growth and development Flashcards
While being comforted in the emergency department, the 6-year-old male sibling of a
pediatric trauma victim blurts out to the nurse, “It’s all my fault! When we were fighting
yesterday, I told him I wished he was dead!” Which response by the nurse is most
therapeutic?
1. Asking the child if he would like to sit down and drink some water
2. Sitting the child down in an empty room with markers and paper so that he can draw a
picture
3. Reassuring the child that it is normal to get angry and say things that we do not mean,
but that we have no control over whether an accident happens
4. Discussing the catheters, tubes, and equipment that the sibling requires, and explaining
why they are needed
- Reassuring the child that it is normal to get angry and say things that we do not mean,
but that we have no control over whether an accident happens
The nurse is conducting a physical assessment for a pediatric client. Which part of
Bronfenbrenner’s ecologic theory of development is the nurse assessing when discussing
the parents’ work environment in relation to the client?
1. Chronosystem
2. Mesosystem
3. Macrosystem
4. Exosystem
- Exosystem
- The chronosystem involves the perspective of time in the child’s life.
- The relationships of one microsystem to another involve a child’s mesosystem.
- Political and cultural beliefs comprise a child’s macrosystem.
- A child’s exosystem is composed of the settings that influence a child even though he or
she is not in daily contact with that system.
The parents of a toddler are concerned that their child seems different from their other
child, stating, “He just doesn’t seem to like new people and wants us with him in these
situations.” Which response by the nurse is appropriate when using the temperament theory to
respond to the toddler’s parents?
1. “Your child seems to withdraw from new situations. This is typical with slow-to-warm-
up children.”
2. “Your child is having an intense reaction to the environment and new people and we
will need to investigate this more closely.”
3. “Difficult children often display a negative mood. Does your child often throw temper
tantrums?”
4. “Slow-to-warm-up children are often diagnosed with autism spectrum disorder.”
- “Your child seems to withdraw from new situations. This is typical with slow-to-warm-
up children.”
Explanation: - Slow-to-warm-up children adapt slowly to new situations and initially will withdraw.
- Having intense reactions to the environment is a characteristic of “difficult” children.
The child in this scenario is not displaying this temperament. This response is inaccurate
and not appropriate. - Displaying a predominately negative mood to the environment is a characteristic of
“difficult” children. The child is this scenario is not displaying this temperament. This
response is inaccurate and not appropriate. - Slow-to-warm-up children are not often diagnosed with autism spectrum disorder. This
statement is inaccurate and not appropriate.
The parents of a 12-month-old client ask the nurse for suggestions regarding age-
appropriate toys for their child. Which toys are appropriate for the nurse to recommend for
this client? Select all that apply.
1. Soft toys that can be mouthed
2. Toys with black-and-white patterns
3. Toys that can pop apart and go back together
4. Jack-in-the-box toys
5. Push-and-pull toys
- Toys that can pop apart and go back together
- Jack-in-the-box toys
- Push-and-pull toys
Explanation: - A 12-month-old client is more mobile and shows less interest in soft toys that can be
placed in the mouth. - A 12-month-old client will tend to enjoy colorful toys, not toys with black-and-white
patterns. - A 12-month-old client has gross and fine motor skills that are becoming more developed
and enjoys toys that can help them refine these skills. - A 12-month-old client enjoys toys that can be manipulated and that grabs his or her
attention. A jack-in-the-box toy allows both. - A 12-month-old client is learning to walk and will enjoy toys that promote mobility.
While assessing the development of a 9-month-old client, the nurse asks the mother if the
child actively looks for toys when they are placed out of sight. Which is the nurse assessing
with this question to the parent?
1. Transductive reasoning
2. Conservation
3. Centration
4. Object permanence
- Object permanence
Explanation: - Transductive reasoning is when a child connects two events in a cause–effect
relationship because the events occurred at the same time. - Conservation is when a child knows that matter is not changed when its form is altered.
- Centration is when a child focuses on only one particular aspect of a situation.
- A child who has developed object permanence has the ability to understand that even
though something is out of sight, it still exists.
A nurse is assessing language development in all the pediatric clients presenting at the
healthcare provider’s office for well-child visits. At which age would the nurse further
assess language development if the client is unable to verbalize the words “dada” and
“mama”?
1. 3 months
2. 6 months
3. 8 months
4. 12 months
- 12 months
Explanation: - By 3 months of age, infants vocalize during play and with familiar people. The infant
may also begin to laugh. At this time, they do not use these as names for the parents. - By 6 months of age, infants will be making the sounds “mamamamam” and “dadadada”
because they like to repeat sounds. At this time, they do not use these as names for the
parents. - By 8 months of age, infants will be making the sounds “mamamamam” and “dadadada”
because they like to repeat sounds. At this time, they do not use these as names for the
parents. - By 12 months of age, children should be able to verbalize “mama” or “dada” to identify
their mother or father. This client would require further assessment by the nurse.
7) Two 3-year-old clients are playing together in a hospital playroom. One is working on a
puzzle, while the other is stacking blocks. Which type of play are these children
participating in based on this scenario?
1. Cooperative play
2. Solitary play
3. Parallel play
4. Associative play
- Parallel play
- Cooperative play is when children demonstrate the ability to cooperate with others and
to play a part in order to contribute to a unified whole. The school-age child participates
in cooperative play. - Solitary play is when a child plays alone. Infants’ play style is described as solitary.
- Parallel play is when two or more children play together, each engaging in his or her
own activities. - Associative play is characterized by children interacting in groups and participating in
similar activities. Preschoolers’ play style is associative.
The nurse is teaching new parents how to communicate with their infant. Which response
by the parents indicates accurate understanding of the information presented?
1. “I will prop the bottle while my baby is in the carseat so that I can cook dinner.”
2. “I will use a low-pitched voice while talking to my baby as this is most appropriate.”
3. “I will unwrap my baby when she is upset to allow interaction with the environment.”
4. “I will talk and sing to my baby while I am providing daily care, including diaper
changes.”
- “I will talk and sing to my baby while I am providing daily care, including diaper
changes.”
Explanation: - Parents should hold their babies during feedings as a method of communicating with
their infants. This parental response indicates the need for further education. - Parents should use a high-pitched, not low-pitched, voice when talking with their infant
children. This parental response indicates the need for further education. - Parents should swaddle and hold their infants when they are upset as a communication
method. Unwrapping the baby when the baby is upset indicates the need for further
education. - Parents should talk and sing to their infants while providing daily care, such as diaper
changes. This parental response indicates accurate understanding of the information
presented.
9) While trying to inform a 5-year-old child about what will occur during an upcoming CT
scan, the nurse notices that the child is engaged in a collective monologue, talking about a
new puppy. Which response by the nurse is age appropriate?
1. “You must be so excited to have a new puppy! They are so much fun. Now let me tell
you again about going downstairs in a wheelchair to a special room.”
2. Redirect the child by saying, “Please stop talking about your puppy. I need to tell you
about your CT scan.”
3. “I’ll come back when you are ready to talk with me more about your CT scan.”
4. Ignore the information regarding the puppy and state, “I need to teach you about going
to the special room later today.”
- “You must be so excited to have a new puppy! They are so much fun. Now let me tell
you again about going downstairs in a wheelchair to a special room.”
The mother of a 6-year-old boy who has recently had surgery for the removal of his tonsils
and adenoids complains that he has begun sucking his thumb again. Which defense
mechanism will the nurse include when responding to the mother?
1. Repression
2. Rationalization
3. Fantasy
4. Regression
- Regression
Explanation: - Repression is the involuntary forgetting of uncomfortable situations. The child is not
exhibiting repression. - Rationalization is an attempt to make unacceptable feelings acceptable. The child is not
exhibiting rationalization. - Fantasy is a creation of the mind to help deal with an unacceptable fear. The child is not
exhibiting fantasy. - Regression is a return to an earlier behavior and can often occur during a hospital stay.
The nurse will include regression in the response to the mother.
The nurse is preparing to administer an intramuscular injection to a toddler-age client.
Which is the most appropriate statement by the nurse prior to this procedure?
1. “It is all right to cry. After we are done, you can go to the box and pick out your favorite
sticker.”
2. “We will give you your shot when your mommy comes back.”
3. “I will wipe your skin with a magic wipe and then hold the needle like this and say ‘one,
two, three, go’ and give you your shot. Are you ready?”
4. “This is a magic sword that will give you your medicine and make you all better.”
- “It is all right to cry. After we are done, you can go to the box and pick out your favorite
sticker.”
Explanation: - The most appropriate response would be to acknowledge the child’s feelings and allow
the child to pick out a sticker at the conclusion of the injection. - Waiting for the mother to come back would be inappropriate because toddlers do not
have an understanding of time. - Giving elaborate descriptions and using colorful language are inappropriate because the
instructions are unclear and lengthy. - The nurse should not make statements that are not true and might confuse the child.
An adolescent client diagnosed with cystic fibrosis suddenly becomes noncompliant with
the medication regimen. Which nursing intervention would most likely improve
compliance?
1. Give the client a computer-animated game that presents information on the management
of cystic fibrosis.
2. Set up a meeting with other adolescents with the cystic fibrosis who have been
managing their disease effectively.
3. Arrange for the primary healthcare provider to sit down and talk to the client about the
risks related to noncompliance with medications.
4. Discuss with the client’s parents that privileges, such as a cell phone, can be taken away
if compliance fails to improve.
- Set up a meeting with other adolescents with the cystic fibrosis who have been
managing their disease effectively.
Explanation: - Interest in games might begin to wane during adolescence.
- Providing adolescents with positive role models who are in their peer group is the
intervention most likely to improve compliance. - Adult opinions, even from a primary healthcare provider, could be viewed negatively
and challenged. - Threatening punishment could further incite rebellion.
The home health nurse is conducting a home visit for a family. The toddler-age child, who
is potty training, has an “accident.” The mother becomes angry with the child and calls him
a baby for messing himself. Which is the nurse concerned with regarding the toddler’s
development, based on the mother’s reaction?
1. The child’s cognitive development
2. The child’s sense of independence
3. The child’s conscience
4. The child’s superego
- The child’s sense of independence
Explanation: - Erikson’s theory is related to psychosocial development. The mother’s criticism will not
affect the child’s ability to think. - Erikson’s toddler stage is autonomy (independence) versus shame and doubt. The
mother’s criticism may hinder the child’s sense of independence. - Conscience is what controls our knowledge of right and wrong and is a component of
Kohlberg’s theory. The mother’s criticism will not affect the child’s conscience,
according to Kohlberg. - In Freudian theory, the superego is the moral and ethical system of the personality. The
mother’s criticism will not affect the child’s superego.
14) The clinic administrator has suggested that the nurse teach all children newly diagnosed
with diabetes in a single class to save nursing time. The children recently diagnosed range
in age from 6 to 15. Which is the rationale for the nursing staff to continue with more than
one group session?
1. Freud’s theory of psychosexual development, which states that the 6-year-old child’s
sexual energy is at rest while the adolescent has developed mature sexuality.
2. Erikson’s psychosocial theory, which discusses how children learn to relate to others.
3. Piaget’s cognitive development theory, which says the 6-year-old child learns by
concrete examples, while the 15-year-old adolescent can think abstractly.
4. Kohlberg’s theory, which says the young children are conventional in their thinking and
will want to learn to please others, while older children can internalize values and will
learn for their own principles.
- Piaget’s cognitive development theory, which says the 6-year-old child learns by
concrete examples, while the 15-year-old adolescent can think abstractly.
Explanation: - This theory would not explain why it would be best to separate the group by age.
- Erikson’s theory is about relationships, not learning ability.
- The younger child will need to handle the equipment and observe demonstrations, while
the older child will require more discussion and less demonstration. - Kohlberg’s theory may explain the reasons the child learns the material but does not
discuss the learning style.
As children grow and develop, their style of play changes. Place the descriptions of play
styles in order from infancy to school age.
1. Plays beside but not with other children
2. Plays games with other children and is able to follow the rules of the game
3. Plays alone with play directed by others
4. Plays with others in loose groups
- Plays alone with play directed by others.
- Plays beside but not with other children
- Plays with others in loose groups
- Plays games with other children and is able to follow the rules of the game.
Explanation: - This describes parallel play, seen in toddlers.
- This describes cooperative play, seen in the school-age child.
- This describes infant-style play, called solitary play.
- This describes associative play, which is seen in the preschooler.
