Deck 25: Development

Question 1

The nurse is caring for a family with four children whose third child has been diagnosed with attention-deficit/hyperactivity disorder (ADHD).After completing an assessment,which statement made by the mother leads the nurse to a diagnosis of compromised family coping?

A) "I don't know how to tell the rest of the family or how we will manage the other children."
B) "We need to alert the teachers at school so they will know how to give the medication."
C) "Will he have to be put in an institution?"
D) "I'm not sure if we should let my child act in the school play."

Answer 1

"I don't know how to tell the rest of the family or how we will manage the other children."

Question 2

The community nurse develops an educational program that focuses on the developmental tasks of adults ages 50 to 60.Which developmental task accomplishment within Gould's theory should the nurse highlight?

A) Self-reflection
B) Personalities are seen as set
C) Adjustment to decreasing physical capacities
D) Period of transformation

Answer 2

Period of transformation

Question 3

A toddler cannot stand next to furniture and does not try to pull himself up from a sitting position.Based on this data,the nurse plans care for this client based on which deficiency?

A) Behavior
B) Height
C) Development
D) Growth

Answer 3

Development

Question 4

The nurse is assessing a 6-month-old infant using the Denver Developmental Screening test.The test shows that the infant is delayed in gross motor development.What activities can the nurse implement to help the child attain appropriate developmental levels?

A) Pull the child to a sitting position and prop the child in a sitting position.
B) Encourage the child to hold a rattle or play patty-cake.
C) Talk to the child and play music.
D) Encourage the child to stand.

Question 5

The mother of a child starting school in a few weeks is concerned how her child will interact with other children.Which response by the nurse is best to address this mother's concern?

A) "The home environment is the major influence."
B) "The child's physical characteristics play a large role in interactions with others."
C) "The child's temperament will determine interaction ability."
D) "The culture in which the child was raised plays a role in interactions with others."

Question 6

The school nurse cares for students with physical challenges and suspects that the needs for physical safety are not being adequately met for several students in the home environment.Which assessment findings support the nurse's concern? Select all that apply.

A) Wearing the same clothes to school several days of the week
B) Limited arm range of motion
C) Scrapes on knees caused be falling from a bicycle
D) Hand burn from touching a hot stove
E) Lunch contains leftovers from previous evening dinner

Question 7

The nurse is utilizing Kohlberg's theory to assess the moral development of several school-age children.According to this theorist,the nurse should recognize this age group is mainly concerned with which step in moral development?

A) A feeling of justice
B) Belief in due process
C) Fear of punishment
D) Wanting the approval of others

Question 8

The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD).When assessing the child's health history,which would the nurse identify as a risk factor for ADHD?

A) The measles, mumps, and rubella (MMR) vaccine
B) The immune response of the child
C) Young parental age at conception
D) Smoking during pregnancy

Question 9

The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD)who wants to play soccer.Which action is the most appropriate for the school nurse to take?

A) Recommend that the child become active in an individual sport, rather than a team sport.
B) Encourage the child to play soccer.
C) Discourage the child from playing a team sport like soccer.
D) Ask the child's mother to get permission from the child's physician to play soccer.

Question 10

The community health nurse,working with a group of women from another country who smoke,encourages them to stop smoking before and during pregnancy.A participant asks the nurse,"why is it important to stop smoking before and during pregnancy?" Which health problem associated with smoking before and during pregnancy will the nurse include in the response?

A) Benzodiazepine withdrawal
B) Attention-deficit/hyperactivity disorder (ADHD)
C) Unhappy memories
D) A personality disorder

Question 11

The nurse is caring for a young school-age child recently diagnosed with attention-deficit/hyperactivity disorder (ADHD).Which statement by the child's mother indicates that teaching goals have not been achieved?

A) "I will let my child do homework while watching a favorite television show."
B) "I will give my child ADHD medication with meals."
C) "I will take my child to the doctor every 3 months for a weight and height check."
D) "I will stick to the same routine each day after school."

Question 12

A psychiatric nurse is actively involved in the planning of a new children's mental health clinic.The nurse understands the importance of including a play area at this site because of the population it will serve.Which is the reason for the use of play and toys to assess children with suspected mental health disorders?

A) Pediatric clients express themselves through play.
B) Only toys that are developmentally appropriate and specific to the child's biological age are used.
C) Pediatric clients do not usually relate to adults.
D) Play enables the nurse to assess the cognitive ability of the pediatric client.

Question 13

A parent of a toddler-age child is explaining to the nurse that the family wishes to raise the child to reflect their spiritual beliefs.According to Westerhoff's stages of faith,which should the nurse advise the parent to help the child grow in the family's faith?

A) Baptize the child in the parents' faith.
B) Read spiritually oriented books to the child.
C) Follow and live the faith of their choice.
D) Take the child to ceremonies of their faith.

Question 14

The nurse is caring for an adolescent with cystic fibrosis who suddenly becomes noncompliant with the medication regimen.Which intervention should the nurse choose to help improve medication compliance for this client?

A) Give the client a computer-animated game that presents information on the management of cystic fibrosis.
B) Recommend to the client's parents that certain privileges should be taken away, such as cell phone use and texting, if compliance fails to improve.
C) Arrange for the physician to discuss the risks related to noncompliance with medications to the client.
D) Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.

Question 15

A school nurse is working with a group of teachers to help them address the developmental needs of preschool students.The nurse tells the group that preschool-age children are experiencing the stage of initiative versus guilt described in Erikson's theory.Which activity should the nurse suggest to foster development at this stage?

A) Providing time for running and playing sports, such as basketball, to increase gross motor skills
B) Helping them develop skills needed in the adult world, such as allowance budgeting
C) Allowing "pretend" time during their classes, such as dress-up or role-playing activities
D) Presenting diversity in culture and practices as part of classroom study

Question 16

A nurse is caring for a school-age client who is scheduled to have a tonsillectomy the next day.The nurse has planned a preoperative teaching session for the child,who has a history of attention-deficit/hyperactivity disorder (ADHD).Which teaching technique is most appropriate for this client?

A) Play a television show in the background.
B) Ask other children who have had this procedure to talk to the child.
C) Allow the child to lead the session to gain a sense of control.
D) Give instructions verbally and use a picture pamphlet, repeating points more than once.

Question 17

The nurse determines that a toddler-age client is unable to respond to noises in the environment and has difficulty following the movement of toys.Which diagnostic tools does the nurse anticipate will be used to further assess this client? Select all that apply.

A) CT scan of the brain
B) Vision test
C) Abdominal x-rays
D) Nerve conduction studies
E) Audiology testing

Question 18

The nurse is teaching the family of a child who is prescribed amphetamine mixed salts (Adderall)for attention-deficit/hyperactivity disorder (ADHD).Which is the best time for the nurse to teach the family to administer the medication?

A) Before lunch
B) At bedtime
C) With the evening meal
D) Early in the morning

Question 19

The nurse instructs a school-age client how to use a peak flow meter to monitor asthma.The client was frustrated at first but now is able to state the reason for using the meter on a daily basis.Which response by the nurse is most appropriate when dealing with the growth and development characteristics of the preadolescent?

A) "It's too bad that you don't want to use the meter; it's just something you'll have to do."
B) "You should feel very proud of yourself for understanding and using your meter."
C) "Maybe you could make a game out of the daily use of your meter."
D) "Think of using the meter as one of your daily chores."

Question 20

The school nurse is administering methylphenidate (Ritalin)to an adolescent is diagnosed with attention-deficit/hyperactivity disorder (ADHD).The adolescent is noncompliant with coming to the nurse's office at noon for the medication.Which does the nurse suspect as the cause of the adolescent's noncompliance with the current medication regimen?

A) The adolescent may fear that this drug may be a "gateway drug" that may lead to abusing other substances.
B) An additional dose of medication is not needed while at school.
C) Alternative coping mechanisms to increase focus during classes have been developed.
D) The adolescent may be embarrassed about having to take medicine at school and fear a social stigma.

Question 21

The nurse is caring for a child diagnosed with autism spectrum disorder (ASD)who is being admitted to the hospital with dehydration.Which action by the nurse is appropriate when the child arrives to the care area?

A) Take the child on a tour of the pediatric unit.
B) Take the child to the playroom for arts and crafts.
C) Quietly orient the child to a single-bed hospital room.
D) Orient the child to a four-bed unit.

Question 22

After completing an assessment,the nurse is concerned that a pregnant client is at risk for having a child with autism spectrum disorder (ASD).Which characteristics should the nurse recognize as increasing the risk for having a child with ASD? Select all that apply.

A) Employed as a computer operator
B) Smokes 1 ppd of cigarettes
C) Drinks 2 glasses of wine on the weekends
D) Age 40
E) Rides a stationary bicycle four times a week for 30 minutes

Question 23

A community health nurse is educating pregnant clients about the prenatal causes and risk factors associated with the development of attention-deficit/hyperactivity disorder (ADHD).Which statement will the nurse include in the educational session?

A) "ADHD has not been linked to prenatal exposure or disease."
B) "ADHD has been linked to a specific gene, and genetic testing may help to diagnose this."
C) "ADHD has been linked to prenatal exposure to cigarette smoke."
D) "ADHD has been linked to childhood exposure to folate."

Question 24

The nurse is caring for a client prescribed baclofen (Lioresal)for cerebral palsy (CP).The client's parents speak very little English and the nurse plans to use an interpreter to teach the parents about the medication.Which instructions should the nurse emphasize during client teaching?

A) "It is important that your child take the medication as prescribed. Do not stop the medication abruptly."
B) "Do not give your child any aspirin-type drugs while on this medication."
C) "It is important for your child to take the medication on an empty stomach."
D) "You will need to increase your child's intake of fiber while on this medication."

Question 25

The nurse is planning care for a child who is diagnosed with cerebral palsy (CP).What are appropriate nursing diagnoses for this child? Select all that apply.

A) Impaired Mobility
B) Risk for Injury
C) Anxiety
D) Caregiver Role Strain
E) Deficient Diversional Activity

Question 26

A nurse working in labor and delivery is teaching a group of pregnant clients about maternal risk factors associated with increased risk of the development of cerebral palsy (CP).Which statements will the nurse include? Select all that apply.

A) "Increased risk for CP occurs in women older than 35 and younger than 20."
B) "Increased risk for CP occurs in mothers and fathers of African-American decent."
C) "Increased risk for CP occurs in first-born children and in children born after the fourth child."
D) "Increased risk for CP occurs in children who are born prematurely."

Question 27

The parents of a child with autism spectrum disorder (ASD)observe that the child has difficulty making friends and are concerned about social expectations for their child.Which is the priority diagnosis for this child based on the parent's concern?

A) Ineffective Coping
B) Deficient Diversional Activity
C) Social Isolation
D) Impaired Social Interaction

Question 28

A nurse is caring for a child who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD).The client's healthcare provider has prescribed amphetamine-dextroamphetamine (Adderall)to treat the child's disorder.Which statement regarding the use of the medication is appropriate for the nurse to include in the medication teaching?

A) "Your child's liver function should be monitored with this medication."
B) "Your child's growth may be delayed with this medication."
C) "This medication may increase the risk of psychosis."
D) "This medication has less abuse tendency because it is not a stimulant."

Question 29

While conducting a well-child assessment,the nurse suspects a 2-month-old has failure to thrive (FTT).Which height and weight measurement parameter should the nurse use to help diagnose this health problem?

A) Height and weight below the 50th percentile
B) Height and weight below the 15th percentile
C) Height and weight below the 5th percentile
D) Height and weight below the 10th percentile

Question 30

The nurse is planning care for a family with five children,one of whom is diagnosed with cerebral palsy (CP_.The child is being cared for in the home,has a tracheostomy,and is on a home ventilator.Which should the nurse include in the plan of care for this family?

A) Meals-on-Wheels
B) Food stamps
C) Psychological counseling
D) Respite care

Question 31

The mother of a young child with cerebral palsy (CP)is pregnant and asks if the second child will be diagnosed with the same disorder.What risk factors for CP should the nurse explain to the mother? Select all that apply.

A) Father over the age of 20
B) Child has meningitis at birth
C) First-born child
D) Mother's age of 42
E) Child is 9 pounds at birth

Question 32

A nurse is caring for a newborn who is suspected of having cerebral palsy (CP).Which should the nurse recognize is the most common cause of cerebral palsy?

A) Injury to the developing neurotransmitters in fetuses and premature infants
B) Decreased levels of cerebral spinal fluid (CSF) in fetuses and premature infants
C) Increased levels of cerebral spinal fluid (CSF) in fetuses and premature infants
D) Injury to the immature periventricular white matter in fetuses and premature infants

Question 33

The nurse is caring for a child newly diagnosed with autism spectrum disorder (ASD).Which is the most appropriate overall outcome for this child?

A) To function more effectively in social and emotional interactions
B) To stay on task
C) To acknowledge the effects of one's own behavior on others
D) To acknowledge personal strengths

Question 34

The nurse caring for a child recently diagnosed with cerebral palsy (CP)is discussing the plan of care with the parents.Which is the major goal of therapy for this child?

A) Promoting optimal global development
B) Increasing the child's IQ level
C) Reversing the degenerative processes that have occurred
D) Curing the underlying defect

Question 35

The nurse is caring for 9-month-old client diagnosed with ataxic cerebral palsy (CP).Which clinical manifestations does the nurse expect when assessing this client? Select all that apply.

A) Muscle instability
B) Hypotonia
C) Hemiplegia
D) Hypertonia
E) Tremors

Question 36

A pediatric nurse is performing an assessment on a toddler who is suspected of having autism spectrum disorder (ASD? When assessing the child's health history,which question to the parents would not provide adequate information to appropriately assess the toddler for this disorder?

A) "Does your child have manic or depressed episodes?"
B) "Tell me about your child's social interactions."
C) "Does your child perform ritualistic behaviors when performing activities?"
D) "Is your child able to name objects?"

Question 37

The nurse assesses several infants during well-baby checkups.Which statement made by a parent would cause the nurse to suspect that the infant may have cerebral palsy (CP)?

A) "My 6-month-old baby is rolling from back to prone now."
B) "My 8-month-old cannot sit without support."
C) "My 10-month-old is not walking."
D) "My 3-month-old smiles at me all the time."

Question 38

The parent of a child with autism spectrum disorder (ASD)asks why family therapy has been prescribed.Which response by the nurse is most appropriate?

A) "Family therapy will help you learn how to assess the child's potential."
B) "Family therapy will provide the child with an opportunity to learn problem-solving skills."
C) "Family therapy will help you interact with your child."
D) "Family therapy will help you learn how to cope with your situation."

Question 39

A nurse is caring for a toddler client whose parent suspects may have attention-deficit/hyperactivity disorder (ADHD).Which statements does the nurse know to be true regarding diagnosis criteria for ADHD? Select all that apply.

A) Children must have 3 or more symptoms that have persisted for 3 or more months with negative impacts.
B) Children must have 6 or more symptoms that have persisted for 6 or more months with negative impacts.
C) Children with learning disabilities are often misdiagnosed as having ADHD.
D) Diagnostic criteria for ADHD are nonspecific and vary with every child.
E) Children must have a physical examination prior to the diagnosis of ADHD to rule out other diseases.

Question 40

A child with cerebral palsy (CP)is scheduled for casting of the lower extremities.When instruction the parents for the purpose of the casts,which will the nurse include in the teaching session? Select all that apply.

A) Promote skeletal alignment
B) Maintain stability
C) Improve muscle tone
D) Improve muscle function
E) Control involuntary movements

Question 41

The nurse suggests that the mother of an infant with failure to thrive (FTT)see a lactation specialist to assist with breastfeeding.Which is an appropriate goal when planning care for this family?

A) Increase the number of well-child checkups for the child.
B) Convince the mother to use formula instead of continuing with breastfeeding.
C) Improve the parent-child relationship.
D) Prevent complications associated with poor nutrition.

Question 42

The parents of an infant report that the baby is fussy all of the time and does not eat or sleep well.Which action by the nurse is most appropriate?

A) Giving the baby medicine for colic
B) Drawing blood for laboratory work
C) Feeding the baby
D) Observing the interactions between the parents and the infant

Question 43

Although a 3-month-old infant's height and weight measurements fall below the 5th percentile,the nurse is not concerned about the development of failure to thrive (FTT).Which information about this child assisted the nurse to make this decision?

A) The infant eats an appropriate amount each day.
B) The child sleeps the whole night through.
C) The parents socialize two nights a week.
D) The child is of Asian-American descent.

Question 44

The nurse is caring for a child with intellectual deficits who is diagnosed with failure to thrive (FTT).The family is expressing difficulty with managing the child's care needs.Which nursing diagnosis would be appropriate for this situation?

A) Impaired Parenting related to poor parenting skills
B) Dysfunctional Family Processes related to a child with mental retardation
C) Hopelessness related to terminal condition of the child
D) Compromised Family Coping related to the child's developmental variations

Question 45

A child with an atrial septal defect (ASD)cannot have surgery without appropriate growth.Which suggestion by the nurse is most appropriate to facilitate weight gain for this child?

A) Buy the child a rocking horse.
B) Sign the child up for swimming lessons.
C) Take the child to the park to play on the swings.
D) Conserve the child's energy use.

Question 46

A nurse is caring for a pregnant client who has a history of depression.When including information to decrease the client's risk for having an infant diagnosed with failure to thrive (FTT),which rationale is appropriate?

A) Women with mental illness have a decreased breast milk supply, increasing the risk of FTT.
B) Women with mental illness may be socially isolated, increasing the risk of FTT.
C) Women with mental illness take medications that pass through the breast milk, increasing the risk of FTT.
D) Women with mental illness lack the knowledge required to provide adequate nutrition, increasing the risk of FTT.

Question 47

A nurse is teaching a mother of an infant who has been diagnosed with failure to thrive (FTT)about the treatment for the condition.Which statement by the nurse is appropriate?

A) "Appetite stimulant medications will be prescribed to help your child gain weight."
B) "If your child is breastfeeding, you must stop and feed your child formula."
C) "A home care nurse will be visiting to see how your child eats."
D) "A home care nurse will be visiting to insert a nasogastric feeding tube in your child."

Question 48

During a home visit,the nurse suspects that a newborn is at risk for failure to thrive (FTT).Which statement by the child's mother support the nurse's suspicions?

A) "I do not like to cook."
B) "I need help learning to breastfeed my baby."
C) "I have a glass of wine with dinner once a week."
D) "I stopped taking Wellbutrin because I was concerned about it affecting my baby."