Pediatric - Growth and Development
Which questions will allow the nurse to assess a preschool-age child diagnosed with asthma for delayed peer relationships? Select all that apply. "Can your child independently dress each day?" "Does your child use 'baby-like' terms when talking?" "Does your child play with the other children in the playroom?" "Has your child ever thought that the asthma is a punishment?" "Does your child become anxious before respiratory treatments?"
"Does your child use 'baby-like' terms when talking?" "Does your child play with the other children in the playroom?" Peer relationships begin to form during the preschool stage of development. This task can be affected by the diagnosis of a chronic illness, such as asthma. The nurse should assess the child for socialization with peers and overprotection by the family by asking if the child uses "baby-like" terms when talking and about interactions with other children in the playroom. Information obtained from these questions will allow the nurse to plan care that enhances the child's ability to socialize with other children. Mastery of self-care skills may also be affected; therefore, the nurse would ask the parent if the child is able to independently dress each day. Preschool-age children learn through preoperational thought which includes magical thinking; therefore, the nurse should assess information related to the child believing the diagnosis is a punishment. The child's body image may also be impacted; therefore, the nurse should assess for anxiety prior to respiratory treatments. However, assessment of these last three aspects addresses other concerns than peer relationships.
The registered nurse is teaching a student nurse about adhesives to be used for preterm infants. Which statement by the student nurse indicates effective learning? "I should remove the adhesive with solvents or bonding agents." "I should remove the adhesive within 24 hours after application." "I should avoid semipermeable dressings to secure intravenous lines." "I should secure pulse oximeter probes with elasticized dressing material."
"I should secure pulse oximeter probes with elasticized dressing material." Elasticized dressing material can effectively secure pulse oximeter probes or electrodes with minimal skin irritation in preterm infants. Adhesive removers, solvents, or bonding agents may result in skin damage in a preterm neonate. Therefore the adhesives are removed using water, mineral oil, or petrolatum. The adhesive should not be removed for at least 24 hours after application. Semipermeable dressings can be used to secure intravenous lines and silicone catheters in a preterm neonate.
What thought is common in an individual during the social contract orientation stage? "I should avoid parties where alcohol is served." "I should follow rules or else the teacher will punish me." "I should work to change a law to better society." "I should complete my homework so that the teacher will reward me."
"I should work to change a law to better society." When an individual thinks of changing a law according to his or her own personal view, this thought corresponds to the social contract orientation stage. People at this stage sometimes disobey rules if they believe that these rules are unfair or are harmful to society. When an individual thinks of avoiding parties where alcohol is served, this thought corresponds to the society maintaining orientation stage. When an individual thinks that breaking a rule will lead to a physical punishment, this thought corresponds to the punishment and obedience orientation stage. When an individual feels that doing a certain task will help win a reward, this thought corresponds to the good boy-nice girl orientation stage.
While teaching parents about the developmental milestones of a 15-month-old child, the nurse informs the parents about various activities that their child should be able to do. Which statement of the parent indicates effective learning? "My child can jump with both feet." "My child can walk up stairs with one hand held." "My child can creep up stairs and kneel without support." "My child goes up and down stairs alone with two feet on each
"My child can creep up stairs and kneel without support." A 15-month-old child has the ability to creep up stairs and kneel without support because of the development of gross motor skills. The child starts jumping with both feet at the age of 30 months. The child will start walking up stairs with one hand held at the age of 18 months. The calf muscles develop sufficiently for the child to walk up and down stairs alone at the age of 24 months.
The nurse is providing care to an infant who is diagnosed with cystic fibrosis (CF). Which parental statement indicates the need for further education related to the potential for poor growth? "My child's diagnosis causes delayed bone growth." "My child will have a poor appetite, which will lead to poor growth." "My child will have increased oxygen demands, which will lead to poor growth." "My child will have a decreased ability to absorb nutrients, which will cause poor growth."
"My child will have a poor appetite, which will lead to poor growth." Pediatric clients who are diagnosed with CF experience poor growth despite a healthy appetite and diet; therefore, the parental statement indicates that the infant's poor appetite will lead to poor growth indicates the need for further education. Pediatric clients diagnosed with CF experience poor growth due to delayed bone growth, increased oxygen demands, and a decreased ability to absorb nutrients.
Which parental statement indicates the need for further education regarding the psychosocial development that occurs during infancy? "My older kids are so excited that our 10-month-old can play hide-and-seek with them." "Peek-a-boo is an appropriate activity to initiate with my baby around 9 months of age." "I just bought my 6-month-old some new rattles to play with because they are easy to grasp." "It is important that my baby develops trust so we always respond when he cries for us at night."
"My older kids are so excited that our 10-month-old can play hide-and-seek with them." Play is an important aspect of an infant's psychosocial development. While more complex interactive games, such as hide-and-seek involving objects is expected by 1-year of age, this statement would require additional education regarding age-appropriate play for the infant. Peek-a-boo and rattles are both appropriate play for the infant. Responding promptly to an infant's cry will establish trust.
What birth weight in a neonate indicates that the infant is a very low birth weight (VLBW) infant? 900 g 1300 g 1700 g 2000 g
1300 g Infants whose birth weight is less than 1500 g are known as very low birth weight infants. Infants whose birth weight is less than 1000 g are known as extremely low birth weight infants. Infants whose birth weight is less than 2500 g are known as low birth weight infants.
The nurse is learning about the shift in total body fluid that occurs from infancy to adulthood. What percentage of body weight is the weight of extracellular fluid (ECF) in an infant at term? 10% 20% 44% 78%
44% The amount of ECF is 44% of the body weight at term. The initial birth weight of a term newborn can decrease by 10% in the first 5 days of life due to ECF compartment contraction, enhanced renal tubular function, and rapidly increasing glomerular filtration rate. The amount of ECF is 20% in adulthood. At birth, 78% of the infant's body weight is water—ECF occupies a significant part of it.
The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics and hypogenitalism. Which chromosomal notation is associated with the child's condition? 45,XO 47,XXX 47,XYY 48,XXXY
48,XXXY The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.
In which age range would the nurse expect a client to understand the concept of conservation related to liquids and numbers when conducting a developmental assessment? 5 to 7 years 6 to 7 years 9 to 10 years 9 to 12 years
5 to 7 years Mastering the concept of conservation related to liquids and numbers occurs at 5 to 7 years of age. Conservation related to length is expected at 6 to 7 years of age. Conservation related to weight and area occurs at 9 to 10 years of age. Conservation related to volume occurs at 9 to 12 years of age.
The nurse is examining a teenage client who has a gawky, long-legged appearance. What is the sequence of growth changes that lead to this characteristic early adolescent appearance? 1.Increase in the length of the trunk 2.Growth of the neck, hands, and legs in length 3.Increase in the breadth of the hips and chest 4.Increase in the width of the shoulders 5.Increase in the depth of the chest
5.Increase in the depth of the chest There is a characteristic sequence in the growth changes that occur during adolescence. The lengthwise growth of the neck and extremities occurs first before growth in other areas of the body. This is followed by an increase in the breadth of the hips and chest. Months later there is increase in shoulder width. Then the trunk increases in length, and finally there is an increase in the depth of the chest. This sequential growth pattern results in the characteristic gawky, long-legged appearance of early adolescence.
At what age does a child start to crawl? 3 months 5 months 7 months 9 months
9 months At the age of 9 months, a child starts to crawl along the floor and can pull himself or herself to a standing or sitting position. At the age of 3 months, a child can lift his or her head and chest and is able to sit erect with support. At the age of 5 months, a child can support much of his or her own weight when pulled to stand. At the age of 7 months, a child can sit alone without support, can bear his or her full weight on his or her feet, and can hold on to furniture.
At which age should the nurse assess the school-age client for mastery of the concept of conservation of volume? 6 years 7 years 8 years 9 years
9 years Mastery of the concept of conservation of volume occurs between the ages of 9 and 12 years; therefore, the nurse would include this in the assessment for the 9-year-old school-age client. Volume conservation is not assessed for the 6-, 7-, or 8-year-old school-age child.
The nurse is assessing a newborn immediately after birth. Which finding indicates normal development? A body weight of 3500 g Blood pressure of 70/60 mm Hg A core body temperature of 96° F (35.6° C) Head circumference 3 cm less than chest circumference
A body weight of 3500 g The newborn has a body weight of 3500 g, which is within the normal range of 2700 to 4000 g. Therefore this indicates normal development. The core body temperature of the newborn is 96° F (35.6° C), which is less than the normal range of 97.7° F to 99.7° F (36.5° C to 37.6° C). Therefore the core body temperature of 96° F (35.6° C) indicates hypothermia. The normal blood pressure of a newborn on the first day of birth is 65/45 mm Hg. A blood pressure finding of 70/60 mm Hg indicates very high blood pressure. The head circumference of the newborn is less than the chest circumference, which indicates that the newborn may have microcephaly.
Which nursing action is appropriate to determine conservation for the 9-year-old client who has mastered the expected conservation for age prior to the current health maintenance visit? Asking the child to compare mass Asking the child to compare length Asking the child to compare weight Asking the child to compare numbers
Asking the child to compare weight The nurse would assess for conservation of weight for the 9-year-old school-age client who has mastered the expected conservation for age up until the current visit. Conservation of mass is expected between 5 and 7 years of age. Conservation of length is expected at 6 to 7 years of age. Conservation of numbers is expected at 5 to 7 years of age.
Which potential source of stress for an 11-year-old client should the nurse plan to include in a teaching session during the scheduled health maintenance visit? Having a fear of getting lost Resenting parental authority Being tempted to drink alcohol Selecting friends of the same sex
Being tempted to drink alcohol Selecting friends of the same sex A source of stress for many school-age children between the ages of 10 and 12 years is the temptation to experiment with drugs and alcohol; therefore, this is an important topic to include in the teaching session with the client and his or her parents. Having a fear of getting lost is a source of stress for a 6-year-old school-age client. Resenting parental authority is a common source of stress for an 8-year-old school-age client. Selecting friends of the opposite, not the same, sex is a source of stress for the school-age client who is 10 to 12 years of age.
Which activities are easier for the school-age client due to changes in proportions from the preschool stage of development? Select all that apply. Climbing Handwriting Riding a bike Problem-solving Cooperative play
Climbing Riding a bike 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.
After assessing a neonate immediately after birth who was delivered using forceps, the nurse confirms facial paralysis. Which information does the nurse provide to the mother? Don't panic; it will resolve within a few days. Take the newborn to a neurologist immediately. The infant requires phototherapy for a few minutes. Refrain from breast-feeding the infant for a few days.
Don't panic; it will resolve within a few days. Facial paralysis may occur in a neonate because of a forceps delivery. This facial paralysis generally disappears within a few hours or days, so no medical intervention is required. Phototherapy does not affect facial paralysis in a neonate. Facial paralysis in a neonate generally does not reflect brain damage, so there is no immediate need to consult a neurologist. Breastfeeding is not contraindicated in neonates with facial paralysis.
The student nurse is learning about the developmental characteristics of vision. Which major developmental characteristics does an infant start exhibiting around age 6 weeks? Select all that apply. Having binocular vision Having doll's eye reflex Having visual acuity 20/40 to 20/60 Having peripheral vision to 180 degree
Having binocular vision Having peripheral vision to 180 degree Beginning at age 6 weeks, the infant has binocular vision, which becomes well established by age 4 months. Within 6 to 12 weeks, the infant has peripheral vision to 180 degrees. An infant has doll's eye reflex at birth, and it disappears within age 6 to 12 weeks. Visual acuity of 20/40 to 20/60 does not develop until age 44 to 52 weeks. Lack of binocular vision indicates strabismus at age 28 to 44 weeks. While binocular vision generally develops by age 6 weeks, a lack of this development at this age is not indicative of strabismus.
Which is an inborn error of metabolism that affects growth and development? Cystic fibrosis Achondroplasia Turner syndrome Hunter syndrome
Hunter syndrome Hunter syndrome is an inborn error of metabolism that hinders development and results in altered physical appearance and impaired mental development. Cystic fibrosis is a genetic disorder that results in accumulation of mucus in the lungs and pancreas. Achondroplasia is a congenital disorder that is a common cause for the structural defect called dwarfism. Turner syndrome is a chromosomal abnormality associated with webbed neck and low-set ears.
Which statement is true regarding the physical development of a preschooler? Children gain about 3 lbs (1.36 kg) per year. Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers grow three times their length at around 4 years.
Preschoolers grow 6.2 to 7.5 cm per year. The average weight of the child at four years is 32 lbs (14.51 kg). Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers gain about 5 lbs (2.26 kg) per year. They also grow double their length at around 4 years old. The average weight of a 4 year old is 37 lbs (16.78 kg).
Which physiologic body functions decrease in response to certain pubertal changes? Select all that apply. Pulse rate Blood volume Strength of the heart Basal heat production Systolic blood pressure
Pulse rate Basal heat production Pubertal changes induce physiologic changes. The physiologic functions that decrease in response to pubertal changes include pulse rate and basal heat production. Blood volume, strength of the heart, and systolic blood pressure increase with changes occurring during puberty. Pubertal changes herald adulthood, and therefore the heart increases in size and strength and the systolic blood pressure increases to reach the adult rate.
Which difficulties faced by an adolescent diagnosed with a chronic illness are attributed to normal development? Select all that apply. Risk taking Rebelliousness Peer socialization Lack of cooperation Hostility toward authority
Risk taking Rebelliousness Lack of cooperation Hostility toward authority Risk taking, rebelliousness, lack of cooperation, and hostility toward authority are attributes of normal personal adolescent development. Peer socialization is something that should be encouraged to achieve independence from family.
In which stage of Kohlberg's theory of moral development does the nurse anticipate a client to realize there is more than one right point of view? Stage 1 Stage 2 Stage 3 Stage 4
Stage 2 Level I, preconventional reasoning, stage 2, is when the nurse anticipates that the client will realize there is more than one right view. In level I, stage 1, the nurse would anticipate absolute obedience to authority and rules. In level II, conventional reasoning, stage 3, the child wants to win approval and maintain expectations of his or her immediate group. Level II, stage 4, is when the client expands focus from the relationship with others to societal concerns.
In which stage of Kohlberg's theory of moral development does the nurse anticipate a client to expand focus from relationships with others to societal concerns? Stage 1 Stage 2 Stage 3 Stage 4
Stage 4 Level II, conventional reasoning, stage 4 is when the nurse anticipates a client will expand focus from the relationship with others to societal concerns. In level I, preconventional reasoning, stage 1, the nurse anticipates absolute obedience to authority and rules. In level I, preconventional reasoning stage 2, the nurse anticipates that the client will realize there is more than one right view. In level II, preconventional reasoning stage 3, the client wants to win approval and maintain expectations of his or her immediate group.
A nurse examines a class of seven-year-old students during a school health program. According to Erikson's theory, which behavior would the students display? Students want to know "Who am I?" Students exhibit a sense of care for others. Students show an eagerness to learn social skills. Students like to pretend and try out new roles.
Students show an eagerness to learn social skills. The nurse will likely notice that seven-year-old students show an eagerness to learn social skills. This stage is identified as the industry versus inferiority stage according to Erikson's theory. During puberty, students want the answer of "Who am I?" This is indicative of the identity versus role confusion stage. Young adults exhibit a sense of caring for others at the intimacy versus isolation stage. Children like to pretend and try out new roles at the stage of initiative versus guilt. This is seen at the age of 3 to 6 years.
The nurse observes that a child fails to make eye contact and has poor impulse control. Upon further assessment, the nurse finds that the parent is an alcoholic and often neglects the child. What can be said about the child? 1 The child needs to be screened for autism. The child is experiencing separation anxiety. The child feels solitary because of the parent's behavior. The child has developed reactive attachment disorder (RAD).
The child has developed reactive attachment disorder (RAD). RAD is a psychological and developmental disorder that occurs in children who are neglected by their primary caregivers. Children with RAD are not cuddly with parents and fail to make eye contact. They also exhibit poor impulse control and may be destructive to themselves and others. Poor eye contact is seen in autistic children as well, but in this case, there is parental neglect that indicates RAD. Separation anxiety is indicated by crying and screaming when the parent leaves the child. Feelings of solitariness do not result in poor impulse control or eye contact.
A worried mother reports that her teenage child wears unusual clothes and make-up and refuses to wear the clothes the mother buys. What does the nurse suspect as the cause for this behavior? The child is establishing self-image in relation to others. The child is establishing gender role identification with the mother. The child is displaying group identity to develop a personal identity. The child is identifying himself or herself as a separate entity from the mother.
The child is displaying group identity to develop a personal identity. The child is seeking to establish a group identity by dressing and wearing make-up in a way that confirms this identity to other members of the group. The child establishes a self-image in relation to others during the latter part of childhood. In early childhood, the child attempts to establish gender role identification with the same-sex parent. During infancy, the child identifies himself or herself as a separate entity from the mother.
The nurse is assessing a female preterm neonate after delivery. Which assessment findings does the nurse document in the hospital reports of the infant? Select all that apply. The infant has a prominent clitoris. The sole of the infant is deeply creased. The hair of the infant is fine and feathery. The infant rests in a more flexed attitude. The infant shows no resistance to the heel-to-ear maneuver.
The infant has a prominent clitoris. The hair of the infant is fine and feathery. The infant shows no resistance to the heel-to-ear maneuver. A female preterm neonate lacks proper growth of the labia majora; therefore, the neonate will have a prominent clitoris. A preterm neonate lacks proper nourishment to the hair, resulting in fine and feathery hair. The knee of a preterm infant does not offer resistance to the heel-to-ear maneuver. The soles of a preterm infant's feet appear more turgid and may have only fine wrinkles. The preterm infant has less subcutaneous tissue, and therefore rests in a relaxed attitude.
During which week of pregnancy does placental development occur? First Third Fifth Seventh
Third Placental development begins during the third week of pregnancy. The other answer options, first, fifth, and seventh, are not when placental development occurs.
Which symptoms present in a child indicate Turner syndrome? Select all that apply. Webbed neck Impaired language Tall stature with long legs Low position of posterior hairline Shield-shaped chest with wide space between the nipples
Webbed neck Low position of posterior hairline Shield-shaped chest with wide space between the nipples Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.