase seen in the size of the skull and the brain, which grow very slowly

A, B, D. Growth and developmental changes during the school-age years that indicate increased maturity include an increase in leg length and waist circumference in relation to standing height. Another measure indicative of increased maturity is a decreased head circumference in relation to standing height. Although it is true that the face grows faster in relation to the remainder of the cranium and there is little increase seen in the size of the skull and the brain during the school-age stage of development, this observation is not indicative of increased maturity.

Which statements would the nurse include in the teaching session for a school-age client's parents based on the concrete operational stage of development? Select all that apply. One, some, or all responses may be correct. A. 'Your child will no longer have a rigid, egocentric outlook.' B. 'Your child will make judgments based on conceptual ideas!' C. 'Your child will make judgments based on what is actually seen.' D. 'Your child will evaluate a current situation based on past experiences.' E. 'Your child will not be able to make decisions based on conservation until adolescence.'

A, B, D. During the concrete operational stage of development, the school-age child will no longer have a rigid, egocentric outlook. He or she will make judgments based on conceptual ideas and will evaluate a current situation based on past experiences. Therefore, the nurse would include these statements in the teaching session with the school-age child's parents. The school-age child moves away from making judgments based on what is seen during this stage of development. Conservation develops during the school-age stage of development and continues to develop through adolescence.

Which clients would the nurse measure head circumference during the growth and development assessment? Select all that apply. One, some, or all responses may be correct. A. A 2-month-old infant B. A 3-year-old preschooler C. A 14-year-old adolescent D. An 18-month-old toddler E. A 6-year-old school-age child

A, B, D. The nurse measures head circumference during the growth and development assessment until 36 months of age. The 2- month-old infant, the 3-year-old preschooler, and the 18-month-old toddler would all require a head circumference measurement to assess growth. The adolescent and school-age child would not require a head circumference measurement to assess growth.

When teaching the parents of a 13- month-old child about normal growth and development, which statements would the nurse include in the teaching session regarding learning through the senses? Select all that apply. One, some, or all responses may be correct. A. 'The toddler often puts new objects in the mouth.' B. 'The toddler may inspect a new toy by turning it over.' C. 'The toddler will touch a new object only once during exploration.' D. 'The toddler will shake a new toy when it is first introduced to the play area.' E. 'The toddler rarely uses the sense of smell to learn about something new introduced within the environment.'

A, B, D. The toddler learns through his or her senses by placing new objects in the mouth, inspecting new items by turning them over, and shaking a new toy when it is first introduced to the play area. The toddler will touch a new object several times when learning about it. The toddler will use the sense of smell to learn.

Which developmental skills are fostered by a child scribbling and drawing? Select all that apply. One, some, or all responses may correct. be A. Reading B. Fine muscle C. Gross motor D. Advanced memory E. Eye-hand coordination

A, B, E. According to Kellogg, scribbling and drawing help children learn to read, develop fine- muscle skills, and develop eye-hand coordination. Scribbling and drawing may not help develop gross motor skills and advanced memory skills.

Which are differences between the pubertal growth of girls and boys? Select all that apply. One, some, or all responses may be correct. A. Girls tend to begin their physical changes 2 years before boys. B. Girls grow until the age of 17 years whereas boys grow until the age of 20 years. C. Girls gain weight at an increased rate whereas boys gain height at an increased rate. D. Girls show alteration in the width of hips whereas boys show alteration in shoulder width. E. Girls who mature early are less happy with their body appearance whereas boys who mature early are satisfied.

A, B, E. The physical changes in girls start 2 years before that in the boys. The growth spurt in girls occurs around 12 years of age whereas in boys, the growth spurt occurs at about 14 years. Girls grow till the onset of menarche (16 or 17 years old) whereas boys continue to grow until 18 to 20 years of age. Girls who mature early are shorter and heavy compared with girls who mature late. Because of this, girls are less satisfied with their body appearance. Boys who mature early are more athletic compared with boys who mature late; boys who mature earlier are more satisfied with their appearance. The proportion of weight and height gain is almost the same in boys and girls. Sex- specific changes such as changes in shoulder and hip width are seen in both girls and boys.

Which fine motor skills would the nurse assess for in a toddler? Select all that apply. One, some, or all responses may be correct. A. Throwing a ball B. Grasping small objects C. Walking up and down steps D. Standing on one foot for several seconds E. Placing a round object in the correctly shaped hole

A, B, E. The toddler continues to develop fine motor skills including throwing a ball, grasping small objects, and placing a round object in the correctly shaped hole. Walking up and down steps and standing on one foot for several seconds also are expected during the toddler stage of development; however, these are gross, not fine, motor skills.

Which statements related to relationships with family would the nurse include in a teaching session for a school-age client and parents? Select all that apply. One, some, or all responses may be correct. A. 'Parents of school-age children must learn to let go of control.' B. 'Strict discipline is the priority over understanding and tolerance.' C. 'Peer groups are highly influential during this stage of development!' D. 'Your child may wish to be more involved with peer activities than family activities.' E. 'When a conflict between peers and parents occurs, family values will predominate.'

A, C, D, E. During the school-age stage of development, parents must learn to let go of control; peer groups are highly influential during this stage of development; the parents must also understand that their child may wish to be more involved with peer activities rather than family activities; and when a conflict occurs between the school- age child's peers and parents their family's values will predominate. Parents of a school- age child best serve their child's interests with understanding and tolerance rather than strict discipline.

The nurse is teaching a group of parents about the developmental needs of adolescents. Which information is the nurse most likely to provide? Select all that apply. One, some, or all responses may be correct. A. The adolescent has an increased need for calories. B. The adolescent's daily requirement of protein decreases. C. The adolescent needs to consume iron in the diet on a daily basis. D.The adolescent will show an increased inclination toward healthy food. E. The adolescent's need for nutrition is better guided by physiological age than chronological age.

A, C, E. The nurse will tell parents that during adolescence, energy needs increase to meet the greater metabolic demands of growth. Adolescent girls need a consistent source of iron to replace menstrual losses. Boys also need adequate iron for muscle development. The nurse would tell parents that physiological age is a better guide to nutritional needs than chronological age is. The daily requirement for protein also increases in adolescents. Fast food, particularly value-size or super-size meals, are popular among teens. These foods contain extra salt, fat, and kilocalories and contribute to nutrient deficiency and obesity.

The children of adolescent mothers experience more cognitive developmental problems than children of adult mothers. Which statements correlate with this observation? Select all that apply. One, some, or all responses may be correct. A. Adolescent mothers may lack parental competence. B. Adolescent mothers are younger than adult mothers. C. Adolescent mothers may view the infant as a plaything. D. Adolescent mothers may be reluctant to seek medical care. E. Adolescent mothers usually conceive before they have pelvic adequacy.

A, C. Adolescent mothers may consider an infant to be a plaything; this may have an adverse effect on an infant's cognitive development. An adolescent mother may not be competent enough to provide a home environment conducive to an infant's growth and development. Seeking medical care, the age of the adolescent mother, and questions about pelvic adequacy do not affect the child's cognitive development.

Which growth findings can the nurse anticipate in a 16-year-old adolescent female client? Select all that apply. One, some, or all responses may be correct. A. Decelerating growth B. Completion of structural growth C. Attaining up to 95% of adult height D. Completion of reproductive growth E. Appearance of secondary sexual characteristics

A, C. Deceleration of growth and attaining a maximum adult height occur in teenagers between 15 to 17 years of age. The completion of structural and reproductive growth is evident in late adolescence. The appearance of secondary sexual characteristics is evident in early adolescence.

Which activities should be easier for the school-age child due to changes in proportions from the preschool stage of development? Select all that apply. One, some, or all responses may be correct. A. Climbing B. Handwriting C. Riding a bike D. Problem-solving E. Cooperative play

A, C. School-age children are more graceful than they were as preschoolers, and they are steadier on their feet. Their bodies take on a slimmer look, with longer legs, varying body proportions, and a lower center of gravity. Posture improves over that of the preschool period to facilitate locomotion and efficiency in using the arms and trunk. These proportions make climbing, bicycle riding, and other activities much easier. Handwriting and problem-solving improve during this stage of development but doesn't occur due to changes in proportions. Cooperative play occurs during the school- age stage of development; however, this is not due to changes in proportions.

During a clinical assessment, which secondary sex characteristics would the nurse observe in a teenage client? Select all that apply. One, some, or all responses may be correct. A. Change in voice B. Enlargement of breasts C. Development of facial hair D. Beginning of menstruation E. Completion of skeletal growth

A, C. Secondary sex characteristics are the changes observed in various parts of the body from hormonal alterations. Voice change occurs as a result of changes in the larynx, and facial hair develops on the face and neck regions. Primary sex characteristics are the changes that occur in the internal and external organs involved in reproductive functions. Enlargement of breasts and beginning of menstruation are regarded as primary sex characteristics. The completion of skeletal growth is seen in postpubescence and is not a secondary sex characteristic.

Which developmental stage would the nurse expect for a preschooler? A. Initiative versus guilt B. Trust versus mistrust C. Identity versus role confusion D. Autonomy versus a sense of shame and doubt

A. According to Erikson's theory, the initiative versus guilt stage is applicable to preschoolers between the ages of 3 and 6 years. The trust versus mistrust stage gives details about an infant from birth through the age of 1 year. The identity versus role confusion stage is seen during puberty. The autonomy versus a sense of shame and doubt stage describes the growth and development of a toddler.

A nurse educates a parent about Erikson's theory of child development. At which age would the nurse advise the parent to begin instilling a sense of trust in the child? A. Birth to 1 year B. 1 to 3 years C. 3 to 6 years D. 6 to 11 years

A. According to Erikson's theory, the period between birth and 1 year is the most appropriate period for instilling a sense of trust in a child. The period between 1 and 3 years is the stage during which a child develops self-control and willpower. Establishing a basic sense of trust is essential for the development of a healthy personality. The period between 3 and 6 years is the best time for a child to achieve self-control and willpower. Between 6 and 11 years, a child is eager to learn socially productive skills and tools.

The parents of an adolescent treated for allergies privately tell the nurse that they suspect that their child is a hypochondriac. Which therapeutic response would the nurse provide? A. Discussing developmental behaviors of adolescents B. Explaining potentially serious complications of allergies C. Discussing some of the underlying causes of hypochondriasis D. Explaining that the parents may be transferring their fears to their adolescent

A. Adolescents are very aware of their changing bodies and become especially concerned with any alteration resulting from illness or injury. Explaining the complications of allergies does not address concepts related to growth and development of the adolescent and may cause unnecessary concern about the child's physical condition. A discussion about hypochondriasis may reinforce the parents' concern. Indicating that the parents may be engaging in transference is accusatory and is not supported by adequate data; this response may precipitate such feelings as anger and guilt.

The mother of a 2-year-old girl expresses concern that her daughter's growth rate has slowed. Which explanation would the nurse give regarding the growth rate of a toddler? A. 'This growth pattern is typical at this age.' B. 'Toddlers are too busy exploring their world to eat.' C. 'Growth patterns can't be interpreted for another year.' D. 'Toddlers usually lose their taste for foods they liked when younger.'

A. As the child gets older, growth slows. Toddlers develop physiologic anorexia because their appetite decreases along with their growth rate. Although the toddler may be too busy to eat, this is not why the growth rate slows. This growth pattern may be interpreted now. Although a toddler may lose his or her taste for a particular food, it is not common in this age group.

In which stage of Piaget's theory of growth and development does an infant develop an action pattern to deal with the environment? A. Sensorimotor B. Preoperational C. Formal operations D. Concrete operations

A. In Piaget's theory, child development is divided into four periods. During the sensorimotor period, an infant develops a schema or action pattern for dealing with the environment. During the preoperational period, children learn to think with the use of symbols and mental images. During the formal operations period, egocentric thought prevails. During the concrete operations period, the child thinks about a recently performed physical action.

Which statement is correct regarding primary sex characteristics? A. They are related to reproduction. B. They develop at the same rate in most adolescents. C. Each sex is identified by the primary sex characteristics. D. Primary sex characteristics are apparent before secondary sex characteristics.

A. Primary sex characteristics are those that are related directly to reproduction—the release of an ovum from the ovaries in a female and the development of viable sperm in a male. The rate of pubertal development varies from adolescent to adolescent. Secondary sex characteristics are those related to maleness (e.g., pubic, axillary, and facial hair; deepening of the voice; increased muscularity) and femaleness (e.g., pubic and axillary hair, breast development). Primary sex characteristics are not apparent before secondary sex characteristics.

The nurse compares a 6-month-old infant's height, weight, and head circumference with the previous findings. Which would the nurse infer from these findings? -----------At Birth------At 6 months of age Weight-----3kg-----------6.08kg Height----19.5in (49.5cm)--25.5in (64.8cm) Head circumference- 35cm----44cm A. The infant is developing normally. B. The infant may develop gigantism. C. The infant may develop megacephaly. D. The infant may develop childhood obesity.

A. The infant has normal growth and development. Infants generally gain 150 to 210 g of weight per week for the first 6 months and at least double their birth weight by 6 months of age. Infants grow 1 inch (2.5 cm) monthly for the first 6 months. Head circumference in infants increases by 1.5 cm per month for 6 months. The body weight, height, and head circumference of 6.08 kg, 25.5 inches, and 44 cm at 6 months of age are normal findings. The infant does not have abnormal growth of height; therefore he or she may not develop gigantism. The infant does not have abnormal head circumference indicating megacephaly. The infant does not have abnormal body weight indicating a risk for childhood obesity.

Which intervention would the nurse provide during the initiative versus guilt stage? A. Teaching the parents about child impulse control B. Helping the client decide on his or her treatment plan C. Guiding parents to help their child achieve self-control D. Assisting individuals in choosing ways to foster social development

A. The initiative versus guilt stage is seen in children between the ages of 3 and 6 years. During this stage, the nurse should teach the parents about child impulse control and cooperative behaviors for better growth and development of the child. Adolescents experience the identity versus role confusion stage, and the nurse should provide enough information to allow the adolescent to choose the treatment plan. The nurse guides the parents to help their child achieve self- control and willpower during the autonomy versus shame and doubt stage. The nurse assists ill adults in choosing creative ways to foster their social development during the generativity versus self-absorption and stagnation stage.

The nurse is teaching growth and development activities to the parents of a 3-month-old infant. Which statements would the nurse include in the teaching plan? Select all that apply. One, some, or all responses may be correct. A. 'Your child should be able to show the grasp reflex.' B.'Your child should be able to coo, babble, and chuckle.' C. 'Your child should be able to pull at blankets or clothes.' D. 'Your child should be able to put the feet into the mouth when supine.' E. 'Your child's head can come up to a 45- to 90-degree angle from the table.'

B, C, E. Cooing, babbling, and chuckling in a 3- month-old infant indicate normal development. A 3-month-old infant can pull at blankets or clothes and can raise his or her head to a 45- to 90-degree angle from the table. The grasp reflex generally disappears by the age of 3 months. A 3-month-old infant may not able to put his or her feet in the mouth when lying in the supine position. Generally a 5-month-old infant can put his or her feet in the mouth when lying in the supine position.

Which behaviors are expected for an 8-month-old infant? Select all that apply. One, some, or all responses may be correct. A. Saying 'Da Da' B. Creeping purposefully C. Displaying a pincer grasp D. Walking without assistance E. Sitting down from a standing position

B, C. Creeping develops around 8 months of age as infants crawl to get from one place to another. The infant is able to keep the abdomen off the floor and coordinate the movement of the extremities. The pincer grasp develops around 8 months of age, along with a preference for using one hand over the other. Saying 'Da Da' usually occurs closer to 12 months of age. Walking with a wide stance and without assistance is usually accomplished by 12 to 13 months of age. Sitting down from a standing position begins around 10 to 12 months of age. Before this, the infant just falls down.

Which fundamental biological changes are observed to be similar during the growth of female and male adolescents? Select all that apply. One, some, or all responses may be correct. A. Detectable changes in voice during late puberty B. Appearance of initial pubic hair during early puberty C. Progression of pubic hair growth during mid-puberty D. Development of axillary hair and detectable facial hair during mid- puberty E. Obtaining peak height and weight velocities simultaneously during late puberty.

B, C. In both male and female adolescents, pubic hair appears during early puberty and progresses to grow during mid-puberty. Detectable change in voice is generally seen in males. Females do not develop detectable levels of facial hair. Peak weight velocity occurs simultaneously only in males whereas in females it occurs about 6 months after obtaining peak height velocity.

Which ages are the most critical for speech development during the preschool years? Select all that apply. One, some, or all responses may be correct. A. 2 years B. 3 years C. 4 years D. 5 years E. 6 years

B, C. The most critical ages for speech development for the preschool-aged client are 3 and 4 years of age. Although critical speech development occurs at the age of 2, this is the toddler, not preschool, stage of development. The ages of 5 and 6 years are not considered critical ages for speech development for the preschool-aged client.

Which statements would the nurse include in a teaching session for pregnant couples regarding fetal growth and development? Select all that apply. One, some, or all responses may be correct. A. All major organs are developed and function before birth.' B. 'Development occurs in a head-to- toe and central-to-peripheral pattern.' C. 'The fetal stage of development is most vulnerable to teratogenic influences.' D. 'Pregnancy includes the preembryonic, embryonic, and fetal stages of development.' E. 'During pregnancy the embryo grows from a single cell to a complex physiologic being.'

B, D, E. Information the nurse would include in A teaching session regarding fetal growth and development during pregnancy includes that development occurs in a head-to-toe (cephalocaudal) and central-to-peripheral (proximal-distal) pattern; the 3 stages of pregnancy include the preembryonic, embryonic, and fetal stages of development; and the embryo grows from a single cell to a complex physiologic being. Although all major organs do develop during pregnancy, not all function before birth. The embryonic, not the fetal, stage of development is most vulnerable to teratogenic influences.

Which developmental language milestone would the nurse expect in a 4-year-old child? Select all that apply. One, some, or all responses may be correct. A. Uses appropriate grammar B. Uses six- and eight-word sentences C. Pronounces the sounds 'ch' and 'th' D. Asks about the meanings of new words E. Has a vocabulary of 1000 words

B, E. Because of developing cognitive abilities, 4- year-old children can form six- to eight-word sentences. Because of expanded experiences and developing cognitive ability, the 4-year- old should have a vocabulary of approximately 1000 words or more. The use of appropriate grammar does not develop until 9 to 12 years of age. By 5 to 6 years of age, children ask the definitions of new words; 4-year-olds have not yet achieved this level of development. By 4 to 5 years of age, a child's speech is intelligible, although sounds such as 'ch,' 'th,' 'sh,' 'z,' 'r,' and 'I' are often imperfect.

The nurse is reviewing the data of clients with amenorrhea. Which client may be diagnosed with primary amenorrhea based on the given data? A. A 17-year-old who is in her first trimester of pregnancy B. An 18-year-old with normally developed secondary sexual characteristics who has not yet reached menarche C. A 13-year-old with undeveloped secondary sexual characteristics who has not yet reached menarche D. A 20-year-old triathlete whose menstruation ceased 3 months ago

B. Absence of menstrual flow is termed amenorrhea. This is a clinical sign for a variety of disorders. The absence of menses by age 16.5 years, regardless of normal growth and development, is known as primary amenorrhea, so the 18-year-old with normal development of secondary sexual characteristics who has not yet started menstruating is experiencing primary amenorrhea. The 13-year-old has not yet started menstruating, but her secondary sexual characteristics have not yet begun developing, and so she is not yet said to be experiencing primary amenorrhea. The 17- year-old is experiencing secondary amenorrhea because her lack of menstruation is due to her pregnancy. The 20-year-old triathlete is also said to be experiencing amenorrhea that is secondary because it is likely due to her rigorous physical activity.

The nurse assesses an 18-month- old's growth and development. Which observation indicates that the toddler is within the expected range? A. Pedals a tricycle easily B. Climbs up several stairs C. Says 150 different words D. Builds a tower of eight blocks

B. Climbing stairs is expected developmental behavior for 18-month-old toddlers; however, they may have difficulty coming back down the stairs. Pedaling a tricycle, having a 150-word vocabulary, and building a tower of eight blocks are above the ability level of an 18-month-old child.

The nurse is teaching growth and development to a group of parents. When discussing puberty, one parent asks at what age a girl will get her first period. Which is the best response by the nurse? A. Before the pubic hair appears B. At the end of the prepubertal growth spurt C. Around the same time at which the breasts develop D. Near the age at which the mother had her first period

B. Menarche occurs when the prepubertal growth spurt is almost completed and after the primary and secondary sexual characteristics are almost fully developed. Pubic hair is apparent about 6 months after the breasts begin to develop and before menarche occurs. The breasts are the first secondary sexual characteristics to develop, early during the prepubertal growth and development period. Although there may be a familial tendency to reach menarche at the same age, there are too many variables for this to be used as a guideline.

Which statement is true regarding the importance of play for children? A. Pretend play hampers the cognitive development of children. B. Playing is important because it helps children to release frustration. C. Children should be introduced to reality if they have imaginary. playmates. D. Children should completely avoid television, electronic games, and computer programs.

B. Playing serves as a medium for children to release frustration. Pretend play allows children to learn to understand others' points of view, develop skills in solving social problems, and become more creative. Some children have imaginary playmates. Imaginary playmates are a sign of health and help children distinguish between reality and fantasy. Television, videos, electronic games, and computer programs support development and the learning of basic skills. There should be limited use of these for preschoolers, but these need not be completely avoided. On the other hand, television, electronic games, and computer programs have lasting negative effects on a toddler's language development, reading skills, and short-term memory.

Which toys would the nurse suggest to the parent of a 4-month-old infant to help promote the child's growth and development? A. Push-pull toys B. Soft squeeze toys C. Nesting blocks and cups D. Wooden hammer and pegboard

B. Soft, noisy squeeze toys are appropriate for a 4-month-old; the infant enjoys squeezing and hearing the sound of the squeaker. Push-pull toys are appropriate for a toddler 12- to 24-months of age. Nesting toys are appropriate for a toddler 16-months of age. Banging toys are appropriate for children. from 12- to 18-months of age.

A 10-year-old child has been working on earning all of the scouting badges. Which of Erikson's stages of psychosocial development is this child achieving? A. Identity B. Industry C. Intimacy D. Initiative

B. The school-aged child is working on industry versus inferiority. A sense of accomplishment is an important part of this stage. Erikson classifies the adolescent as working on the development of identity versus confusion. It occurs as the child becomes independent from parents, creates a sense of self, and develops relationships with others. Intimacy versus isolation is the psychosocial developmental stage of young adulthood, when the security of self-identity changes to the insecurity of trying to establish a close relationship with another person. Initiative versus guilt is the psychosocial developmental stage of preschool children, who strive to seek out new experiences and discover their capabilities.

Which rationales would the nurse provide the father of a toddler to encourage pretend play? Select all that apply. One, some, or all responses may be correct. A. To help improve sleeping habits B. To help develop fine muscle skills C. To help the child become more creative D. To help the child develop social problem-solving skills E. To help the child learn to understand other points of view

C, D, E. Pretend play helps children become more creative, develop skills in solving social problems, and learn to understand other points of view. Parents should help their children slow down before bedtime to develop better sleeping habits. Scribbling and drawing help a child develop fine muscle skills.

After an assessment, the nurse observes a feeling of an altered perception of body appearance in an adolescent. Which action would be beneficial in this situation? Select all that apply. One, some, or all responses may be correct. A. Developing a mutually agreeable targeted daily caloric intake goal B. Monitoring activities of detrimental behaviors like purging and binging C. Providing a therapeutic discussion of personal attributes perceived as positive D. Encouraging a discussion of maladaptive behaviors surrounding food and fluid intake E. Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment

C, D, E. Providing a therapeutic discussion of positive personal attributes would be beneficial for an adolescent who has a feeling of an altered perception of body appearance. Encouraging a discussion on maladaptive behaviors surrounding food and fluid intake would provide consistency in therapy and allow for a mutual discussion. Involving the adolescent in activities designed to promote a positive image of self-worth and accomplishment also promotes a sense of accomplishment and enhances the self-image of the adolescent. When an adolescent's weight is below the ideal weight, then the nurse would develop a mutually agreeable targeted daily calorie intake goal with the adolescent. If an adolescent has misconceptions about his or her body image, then the nurse would monitor for detrimental activities such as purging and binging in the adolescent.

Which maturational factor would the nurse recognize is most associated with participating in risk taking behaviors? Select all that apply. One, some, or all responses may be correct. A. Prepubescent girl B. Preadolescent boy C. Early developing girl D. Late developing boy E. Preadolescent period

C, D. Early appearance of secondary sex characteristics in girls and late development in boys have been associated with participation in risk taking behaviors. A prepubescent girl, preadolescent boy, or the preadolescent period do not have the highest| link to risk taking behaviors.

The nursing instructor asks the nursing student to explain the developmental needs of toddlers. Which statement by the nursing student indicates a need for further teaching? Select all that apply. A. 'They need fewer calories.' B. 'They have a decreased appetite.' C. 'They are easy to please with food.' D. 'They are growing at an increased rate.' E. 'They need calcium for healthy bone growth.'

C, D. Toddlers exhibit strong food preferences and become picky eaters. The growth rate slows during the toddler years (i.e., from 1 to 3 years of age). Toddlers need fewer kilocalories than infants; however, they require an increased amount of protein in relation to body weight. The toddler's appetite often decreases at 18 months of age. Calcium and phosphorus are important for healthy bone growth in toddlers.

Which statements describe gynecomastia? Select all that apply. One, some, or all responses may be correct. A. Inflammation of epididymis of testis B. Suspended testis from its vascular structures C. Bilateral or unilateral enlargement of breast in adolescent boys D. Elongation and dilation of the veins of the spermatic cord superior to the testicle E. An unusual physical change during the growth and development of sexual organs

C, E. Gynecomastia is a bilateral or unilateral enlargement of breast seen in adolescent boys. It is an unusual change during growth and development and subsides on its own. Gynecomastia is caused by a hormone imbalance of testosterone and estrogen. Epididymitis is inflammation of epididymis of testis. Intravaginal torsion of the testicle is a condition in which the tunica vaginalis, which normally encases the testicle, fails to do so and the testis hangs free from its vascular structures. A varicocele is characterized by elongation, dilation, and tortuosity of the veins of the spermatic cord superior to the testicle.

The nurse finds that a mother severely punishes her 2-year-old child. Which would the nurse advise the mother, according to Erikson's theory? A. 'Your behavior may induce a feeling of isolation in your child.' B. 'You need to establish a sense of trust or the child may lose trust in you!' C. 'Your child needs support and love or else he or she may develop feelings of shame and doubt. D. 'You should control your child's impulses or the child may suffer guilt and frustration.'

C. According to Erikson, a 2-year-old child is in the stage of autonomy versus sense of shame and doubt. The nurse would counsel the mother that severely punishing her child may lead to a feeling of shame and doubt in the child. This may hamper the child's healthy growth. Intimacy versus isolation stage leads to feelings of isolation in young adults. A feeling of mistrust is observed in infants less than 1 year of age. Guilt and frustration is observed in preschoolers in the stage of initiative versus guilt.

At which age will an infant's anterior fontanel close? A. 6 to 8 months of age B. 9 to 12 months of age C. 12 to 18 months of age D. 19 to 36 months of age

C. According to the standards of growth and development, the anterior fontanel closes between 12 and 18 months of age. Six to 8 months and 9 to 12 months are both too early; early closure may impede the growth of the infant's brain, impairing mental development. The closure should occur by 18 months; delayed closure may indicate neurological problems.

Determine how an adolescent can establish group identity during psychosocial development? A. By evaluating his or her own health with a feeling of well-being B. By fostering his or her independence with balanced family structure C. By building close peer relationships to achieve acceptance in the society D. By achieving marked physical changes with masculine and feminine behaviors

C. By building close peer relationships, adolescents develop a sense of belonging, approval, and the opportunity to learn acceptable behavior. This behavior establishes the group identity. By evaluating his or her own health with a feeling of well- being, an adolescent establishes health identity. An individual establishes family identity by fostering his or her independence with balanced family structure. The sound and healthy growth of an adolescent with marked physical changes helps build sexual identity.

The student nurse is learning about the social milestones reached by children at different stages of development. Which statement made. by the student nurse demonstrates adequate knowledge on the topic? A. 'A 10-year-old child is a boaster.' B. 'A 9-year-old child spends a lot of time alone.' C. 'An 8-year-old child begins to get interested in boy-girl relationships.' D. 'A 6-year-old child plays mostly with groups of the same sex but is beginning to play with children of the opposite sex.'

C. Children in the age group of 8 to 9 years develop interest in boy-girl relationships but will not admit it. So, this statement made by the nurse indicates adequate knowledge about the social milestones reached by children at different stages of development. A 6-year-old child is a boaster; children in the age group of 10 to 12 years are more diplomatic. A 7-year-old child spends a lot of time alone and does not require a lot of companionship. A 9-year-old, in contrast, is more social and enjoys organizations, clubs, and group sports. Children in the age group of 8 to 9 years play mostly with groups of their same sex, but are beginning to mix genders in playgroups; this is not seen in 6- year-old children.

Which nursing action would be given to an individual in the initiative Versus guilt stage of Erikson's theory? A. The nurse should help the parents cope with the hospitalization of an infant. B. The nurse should assist physically ill adults in choosing creative ways to foster social development. C. The nurse should teach parents about a child's impulse control to avoid the risks of altered growth and development. D. The nurse should help hospitalized adolescents deal with their illness by giving them enough information to make informed decisions about their treatment plans.

C. During a child's initiative versus guilt stage of Erikson's theory, a nurse would teach parents about the child's impulse control to avoid the risks of altered growth and development. A nurse helps the parents to cope with the hospitalization of an infant during the infant's trust versus mistrust stage. The nurse assists physically ill adults in choosing creative ways to foster social development during the client's generativity and self-absorption and stagnation stage. A nurse helps hospitalized adolescents deal with their illness by giving them enough information to make informed decisions about their treatment plan during the individual's identity versus role confusion stage.

Which would the nurse teach to a preschool-age client to avoid the risk of altered growth and development? A. Trust B. Empathy C. Impulse control D. Problem-solving

C. Teaching a preschool-age child, and his or her parents, the importance of impulse control is necessary to avoid the risk for altered growth and development. Trust is an important teaching point during infancy. Empathic guidance is important to provide to the parents of a toddler-age client. Problem-solving is an important teaching point for the school-age child.

While assessing the moral development of a child according to Kohlberg's theory, the nurse determines that the child is at the preconventional level of moral development. Which behavior led the nurse to this conclusion? A. The child is very concerned about loyalty to parents and friends. B. The child behaves according to the standards agreed upon by society. C. The child is very obedient and tries to avoid punishment from parents and teachers. D. The child has moral development corresponding with the concrete operations stage.

C. The child who is at the preconventional level of Kohlberg's development will have intuitive thoughts. In the preconventional level, the child remains obedient and tries to avoid punishment. The child who is in the conventional level of Kohlberg's moral development will have concerns about conformity and loyalty. In the postconventional level of moral development, the child believes that the correct behavior follows the standards set by society. The conventional level of moral development corresponds with the concrete operations stage in cognitive development.

The nurse is preparing a presentation related to normal growth and development at a local community center. Which statement would the nurse include in the presentation? A. 'Physical growth slows during infancy.' B. 'Toddlers will begin to participate in collaborative play activities.' C. 'The loss of deciduous teeth occurs during the school-age stage of development. D. 'Adolescence is known as the ugly duckling stage because of the changes associated with puberty.

C. The loss of deciduous teeth occurs during the school-age stage of development; therefore this is an accurate statement for the nurse to include in the community presentation related to normal growth and development. Physical growth slows during the toddler stage of development, not infancy. Preschoolers, not toddlers, begin to participate in collaborative play activities; however, the primary type of play during both stages of development is parallel play. The school-age stage of development, not adolescence, is often referred to as the ugly duckling stage because the new secondary teeth appear to be much too large for the smaller face.

To which client would the nurse provide education regarding the pubertal growth spurt? A. An 8-year-old school-age male client B. A 16-year-old adolescent male client C. A 12-year-old school-age female client D. An 18-year-old adolescent female client

C. The pubertal growth spurt reaches a peak for female clients at 12 years of age; therefore the nurse would provide education to this client regarding expected growth during this time period. The 8-year-old male client would not be expected to experience the pubertal growth spurt until the age of 14 years. The 16-year-old and the 18-year-old adolescent clients would have already experienced the pubertal growth spurt.

The nurse asks a client about developmental milestones such as the age at which thelarche and menarche occurred. The nurse determines that the client experienced pubertal delay. Which finding in the client's history supports this conclusion? A. Weight increased by 8 to 12 kg. B. Menarche occurred 2 thelarche. years after C. Breast development occurred by 15 years of age. D. Growth in height stopped 2 years after menarche.

C. When the development of breasts has not occurred by 13 years of age in girls, it is considered pubertal delay. An increase in weight between 7 and 25 kg is considered normal during the growth spurt period. The occurrence of menarche within 2 years of onset of breast development, or thelarche, is a normal finding. Generally, in girls, growth in height stops 2 to 2.5 years after menarche.

Which parent education would the nurse provide about typical behaviors of an 8-month-old infant? Select all that apply. One, some, or all responses may be correct. A. Standing alone B. Drinking from a cup C. Smiling spontaneously D. Being shy with strangers E. Showing interest in small objects

D, E. Being shy and exhibiting stranger anxiety are typical behaviors of 8-month-old infants. Children of this age are able to differentiate between familiar and strange faces and have developed trust in primary caregivers. Eight- to 9-month-old infants have developed the pincer grasp and hand-to-mouth coordination, thus showing interest in small objects. Standing alone is a behavior typical of a 10-month-old; it requires strength and balance that an 8-month-old infant does not have. Drinking from a cup is a behavior associated with 10- to 12-month-old infants. First spontaneous smiling occurs between birth and 2 months of age.

A mother of a 7-year-old child complains to the nurse that her child wets the bed at night. Upon interaction with the child, the nurse learns that the child is afraid of the dark. Which would the nurse recommend to the mother? Select all that apply. One, some, or all responses may be correct. A. 'Take your child for a walk before going to bed.' B. 'Provide nutritious food to at dinner.' your child C. 'Give your child a glass of milk before going to bed.' D. 'Allow your child to keep a light on in the bedroom at night.' E. 'Encourage your child to copy his siblings who sleep alone in their rooms.'

D, E. Keeping a light on at night will help comfort a child who is afraid of the dark. Encouraging the child to copy his or her siblings who sleep alone in their rooms helps develop desensitization to darkness and reduces the child's fear. Taking the child for a walk before going to bed may promote sleep but does not reduce fear of darkness. Providing nutritious food to the child will be beneficial to improve overall growth and development. Providing milk before bed promotes sleep but does not address the fear of darkness.

Which parental statement would the nurse recognize as indicating a need for further education about the importance of play in the development of their preschool-age child? Select all that apply. One, some, or all responses may be correct. A. 'Playing helps the child socialize with others.' B. 'Pretend play helps children learn to understand others.' C. 'Playing is important because it helps the child release frustration.' D. 'We should eliminate all television, electronic games, and computer programs.' E. 'If the child fantasizes about imaginary playmates, we should bring him or her back to reality!'

D, E. Television, videos, electronic games, and computer programs support development and the learning of basic skills. There should be limited use of these items for preschoolers, but these need not be completely avoided. Imaginary playmates are developmentally normal and allow the child to distinguish between reality and fantasy. The parents should know that playing helps the child socialize with others. Pretend play allows children to learn to understand others' points of view, develop skills in solving social problems, and become more creative. Playing also serves as a medium for the child to release frustration.

Which cognitive development is seen in early adolescence? A. Having established abstract thoughts B. Developing capacity for abstract thinking C. Exploring the ability to attract opposite sex D. Exploring a newfound ability for limited abstract thoughts

D. Exploring a newfound ability for limited abstract thoughts is observed in early adolescence. Formal operational thought includes being able to think in abstract terms, think about possibilities, and think through hypotheses, which are characteristic features of cognitive development during adolescence. Middle and late adolescents have abstract thoughts and develop the capacity for abstract thinking. Exploring the ability to attract opposite sex is part of adolescence, but it is not a cognitive development.

According to Erikson's theory, which suggestion would the nurse make to the parent of a preschooler who is worried about ongoing conflicts with the child because of strict behavior standards? A. 'Your behavior may induce a feeling of isolation in your child.' B. 'You need to establish a sense of trust, or the child may lose trust in you!' C. 'Your child needs support and love or may develop feelings of shame and doubt.' D. 'You could cooperate with the child's desires within reason to avoid guilt and frustration for your child.'

D. According to Erikson, a child between 3 and 5 years of age is in the initiative versus guilt stage. The nurse might tell the parent to cooperate with the child's desires within reason to reduce conflicts. Otherwise, the child may develop a sense of guilt and frustration. If a young adult is not able to develop companionship with others, this can lead to a feeling of isolation. A feeling of mistrust can be seen in infants less than 1 year of age. Giving harsh punishments to a child may lead to a feeling of shame and doubt in the child and may hamper his or her healthy growth.

The nurse teaching a growth and development class to a group of parents explains that toddlers strive for a sense of what? A. Trust B. Industry C. Initiative D. Autonomy

D. According to Erikson, the toddler strives for autonomy; most exploratory and negativistic behavior is based on the need to achieve this developmental task. Trust is the developmental task of the infant. Industry is the developmental task of the school-age child. Initiative is the developmental task of the preschool child.

The nurse assesses the growth and development of a 12-month-old infant and compares the results with the previous assessment findings. Which finding indicates an abnormality in the neonate? Findings---@ 6months---@ 12 months Height-----65cm-----------74cm Weight-----7.3kg-----------9.75kg Head Circumference-43cm----46cm Chest Circumference-42cm----43cm A. Height B. Weight C. Head circumference D. Chest circumference

D. An infant's chest circumference equals the head circumference by the end of the 1st year. The chest circumference of 43 cm indicates decreased growth. The average height of an infant at 6 months and 1 year of age is 65 and 74 cm, respectively; therefore it does not indicate an abnormality in the infant. The average weight of an infant at 6 months and 1 year of age is 7.3 and 9.75 kg, respectively; therefore it does not indicate an abnormality in the infant. The average head circumference of an infant at 6 months and 1 year of age is 43 and 46 cm, respectively; therefore it does not indicate an abnormality in the infant.

The parents of a 3-month old infant who is breast-fed ask the nurse how to prevent nutritional anemia. Which is the best response by the nurse? A. Supplemental iron will not be needed for the first year. B. Solid foods need not be introduced until 7 or 8 months of age. C. Anemia will not develop as long as the infant is gaining weight. D. Baby cereal or an iron supplement should be given around 4 months of age.

D. Baby cereals are fortified with iron. The breast-fed infant is ready to have this food introduced by about 4 months; if solid foods are not offered by this age, an iron supplement is needed. Maternally derived iron stores are adequate for the first 5 to 6 months in a full-term infant. After this time iron supplementation is necessary to meet the infant's growth demands.

The nurse is assessing a group of children. Which child is underdeveloped according to the table? Child--age(yrs)--Height(cm)--Weight(kg) A-------3-----------95------------14 B-------3.5---------96------------16 C-------4.1---------103------------17 D-------5-----------80------------11

D. Child D is underdeveloped, because the average height and weight of a 5-year-old child are 110 cm and 19 kg, respectively. The average height and weight of a 3-year-old child are 95 cm and 14.5 kg. Child A and child B show normal growth and development. The average height and weight of a 4-year-old child are 103 cm and 16.7 kg. Child C is not underdeveloped.

Which type of play will help develop a leader-follower type of relationship? A. Solitary play B. Parallel play C. Associative play D. Cooperative play

D. Children who are involved in cooperative play discuss and plan activities. A leader- follower type of relationship will develop among the children. During solitary play, the child plays with toys alone. During parallel play, children play side by side but individually with different toys. During associative play, the children borrow or lend play materials but do not control each other's activities and do not develop a leader- follower type of relationship.

Which would the nurse expect a 24- month-old toddler to be able to do? A. Build a tower of eight blocks B. Balance on one foot momentarily C. Construct a bridge with three blocks D. Climb stairs with two feet on each step

D. The ability to ascend steps develops in increments over time. At 15 months of age, the toddler creeps up the stairs; at 18 months of age, the child climbs stairs while holding someone's hand; and by 24 months of age, the toddler can climb stairs alone, with two feet on each step. Building a tower of eight blocks is a fine motor skill that develops around 30 months of age. Balancing on one foot momentarily is a gross motor skill that develops around 30 months of age. Constructing a bridge with three blocks is a fine motor skill that develops around 36 months of age.

Vital signs and measuring height and weight are taken during a well-child checkup. The nurse then plots the child's growth on the growth chart that the clinic has maintained since the child's birth. Which information is most important for the nurse to share with the health care provider regarding the findings on the growth chart? A. The child's height is at the 25th percentile for her age. B. The child missed appointments between the ages of 7 months and 12 months. C. The child's height is at the 25th percentile, but her weight is at the 10th percentile. D. The child's weight has dropped from the 25th percentile to the 10th percentile in the last 6 months.

D. The child has 'fallen off' her growth curve and is not gaining as expected. The child needs to be evaluated further so that the reason for this failure may be determined. The child's height has been consistently at the 25th percentile; therefore, it is not a concern. Missing appointments 7 and 12 months ago would not be a current concern because the child has made the past three checkups on schedule. Height and weight percentiles are not always the same. Height at the 25th percentile with the weight at the 10th percentile is also not a concern.

Which is the priority nursing action to facilitate growth and development when providing care to a pediatric client who is diagnosed with a chronic illness? A. Monitoring growth patterns and plotting on the growth chart B. Teaching the client and family how the illness affects physical growth C. Assessing stage of development frequently and documenting it in the medical record D. Planning activities to promote progression from one stage of development to the next

D. The priority nursing action to facilitate growth and development when providing care to a pediatric client who is diagnosed with a chronic illness is to plan activities that will promote the progression of the client from one stage of development to the next. Chronic illness can often cause developmental delays. Monitoring growth patterns, plotting on the growth chart; educating the client and family about how the illness affects physical growth; assessing the stage of development and documenting in the medical record are all appropriate nursing actions; however, these are not the priority for facilitating growth and development for this client.

When assessing the development of a school-age child, the nurse concludes that the child has normal development according to Fowler's spiritual development. Which behavior would have been observed? A. The child imitates the religious gestures of elders. B. The child does not differentiate between right and wrong actions. C. The child has spiritual disappointment and modifies religious practices. D. The child believes God will punish bad behavior and reward good behavior.

D. The school-age child will have a developing conscience. The child believes that God will punish bad behavior and reward good behavior. This indicates that the child is in the mythical-literal stage of Fowler's spiritual development. A preschooler who is in the intuitive-projective stage of Fowler's spiritual development will imitate the behavior of others. An infant who is in differential stage of Fowler's development will not have a concept of right and wrong. An adolescent who is in the synthetic-convention stage of Fowler's spiritual development will be disappointed that God does not answer all prayers. The child will modify his or her religious beliefs.

A parent tells the nurse, 'My 9- month-old doesn't have the same strong grasp as at birth, and my child is not startled by loud noises anymore.' Which education would the nurse provide the parent to explain these changes in behavior? A. 'Let me check these responses before deciding how to proceed.' B. 'When these responses fail, it may indicate a developmental delay.' C. 'The baby needs more sensory stimulation to get these responses back.' D. 'Those responses are replaced by voluntary activity around 5 months of age.'

D. Touching the palm of a newborn causes flexion of the fingers (grasp reflex); this response usually diminishes after 3 months of age. An unexpected loud noise causes the newborn to abduct the extremities and then flex the elbows (startle reflex); this response usually disappears by 4 months of age. Persistence of primitive reflexes is usually indicative of a developmental delay. It is not necessary to gather more data, because these changes are consistent with expected growth and development. The data do not support the conclusion that the child is developmentally delayed and saying so may cause needless concern. Sensory stimulation at this age is directed toward experiences to add new motor, language, and social skills.

Which concept would the nurse incorporate to determine the ability of a 10-year-old to grasp the concept of conservation with cookie dough? Select all that apply. One, some, or all responses may be correct. A. Industry B. Maturity C. Inferiority D. Autonomy E. Reciprocity

E. The concept of conservation involves reciprocity, wherein the child can change the shape of an object, but it still contains the same mass. Industry, inferiority, and autonomy are stages within Erikson's stages of growth and development. Maturity addresses the developmental level of the child.

Which concern may be specifically seen in middle adolescents? Physical appearance and peer group acceptance

Middle adolescents tend to have health-related concerns regarding physical appearance, peer-group acceptance, and relationship with friends. Young adolescents will be undergoing physical changes of puberty, so their concern will be mostly on growth and development. All adolescents may experience issues with violence within their social environment. Older adolescents are mostly concerned with their school performances and future careers.