PH 22

Which of the following nurses is most likely to care for patients who are trying to resolve identity versus role confusion?

A nurse who provides care in a large junior high school

Which of the following statements by a school-aged child demonstrates Erikson's psychosocial stage of industry versus inferiority?

"I have friends and I succeed" versus "I have no friends and am incapable."

The parent cannot understand why the 12-month-old can throw a ball but cannot catch the ball. Which statement by the nurse helps the parent understand this?

"Maturation of neurological and muscular functioning has not occurred for this skill"

A parent tells the nurse that a 9 year old has to go home alone for 2 hours until the parents get off work, and they are afraid the child will begin smoking and drinking. What can the nurse inform them about "latchkey" children?

"No evidence supports that children will have these behaviors if they are recognized for their dependability."

The nurse is admitting a 9-year-old child for a surgical procedure. Which of the following statements would be most appropriate for the nurse to initially make to this child?

"Tell me the reason you came to the hospital today."

The nurse is discussing the latchkey child with a group of working caregivers. Which of the following statements made by the caregivers indicates an understanding of an important responsibility of the caregiver of the latchkey child?

"We have a list of phone numbers of our family and neighbor by the phone."

A nurse is teaching a 7-year old diabetic child who is in Piaget's concrete operational stage about insulin injections. Based on Piaget's theory, what would be the nurse's best method of preparation for this child?

Demonstrate the procedure on a teddy bear.

Children use centering to take in information and change it to fit their existing ideas.

False

A homeless parent brings a child with a severe earache to the clinic. What can the nurse do to establish a therapeutic relationship so that the parent feels respected?

Focus on positive factors in the caregiver's relationship with the child.

Erik Erikson described human psychosocial development as a series of tasks that must be mastered before moving on to the next task. The stage in which the child is more assertive and starts to accept punishment for doing wrong is which of the following stages?

Initiative vs. guilt

Using Erikson's theory, a nurse asks a young adult questions about family, friends, and support systems. Why is this important during assessments of adolescents?

Fear of commitments may lead to loneliness and isolation.

According to Freud, which of the following influences is the primary force that drives an individual's development?

Sexuality

A nurse is working with a new mother and her infant daughter. The mother appears exhausted and distraught. She explains that her daughter wakes up at a different time each night, making it difficult for the mother to develop a sleep routine and to get enough sleep. Which of the following would be the best nursing diagnosis for the mother in this case?

Sleep deprivation related to lack of rhythmicity in the infant

According to Freud, what is the name given to the part of the mind that represents one's conscience?

Superego

Genetics have an influence on many aspects of growth and development. What is the genetic influence that has to do with the way a person thinks, behaves, and reacts referred to as?

Temperament

When caring for a child with a cognitive impairment, what is a primary factor for the nurse to consider regarding the approach for interaction with the child?

The developmental stage is based on developmental tasks achieved.

The nurse in the emergency center admits a 16-year-old girl who looks like she weighs more than her stated weight. After collecting data from the adolescent, the nurse suspects the child is a runaway child. Which of the following topics would be most important for the nurse to gather data about first?

The possibility that the adolescent is pregnant.

An 8 month old hospitalized with bronchiolitis is crying in the crib because it is time for a feeding. The parent caring for the child has left the room to eat lunch. If the needs of the child are not met, what phase of the developmental stage will not be achieved according to Erikson?

Trust

A nurse is assessing a 4-month-old infant. Which of the following would the nurse identify as reflecting the infant's auditory receptive language?

Turning head to a voice

The nurse is aware that which of the following might cause a fetus to be prone to certain diseases?

culture

Many different factors affect growth and development. For example, why does Mary have blonde hair and blue eyes while John has brown hair and green eyes?

genetic inheritance

A nursing student will correctly identify that growth is measured by which of the following patterns?

height and weight

A nurse is assessing a 10-year-old at a well-child visit. Which statement by the child would indicate to the nurse that the child is developing a sense of industry? Select all that apply.

• "I like to learn about new things." • "I keep trying until I get something done."

A nurse is preparing to obtain vital signs for a 3 year old. What interventions can the nurse provide to keep the child calm and cooperative? (Select all that apply.)

• Be honest and tell the child how he or she will feel. • Allow the child to handle the equipment prior to beginning the procedure. • Allow the parent to hold the child when procedures are being performed.

A nurse recognizes that a pregnant homeless woman has challenges that other pregnant women may not. What problems should the nurse anticipate that the homeless pregnant patient will have? (Select all that apply.)

• Lack of prenatal care • Poor nourishment • Delivery of low birth weight infants

Many researchers have theories relating to the stages of growth and development. Which of the following stages of accepted theories relate to the preschool-age child from ages 4 to 6 years? Select all that apply.

• Phallic stage • Initiative vs. guilt • Preoperational phase • Pre-conventional level stage 2

A nursing instructor teaching about normal growth and development identifies a need for further instruction when the student makes which of the following statements?

"A growth chart is the best tool to diagnose growth problems."

A father brings his 2-year-old son in for a well visit, and the nurse asks him how potty training is going with the child. The father says, "Oh, we are pretty laid back about it. We believe he'll learn in time and that it's not healthy to make too big a deal about it." The nurse recognizes that this attitude is most in line with which of the following theories of development?

Freud's theory of psychosexual development

A nurse is assessing a child and determines that the child reflects the temperament of an easy child. Which of the following would the nurse have assessed?

Predominantly positive mood

A 13-year-old mother 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?

Prenatal factors

A child demonstrates increasing language skills and an understanding of symbols. Creative play and the use of imagination is an important activity in the child's life. Based upon these characteristics, what stage of cognitive development according to Jean Piaget's theory is the child demonstrating?

Preoperational stage

According to Erikson, normal adolescent behavior includes trying on new roles and possibly even rebelling. What is the purpose of this behavior in adolescents?

To establish a sense of identity

Which of the following factors would contribute least to the ultimate height that a child reaches?

Whether he enjoys active sports or not.

The mother of a 6-month-old infant asks the nurse at a community health center what she should do about her baby, who always wants to put everything in his mouth. What would be an appropriate response by the nurse, based on Freud's theory?

"Babies at this age explore and enjoy their world with their mouths."

A parent is comparing a child's development on the growth chart with those of another child and is concerned that her child is not in the "normal" range. What can the nurse inform the parent to alleviate her anxiety?

"Growth charts are just a standard measurement. If your child doesn't fall into the 'normal' range, it doesn't indicate something is wrong."

A mother, who is vegan, when asked about the nutritional intake of her 18-month-old tells the nurse not to worry, that she is providing plenty of protein to her daughter. "And," she says, "I avoid giving her fats." Which of the following would be the most appropriate response for nurse to give this mother?

"Your child needs fat in the diet at this age, as it is needed for myelination of spinal nerves."

Preventing injuries in children is a nursing responsibility accomplished through which of the following?

Anticipatory guidance education

During a health history, a middle-aged man tells the nurse, "I will always take care of my children because my parents took care of me." Based on Kohlberg's theory, what level of moral development is the man demonstrating?

Conventional

A nurse is performing a routine physical examination of a 5-year-old girl. Which of the following should the nurse note as developmentally inappropriate for this child?

Evidence of early breast development

Children ages eight to nine years of age are playing games together. Everyone takes turns and has an opportunity to play and share equally. This describes which of the following perspectives?

Fairness

Infants respond with the whole body by crying and frantically moving arms and legs when upset, hungry or in discomfort. In early childhood the child acts out with hitting a specific target or protecting the area hurt or causing pain. Which principle of growth and development is demonstrated in the example?

General to specific

During their school-age years, children understand concepts best if they can see the concept illustrated. This type of thinking is termed

concrete thought.

According to Piaget, one basic concept that a child will learn during the first year is that

he is separate from his parents.

A nursing instructor asks the class to describe growth and development using only one word. Which of the following would be the best choice?

individualized

A child's temperament makes her easy to care for. Her characteristics probably include

long attention span, high level of persistence.

If a preschooler sees you pour his liquid medicine from a tall, thin glass into a short, wide one, he will probably reason that

the amount of medicine is less (the glass is not as full).

A 2 year old with pneumonia has recently been hospitalized. When the lunch tray arrives to the floor, the nurse caring for the patient sets up the tray and allows the child to self-feed with a spoon despite the mess. What is the nurse's best reason for these actions?

to foster autonomy

After teaching a group of nursing students about developmental theorists, the instructor determines that the teaching was successful when the students identify which of the following as a cognitive theorist? Select all that apply.

• Piaget • Elkind • Gardner

A nurse understands that patients use silence for which of the following reasons? (Select all that apply.)

• Shows the person is thinking • Shows the person is unclear of what is being said • Indicates the person is having difficulty responding • Indicates the person is angry

The nurse is discussing the effects of childhood obesity with the mother of a 9-year-old boy who is obese. Which of the following potential effects on the boy's health should the nurse mention to the mother? (Select all that apply.)

• Slower development of motor skills • Lack of a strong and supportive group of friends • Depression • Risk for diabetes

A 4 year old is being seen in the emergency department after a fall down the steps. How can the nurse communicate with the child to develop rapport? (Select all that apply.)

• Stand at eye level with the child when speaking to him or her. • Speak in a slow, clear, positive voice. • Speak in short sentences.

A community health nurse is giving a lecture to parents of children home alone in the afternoons ("latchkey" children). What advice should the nurse include? (Select all that apply.)

• Teach the child to keep the house key hidden. • Let the child know if you are going to be delayed. • Plan a telephone contact on the child's arrival home.

A pediatric nurse realizes that people react differently to the same situation as a result of temperament, which is evidenced by which of the following? (Select all that apply.)

• activity level • development of regular patterns of walking and eating daily • how one approaches a situation

A nursing student correctly identifies which of the following to be influences on a child's growth and development? (Select all that apply.)

• mother's general health during the pregnancy • mother's nutrition during the pregnancy • mother's behaviors during the pregnancy • genetics • environment

A breastfeeding infant will gaze intently into his or her mother's eyes, grasp her finger, and smell and taste the milk. This use of the senses is attributed to a phase of development that is part of which theory?

Piaget's theory

In what stage of Kohlberg's Moral Development Theory do people make judgments based solely on their own needs?

Preconventional

After a child plays in the yard, his mother asks him to pick up his toys and put them in the toy bin in the garage. Knowing that he does not want to spend time in his room as a punishment, the child follows his mother's directions. What stage of moral development, according to Kohlberg, is this child demonstrating?

Preconventional level: stage 1

Using Erikson's theory, which of the following activities would the nurse use to provide a sense of fulfillment and purpose in later adulthood?

Reminiscing about life events

You watch a child arranging sugar packets from his meal trays in order of their weight. This activity of conservation is most typical of what age child?

School age

Which of the following can have an influence over the individual's physiological growth and development trajectory?

Sensory stimulation and nutrition

The 8-year-old child during developmental surveillance shows a significant change in growth parameters. The nurse should give the parents which of the following explanations/instructions?

The child should continue to be closely monitored.

A seasoned pediatric nurse realizes that the need for identity when hospitalized is strongest in which of the following groups?

adolescents

When you examine a toddler, you suggest to his mother that the activity that could most appropriately foster his developmental task according to Erikson would be to

allow him to pull a talking-duck toy.

The adolescent is in an auto accident and sustained a cut above his forehead and needs stitches. What would be the major concern of the teenager?

Identity

The adolescent is in an auto accident and sustained a cut above his forehead and needs stitches. Which developmental task would be a major concern for the adolescent at this stage?

Identity

A 10-year-old girl is excited when she receives the "most improved player" award on her softball team. Although she was not the strongest player on the team, she always tried to perform at her best level and never gave up on practicing her skills. What stage of psychosocial development according to Erik Erikson is this child demonstrating?

Industry versus inferiority

A father discusses with the nurse how his daughter, who recently started first grade, is extremely conscientious about her school work and is constantly asking her teachers if she is doing the work correctly. According to Erikson, which of the following developmental tasks is this girl currently learning?

Industry versus inferiority

Body proportions change from fetal life through adulthood. The trunk of the body grows most rapidly during which of the following stages of development?

Infancy

A 4 year old is in the hospital playroom with the nurse playing a game. The child informs the nurse that he has to know the rules of the game so that no one cheats. What stage of development, according to Erikson, does the nurse recognize in this child?

Initiative versus guilt

Which theorist believes that the child progresses from making decisions with no moral sensitivity to making decisions based on personal standards and values?

Kohlberg

The parents of a 2-year-old ask the nurse the purpose of administering the Denver II Developmental Screening Test and the Revised Prescreening Development Questionnaire (R-PDQ). Which of the following responses should the nurse give the parents?

This is a screening to assess overall development.

Kohlberg's theory is frequently challenged as being male-oriented because his original research was conducted entirely with boys.

True

A pediatric nurse observes an infant holding a rattle. Upon dropping the rattle, the baby cannot pick it up with his fingers on his own. The nurse correctly identifies this to be an example of which type of growth?

proximodistal

Like many 4 year olds, Ethan is constantly seeking out and exploring new experiences and repeatedly asking his parents why-type questions. Ethan's behavior suggests that he is successfully navigating an important developmental task within the developmental theory of:

Erikson

A nursing student realizes that which of the following is true about Kohlberg's theory of moral development?

At age 2 to 3 years, the child determines right or wrong by the physical consequence of a particular act.

All humans learn from both formal and informal experiences. What orderly pattern of changes results in part from learning?

Development

A 10-year-old boy tells his mother that he is going to be just like his father when he grows up. According to Freud, what stage of development is this child experiencing?

Latency

The nurse is caring for a hospitalized 8-year-old child whose parents have been divorced. Which of the following is most important for the nurse to do for this child?

The nurse should have clear information about who may contact the child.

The nurse assesses a 6 month old. What body part should show significant growth?

The trunk

A nurse is caring for a hospitalized child with divorced parents. What intervention is important for the nurse to provide when caring for this child?

The nurse should have clear information about who the custodial parent is and adhere to his or her wishes.

According to Sigmund Freud's theory of development, which of the following infants is most likely to be experiencing a significant conflict in his or her development?

An infant whose mother is weaning him in order to facilitate her return to work.

A hospitalized 2 year old is toilet training and excited to show the nurse the product created in the toilet. What stage does the nurse recognize this child is in according to Freud?

Anal stage

A 2 year old wants to feed herself and becomes agitated when the nurse attempts to feed her. What does the nurse understand is the developmental age of this child according to Erikson?

Autonomy vs. doubt and shame

The pattern of growth in which the child is able to control the head and neck before the arms and legs is known as which of the following?

Cephalocaudal

The child has learned to crawl and walk, and later throws a ball and knows the names of colors. Which principle of growth and development is the child demonstrating?

Cephalocaudal and proximodistal

A pediatric nurse practitioner is assessing the development of a child. The nurse's assessment of development will focus on which of the following?

Changes in thoughts, feelings, and behaviors

A nursing instructor informs the class that for the child to be successful at achieving maturation, he or she must first master milestones. The instructor determines that the students understand when they correctly identify these milestones as what tasks?

Developmental

What is the appropriate time when children should be taught genitalia terminology and about personal privacy?

Early childhood

A nurse is caring for a child in the emergency department who has had a cast applied for a fractured arm. The nurse is providing information to the parent on cast care and asks the parent if there are further questions about the cast. The parent stares at the nurse and shrugs. What may this indicate to the nurse?

The parent may have a further concern and does not know how to express it.

After teaching a group of nursing students about factors affecting growth and development, the instructor determines that the teaching was successful when the group identifies which of the following as a biological factor that has influence on growth and development?

Genetics

When planning care for children, the nurse knows which of the following factors has the largest impact but is not able to be altered to influence the growth and development of children?

Genetics

Which of the following is a biological factor that has influence on growth and development?

Genetics

After teaching a group of nursing students about morality and gender differences, the students demonstrate understanding when they identify which theorist as advocating that responses to morality have gender differences based in child-rearing practices of boys and girls?

Gilligan

525The nurse is observing an infant and notices that the infant has learned to roll over from one side to the other and then back again. The nurse identifies this as which of the following?

Gross motor skills

A child gains weight and becomes taller each year. What is this process called?

Growth

A trend with growth and development of the infant is that development is proximodistal. This means:

Growth progresses from gross motor movements to fine motor movements.

Based on the principles of growth and development, which of the following assessment findings would lead you to determine that a child is developing normally?

He can throw a large but not a small ball.

As the fetus develops, certain growth and development trends are regular and predictable. The first trend is cephalocaudal growth. What does this mean?

Head and brain develop first.

According to the theories of child development of Sigmund Freud, the child who is between 6 and 10 years old is in which of the following stages?

Latency stage

An 8-year-old boy 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?

Latency stage

A school-aged child always follows the rules and obeys traffic lights when crossing the street. Based on Kohlberg's theory, what type of development is being demonstrated?

Moral

According to Kohlberg, which of the following considerations is central to human development?

Morality

A 2-year-old child is hospitalized for a surgical procedure. Although previously all fluids were taken from a cup, the toddler wants a bottle to suck on. The nurse recognizes this behavior as what?

Normal regression

The nurse is playing with the 8-month-old infant. The nurse hides the toy to assess cognitive function of the infant. The infant tries to find the toy. The nurse is assessing which characteristic of Piaget's stages of cognitive development?

Object permanence

Put the following psychosexual stages of Freud's theory childhood development in the correct order:

Oral stage Anal stage Phallic stage Latent stage Genital stage

The mother of a 5-year-old girl expresses concern over the fact that her daughter is not nearly as verbal as her older two children when they were at that age. She wonders about the reason for this difference. Which of the following factors is mostly likely to account for this difference?

Ordinal position in the family

A mother is concerned about her 2-year-old son acquiring sufficient protein while following the family's vegan diet. Which of the following foods would be appropriate for the nurse to recommend to this mother?

Peanut butter and wheat bread

An 82-year-old resident of a long-term care facility 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?

The need to demonstrate that his life was meaningful and purposeful.

A nurse wants to teach children about oral health. Based on Piaget's theory, to what age group would it be most appropriate to teach this topic?

Third and fourth graders

When working with school-aged children the nurse should direct the conversation by focusing on which of the following?

patient

A pediatric nurse caring for children of all age groups knows that children learn about themselves, the environment, and relationships best through which of the following?

play