Chapter 21: Developmental Concepts

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' heights and weights as they file through the station, observing that there is a large variation in physical size and emotional maturity. Which of the following factors may affect emotional growth of children? (select all that apply.) A. praise for doing well B. development of trust C. availability of books D. loving caregivers E. colorful toys

A, B, and D

A nurse caring for hospitalized 3-year-old female who is having surgery for a cleft palate repair. While in the hospital, the parents of the child tell the nurse that their child who was previously potty-trained has begun to wet her pants. What is the best response of the nurse? A. this is normal, children often regress during difficult periods or crises B. just put a diaper on her while she is in the hospital C. we should have a child psychologist assess your child D. you should offer her a reward for not wetting the bed

A.

A school nurse is studying Kohlberg's theory of moral development to prepare a parent discussion addressing the problem of bullying. According to Kohlberg, which factor initially influences the moral development of children? A. parent/caregiver -child communications B. societal rules and regulations C. social and religious rules D. a persons beliefs and values

A.

Based on Piaget's theory of cognitive development, which activities would a nurse recommend to parents of children in the preoperational stage? A. play activities B. organized sports C. church lessons D. solve multiple problems

A.

The nurse is caring for a man 79 years of age who was admitted for hip replacement. He visits with the nurse every chance he gets, he seems lonely. He tells the nurse his wife died two years ago. He has children in nearby cities and has nine grandchildren. He said his life is been good and is content even know he misses his wife. The nurse assesses him for developmental issues and knows that he fits well into which of the Erikson's stages of development? A. integrity vs despair B. intimacy vs isolation C. generativity vs stagnation D. mental health vs instability

A.

Which of the following actions should a nurse take in order to apply theories of development into nursing care? A. choose outcomes that are reflective of the clients developmental stages B. grant autonomy to clients who are in the later developmental stages but make decisions for those in earlier stages C. consistently ask clients what developmental stage they're currently experiencing D. maintain separation between clients with widely varying developmental stages

A.

A nurse is caring for older adults in a long term care facility encourages an older adult to reminisce about past life events. This life review, according to Erikson, is demonstrating what developmental stage of alter adult years? A. ego integrity B. generativity C. intimacy D. initiative

A. ego integrity Rationale: reminiscence during the older years of life provides a sense of purpose (ego integrity). Generativity is of the middle adult years. Intimacy is a task during adolescent to adult years and initiative is a task of the preschooler to early school age years

The nurse is caring for a mother of a healthy infant age 6 months. The mother expresses concern about the child putting everything in his mouth. The nurse uses Freud's theory to teach the mother which of the following about this behavior? A. it is the way the infant explores B. it is abnormal for this stage C. it shows early neuromuscular control D. it allows the infant to gain trust

A. it is the way the infant explores Rationale: the oral stage is where the infant uses their mouth as the major source of gratification and exploration and is normal for this age.

The nurse is seeing a male client 6 years of age in the clinic. The nurse is measuring height and weight for the pt, his mother comments on how coordinated his is becoming. The nurse knows that this increase in coordination is which of the following? A. related to development B. due to growth C. part of being prepubescent D. a reflex

A. related to development

A nurse examining a toddler in a pediatric office documents that the child is in the 90th percentile for height and weight and has blue eyes. These physical characteristics are primarily determined by which of the following? A. socialization with caregivers B. maternal nutrition during pregnancy C. genetic info on chromosomes D. meeting developmental tasks

C. genetic info on chromosomes

A student nurse is assisting the school nurse with a health fair at a middle school. The student nurse assesses the students' heights and weights as they file through the station, observing that there is a large variation in physical size and emotional maturity. Which of the following factors may affect emotional growth of children? (select all that apply.) A. colorful toys B. heredity C. prenatal nutrition D. physical activity E. availability of blocks

B, C, and D Rationale: growth and development can be affected by heredity, prenatal, individual, and caregiver factors, and environment and nutrition

The nurse is providing prenatal education for a group of pregnant teenagers. The nurse talks about substance abuse during pregnancy and relates which of the following possible newborn consequences? (select all that apply) A. development of distrust B. congenital abnormalities C. premature birth D. poor development of superego E. low birth weight

B, C, and E

The nurse is caring for a 4 year old boy who has gone through a painful surgery. During the hospitalization the child has been wetting his bed. The child's mother expresses dismay and anger, saying that her son has been toilet trained for over a year. The nurse recalls which of the following general principles of growth and development when responding to the mother? A. parents often expect perfection of their children B. anticipate possible regression during difficult periods C. children most often develop at their own pace D. male children often have difficulty maintaining urinary continence

B.

A resident of a long-term care facility, age 82 years, often tells stories of the role that he played in the Korean War. According to Erikson, which of the following needs may underlie the resident's storytelling? A. the need to show his life was characterized by moral integrity B. the need to demonstrate that his life was meaningful and purposeful C. the need to demonstrate that he was capable of physical aggression in earlier adulthood D. the need to show that others were dependent on him in earlier stages of life

B. Rationale: Erikson's final development stage is when older adults reminisce to identify fulfillment and purpose in the lives they have lived.

A nurse is reviewing developmental theories for class discussion. The nurse knows that Freud's theory emphasizes the effect of instinctual human drives on behavior. He identified the underlying stimulus for human behavior as sexuality, which he called libido. Freud defined libido as which of the following? A. pure genital gratification B. general pleasure seeking instincts C. seeking sexual stimulation D. seeking sexual gratification

B. Rationale: Freud defines libido as general, pleasure seeking instincts rather than purely genital gratification.

The school nurse is teaching growth and development in a health class. What should the nurse teach the student about development? A. it centers around the increase in body size B. it is the process of ongoing change C. it is influence by genetically predisposed alterations D. it is best defined as intellectual growth

B. Rationale: development is the process of ongoing change, reorganization and integration that occurs through life.

A mother 13 years of age delivers a low-birth-weight neonate, and the neonate is transferred to the neonatal intensive care unit. The mother reports receiving occasional prenatal care and has a history of excessive alcohol consumption. The growth and development of this neonate has been influenced by which of the following? A. spiritual factors B. prenatal factors C. individual factors D. caregiver factors

B. prenatal factors Rationale: fetal development can be altered by prenatal factors such as maternal age, substance abuse, inadequate prenatal care, and inadequate nutrition of the mother.

According to Freud, which of the following influences is the primary force that drives an individual's development? A. security B. sexuality C. autonomy D. faith

B. sexuality Rationale: according to Freud, the stages of development are based on sexual motivation.

The nurse is educating new parents about meeting the newborn's needs such as providing warmth, comfort, and feeding when hungry. According to Erikson, which stage of growth and development will be met if the parents are successful in this phase? A. autonomy vs shame and doubt B. industry vs inferiority C. trust vs mistrust D. identify vs role confusion

C. Rationale: in this stage the infant relies on the caregiver for these things and mistrust can form if the parents are inconsistent or provide inadequate care

A mother brings her toddler into the clinic for immunizations. She talks about trying to initiate toilet training a few weeks ago but her son wasn't interested. She decided to put it off for a while. She told her son he was a good boy and would try again another time. According to Erikson's theory, what is the likely outcome of the toddlers developmental stage? A. identity B. initiative C. autonomy D. intimacy

C. autonomy Rationale: autonomy vs shame and about implies that if the caregivers are overprotective or have expectations that are too high, shame and doubt might develop in the child. Initiative is about preschool children, identity is adolescence, and intimacy is young adulthood

The nurse sees a client age 4 years and her mother at the pediatric clinic. The client is here for immunizations. She is bubbly and talkative, and tells you about her dance lessons and her new baby brother. Her mother tells you she encourages her daughter to try new experiences and enjoy life. You know that according to Erikson's developmental theory, the client is well on the way to achieving which of the following? A. self-identity B. autonomy C. initiative D. industry

C. initiative Rationale: confidence gained as a toddler allows the preschooler to take the initiative in learning so that the child actively seeks out new experiences and explores the how and why of activities

The nurse is caring for a woman 68 years of age who is admitted for fixation of an ankle fracture related to a fall at home. The client states that she is thinking of selling her home and moving to a smaller place. Her husband died six months ago and she is unable to physically maintain her home without him. She sounds accepting of this. According to Robert Havighurst, in which of the following developmental stages is the client? A. midlife transition B. generativity vs stagnation C. later maturity D. ego integrity vs despair

C. later maturity Rationale: later maturity includes tasks of adjusting to decreasing physical strength and heath, retirement and reduced income, and the death of a spouse. B and D are Erikson's theories and A is one of Levinson's phases

A nurse is caring for a 40 year old woman, who is admitted for fixation of ankle fracture related to a rollerblading accident. She comments to the nurse that she plans to give up because her balance and reflexes are not as good as they once were. She sounds accepting of this. According to Robert Havighurst, in which of the following developmental stages is this client? A. midlife transition B. integrity vs despair C. middle adulthood D. generativity vs stagnation

C. middle adulthood Rationale: middle adulthood includes the task of adjusting to physical changes. B and D are Erikson's stages and Levinson associates the theory of midlife transition in persons aged 40-45

A nurse is interviewing a 42 year old pt who is visiting an internist for a blood pressure screening. The pt states, "I'm currently a sales associate, but I'm considering a different career and I'm a little anxious about the process." According to Levinson, what phase of adult life is this pt experiencing? A. entering the adult world B. settling down C. midlife transition D. entering middle adulthood

C. midlife transition

According to Kohlberg, which of the following considerations is central to human development? A. influence B. agency C. morality D. safety

C. morality Rationale: Kohlberg's theory of development focuses specifically on the changes in morality that occur over time

A nurse is observing a child pick up a rattle and shake it to hear a sound. The nurse understands that the child is considered to be in which of the following Piaget's cognitive development stages? A. formal operational thought B. concrete operational thought C. sensoriomotor stage D. preoperational stage

C. sensoriomotor stage Rationale: this stage shows that the child is relating his/her own behavior to the environment. in the preoperational stage the child uses symbols and pictures to represent themselves. in the concrete operational stage the child can manipulate objects and with the formal operational stage the child uses abstract thinking

Newborns are capable of activities such as grasping objects and displaying basic reflexes. To which of the following of Piaget's cognitive developmental stages do the newborns belong? A. formal operational B. preoperational C. concrete operational D. sensoriomotor

D. Rationale: newborns belong to the sensorimotor stage which is activities like grasping and displaying basic reflexes

The school nurse uses the principles and theories of growth and development when planning programs for high school students. According to Havighurst, what is a developmental task for this age group? A Finding a congenial social group B Developing a conscience, morality, and a scale of values C Achieving personal independence D Achieving a masculine or feminine gender role

D. Rationale: according to Havinghurst, it is the role of the adolescent to achieve a masculine or feminine gender role. A is a factor of young adulthood, B is the role of the middle childhood and C is the role of middle childhood

A student nurse is visiting a day care, where the focus is to observe object permanence. According to Piaget, object permanence does not occur until which of the following ages? A. 24 mo B. 8 mo C. 6 mo D. 12 mo

D. 12 months

A boy 8 years of age is looking at his father's razor and shaving cream in the bathroom medicine cabinet. He watches his father shave daily and asks his father when he will need to start shaving. This child is demonstrating characteristics common during which of Freud's psychoanalytic developmental stages? A. anal stage B. phallic stage C. genital stage D. latency stage

D. latency stage Rationale: this phase makes the transition to the genital stage during adolescence and is characterized by increasing sex-role identification with the parent of the same sex

A mother brings her toddler, age 20 months, to the clinic for immunizations. She talks about trying to initiate toilet training a few weeks ago, but her son wasn't interested. She decided to put it off for a while. She told her son he was a good boy and they would try again another time. According to Erikson's theory, what is the likely outcome for the toddler's developmental stage? A. inferiority B. guilt C. isolation D. shame and doubt

D. shame and doubt Rationale: the toddlers task is to achieve autonomy vs shame and doubt. If the caregivers are overprotective or have too high of expectations shame and doubt might develop in the child