Human Growth & Development

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Which type of family is formed when both parents bring children from previous relationships into a joint living situation?

Blended family Rationale: A blended family is formed when both parents bring children from previous relationships into a new household.

What is the average weight of a 5-year old child?

41 pounds (18.59 kg)

Which stage is observed in a 2-year-old child according to Freud's theory?

Anal Rationale: According to Freud, the anal stage is observed in children between 18 months and 3 years of age (toddlers). The oral stage is observed during infancy, which is from birth to 18 months of age. The latent stage is observed in 6- to 12-year-old children. The phallic stage is observed in 3- to 5-year-old children (preschoolers).

An 8-year-old child is being prepared for surgery the next day. How should the nurse present preoperative instructions to this child?

By focusing on simple anatomic diagrams Rationale: According to Piaget, an 8-year-old child's level of development is in the stage of concrete operations; the child will benefit from simple, concrete examples. The preschooler and younger child, not the school-age child, require repetition. Therapeutic needle play is more appropriate if and when the child is to receive an injection. The child who is in the period of concrete operations cannot think in the abstract; the ability to do this develops during adolescence.

Who would form an integral part of a nuclear family?

Married parents with children

Which content type of play allows a child to experience pleasure by swinging?

Sense-pleasure play Rationale: Sense-pleasure play is a nonsocial stimulating experience in which the pleasurable experiences are derived from the environment, handling of raw materials, and body motion such as swinging, bouncing, and rocking. In skill play, infants persistently demonstrate and exercise their newly acquired abilities. The simple, imitative, dramatic play of toddlers, such as using a telephone, driving a car, or rocking a doll is called pretend play or dramatic play. In social-affective play, the infant takes pleasure in relationships with people. As adults talk, touch, nuzzle, and in various ways elicit responses from an infant, the infant soon learns to provoke parental emotions and responses.

Which concerns are a priority for limiting risk and promoting health in adolescents? Select all that apply.

Suicide Accidents Interpersonal violence

The mother of a toddler is anxious about her child's eating habits because the child is very fussy and doesn't eat well. What should the nurse explain to the mother?

The child's eating habits are normal for this age

Which stage of life is termed senescence stage?

The last stage of the life cycle

What is a physical clinical manifestation of autism?

Constipation

Which motor response appears at 8 months of age?

Crude pincer grasp Rationale: A crude pincer grasp is a fine motor skill that is observed in 8- to 10-month-old infants. Complete head lag can be observed in infants at 1 month of age. Partial head lag is seen in 2-month-old infants. Unidextrous approach and grasp is seen in infants at 7 months of age.

Which activities should the nurse expect to see exhibited by a healthy 6-month-old infant during an evaluation of the infant's growth and development? Select all that apply.

Playing peek-a-boo Turning completely over Reaching to be picked up Sitting for a short time without support

The nurse is providing care to a client from another culture who is involved in a motor vehicle accident. Which is the priority nursing action to provide culturally sensitive care for this client?

Asking the client and family if there is any special care related to their culture Rationale: The priority nursing action when providing care to a client who is from a different culture is to ask the client and family if there is any special care related to the cultural background. It is appropriate for the nurse to review information related to the client's culture, but it is not certain that this information would apply to this specific client. There is no indication that the client does not speak English; therefore, it is not necessary to notify the medical interpreter. There is no indication that the client's culture necessitates care from one gender or the other.

Which stage of psychosocial development should an individual successfully master to achieve self-control and willpower, according to Erikson's theory?

Autonomy versus shame and doubt Rationale: In the autonomy versus shame and doubt stage, the child becomes more independent and develops autonomy by making choices. Limiting the choices and enacting harsh punishment leads to feelings of shame and guilt. Therefore, the individual who succeeds at this stage will achieve self-control and willpower. Success in the trust versus mistrust stage results in faith and optimism in the individual. The successful resolution of the initiative versus guilt stage results in direction and purpose. Failure during the industry versus inferiority stage results in the development of a sense of inadequacy and inferiority.

According to Piaget's theory of cognitive development, what should the nurse expect a 6-month-old infant to demonstrate?

Beginning of object permanence Rationale: The concept of object permanence begins to develop around 6 months of age. Early traces of memory and beginning sense of time occur between 13 and 24 months. Repetitious reflex responses occur during the first several months of life. These diminish as the newborn grows.

Which family has at least one step-parent and step-sibling?

Blended family Rationale: The blended family includes at least one step-parent who is the spouse of a child's biological parent, but is not the child's biological parent. It also includes a step-sibling or half-sibling who does not share one common biological parent. The nuclear family is composed of two parents and their children, in which the parent-child relationship and sibling ties may be biological, step, adoptive, or foster. The extended family includes at least one parent, one or more children, and one or more relatives or nonrelatives other than a parent or sibling. Parent-child relationships may be biological, step, adoptive, or foster in an extended family. The traditional nuclear family consists of married couples and their biological children.

Which could be the result if a person fails to master the intimacy vs. isolation stage of Erikson's psychosocial development?

Egocentricity Rationale: Failure during the intimacy vs. isolation stage results from an inability to establish intimate bonds of love and friendship. This failure leads to emotional isolation and egocentricity. Failure during the generativity vs. stagnation stage results in self-absorption. Failure during the industry vs. inferiority stage causes a sense of inferiority. Failure during the ego integrity vs. despair stage can cause dissatisfaction with life.

What should the nurse advise the parents of a child who performs manual stimulation of his genitalia in public places?

Explain that genital stimulation is acceptable in private places

During data collection, the nurse finds that a preschool-age child is stressed about the family relocating to a different city. The nurse tells the parents about ways to reduce the child's stress during the transition. What is the best approach the parents can take to help their child cope with the transition?

Explaining what the child can expect

Which family consists of a traditional family and an additional family?

Extended family Rationale: An extended family consists of a traditional family and an additional family that includes grandparents, grandchildren, aunts, and uncles living in the same household. A grandfamily consists of children under the age of 18 years who live with their grandparents. A nuclear family consists of parents and their biologic offspring. A blended family consists of children from a previous marriage.

Which type of family involves a nuclear family plus additional family members living in the same household?

Extended family Rationale: An extended family involves a nuclear family plus additional members living in the same household who share responsibilities. In grandfamilies, the biological parents may or may not take part in the child's care. A nuclear family involves a married man, woman, and their children. A blended family involves an adult who is previously married who remarries and combines children within the new household.

The nurse has taught newborn care and safety to a group of expectant mothers. Which statement by a mother indicates the need for additional teaching?

I'll keep my baby in a backward-facing car seat until he's a year old. Rationale: New guidelines recommend keeping a child in a backward-facing car seat until 2 years of age. Putting a baby to bed on his or her back will reduce the risk of sudden infant death syndrome. The house should be toddler-proofed when the child starts crawling. Choking is a major hazard for the young infant, who will place anything at hand in his or her mouth.

A nurse is assessing the oral cavity of a 6-month-old infant. The parent asks which teeth will erupt first. What is the nurse's response?

Incisors Rationale: The bottom incisors are the first teeth to erupt, between 6 and 8 months of age. The canine teeth appear around 18 months. The first molars, both upper and lower, appear around 20 months.

A nurse is caring for an infant with meningitis. When the nurse extends the baby's leg, the hamstring muscles go into spasm and the infant begins to cry. What sign or reflex is the infant exhibiting?

Kernig sign Rationale: The Kernig sign is indicative of meningitis; it is demonstrated by a spasm of the hamstring muscles when the legs are extended. The Babinski reflex is dorsiflexion and fanning of the toes when the sole is stroked; adults with neuromuscular impairment and healthy infants exhibit this sign. The Chvostek sign is elicited by tapping on the facial nerve in the region of the parotid gland; spasm indicates tetany. In a male, the cremasteric reflex is elicited by stroking the inner thigh; this should cause the testes to retract into the scrotal sac.

Which statement made by the mother of a 9-month-old infant supports the nurse's conclusion that the infant has good fine motor development?

My baby picks up small objects Rationale: Infants between 8 and 10 months of age are capable of picking up small objects, which is a fine motor skill. Therefore, this statement by the mother indicates that the infant has good fine motor development. Banging objects together is a fine motor skill seen in 6- to 8-month-old infants. Therefore, a 9-month-old infant is capable of this. Therefore, it does not indicate good fine motor development in a 9-month-old infant. The ability to creep on the hands and knees indicates gross motor development in 8- to 10-month-old infants. The ability to move from a sitting to a kneeling position indicates gross motor development in 6- to 8-month-old infants.

During testing of the neurologic reflexes of an infant, which reflex should the nurse expect to appear at 3 months and persist until 24 to 36 months of age?

Neck righting Rationale: While the infant is supine, if the head is turned to one side, the shoulder, trunk, and finally pelvis will turn toward that side. This reflex appears at 3 months and persists until 24 to 36 months of age. Body righting is a modification of the neck-righting reflex in which turning hips and shoulders to one side causes all other body parts to follow; it appears at 6 months and persists until 24 to 36 months of age. When the body of an erect infant is tilted, the head is returned to an upright, erect position; this is known as otolith righting, which appears at 7 to 12 months of age and persists indefinitely. When an infant in prone or supine position is able to raise the head, it is known as labyrinth righting. It appears at 2 months and is strongest at 10 months of age.

A 9-month-old infant who appears well nourished, alert, and happy is brought to the well-baby clinic for a routine physical examination. Using Freud's psychosocial theory of development, the nurse determines that the infant is in which stage?

Oral-sensory stage Rationale: According to Freud's psychosocial theory, the oral-sensory stage extends from birth to 18 months. The genital stage runs from 12 years to early adulthood. The latency stage is between 6 and 12 years of age. The anal-urethral stage extends from 1 to 3 years of age.

The nurse is explaining to a parent about Freud's theory of child development. What stages does the nurse include in the discussions? Select all that apply.

Phallic stage Latency stage Rationale: Freud's psychoanalytic model of personality development involves the phallic and latency stage. The sensorimotor stage and formal operation stage are explained under Piaget's theory. The punishment orientation stage is explained under preconventional reasoning in Kohlberg's theory of moral development.

Which nursing action is most accurate when assessing the chest circumference of a newborn during the initial physical assessment?

Placing the measuring tape around the rib cage at the nipple line Rationale: The most accurate nursing action when assessing the chest circumference of a newborn during the initial physical assessment is to place the measuring tape around the rib cage at the nipple line. Two measurements should be performed, one during inspiration and one during expiration. The average of these two measurements is then plotted on the growth chart.

While sitting on the counter, a child touches a pan on the stove and burns her hands. The child learns that it is not safe to touch objects on the stove. Which stage of Piaget's cognitive development does the child's behavior demonstrate?

Sensorimotor

While playing with her child, a mother takes a toy from the child and hides it. She then observes that the child begins to look for the hidden object. According to Piaget, which developmental stage is indicated by this behavior?

Sensorimotor Rationale: The ability to recognize the permanence of objects is seen in the sensorimotor stage. The child has learned that objects in the environment are still present even when they are not seen. During the preoperational stage, the child develops symbolic mental abilities. A child learns to think abstractly during the stage of formal operations. Logical and objective thinking are present in the stage of concrete operations.

During a family assessment, a client reports that she and her husband are divorced and that she wants to adopt a child. Which type of family does this report indicate?

Single-parent family Rationale: A family consisting of a single parent and one or more children is called a single-parent family. A single-parent family may be formed when one parent leaves the family because of divorce and decides to adopt a child. A blended family is formed when both parents marry and bring their children from previous relationships. A family consisting of two partners and their adoptive children is called an adoptive family. An extended family includes a traditional nuclear family along with other relatives

Which stage of Lawrence Kohlberg's theory of moral development is associated with a person following a law even if it is discriminatory to a racial group?

Social contract orientation

A 2-year-old child attempts to jump, but falls down, and everyone around starts laughing at the child. What would be the result, if this pattern keeps repeating?

The child will develop doubt and shame Rationale: A 2-year-old child comes under Erikson's stage of autonomy versus shame and doubt. The child may try to gain autonomy by performing tasks. However, failure to do so may make the child feel shameful and doubtful about his abilities. An older child (ages 6 to 12) who is in the industry versus inferiority stage may feel inferior if unable to perform a task. A child in the initiative versus guilt stage (ages 3 to 6) may feel guilty for not being able to perform a task. Infants in the trust versus mistrust may develop mistrust toward caregivers if basic needs are inadequately met.

During a well-baby clinic visit, the nurse finds that a 1-year-old infant says "ma" and "pa." The infant does not say anything else and uses gestures to communicate. What should the nurse infer from this finding?

The infant exhibits normal language development Rationale: Infants usually use very few words to convey their needs, and rely mostly on gestures. Therefore, the infant has normal language development. The infant may enjoy spending time with peers, but it may not help in furthering language development. As the infant has normal growth and development, the infant does not need a consultation with the pediatrician. The normal language development indicates that the infant does not have cognitive impairment.

Which statement is true regarding the stages of family development?

The roles of parenting change during the disengagement stage Rationale: The disengagement stage is a period of family life when grown children depart from the home. During this stage, the roles of parenting change. The establishment stage begins with a couple's official union and ends with the birth of the first child. The parenthood stage begins at the birth of a couple's child. The commitment stage begins when a couple acknowledges that they are considering marriage.

The mother of a 2-year-old girl expresses concern that her daughter's growth rate has slowed. What should the nurse explain to the mother about the growth of toddlers?

This growth pattern is typical at this age Rationale: 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.

What is the site of choice for administration of an intramuscular (IM) medication to an infant?

Vastus lateralis Rationale: IM injections are given in the vastus lateralis muscle of the thigh in infants. The ventrogluteal site is not used until children have been walking. The dorsogluteal site is considered high risk for damage to the sciatic nerve or a major blood vessel. The deltoid site in the arm has a small muscle mass that limits the amount of medication that can be injected.

The parent of a 7-year-old child states, "My 7-year-old is the same size as my friend's 10-year-old. I get embarrassed when we are all out together, as my child is not nearly so well behaved." What is the best response from the nurse?

Your child's behavior is age-appropriate Rationale: In school-age children, physical maturity may not correspond to emotional and social maturity. The child should not be forced to behave emotionally like an older child, as it may harm the child's self-esteem. The parents should not be strict with the child who has age-appropriate behavior. Every child is different, and discipline tips from one parent may not be applicable to another parent. The child does not need any special training in discipline and good manners, because he or she exhibits age-appropriate behavior.


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