1220 EAQ 2 Development
Which is the maximum recommended length for enema tube insertion in an adolescent?
10 cm RATIONALE: In adolescents, the maximum length for insertion of an enema tube is 10 cm.
By which age does the anterior fontanelle of the skull close?
12 to 18 months RATIONALE: The anterior fontanelle usually closes between 12 and 18 months. Hence, 20 to 24 months, 26 to 30 months, and 32 to 36 months are all incorrect choices.
How many days is the neonatal period?
28 days RATIONALE: The neonatal period is the first 28 days of life.
Which age is considered critical for speech development during the preschool years?
3 years 4 years RATIONALE: The most critical ages for speech development for the preschool-aged client are 3 and 4 years of age. Although critical speech development occurs at the age of 2 years, this is the toddler, not preschool, stage of development. The ages of 5 and 6 years are not considered critical ages for speech development for the preschool-aged client.
Which is the minimum number of hours of sleep the nurse would recommend for an 11-year-old client?
9 RATIONALE: A school-age client who is 11 years of age is recommended to receive 9-11 hours of sleep per night. The minimum number of hours the nurse would recommend is 9. Eight hours is the minimum number of hours recommended for an adolescent. Ten hours of sleep is the minimum recommended for a preschool age client. Eleven hours of sleep is the minimum recommended for a toddler.
Which is the most common cause of death among adolescents?
Accidents RATIONALE: Accidents are the most common cause of death in adolescents; approximately 74% of all adolescent deaths are caused by accidents. Suicide is the third leading cause of death in adolescents. Homicide is the second leading cause of death in adolescents. Death by substance abuse affects 30% of adolescents.
In which stage of Erikson's psychosocial stages of development would toilet training be achieved?
Autonomy versus shame RATIONALE: Children between the ages of 18 months and 3 years attempt to develop independence; control over self; and mastery of toileting, dressing, and feeding. Infants between birth and 1 year attempt to meet basic oral and sensory needs and develop a sense of trust in themselves and others. Children between the ages of 3 and 6 years develop a sense of purpose; they accept responsibility, learn to be cooperative, and are enthusiastic about helping others. Children between the ages of 7 and 11 years develop a sense of competence; through learning and mastery of skills, they develop self-assurance.
Which stage must a 3-year-old accomplish according to Erikson's psychosocial stages of development?
Autonomy versus shame RATIONALE: For children 18 months to 3 years of age, the autonomy versus shame stage is about acquiring mastery over self and and the environment. The trust-versus-mistrust stage is associated with infancy. The industry-versus-inferiority stage is associated with middle childhood. The generativity-versus-stagnation stage is associated with middle adulthood.
Thick mucous gland secretions, elevated sweat electrolytes, meconium ileus, and difficulty maintaining and gaining weight are associated with which autosomal recessive disorder?
Cystic fibrosis RATIONALE: The early symptoms of cystic fibrosis is meconium ileus, which is impacted stool in the newborn. Thick mucous secretions, salty sweat, and difficulty gaining weight because of high caloric demands are characteristics of the condition. Cerebral palsy is a motor disorder caused by damage to the brain. Muscular dystrophy is a muscular disorder. Multiple sclerosis is a condition with progressive disintegration of the myelin sheath.
The nurse understands which medication may cause gynecological malignancies in females?
Diethylstilbestrol RATIONALE: Diethylstilbestrol may cause gynecological malignancies such as endometrial, ovarian, and cervical cancers. Oxytocin is a hormone and uterotonic agent. It can be used to start or strengthen with gynecological malignancy. Raloxifene is used to prevent postmenopausal osteoporosis. The use of thalidomide during pregnancy may cause birth defects in the newborn.
Which statement is true about Piaget's theory of cognitive development?
During the sensorimotor stage, infants develop a schema or action pattern for dealing with the environment. Piaget's theory includes four periods that are related to age. In the early preoperational stage, children experience animism. During the concrete operations stage, children are able to perform mental operations.
Which action by the nurse would be therapeutic after obtaining the consent of an adolescent girl who is concerned about her body image after amputation of a leg for bone cancer?
Encouraging her peers to visit RATIONALE: Peer acceptance is crucial during this period; friends must have the opportunity to accept the client with one leg. Concealment does not help the adolescent or other accept the loss. Isolating the adolescent will increase feelings of alienation and being different. An adolescent needs to relate to and be accepted by peers and family.
Which period of Piaget's theory covers the prevalence of egocentrism in adolescents?
Formal operations RATIONALE: Formal operations is the fourth period of Piaget's theory. During this period, there is a prevalence of egocentric thought. This egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self-consciousness. The sensorimotor period is the first period of Piaget's theory. In this period, infants develop a schema or action pattern for dealing with this environment. The preoperational period is the second period. During this time, children learn to think with the use of symbols and mental images. Concrete operations is the third period of Piaget's theory. During this period, children are able to coordinate two concrete perspectives in social and scientific thinking.
Which stage is followed by society-maintaining orientation, according to Kohlberg's theory?
Good boy-nice girl orientation RATIONALE: According to Kohlberg's theory, good boy-nice girl orientation (stage 3) is followed by society-maintaining orientation (stage 4). Social contract orientation is stage 5. Instrumental relativist orientation is stage 2. Punishment and obedience orientation is stage 1
Which information would the nurse provide to maintain a positive self-image during treatment of a 13-year-old with idiopathic scoliosis who is upset about the treatment regimen and is worried about being different from peers?
Help investigate appropriate clothing to minimize appearance of the brace RATIONALE: Clothes can be selected to minimize the appearance of a brace, especially if an effort is made to wear current styles. Reminding the child how they will look without treatment has a negative connotation that emphasizes with the problem. Focusing only on positive attributes may be misinterpreted as unqualified praise; adults should give honest appraisals of both positive and negative attributes. There are no data to indicate that the child will not adjust to the treatment regimen.
In which settings would the nurse perform developmental assessments for pediatric clients?
Home School Hospital Daycare center RATIONALE: Pediatric developmental assessments are performed in many settings, including the home, school, hospital, and daycare center environments. It is unlikely that a pediatric developmental assessment would be performed in an assisted living center
Which developmental conflict affects a 4-year-old child according to Erikson's psychosocial stages of development.
Initiative versus guilt RATIONALE: Initiative versus guilt is the developmental conflict that faces the preschool child; the child will feel guilty if initiative is stifled by others. Industry versus inferiority is the conflict of the school-aged child. Trust versus mistrust is the conflict of infants aged 0 to 18 months. Autonomy versus shame is the conflict for children aged 18 months to 3 years.
Which nursing objective would the nurse add to the plan of care for a child with attention-deficit/hyperactivity disorder (ADHD) who engages in self-destructive behavior?
Keeping the child from inflicting any self injury RATIONALE: The nursing objective is to keep the child from inflicting any self-injury. All nursing care would be directed toward preventing injury, particularly with a self-destructive child. Although improved communication skills are important, this is usually not an issue with ADHD. Although formulation of realistic ego boundaries is important, it is not the priority. Opportunities to discharge energy are important but prevention of injury is the priority.
Which type of immunity is acquired through the transfer of colostrum from the mother to the child?
Natural passive immunity RATIONALE: Natural passive immunity is acquired through the transfer of colostrum from the mother to the child. Natural active immunity is acquired when there is a natural contact with an antigen through clinical infection. Artificial active immunity is acquired through immunization with an antigen. Artificial passive immunity is acquired by injecting serum from an immune human.
Which stage of development classifies boys and girls as differing very little in terms of size?
School-age RATIONALE: During the school-age stage of development, boys and girls differ very little in terms of size. During the toddler, preschool, and adolescence stages of development boys are often larger than girls
Which sign in the newborn infant would reflect an Apgar score of 1 in the category of respiration.
Slow, weak cry RATIONALE: A slow, weak cry would be scored as a 1 in the category of respiration in the Apgar scoring system. A good cry would receive a score of 2. A grimace is a sign that is evaluated in the category of reflex irritability, not respiration. Absent respiration would receive a score of 0 in the respiration category of the Apgar score system.
Which toys would the nurse suggest to the parent of a 4-month-old infant to help promote the child's growth and development?
Soft squeeze toys RATIONALE: Soft, noisy squeeze toys are appropriate for a 4-month-old; the infant enjoys squeezing and hearing the sound of the squeaker. Push-pull toys are appropriate for a toddler 12- to 24-months of age. Nesting toys are appropriate for a toddler 16-months of age. Banging toys are appropriate for children from 12- to 18-months of age.
Children's patterns of play change as they grow from infancy through school age. Rank the order of appearance of each type of play, starting with infant play.
Solitary Parallel Associative Cooperative RATIONALE: The infant plays alone, with other initiating the play activity. Toddler's play activity is described as parallel; they play beside other children but not with them. Preschoolers' play is associative in loose groups, with activities involving interaction among players. The school-age child is capable of cooperative play, which includes organized play such as sports, board games, and card games.
Which condition poses an increase risk for injury for an adolescent?
Substance abuse Motor vehicle accidents RATIONALE: Substance abuse and motor vehicle accidents pose an increased risk among adolescents. Poisoning and child abductions are common among toddlers and preschoolers. Home accidents are common among toddlers as well.
Which age group has the highest incidence of lead posoning?
Toddler RATIONALE: The incidence of lead poisoning is highest in late infancy and toddlerhood. Children at this stage explore the environment and because of their increased level of oral activity, put objects in their mouths. Adults have a greater risk of cardiovascular or pulmonary disease. Drowning and motor vehicle accidents are more common among adolescents. Bicycle accidents are common among school-aged children.
