Chapter 28: NCLEX practice questions
Which best describes Piaget's cognitive stage of formal operations? A) Deductive and abstract reasoning B) Inductive reasoning and beginning logic C) Transductive reasoning and egocentrism D) Cause-and-effect reasoning and object permanence
*A) Deductive and abstract reasoning* Rationale: Piaget's cognitive stage of formal operations occurs between the ages of 11 and 15; deductive and abstract reasoning are developed. Inductive reasoning and beginning logic begin in the concrete operations stage between the ages of 7 and 11. Transductive reasoning and egocentrism occur in the preoperational stage at age 2 to 7. Cause-and-effect and object permanence occur during the sensorimotor stage from birth to 2 years.
Based on Piaget's theory of cognitive development, what is one basic concept a child is expected to attain during the first year of life? A) If an object is hidden, that does not mean that it is gone. B) He or she cannot be fooled by changing shapes. C) Parents are not perfect. D) Most procedures can be reversed.
*A) If an object is hidden, that does not mean that it is gone.* Rationale: Part of learning permanence is learning that although an object is no longer visible, it still exists. At 1 year of age, a child may not be able to understand that an object that changes shape is still the same object. Understanding conservation occurs between ages 7 to 11 years.
A preschool child watches a nurse pour medication from a tall, thin glass to a short, wide glass. Which statement is appropriate developmentally for this age group? A) The amount of medicine is less. B) The amount of medicine did not change, only its appearance. C) Pouring medicine makes the medicine hot. D) The glass changed shape to accommodate the medicine.
*A) The amount of medicine is less.* Rationale: A preschool child does not have the ability to understand the concept of conservation. This concept is not developed until school age. Understanding conservation occurs between 7 to 10 years of age, when a child begins to realize that physical factors, such as volume, weight, and number, remain the same even though outward appearances are changed. Children are able to deal with a number of different aspects of a situation simultaneously. This is not an expected response by a child. A preschool child will not typically believe the glass changed shape to accommodate the medicine but rather that the amount of medicine is less in the short, wide glass.
During their school-age years, children best understand concepts that can be seen or illustrated. The nurse knows this type of thinking is termed as: A) concrete operations. B) preoperational. C) school-age rhetoric. D) formal operations.
*A) concrete operations.* Rationale: Black-and-white reasoning involves a situation in which only two alternatives are considered, when in fact there are additional options. Preoperational thinking is concrete and tangible. During the school-age years, children deal with thoughts and learn through observation. They do not have the ability to do abstract reasoning and learn best with illustration. Thought at this time is dominated by what the school-age child can see, hear, or otherwise experience. School-age rhetoric simply refers to the type of ideas that arise out of the years children attend school. Formal operations are characterized by the adaptability and flexibility that occurs during the adolescent years.
During a well-baby visit, the parents of a 12-month-old ask the nurse for advice on age-appropriate toys for their child. Based on the nurse's knowledge of developmental levels, the most appropriate toys to suggest are: (Select all that apply.) A) push-pull toys. B) toys with black-white patterns. C) pop-up toys, such as a Jack-in-the-box. D) soft toys that can be put in the mouth. E) toys that pop apart and go back together.
*A) push-pull toys.* *C) pop-up toys, such as a Jack-in-the-box.* *E) toys that pop apart and go back together.* Rationale: Both gross and fine motor skills are becoming more developed and children at this age enjoy toys that can help refine these skills. Children at this age enjoy more colorful toys. Children at this age are less interested in placing toys in the mouth and more interested in toys that can be manipulated.
A nurse is knowledgeable about both growth and development. Which assessment finding indicates the child's development is on target? A) The child has not gained weight for 3 months. B) The child can throw a large ball but not a small ball. C) The child's arms are the most rapidly growing part of the child's body. D) The child can pull herself or himself to her or his feet before the child is able to sit steadily.
*B) The child can throw a large ball but not a small ball.* Rationale: Development is continuous and proceeds from gross to refined, so children whose development is on target can usually throw large objects before small ones. Not gaining weight for 3 months is an abnormal assessment finding; it would indicate that the child's development may not be on target. In children, the legs are normally the most rapidly growing part of the body; if this is not the case, the child's development may not be on target. A child whose development is on target can sit steadily before pulling herself or himself up to her or his feet.
Which statement helps explain the growth and development of children? A) Development proceeds at a predictable rate. B) The sequence of developmental milestones is predictable. C) Rates of growth are consistent among children. D) At times of rapid growth, there is also acceleration of development.
*B) The sequence of developmental milestones is predictable.* Rationale: *There is a fixed, precise order to development. There are periods of both accelerated and decelerated growth and development.* Each child develops at his or her own rate. Physical growth and development proceed at differing rates.
Parents are often confused by the terms growth and development and use the terms interchangeably. Based on the nurse's knowledge of growth and development, the most appropriate explanation of development is: A) a child grows taller all through early childhood. B) a child learns to throw a ball overhand. C) a child's weight triples during the first year. D) a child's brain increases in size until school age.
*B) a child learns to throw a ball overhand.* Rationale: Development is the mental and cognitive attainment of skills. Growth is the increase in physical size—both height and weight.
A nurse is examining a toddler and is discussing with the mother psychosocial development according to Erikson's theories. Based on the nurse's knowledge of Erikson, the most age-appropriate activity to suggest to the mother at this stage is to: A) feed lunch. B) allow the toddler to start making choices about what to wear. C) allow the toddler to pull a talking-duck toy. D) turn on a TV show with bright colors and loud songs.
*B) allow the toddler to start making choices about what to wear.* Rationale: A toddler is developing autonomy and is able to start making some choices about what he or she can wear, focusing on doing things for himself or herself and therefore would not want the mother to feed him or her. The child is at the stage of autonomy versus shame and doubt, as defined by Erikson. At this age, the mother should provide opportunities for the child to be active and learn by experience and imitation. Providing toys the child can control will help achieve this stage. A toddler might easily become overstimulated by images from TV and loud sounds. Toddlers are more interested in manipulating and learning from objects in the environment.
The nurse is developing a teaching plan about preventing fetal exposure to teratogens. The nurse should include which teratogenic agents or conditions? (Select all that apply.) A) acetaminophen (Tylenol) B) isotretinoin (Accutane) C) Cocaine D) Hyperthermia E) Ethyl alcohol F) phenytoin (Dilantin)
*B) isotretinoin (Accutane)* *C) Cocaine* *D) Hyperthermia* *E) Ethyl alcohol* *F) phenytoin (Dilantin)* Rationale: Teratogens, agents that cause birth defects when present in the prenatal environment, account for the majority of adverse intrauterine effects not attributable to genetic factors. Types of teratogens include drugs (phenytoin [Dilantin], warfarin [Coumadin], isotretinoin [Accutane]); chemicals (ethyl alcohol, cocaine, lead); infectious agents (rubella, cytomegalovirus); physical agents (maternal ionizing radiation, hyperthermia); and metabolic agents (maternal PKU). Many of these teratogenic exposures and the resulting effects are completely preventable, such as ingestion of alcohol resulting in fetal alcohol syndrome or fetal alcohol effects, which causes severe birth defects, including cognitive impairment. The incidence of fetal alcohol syndrome is estimated at 5.2 per 10,000 live births (American Academy of Pediatrics, 2000).
A nurse is discussing various developmental theories at a parenting class. Which individual is associated with the moral development theory? A) Erikson B) Fowler C) Kohlberg D) Freud
*C) Kohlberg* Rationale: Kohlberg developed the theory of moral development sequence for children. It includes how children acquire moral reasoning and is based on cognitive developmental theory. Erikson developed the theory of psychosocial development. Fowler developed the theory of spiritual development. Freud developed the theory of psychosexual development.
The nurse is talking to a group of parents about different types of play in which children engage. Which statement made by a parent would indicate a correct understanding of the teaching? A) "Parallel-play children borrow and lend play materials and sometimes attempt to control who plays in the group." B) "In associative play, children play independently but among other children." C) "During onlooker play, children play alone with toys different from those used by other children in the same area." D) "Cooperative play is organized, and children play in a group with other children."
*D) "Cooperative play is organized, and children play in a group with other children."* Rationale: Cooperative play is play that is organized; children play in a group with other children and plan activities for purposes of accomplishing an end. Play in which children borrow and lend play materials and attempt to control who plays in the group is known as associative play. Parallel play occurs when children play independently but among other children. Onlooker play is described as play in which children watch but make no attempt to enter into play with other children.