Question 1

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.

Accepted Answer

Sturdy head control occurs around 6 months of age.The findings should be documented,but there is no need to alert the health-care provider because this is a normal finding for a 3-month-old.Simply reassuring the mother does not give her the information she needs.

Question 2

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?"

Accepted Answer

The parents should note any signs of fatigue in a child,such as rubbing eyes,temper tantrums,yawning,or fussiness.They should use this information to help set a routine bedtime.At this age,children need between 12 and 16 hours of sleep a night.Consistency is important,but the bedtime needs to be early enough to ensure adequate sleep.Children,especially infants,should not be over-warm when sleeping.

Question 3

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."

Accepted Answer

According to Duvall's theory of family development,the activities of the oldest child in a family are the marker for family transition.As the oldest child prepares to leave home (family launching young adult stage),the marriage needs to become a major area for focus.This activity starts in the stage in which the oldest child is an adolescent and looking to launch in the future.The role of the older family is to start coping with loss.The statement that the woman is lucky is disrespectful and does not address her needs.Helping children with separation is the task of the family with preschool children.

Question 4

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.

Accepted Answer

According to Kohlberg,a child passes through three stages when learning to make moral decisions.In the first (preconventional)stage,a child may not see an action as wrong if he or she can justify the action in his or her mind.The best response by the nurse would be to explain this to the father and help him develop strategies to work with this.Ensuring the child knows the rules is important before inflicting consequences for behavior.Stating that rule breaking is problematic does not help the father deal with the problem.Time-outs can be effective disciplinary strategies.

Question 5

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

Accepted Answer

Vygotsky posited that learning takes place in a "zone of proximal development," which means that children learn best when assisted by another person.He also thought culture had a profound impact on language.Howard Gardner argued that intelligence cannot be measured by a single number from an IQ test.The ecological theory of Urie Bronfenbrenner emphasized three systems in a child's life (microsystem,mesosystem,exosystem).The preoperational stage is part of Jean Piaget's work.

Question 6

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

Accepted Answer

According to Piaget,children age 11 to 15 should be in the formal operational stage,in which they are able to use abstract reasoning and can consider both sides of an issue.

Question 7

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?"

Accepted Answer

Duvall's family development theory uses the oldest child as the marker for transitions within the family.The nurse should inquire about the age of the oldest child.The other questions are not directly related to Duvall's theory.

Question 8

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

Accepted Answer

According to Bandura,lack of positive modeling leads to poor self-esteem,and the child has no opportunity to master developmental tasks and skills.Bonding,industry,and school success are not directly related to Bandura's theory,although correlations can be made.

Question 9

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

Accepted Answer

According to Howard Gardner,there are eight forms of intelligence: bodily-kinesthetic,interpersonal,intrapersonal,linguistic,logical-mathematical,musical,naturalistic,and spatial.Although children possess all eight forms,they typically develop one to a greater degree.Using this form of intelligence is best to help the child learn.By assessing the child's hobbies and interests,the nurse gains insight into which form a child uses.This child prefers the bodily-kinesthetic form of intelligence,and using bodily motion in learning activities will improve learning.The other answers are not accurate.

Question 10

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.

Accepted Answer

The answer of A nurse is assessing a 1-year-old child...

Question 11

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."

Accepted Answer

This child displays difficulty with adapting to new situations.The mother's attempts to provide new experiences are antagonizing the child's natural temperament.According to the temperament theory of Thomas,Chess,and Birch,the mother should provide structure with limited variation in this slow-to-adapt child's daily activities.

Question 12

A nurse uses Urie Bronfenbrenner's theory to guide practice.In order to determine a child's microsystem,which items should the nurse assess? (Select all that apply.)
A)Dynamics between school and home
B)Family
C)Peer group
D)Parental job status
E)School

Accepted Answer

According to Bronfenbrenner,a child's microsystem includes systems in which the child is actively involved and typically includes family,peer group,and school.The dynamics between school and home make up the mesosystem.A parent's job would be part of the exosystem.

Question 13

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.

Accepted Answer

At this age,exploration and crying are normal behaviors.Children in this age group do not misbehave,and so discipline needs to be focused on redirection to keep the child safe.Crying may also indicate frustration in this preverbal child.Making a blanket statement that objects are dirty and should not be in the child's mouth does not provide guidance on age-appropriate behaviors and reasonable responses.

Question 14

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.

Accepted Answer

Many IQ tests have been criticized for not considering the impact of culture or socioeconomic status.The nurse should assess these factors before proceeding further.Simply reassuring the mother that IQ tests are often wrong does nothing to help her with her concern and sounds paternalistic.That statement could also cause confusion;as the school administered the test,the mother might not believe the nurse.

Question 15

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.

Accepted Answer

All outcomes might be good starts,but an outcome needs to be measurable,be specific,and have a timeframe.The outcome that best fits this description is the one that has a specific age-appropriate activity associated with it."Attain age-appropriate milestones," "attain normal weight and height," and "fewer tantrums" are all vague.

Question 16

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

Accepted Answer

Carol Gilligan's work focused on the differences in moral development in women.The seven stages of faith/religious development was the work of James Fowler.The nine temperamental traits was the work of Thomas,Chess,and Birch.The family development theory that uses the oldest child as the marker for transition within a family is the work of Duvall.

Question 17

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

Accepted Answer

The Erikson stage of autonomy versus shame and doubt occurs during the ages of 1 to 3.During this stage,the child develops a "can-do" attitude and wishes to be independent.A child who does not successfully meet the tasks of this stage will suffer from self-doubt later on.The most independent child in the options is the 24-month-old dressing independently.This child is mastering the tasks of this developmental stage.

Question 18

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.

Accepted Answer

The ability to walk backward is accomplished in the toddler stage (1-3 years).The ability to play video games is more likely seen in the adolescent stage.Screwing and unscrewing objects is appropriate for a toddler.Using scissors to accurately cut a figure from an outline is a milestone of the early childhood stage (3-6 years).

Question 19

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.

Accepted Answer

The toddler is actively exploring his or her world,and with this increasing sense of mastery and lack of knowledge of consequences,toddlers often end up in situations in which their safety is compromised.Keeping the child safe becomes increasingly challenging.At this point language is developing and is focused on the child's needs.Competing and winning are important in the early childhood years (ages 6-9).Locations for time-outs need to be safe,which means in a location the parent can monitor and see.

Question 20

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.

Accepted Answer

A toddler should gain 4-6 lb each year from the ages of 1 to 3.This child should now weigh somewhere between 26 and 28 lb,so he or she is underweight.

Quiz 20: Caring for the Developing Child

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 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 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 nurse educator is discussing developmental theories with a student.What information is appropriate for the educator to provide regarding Lev Vygotsky's theory? (Select all that apply.)

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?

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 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 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 nurse uses Urie Bronfenbrenner's theory to guide practice.In order to determine a child's microsystem,which items should the nurse assess? (Select all that apply.)

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 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?

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

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 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 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 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 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?