Fundamentals of Nursing Past Paper PDF

lOMoARcPSD|47336272 fundamentals of nursing Fundamentals of nursing (Aiken Technical College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Shannon Downing ([email protected]...

lOMoARcPSD|47336272 fundamentals of nursing Fundamentals of nursing (Aiken Technical College) Scan to open on Studocu Studocu is not sponsored or endorsed by any college or university Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Chapter 9. Life Span: Infancy Through Middle Adulthood Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. The nurse is providing prenatal counseling for a couple who is trying to become pregnant. The priority for the nurse is to include which information? 1. Stages of growth and development of the fetus 2. Recommended schedule of visits to her healthcare provider 3. Recommended average weight gain during pregnancy 4. Healthy eating habits before and during pregnancy ____ 2. According to Erikson, which behavior demonstrates an important psychosocial task for a toddler to exhibit? 1. Acting defiantly by refusing to hold a parent’s hand while crossing the street 2. Recognizing that it is wrong to take a toy away from someone else 3. Displaying an ability to understand the concept of time in hours 4. Expressing to parents and playmates when something is disliked ____ 3. A parent comes to the clinic with a 1-week-old infant for a newborn checkup. The parent tells the nurse, “My baby looks yellow to me.” Which is the nurse’s best response? 1. “What type of detergent are you using to wash the baby’s clothes?” 2. “Is there a possibility you had hepatitis during your pregnancy?” 3. “The color is from the breakdown of maternal red blood cells.” 4. “There is a cream you can use to reduce the yellowing.” ____ 4. A parent brings a toddler to the clinic for well-child care. Which is most important for the nurse to assess? 1. How successful the child is with potty training 2. How the child acts when you enter the room 3. Whether the child is using eating utensils 4. Whether the home is childproofed ____ 5. The nurse is performing physical assessment on a female client who is in her early 50s. Which comment made by the client is a cue indicating the need for further assessment for a problem? 1. “My skin is so dry I need to use lotion every day after I bathe.” 2. “I have episodes when I feel really hot even when others are not.” 3. “It’s getting harder to lift those big bags of dog food.” 4. “I have to write myself notes because I’m getting so forgetful.” Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 ____ 6. The nurse is instructing a group of parents about common adolescent behavior. Which comment by a parent indicates an urgent need for further discussion? 1. “I guess my daughter won’t be asking my opinion very much.” 2. “I’m really going to watch my daughter’s eating habits.” 3. “We are really going to have to think about rules we want to enforce after he gets his driver’s license.” 4. “We don’t keep alcohol in the house, so that’s at least one thing we don’t need to worry about.” ____ 7. Which consideration does the nurse recognize as being a typical priority for an adolescent? 1. Importance of being a good student 2. Conflict about being sexually active 3. Being picked to be on the soccer team 4. The ability to function independently ____ 8. The nurse is interviewing a middle-aged adult. Which comment by the client does the nurse recognize as being representative of Erikson’s theory of psychosocial development? 1. “I look in the mirror and just see an old person.” 2. “The best part of life is over, and my years are numbered.” 3. “I take pride in all that I have accomplished during life.” 4. “Finally, I feel I have a relationship that will last forever.” ____ 9. The nurse teaches the parent of a preschool-age child about expected development. Which comment by the parent indicates understanding of the information? 1. “She understands that the monsters in books are not real.” 2. “When I mention her birthday is in a week, she understands.” 3. “I am saving to buy her the roller skates she’s been asking for.” 4. “I can’t expect her to understand why a friend doesn’t agree with her.” ____ 10. A parent brings an 8-month-old infant to the healthcare clinic for a well-child appointment. Which consideration does the nurse use to compare the child’s physical development with age-appropriate norms? 1. If the child walks while holding onto furniture 2. If the child crawls on hands and knees 3. If the child picks up food with fingers 4. If the child sits up without support Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 ____ 11. A parent brings a 5-year-old male child to the healthcare clinic for a regular health visit prior to kindergarten admission. Which comment by the parent indicates the need for follow-up questions by the nurse? 1. “He is not a good child like my firstborn.” 2. “I’ve had to do lice treatments a couple of times.” 3. “He has an imaginary friend called Buddy.” 4. “He is so funny when imitating his father.” ____ 12. Which behavior by the parent does the nurse recognize as having the most impact on an infant developing trust? 1. Talking to the infant 2. Breastfeeding instead of bottle feeding 3. Responding promptly to the infant’s crying 4. Having the infant sleep in the same room as the parents ____ 13. The nurse is presenting material to a class of 9- to 11-year-old children. Which is the most important topic for the nurse to present for this age group? 1. Safe sex practices 2. Healthy food choices 3. Use of seat belts and safety equipment 4. The importance of getting enough sleep ____ 14. A 38-year-old client comes into the clinic for a health examination. The nurse is aware of the psychosocial development tasks and common health problems for this age group. Which question is most important for the nurse to ask? 1. Whether the client has episodes of feeling depressed 2. Whether the client practices safe sex 3. About the client’s exercise habits 4. About the health history of the client’s parents ____ 15. A mother watches the nurse perform an assessment on her newborn and asks the nurse why the nurse is doing things like stroking the bottom of the newborn’s feet. Which response by the nurse is correct? 1. “Just checking the blood flow to your baby’s feet to make sure it’s normal.” 2. “Testing to see if your baby’s neuromuscular system is fully developed.” 3. “Evaluating to see if your baby has the reflex responses we anticipate.” 4. “Determining if your baby has normal sensation in his feet.” ____ 16. The nurse conducts a class on health promotion for a group of young male adults. Which comment indicates to the nurse the teaching is effective? Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 1. “I need to get screened for colon cancer.” 2. “I am going to continue doing testicular self-exams.” 3. “I will request a prostate check at my annual exam.” 4. “I have no need to do breast self-exams until I am 40.” ____ 17. Which action is an example of a school-aged child meeting a psychosocial development task? 1. Wants to show off the latest mastered bicycle trick 2. Becomes interested in friendships with the opposite sex 3. Starts to see the value of making good decisions 4. Wants to buy the same jacket bought by a friend ____ 18. The nurse works in a pediatric emergency department. During the nurse’s shift, a 6-year-old child arrives with a parent. The nurse notices bruises on the child, and the parent avoids answering any questions about them. Which is the most appropriate action by the nurse? 1. Contact a child abuse hotline. 2. Notify the physician. 3. Contact the nurse’s supervisor. 4. Continue to ask the mother more questions. ____ 19. The nurse in a pediatric clinic is performing a developmental assessment on a toddler who is a regular client. Over a period of months, the nurse notices the toddler’s inability to walk without holding on to something and poor pincer grasp. The parent states, “There is nothing wrong with my child. We just need to give him more time.” Which developmental principle does the nurse convey to the parent using Havighurst’s Developmental Task Theory? 1. Many infants and toddlers will lag behind in physical development. 2. Failure to master a task leads to difficulty mastering future tasks. 3. Young children often require additional time for developmental tasks. 4. Concerns about early cognitive and physiological tasks are unfounded. ____ 20. The nurse is interviewing the parents of an infant. One parent states, “I was not raised in a family of faith, and I don’t know how to give that to my child.” Using James Fowler’s Spiritual Development Theory, which information does the nurse provide? 1. The stages of faith development are closely associated with evolving cognitive abilities. 2. Faith, for a child, requires the ability to use logic and hypothetical thinking. 3. In a family of faith, a child reaches high levels of faith refinement in adolescence. 4. Parents without a personal understanding of faith will need professional assistance. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 ____ 21. An adolescent, single mother of a 2-month-old infant comes to the clinic and tells the nurse, “Sometimes no matter what I do, my baby won’t stop crying, and I hold him up in the air and shake him until he stops.” Based on these statements by the mother, which is the first action by the nurse? 1. Teach the mother about the dangers of shaking a baby. 2. Report child abuse to the appropriate authorities. 3. Teach the mother other methods to stop the baby from crying. 4. Encourage the mother to obtain more support from a significant other. ____ 22. The nurse is beginning a routine assessment on a client who is 3 years of age. Which is the most appropriate action by the nurse to gain trust and cooperation from the child? 1. Explain to the child what is going to be done at the visit. 2. Allow the child to control the pace of the assessment. 3. Encourage the parents to leave the room during the assessment. 4. Play a game of ball with the child. ____ 23. A 30-year-old female comes to the emergency department with visible bruises to her face and arms. She tells the nurse: “My husband has been hitting me.” Which is the most appropriate response by the nurse? 1. “Would you like me to contact our domestic violence advocate for you?” 2. “These issues are between you and your husband, but a social worker may be helpful.” 3. “Is this the first time this has happened, or is this an ongoing issue?” 4. “The doctor will need to check you before we go any further.” ____ 24. A 52-year-old female comes to the office for her routine yearly physical examination. As part of the nurse’s assessment, which physical change in women of this age group is most expected? 1. Graying hair 2. Breast cancer 3. Menopause 4. Mood swings ____ 25. A 16-year-old male tells the nurse, “For weeks now, I am just not interested in doing anything, and I’ve stopped all my sports activities. I just feel sad all the time, and I just don’t want to go on.” The nurse completes an assessment and begins to develop a plan of care. What is the most appropriate nursing intervention at this time? 1. Inform the patient you will be contacting his parents. 2. Inform the patient you are completing a mental health referral. 3. Teach the patient about coping strategies. 4. Contact the patient’s teachers for further information. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Multiple Response Identify one or more choices that best complete the statement or answer the question. ____ 26. The parents of an adolescent client ask about strategies to use to aid in obesity prevention. Which strategies does the nurse present to the parents? Select all that apply. 1. Maintain a well-balanced diet, but eat smaller portions. 2. Teach the adolescent how to recognize healthier snacks. 3. Do not eat fast foods or drink sodas. 4. Try to have 30 minutes of outdoor activity every day. 5. Follow a popular diet trend (e.g., low-carbohydrate diet). ____ 27. A sexually active high school student is asking about contraceptive devices. Which comment by the student indicates to the nurse that the student understands the information provided? Select all that apply. 1. “Condoms are a foolproof method of preventing sexually transmitted infections (STIs) and HIV/AIDS.” 2. “Oral sex does not put me at risk for STIs, so condoms are not needed.” 3. “STIs are major health consequences especially with unprotected sexual activity.” 4. “Consistent and effective use of condoms can help prevent pregnancy.” 5. “Avoiding vaginal sex is an effective way to prevent STIs and HIV/AIDS.” ____ 28. The pediatric nurse is presenting information about teeth brushing to a preschooler class. Prior to the start of class, the nurse spends some time meeting and talking with the students. Which statement(s) by the preschoolers indicates normal development for this group? Select all that apply. 1. “I am going to read my book. I love my book.” 2. “You should never steal anything from anyone.” 3. “Water and ice are really not the same.” 4. “I can count to 20 without any help.” 5. “I already know how to brush my teeth.” ____ 29. A 12-year-old child diagnosed with cancer is hospitalized for the first time. Considering many children in this age group have a fear of hospitals, which strategies will the nurse use to help the child during hospitalization? Select all that apply. 1. Encourage visits from friends. 2. Ask the parents to bring in personal items from home. 3. Maintain a strict daily routine to keep the child focused. 4. Limit parental responsibilities for the child’s care. 5. Provide medical equipment for pretend activities. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 ____ 30. The nurse is providing information to a parent group of adolescent children about body piercings and tattoos. Which information is most important for the nurse to include in the teaching? Select all that apply. 1. Body piercing and tattooing often indicate low self-esteem. 2. Tattoos and piercings can be a source of hepatitis. 3. Tattoos and piercings carry a high risk of skin infections. 4. Body piercings and tattoos are indications of drug abuse. 5. Body piercings and tattoos indicate psychosocial problems. ____ 31. The nurse from the local high school is giving a presentation to 16-year-olds on the risks associated with driving. Which information does the nurse include in the presentation as high-risk activities for causing motor vehicle crashes? Select all that apply. 1. Listening to the radio 2. Talking with passengers 3. Texting 4. Drinking alcohol 5. Eating snacks ____ 32. The nurse is preparing a health promotion class for middle-aged males. As part of the teaching plan, the nurse will provide information on which common health problems associated with this age group? Select all that apply. 1. Cardiovascular disease 2. Cancer 3. Alcoholism 4. Obesity 5. Sports injuries Chapter 9. Life Span: Infancy Through Middle Adulthood Answer Section MULTIPLE CHOICE 1. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the principles of growth and development. Page: 156 (V1) Heading: Effects of Maternal Nutrition Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Feedback 1 This is incorrect. “Stages of growth and development of the fetus” is information the nurse will share after conception, but this information does not have an immediate impact on fetal health and is not a priority. 2 This is incorrect. “Recommended schedule of visits to the female’s healthcare provider” is important information, but this does not have an immediate impact on fetal health and is not the priority. 3 This is incorrect. “Recommended average weight gain during pregnancy” is information that will be shared by the nurse after conception, but this information does not have an immediate impact on fetal health and is not a priority. 4 This is correct. Maternal nutrition is vital to the healthy growth of the fetus. Poor maternal nutrition leads to an undergrown placenta. A small, poorly functioning placenta and smaller-than-normal umbilical cord are the causes of small-for-gestational age (otherwise known as small-for-date) babies. PTS: 1 CON: Growth and Development 2. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Compare and contrast developmental task theory, psychoanalytic theory, cognitive theory, and the psychosocial theory of growth and development. Page: 154 (V1) Heading: Psychosocial Development Theory Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is correct. The primary task during Erikson’s stage 2, Autonomy Versus Shame and Doubt, is establishing an identity as separate from the parent/caregiver. A child age between 18 months and 3 years typically tests the boundaries as part of exercising the will to control the environment. “No” is a declaration of independence and a bid for increased autonomy. Acts of independence and autonomy (e.g., refusing to hold the parent’s hand) are normal during this developmental stage. 2 This is incorrect. Recognizing that it is wrong to take a toy away from someone else is a task accomplished during the preschool stage. 3 This is incorrect. Displaying an ability to understand the concept of time in hours is a task commonly accomplished during the preschool stage of development. 4 This is incorrect. Expressing to parents and playmates when something is disliked is a developmental task that is likely to be accomplished during the preschool stage. PTS: 1 CON: Growth and Development Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 3. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 160 (V1) Heading: Physical Development of the Neonate Integrated Processes: Nursing Process Client Need: Physiological Integrity: Physiological Adaptation Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is incorrect. If detergent caused a reaction, the reaction would commonly present as a rash. 2 This is incorrect. Although hepatitis B virus may pass through the placenta to the fetus, the infant does not typically show signs at week 1 of life. 3 This is correct. Jaundice results from the breakdown of the maternal red blood cells that are in the baby’s system after birth, which elevates the bilirubin in serum. 4 This is incorrect. If treatment becomes necessary, the infant would receive phototherapy; there is no cream to reduce the yellow appearance related to newborn jaundice. PTS: 1 CON: Growth and Development 4. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 169 (V1) Heading: Interventions (Toddlerhood) Integrated Processes: Nursing Process Client Need: Safe and Effective Care Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Potty training is typically accomplished between 18 months and 3 years of age but is not a safety concern. 2 This is incorrect. It would be normal for a child at this age to be afraid of strangers. 3 This is incorrect. The child should be using utensils for most foods, but, again, it is not a safety concern. 4 This is correct. Although all of these areas address important developmental tasks during the toddler period, safety is the highest priority at this age because the child has increased dexterity, mobility, and determination and is becoming more independent. PTS: 1 CON: Growth and Development Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 5. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 186 (V1) Heading: Common Health Problems of Middle Adults Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. There is a normal decrease in skin moisture and muscle tone in middle adulthood. 2 This is incorrect. The perimenopausal period occurs during this time, hallmarked by hot flashes and night sweats. 3 This is incorrect. A decrease in physical strength is not unexpected for the middle adult; the presence of pain or weakness not associated with activity would prompt further assessment. 4 This is correct. Memory in middle adulthood should remain intact, and the nurse will perform additional assessment to determine if the client’s memory loss is normal or abnormal. PTS: 1 CON: Growth and Development 6. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 182 (V1) Heading: Interventions (Adolescents) Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. During the teen years, the relationships among peers strengthen and strongly influence adolescent behavior. Although the parents typically still maintain influence on the core values in the home, teens seek peers’ opinions for matters about social life or concerns of everyday living. 2 This is incorrect. As teens are developmentally concerned with appearance and social relationships, there can be an overemphasis on body image, leading to obesity and eating disorders. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 3 This is incorrect. Motor vehicle accidents are a leading cause of death among teenagers, typically because of distractibility, inattention, impulsiveness, and inexperience in various driving situations. 4 This is correct. Concerns about alcohol intake during adolescence are the highest priority, whether or not alcohol is kept in the house. Alcohol-related injuries and death are risks that should be avoided in every circumstance. Not having alcohol in the house does not guarantee that the teenager will not consume it with friends. PTS: 1 CON: Growth and Development 7. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 181 (V1) Heading: Assessment (Adolescents) Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. School-age children need to receive positive reinforcement for accomplishments and desired behavior, such as being good students. However, this may not be the priority concern for the adolescent. 2 This is incorrect. Although a small number of preadolescents are sexually active, it is not the major focus for this age; however, sexual activity increases with the age of the adolescent. 3 This is correct. The developmental task during adolescence is to establish personal identity. Socially, preteens and teens are driven by the need to belong to a group (e.g., be on the soccer team). 4 This is incorrect. Adolescents may desire and seek some level of independence; however, functioning independently is primarily a task for the young adult. PTS: 1 CON: Growth and Development 8. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 153 (V1) Heading: Psychosocial Development Theory Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. During the middle years, many adults are realistic and insightful about age-related physical and emotional changes. Others experience difficulty coping with passing youth and advancing age. 2 This is incorrect. Accepting death as part of the continuum of life is a task for the older adult. 3 This is correct. Generativity versus stagnation is the stage Erikson describes for the middle-aged adult. During this stage, a mature adult wishes to make a contribution. The middle-aged adult either continues to gain skills, be productive, and pass on his or her knowledge to the next generation or stagnates. 4 This is incorrect. Developing meaningful relationships is a task most characteristic of the young adult. PTS: 1 CON: Growth and Development 9. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 169 (V1) Heading: Preschool Age: Ages 4 and 5 Years Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. The imagination of a preschool-age child is typically active, whereby they have fears of mythical figures, such as monsters. 2 This is incorrect. Preschool-age children have a limited ability to understand the concept of time or to tell time. 3 This is correct. Preschoolers’ eye–hand coordination develops markedly during this period. They can hop on one foot, skip, and begin to learn to skate. 4 This is incorrect. A preschooler has the ability to consider simple viewpoints of other people. PTS: 1 CON: Growth and Development 10. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 163 (V1) Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Heading: Assessment (Infant) Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Cruising usually occurs around 8 to 12 months. This development may or may not be present. 2 This is incorrect. At about 7 to 10 months, a child begins to crawl. This development may or may not be present. 3 This is incorrect. Infants develop a pincer grasp around 10 months. It is not expected for the infant to have this development. 4 This is correct. At 7 months, most children can sit up by themselves. This is an assessment for a definite development skill. PTS: 1 CON: Growth and Development 11. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 163 (V1) Heading: EXAMPLE PROBLEM: Abuse, Neglect, and Violence Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is correct. Negative comments or comparisons with another child can be an indicator of or potential for child abuse. The nurse needs to determine whether this is an actual problem. 2 This is incorrect. Head lice are a common health problem among children of this age group because of close physical contact during play. The parent seems to have a healthy attitude about the infestations and to be knowledgeable about the treatment. 3 This is incorrect. Imaginary play, magical thinking, and belief in mythical figures are normal at age 5 years. 4 This is incorrect. A child this age will normally imitate adults, especially the same-sex parent. PTS: 1 CON: Growth and Development 12. ANS: 3 Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Compare and contrast developmental task theory, psychoanalytic theory, cognitive theory, and the psychosocial theory of growth and development. Page: 153 (V1) Heading: Psychosocial Development Theory Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Mother–infant attachment is complex and involves all senses—not simply hearing the mother talk to him. 2 This is incorrect. There are physical and emotional benefits to breastfeeding, but it is not necessary for mother–infant attachment. 3 This is correct. Because the infant is totally dependent on the parents, quickly responding to cries promotes attachment and trust. Although all options may promote attachment, they are not absolutely necessary for bonding to occur. 4 This is incorrect. Sleeping in the same room may help the parent respond more quickly to the infant’s needs but is not the basis for attachment. PTS: 1 CON: Growth and Development 13. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 172 (V1) Heading: School-Age: Ages 6 to 12 Years Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. The identified group of children may be just starting puberty, so sexual activity is still not usual. This is not the most important topic for the nurse to present. 2 This is incorrect. The discussion of appropriate food choices should be conducted periodically throughout the child’s developmental stages; it is not specific or limited to age 10 to 12 years. 3 This is correct. All are important topics to discuss with school-age children, but children of this age are very active, and injuries are common. Motor vehicle accidents are a common cause of injury. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 4 This is incorrect. The preteen years are particularly important for adequate sleep and rest primarily because of the physical changes, active social lives, and increasingly complex demands on their lives. However, this is not the most important topic for the nurse to present. PTS: 1 CON: Growth and Development 14. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 184 (V1) Heading: Young Adulthood: Ages 19 to 40 Years Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is correct. Striving to be self-sufficient and successful and to establish a career and family are the tasks for this age. These tasks are demanding and can be emotionally difficult and potentially cause depression. Untreated depression is a leading cause of death among young adults. 2 This is incorrect. Sexually transmitted infections are a risk for this age group but are not as severe a threat as is depression. 3 This is incorrect. Exercise is important to overall health but is not a source of stress; however, it is not the most important question to ask. 4 This is incorrect. There are genetic health problems that can impact the client, but the question is asking about psychosocial development and common health problems. PTS: 1 CON: Growth and Development 15. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 158 (V1) Heading: The Neonatal Period: Birth to 28 Days Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Stroking the bottom of the foot is not an assessment of circulation to the feet. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 2 This is incorrect. The neuromuscular system is not fully developed at birth, but reflexes are present. 3 This is correct. The Babinski reflex is elicited by stroking upward on the side of the sole of the foot. This is one of several reflexes that should be present at birth. 4 This is incorrect. Because an infant is not able to report sensation, which is a subjective finding, this is not the purpose of the nurse’s action. PTS: 1 CON: Growth and Development 16. ANS: 2 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Describe special assessments unique to each age group. Page: 185 (V1) Heading: Assessment (Young Adults) Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Colon cancer screening starts at age 50 years or older for both males and females. 2 This is correct. Testicular self-exam can be introduced in early adolescence, due to risk of testicular cancer after puberty. Men need to perform monthly testicular exams until they are 40 years old or older. 3 This is incorrect. Prostate exams are part of an annual health exam for middle adults; there is no definitive reason to begin this screening for young adults. 4 This is incorrect. Even young adults should perform breast self-examination (although some practitioners question recommending it routinely). Whatever screening method is chosen, young adults, both male and female, do develop breast cancer; it is not a problem only for those past age 40. PTS: 1 CON: Growth and Development 17. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 173 (V1) Heading: Psychosocial Development of the School-Age Child Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Moderate Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Feedback 1 This is incorrect. Pride in showing off new skills and possessions is normal for all stages of development, particularly during the preschool period. 2 This is incorrect. Friendships are typically between those the same sex at this age. 3 This is incorrect. A value system does not start to develop until adolescence. 4 This is correct. Peers are increasingly more important to the school-age child. The child wants to have what his friends have. PTS: 1 CON: Growth and Development 18. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 173 (V1) Heading: School-Age: Ages 6 to 12 Years Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. If a nurse suspect child abuse, the nurse is legally responsible for reporting the observations; in this setting, suspicions will be reported to the nurse’s supervisor. 2 This is incorrect. The nurse can notify the physician, who is also obligated to report suspected abuse; however, it is not incorrect for the nurse to report to the supervisor. 3 This is correct. If the nurse suspects child abuse, the nurse is legally responsible for reporting any observations that support the suspicion. The nurse contacts the nurse’s supervisor and does not report the suspected abuse directly. 4 This is incorrect. The nurse does not continue to question the parent, which may cause the parent to become angry and leave the facility. This action places the child at greater risk. PTS: 1 CON: Growth and Development 19. ANS: 2 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Incorporate developmental principles into nursing care. Page: 162 (V1) Heading: Table 9-1: Havighurst’s Developmental Task Theory Integrated Processes: Nursing Process Client Need: Physiological Integrity: Physiological Adaptation Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Feedback 1 This is incorrect. Havighurst does not support the idea that many infants and toddlers will lag behind in physical development. Instead, the theory supports a person moving through six life stages, each associated with a number of tasks that must be learned. 2 This is correct. Havighurst’s theory states failure to master a task leads to difficulty mastering future tasks and interacting with others. This is the information the nurse needs to convey to the parent of a toddler who is not meeting developmental expectations. 3 This is incorrect. Some young children may require additional time for developmental tasks, such as, children who are born prematurely or experience serious illnesses or conditions. However, the scenario does not cite either of these causes. 4 This is incorrect. The inability to meet developmental tasks is a matter of concern. Havighurst’s theory is based on the concept of a developmental task being “midway between an individual need and societal demand. It assumes an active learner interacting with an active social environment.” PTS: 1 CON: Growth and Development 20. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Outline the major principles involved in moral and spiritual development. Page: 154 (V1) Heading: Spiritual Development Theory Integrated Processes: Nursing Process Client Need: Psychological Integrity Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is correct. Fowler’s Spiritual Development Theory recognizes six stages. Stages 0, 1, and 2 are closely associated with evolving cognitive abilities. In these stages, faith depends largely on the views expressed by parents, caregivers, and those who have significant influence in the life of the person. This is the information the nurse needs to share. 2 This is incorrect. Fowler’s stage 3 coincides with the ability to use logic and hypothetical thinking to construct and evaluate ideas. At this point, faith is largely a collection of conventional, unexamined beliefs. Fowler’s studies demonstrated that approximately one- fourth of all adults function at this level or lower. This principle is not applicable to children alone. 3 This is incorrect. Fowler’s stages 4, 5, and 6 represent increasing levels of refinement of faith. With each increase in level, there is decreasing likelihood that an individual can attain this stage of development. Fowler found that very few people achieve stage 6; it is not expected to be obtained by adolescence. 4 This is incorrect. The statement that parents without a personal understanding of faith will Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 need professional assistance, is not part of Fowler’s Spiritual Development Theory. PTS: 1 CON: Growth and Development 21. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 180 (V1) Heading: Adolescent Pregnancy Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is correct. In this item, safety is the first concern. The mother needs education about the dangers of shaking the baby. Abusive head trauma (AHT), formerly known as “shaken-baby syndrome,” is a form of child abuse that causes severe brain injury. However, in this item, it appears that the mother is open and honest about her concerns and does not know the dangers of shaking the baby. 2 This is incorrect. Further assessment and questioning are indicated prior to reporting child abuse. 3 This is incorrect. It is most important to first teach the mother the dangers of shaking the baby; then, the nurse can proceed with offering suggestions on managing a crying baby. 4 This is incorrect. In incidences of adolescent pregnancy and parenthood, the presence of a significant other is commonly missing. The nurse needs to concentrate on teaching the mother safe and effective parenting skills. PTS: 1 CON: Growth and Development 22. ANS: 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Incorporate developmental principles into nursing care. Page: 169 (V1) Heading: Assessment (Toddlerhood) Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is incorrect. Toddlers are too young to understand verbal explanations about the physical examination. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 2 This is incorrect. Toddlers are attempting to exercise some level of independence and cannot be expected to control the pace of the examination. The nurse needs to complete assessment tasks in a timely manner while promoting calmness in the toddler. 3 This is incorrect. Parents are encouraged to relieve their child’s stress and anxiety by holding the child during the examination and speaking to the child in a calm and reassuring voice. Asking the parents to leave the examination room will intensify the child’s anxiety and decrease cooperation. 4 This is correct. When performing an assessment on a toddler, the nurse must be sensitive to the fact that children of this age are generally fearful of strangers. Thus, before beginning an assessment, the nurse needs to establish a rapport with the child. To do so, the nurse might engage in play, for example, playing catch with a ball. PTS: 1 CON: Growth and Development 23. ANS: 1 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 154 (V1) Heading: Moral Development Theory: Gilligan Integrated Processes: Nursing Process Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Moderate Feedback 1 This is correct. Suspected child abuse and elder abuse must be reported to the appropriate agency, according to federal and state laws. Reporting spousal abuse may be mandatory, depending on the state law. The Joint Commission requires that all cases of possible abuse or neglect be immediately reported in the hospital. If a patient discloses domestic violence, act immediately. Ask the patient whether she would like you to contact the agency’s domestic violence advocate (if there is one). If not, provide contact information for community domestic violence programs. 2 This is incorrect. When the nurse states that the issues are between the client and the spouse, the nurse essentially indicates that abuse is a personal problem that is not a concern of the nurse. Offering the services of a social worker may or may not be useful. 3 This is incorrect. Initially, the time frame of abuse is not the most important information; the client needs someone who can offer safety measures. 4 This is incorrect. It is true that the client may need to be examined by the physician for injuries; however, the nurse needs to obtain a support person for the client first. PTS: 1 CON: Growth and Development 24. ANS: 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Objective: Discuss the principles of growth and development. Page: 185 (V1) Heading: Physical Development of Middle Adults Integrated Processes: Nursing Process Client Need: Physiological Integrity: Physiological Adaptation Cognitive Level: Comprehension [Understanding] Concept: Growth and Development Difficulty: Easy Feedback 1 This is incorrect. Graying hair, decreasing muscle tone, decreasing bone mass, and decreasing elasticity of blood vessels are physiological changes in this age group; however, the principal change in a woman in this age group is menopause. 2 This is incorrect. Breast cancer is a common health problem but not an expected or principal change in this age group. 3 This is correct. One of the principal changes that middle-aged women experience is menopause, the cessation of menstrual periods for at least 12 months. Some symptoms include hot flashes, a decrease in breast size, nighttime awakenings, and mood swings. However, each patient is different and experiences different symptoms. 4 This is incorrect. Mood swings may be related to menopause; however, this manifestation is not a principal change. PTS: 1 CON: Growth and Development 25. ANS: 2 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss age-appropriate interventions for each age group. Page: 176 (V1) Heading: Psychosocial Development of Adolescents Integrated Processes: Nursing Process Client Need: Safe and Effective Care Environment: Management of Care Cognitive Level: Application [Applying] Concept: Growth and Development Difficulty: Difficult Feedback 1 This is incorrect. Confidentiality is important in this age group; however, if there is concern about suicide, explain to the adolescent that you are required to share this information with others, including mental health specialists and his parents. Contacting the parents is important, but the first action is to make a mental health referral. 2 This is correct. Depression affects up to 8.3% of adolescents in the United States, and the percentage may be even higher. Adolescents who report feeling sad or hopeless almost every day for more than 2 weeks usually stop doing some activities they used to consider fun. Additionally, they may have difficulty identifying and describing their emotional or mood states. In this item, the male is expressing how he feels. He is also describing a severe depressive state by stating, “I do not want to go on.” The nurse must be alert to this Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 and immediately intervene by making a mental health referral, as this male is at high risk for suicide. 3 This is incorrect. The information in this scenario indicates the adolescent is beyond the stage of learning about coping strategies. The nurse needs to recognize the risk of suicide and initiate interventions to protect the adolescent and others. 4 This is incorrect. Contacting the adolescent’s teachers is unnecessary and can be considered a breach in confidentiality. PTS: 1 CON: Growth and Development MULTIPLE RESPONSE 26. ANS: 1, 2, 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 177 (V1) Heading: Common Health Problems of Adolescents Integrated Processes: Nursing Process Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is correct. Appropriate teaching topics to prevent obesity in adolescents include eating smaller portions and maintaining a well-balanced diet. 2. This is correct. Appropriate teaching topics is aimed at teaching the adolescent to identify and select healthier snacks. 3. This is incorrect. During a development stage in which adolescents strive for independence, avoid highly restrictive diets that forbid favorite foods (e.g., fast foods, sodas). 4. This is correct. Appropriate teaching topics to prevent obesity in adolescents include avoiding sedentary lifestyles by adhering to an exercise program. 5. This is incorrect. Following diet trends may be effective for short-term weight loss but does not lead to sustained weight maintenance. PTS: 1 CON: Growth and Development 27. ANS: 3, 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 177 (V1) Heading: Common Health Problems of Adolescents Integrated Processes: Teaching and Learning Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is incorrect. Condoms alone are not a fail-proof method of avoiding pregnancy or STIs. 2. This is incorrect. STIs can be transmitted orally; oral sex still requires the use of a condom. 3. This is correct. Sexual experimentation is common among teenagers. STIs, including HIV/AIDS, and pregnancy are major health consequences associated with sexual activity, especially with unprotected sexual activity. 4. This is correct. Use of condoms and safe sex practices are essential in preventing the unwanted consequences of sexual activity. However, condoms are not 100% effective in preventing either STIs or pregnancy. 5. This is incorrect. STIs can be transmitted during oral or anal sex. PTS: 1 CON: Growth and Development 28. ANS: 1, 2, 4, 5 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss age-appropriate interventions for each age group. Page: 170 (V1) Heading: Psychosocial Development of Preschoolers Integrated Processes: Nursing Process Client Need: Psychosocial Integrity Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is correct. Verbal skills of a preschooler expands dramatically, and they are increasingly interested in books and reading. 2. This is correct. Psychosocially, the child at this age develops a conscience and readily recognizes right from wrong. 3. This is incorrect. Preschoolers do lack the ability to reason formally and are unable to understand that two objects that appear different may, in fact, be the same, for example, ice and water. 4. This is correct. Preschoolers are interested in counting and are willing to readily share information about their accomplishments and independence. 5. This is correct. Preschoolers age 4 to 5 years become increasingly verbal and independent but are also interested in learning. Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 PTS: 1 CON: Growth and Development 29. ANS: 1, 2 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss age-appropriate interventions for each age group. Page: 175 (V1) Heading: Helping the Hospitalized Child Integrated Processes: Nursing Process Client Need: Physiological Integrity: Basic Care and Comfort Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is correct. School-age children are bothered by separations from family and friends and by the loss of control over their personal needs. Hospitalized children may fear the unknown, the strange environment, and strange professionals. The nurse can help by maximizing their contact with friends and school. 2. This is correct. They report missing the comforts of home, their mother’s cooking, their own room, and so on. Encourage parents to bring familiar items from home to personalize their space. 3. This is incorrect. Offer children choices, when possible, to restore some sense of control. For example, allow them to express meal preferences or times for bathing. 4. This is incorrect. Involve parents in their care as much as possible, and provide the parents with accurate information so that they can relieve the child’s anxieties. 5. This is incorrect. Pretend play is an effective way to decrease anxiety in preschool-age children. The school-age child would not likely to be interested in this intervention. PTS: 1 CON: Growth and Development 30. ANS: 2, 3 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 176 (V1) Heading: Psychosocial Development of Adolescents Integrated Processes: Teaching and Learning Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is incorrect. One of the strongest needs for teens is to feel accepted within a group of their own choosing. Acceptance on a sports team, in a club, or in a clique increases the teen’s Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 sense of self-esteem. Additionally, adolescents may engage in the trend of body art and piercings for a number of reasons, including a desire for social bonding, desire to look like their peers, and the wish to commemorate a friend or loved one. Therefore, tattoos and piercings are not necessarily an indication of low self-esteem. 2. This is correct. Tattoos and piercings can be a source of blood-borne diseases, such as HIV and hepatitis, and parents and teens should be educated about this. 3. This is correct. Tattoos and piercings can cause skin infections, and parents and teens should be educated about this. 4. This is incorrect. Although studies have reported a significant relationship between piercing and substance abuse, leading some to speculate that body piercing may serve as a marker of an at-risk teen, most teens who have tattoos and piercings do not have a substance abuse problem. 5. This is incorrect. The decision to obtain body piercing and/or tattoos is not necessarily an indication of psychosocial problems. PTS: 1 CON: Growth and Development 31. ANS: 3, 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Discuss the cognitive and psychosocial challenges for each age group, infant through middle age. Page: 183 (V1) Heading: Other Health Promotion Activities Integrated Processes: Teaching and Learning Client Need: Physiological Integrity: Reduction of Risk Potential Cognitive Level: Analysis [Analyzing] Concept: Growth and Development Difficulty: Difficult Feedback 1. This is incorrect. Listening to the radio can be a distraction while driving, but not to the same degree of high risk as texting and drinking. Changing channels while driving is a greater risk because it involves taking eyes off the road. 2. This is incorrect. Talking to other people in the car while driving is commonly not a distraction, provided the conversation is low key and does not include “horsing around.” Texting and drinking pose a higher degree of risk. 3. This is correct. In the United States, 77% of all deaths among young people age 10 to 25 years result from four causes; motor vehicle crashes are responsible for 30% of these. Texting while driving poses a high risk for accidents. 4. This is correct. Many adolescents engage in behaviors that increase the risk for and likelihood of death or injury, including driving and drinking. 5. This is incorrect. Eating snacks while driving may or may not be a cause of accidents. The type of snacks is a consideration. Nonmessy finger foods may not be a problem, but eating Downloaded by Shannon Downing ([email protected])  lOMoARcPSD|47336272 messy foods can definitely contribute to accidents. Texting and drinking are the higher-risk activities. PTS: 1 CON: Growth and Development 32. ANS: 1, 2, 4 Chapter: Chapter 9 Life Span: Infancy Through Middle Adulthood Objective: Identify common health problems seen in each stage of development. Page: 186 (V1) Heading: Common Health Problems of Middle Adults Integrated Processes: Teaching and Learning Client Need: Health Promotion and Maintenance Cognitive Level: Analysis [Analyzing] Difficulty: Difficult Feedback 1. This is correct. Obesity, diabetes mellitus, hypertension all increase the incidence of cardiovascular disease. Health promotion and health screenings should be conducted in all these areas. 2. This is correct. In middle adulthood, chronic diseases emerge as a major health problem. One of the most common is cancer, especially cancers of the lung, breast, colon, and prostate. Health promotion and health screenings should be conducted in all these areas. 3. This is incorrect. Alcoholism is a health problem in many age groups, but it is not classified as a major health problem among middle-aged adults. 4. This is correct. Obesity becomes a higher risk to the health of the middle-aged adult because of a likelihood of decreased physical activity, along with some physiological changes, such as arthritis. 5. This is incorrect. Sports injuries are not classified as a major health problem among middle- aged adults; playing competitive and contact sports is not common in this age group. PTS: 1 CON: Growth and Development Downloaded by Shannon Downing ([email protected])