Ch 17 Elsevier Questions
Which question should the nurse ask a mother while assessing the growth and development of a 2-month-old infant? 1. "Does your baby smile at you?" 2. "Does your baby laugh out loud?" 3. "Does your baby imitate sounds?" 4. "Does your baby say "da-da"?"
1. "Does your baby smile at you?" The nurse asks health assessment questions during each visit to obtain subjective data about the infant. The nurse would expect the infant to be able to smile at the mother by 2 months of age. Infants do not laugh until they are 4 to 6 months old. The nurse would expect an infant to imitate sounds and say "da-da" at 12 months of age.
A head nurse is teaching student nurses about Sigmund Freud's theory of development. According to Freud, what is the basic instinctual impulse drive to achieve pleasure called? 1. Id 2. Ego 3. Superego 4. Conscience
1. Id According to Freud, there are different components in human personality that develop in stages. These components include the id, ego, and superego. The id is defined as the basic instinctual impulse drive to achieve pleasure. The ego mediates conflicts between the environment and the forces of the id. The third component, the superego, performs regulating, restraining, and prohibiting actions. Conscience is synonymous with the superego.
Approximately how many inches does a preschool child grow each year? 1. 1 2. 3 3. 5 4. 5 1/2
2. 3 Biological growth slows for the preschool child. The average weight gain is about 5 pounds per year and the average increase in height is about 2½ to 3 inches per year.
A head nurse is conducting a class on moral development stages in children. Which theory should the nurse include in the session? 1. Piaget's theory 2. Freud's theory 3. Kohlberg's theory 4. Erikson's theory
3. Kohlberg's theory Different researchers have elaborated developmental theories based on different principles. Lawrence Kohlberg's theory is based on moral development, whereas Freud's theory focuses on psychosexual development. Piaget's theory is based on cognitive development, and Erikson based his theory on psychosocial values. STUDY TIP: Think Ko-mo: Kohlberg-moral development.
The nurse observes a patient in the play area. The patient is able to think rationally, arrange things in a logical order, and view things from others' perspectives. Which stage of cognitive development is the patient experiencing according to Piaget's theory? 1. Sensorimotor stage 2. Preoperational stage 3. Formal operational stage 4. Concrete operational stage
4. Concrete operational stage Piaget described the process of cognitive development through four stages. A school-aged child between 7 and 11 years of age is in the concrete operational development stage. During this stage, the child develops seriation, in which the child thinks logically and arranges things in a logical order. The sensorimotor stage is the first stage of cognitive development, which lasts from birth to 2 years of age. A child at this stage develops sensory, gross, and fine-motor skills. At the preoperational stage, the child develops language skills rapidly and exhibits centration and egocentric thinking. During the formal operational stage (from 12 to 19 years of age), the child's thought develops from abstract thinking to problem-solving processes in which the child seeks meaning in life.
Which reflexes of an infant persist into adulthood? Select all that apply. A. Startle B. Sucking C. Yawning D. Blinking E. Coughing
C. Yawning D. Blinking E. Coughing An important sign of nervous system development and function is the presence and strength of a reflex. Many infant reflexes disappear as the child becomes older. The reflexes present in adulthood and throughout life are blinking, yawning, and coughing. If an adult possesses the startle or suckling reflex, it indicates an abnormality and nervous system damage in the adult. Test-Taking Tip: Remember to use "common sense" and good nursing judgment for multiple response questions by first eliminating incorrect responses. For this question, you could eliminate "Startle" and "Sucking" because they are not normally seen in adults.
Based on knowledge of the developmental tasks of Erikson's Industry versus Inferiority stage, the nurse emphasizes proper technique for use of an inhaler with a 10-year-old boy so he will: 1. Increase his self-esteem with mastery of a new skill. 2. Accept changes in his appearance and physical endurance. 3. Experience success in role transitions and increased responsibilities. 4. Appreciate his body appearance and function.
1. Increase his self-esteem with mastery of a new skill.
When Ryan was 3 months old, he had a toy train; when his view of the train was blocked, he did not search for it. Now that he is 9 months old, he looks for it, reflecting the presence of: 1. Object permanence. 2. Sensorimotor play. 3. Schemata. 4. Magical thinking.
1. Object permanence. He is now in Piaget's later stage of sensorimotor thought and has learned that objects exist even though he cannot see or touch them.
Arrange the five stages of Sigmund Freud's psychosexual development in an order that a person would experience them. 1. Phallic 2. Genital 3. Anal 4. Oral 5. Latency
1. Oral 2. Anal 3. Phallic 4. Latency 5. Genital Freud described five stages of psychosexual development in humans. The first is the oral stage from birth to 18 months. During this stage, the child gains pleasure from chewing, sucking, and biting. The anal stage is the second stage from 18 months to 3 years of age. During this stage, many children learn bowel and bladder control. The phallic stage is the period between 3 and 6 years of age. During this stage, the child gains pleasure through self-stimulation. Latency is the period from 6 years to puberty, during which all sexual interests are repressed. The genital stage is the final stage of psychosexual development. This stage occurs from puberty onward, during which sexual feelings are reawakened.
A child between the ages of 3 and 6 years fantasizes about the parent of the opposite sex. Whose developmental theory explains this behavior? 1. Sigmund Freud 2. Arnold Gesell 3. Erik Erikson 4. Jean Piaget
1. Sigmund Freud Freud's psychoanalytical model of personality development is based on the principle that each stage of development is characterized by sexual pleasures in different body parts. According to this theory, a child between the ages of 3 and 6 years fantasizes about the parent of the opposite sex. Gesell's theory of development is based on the principle that each person's development is directed by gene activity. Erikson's theory focuses on psychosocial stages and Piaget's theory is based on cognitive thinking.
A mother approaches a primary healthcare provider with a 5-year-old child suffering from pneumonia. The girl is continuously crying and is demanding to see her father. The girl has a short stature. She is pretending to play and not allowing the nurse to administer medication. According to Erik Erikson's theory of psychosocial development; which stage is the child in? 1. Trust versus mistrust 2. Initiative versus guilt 3. Intimacy versus isolation 4. Autonomy versus sense of shame and doubt
2. Initiative versus guilt According to Erik Erikson's theory of psychosocial development; the girl is in the initiative versus guilt stage. In this stage, the child likes to pretend and try out new roles to escape. This stage is from 3 years to 6 years of age. In the stage of trust versus mistrust, which is from birth until 1 year of age, the child develops the feeling of trust. The intimacy versus isolation stage refers to young adults when they develop a sense of identity and search for meaningful friendships. In the age group of 1 to 3 years, the child learns some basic self-care activities. It is the stage of autonomy versus sense of shame and doubt. STUDY TIP: Assign stages of Erickson's development to the children and people you know. It will help you to remember Erickson's stages if you have an actual person to consider for each stage.
While collecting data on a pregnant patient of Eastern European origin, the nurse determines that the fetus is at increased risk of Tay-Sachs disease. Which diagnostic test does the nurse expect the primary health care provider to prescribe in order to identify whether the patient is a carrier of the disease? 1. Papanicolaou test 2. Simple blood test 3. Clean-catch urinalysis 4. Renal function test
2. Simple blood test Tay-Sachs disease is a genetic lipid disorder. The primary health care provider suggests a simple blood test to identify whether the patient is a carrier of the disease. The disease is confirmed by taking a blood sample and extracting DNA from it in order to check for the HEXA mutation. The nurse would not expect a Papanicolaou test, because that test is performed to diagnose cervical carcinoma. A urinalysis is performed to detect any abnormal cells or signs of infection, and to know the color, components, and concentration of the urine. The nurse would not expect a renal function test, because the patient has a genetic disorder that does not alter the function of the kidneys or the renal system.
According to Sigmund Freud's theory of development, at which stage does a child start identifying with the parent of the same sex? 1. Stage 2 2. Stage 3 3. Stage 1 4. Stage 5
2. Stage 3 According to Freud, each person goes through five different stages of psychosexual development and each stage is characterized by pleasure in different body parts. In the third stage (phallic stage), the focus of sexual pleasure is in the genital organs. In this stage, the child fantasizes about the parent of the opposite sex. By the end of this stage the child starts identifying with the parent of the same sex. In stage 2, the focus of pleasure is in the anal region, whereas in stage 1 the focus is in the oral region. In the final or fifth stage, the focus of sexual pleasure is directed towards people outside the family circle.
The type of injury a child is most vulnerable to at a specific age is most closely related to which of the following? 1. Provision of adult supervision. 2. Educational level of the parent 3. Physical health of the child 4. Developmental level of the child
4. Developmental level of the child The child's cognitive and physical development need to be considered initially when assessing the potential risk for injury.
Which stage of cognitive development would the nurse observe while assessing an adolescent at a check-up? 1. Sensorimotor stage 2. Preoperational stage 3. Formal operational stage 4. Concrete operational stage
3. Formal operational stage Adolescence is the period from 13 to 19 years of age. The formal operational stage of cognitive development occurs during adolescence. Children at this stage are able to think abstractly, solve problems in a systemic fashion, and provide reasons for hypothetical situations. The sensorimotor stage is the first stage of development and occurs between birth and 2 years of age. The infant's actions are reflexive in nature in response to stimuli. The preoperational stage occurs during preschool age; children in this stage exhibit egocentric and magical thinking. The concrete operational stage occurs in school-age children as they master the concept of conservation.
A 13-year-old female patient is preoccupied with her appearance and image in her school. In which stage is this patient according to Erikson's theory? 1. Trust versus mistrust 2. Intimacy versus isolation 3. Initiative versus guilt 4. Identity versus role confusion
4. Identity versus role confusion Erikson identified eight stages of development based on psychosocial stages. According to this theory, an adolescent is usually in the identity versus role confusion stage. In this stage adolescents are preoccupied with their appearance and body image. Trust versus mistrust is seen in infants. Intimacy versus isolation is seen in young adults, whereas the initiative versus guilt stage is seen in children aged 3 to 6 years. Test-Taking Tip: Thinking about how teenagers behave, you know they are preoccupied with appearance. Now connect teenagers with the Erikson's theory and you know they are also concerned with their own identities; so your answer is clear!
Which approach would be best for the nurse to use with a hospitalized toddler? 1. Always give several choices. 2. Set few limits to allow for open expression. 3. Use noninvasive methods when possible. 4. Incorporate routines from home.
4. Incorporate routines from home. Toddlers in the hospital often find the experience upsetting, as it disrupts the comfort of their routine. The nurse may find it helpful to ask the parents about rituals and routines at home and try to incorporate them into the care of the child. Providing too many choices does not support their efforts to gain control.
Which of the following statements is most descriptive of the psychosocial development of school-age children? 1. Boys and girls play equally with each other. 2. Peer influence is not yet an important factor to the child. 3. They like to play games with rigid rules. 4. Separation from peers can be stressful.
4. Separation from peers can be stressful. Peer relationships become very important to school-age children, and they usually develop close friendships. Encouraging visits, cards, and phone conversations with friends and family can reduce anxiety and feelings of isolation. Test-Taking Tip: Avoid looking for an answer pattern or code. There may be times when four or five consecutive questions have the same letter or number for the correct answer.
According to Lawrence Kohlberg's theory of moral development, what does a child in level 1 perceive as the reason for contracting illness? 1. The child knows the exact cause of their disease 2. The child believes that illness is a result of going to school where other children are ill. 3. The child believes that illness is a blessing that will lead to a day off from school. 4. The child believes that illness is a punishment for fighting with parents.
4. The child believes that illness is a punishment for fighting with parents. According to Kohlberg's theory of moral development, there are six stages of moral development under three levels. In level I, children have preconventional and limited cognitive thinking, and they believe that their illness is a punishment for fighting with parents or siblings. In level I, children do not have rational thinking, so they will not know the exact reason for their illness. It is unlikely that children in level I moral development would believe their illnesses are a result of going to school or a blessing and opportunity to miss school.
An adolescent has successfully mastered the identity versus role confusion stage of Erik Erikson's theory of psychosocial development. According to Erikson, what is the most accurate statement about how a person at this stage would behave? 1. The person is loyal only towards others. 2. The person is loyal only to his or her own ideals. 3. The person shows no loyalty to others or his or her own ideals. 4. The person is loyal towards others and his or her own ideals.
4. The person is loyal towards others and his or her own ideals. According to Erikson's theory, when a person masters the identity versus role conversion stage, around the time of puberty, he or she will show devotion towards others as well as his or her own ideals. People at this stage of development are capable not only of showing loyalty to ideals; they can balance loyalty toward their own ideals and those of others.
The nurse is caring for a 35-year-old patient who is pregnant and carrying multiple fetuses. With whom should the nurse try to collaborate in order to provide effective care to the patient? Select all that apply. A. Dietician B. Obstetrician C. Primary care provider D. Physical therapist E. Respiratory therapist
A. Dietician B. Obstetrician C. Primary care provider The nurse collaborates with other health care professionals to provide safe and effective patient-centered care. The nurse refers the patient to a dietician in order to promote health by suggesting a proper well-balanced diet. The nurse may refer the patient to an obstetrician who specializes in high-risk pregnancies to ensure the safe delivery of the babies. The nurse refers the patient to a primary care provider for close supervision. The patient does not have any physical impairment or need for physical therapy; therefore, the nurse would not refer the patient to a physical therapist. The nurse would not refer the patient to a respiratory therapist because the patient does not have an airway obstruction or any other related problems.
Which questions does the nurse ask when assessing high-risk behaviors sometimes found among teens? Select all that apply. A. Have you been sexually active? B. Do you ever consume alcohol? C. Do you have any religious beliefs? D. Do you smoke or use tobacco? E. What kind of books do you read?
A. Have you been sexually active? B. Do you ever consume alcohol? C. Do you have any religious beliefs? D. Do you smoke or use tobacco? The nurse should ask questions to complete a comprehensive assessment of the adolescent's health practices. Adolescents tend to take risks due to their desire to become independent. The nurse should ask the adolescent whether he or she is sexually active. If so, the nurse needs to provide further education regarding safe sex practices. Adolescents also may succumb to peer pressure when it comes to drinking alcohol or using tobacco products. The nurse needs this information in order to effectively teach the adolescent about the dangers of alcohol and tobacco products. Asking the adolescent about his or her religious beliefs is not related to the patient's health. The nurse will not obtain any health information by asking what kind of books the adolescent prefers to read.
A nurse is teaching a group of young girls about the process of puberty and development of secondary sexual characteristics. What changes are expected in the girls during puberty? Select all that apply. A. Increase in height B. Pubic hair growth C. Increase in weight D. Breast development E. First menstrual period
B. Pubic hair growth D. Breast development E. First menstrual period Puberty is an important stage of development. Pubic hair growth and development of breasts are secondary sexual characteristics. During this period, the girls may have their first menstrual period, called menarche. Adolescents do experience a growth spurt characterized by an increase in weight and height; however, this adolescent growth spurt is not an indicator of puberty or a secondary sexual characteristic.
A school health nurse is teaching a group of adolescents about prevention of health risks. Which are the most important health risks in this age group that the nurse should address? Select all that apply. A. Stunted growth B. Suicide C. Falls and injuries D. Pregnancy E. Sexually transmitted diseases
B. Suicide D. Pregnancy E. Sexually transmitted diseases Suicide is an important health risk in adolescence. An adolescent may attempt suicide due to depression and social isolation. Adolescent pregnancies are also a cause of concern in adolescent girls; the teaching should be focused on perinatal nutrition, childcare, and planning for the future. The sexual behavior of adolescents contributes to morbidity and mortality due to sexually transmitted diseases. Stunted growth is not typically a problem faced during adolescence. Falls and injuries are seen more in younger children, not adolescents.
