Chapter 28

33. A nurse is preparing to administer a Denver II. Which statement(s) about the Denver II test is (are) accurate (Select all that apply)? a. All items intersected by the age line should be administered. b. There is no correction for a child born prematurely. c. The tool is an intelligence test. d. Toddlers and preschoolers should be prepared by presenting the test as a game. e. Presentation of the toys from the kit should be done one at a time.

ANS: A, D, E

14. The nurse is observing parents playing with their 10-month-old daughter. What should the nurse recognize as evidence that the child is developing object permanence? a. She looks for the toy the parents hide under the blanket. b. She returns the blocks to the same spot on the table. c. She recognizes that a ball of clay is the same when flattened out. d. She bangs two cubes held in her hands.

ANS: A

25. What is probably the single most important influence on growth at all stages of development? a. Nutrition c. Culture b. Heredity d. Environment

ANS: A

18. At what age do children tend to imitate the religious gestures and behaviors of others without understanding their significance? a. Toddlerhood c. Older school-age period b. Young school-age period d. Adolescence

ANS: A Toddlerhood is a time of imitative behavior. Children will copy the behavior of others without comprehending any significance or meaning to the activities. During the school-age period most children develop a strong interest in religion. The existence of a deity is accepted, and petitions to an omnipotent being are important. Although adolescents become more skeptical and uncertain about religious beliefs, they do understand the significance of religious rituals.

26. Which strategy would be the least appropriate for a child to use to cope? a. Learning problem solving c. Having parents solve problems b. Listening to music d. Using relaxation techniques

ANS: C

4. By what age does birth length usually double? a. 1 year c. 4 years b. 2 years d. 6 years

Answer C

34. What factors indicate that parents should seek genetic counseling for their child (Select all that apply)? a. Abnormal newborn screen b. Family history of a hereditary disease c. History of hypertension in the family d. Severe colic as an infant e. Metabolic disorder

ANS: A, B, E

32. Play serves many purposes. In teaching parents about appropriate activities, the nurse should inform them that play serves the following function (Select all that apply): a. Intellectual development b. Physical development c. Self-awareness d. Creativity e. Temperament development

ANS: A, C, D

11. A mother reports that her 6-year-old child is highly active and irritable and that she has irregular habits and adapts slowly to new routines, people, or situations. According to Chess and Thomas, which category of temperament best describes this child? a. Easy child c. Slow-to-warm-up child b. Difficult child d. Fast-to-warm-up child

ANS: B

21. The nurse observes some children in the playroom. Which play situation exhibits the characteristics of parallel play? a. Kimberly and Amanda sharing clay to each make things b. Brian playing with his truck next to Kristina playing with her truck c. Adam playing a board game with Kyle, Steven, and Erich d. Danielle playing with a music box on her mothers lap

ANS: B

24. Which statement is true about toy safety? a. Adults should be the only ones who select toys. b. Adults should be alert to notices of recalls by manufacturers. c. Government agencies inspect all toys on the market. d. Evaluation of toy safety is a joint effort between children and adults.

ANS: B

12. By the time children reach their twelfth birthday, they should have learned to trust others and should have developed a sense of: a. Identity. c. Integrity. b. Industry. d. Intimacy.

ANS: B Industry is the developmental task of school-age children. By age 12 years, children engage in tasks that they can carry through to completion. They learn to compete and cooperate with others, and they learn rules. Identity versus role confusion is the developmental task of adolescence. Integrity and intimacy are not developmental tasks of childhood.

15. What is characteristic of the preoperational stage of cognitive development? a. Thinking is logical. c. Reasoning is inductive. b. Thinking is concrete. d. Generalizations can be made.

ANS: B Preoperational thinking is concrete and tangible. Children in this age group cannot reason beyond the observable, and they lack the ability to make deductions or generalizations. Increasingly logical thought, inductive reasoning, and the ability to make generalizations are characteristic of the concrete operations stage of development, ages 7 to 11 years.

10. Which statement is true about the basal metabolic rate (BMR) in children? a. It is reduced by fever. b. It is slightly higher in boys than in girls at all ages. c. It increases with the age of child. d. It decreases as proportion of surface area to body mass increases.

ANS: B The BMR is the rate of metabolism when the body is at rest. At all ages the rate is slightly higher in boys than in girls. The rate is increased by fever. The BMR is highest in infancy and then closely relates to the proportion of surface area to body mass. As the child grows, the proportion decreases progressively to maturity.

28. The karyotype of a person is 47, XY, +21. This person is a: a. Normal male. c. Normal female. b. Male with Down syndrome. d. Female with Turner syndrome.

ANS: B This person is male because his sex chromosomes are XY. He has one extra copy of chromosome 21 (for a total of 47 instead of 46), resulting in Down syndrome. A normal male would have 46 chromosomes. A normal female would have 46 chromosomes and XX for the sex chromosomes. A female with Turner syndrome would have 45 chromosomes; the sex chromosomes would have just one X.

27. The intrauterine environment can have a profound and permanent effect on the developing fetus with or without chromosome or gene abnormalities. Most adverse intrauterine effects are the result of teratogens. The nurse is cognizant that this group of agents does not include: a. Accutane c. Amniotic bands b. Rubella d. Alcohol

ANS: C

29. Frequent developmental assessments are important for which reason? a. Stable developmental periods during infancy provide an opportunity to identify any delays or deficits. b. Infants need stimulation specific to the stage of development. c. Critical periods of development occur during childhood. d. Child development is unpredictable and needs monitoring.

ANS: C Critical periods are blocks of time during which children are ready to master specific developmental tasks. The earlier that delays in development are discovered and intervention initiated, the less dramatic their effect will be. Infancy is a dynamic time of development that requires frequent evaluations to assess appropriate developmental progress. Infants in a nurturing environment will develop appropriately and will not necessarily need stimulation specific to their developmental stage. Normal growth and development are orderly and proceed in a predictable pattern on the basis of each individuals abilities and potentials.

16. Which behavior is most characteristic of the concrete operations stage of cognitive development? a. Progression from reflex activity to imitative behavior b. Inability to put oneself in anothers place c. Increasingly logical and coherent thought processes d. Ability to think in abstract terms and draw logical conclusions

ANS: C During the concrete operations stage of development, which occurs approximately between ages 7 and 11 years, increasingly logical and coherent thought processes occur. This is characterized by the childs ability to classify, sort, order, and organize facts to use in problem solving. The progression from reflex activity to imitative behavior is characteristic of the sensorimotor stage of development. The inability to put oneself in anothers place is characteristic of the preoperational stage of development. The ability to think in abstract terms and draw logical conclusions is characteristic of the formal operations stage of development.

19. A toddler playing with sand and water would be participating in _____ play. a. Skill c. Social-affective b. Dramatic d. Sense-pleasure

ANS: D

23. Which function of play is a major component of play at all ages? a. Creativity c. Intellectual development b. Socialization d. Sensorimotor activity

ANS: D

7. A childs skeletal age is best determined by: a. Assessment of dentition. c. Facial bone development. b. Assessment of height over time. d. Radiographs of the hand and wrist.

ANS: D

8. Trauma to which site can result in a growth problem for childrens long bones? a. Matrix c. Calcified cartilage b. Connective tissue d. Epiphyseal cartilage plate

ANS: D

13. The predominant characteristic of the intellectual development of the child ages 2 to 7 years is egocentricity. What best describes this concept? a. Selfishness c. Preferring to play alone b. Self-centeredness d. Inability to put self in anothers place

ANS: D According to Piaget, this age child is in the preoperational stage of development. Children interpret objects and events not in terms of their general properties but in terms of their relationships or their use to them. This egocentrism does not allow children of this age to put themselves in anothers place. Selfishness, self- centeredness, and preferring to play alone do not describe the concept of egocentricity.

6. A 13-year-old girl asks the nurse how much taller she will become. She has been growing about 2 inches per year but grew 4 inches this past year. Menarche recently occurred. The nurse should base her response on knowing that: a. Growth cannot be predicted. b. The pubertal growth spurt lasts about 1 year. c. Mature height is achieved when menarche occurs. d. Approximately 95% of mature height is achieved when menarche occurs.

ANS: D Although growth cannot be definitely predicted, at the time of the beginning of menstruation or the skeletal age of 13 years, most girls have grown to about 95% of their adult height. They may have some additional growth (5%) until the epiphyseal plates are closed. Responding that the pubertal growth spurt last about 1 year does not address the girls question. Young women usually will grow approximately 5% more after the onset of menstruation.

9. Lymphoid tissues such as lymph nodes are: a. Adult size by age 1 year. b. Adult size by age 13 years. c. Half their adult size by age 5 years. d. Twice their adult size by age 10 to 12 years.

ANS: D Lymph nodes increase rapidly and reach adult size at approximately age 6 years. They continue growing until they reach maximal development at age 10 to 12 years, which is twice their adult size. A rapid decline in size occurs until they reach adult size by the end of adolescence.

17. According to Kohlberg, children develop moral reasoning as they mature. What is most characteristic of a preschoolers stage of moral development? a. Obeying the rules of correct behavior is important. b. Showing respect for authority is important behavior. c. Behavior that pleases others is considered good. d. Actions are determined as good or bad in terms of their consequences.

ANS: D Preschoolers are most likely to exhibit characteristics of Kohlbergs preconventional level of moral development. During this stage they are culturally oriented to labels of good or bad, right or wrong. Children integrate these concepts based on the physical or pleasurable consequences of their actions. Obeying rules of correct behavior, showing respect for authority, and knowing that behavior that pleases others is considered good are characteristic of Kohlbergs conventional level of moral development.

22. Three children playing a board game would be an example of: a. Solitary play c. Associative play b. Parallel play d. Cooperative play

ANS: D Using a board game requires cooperative play. The children must be able to play in a group and carry out the formal game. In solitary, parallel, and associative play, children do not play in a group with a common goal.

1. The head-to-tail direction of growth is referred to as: a. Cephalocaudal. b. Proximodistal. c. Mass to specific. d. Sequential.

Answer A

2. Which term refers to those times in an individuals life when he or she is more susceptible to positive or negative influences? a. Sensitive period c. Terminal points b. Sequential period d. Differentiation points

Answer A

30. The theorist who viewed developmental progression as a lifelong series of conflicts that need resolution is: a. Erikson. c. Kohlberg. b. Freud. d. Piaget.

Answer A

31. Which expected outcome would be developmentally appropriate for a hospitalized 4-year-old child? a. The child will be dressed and fed by the parents. b. The child will independently ask for play materials or other personal needs. c. The child will be able to verbalize an understanding of the reason for the hospitalization. d. The child will have a parent stay in the room at all times.

Answer B

5. How does the onset of the pubertal growth spurt compare in girls and boys? A. It occurs earlier in boys. B.It occurs earlier in girls. C.It is about the same in both boys and girls.

Answer B

20. In what type of play are children engaged in similar or identical activity without organization, division of labor, or mutual goal? a. Solitary c. Associative b. Parallel d. Cooperative

Answer C

3. An infant who weighs 7 pounds at birth would be expected to weigh how many pounds at age 1 year? a. 14 c. 18 b. 16 d. 21

Answer D