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Growth and Development NCLEX Practice Questions Quiz #1 (25 Questions)
Which age group has the greatest potential to demonstrate regression when they are sick?
- A. Infant
- B. Toddler
- C. Adolescent
- D. Young Adult
Correct Answer: B. Toddler
Regression is most seen among toddlers and it can be caused by stressful situations such as hospitalization, the arrival of a new sibling, or starting a new school. When a child regresses, he or she appears to be going backward in an earlier stage of development where he or she feels comfortable (e.g. toilet trained toddlers suddenly start wetting their pants when they become sick, thumbsucking).
- Option A: Babies are almost entirely dependent on their caregivers. So it should come as no surprise that how parents interact with their babies has a profound effect on both their physical and mental health. Noticing and responding to these signals, whether they are cries, body movements, coos, or even words, helps them learn to trust the people and the world around them.
- Option C: There’s no doubt the teen years can be a more challenging time to deal with a health condition. In addition to the social pressures to fit in, it’s a time of learning about and understanding their bodies. At a time when it’s natural to be concerned with body image, it can seem hard to feel different. It’s understandable that people can feel just plain sick and tired of dealing with a chronic illness once in a while.
- Option D: Regression may happen in this age group but it is more common in toddler years. Struggling in this stage of life can result in loneliness and isolation. Loneliness can affect overall health in other ways. For example, socially isolated people tend to have unhealthier diets, exercise less, experience greater daytime fatigue, and have poorer sleep.
Which is a major concern when providing drug therapy for older adults?
- A. Older adults may chew on tablets instead of swallowing them.
- B. Older adults have difficulty swallowing large tablets.
- C. Alcohol is used by older adults to cope with the multiple problems of aging.
- D. Hepatic clearance is reduced in older adults.
Correct Answer: D. Hepatic clearance is reduced in older adults.
Age-related changes such as a reduction in total liver size and decrease in hepatic blood flow would limit the exposure of the drug to the metabolizing enzymes resulting in reduced hepatic clearance of a drug increasing its side effects.
- Option A: Older adults may end up chewing tablets that will quickly release the effect of long-acting medications when crushed or the drug may not work properly however a physician may give smaller pills that will be easier to swallow or a liquid preparation may also be available.
- Option B: Older adults may experience difficulty taking tablets due to swallowing problems secondary to health conditions such as stroke, dementia, Parkinson’s disease but there are other techniques to make swallowing pills easier (e.g.” pop bottle method”).
- Option C: Alcohol is not used to cope with problems of aging since it can cause bad interactions with medications causing adverse effects. Aging can lower the body’s tolerance for alcohol. Older adults generally experience the effects of alcohol more quickly than when they were younger. This puts older adults at higher risks for falls, car crashes, and other unintentional injuries that may result from drinking.
One of the participants attending a parenting class asks the teacher “What is the leading cause of death during the first month of life?
Correct Answer: C. SIDS
According to the CDC, sudden infant death syndrome (SIDS) remains to be one of the leading causes of infant death. Around 1,300 infants died in 2018 due to this condition. SIDS is defined as the sudden and unexplained death of a baby younger than 1-year-old. Most of the deaths happened between the ages of one and 6 months. Factors that increase the risk of SIDS include stomach sleeping, a sibling who died of SIDS, mothers who smoke during pregnancy, exposure to secondhand smoking, sleeping areas containing soft blankets, pillows, or toys, and a lack of prenatal care.
- Option A: Neonatal sepsis refers to an infection involving the bloodstream in newborn infants less than 28 days old. It remains a leading cause of morbidity and mortality among neonates, especially in middle and lower-income countries. Due to the nonspecific neonatal presentation for sepsis and the high risk of mortality and morbidity without treatment, many asymptomatic neonates undergo a sepsis workup if risk factors are present and/or clinically indicated.
- Option B: As the most common cause of respiratory distress in premature infants, RDS occurs in about 24,000 infants born in the United States annually. It is also the most common complication of prematurity leading to significant morbidity in late preterm neonates and even mortality in very low birth weight infants.
- Option D: Neonatal hemorrhage is also part of the leading causes of infant mortality but occurs less often than SIDS. All infants irrespective of race, sex, color, religion, national origin, etc. are known to be affected by vitamin K deficiency bleeding. In early VKDB, the incidence in infants who have not received vitamin K prophylaxis ranges from about 6% to 12%. In classic VKDB, the incidence has gone down from 0.25% to 1.5% in earlier studies to 0.01% to 0.44% in recent studies.
Which stage of development is most unstable and challenging regarding the development of personal identity?
- A. Adolescence
- B. Toddlerhood
- C. Middle childhood
- D. Young adulthood
Correct Answer: A. Adolescence
Although it occurs throughout one’s lifetime, identity development is considered to be the primary psychosocial task of adolescence or as described by Erickson on identity versus identity confusion. Individuals in this stage start to integrate their values, abilities, inner drives, and past experiences into who they are as persons.
- Option B: Toddlers at their age focus on developing their physical, emotional, cognitive, language, and motor skills. Gaining a sense of personal control over the world is important at this stage of development. Children at this age are becoming increasingly independent and want to gain more control over what they do and how they do it.
- Option C: Middle childhood is a stage where children learn skills that will help them build social relationships that will prepare them for adolescence. A child’s social world expands considerably as they enter school and gain new friendships with peers. Through social interactions, children begin to develop a sense of pride in their accomplishments and abilities.
- Option D: Young adulthood would focus on building intimate and loving relationships with other people. Romantic and sexual relationships can be an important part of this stage of life, but intimacy is more about having close, loving relationships. It includes romantic partners, but it can also encompass close, enduring friendships with people outside of the family.
Which age group would have the most tendency towards eating disorders?
- A. Adolescence
- B. Toddlerhood
- C. Preschool
- D. Infancy
Correct Answer: A. Adolescence
The adolescent stage is the time where the body starts to change and with factors including exposure from media and peer pressure that provide them the perception of an ideal body image which would then affect their dietary behaviors leading to eating disorders.
- Option B: Gaining a sense of personal control over the world is important at this stage of development. Children at this age are becoming increasingly independent and want to gain more control over what they do and how they do it. Other important events include gaining more control over food choices, toy preferences, and clothing selection.
- Option C: This is the age group where they become picky eaters but it would not lead to serious eating disorders. Children need to begin asserting control and power over the environment by taking initiative by planning activities, accomplishing tasks, and facing challenges.
- Option D: During infancy, infants’ eating habits are characterized by a transition from consuming breastmilk or formula to consuming solid foods. Erikson also believed that feeding played a pivotal role in the development of trust. By feeding an infant when the child is hungry, they learn that they can trust their need for nourishment will be met.
- A. Nail growth
- B. Skin turgor
- C. Urine residual
- D. Nerve conduction velocity
Correct Answer: C. Urine residual
- Option A: Nail growth is expected to slow with aging due to decreased blood flow to the hands and feet. With advancing age, various changes in nail plate thickness might occur, becoming thicker, thinner, or remaining the same. Nail plate growth rates of fingernails and toenails normally average 3.0 and 1.0 mm/mo, respectively. With advancing age, starting at the age of 25 years, this rate tends to decrease by approximately 0.5% per year.
- Option B: Skin loses its elasticity with age so the skin turgor is expected to decrease. The epidermis of the skin atrophies with age and due to changes in collagen and elastin, the skin loses its tone and elasticity.
- Option D: Nerve conduction velocities are expected to decrease with aging. It is caused either by an injury or nerve damage. During normal aging, blood flow in the brain decreases and gets less efficient at recruiting different areas into operations. The whole group of changes taking place in the brain with aging decreases the efficiency of cell-to-cell communication, which declines the ability to retrieve and learn.
A maternity nurse is providing instruction to a new mother regarding the psychosocial development of the newborn infant. Using Erikson’s psychosocial development theory, the nurse would instruct the mother to:
- A. Allow the newborn infant to signal a need.
- B. Anticipate all of the needs of the newborn infant.
- C. Avoid the newborn infant during the first 10 minutes of crying.
- D. Allow the infant to cry, once lessen, then attend to the infant.
Correct Answer: A. Allow the newborn infant to signal a need.
If a newborn is not allowed to signal a need, the newborn will not learn how to control the environment. The primary way the caregiver can build trust with the baby is to respond when they try to communicate. Because babies can’t use words to express themselves, they use nonverbal strategies to communicate what they’re thinking and feeling at all times.
- Option B: According to Erikson, the caregiver should not try to anticipate the newborn infant’s needs at all times but must allow the newborn infant to signal needs. Crying is one of the most common strategies babies use to communicate with their caregivers, and it carries different meanings.
- Option C: It is important for caregivers to provide comfort to an infant by holding them closely and securely. This provides both warmth and physical contact. Feeding, bathing, and comforting your child helps them learn to trust that their needs will be met.
- Option D: Erikson believed that a delayed or prolonged response to a newborn’s signal would inhibit the development of trust and lead to mistrust of others. By responding quickly and appropriately to the infant’s cries, the caregiver is building a foundation of trust.
A mother of a three (3)-year-old tells a clinic nurse that the child is constantly rebelling and having temper tantrums. The nurse most appropriately tells the mother to:
- A. Punish the child every time the child says “no”, to change the behavior.
- B. Allow the behavior because this is normal at this age period.
- C. Set limits on the child’s behavior.
- D. Ignore the child when this behavior occurs.
Correct Answer: C. Set limits on the child’s behavior.
Being consistent and setting limits on the child’s behavior are the necessary elements in order for the toddler to learn what is acceptable so they can understand the impact of their behaviors.
- Option A: Saying things like “no” or “mine” and having temper tantrums are common during this period of development. Parents who are negative or who punish a child for simple mistakes can contribute to feelings of shame or self-doubt.
- Option B: According to Erikson, the child focuses on independence between ages 1 and 3 years. Gaining independence often means that the child has to rebel against the parents’ wishes. Children at this age are becoming increasingly independent and want to gain more control over what they do and how they do it.
- Option D: Do not ignore the child when this behavior occurs. Instead, provide opportunities for children to be independent. Allow them to make food, clothing, and toy choices and provide reassurance that they have done a good job.
The parents of a two (2)-year-old boy arrive at a hospital for a visit. The child is in the playroom when the parents arrive. When the parents enter the playroom, the child does not readily approach the parents. The nurse interprets this behavior as indicating that:
- A. The child is withdrawn.
- B. The child is self-centered.
- C. The child has adjusted to the hospitalized setting.
- D. This is a normal pattern.
Correct Answer: D. This is a normal pattern.
The phases through which young children progress when separated from their parents include protest, despair, and denial or detachment. In the stage of despair, the child may not approach them readily or may cling to a parent.
- Option A: In the stage of protest, when the parents return, the child readily goes to them. The protest phase begins immediately upon separation and lasts up to weeks on end. It is indicated by outward signs of distress such as crying, tantrum behavior, and searching for the return of the parent. Protest decreases during the despair phase, and children become withdrawn and helpless.
- Option B: While it may be frustrating to have children who appear to be self-centered, unrelenting, and impulsive, it can be comforting to learn that these traits are typical of the development of all children. When children are listened to and their feelings are accepted, they are more likely to respond to other people with understanding and compassion.
- Option C: In denial or detachment, when the parents return, the child becomes cheerful, interested in the environment and new persons (seemingly unaware of the lost parents), friendly with the staff, and interested in developing superficial relationships.
The mother of a three (3)-year-old is concerned because her child still insists on a bottle at nap time and bedtime. Which of the following is the most appropriate suggestion to the mother?
- A. Do not allow the child to have the bottle
- B. Allow the bottle during naps but not at bedtime
- C. Allow the bottle if it contains juice
- D. Allow the bottle if it contains water
Correct Answer: D. Allow the bottle if it contains water
It is recommended that parents should wean their children off the bottle at 15-18 months of age. But If a bottle is still attached to the child at 3 years of age during naptime or bedtime, it should contain only water to prevent the risk of dental caries.
- Option A: Generally, the last bottle to stop should be the nighttime bottle. That bottle tends to be a part of the bedtime routine and is the one that most provides comfort to babies. If you keep getting asked for a bottle, find out what the child really needs or wants and offer that instead.
- Option B: As the parent weans the baby from the bottle, try diluting the milk in the bottle with water. For the first few days, fill half of it with water and half of it with milk. Then slowly add more water until the entire bottle is water. By that time, it’s likely that the child will lose interest and be asking for the milk that comes in a cup.
- Option C: A toddler should never be allowed to fall asleep with a bottle containing milk, juice, soda, or sweetened water because frequent and long exposure to drinks containing sugar may cause tooth decay and cavities.
A nurse is evaluating the developmental level of a two (2)-year-old. Which of the following does the nurse expect to observe in this child?
- A. Use a fork to eat.
- B. Use a cup to drink.
- C. Uses a knife for cutting food.
- D. Pour own milk into a cup.
Correct Answer: B. Uses a cup to drink
By age 2 years, the child can use a cup and can use a spoon correctly but with some spilling. Children can start learning how to use a cup without a lid when they are 9 months old. Most experts recommend introducing utensils between 10 and 12 months, as an almost-toddler starts to show signs that she’s interested. A spoon should be first on the child’s tray, since it’s easier to use.
- Option A: By ages 3 to 4, the child begins to use a fork. She’ll have more success with a fork as her fine motor skills get a little sharper, starting around 15 months.
- Option C: By the end of the preschool period, the child should be able to begin to use a knife for cutting. The child can hold onto the helper’s hands as they cut the food using the knife and fork.
- Option D: Preschoolers can pour their own drinks. Pouring is a great hand-eye exercise. It requires self-control in the form of motor control. Autonomy is something children crave at this age, and this is certainly an activity they can do on their own when appropriate parameters are set.
The nurse is providing an educational session to new employees, and the topic is abuse to the older client. The nurse tells the employees that which client is most characteristic of a victim of abuse?
- A. A 90-year-old woman with advanced Parkinson’s disease.
- B. A 68-year-old man with newly diagnosed cataracts.
- C. A 70-year-old woman with early diagnosed Lyme’s disease.
- D. A 74-year-old man with moderate hypertension.
Correct Answer: A. A 90-year-old woman with advanced Parkinson’s disease
The typical abuse victim is a woman of advanced age with few social contacts and at least one physical or mental impairment that limits the ability to perform activities of daily living. In addition, the client usually lives alone or with the abuser and depends on the abuser for care.
- Option B: An elderly with newly diagnosed cataracts has less chance of being a victim of elder abuse. In general, elder abuse is considered a direct action, inaction, or negligence toward an older adult that harms them or places them at risk of harm either by a person in a position of presumed trust or by an outside individual targeting the victim based on age or disability.
- Option C: A 70-year-old woman with Lyme’s disease has less chance of being subjected to elder abuse. Older adults with dementia or other cognitive impairment are at the highest risk, with nearly five times the rate of elder abuse seen compared to older adults without dementia.
- Option D: A man with moderate hypertension will have the least chance of being a victim of elder abuse since they are not considered to have very poor health and are not yet functionally impaired. A prevalent belief is that the increased reliance on a caregiver leads to a high caregiver burden, which may manifest as elder abuse.
The home care nurse is visiting an older female client whose husband died six months ago. Which behavior, by the client, indicates ineffective coping?
- A. Visiting her husband’s grave once a month.
- B. Participating in a senior citizens program.
- C. Looking at old snapshots of her family.
- D. Neglecting her personal grooming.
Correct Answer: D. Neglecting her personal grooming.
Coping mechanisms are behaviors used to decrease stress and anxiety. In response to a death, ineffective coping is manifested by an extreme behavior that in some instances may be harmful to the individual physically or psychologically. Neglecting personal grooming is indicative of behavior that identifies an ineffective coping behavior in the grieving process.
- Option A: This is an effective way to help the client cope and express their feelings when grieving. Acknowledge the patient’s need to review the loss experience. In this way, the patient and family members integrate the event into their experience.
- Option B: A senior citizen program provides activities and enrichment classes that can help the widow alleviate feelings of helplessness, loneliness, and boredom after a loss of a loved one.
- Option C: Strengthen the patient’s efforts to go on with his or her life and normal routine. Review and point out strengths and progress to date. Encourage the patient to manage their own self-care needs for rest, sleep, nutrition, and leisure activities.
A clinic nurse assesses the communication patterns of a five (5)-month-old infant. The nurse determines that the infant is demonstrating the highest level of developmental achievement expected if the infant:
- A. Uses simple words such as “mama”.
- B. Uses monosyllabic babbling.
- C. Links syllables together.
- D. Coos when comforted.
Correct Answer: B. Uses monosyllabic babbling.
Monosyllabic babbling occurs between 3 and 6 months of age. The infant starts to produce vowels and combines them with consonants, producing syllables (e.g., ba, da, la, ga). An infant should be babbling away by now, and those babbles might even be starting to sound like real words. Five-month-olds can begin to put consonant and vowel sounds together.
- Option A: Using simple words such as “mama” occurs between 9 and 12 months. While it can happen as early as 10 months, by 12 months, most babies will use “mama” and “dada” correctly (she may say “mama” as early as eight months, but she won’t be actually referring to her mother), plus one other word. That third word can be what’s called a “word approximation.”
- Option C: Linking syllables together when communicating occurs between 6 and 9 months. At 18 months, most toddlers use two-word combinations. Some toddlers may combine words as early as 15 months. Factors that affect when toddlers begin combining words include when they produce their first word when they understand 50 words, and the responsiveness of caregivers at 12 months.
- Option D: Cooing is the production of a single syllable, vowel-like sound like “aah”. It begins at birth and continues until 2 months. It is considered the first vocal milestone of a baby.
A nurse is preparing to care for a five (5)-year-old who has been placed in traction following a fracture of the femur. The nurse plans care, knowing that, which of the following is the most appropriate activity for this child?
- A. Large picture books
- B. A radio
- C. Crayons and coloring book
- D. A sports video
Correct Answer: C. Crayons and coloring book
In the preschooler, play is simple and imaginative and includes activities such as crayons and coloring books, puppets, felt and magnetic boards, and Play-Doh. They spend much of their playtime in fantasy activity, which tends to be more cooperative than play that’s focused on toys or games.
- Option A: Large picture books are most appropriate for the infant where they start to show interest in seeing books with pictures. Regularly read books to the baby, pointing to the pictures when reading and engaging her by changing voices for different characters. Invite the little one to participate by encouraging her to laugh or act surprised by the story, touch the pictures, and turn the pages.
- Option B: A radio is most appropriate for the adolescent. Analysis of teenage behavior during play shows that their behavior mimics and practices being an adult, which is a positive for their development. However, it is still important as a parent to hold a discussion with your child to set clear boundaries e.g. controls on the internet and phones, so that they can grow and explore their identity but still within a safe environment.
- Option D: Sport is a great way of keeping an element of play in the life of a young adult, and if they keep engaging in sport through their adolescence they will be more likely to be active throughout the rest of adulthood.
A 16-year-old is admitted to the hospital for acute appendicitis, and an appendectomy is performed. Which of the following nursing interventions is most appropriate to facilitate normal growth and development?
- A. Allow the family to bring in the child’s favorite computer games.
- B. Encourage the parents to room-in with the child.
- C. Encourage the child to rest and read.
- D. Allow the child to participate in activities with other individuals in the same age group when the condition permits.
Correct Answer: D. Allow the child to participate in activities with other individuals in the same age group when the condition permits.
Adolescents often are not sure whether they want their parents with them when they are hospitalized. Because of the importance of the peer group, separation from friends is a source of anxiety. Ideally, the members of the peer group will support their ill friend.
- Option A: Adolescents love computer games, however, peer groups and spending time with friends is extremely important. Self-esteem is largely influenced by peer acceptance.
- Option B: Having the parent’s room-in is more appropriate with a toddler or preschooler because they have a fear of separation. Going to the hospital can be overwhelming, boring, and frustrating for children. It’s normal for children to behave in some unexpected ways.
- Option C: Reading a book while in the hospital may be appropriate, but this can isolate the child from the peer group. Set up ways for the child to keep in contact with family, friends, and schoolmates. This can be done by asking people to visit, letting the child use email or social media to keep in touch, or setting up video calls.
The mother of a nine (9)-year-old who is four (4) feet tall asks a nurse which of the following car safety devices is the most appropriate to use. The best nursing response is which of the following?
- A. Booster belt
- B. Seat belt
- C. Front-facing convertible seat
- D. Rear-facing convertible seat
Correct Answer: A. Booster belt
A belt-positioning booster seat is typically used for children whose weight or height exceeds the forward-facing limit for the car safety seat. This is applicable for ages 8-12-year-old and at least 4 feet, 9 inches tall. Booster seats can only be used with the adult lap and shoulder belt.
- Option B: Children can start using a seat belt if they can easily rest their back against the seat of the vehicle and can bend their knees over the edge of the seat. Seatbelts must be worn correctly for them to work properly. Make sure the lap belt fits comfortably across the thighs (not the stomach) and that the child is not slouching. The shoulder strap should go across the chest and shoulder, and never goes beneath a child’s arm, behind the back, or across the neck.
- Option C: When children outgrow their rear-facing seat, they are buckled in a forward-facing car seat until the age of five or when they reach the upper weight or height limit of the seat. Most convertible car seats can be used in the rear-facing position until a child reaches the weight limit, typically 40 to 50 pounds. At that point, the seat can be converted into a forward-facing car seat. These seats are larger and designed to stay installed in the vehicle.
- Option D: Rear-facing–only seats are used for infants up to 22 to 45 pounds. All infants and toddlers should ride in a rear-facing seat as long as possible until they reach the highest weight or height allowed by their car safety seat manufacturer. Most convertible seats have limits that will allow children to ride rear-facing for 2 years or more.
The nurse is caring for an agitated older client with Alzheimer’s disease. Which nursing intervention most likely would calm the client?
- A. Playing the radio.
- B. Turning the lights out.
- C. Putting an arm around the client’s waist.
- D. Encouraging group participation.
Correct Answer: C. Putting an arm around the client’s waist.
Nursing interventions for the client with Alzheimer’s disease who is angry, frustrated, or hostile include decreasing environmental stimuli, approaching the client calmly and with assurance, not demanding anything from the client, and distracting the client. For the nurse to reach out, touch, hold a hand, put an arm around the waist, or in some way maintain physical contact is important.
- Option A: Playing a radio may increase stimuli. Noise and crowds are usually excessive for the sensory neurons and can increase interference. Television and radio programs may be overstimulating and may increase agitation.
- Option B: Turning the lights out may produce more agitation. Limit sensory stimuli and independent decision-making. This decreases frustration and distractions from the environment. Decreasing the stress of making a choice helps to promote security.
- Option D: The client with Alzheimer’s disease would not be a candidate for group work if the client is agitated. Provide an opportunity for social interaction, but do not force interaction. Forcing interaction usually results in confusion, agitation, and hostility.
The nurse who volunteers at a senior citizens center is planning activities for the members who attend the center. Which activity would best promote health and maintenance for these senior citizens?
- A. Gardening every day for an hour.
- B. Aerobics 3 times a week for 30 minutes.
- C. Sculpting twice a week for 60 minutes.
- D. Walking 3 to 5 times a week for 30 minutes.
Correct Answer: D. Walking three (3) to five (5) times a week for 30 minutes.
Exercise and activity are essential for health promotion and maintenance in older adults and to achieve an optimal level of functioning. About half of the physical deterioration of the older client is caused by disuse rather than by the aging process or disease. One of the best exercises for an older adult is walking, progressing to a 30 minutes session three (3) to five (5) times each week. Swimming and dancing are also beneficial.
- Option A: Gardening is a muscle-strengthening activity that can be done by an older adult for at least 2 or more days a week. Everyday gardening is not advisable. Some physical, mental, and age-related conditions must be considered when older people work in the garden, but they should not prevent people from enjoying the garden.
- Option B: Aerobic activity considered a vigorous-intensity activity should be done for 75 minutes a week in 10 minutes duration. Aerobics or cardio exercises pretty much fit everyone but the frequency and intensity of each exercise should be considered before sticking to a particular regime.
- Option C: Body sculpting for 60 minutes is an activity that is too vigorous for an adult. These popular workouts are well-suited for younger adults looking to bulk up or shed weight in a hurry, but they may put an unhealthy strain on older adults with joint pain, atrophied muscles, posture problems, or issues with balance.
A 16-year-old boy is hospitalized, according to Erik Erikson, what is an appropriate intervention?
- A. Tell the friends to visit the child.
- B. Encourage the boy to learn missed school lessons.
- C. Call the priest to intervene.
- D. Ask the patient’s girlfriend to visit.
Correct Answer: A. Tell the friends to visit the child.
A 16-year-old child is in the stage of identity vs role confusion. The most significant persons in this group are their peers. Peer groups and spending time with friends is extremely important. Self-esteem is largely influenced by peer acceptance.
- Option B: This is appropriate for children in the school-age where they need to feel productive. Children at this age begin taking pride in their work and seek recognition for their accomplishments. They are learning rules for social cooperation and appropriate behaviors.
- Option C: The child is not dying and the situation did not even talk about the child’s belief therefore, calling the priest is unnecessary. Adolescents enjoy watching movies and playing video games. Cell phones and the internet are common means of keeping in touch with friends.
- Option D: Allowing the patient’s girlfriend is applicable to an adolescent in the Erickson stage of intimacy vs isolation. This stage takes place during young adulthood between the ages of approximately 19 and 40.
A clinical instructor asks a nursing student to report about the psychosexual stages of development by Sigmund Freud. Which of the following explains the latency period? Select all that apply.
- A. No psychosexual development takes place during this stage.
- B. Energy is directed to physical and intellectual activities.
- C. This stage begins at puberty and constitutes mature adult sexuality.
- D. Males have a tendency to develop Oedipus Complex.
- E. Children spend more time interacting with same-sex peers.
Correct Answer: A, B, & E
At the latency stage, sexual drives are dormant. The stage begins around the time that children enter school and become more concerned about school work, hobbies, and peer relationships. Children also usually engage in activities with peers of the same sex, which serves to consolidate a child’s gender-role identity.
- Option A: During this stage, the superego continues to develop while the id’s energies are suppressed. Children develop social skills, values, and relationships with peers and adults outside of the family.
- Option B: The latent period is a time of exploration in which the sexual energy is repressed or dormant. This energy is still present, but it is sublimated into other areas such as intellectual pursuits and social interactions. This stage is important in the development of social and communication skills and self-confidence.
- Option C: This refers to the genital stage where it begins in puberty. Adolescents develop mature sexual feelings and experience pleasure from sexual relationships with others.
- Option D: This refers to the phallic stage when children discover physical sexual differences. Children develop an incestuous desire for the opposite-sex parent (Oedipus Complex).
- Option E: The development of the ego and superego contribute to this period of calm. The stage begins around the time that children enter into school and become more concerned with peer relationships, hobbies, and other interests.
Which of the following best describes the development of a school-age child? Select all that apply.
- A. Death has yet no meaning.
- B. Same-sex peers are more important than family.
- C. School-age children are concerned about how they appear to others.
- D. Children enjoy playing board games and sports.
- E. Causes of injuries include bicycle crashes, head injuries, and sprains.
Correct Answer: B, D, & E
School-age children feel a greater sense of affiliation with peers of the same sex and prefer socializing with them over family members; With a decreased attention span, play for school-age children lean towards following rules designed by others such as board games and sports; With an increase in motor skills, and independence, school-age children are prone to injuries that are caused by their physical activities.
- Option A: School-age children start to have an understanding of death and often view it as someone who “goes to heaven”. School-aged children have a more realistic understanding of death. Although death may be personified as an angel, skeleton, or ghost, this age group is starting to view death as permanent. They know that everyone dies.
- Option B: A child’s social world expands considerably as they enter school and gain new friendships with peers. Through social interactions, children begin to develop a sense of pride in their accomplishments and abilities.
- Option C: School-aged children are not particularly concerned about how they appear from others but rather are more concerned with understanding social roles and responsibilities.
- Option D: During the industry versus inferiority stage, children become capable of performing increasingly complex tasks. As a result, they strive to master new skills. Children who are encouraged and commended by parents and teachers develop a feeling of competence and belief in their abilities.
- Option E: Children enjoy challenges and risks in play. This might be climbing trees or going fast on bikes or scooters. When children take these types of risks, they’re building physical and problem-solving skills. They’re also learning about their physical and emotional limits.
The nurse is preparing to care for a toddler who is admitted due to fever, diarrhea, and vomiting. The doctor diagnosed the child with acute gastroenteritis. Which interventions are appropriate for the child? Select all that apply.
- A. Limit parental presence to promote faster recovery.
- B. Inform the child of his scheduled ultrasound on day 5 of his hospitalization.
- C. Allow to bring his favorite pillow or provide activity e.g., blowing bubbles.
- D. Allow the child to hold the thermometer before getting the temperature.
- E. Provide an option between fruit cups and jellies for dessert.
Correct Answer: C, D, & E
Allowing the child to bring familiar objects such as a favorite pillow or blanket to promote comfort; Letting the child hold medical equipment will lessen the fear and stress from the toddler.
- Option A: Parental stay in the hospital is encouraged instead to combat separation anxiety and the fear of being abandoned. The parents should be present and participate in their toddler’s care as much as possible.
- Option B: A toddler should be told at least a day or two prior to a procedure. An announcement that is too advanced would make the child more anxious. Toddlers have extremely short attention spans — keep this in mind as you talk to your child about the hospital (give small pieces of information at a time).
- Option C: Allow your child to carry security objects to procedures (blanket, stuffed animal). Play in the hospital makes the hospital environment less scary and more child-friendly. It also encourages children to focus on activity, rather than on their illness.
- Option D: Toddlers are building a sense of autonomy — encourage them to play and do things on their own. Allowing them to hold an instrument like a thermometer may assure them that it would not hurt them to have their temperature taken.
- Option E: Toddlers like saying, “NO” — Give options between two things rather than yes or no questions. Offer choices when appropriate. For instance, taking medications is not a choice, but drinking the medicine through a cup or syringe is a choice your child can make on his/her own.
A nurse instructor is preparing to conduct a seminar about Piaget’s Theory of Cognitive Development. The current topic is the concrete operational stage. Which of the following milestones during this stage should be included in the discussion, except?
- A. Ability to think logic about objects and events.
- B. Ability to understand that an object does not affect its number, length, volume, or mass when it changes appearance or shape.
- C. Increased classification skills.
- D. Ability to exhibit propositional thought.
- E. Ability to perform mathematical problems in both addition and subtraction
Correct Answer: D. Ability to exhibit propositional thought.
This is achieved during the formal operational stage. Propositional thought is the ability of an individual to evaluate the logic of prepositions without referring to real-world circumstances.
- Option A: Piaget determined that children in the concrete operational stage were fairly good at the use of inductive logic (inductive reasoning). During this stage, children begin to think logically about concrete events. Their thinking becomes more logical and organized, but still very concrete.
- Option B: Another key development at this stage is the understanding that when something changes in shape or appearance it is still the same, a concept known as conservation. They begin to understand the concept of conservation; that the amount of liquid in a short, wide cup is equal to that in a tall, skinny glass, for example.
- Option C: Children begin using inductive logic, or reasoning from specific information to a general principle. This growing ability to mentally manipulate information and think about the thoughts of others will play a critical role in the formal operational stage of development when logic and abstract thought become critical.
- Option E: All these things are evident during the concrete operational stage. While children are still very concrete and literal in their thinking at this point in development, they become much more adept at using logic.
Kim and her daughter Jane went grocery shopping to only buy essential things needed at home. As they went along the different sections of the store, Jane saw a limited-edition Barbie doll. She is tempted to get it but decides not to grab it for fear of being slapped. This behavior of Jane is considered to be in what stage of Kohlberg’s Moral Development?
- A. Conventional Stage 3: Good Boy/Nice Girl Orientation
- B. Preconventional Stage 1: Punishment/Obedience Orientation
- C. Conventional Stage 2: Law and Order Orientation
- D. Preconventional Stage 2: Instrumental Relativist Orientation
Correct Answer: B. Preconventional Stage 1: Punishment/Obedience Orientation
Jane is in the pre-conventional level stage 1 where judgment is motivated by fear of punishment. Children in this stage are responsive to rules that will affect their physical well-being. Stage 1 focuses on the child’s desire to obey rules and avoid being punished. For example, an action is perceived as morally wrong because the perpetrator is punished; the worse the punishment for the act is, the more “bad” the act is perceived to be.
- Option A: This is the stage where proper behavior is driven by social approval. In stage 3, children want the approval of others and act in ways to avoid disapproval. Emphasis is placed on good behavior and people being “nice” to others.
- Option C: This is the stage where obeying laws is one’s duty to society and a sign of respect for authority. In stage 4, the child blindly accepts rules and conventions because of their importance in maintaining a functioning society. Rules are seen as being the same for everyone, and obeying rules by doing what one is “supposed” to do is seen as valuable and important.
- Option D: This is the stage where a person bases heavily on obtaining a reward or exchanging favors. Stage 2 expresses the “what’s in it for me?” position, in which right behavior is defined by whatever the individual believes to be in their best interest. Stage two reasoning shows a limited interest in the needs of others, only to the point where it might further the individual’s own interests.
Growth and Development NCLEX Practice Questions Quiz #2 (25 Questions)
The nurse is caring for the mother of a newborn. The nurse recognizes that the mother needs more teaching regarding cord care because she:
- A. Keeps the cord exposed to the air.
- B. Washes her hands before sponge bathing her baby.
- C. Washes the cord and surrounding area well with water at each diaper change.
- D. Check it daily for bleeding and drainage.
Correct Answer: C. Washes the cord and surrounding area well with water at each diaper change.
Washing the surrounding area is fine but wetting the umbilical cord predisposes it to infection. The cord is kept dry and it will eventually fall off within one to three weeks after birth. Parents were once instructed to swab the stump with rubbing alcohol after every diaper change. Researchers now say this might kill bacteria that can help the cord dry and separate.
- Option A: Exposure to air helps dry the cord. Expose the stump to air to help dry out the base. Keep the front of the baby’s diaper folded down to avoid covering the stump.
- Option B: Good hand washing is the prime mechanism for preventing infection. While there’s no harm in getting the stump wet, sponge baths might make it easier to keep the stump dry.
- Option D: It is important to check for complications of bleeding and drainage that might occur. Contact the baby’s doctor if the umbilical area oozes pus, the surrounding skin becomes red and swollen, or the area develops a pink moist bump. These could be signs of an umbilical cord infection.
A client telephones the clinic to ask about a home pregnancy test she used this morning. The nurse understands that the presence of which hormone strongly suggests a woman is pregnant?
Correct Answer: B. Human chorionic gonadotropin (HCG)
Human chorionic gonadotropin (HCG) is the biological marker on which pregnancy tests are based. Reliability is about 98%, but the test does not positively confirm pregnancy. Human chorionic gonadotropin is a hormone produced primarily by syncytiotrophoblastic cells of the placenta during pregnancy. The hormone stimulates the corpus luteum to produce progesterone to maintain the pregnancy.
- Option A: Estrogen is a steroid hormone associated with the female reproductive organs and is responsible for the development of female sexual characteristics. Estrogen is often referred to as estrone, estradiol, and estriol.
- Option C: Alpha-fetoprotein is a protein produced by a fetus. High levels of AFP can be seen from 12 weeks of pregnancy and peak during the early 3rd trimester but are not used as a confirmatory test for pregnancy.
- Option D: Progesterone is an endogenous steroid hormone that is commonly produced by the adrenal cortex as well as the gonads, which consist of the ovaries and the testes. Progesterone is also secreted by the ovarian corpus luteum during the first ten weeks of pregnancy, followed by the placenta in the later phase of pregnancy.
The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected?
- A. Pulling up to a standing position
- B. Can feed self with a spoon
- C. Sits alone
- D. Speaks in short sentences
Correct Answer: C. Sits alone
A six-month-old child begins to sit alone without support, rolls over in both directions (front to back and vice versa), bounces when in a standing position, supports weight on legs, and rocks back and forth on hands and knees. To get ready, babies first prop themselves up with their hands, but over time they can start to let go and sit unsupported.
- Option A: According to the Denver II Developmental Assessment milestone’s chart, infants can usually begin to pull to a standing position between 8 to 10 months. Most younger infants are able to stand up with support and bear some weight on their legs between 2 and 4 ½ months. This is an expected and safe developmental stage that will progress to pulling up independently and won’t cause them to have bow-legs.
- Option B: Babies can start to use a spoon by themselves at around 10 to 12 months old. The child will continue to get better at using tools like spoons and forks. Give the child a chance to use spoons and forks—even if it is messy.
- Option D: The child develops language skills between the ages of one and three. In order to communicate, children must know how to use the words they are learning. In this stage of language development, children are able to recognize the difference between nouns and verbs. Generally, the first words in a child’s vocabulary are nouns.
While teaching a 10-year-old child about their impending heart surgery, the nurse should
- A. Explain the surgery using a model of the heart.
- B. Provide a verbal explanation just prior to the surgery.
- C. Introduce the child to another child who had heart surgery three days ago.
- D. Provide the child with a booklet to read about the surgery.
Correct Answer: A. Explain the surgery using a model of the heart.
Based on Piaget’s theory, the school-age child is in the concrete operations stage of cognitive development. During this stage, children begin to think logically about concrete events. Using something concrete, like a model will help the child understand the explanation of heart surgery.
- Option B: This refers to the formal operational stage where the child has the ability to think logically and understand abstract concepts. The ability to think about abstract ideas and situations is the key hallmark of the formal operational stage of cognitive development. The nurse uses a book or provides a verbal explanation about the surgery.
- Option C: This refers to the preoperational stage (2-7 years old). It is characterized by egocentric and concrete thinking. While they are getting better with language and thinking, they still tend to think about things in very concrete terms.
- Option D: The final stage of Piaget’s theory, the formal operational stage, involves an increase in logic, the ability to use deductive reasoning, and an understanding of abstract ideas. At this point, people become capable of seeing multiple potential solutions to problems and think more scientifically about the world around them.
When caring for an elderly client it is important to keep in mind the changes in color vision that may occur. What colors are apt to be most difficult for the elderly to distinguish?
- A. Red and blue
- B. Blue and green
- C. Red and green
- D. Blue and gold
Correct Answer: B. Blue and green
The elderly have poor blue-green discrimination. The effects of age are greatest on short wavelengths. These changes are related to the yellowing of the lens with age. Nearly 80 percent of the abnormalities involved confusion of the lighter (pastel) shades of blue versus purple and yellow versus green and yellow-green. These “blue-yellow” errors are distinct from the “red-green” errors observed in people with inherited color blindness, which affects about eight percent of males and 0.5 percent of females.
- Option A: The elderly are better able to distinguish between red and blue because of the difference in wavelengths. Cells in the retina that are responsible for normal color vision decline in sensitivity as people age, causing colors to become less bright and the contrast between different colors to be less noticeable.
- Option C: Red-green color vision deficiencies occur when there are defects with the OPN1LW (red pigment cone) and OPN1MW (green pigment) genes. These affect the way that color wavelengths are detected by the cones in the retina. Red and green color blindness is an inherited disorder that is unrelated to age. Red-green color blindness is typically caused by genetic mutations.
- Option D: The elderly are better able to distinguish between blue and gold because of the difference in wavelengths. Blue-yellow color vision defects affect males and females equally. This condition occurs in fewer than 1 in 10,000 people worldwide. Blue cone monochromacy is rarer than the other forms of color vision deficiency, affecting about 1 in 100,000 people worldwide.
While giving nursing care to a hospitalized adolescent, the nurse should be aware that the major threat felt by the hospitalized adolescent is
- A. Fear of the unknown
- B. Loss of bodily control
- C. Altered body image
- D. Separation from family
Correct Answer: C. Altered body image
The hospitalized adolescent may see each of these as a threat, but the major threat that they feel when hospitalized is the fear of altered body image, because of the emphasis on physical appearance. Changes in physical appearance, function, and body integrity are typically central to the experience of illness and to medical treatment. Unfortunately, dissatisfaction with body image has become more prevalent since the early 1970s, possibly due to an increase in the influence of the media.
- Option A: Fear of the unknown is common among toddlers. There is so much going on in the world of a 3-year-old-so much mastery, so many things they’ve already become familiar with. At the same time, however, children this age may be disturbed by characteristics they find unfamiliar.
- Option B: Adolescents may fear the loss of independence and control. Honest preparations for procedures and surgery is imperative for this age group. Let them know if any procedures or medicines will change the way their bodies look or work.
- Option D: It is not unusual for 5-year-olds to still have fears about losing a parent. Separation issues that may or may not have occurred at the beginning of the school year may arise at the end of it.
A woman who is 32 years old and 35 weeks pregnant has had rupture of membranes for eight hours and is four (4) cm dilated. Since she is a candidate for infection, the nurse should include which of the following in the care plan?
- A. Universal precautions
- B. Oxytocin administration
- C. Frequent temperature monitoring
- D. More frequent vaginal examinations
Correct Answer: C. Frequent temperature monitoring
Temperature elevation will indicate beginning infection. This is the most important measure to help assess the client for infections since the lost mucus plug and the ruptured membranes increase the potential for ascending bacteria from the reproductive tract. This will infect the fetus, membranes, and uterine cavity.
- Option A: Universal precautions are necessary for all clients but a specific assessment of the client’s temperature will give an indication the client is becoming infected.
- Option B: Oxytocin may be needed to induce labor if it is not progressing, but it is not done initially. In the antepartum period, exogenous oxytocin is FDA-approved for strengthening uterine contractions with the aim of successful vaginal delivery of the fetus. It is indicated for mothers with inactive uteri that require stimulation to start labor
- Option D: More frequent vaginal examinations are not recommended, as frequent vaginal exams can increase the chances of infection. VEs following rupture of membranes has been demonstrated to increase the risk of chorioamnionitis. Obstetricians are, therefore, routinely expected to weigh the need for VEs for the assessment of labor progression, against the risk of maternal discomfort and of infection with an increased number of examinations.
The nurse prepares for a Denver Screening test with a 3-year-old child in the clinic. The mother asks the nurse to explain the purpose of the test. The best response is to tell her that the test
- A. Measures potential intelligence
- B. Assesses a child’s development
- C. Evaluates psychological responses
- D. Diagnose specific health problems
Correct Answer: B. Assesses a child’s development
The Denver Developmental Test II is a screening test to assess children from birth through 6 years in personal/social, fine motor adaptive, language, and gross motor development. The Denver Developmental Screening Test (DDST) was devised to provide a simple method of screening for evidence of slow development in infants and preschool children. A child experiences the fun of play during the test.
- Option A: Instruments used for measuring intelligence are the Wechsler Adult Intelligence Scale and the Kaufman Brief Intelligence scale. The Wechsler scales were the first intelligence scales to base scores on a standardized normal distribution. IQ tests are used to measure human intelligence quotients as measured against an age-based average intelligence score.
- Option C: Health professionals often use questionnaires, psychological exams, and interviews when evaluating psychological responses. Psychologists use tests and other assessment tools to measure and observe a client’s behavior to arrive at a diagnosis and guide treatment.
- Option D: Denver Developmental Test does not diagnose specific health problems but rather assesses the cognitive and behavioral problems of children. The test covers four functions: gross motor, language, fine motor-adaptive, and personal-social.
A 27-year-old woman has Type I diabetes mellitus. She and her husband want to have a child, so they consulted her diabetologist, who gave her information on pregnancy and diabetes. Of primary importance for the diabetic woman who is considering pregnancy should be:
- A. Early prenatal medical care.
- B. A review of the dietary modifications that will be necessary.
- C. Understanding that this is a major health risk to the mother.
- D. Adoption instead of conception.
Correct Answer: A. Early prenatal medical care.
Pregnancy makes metabolic control of diabetes more difficult. It is essential that the client starts prenatal care early so that potential complications can be controlled or minimized by the efforts of the client and health care team. The woman does need to be proactive in her diabetes care prior to pregnancy to optimize her health and her baby’s and prevent possible complications.
- Option B: The doctor may refer the woman to a diabetes educator and/or a dietitian to help her with a meal plan and blood sugar management. A review of dietary modifications is important once the woman is pregnant. However, it is not of primary importance when considering pregnancy.
- Option C: While there is some risk to the pregnant diabetic woman, it is not considered a major health risk. The greater risk is to the fetus. Other potential risks of poorly controlled diabetes in pregnancy include low blood glucose in the baby at birth, a large baby, or under certain circumstances, a growth-restricted baby.
- Option D: The alternative of adoption is not necessary just because the client is a diabetic. Many diabetic women have pregnancies with successful outcomes if they receive good care. Having diabetes, especially with out-of-control blood sugars, increases the risks of pregnancy. However, with good planning and blood sugar control, the risks can be lowered.
The nurse is planning care for an 18 month-old child. Which of the following should be included in the child’s care?
- A. Hold and cuddle the child often.
- B. Encourage the child to feed himself finger food.
- C. Allow the child to walk independently in the nursing unit.
- D. Engage the child in games with other children.
Correct Answer: B. Encourage the child to feed himself finger food.
According to Erikson, the toddler is in the stage of autonomy versus shame and doubt. The nurse should encourage increasingly independent activities of daily living. Gaining a sense of personal control over the world is important at this stage of development. Children at this age are becoming increasingly independent and want to gain more control over what they do and how they do it.
- Option A: This refers to the Erickson stage of trust vs mistrust where the child develops a sense of trust after receiving consistent and reliable care. Children who learn to trust caregivers in infancy will be more likely to form trusting relationships with others throughout the course of their lives.
- Option C: This refers to the Erickson stage of identity vs role confusion where the child is becoming more independent. Those who receive proper encouragement and reinforcement through personal exploration will emerge from this stage with a strong sense of self and a feeling of independence and control.
- Option D: This refers to the Erickson stage of initiative vs guilt where the child begins to develop interpersonal skills by spending their time playing with other children. During the initiative versus guilt stage, children begin to assert their power and control over the world through directing play and other social interaction.
The nurse in an infertility clinic is discussing the treatment routine. The nurse advises the couple that the major stressor for couples being treated for infertility is usually:
- A. Having to tell their families.
- B. The cost of the interventions.
- C. The inconvenience of multiple tests.
- D. The right scheduling of sexual intercourse.
Correct Answer: D. The right scheduling of sexual intercourse.
Sexual activity “on-demand” is the major cause of stress for most infertile couples. It is important for couples to have sexual intercourse around the time of ovulation to increase the pregnancy rate.
- Option A: Having to tell families may also be a factor contributing to stress but is not the major stressor. Despite the prevalence of infertility, the majority of infertile women do not share their stories with family or friends, thus increasing their psychological vulnerability.
- Option B: Cost may also be a contributing factor to stress but is not usually the major factor. There are disadvantages of this new science for patients: the cost of preimplantation genetic screening can add thousands of dollars to an already expensive treatment cycle.
- Option C: The inconvenience of multiple tests may also be a factor contributing to stress but is not usually the major factor. Some patients will get pregnant quite easily from assisted reproductive treatment, conceiving on their first cycle. However, that is the exception; for many, it may take years, or not happen at all.
The nurse is assessing a four-month-old infant. The nurse would anticipate finding that the infant would be able to:
- A. Hold a rattle
- B. Bang two blocks
- C. Move the small toy from one hand to another
- D. Wave “bye-bye”
Correct Answer: A. Hold a rattle
The age at which a baby will develop the skill of grasping a toy with help between the 4th to 6th month. Around the same time that baby learns to reach for an object, which happens by month 4 or so, he’ll learn to grasp an object, such as a rattle, that’s held to his fingers.
- Option B: At 9 months, babies repeat different actions with objects. The mouth objects to explore the features. They bang objects with their hand and bang two objects together to create sounds and actions. Banging two objects together is a milestone that can be seen between the age of 9 months and a year.
- Option C: By age 6-8 months, they can transfer objects from hand to hand, turn them from side to side, and twist them upside down. Babies’ broadening range of vision is apparent as they concentrate and focus on objects and follow movements.
- Option D: Learning how to wave bye-bye is an important milestone for an infant that usually occurs between the age of 10 months and a year. A study in Pediatrics International found premature infants mastered the bye-bye gesture significantly later than full-term babies and used different hand and wrist motions.
The nurse is evaluating a new mother feeding her newborn. Which observation indicates the mother understands proper feeding methods for her newborn?
- A. Holding the bottle so the nipple is always filled with formula.
- B. Allowing her seven-pound baby to sleep after taking 1 ½ ounce from the bottle.
- C. Burping the baby every ten minutes during the feeding.
- D. Warming the formula bottle in the microwave for 15 seconds and giving it directly to the baby.
Correct Answer: A. Holding the bottle so the nipple is always filled with formula.
When feeding an infant, tilt the bottle so the milk completely fills the nipple. Holding the bottle so the nipple is always filled with formula prevents the baby from sucking air. Sucking air can cause gastric distention and intestinal gas pains.
- Option B: A seven-pound baby should be getting 50 calories per pound: 350 calories per day. Standardized formulas have 20 calories per ounce. This seven-pound baby needs 17.5 ounces per day. 17.5 ounces per day divided by 6-8 feedings equals 2-3 ounces per feeding.
- Option C: A normal newborn without feeding problems could be burped halfway through the feeding and again at the end. If burping needs to be at intervals, it should be done by ounces or half ounces, not minutes.
- Option D: Microwaving is not recommended as a method of warming due to the uneven heating of the formula. If used, the formula should be shaken after warming and the temperature is then checked with a drop on the wrist. The recommended method of warming is to place the bottle in a pan of hot water to warm, and then check the temperature on the wrist before feeding.
The nurse is caring for a pregnant client. The client asks how the doctor could tell she was pregnant ‘just by looking inside.’ The nurse tells her the most likely explanation is that she had a positive Chadwick’s sign, which is a:
- A. Bluish coloration of the cervix and vaginal walls.
- B. Pronounced softening of the cervix.
- C. Clot of very thick mucus that obstructs the cervical canal.
- D. Slight rotation of the uterus to the right.
Correct Answer: A. Bluish coloration of the cervix and vaginal walls.
Chadwick sign is an early sign of pregnancy that is characterized by the bluish-purple coloration of the cervix and vaginal walls which occurs during the 4th week of pregnancy. It is caused by vasocongestion.
- Option B: Softening of the cervix is called the Goodell’s sign.In medicine, Goodell’s sign is an indication of pregnancy. It is a significant softening of the vaginal portion of the cervix from increased vascularization. This vascularization is a result of hypertrophy and engorgement of the vessels below the growing uterus. This sign occurs at approximately four weeks’ gestation.
- Option C: An increase in vaginal discharge happens during the late third trimester. This thick mucous plug obstructs the cervical canal to prevent bacteria from entering the uterus. Towards the end of pregnancy, the amount of discharge increases further. In the last week or so of pregnancy, it may contain streaks of sticky, jelly-like pink mucus.
- Option D: With ascent from the pelvis, the uterus is slightly rotating to the right due to the presence of the rectosigmoid colon to the left side. This is called dextro-rotation.
Which of the following is the most appropriate activity for a 5-year-old child?
- A. Squeeze toy
- B. Board games
- C. Play-Doh
- D. Computer games
Correct Answer: C. Play-Doh
In the preschooler, play is simple and imaginative that includes activities such as puppets, play-doh, and coloring books. While the kids are molding play dough into different shapes, they are actually building up strength in their tiny hands. The acts of squishing, rolling, flattening, and more help your children develop muscles used in their hands for fine motor movements useful in the future, such as holding a pencil or using scissors.
- Option A: Easy and safe to hold toys such as squeeze toys are appropriate for infants. Infants are fascinated with movement, sounds, and simple black and white visuals. They are discovering their own bodies, working on eye-hand coordination, reaching, and grasping.
- Option B: Toys that require concentration such as board games are appropriate for the school-age child. In addition to teaching them about teamwork, patience, and how to win and lose gracefully, board games can actually benefit kids’ brains and language development.
- Option D: A play that requires problem-solving techniques like computer games is appropriate for an adolescent. Some games might improve kids’ hand-eye coordination and problem-solving skills. Video games that require kids to actually move or manipulate the game through their own physical movement can even get sedentary kids moving.
Ben feels hatred each time he sees her father showing affection to her mother. According to Freud, this behavior is known as?
- A. Misomater
- B. Oedipus complex
- C. Superiority complex
- D. Electra complex
Correct Answer: B. Oedipus complex
Oedipus complex is a Freudian concept that describes a child’s sexual desire for the parent of the opposite sex and a sense of rivalry with the parent of the same sex. This desire is kept out of conscious awareness through repression, but Freud believed that it still had an influence over a child’s behavior and played a role in development.
- Option A: Misomater is a term that describes a person’s animosity toward his or her mother. Parent-offspring conflict describes the evolutionary conflict arising from differences in optimal fitness of parents and their offspring.
- Option C: Superiority complex is a psychological behavior that exists when a person overcompensates his or her feelings of inferiority. A superiority complex is a belief that one’s abilities or accomplishments are somehow dramatically better than other people’s. People with a superiority complex may be condescending, smug, or mean to other people who don’t agree with them.
- Option D: Electra complex is used to describe a girl’s attraction to their father and resentment or rivalry towards their mothers. The term Electra complex was introduced by Carl Jung to describe how this complex manifests in girls.
A woman who is six months pregnant is seen in an antepartal clinic. She states she is having trouble with constipation. To minimize this condition, the nurse should instruct her to:
- A. Increase her fluid intake to three liters/day.
- B. Request a prescription for a laxative from her physician.
- C. Stop taking iron supplements.
- D. Take two tablespoons of mineral oil daily.
Correct Answer: A. Increase her fluid intake to three liters/day.
During pregnancy, constipation results from decreased gastric motility and increased water reabsorption in the colon caused by increased levels of progesterone. Increasing fluid intake to three liters a day will help prevent constipation. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated.
- Option B: Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. Laxatives are medicines used to treat constipation and are generally poorly absorbed from the mother’s gut into her bloodstream. They are not associated with problems for the unborn or breastfed baby.
- Option C: Iron supplements are necessary during pregnancy, as ordered, and should not be discontinued. Daily oral iron and folic acid supplementation with 30 mg to 60 mg of elemental iron and 400 µg (0.4 mg) folic acid is recommended for pregnant women to prevent maternal anemia, puerperal sepsis, low birth weight, and preterm birth.
- Option D: Mineral oil is especially bad to use as a laxative because it decreases the absorption of fat-soluble vitamins (A, D, E, K) if taken near mealtimes. Mineral oil should always be prohibited during pregnancy, as its use can cause hemorrhagic disease of the newborn due to impaired absorption of vitamin K. Similarly, castor oil is absolutely prohibited during pregnancy.
The nurse is observing children playing in the hospital playroom. She would expect to see 5-year-old children playing:
- A. Building a tower out of blocks
- B. With their own toys alongside other children
- C. Alone with handheld computer games
- D. Cooperatively with other preschoolers
Correct Answer: D. Cooperatively with other preschoolers
Cooperative play is typical of the preschool period. Children engage in an activity where they assume equal roles and responsibilities in order to reach a common goal. When a child plays together with others and has an interest in both the activity and other children involved in playing they are participating in cooperative play.
- Option A: When a child engages in a mutual activity but is not working toward a common goal is called associative play and is seen at 3-4 years of age. When a child starts to interact with others during play, there is not a large amount of interaction at this stage. A child might be doing an activity related to the kids around him, but might not actually be interacting with another child.
- Option B: When a child plays alongside other children but does not play with them is referred to as parallel play and is seen at 2 years of age. Play is a highly imaginative pursuit that engages the body and mind. Whether toddlers simply repeat an activity or experiment with something new they picked up during parallel play, it’s all part of learning and growing.
- Option C: When children play alone with their own toy and are not yet interested in playing with others is known as solitary play. This is seen from birth until 2 years of age.
The nurse is caring for residents in a long-term care setting for the elderly. Which of the following activities based on Erickson’s theory will be most effective in meeting the growth and development needs of a person in this age group?
- A. Boardgame
- B. Mentor other elderly clients
- C. Reminiscence groups
- D. Regularly scheduled social activities
Correct Answer: C. Reminiscence groups
According to Erikson’s theory, older adults need to find and accept the meaningfulness of their lives, or they may become depressed, angry, and fear death. Reminiscing contributes to successful adaptation by maintaining self-esteem, reaffirming identity, and working through loss.
- Option A: Playing board games is an activity that is appropriate for school-age children where there is an equal share of efforts and tasks to reach a common goal. In addition to teaching them about teamwork, patience, and how to win and lose gracefully, board games can actually benefit kids’ brains and language development.
- Option B: Mentoring is an activity for individuals who are in their middle adulthood where it involves finding one’s purpose and contributing to the development of others.
- Option D: Attending social activities is an activity that benefits individuals who are in their adolescent years where these kinds of events play a role in creating and shaping their identity.
Emily is talking to her 6-year-old sister Julia. She asks why the sun shines so bright? Julia answered that “it always keeps her warm. What stage in the cognitive theory of development explains this?
- A. Formal operational
- B. Concrete operational
- C. Sensorimotor
- D. Preoperational
Correct Answer: D. Preoperational
Children in this stage tend to be egocentric and have difficulty taking the viewpoint of others. At this stage, kids learn through pretend play but still struggle with logic and taking the point of view of other people. They also often struggle with understanding the idea of constancy.
- Option A: Children in this stage can think logically about abstract propositions and test hypotheses systematically. Teens begin to think more about moral, philosophical, ethical, social, and political issues that require theoretical and abstract reasoning.
- Option B: Children in this stage can think logically about objects and events. Their thinking becomes more logical and organized, but still very concrete. While children are still very concrete and literal in their thinking at this point in development, they become much more adept at using logic.
- Option C: Children in this stage obtain knowledge about the environment through the use of senses and reflexes. A child’s entire experience at the earliest period of this stage occurs through basic reflexes, senses, and motor responses.
A pregnant woman is advised to alter her diet during pregnancy by increasing her protein and Vitamin C to meet the needs of the growing fetus. Which diet best meets the client’s needs?
- A. Scrambled egg, hash browned potatoes, half-glass of buttermilk, small nectarine
- B. 3oz. Chicken, ½ cup corn, lettuce salad, small banana
- C. 1 C. macaroni, ¾ cup peas, a whole glass milk, a medium pear
- D. Beef, ½ cup Lima beans, a glass of skim milk, ¾ cup strawberries
Correct Answer: D. Beef, ½ C. Lima beans, a glass of skim milk, ¾ cup strawberries
Increasing vitamin C intake helps the pregnant woman in the absorption of iron while protein aids in building the baby’s bones, muscles, and other tissues during the second and third trimester. Beef and beans are an excellent source of protein as is skim milk. Strawberries are a good source of Vitamin C.
- Option A: Hash browns, quick-cook oats, bacon, and even eggs (prepared in restaurants) can be loaded with sodium. Sodium causes the woman to retain water, which leaves her bloated from the start of the day.
- Option B: Oranges have a perfect score of 100, earning more credit than apples (96) and bananas (91) due to high concentrations of vitamin C, fiber, calcium, folate, bioflavonoids, and carotenoids.
- Option C: They contain the least amount of protein and vitamins needed for the growing fetus. A pregnant woman can have around three glasses of milk, preferably the low-fat or non-fat variety, every day to benefit from it.
Kelly, a first-time mother, went to the community clinic and asked the nurse what kind of toy would be most appropriate for her 15th-month-old child?
- A. Knitting knits
- B. Board games
- C. Ball popper toys
- D. Checkers
Correct Answer: C. Ball popper toys
At 15 months, the child’s cognitive development and fine motor skills are growing so provide toys that have cause and effect such as ball popper toys. Their ability to successfully manipulate smaller and smaller objects can place them at risk of choking or swallowing dangerous items.
- Option A: School-age children acquire adult-like interests, abilities, and hobbies and may display a passion by becoming a collector. Girls still love doing crafts and writing in diaries, and boys find computer and video games irresistible.
- Option B: School-age is the age when kids often become huge fans of computer games, but they also enjoy having their friends over to play sports, card games, and board games.
- Option C: Checkers is appropriate for school-age children and they require a good amount of concentration that a 15th-month-old is not yet ready to have.
The following are the descriptions of Kohlberg’s Theory of Moral Development. Put them in the correct order from levels 1 to 3.
- Avoidance of punishment.
- Act to further one’s own interest or personal gain.
- Conforms to avoid disapproval or disliked by others.
- Conforms to avoid censure by authorities.
- Emphasis on individual rights.
- Individual principles of conscience.
The correct order of answers is shown above.
Level one of moral developments starts Preconventional with stage 1: Punishment-Obedience Orientation (obeying rules to avoid punishment), stage 2: Instrumental Relativist Orientation (conform to get rewards and to have favors returned), followed by level 2 Conventional Morality stage 3: Good Boy-Nice Girl Orientation (based on the approval of others), stage 4: Law and Order Orientation (judgment based on the rules and law of society), lastly level 3 Postconventional stage 5: Social contract and Legalistic Orientation (social contract rules and laws of social good), stage 6: Universal Ethical Principles Orientation (guided by moral principle of justice).
- Stage 1 focuses on the child’s desire to obey rules and avoid being punished. For example, an action is perceived as morally wrong because the perpetrator is punished; the worse the punishment for the act is, the more “bad” the act is perceived to be.
- Stage 2 expresses the “what’s in it for me?” position, in which right behavior is defined by whatever the individual believes to be in their best interest. Stage two reasoning shows a limited interest in the needs of others, only to the point where it might further the individual’s own interests.
- In stage 3, children want the approval of others and act in ways to avoid disapproval. Emphasis is placed on good behavior and people being “nice” to others.
- In stage 4, the child blindly accepts rules and conventions because of their importance in maintaining a functioning society. Rules are seen as being the same for everyone, and obeying rules by doing what one is “supposed” to do is seen as valuable and important.
- In stage 5, the world is viewed as holding different opinions, rights, and values. Such perspectives should be mutually respected as unique to each person or community. Laws are regarded as social contracts rather than rigid edicts.
- In stage 6, moral reasoning is based on abstract reasoning using universal ethical principles. Generally, the chosen principles are abstract rather than concrete and focus on ideas such as equality, dignity, or respect.
Erickson’s stage of psychosocial development in which social relationships develop and productivity increases.
- A. Initiative vs guilt
- B. Autonomy vs shame and doubt
- C. Industry vs inferiority
- D. Generativity vs stagnation
Correct Answer: C. Industry vs inferiority
Industry vs inferiority starts from 6 to 12 years of age when children need to cope with social and academic demands. Success at this stage leads to competence and self-confidence. Once school begins, actual performance and skill are evaluated. Grades and feedback from educators encourage kids to pay more attention to the actual quality of their work.
- Option A: Initiative vs guilt (3 to 6 years) is the stage when children become purposeful and directive. Children need to begin asserting control and power over the environment by taking initiative by planning activities, accomplishing tasks, and facing challenges.
- Option B: Autonomy vs shame and doubt (18 months to 3 years) is the stage when children learn to control their own bodies. It is at this point in development that young children begin to express a greater need for independence and control over themselves and the world around them.
- Option D: Generativity vs stagnation (35 to 65 years) is the stage when the concern is centered on family and society. During this time, adults strive to create or nurture things that will outlast them; often by parenting children or contributing to positive changes that benefit other people.
A 3-year old boy with vesicoureteral reflux is scheduled for ureteral reimplantation. His father plans to go home during the surgery to get his favorite toy. When the father left, the boy asked the nurse when will his father be back? The nurse’s best response is:
- A. “Your daddy will be back later this afternoon.”
- B. “Your daddy will be back at 11 am.”
- C. “Your daddy will be back after you wake up.”
- D. “Your daddy will be back within 2 ½ hours.”
Correct Answer: C. “Your daddy will be back after you wake up.”
A preschool child understands the concept of time through events and symbols. Following and being involved with a familiar sequence of routines and schedules enhances their time awareness of the present, past, and future. Preschoolers also need to build on these experiences, because time is such an abstract concept for young children. For them, it is rather intangible.
- Option A: Between ages 4-5, a child begins to have an understanding of time but it is still vague. Before and after are time concepts understood by preschoolers. Although 3- and 4-year-olds have the ability to describe events that happen in the past and know specific words that describe past events (“last week” or “a few days ago”), they may not always get the duration of the time exactly right.
- Option B: Between ages 6 to 8 years old, children learn the concept of minutes in an hour, number of hours in a day, and can compare time. Of course, recognizing the parts of the day is the most basic way children become aware of the passage of time. Their capacity to learn about time increases as they become aware of how events reoccur at specific times during the day.
- Option D: Kindergartners want to know what time it is and are beginning to understand that certain things (like the start and end of school) happen at a defined time each day. Make a photographic timeline for the day at school, marking each event with a picture of the clock at that time and the time written numerically.