Question 1

A baby was born prematurely during the sixth month of pregnancy. The new parents question the nurse about the hair all over their baby. The nurse's best response is:

Accepted Answer

Fine downy hair, or lanugo, is a normal occurrence in fetal development and is most commonly seen in premature infants. It will gradually shed in the weeks following birth. The nurse should provide accurate and reassuring information to the parents. Option A implies that premature infants are hairier than full-term infants, which is not true. Option C is dismissive of the parents' concerns and may cause unnecessary stress. Option D is unrelated to the parents' question about the baby's appearance.

Question 2

According to Kohlberg's moral developmental theory, school-age children progress through several stages of their development. Put the following stages in order.

Accepted Answer

According to Kohlberg's moral developmental theory, school-age children progress through several stages of their development in a particular order. The order is as follows:

1. Punishment and obedience - children obey rules to avoid punishment. 
2. Instrumental-relativist orientation - children realize that there is not necessarily one right way of doing things and that there may be different perspectives. 
3. Good boy-nice girl stage - children begin to conform to social norms and values in order to be seen as "good" by others. 
4. Law-and-order orientation - children understand the importance of maintaining social order and following society's rules and laws.

Therefore, the correct order is A, C, D, B.

Question 3

The parents of a toddler are concerned that their child is so messy during eating, they just feed him. The nurse's best response to this is:

Accepted Answer

Messy eating is a normal part of a toddler's development, and their motor skills will continue to improve with age. It's important for children to experience different textures and learn how to feed themselves. The nurse can offer reassurance to the parents that this messiness is a normal stage and encourage them to continue to offer opportunities for their child to practice feeding themselves.

Question 4

According to Fowler's (1981) spiritual development theory, a school-age child who is still influenced largely by parental views is in the:

Accepted Answer

According to Fowler's theory, the mythic-literal stage is typical of school-age children (approximately 7-12 years old) who still rely heavily on their parents' beliefs and interpretations of spiritual and religious concepts. In this stage, children are concrete thinkers and are not yet able to understand abstract or symbolic representations of spiritual ideas. They believe in the literal truth of religious stories and adhere to strict rules and rituals.

Question 5

A 4-year-old was hospitalised for several days with an acute illness. Though the child had control of bowel and bladder prior to hospitalisation, now she has been wetting the bed at night and is having incontinent accidents during the day. The nurse addresses the parents' concerns with the following statement:

Accepted Answer

Regression is a common response in young children to stress, change, or illness. It is important for the nurse to reassure the parents and encourage them to be patient and understanding while their child adjusts back to their normal routine. Option B focuses solely on physical causes, while option C is not appropriate as it suggests blaming and punishing the child. Option D validates the parents' feelings but does not provide helpful advice.

Question 6

New parents are discovering their baby and all his features the day after the baby is born. They ask the nurse why the baby's head seems lopsided and not round, as they thought it should be. The nurse's best response is:

Accepted Answer

The nurse should explain to the new parents that it is normal for a newborn's head to be lopsided or not perfectly round because it had to shape itself to the birth canal during delivery. This condition is called molding and typically resolves within a few days without any intervention.

Question 7

A 2-year-old is brought into the clinic for a well check. Her birth weight was 2.8 kilograms. If she is following normal growth and development patterns, what should her weight be at this point in her life?

Accepted Answer

By the age of 2, a child's weight typically quadruples from their birth weight. Given that this child's birth weight was 2.8 kilograms, multiplying this by 4 gives 11.2 kilograms, which is the expected weight at 2 years old if following normal growth patterns.

Question 8

The nurse is working with a client who hopes to become pregnant within the next year. The client asks about nutritional needs before and during pregnancy. The nurse responds by telling the client she should increase her intake of which of the following food groups?

Accepted Answer

Oranges and green leafy vegetables are good sources of folate, a B vitamin that helps prevent birth defects of the baby's brain and spine.

Question 9

New parents are concerned about the things their baby is and is not doing at age eight months. The nurse might suggest screening the baby with which of the following?

Accepted Answer

The DDST-II (Denver Developmental Screening Test-II) is a commonly used screening tool to assess a child's developmental progress and identify any potential delays or concerns in areas such as gross motor skills, language, social skills, and fine motor skills. It is specifically designed for children between 1 month and 6 years of age, making it an appropriate option for an 8-month-old baby. The other options listed, such as state education department assessment tools or the Apgar scoring system, are not relevant for assessing an 8-month-old baby's developmental progress. Growth and development charts may provide information on expected milestones, but they are not a screening tool for identifying potential developmental delays.

Question 10

According to Erikson's (1963) psychosocial development theory, the teenager is:

Accepted Answer

According to Erikson's theory, the psychosocial stage of adolescence is "role identity versus confusion." During this stage, teenagers are focused on developing a sense of self and their place in society. They are grappling with questions like "who am I?" and "what do I want to be?".

Question 11

According to Piaget (1966), the cognitive development of an infant proceeds from:

Accepted Answer

Piaget's theory of cognitive development begins with the sensorimotor stage, which emphasizes reflexive abilities as the foundation of cognitive development in infants. This stage highlights how infants start to understand the world through their reflexes and later through their actions and sensory experiences.

Question 12

A school nurse is working with teachers in helping them address the developmental needs of primary school students, according to Erikson's theory of industry versus inferiority. The nurse suggests which of the following activities?

Accepted Answer

Erikson's stage of industry versus inferiority focuses on developing competence and skills. Activities like budgeting with pocket money help children develop practical skills and a sense of accomplishment.

Question 13

A baby was born with flaccid muscle tone, regular respirations with crying, heart rate of 85, and blue extremities. What would the Apgar score be?

Accepted Answer

The Apgar score is calculated by assessing five criteria: Appearance, Pulse, Grimace, Activity, and Respiration. The baby has a heart rate of 85 (1 point), regular respirations with crying (2 points), flaccid muscle tone (0 points), blue extremities (1 point), and presumably some response to stimulation (1 point). This totals to an Apgar score of 6.

Question 14

A preschool class is being screened by a group of nursing students who are working in a community health course. Few of the children have 20/20 vision. Most have 20/30, and some have 20/40. What observation would the nursing students make to their instructor?

Accepted Answer

The nursing students would observe that most of the children have 20/30 vision, which is normal for their age group. Having 20/20 vision is actually uncommon, so it is not concerning that few of the children have this level of vision. Additionally, there is no evidence to suggest that these children have poor nutrition or need glasses, so options A, B, and D are not appropriate observations to make.

Question 15

The parents of a newborn ask the nurse about the things their baby can see. The nurse responds correctly by saying:

Accepted Answer

Newborns can see light and dark contrasts, and can focus on objects that are within 8-12 inches of their face. They may also be able to track larger moving objects. However, their visual acuity is not fully developed yet, so everything may appear blurry. It is also important to note that every baby develops at their own pace, so some may demonstrate these abilities earlier or later than others.

Question 16

A nurse is teaching a class to new parents how to handle some of the behaviours that could be demonstrated by toddlers. One of the parents asks what to do when their child throws a temper tantrum. The nurse should reply:

Accepted Answer

When a child is throwing a temper tantrum, it is important to make sure that they are safe from harm (e.g. not hitting their head on a hard surface) but then it is best to calmly walk away. Giving in to a tantrum will reinforce the behaviour, whilst ignoring and then finding a moment to discuss and redirect the child is a more effective approach. Holding the child tightly can cause harm and should never be recommended.

Question 17

According to Kohlberg's (1984) moral development theory, a child's moral decision making, which is motivated more by significant people's expectations than their own needs, is in which stage?

Accepted Answer

The answer of According to Kohlberg's (1984) moral development theory,...

Question 18

The parents of a newborn ask the nurse about colic pain. The nurse correctly responds with which of the following?

Accepted Answer

Newborns can experience pain, and colic pain can be quite discomforting for them. Swaddling can help alleviate this pain. Option A suggests a referral to a paediatrician, which may not be necessary for colic pain. Option B is incorrect as colic pain can occur in newborns. Option C is incorrect as newborns can feel pain.

Question 19

A client asks about what causes low birth weight babies. Which of the following factors would indicate that the client was at risk for this to occur?

Accepted Answer

Smoking is a known risk factor for having a low birth weight baby. It can decrease oxygen supply to the fetus and reduce growth. While genetic history, teratogen exposure, and low levels of folic acid can also contribute to low birth weight, smoking is the most significant risk factor.

Question 20

A new mother is concerned about taking her baby home. Her mother-in-law has told her to leave the baby in the bassinette and not to cuddle her too much as it will spoil the baby. The new mother is not sure about the advice. The nurse would respond that at this stage the baby's healthy development is about:

Accepted Answer

The healthy development of a newborn is primarily about learning trust and developing a close bond with their caregiver. This can be achieved through frequent cuddling and responding to the baby's cries. Leaving the baby in the bassinette and not cuddling them enough can lead to feelings of mistrust and a lack of bonding, which can have negative impacts on their development in the long run. Maintaining good relations with grandparents and learning about boundaries may also be important, but they are not as crucial for the healthy development of the newborn as building a strong bond with their primary caregiver. Learning not to cry is not a healthy developmental goal for a baby, as crying is their primary means of communication and it is important to respond to their needs.

Quiz 22: Promoting Health From Conception Through to Adolescence