NURS306- Exam 1

when is symbolic function present? what age?

2 to 7

Which statement by the parent of a hospitalized 4-year-old child indicates an understanding of the child's needs? 1. "I am going to buy him a box of new toys to keep him busy while in the hospital." 2. "I am going to bring some of his favorite toys from home for him to play with while in the hospital." 3. "I'm glad there is a television in the room for him to watch all day." 4. "I will stay every day until he falls asleep and then I will go home."

2. "I am going to bring some of his favorite toys from home for him to play with while in the hospital." The use of a transitional object, such as a blanket or a favorite toy from home, promotes security.

When providing therapeutic play, which of the following toys would best promote imaginative play in a 4-year-old? 1. Large blocks 2. Dress-up clothes 3. Wooden puzzle 4. Big wheels

2. Dress-up clothes

The best way to minimize separation anxiety in a hospitalized infant is to: 1. Explain routines carefully 2. Encourage parent to room-in 3. Provide age-appropriate roommates 4. Provide an age-appropriate toy

2. Encourage parent to room-in

When providing health teaching for a 4-year-old, the nurse knows that the child is capable of which of the following? 1. Understanding another's point of view 2. Making simple classifications 3. Exhibiting intuitive thought 4. Seeing relationships in reverse

2. Making simple classifications

The successful resolution of developmental tasks for the school-age child, according to Erikson, would be identified by: A. Learning from repeating tasks B. Developing a sense of worth and competence C. Using fantasy and magical thinking to cope with problems D. Developing a sense of trust

B. Developing a sense of worth and competence

autonomy vs. shame & doubt age?

1-3 years (toddlers)

Which of the following would the nurse use to respond to the mother of an 8-year-old girl who asks about when her child will begin puberty? 1. "It begins between ages 8 and 13." 2. "It begins between ages 10 and 13. "3. "It begins between ages 12 and 15." 4. "It begins between ages 14 and 15."

1. "It begins between ages 8 and 13."

The mother of a 3-year-old asks a clinic nurse about appropriate and safe toys for the child. The nurse should tell the mother that the most appropriate toy for a 3-year-old is which? 1. A wagon 2. A golf set 3. A farm set 4. A jack set with marbles

1. A wagon Toys for the toddler must be strong, safe, and too large to swallow or place in the ear or nose. Toddlers need supervision at all times. Push-pull toys, large balls, large crayons, large trucks, and dolls are some of the appropriate toys. A farm set, a golf set, and jacks with marbles may contain items that the child could swallow.

Which of the following characteristics would the nurse expect to see in an adolescent who has developed the capacity for formal thought? 1. Ability to analyze relationships for their effects 2. Use of random cognitive behavior to approach problems 3. Ability to say that something is wrong but not why 4. Focusing on immediate physical reality of here and now

1. Ability to analyze relationships for their effects

Which of the following principles of development is being addressed when new parents are taught that infants are able to lift their heads before their trunks? 1. Cephalocaudal 2. Proximodistal direction 3. Simple to the complex 4. General to the specific

1. Cephalocaudal

Wellness promotion for toddlers should include which of the following? (Select all that apply.) 1. Discussing negativity and temper tantrums 2. Discussing nightmares and night terrors 3. Encouraging gross motor skills 4. Reinforcing supine sleeping position 5. Talking about bedtime rituals 6. Helping the child differentiate junk from healthy foods

1. Discussing negativity and temper tantrums 3. Encouraging gross motor skills 5. Talking about bedtime rituals

A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should be implemented to alleviate the child's fears? 1. Encourage the child's parents to stay with the child. 2. Encourage play with other children of the same age. 3. Advise the family to visit only during the scheduled visiting hours. 4. Provide a private room, allowing the child to bring favorite toys from home.

1. Encourage the child's parents to stay with the child. Although the preschooler already may be spending some time away from parents at a day care center or preschool, illness adds a stressor that makes separation more difficult. The child may ask repeatedly when parents will be coming for a visit or may constantly want to call the parents. Options 3 and 4 increase stress related to separation anxiety. Option 2 is unrelated to the subject of the question and, in addition, may not be appropriate for a child who may be immunocompromised and at risk for infection.

What are the stages of separation anxiety in the toddler? 1. Protest, despair, and denial 2. Denial, dependence, and submission 3. Protest, sadness, and despair 4. Despair, anxiety, and regression

1. Protest, despair, and denial

at what age is it common for kids to struggle with their sexuality? (for a short period of time)

12 and up

what is the age range of an adolescent?

12 to 21 years

what is the age range of a toddler?

12 to 36 months

identity vs. identity confusion age?

12-18 years

If parents keep a toddler dependent in areas where he is capable of using skills, the toddler will develop a sense of which of the following? 1. Mistrust 2. Shame 3. Guilt 4. Inferiority

2. Shame According to Erikson, toddlers experience a sense of shame when they are not allowed to develop appropriate independence and autonomy. Infants develop mistrust when their needs are not consistently gratified. Preschoolers develop guilt when their initiative needs are not met while school-age children develop a sense of inferiority when their industry needs are not met.

When teaching the parents of a toddler about the child's normal fears, which of the following fears would the nurse typically associate with toddlerhood? 1. Mutilation 2. The dark 3. Ghosts 4. Going to sleep

2. The dark

The nurse is evaluating the developmental level of a 2-year-old. Which does the nurse expect to observe in this child? 1. Uses a fork to eat 2. Uses a cup to drink 3. Pours own milk into a cup 4. Uses a knife for cutting food

2. Uses a cup to drink By age 2 years, the child can use a cup and spoon correctly but with some spilling. By age 3 to 4, the child begins to use a fork. By the end of the preschool period, the child should be able to pour milk into a cup and begin to use a knife for cutting.

what is the age range of a preschooler?

3-5 years

initiative vs. guilt age?

3-6 years (preschool)

The mother of a 20-month-old boy asks the nurse why her son has temper tantrums. Which of the following would be the nurse's best response? 1. "It is the only way he can get attention from his mother." 2. "He is probably spoiled and needs discipline." 3. "He cannot express his feelings or frustrations verbally." 4. "He is expressing his need for identity."

3. "He cannot express his feelings or frustrations verbally."

After teaching a group of parents about accident prevention for school-age children, which of the following statements by the group would indicate the need for more teaching? 1. "School-age children are more active and adventurous than are younger children." 2. "School-age children are more susceptible to home hazards than are younger children." 3. "School-age children are unable to understand potential dangers around them." 4. "School-age children are less subject to parental control than are younger children."

3. "School-age children are unable to understand potential dangers around them." The school-age child's cognitive level is sufficiently developed to enable good understanding of and adherence to rules. Thus school-age children should be able to understand the potential dangers around them. With growth comes greater freedom and children become more adventurous and daring. The school-age child is also still prone to accidents and home hazards, especially because of increased motor abilities and independence. Plus, the home hazards differ from other age groups. These hazards, which are potentially lethal but tempting, may include firearms, alcohol, and medications. School-age children begin to internalize their own controls and need less outside direction. Plus, the child is away from home more often. Some parental or caregiver assistance is still needed to answer questions and provide guidance for decisions and responsibilities.

Which of the following is an appropriate toy for an 18-month-old? 1. Multiple-piece puzzle 2. Miniature cars 3. Finger paints 4. Comic book

3. Finger paints Young toddlers are still sensorimotor learners, and they enjoy the experience of feeling different textures. Thus, finger paints would be an appropriate toy choice. Multiple-piece toys such as puzzles are too difficult to manipulate and may be hazardous if the pieces are small enough to be aspirated. Miniature cars also have a high potential for aspiration. Comic books are on too high a level for toddlers. Although they may enjoy looking at some of the pictures, toddlers are more likely to rip a comic book apart.

A preschooler who is made to feel that his imagination and activities are unacceptable is likely to develop a sense of which of the following? 1. Mistrust 2. Shame 3. Guilt 4. Inferiority

3. Guilt

Unrealistic expectations or a sense of failing to meet standards would cause a school-age child to develop a sense of which of the following? 1. Shame 2. Guilt 3. Inferiority 4. Role confusion

3. Inferiority

Which of the following would the nurse identify as the underlying rationale for a 4-year-old who tells the nurse that her doll is in the hospital because it was bad? 1. Egocentrism 2. Past experience 3. Magical thinking 4. Oedipal conflict

3. Magical thinking The fantasies of preschoolers can result in a sense of guilt. Because they cannot discern cause and effect, they see hospitalization as punishment for some real or fantasized misdoing. Magical thinking causes preschoolers to view illness as a punishment. Moreover, preschoolers are experiencing psychosexual conflicts and fears of mutilation, making them especially fearful of procedures such as rectal temperatures and urinary catheterizations. Egocentrism accounts for the preschooler's inability to see another's point of view. Past experience can affect the preschooler's reaction to hospitalization, but this is not the underlying rationale here. Oedipal conflicts do not directly affect hospitalization.

According to Erikson, which of the following reasons explains why an adolescent may have difficulty mastering appropriate psychosocial tasks? 1. The basic focus is on mastery of sexual relationships. 2. Only a limited interaction occurs between culture and individual development. 3. Modern culture tends to make identity crisis the most challenging to resolve. 4. The adolescent commonly lacks positive role models.

3. Modern culture tends to make identity crisis the most challenging to resolve.

Which of the following skills is the most significant one learned during the school-age period? 1. Collecting 2. Arranging 3. Reading 4. Sorting

3. Reading The most significant skill learned during the school-age period is reading. During this time the child develops formal adult articulation patterns and learns that words can be arranged in structure. Collecting, arranging, and sorting, although important, are not the most significant skills learned.

A 4-year-old hospitalized child wets his bed. The parents tell the nurse that the child was completely toilet trained. What should the nurse understand? 1. The parents are denying a problem exists. 2. The child may be developmentally delayed. 3. The child may be experiencing regression. 4. The child is probably "punishing" the parents.

3. The child may be experiencing regression. Regression is the loss of an achieved level of functioning that previously had been successful to a past level of behavior.

A 16-year-old client is admitted to the hospital for acute appendicitis and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development postoperatively? 1. Encourage the client to rest and read. 2. Encourage the parents to room in with the client .3. Allow the family to bring in the client's favorite computer games. 4. Allow the client to interact with others in his or her (Adolescent) same age group.

4. Allow the client to interact with others in his or her (Adolescent) same age group. Adolescents often are not sure whether they want their parents with them when they are hospitalized. Because of the importance of their peer group, separation from friends is a source of anxiety. Ideally, the members of the peer group will support their ill friend.

The nurse is conducting an interview of a 4-year-old client; the nurse should do which of the following? 1. Ask detailed questions. 2. Maintain confidentiality. 3. Disallow the use of equipment. 4. Avoid words with double meaning.

4. Avoid words with double meaning.

The nurse is preparing to care for a 5-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that which is the most appropriate activity for this child? 1. A radio 2. A sports video 3. Large picture books 4. Crayons and a coloring book

4. Crayons and a coloring book In the preschooler, play is simple and imaginative, and includes activities such as crayons and coloring books, puppets, felt and magnetic boards, and Play-Doh. A radio or a sports video is most appropriate for the adolescent. Large picture books are most appropriate for the infant.

A 2-year-old's mother has just left the hospital to check on her other children. Which of the following would best help the 2-year-old who is now crying inconsolably? 1. Taking a nap 2. Peer play group 3. Large cuddly dog 4. Favorite blanket

4. Favorite blanket The mother's departure has triggered the protest stage of separation anxiety in this child. Therefore, a favorite blanket or other transitional object (representation of parent) will help best ease separation fears. A nap may actually increase separation fears. A 2-year-old is too young to interact with peers, other than in parallel play. Toddlers are usually fearful of large dogs.

When teaching parents about the child's readiness for toilet training, which of the following signs should the nurse instruct them to watch for in the toddler? 1. Demonstrates dryness for 4 hours 2. Demonstrates ability to sit and walk 3. Has a new sibling for stimulation 4. Verbalizes desire to go to the bathroom

4. Verbalizes desire to go to the bathroom

an infant should be able to hold up its head at what age?

5 months

Birth wt is doubled by _ to _ months and triples by __months

5 to 6 and 12

what is the age range for school age?

6-12 years

industry vs. inferiority age?

6-12 years (school age)

Which of the following are reasons that stealing occurs in school-age children? Select all that apply. A. To escape punishment B. High self-esteem C. Low expectations of family/peers D. Lack of sense of propriety E. Strong desire to own something

A. To escape punishment D. Lack of sense of propriety E. Strong desire to own something

pediatric nursing differs from adult nursing in that the nurse must? SATP A. Use unique pediatric assessment tools B. Evaluate developmental milestones C. Assess psychosocial needs D. Provide education regarding educational needs E. Monitor growth and development

A. Use unique pediatric assessment tools B. Evaluate developmental milestones E. Monitor growth and development

The nurse is preparing the playroom on a newly opened pediatric unit. The nurse should include which items to foster the development of the preschool child? (Select all that apply.) A. large blocks B. alphabet flash cards C. 100-piece puzzles D. dolls E. hand puppets

A. large blocks B. alphabet flash cards D. dolls E. hand puppets

family centered care

A.integrates the family, child, and caregivers into the decision-making and care delivery model.

The mother of an 8 year old child tells the clinic nurse that she is concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial development theory, the appropriate nursing response is:

At this age, the child is developing his own personality

You are assisting a group of parents of adolescents to develop skills that will improve communication within the family. You hear one parent state, "My son knows he better do what I say". Which parenting style does this reflect?

Authoritarian

The father of a 2-month-old girl is expressing concern that his infant may be getting spoiled. The nurse's best response is: A. "She just needs love and attention. Don't worry; she's too young to spoil." B. "Consistently meeting the infant's needs helps promote a sense of trust." C. "Infants need to be fed and cleaned; if you're sure those needs are met, just let her cry." D. "Consistency in meeting needs is important, but you're right, holding her too much will spoil her."

B. "Consistently meeting the infant's needs helps promote a sense of trust."

The nurse would most likely assess separation anxiety in which child? A. A 2-month-old-infant B. A 15-month-old toddler C. A 4-year-old preschooler D. An 11-yearold

B. A 15-month-old toddler

The nurse is caring for a hospitalized 30-month-old who is resistant to care, is angry, and yells "no" all the time. The nurse identifies this toddler's behavior as A. Problematic, as it interferes with needed nursing care. B. Normal for this stage of growth and development. C. Normal because the child is hospitalized and out of his routine.

B. Normal for this stage of growth and development.

The nurse is assessing the cognitive development of an adolescent. Which of the following statements accurately represents a normal finding at this stage? A. The adolescent progresses from an abstract to a concrete framework of thinking B. The adolescent develops the ability to think outside the present C. All adolescents achieve formal operational reasoning at the same time D. Adolescent thinking starts out very introspective and then becomes egocentric

B. The adolescent develops the ability to think outside the present

The nurse's BEST approach for effective communication with a preschool age child is through: A. speech. B. play. C. drawing. D. actions.

B. play.

The nurse is caring for a hospitalized 4-year-old who insists on having the nurse perform every assessment and intervention on her imaginary friend first. She then agrees to have the assessment or intervention done to herself. The nurse identifies this preschooler's behavior as: A. Problematic; the child is old enough to begin to have a basis in reality. B. Normal, because the child is hospitalized and out of her routine. C. Normal for this stage of growth and development. D. Problematic, as it interferes with needed nursing care.

C. Normal for this stage of growth and development.

Parents of an 8-month-old girl express concern that she cries when left with the babysitter. How does the nurse best explain this behavior? A. Crying when left with the sitter may indicate difficulty with building trust. B. Stranger anxiety should not occur until toddler-hood; this concern should be investigated. C. Separation anxiety is normal at this age; the infant recognizes parents as separate beings. D. Perhaps the sitter doesn't meet the infant's needs; choose a different sitter.

C. Separation anxiety is normal at this age; the infant recognizes parents as separate beings.

what does a healthy family provide? A. few interactions, so as not to interfere in the child's social development B. limited intrusions into school activities, except for homework C. clear, concise and consistent verbal and nonverbal cues D. clear rules and boundaries, with serious and immediate consequences for deviations

C. clear, concise and consistent verbal and nonverbal cues

When caring for a preschool age child, the nurse should incorporate knowledge that body image has developed to include: A. a well-defined body boundary. B. knowledge about his or her internal anatomy. C. fear of intrusive procedures. D. anxiety and fear of separation.

C. fear of intrusive procedures.

According to Erikson, the primary psychosocial task of the preschool period is developing a sense of: A. identity. B. intimacy. C. initiative. D. industry.

C. initiative.

Growth and Dev occurs in what two ways?

Cephalocaudal and proximodistal

what type of play is used during identity vs. identity (12-18)?

Cooperative play

Which play patterns does a 3-year-old child typically display (select all that apply)? a. Imaginary play b. Parallel play c. Cooperative play d. Structured play e. Associative play

a. Imaginary play b. Parallel play c. Cooperative play e. Associative play

The nurse would expect that most children would be using sentences of six to eight words by age: A. 18 months. B. 24 months. C. 3 years. D. 5 years.

D. 5 years.

a nurse on the pediatric floor is preparing an education program on working with families for a group of newly hired nurses. which of the following should the nurse include when discussing the developmental theory? A. describe that stress is inevitable B. emphasizes that change with one member affects the entire family C. provides guidance to assist families adapting to stress D. Defines consistencies in how families change

D. Defines consistencies in how families change

autonomy vs. shame & doubt

Erikson's stage in which a toddler learns to exercise will and to do things independently (away from mother); failure to do so causes shame and doubt - ritualism - negativism - independence potty training locomotion toys (ability to move from one place to another) parallel playing

initiative vs. guilt

Erikson's third stage in which the child finds independence in planning, playing and other activities (very busy) - might be overwhelmed with failure fine (dolls and crayons) + gross motor toys (moving with the body) - tricycle - sandboxes - transitions from pre-conceptual thought to intuitive thoughts at 4 years of age (quick decision off cognitive) - understands time - associative playing

Which toys should a nurse provide to promote imaginative play for a 3-year-old hospitalized child (select all that apply)? a. Plastic telephone b. Hand puppets c. Jigsaw puzzle (100 pieces) d. Farm animals and equipment e. Jump rope

a. Plastic telephone b. Hand puppets d. Farm animals and equipment

In terms of cognitive development, the 5-year-old child would be expected to: a. Use magical thinking. b. Think abstractly. c. Understand conservation of matter. d. Be able to comprehend another person's perspective.

a. Use magical thinking.

parallel play

activity in which children play side by side without interacting does this at autonomy vs. shame & doubt (ages 1-3)

what can we as nurses do to establish rapport with a hospitalized child?

allow them the option of giving themselves their PO meds using a syringe

Separation anxiety is most pronounced for a _______.

Toddler

When does discharge planning begin?

Upon admission

An 8 year old in the hospital and is NPO—what type of toy would you use to distract him from his hunger and hospital stay?

a board game

what is a good toy for a child in substage 4 or age 8 to 12 months?

a music rattle

What is Munchausen Syndrome by Proxy?

a parents' a mental illness and is a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick. No one is sure what causes Munchausen syndrome by proxy, sometimes, the person was abused as a child.

what is an appropriate toy for a 1 year old?

a rattle

Preschoolers' fears can best be dealt with by which intervention? a. Actively involving them in finding practical methods to deal with the frightening experience b. Forcing them to confront the frightening object or experience in the presence of their parents c. Using logical persuasion to explain away their fears and help them recognize how unrealistic the fears are d. Ridiculing their fears so they understand that there is no need to be afraid

a. Actively involving them in finding practical methods to deal with the frightening experience

from age 1 to 3, the child's source of satisfaction is the _______ and __________.

anus and buttocks

What is descriptive of the preschooler's understanding of time? a. Has no understanding of time b. Associates time with events c. Can tell time on a clock d. Uses terms like "yesterday" appropriately

b. Associates time with events

A 4-year-old boy is hospitalized with a serious bacterial infection. He tells the nurse that he is sick because he was "bad." The nurse's best interpretation of this comment is that it is: a. A sign of stress. b. Common at this age. c. Suggestive of maladaptation. d. Suggestive of excessive discipline at home.

b. Common at this age.

In terms of language and cognitive development, a 4-year-old child would be expected to have which traits (select all that apply)? a. Think in abstract terms. b. Follow directional commands. c. Understand conservation of matter. d. Use sentences of eight words. e. Tell exaggerated stories.

b. Follow directional commands. e. Tell exaggerated stories.

In terms of language and cognitive development, a 4-year-old child would be expected to: a. Think in abstract terms. b. Follow simple commands. c. Understand conservation of matter. d. Comprehend another person's perspective.

b. Follow simple commands.

trust vs mistrust age?

birth to 1 year (infants)

what is the age range of an infant?

birth to 12 months

what are the 2 stages with of rapid growth/metabolism periods?

birth to 2 years and puberty (adolescence)

what is the child's major task in ages 1 to 3?

bowel and bladder training

Which type of play is most typical of the preschool period? a. Solitary b. Parallel c. Associative d. Team

c. Associative

Which accomplishment would the nurse expect of a healthy 3-year-old child? a. Jump rope b. Ride a two-wheel bicycle c. Skip on alternate feet d. Balance on one foot for a few seconds

d. Balance on one foot for a few seconds

In terms of fine motor development, what could the 3-year-old child be expected to do? a. Tie shoelaces. b. Use scissors or a pencil very well. c. Draw a person with seven to nine parts. d. Copy (draw) a circle.

d. Copy (draw) a circle.

Which is probably the most important criterion on which to base the decision to report suspected child abuse? a. Inappropriate parental concern for the degree of injury b. Absence of parents for questioning about child's injuries c. Inappropriate response of child d. Incompatibility between the history and injury observed

d. Incompatibility between the history and injury observed

industry vs. inferiority (6-12)

development of skills and knowledge that allows them to work through individual differences or to complete a task successfully enjoys working in peer groups takes pride in accomplishments

what should we recommend parents to do for their child during the trust vs mistrust phase?

encourage the parents to hold and talk to the infant

in ages 3 to 6, what is the center of satisfaction?

genitals

A nurse is performing a family assessment. Which of the following should the nurse include?

medical history, patients education level, support systems, and stressors

Freuds theory says that from birth to 1 year, the child's source of pleasure is the ___________.

mouth

what are the 4 types of child abuse?

physical, emotional, sexual, neglect

Human growth follows an orderly pattern in a systematic fashion but is not ____________________. Events can happen that alter growth .

predictable

You are getting ready to discuss the concepts of moral development with a mother. To do this you understand that according to Kohlberg's theory of moral development, in the preconventional level, moral development is thought to be motivated by which of the following:

punishment and reward

what is Battered Child syndrome?

refers to non-accidental injuries sustained by a child as a result of physical abuse, usually inflicted by an adult caregiver.

what is cephalocaudal growth ?

starts at the head and moves downward

what is proximodistal growth?

starts in the center and progresses to the periphery

What is the leading cause of adolescent mortality in the U.S.?

unintentional injury or accident