Deck 20: Caring for the Developing Child

Question 1

A 15-year-old adolescent tells the school nurse that he is busy preparing for a forensics competition and would like to be a lawyer one day.According to Piaget's stages of development,the adolescent is in which stage of development?

A) Concrete operational stage
B) Formal operational stage
C) Preoperational stage
D) Sensorimotor stage

Answer 1

Formal operational stage

Question 2

A nurse notes that when an infant is startled,she looks at her mother.What conclusion can the nurse make about this infant's development?

A) The child is slow to adapt and is distressed over small changes.
B) The developmental needs of the child are not being met.
C) The infant can develop other relationships because he is secure.
D) The infant has an unstable home environment and is insecure.

Answer 2

The infant can develop other relationships because he is secure.

Question 3

A pediatric nurse works with the family of twins at designated stages in their lives to help the parents anticipate and move through the periods of disequilibrium.What is the model of child development that focuses on disruptive periods of development?

A) Bowlby's attachment theory of development
B) Brazelton's touchpoints model of development
C) Erikson's stages of development
D) Freud's stages of psychosexual development

Answer 3

Brazelton's touchpoints model of development

Question 4

A nurse is observing infants at a day-care center to determine how their behavior fits into attachment theories.The nurse notes a wide variety of attachment behaviors.What other assessment is appropriate for the nurse to make?

A) Cultural background
B) Fussiness of the babies
C) Time dropped off
D) Time spent in day care

Question 5

A 7-year-old hospitalized for a fracture following a car crash tells the pediatric nurse "God is in heaven with his angels and is looking down on me." Which stage of Fowler's spiritual development is this child exhibiting?

A) Intuitive-projective stage
B) Mythical-literal stage
C) Synthetic-convention stage
D) Undifferentiated stage

Question 6

A hospitalized 11-year-old child turns down opportunities to play or engage in diversionary activities.When questioned,the child states "I'm bad at that" or "I can't do anything." What action by the nurse is best?

A) Arrange a pediatric psychology consultation.
B) Assess the child for emotional abuse at home.
C) Consult the child developmental specialist.
D) Document the statements in the child's chart.

Question 7

The pediatric nurse explains to a new mother that two factors,"nature" and "nurture," may influence the formation of her child's essence.Which factor among the following would be considered "nature"?

A) Cultural aspects
B) Parenting skills
C) The era in which the child develops
D) Traits inherent in the infant

Question 8

A nurse observes several preschool-aged children during play and overhears one of them say "My mommy won't let me do that." What conclusion is the most appropriate by the nurse regarding this child's development?

A) The child has developed a superego according to Freud.
B) The child has mastered Bandura's concept of self-mastery.
C) The child is behind in moral reasoning and development.
D) The child is in Erikson's autonomy versus shame and doubt phase.

Question 9

A parent is frustrated that her toddler cannot button a shirt on his own.Which teaching point is most appropriate for the nurse to provide to this parent?

A) A toddler is incapable of buttoning his own shirt, and the parent should stop pushing.
B) Developing large muscle groups has to occur before developing small muscle groups.
C) The parent should select toys and games that will help the child develop and master this skill.
D) The child has not met a major milestone and needs a developmental consultation.

Question 10

A mother takes her 10-year-old son to the pediatrician for a sprained wrist.During the medical history,the pediatric nurse listens to the mother describe her son as "busy playing basketball all day long with the other boys in the neighborhood." Based on the nurse's assessment,which stage of Freud's psychosocial development is this child experiencing?

A) Anal stage
B) Genital stage
C) Latency stage
D) Phallic stage

Question 11

The pediatric nurse teaches the parents of a 3-month-old baby the principles of growth and development that will occur in their child's lifetime.Which statement accurately describes one of these principles?

A) Each child progresses through predictable stages within a predictable timeframe.
B) Growth and development begin in infancy and continue until the adult years.
C) Growth refers to the ongoing process of adapting throughout the life span.
D) Within each child, body systems develop at the same rate.

Question 12

A parent is frustrated that her toddler wants to do everything on his own and in "my way." The parent wants to know the appropriate way to discipline the child for not obeying and allowing the parent to dress him quickly in the morning.Which response by the nurse is most appropriate?

A) "At this stage in life, discipline is not very effective and will frustrate you both more."
B) "I know it's frustrating, but being independent is a very important job at this age."
C) "Put him in a time-out, and because he is 2 years old, have him in time-out for 2 minutes."
D) "You really need to allow your child to be independent as much as possible."

Question 13

A pediatric nurse examines a 7-year-old at a well-child visit.Based on Erikson's theory,which basic task does the nurse anticipate for this child?

A) Balance independence and self-sufficiency against uncertainty and misgiving.
B) Develop a sense of confidence through mastery of different tasks.
C) Develop resourcefulness to achieve and learn new things without self-reproach.
D) Recognize there are people in his or her life who can be trusted to take care of basic needs.

Question 14

A young couple brings their 20-month-old daughter to the pediatrician's office for immunizations.The mother tells the nurse that she is going back to work and is looking for a day-care center in the vicinity of the clinic.What assessment is priority before recommending a day-care center that would help the parent and child adapt to the experience?

A) Available financial assets
B) Available support people
C) Potty-training status
D) The child's temperament

Question 15

A mother has brought her 3-year-old child in to the clinic over concern about the child's lack of development in the last 3 months.Which information is the most appropriate for the nurse to provide to this mother?

A) Children should continue their growth and development uninterrupted.
B) Periods of growth and development are often followed by periods of rest.
C) There is no need for concern unless no changes are seen for 1 year.
D) A 3-year-old often does not exhibit changes in growth and development.

Question 16

During a well-child visit,the pediatric nurse assesses a 2-year-old child for language development.Which developmental domain is the nurse assessing?

A) Cognitive
B) Family development
C) Moral/spiritual
D) Psychosocial

Question 17

A student nurse asks a pediatric nurse what cephalocaudal development means.Which response by the nurse is most accurate?

A) Growth that occurs from bottom to top
B) Growth that occurs from midline outward
C) Growth that occurs from outside to midline
D) Growth that occurs from top to bottom

Question 18

A 10-year-old child who has been hospitalized frequently and for long periods of time has the nursing diagnosis of delayed growth and development.Which action by the child would demonstrate that outcomes for this diagnosis have been met?

A) Able to play harmoniously with peers
B) Does own homework independently
C) Seeks out parental approval for activities
D) Selects age-appropriate games and toys

Question 19

The pediatric nurse is examining a newborn infant and notes a turning in of the foot and turning out of the toes when the sole of the foot is stroked.Which action by the nurse is most appropriate?

A) Arrange a consultation with a developmental specialist.
B) Assess the parents' family histories for genetic defects.
C) Document the findings in the patient's chart.
D) Instruct the parents on required follow-up care.

Question 20

A 12-year-old child is in the hospital for an extended period of time.Which action by the nurse would most promote the child's sense of self-esteem?

A) Allow the child to set a daily schedule for activities.
B) Encourage the child's friend to come and visit.
C) Have the child choose food from the menu.
D) Let the parents have unlimited visitation time.

Question 21

A mother brings her 1-year-old child to the pediatric clinic and appears frustrated and stressed.During the assessment,the mother states she tries to give her child exposure to new situations and people several times a week,but the outings always end with the child screaming and crying.Which response by the nurse is the most appropriate?

A) "Keep trying; new situations are so stimulating for children."
B) "Stop taking your child to new places and meeting new people."
C) "Use an established routine and add new experiences slowly."
D) "Your child will soon become used to such daily activity."

Question 22

A home health-care nurse sees several pediatric patients who have the nursing diagnosis of delayed growth and development.Which action by a child would indicate that outcomes have been met?

A) A 3-year-old child walks backward.
B) A 4-year-old child plays video games.
C) A 5-year-old child can unscrew items.
D) A 7-year-old child uses scissors to cut an outline figure.

Question 23

A nurse has assessed a 14-year-old hospitalized patient over several days and notes that the child has difficulty with abstract concepts and is unable to appreciate diverse points of view.According to Piaget,how would the nurse categorize this child's development?

A) Ahead in development
B) Behind in development
C) Development is normal
D) Not applicable to development

Question 24

A nurse uses Urie Bronfenbrenner's theory to guide practice.In order to determine a child's microsystem,which items should the nurse assess?

A) Dynamics between school and home
B) Family
C) Peer group
D) Parental job status
E) School

Question 25

A couple brings their child to the well-child clinic for guidance in improving the child's school performance.The nurse assesses the child and finds that favorite activities are running,playing basketball,and building models.Which conclusion is most appropriate for the nurse to make based on the assessment findings?

A) Hyperactive and may need medication
B) Learns best through bodily activity
C) Needs firm structure for completing schoolwork
D) Normal activity; school performance will improve with time

Question 26

Which outcome is most appropriate for a 3-year-old with the nursing diagnosis of delayed growth and development related to chronic illness?

A) Child will attain age-appropriate milestones in 3 months.
B) Child will attain normal weight and height in 2 months.
C) Child will draw using large crayons in 2 months.
D) Child will have fewer tantrums in 3 months.

Question 27

A nurse educator is discussing developmental theories with a student.What information is appropriate for the educator to provide regarding Lev Vygotsky's theory?

A) Children learn best with assistance from someone else.
B) Culture plays a vital role in language development.
C) Intelligence cannot be accurately measured.
D) The ecological approach emphasizes three important systems.
E) Motor skills are developed and refined in the preoperational stage.

Question 28

A father is frustrated that his child frequently disobeys well-established rules and then attempts to excuse the action by stating "Well I just thought ...." The father asks for guidance with discipline.What information is most appropriate for the nurse to provide?

A) Ensure the child knows the rules.
B) Habitual rule breaking is problematic.
C) This is a normal developmental stage.
D) Time-outs are ineffective for lying.

Question 29

The nurse is providing care to a newborn client and family during a well-baby checkup.Using Duvall's family development theory,which question is most appropriate for the nurse to ask?

A) "Do you plan to have more children?"
B) "How far apart are your closest children?"
C) "How many children do you have?"
D) "How old is your oldest child?"

Question 30

A nurse educator is presenting developmental theories to a group of students.Which statement encompasses the impact that Carol Gilligan had on developmental theories?

A) Helped define moral development in women as unique from men
B) Described the seven stages of religious/faith development
C) Identified nine temperamental traits present at birth in all children
D) Viewed the status of the family's oldest child as the marker for transition

Question 31

A mother and 1-year-old child are being seen in the well-child clinic.The mother asks the nurse for guidance in setting an appropriate bedtime for the child.She and her husband have tried several different times and can't seem to agree on the right time.Which response by the nurse is the most appropriate?

A) "As long as it's consistent, it doesn't matter when bedtime is."
B) "At this age, your child needs 10 to 12 hours of sleep each night."
C) "Children get sleepy when warm, so dress your child heavily for bed."
D) "What 'sleepy' behaviors does your child show when tired?"

Question 32

A 2-year-old is seen for a well-child visit and is scheduled to receive immunizations.The child weighed 22 lb (9.97 kg)at 1 year of age (1 year ago).Today the child weighs 23 lb (10.4 kg).Which conclusion is most appropriate for the nurse to make regarding this assessment data?

A) The child is at an expected weight.
B) The child is over expected weight.
C) The child is seriously overweight.
D) The child is underweight for age.

Question 33

A mother is worried that her 3-month-old child is not holding her own head up.Which action by the nurse is most appropriate?

A) Explain that sturdy head control occurs around 6 months.
B) Document the findings and alert the health-care provider.
C) Reassure the mother that her baby is completely normal.
D) Teach the mother that head control is evident at 9 months.

Question 34

A nurse is working with a child at a nutrition site.The father is not in the child's life,and the mother has been in and out of jail,resulting in a series of caregivers for the child,who appears malnourished.Using Bandura's theory of growth and development,what should the nurse assess as a priority?

A) Bonding
B) Industry
C) School success
D) Self-esteem

Question 35

A nurse is working at a community health-screening event.A woman tells the nurse that her oldest child is leaving home in a month and that this change is making her feel stressed and unneeded.What response by the nurse is the most appropriate?

A) "At your age you need to start coping with losses."
B) "Lucky you; I can't wait 'til my kids leave home!"
C) "This is a great time to refocus on your marriage."
D) "Your other children will need help with separating."

Question 36

A mother brings her child to the well-child clinic.She is distraught because the child tested well below normal on a school-administered intelligence (IQ)test.Which action by the nurse is the most appropriate?

A) Advise the mother to have the test repeated next year.
B) Assess cultural background and economic status.
C) Facilitate a referral to a developmental specialist.
D) Reassure the mother that IQ tests are often wrong.

Question 37

A father brings his 10-month-old infant to the well-baby clinic and expresses frustration that his child "puts everything in her mouth" and "gets into everything," then cries when objects are taken away.In providing anticipatory guidance,what action by the nurse is the most appropriate?

A) Advise the father that crying indicates fatigue and the child should rest.
B) Explain that objects may be dirty and should not be put in the mouth.
C) Give the father written material on effective disciplinary techniques.
D) Teach the father that this behavior is normal and not misbehaving.

Question 38

A nurse is assessing a 1-year-old child who weighed 7 lb,8 oz at birth.Today's weight is 23 lb.What conclusion can the nurse make about the child's weight?

A) The child is at an expected weight.
B) The child is over expected weight.
C) The child is seriously overweight.
D) The child is seriously underweight.

Question 39

A nurse is providing anticipatory guidance to the parents of a toddler.Which information is most important for the nurse to include regarding typical toddler behaviors?

A) Children at this age rarely lie about misbehaving and want to please their parents.
B) Competing and winning are important, so "rewards" for good behavior are great tools.
C) Toddlers need constant supervision, because they don't understand what consequences can occur.
D) Time-out for misbehavior works well if the child is placed quietly in his or her own room.

Question 40

A nurse is assessing several children during a shift at the well-child clinic.Which child demonstrates successful resolution of the Erikson stage of autonomy versus shame and doubt?

A) A 15-month-old playing on the floor with supervision
B) An 18-month-old being consistently consoled by her father
C) A 20-month-old using building blocks with her grandfather
D) A 24-month-old being allowed to independently dress himself

Question 41

A mother brings her 8-year-old son into the clinic for a well-child visit.She is concerned because her son does not take responsibility for completing and handing in his school assignments on time,and his teacher has given him several warnings for missing homework.Which responses are appropriate for the nurse to this child's mother?

A) "A good discipline strategy for this stage of development is a time-out in a specific location, which could include focusing on homework at this time."
B) "As a parent, you should refrain from rescuing your child from the consequences of his behaviors and allow him to learn a valuable lesson from them."
C) "At 8, children can internalize rules, so it's important to allow him to be responsible for his actions and to accept the consequences of his behavior."
D) "Eight-year-old children are not ready to accept the consequences of their actions and need to be constantly reminded of their responsibilities."
E) "Natural consequences are important, and removing privileges, especially time with friends, is often a successful technique at this age."

Question 42

A nurse is working with a child who has a chronic illness requiring medication and frequent hospitalizations.The parents refuse to allow the child to go to the playroom,fearing germs from other children will harm their child.Which actions by the nurse are most appropriate?

A) Allow the parents to voice their concerns without being judgmental.
B) Consult with a child developmental specialist for appropriate in-room activities.
C) Document the parents' choice on the patient record and inform the staff.
D) Help the parents see the ways their child is normal while having an illness.
E) Tell the parents that the playroom and all its objects are disinfected often.

Question 43

The nurse is preparing to educate the parents of an 8-year-old child about normal growth and development.Which information should the nurse include?

A) Boys and girls play equally with each other.
B) Children frequently have best friends at this age.
C) Peer approval is not yet important, but will be for teens.
D) Puberty changes should be discussed before they occur.
E) Typical weight gain is 4-6 lb (1.8-2.7 kg)/year.

Question 44

A toddler has been adopted from a foreign country and has the nursing diagnosis of delayed growth and development related to poor nutrition.Which activities should the nurse include in the plan of care to assist the child to meet outcomes?

A) Allow the toddler to use a fork and knife with supervision.
B) Allow toddler to choose foods within appropriate parameters.
C) Consult with a dietician to provide a high-calorie, high-protein diet.
D) Force the toddler to eat if he or she chooses not to at mealtime.
E) Provide only foods that the toddler can eat with the fingers.

Question 45

A nurse is providing anticipatory guidance to the parents of a school-age child.What information is appropriate for the nurse to include for school-age children?

A) Discuss physical changes related to puberty.
B) Discuss smoking and substance abuse.
C) Provide simple explanations for questions.
D) Read short stories daily to help language.
E) School-age children require 8 to 12 hours of sleep each night.

Question 46

A nurse is teaching parents about appropriate discipline for their toddler.Which information is appropriate for the nurse to include in the session?

A) Be firm and specific but respectful.
B) Deliver consequences immediately.
C) Tie consequences to the action if possible.
D) Time-outs are 5 minutes for each year of life.
E) Try to anticipate and avoid tantrums.

Question 47

A school nurse is working with high school students.The nurse wants to influence these teenagers to make healthy decisions.Which actions are most appropriate by the school nurse to influence health decisions?

A) Discouraging questioning rules
B) Discussing without judging
C) Encouraging critical thought
D) Listening carefully to the teen
E) Paying attention to nonverbal cues

Question 48

A nurse is providing anticipatory guidance to the parents of a 5-month-old baby.Which nursing statements are appropriate by the nurse to these parents?

A) "Do not leave the child alone on the changing table."
B) "Until the age of 3, falls are common due to large head size."
C) "Peek-a-boo is an appropriate game for this age."
D) "Wrap up mini-blind ties so the child can't reach them."
E) "You need to childproof all your cabinets now."

Question 49

The nurse is preparing to provide information to the parents of a 14-year-old who is within normal limits for growth and development.What information is appropriate for the nurse to include?

A) Children of this age can anticipate long-term consequences of choices.
B) Growth, although slowed, can still be significant.
C) The child of this age may be able to give informed consent in some situations.
D) The child of his age is not normally worried about sexual identity.
E) Peer group influence is often stronger than family influence.