Growth And Development

D

5-1 At what age would a child be expected to remember a string of six numbers and repeat them backward? A. 3 years B. 6 years C. 9 years D. 12 years

B

5-10 As people age, they try to maintain previous lifestyles that have contributed to their personalities. This is an example of A. activity theory. B. continuity theory. C. disengagement theory. D. age stratification theory.

A

5-100 When performing a mental status examination, you should keep in mind the ABCTs. What does the C stand for? A. Cognition B. Consciousness C. Capabilities D. Conscience

C

5-11 Sleep in older adults is characterized by which pattern? A. Increased time spent in REM sleep B. Increased overall sleep time C. Increased sleep latency D. Increased proportion of deep sleep

C

5-12 What is the term used when the last child leaves home, either for school or to move out on his or her own? A. Longed-for freedom B. Silent guilt C. Empty nest D. Abandonment

A

5-13 Adolescent thinking is egocentric, and adolescents sometimes perceive that they are the focus of everyone else ' s attention. This has been called the A. imaginary audience. B. personal fable. C. invulnerable self. D. ego ideal.

B

5-14 While assessing the skin of an infant, you note café-au-lait spots. Which disease should be ruled out? A. Tuberous sclerosis B. Neurofibromatosis C. Sturge-Weber syndrome D. Fetal alcohol syndrome

C

5-15 At what age does a child usually develop the ability to mentally reverse actions that have been completed? A. 2 years B. 4 years C. 6 years D. 10 years

D

5-16 Delayed development can be the result of malnutrition from a deficiency of protein, calories, or both. This is referred to as protein energy malnutrition, kwashiorkor, or A. protein-wasting disease. B. hypermetabolic disease. C. cachexia. D. marasmus.

C

5-17 Middle-aged persons who still have responsibilities for their children's care and are now caring for their own aging parents are sometimes said to A. have institutional guilt syndrome. B. have the " full-nest " syndrome. C. be in the " sandwich " generation. D. be members of Generation X.

B

5-18 The body and the senses typically reach their peak during which stage of life? A. Adolescence B. Early adulthood C. Middle adulthood D. Late adulthood

A

5-19 The tasks of middle adulthood include all of the following except A. affiliating with one ' s age group. B. accepting and adjusting to the physical changes of middle age. C. reviewing and redirecting career goals. D. achieving desired performance in a career.

C

5-2 The diet of a healthy nondiabetic older adult female is based on which guidelines? A. Energy needs are 2,500 - 3,000 kcal/day. B. 5 - 10% of calories should come from fats, especially monounsaturated fats. C. 20 - 30% of calories should come from protein sources. D. Calcium requirements decrease after age 70.

B

5-20 Jon, age 13, has some enlargement of the scrotum and testes, a reddened scrotal sac, and some hair texture alteration, but his penis is not enlarged. He is in Tanner stage A. I. B. II. C. III. D. IV.

A

5-21 Justin, age 18 months, crosses his legs when lifted from behind rather than pulling them up. His legs are also hard to separate, making diaper changing difficult. He persistently uses only one hand. What condition do you suspect? A. Cerebral palsy B. Mild hydrocephalus C. Mild spinal cord defect (spina bifida occulta) D. Fetal alcohol syndrome

A

5-22 You are examining a 58-year-old man who complains of recent onset of erectile dysfunction (ED). The approach to his concern should be guided by which principle? A. There are multiple physical conditions associated with the development of ED. B. Almost all men will develop ED by the time they reach their 60s. C. Most ED is caused by hormonal imbalance D. ED is correlated with the development of benign prostatic enlargement

B

5-23 Common medications for treating ADHD include A. aminophylline and antihistamines. B. methylphenidate, amphetamine, and their derivatives. C. amphetamines and Accutane. D. codeine and Valium.

B

5-24 Victoria ' s mother brings her for her 1-year checkup. As you are weighing her, you remember that at 1 year, her weight should be A. twice her birth weight. B. triple her birth weight. C. four times her birth weight. D. at least 25 pounds.

A

5-25 Which tooth is the first to erupt in an infant? A. A lower central incisor B. A lower lateral incisor C. Lower canine D. Upper lateral incisor

A

5-26 Which one of the following is a normal physiological change of aging? A. A decrease in strength and speed of muscle contraction in the extremities B. Degenerative arthritis C. Rheumatoid arthritis D. Bulging intervertebral disks

C

5-27 Johnny, age 3, is at the clinic for his wellchild visit. He has trouble removing his own shirt as requested. His mother yanks off his shirt after smacking his wrist and saying, " You must do as you ' re told — quickly. " Which action is indicated? A. Ignore the behavior because both Johnny and his mother are probably nervous about being there. B. Tell the mother that Johnny ' s behavior is perfectly normal. C. Observe Johnny for signs of child abuse. D. Report the mother to child protective services.

C

5-28 To best help parents foster social-emotional development in their preschooler, age 4, you advise them to A. give instructions rather than choices to the child. B. set strict limits for behavior and quickly discipline for misbehavior. C. provide frequent opportunities to interact with other children. D. ask questions that direct the child to think about how others are feeling.

A

5-29 A 6-year-old would most likely view a friend as A. someone to share enjoyable activities with. B. someone who has the traits that satisfy the child ' s needs and wants. C. someone to share loyalty with. D. someone to be intimate with.

A

5-3 Nine-year-old Mark is a highly active child with limited self-control. He is easily distracted and has difficulty staying on task and working toward a goal. You determine that he should have a neurodevelopmental evaluation because he is showing signs of A. ADHD. B. dyslexia. C. autism. D. impaired hearing.

C

5-30 According to Piaget, the ability to develop abstract thinking occurs during which stage of life? A. Early childhood B. Middle school age C. Adolescence D. Early adulthood

B

5-31 Older adults face greater risks for fluid imbalance than young and middle adults due to which age-related factor? A. Increased amounts of intracellular fluid and total body water B. Higher proportion of fat to muscle cells C. Faster speed of metabolism D. Increased intestinal motility

A

5-32 David, a new father, expresses his concern that his newborn son does not smile at him when he talks to him. What do you tell him? A. " True social smiles usually do not emerge until 4 - 9 weeks of age. " B. " Continue to watch his response so we can be certain that he is seeing. " C. " Babies usually have a preference for the mother ' s face. That ' s probably why he doesn ' t smile at you. " D. " This may just be his personality. "

A

5-33 Developmental tasks of adolescence include which of the following? A. Searching for one 's identity and growing independent from parents B. Graduating from high school C. Learning to establish meaningful relationships with siblings D. Engaging in community service projects to assist acceptance into college

D

5-34 Which of these language behaviors would be cause for concern at a primary care visit? A. A 1-year-old cannot say more than two words with meaning. B. An 18-month-old uses unintelligible jargon and has only a few words that are intelligible to family members. C. A 2-year-old uses only two- to three-word sentences. D. A 3-year-old does not use three- to five-word sentences.

A

5-35 Male reproductive system changes during middle and later adulthood result in which manifestation? A. Slight decrease in sperm production B. Testicular enlargement C. Decrease in estrogen-like hormone production D. Stable levels of testosterone

B

5-36 Why are younger children more predisposed to acute otitis media than older children? A. They are more susceptible to the new bacteria that they encounter. B. Their eustachian tubes are more flaccid and more horizontal than those of older children. C. They have more viral infections, which precipitate otitis infections. D. They have more allergies, which are a frequent cause of serous otitis media.

C

5-37 Debbie is developing self-assertion, spontaneity, self-sufficiency, direction, and purpose as her mother encourages, reassures, and cheers her on. Which of Erikson ' s stages of ego development best characterizes Debbie? A. Trust versus mistrust B. Autonomy versus shame and doubt C. Initiative versus guilt D. Industry versus inferiority

A

5-38 Susie is 18 months old and does not seem the least bit interested in being toilet trained. What do you tell her mother? A. Susie ' s behavior is typical, because most children are not ready for toilet training until age 2. B. The majority of children Susie ' s age have started showing readiness behaviors related to toilet training by this age. C. She can use reinforcement conditioning to discipline Susie whenever she soils her diapers and reward her when she stays dry. D. She should have Susie spend time around other toddlers who are toilet trained so that she can learn from them.

C

5-39 Mrs. Groome calls the clinic to say she is distressed that her 3-month-old baby is still not sleeping through the night. Your best response to her would be A. " At this age infants are typically sleeping at least 10 hours at night without waking. " B. " It may be helpful to give some rice cereal right before bedtime, because she probably is waking up at night due to hunger. " C. " The length of sleep for young babies is variable, but most sleep through the night by the end of the first year. " D. " Babies never sleep through the night until they are at least 6 months old. "

A

5-4 Developmental tasks of early adulthood (ages 20 - 45) include which of the following? A. Psychological separation from parents and developing a capacity for intimacy with a partner B. Starting a family C. Achieving desired performance in a career D. Graduating from college or a vocational school

D

5-40 Infants, born at term, are expected to sit well without support by what age? A. 1 - 2 months B. 3 - 4 months C. 5 - 6 months D. 7 - 8 months

A

5-41 A 14-year-old girl ' s BMI is plotted between the 85th and 95th percentiles. Based on developmental characteristics, which strategy is best to use when educating her about self-care changes that are needed? A. Emphasize the benefits of diet and activity changes that she identifies as most important. B. Describe the relationship between current health choices and later health risks. C. Encourage her parents to share their recent experiences with weight management. D. Tell her frankly that her weight is too high, and she must make changes to decrease risks for developing chronic illness like diabetes.

C

5-42 While assessing the eyes of baby Thomas, you observe inner canthal folds and Brushfield spots. What do you suspect? A. Trisomies B. Turner ' s syndrome C. Down syndrome D. Neurofibromatosis

A

5-43 Beginning at about age 55, most people can expect which of the following changes? A. A 1- to 2-in. decline in height B. Stable body weight C. Sharper vision and hearing D. Increased strength

A

5-44 Which cardiac finding can be normal in children and young adults? A. Third heart sound (S 3 ) B. Fourth heart sound (S 4 ) C. Ejection click D. Diastolic murmur

C

5-45 At what age should a normally developing child be able to use a pincer grasp and pick up small cereal pieces, raisins, and finger foods? A. 2 - 3 months B. 5 - 6 months C. 9 - 10 months D. 12 - 14 months

C

5-46 Self-actualization is the goal of personality development for which of the following theories? A. Peck ' s expansion of Erikson ' s theory B. Maslow ' s hierarchy of human needs C. Jung ' s theory of individualism D. Erikson ' s eight stages of life

D

5-47 Suzanne ' s 8-year-old daughter, Natasha, has attention deficit-hyperactivity disorder (ADHD). She asks if Natasha will " outgrow " her ADHD. You respond, A. " Yes; when they become young adults, most children outgrow the problem. " B. " No; unfortunately, Natasha will have this for the rest of her life. " C. " No, but there are many treatments available that we need to start now. " D. " About 50% or more of affected children will continue to have some difficulty as adolescents and adults. "

C

5-48 Fragile X syndrome is usually diagnosed when a child A. is a newborn. B. begins to walk. C. is past the toddler stage. D. begins puberty.

D

5-49 At what age/stage of development would you expect a boy to reach his adult height? A. One year after the enlargement of the testicles B. When his voice changes C. By the time he is 17 D. He may continue to grow past his teenage years.

A

5-5 Cyndy is 5 years old and cannot understand how the half-cup of vegetables on her plate is the same amount as the half-cup of vegetables in the saucepan. According to Piaget, she is at which stage of cognitive development? A. Preoperational B. Sensorimotor C. Formal operations D. Concrete operations

A

5-50 Hattie, age 6, appears to be masturbating when she rubs herself back and forth against the rug. Her mother asks you for advice because she believes masturbation may cause emotional problems and blindness. What is your best response? A. " Masturbation causes no physical, sexual, or mental problems. " B. " Stop her now because she may progress to other sexual behaviors. " C. " There is no research to show that masturbation causes blindness. " D. " Don ' t worry; Hattie will be fine. "

B

5-51 Which of the following is a result of changes in the cell-mediated immune function that occur from aging? A. Fewer neutrophils, so older adults do not respond to local infections quickly B. Increases in autoantibodies as a result of altered immune function C. Fewer thrombocytes D. The pancytopenia of aging

D

5-52 Amanda states that her baby will not go to bed without her bottle. You tell her that if the baby must have a bottle at night, it should be a bottle containing A. formula. B. breastmilk. C. diluted juice. D. plain water.

B

5-53 Marta, age 16, is not happy with the size of her breasts. She asks if her breasts will continue to enlarge. How do you respond? A. " Full breast growth occurs around age 15. " B. " No, this is probably the size your breasts will remain. " C. " Your breasts will continue to develop until about age 18. " D. " Your breasts will continue to develop until about age 20. "

B

5-54 Evaluating an older adult client according to the successful aging paradigm involves assessment of A. cognition, problem-solving, physical skills, and memory. B. health, social engagement, mental activity, and life satisfaction. C. vision, hearing, balance, and strength. D. coping, social support,

B

5-55 Children begin to develop real friendships at the age of A. 18 months. B. 3 years. C. 6 years. D. 10 years.

C

5-56 Photosensitivity of the epidermis increases in older adults due to which of the following normal developmental changes of aging skin? A. Reduction of Langerhans cells B. Decrease in vitamin D synthesis C. Decrease in enzymatically active melanocytes D. Significant decrease in vascular supply

C

5-57 Erikson ' s stage of intimacy versus isolation occurs between what ages? A. 12 and 16 B. 16 and 20 C. 20 and 30 D. 50 and 60

B

5-58 Shannon, age 4 months, is waiting in the exam room with her mother. When you walk into the room, you expect Shannon to A. begin crying. B. turn her head toward the sound of the door or your voice. C. not notice you. D. smile at you.

A

5-59 The diagnosis of ADHD is made using which of these? A. Comparison of child ' s characteristics with criteria in the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV-TR) B. Blood assays demonstrating elevated lead levels C. Identification of EEG abnormalities D. Scores on the Connors Parent and Teacher rating scales

A

5-6 What is the first male secondary sexual characteristic to emerge? A. Testicular enlargement B. Growth of axillary and pubic hair C. Growth of facial and chest hair D. Deepening of the voice

B

5-60 Which of these infant characteristics is associated with readiness for the introduction of solid foods into an infant ' s diet? A. At least one tooth has emerged. B. Extrusion reflex has faded. C. Infant is at least 3 months of age. D. Infant wants to nurse every 3 - 4 hours.

C

5-61 Assessment of an adolescent using the HEADSS framework involves asking the teen about A. habits. B. exercise. C. school. D. disabilities.

D

5-62 Erikson ' s final ego stage in older adults occurs when successful resolution results in these adults feeling comfortable with their life choices and the knowledge that they would have done everything the same way again. What is this ego stage called? A. Generativity versus stagnation B. Workaholism versus retirement C. Success versus failure D. Integrity versus despair

A

5-63 Four-year-old Jamie believes that there is more juice in a tall, thin glass than in a shorter, wider one. Jamie has not yet achieved which of the principles of Piaget? A. Conservation B. Object permanence C. Formal operations D. Abstract reasoning

B

5-64 Your 66-year-old patient is able to correctly interpret the meaning of the proverb " a penny saved is a penny earned. " This helps to establish the patient ' s expected ability to A. access long-term memory. B. engage in abstract reasoning. C. execute concrete operations. D. follow complex instructions.

B

5-65 Sally Ann is concerned that she cannot afford special walking shoes for her baby, who is beginning to pull himself up to his feet. What do you tell her? A. " High-top shoes are necessary to prevent any ankle injuries when your baby falls. " B. " Don ' t worry; special shoes are not necessary. The more flexible the shoe, the better. " C. " Try to keep him off of uncarpeted floors until you can obtain shoes. " D. " The sock-type booties you have are fine. "

C

5-66 In a game of hide-and-seek, 3-year-old Michael hides his face and believes that no one else can see him. This behavior is an example of A. conservation. B. object permanence. C. egocentric thought. D. concrete operations.

A

5-67 Jason is in first grade. His mother expresses concern because he pronounces the th sound as f. For instance, he says " free " for " three. " You respond to his mother, A. " This is normal at his age. " B. " He may have a hearing problem and does not know how it should sound. C. " You should correct him when he does this, or he will not learn the proper way to say it. " D. " He should be referred to a speech therapist for evaluation. "

A

5-68 You are watching a baby play with a toy in the examining room. You move the toy and cover it with a cloth. The baby removes the cloth and reclaims the toy. This is an indication that the baby has achieved which of the following? A. Object permanence B. Conservation C. Basic trust D. Initiative

A

5-69 While examining a 12-month-old boy whose family recently immigrated to the United States from Mexico, you notice that his weight is in the 95th percentile and his height is in the 50th percentile. You begin to discuss the implications of maintaining a healthy weight, and the mother tells you that she is very proud of her son ' s size. Your response to her is guided by your understanding that A. some cultures believe that a fat baby is a healthy baby. B. she is probably overfeeding the baby to stop his crying. C. she does not understand the nutritional value of foods. D. the relationship of obesity to childhood health risks has not been explained to her.

D

5-7 Which theory of aging focuses on older adults' development of specific strategies to manage losses of function over time? A. Disengagement theory B. Activity/developmental task theory C. Person-environment fit theory D. Selective optimization with compensation theory

D

5-70 Germaine, age 12 years, comes to see you for her checkup. After weighing her, you note that her BMI is at the 96th percentile on the National Center for Health Statistics graph. Your response to this will be guided by the knowledge that A. her size is acceptable for her age, and you will continue to follow up weight during subsequent checkups. B. she has been in a phase of rapid growth, and it will slack off within a year. C. she is healthy but may be at risk for an eating disorder. D. she is obese and at risk for hypertension and diabetes.

B

5-71 Sue takes her young son Michael to day care every day. He has begun to cry loudly and try to cling to her when she leaves. Michael is likely what age? A. 4 - 5 months B. 8 - 9 months C. 12 - 15 months D. 15 - 18 months

B

5-72 When does the onset of menses usually occur? A. Between ages 10 and 11 B. Between ages 12 and 13 C. Between ages 14 and 15 D. Between ages 16 and 17

B

5-73 Donna is breastfeeding her 3-month-old infant exclusively. She expresses concern to you that the baby ' s growth seems to be slowing down, and she wonders if she should supplement the diet with other foods. What would be your response? A. " You are probably not producing enough milk. Try introducing several tablespoons of rice cereal, in addition to breastfeeding, once each day. " B. " As long as you are well nourished, the baby will get what she needs. Her growth pattern is normal for an exclusively breastfed baby. " C. " Other foods are not needed now, but supplement breastfeeding by offering about eight ounces of formula each day. " D. " This indicates it is time to begin weaning from breast to bottle and to begin to introduce solid foods. "

B

5-74 You suspect autism in the young child of a client of yours, but the client says the child is just shy. For a diagnosis of autism, you know the Diagnostic and Statistical Manual of Mental Disorders requires that three criteria be present. Which of these behaviors would lead the nurse practitioner to suspect autism in a young child? A. Receiving immunizations that use thimerosal as adjuvants B. Abnormal verbal and nonverbal communication C. Reliance on an imaginary friend for all interactions by a preschooler D. Inability of a newborn to track mother ' s face from left to right

D

5-75 Which age-related changes in the respiratory system make drugs like albuterol (Proventil) and salmeterol (Serevent) less effective in older adults? A. The vital capacity of the lungs decreases. B. Residual lung volume increases. C. There is a decrease in cellular oxygen uptake in lung tissue. D. There is a decrease in the number of beta receptors.

A

5-76 What is the major determinant of sexual activity in older adults? A. Physical and mental health B. Social sanctions C. Religious beliefs D. Age

B

5-77 Davy, age 4, is here for a well-child visit. To assess for age-appropriate fine motor skills, what activity would you ask him to perform? A. Copy a circle. B. Cut on a line with scissors. C. String beads. D. Copy a square.

A

5-78 The feature(s) of fragile X syndrome that should be evaluated during well-child examinations include A. being easily overwhelmed by stimuli and language delays. B. shorter linear growth. C. increased frequency of ear infections. D. difficulty swallowing.

D

5-79 Which strategy for care of older adults is inconsistent with an approach supportive of aging in place? A. Make changes to the home environment that can accommodate an individual ' s changing needs. B. Refer for home care and adult day-care services. C. Hire assistants to help with activities of daily living. D. Emphasize the individual ' s limitations and likely need for long-term care placement.

A

5-8 A 2-year-old is brought to the clinic for his annual exam. His mother tells you that he can speak approximately 5 - 10 single words but that she can understand what the child is saying only 25% of the time. To make his needs known, he typically resorts to gesturing rather than trying to use words. He appears to understand half of her commands. The child does not live in a bilingual household. Which steps are indicated? A. Conduct an ear examination with pneumatic otoscopy and refer to audiology/speech clinic for evaluation. B. After a normal ear examination with a pneumatic otoscopy, reevaluate the child in 6 months. C. Treat with an antibiotic for presumptive chronic otitis media with effusion. D. Give the child an articulation screening examination.

B

5-80 Physiologic changes of aging can affect functional mobility. Screening for functional mobility of older adults involves which screening tool? A. Katz Index B. Get Up and Go Test C. Functional Independence Measure D. Mini Mental State Exam

C

5-81 The mother of your 3-year-old client is concerned because the child stutters. What should your approach be? A. Refer to a speech clinic for a full evaluation. B. Refer to a pediatric neurologist. C. Explain that this can be normal until 4 years of age. D. Perform an articulation test on the child.

D

5-82 Risks for automobile accidents are increased in older adult drivers due to which normal changes associated with aging? A. Decreased ability to understand the driving related dangers B. Lack of recognition of their own physical challenges C. Magnified physiological response to stressful situations D. Increased reaction time

B

5-83 A 6-year-old has just been diagnosed with attention deficit hyperactivity disorder. His parents report that he is doing poorly in school and is often disruptive in the classroom. They ask what they can do. Your best response is: A. " Children usually outgrow a high activity level. " B. " Use a consistent approach with behavioral ' cues ' both at home and at school. " C. " Medications are the only interventions that can help with ADHD. " D. " You can have him tested for food and environmental allergies.

C

5-84 At what stage of sexual development should a boy expect to begin to have nocturnal emissions? A. When he starts to get facial hair B. When his scrotal sac begins to darken in color C. Approximately 6 - 12 months after his penis begins to enlarge D. At 15 years of age, regardless of his sexual development

A

5-85 You are examining a previously healthy 6-month-old who was delivered by cesarean section at 32 weeks ' gestation. Examination reveals the presence of Moro, Babinski, and Landau reflexes. Which interpretation of findings is accurate? A. Findings are normal. B. Findings suggest developmental delay. C. Findings indicate persistence of primitive reflexes often associated with neurological dysfunction. D. Findings are imprecise due to the infant ' s age.

B

5-86 To determine your client ' s emotional and cognitive level of functioning when you are performing a mental status examination, you assess several individual behaviors. What is the term used when one ponders a deeper meaning beyond the concrete and literal? A. Thought process B. Abstract reasoning C. Consciousness D. Perception

B

5-87 Josephine, age 6, is just learning to hop on one foot. You know that A. she should have been able to do this at age 3. B. she should have been able to do this at age 4. C. she should have been able to do this at age 5. D. this is a normal age-related activity for her.

A

5-88 Which of these musculoskeletal changes accompany older adulthood? A. Change in stature B. Increased stride length C. Improved fine motor skill D. Stretching of muscle fibers

B

5-89 Jane, age 45, is having her annual physical. She wants to know when she can expect to go through menopause. Your response to her would be A. " You should not have any more periods after the age of 50. " B. " Most women begin having irregular periods in their late 40s, but age can range from 40 - 60. " C. " It is typical to complete the process of menopause at your age. I ' m surprised you haven ' t gone through it yet. " D. " You should think about hormone replacement therapy now. "

C

5-9 Fine motor coordination improves during the middle childhood years. A person ' s ability to manipulate objects reaches adult capacity by which age? A. 6 years B. 9 years C. 12 years D. 21 years

C

5-90 Miranda is playing with clay and realizes that she can roll a lump of clay into a long snakelike shape and then return that snakelike shape to a lump. She is exhibiting cognitive development typical of which of Piaget ' s stages? A. Sensorimotor B. Preoperational C. Concrete operations D. Formal operations

A

5-91 You are examining 14-year-old Bobby. He tells you he is embarrassed to undress in the school locker room because his " chest is swollen. " You observe very slight breast enlargement and palpate small subareolar disks of soft, slightly tender tissue bilaterally. There are no other significant findings. His BMI is between the 75 th and 85 th percentile for his age. He takes no medications, supplements, or other substances. Which response to Bobby ' s concern is indicated? A. " This is called gynecomastia. It is normal, and many boys develop it during early adolescence. It usually resolves on its own within a year or so. " B. " You do have some excess tissue on your chest. It ' s because of your weight. Once you lose some weight, the swelling will go away. " C. " It ' s due to a condition called precocious puberty and means puberty is a bit too early. It will be important to do some blood tests to check your hormones. " D. " Swollen breasts in boys need further evaluation to make sure there ' s nothing wrong. You will need to have some x-rays, imaging, and blood tests. "

A

5-92 When assessing growth and development from a cross-cultural perspective, health-care providers need to be aware that A. there may be differences in normal growth curves. B. children with immigrant parents have a difficult time developing social relationships in their age groups. C. cognitive development may be delayed if children live in a bilingual household. D. children from Asian households have higher IQs than American children.

C

5-93 When an adolescent girl ' s breasts and areolae are enlarged and there is no contour separation, which Tanner stage is she in? A. I B. II C. III D. IV

C

5-94 At what age can a baby usually say two to three words with meaning? A. 8 months B. 10 months C. 12 months D. 24 months

B

5-95 After conducting the Tumbling E Snellen eye test on a verbal 4-and-a-half-year-old boy, you determine that his vision is 20/30 in both eyes. Your next step is to A. refer to a pediatric ophthalmology clinic to be evaluated for glasses. B. recheck vision at the next well-child exam. C. notify the preschool he will be attending in the fall that he needs to be seated in the front of the classroom. D. reevaluate the child ' s vision in 3 months.

B

5-96 Your 49-year-old female client reports that she has not had a menstrual period in 3 months. She uses contraception. She is experiencing occasional poor sleep, sweating, and flushing. She believes she is entering menopause. Which step is appropriate to take next? A. Initiate calcium supplementation B. Obtain pregnancy test results C. Send blood samples for follicle-stimulating hormone (FSH) and estradiol levels D. Refer for bone density test

A

5-97 Some psychologists have suggested that at the end of adolescence, a kind of thinking emerges that goes beyond logic to encompass interpretive and subjective thinking. What is this called? A. Postformal thought B. Mature thinking C. Adult cognition D. Ephemeral perception

D

5-98 The mother of your 12-year-old female client is concerned because all of her daughter ' s friends have started their periods, but her daughter has not. Upon physical exam, you note that her pubic hair and breast development are both at stage III (Tanner). Your next step should be to A. refer to an endocrinologist. B. start the girl on birth control pills to encourage her menses to start. C. order bone age x-rays. D. explain to the mother and child that this appears to be normal for this child.

A

5-99 Why is Alzheimer ' s disease (AD) considered a specific disease, distinct from the normal developmental changes of aging? A. There are types of AD that are inherited and present before age 60. B. There are changes in biological processes that occur with normal aging. C. There is a notable decline incognitive functioning as people age. D. There are multiple changes in organ functioning, especially in the brain.