Growth and Development Chapter 6-8 PDF

lOMoARcPSD|26218436 Chapter 6: Prenatal Influences on Healthy Development Leifer: Growth and Development Across the Lifespan, 3rd Edition MULTIPLE CHOICE 1. The Human Genome Project i...

lOMoARcPSD|26218436 Chapter 6: Prenatal Influences on Healthy Development Leifer: Growth and Development Across the Lifespan, 3rd Edition MULTIPLE CHOICE 1. The Human Genome Project is credited with the development of significant research on the subject of: a. analysis of chemicals that make up RNA. b. prevention of birth defects. c. ethical use of stem cells. d. gene mapping. ANS: D The Human Genome Project was involved in gene mapping, which determined the make-up of all human genes. DIF: Cognitive Level: Comprehension REF: p. 84 OBJ: 1 TOP: The Genome Project KEY: Nursing Process Step: Implementation MSC: NCLEX: NA 2. The ELSI program has been developed for the purpose of: a. promoting fund raising for the study of gene therapy. b. publishing up-to-date information on the progress of gene therapy. c. evaluating the ethical, legal, and social implications of gene therapy. d. educating the general public about the benefits of gene therapy. ANS: C The ELSI program’s purpose is to evaluate the ethical, legal, and social implications of gene therapy. DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 1 TOP: ELSI program KEY: Nursing Process Step: NA MSC: NCLEX: NA 3. The newlywed couple most appropriately referred to genetic counseling would be the: a. couple who feel they must have a male child. b. couple who both have family histories of schizophrenia. c. couple of two different cultures. d. couple, one of whom has sickle cell trait. ANS: D Counseling is a significant consideration for persons with sickle cell trait who need information about the probability of passing the disease on to the next generation. DIF: Cognitive Level: Analysis REF: p. 86 OBJ: 1 TOP: Genetic counseling KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 4. A woman who is 14 weeks pregnant says that she has abstained from alcohol during her first trimester and would like to know if it is now safe to have a drink with dinner. The health-care worker’s best response would be: a. “As you are in your second trimester, there is no problem with having one drink with dinner.” b. “One drink every night is too much. One drink three times a week should be fine.” c. “Because no one knows how much or how little alcohol it takes to cause fetal problems, it is recommended that you abstain throughout your pregnancy.” d. “Because you are in your second trimester, you can drink as much as you like.” ANS: C Maternal ingestion of substances such as alcohol can interfere with cell growth in the developing fetus. DIF: Cognitive Level: Application REF: p. 92 OBJ: 4 TOP: Teratogens KEY: Nursing Process Step: Intervention MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 5. The home health-care worker visiting a pregnant woman in her second trimester observes the patient doing chores and performing errands. Because of a threat to the fetus, the woman should refrain from: a. walking a mile to the grocery store. b. sweeping the floor with a broom. c. using bleach when doing the wash. d. emptying and cleaning the cat box. ANS: D Contact with cat litter boxes poses a threat of contracting toxoplasmosis. DIF: Cognitive Level: Comprehension REF: p. 92 OBJ: 3 | 4 TOP: Toxoplasmosis KEY: Nursing Process Step: Intervention MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease Copyright © 2022, Elsevier Inc. All rights reserved. 1 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 6. According to parental role development theory, the reality of the pregnancy occurs for the couple when: a. the mother is aware that she has missed her period. b. the pregnancy is confirmed in the first trimester. c. movement is felt in the second trimester. d. actual plans for the birth are made in the third trimester. ANS: C According to the parental role development theory, the reality of the pregnancy and the introduction of a new baby into a family unit usually occurs in the second trimester when movement is felt and ultrasound pictures are taken. DIF: Cognitive Level: Comprehension REF: p. 93 OBJ: 9 TOP: Parental role development KEY: Nursing Process Step: NA MSC: NCLEX: NA 7. The difference between a nurse midwife and a doula is that a doula is a: a. registered nurse with advanced training in labor and delivery. b. registered nurse with advanced practice education. c. specially trained coach that stays with the mother during labor and delivery. d. medical doctor with advanced education in women’s health. ANS: C A doula is a person who will act as a coach during labor and delivery. This person is not necessarily a nurse. DIF: Cognitive Level: Comprehension REF: p. 95 OBJ: NA TOP: Doula KEY: Nursing Process Step: NA MSC: NCLEX: NA 8. A new mother of a baby girl who has a 2 1/2-year-old son at home says, “I don’t know how I’ll ever manage both children when I get home.” The most informative response would be: a. “Your son is a big brother now and will love his new sister.” b. “You might consider letting your son stay with his grandparents for several weeks to allow him to adjust to the new baby.” c. “Make sure your husband bonds with your son while you are busy with your new daughter.” d. “You may see babyish behavior in your son, which is a typical reaction.” ANS: D Sibling rivalry is the competition between siblings for parental love and attention. Toddlers may regress and be angry at the birth of a new sister or brother. DIF: Cognitive Level: Application REF: p. 99 OBJ: 11 TOP: Regression KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 9. The health-care worker observes several interactions between a postpartum woman and her newborn. The behavior that would be assessed as maladaptive is: a. seldom making eye contact with the baby. b. reading a magazine while the baby sleeps. c. cuddling the baby close to her chest. d. telling visitors how well the baby is feeding. ANS: A Bonding is the term often used to describe the emotional relationship that begins to develop between parent and newborn in the first few hours or days after birth. Touch and visual interaction are critical factors in facilitating this process. DIF: Cognitive Level: Comprehension REF: p. 96 OBJ: 11 TOP: Bonding KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 10. A 15-year-old mother seems to ignore her newborn. A strategy that the health-care worker can use to facilitate mother–infant attachment in this mother is to: a. tell the mother that she must pay attention to her baby. b. show the mother how the baby initiates interaction in face-to-face encounters. c. demonstrate for the mother different positions for holding her baby while feeding. d. arrange for the mother to watch a video on parent–infant interaction. ANS: B Facilitating the mother’s appreciation of the newborn’s reaction to her in a face-to-face encounter can stimulate bonding. DIF: Cognitive Level: Application REF: p. 97 OBJ: 11 TOP: Stimulation of bonding KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation Copyright © 2022, Elsevier Inc. All rights reserved. 2 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 11. “Taking hold” is occurring when the new mother: a. requests help with ambulation and perineal care. b. shows interest in learning more about infant care. c. sleeps most of the time when the baby is not present. d. is very excited and talkative about the birth experience. ANS: B According to Reva Rubin, the “taking hold” phase is introduced when the mother begins to initiate care of the newborn and is most receptive to teaching at this stage. DIF: Cognitive Level: Comprehension REF: p. 98, Table 6-2 OBJ: 9 TOP: Transition to motherhood KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 12. During a telephone follow-up conversation 5 days postpartum, the woman tells the health-care worker, “I don’t know what’s wrong with me. I love my baby, but I seem to be crying all the time!” The woman is most likely experiencing: a. taking-in. b. letting go. c. postpartum blues. d. attachment. ANS: C During the transition to motherhood, mood swings are common. Conflicting feelings of happiness and depression are called postpartum blues, and the symptoms are generally self-limiting. DIF: Cognitive Level: Application REF: p. 97 OBJ: 9 TOP: Postpartum blues KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: coping and adaptation 13. The home health-care worker can help a father in his transition to parenthood by: a. pointing out that the infant recognizes his voice. b. asking him what child care arrangements have been made. c. teaching him to tape the baby’s diaper a different way. d. reminding him that he must be ready to help with household chores. ANS: A Fathers develop an intense focus on the newborn, called engrossment. An outstanding response to this is one of strong attraction to the newborn, leading to the development of strong bonds with the infant over time. Subsequently, fathers often reevaluate their relationship with their own parents. DIF: Cognitive Level: Application REF: p. 98 OBJ: 11 TOP: Fathers or significant others KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 14. The mother asks how much her baby will sleep every day. The best response is: a. “He will only wake up to be fed, and you should not bother him between feedings.” b. “A newborn sleeps about 17 hours a day with periods of wakefulness gradually increasing.” c. “He will probably follow your same sleep and wake patterns, so you can expect him to be awake soon.” d. “You should try to limit day sleep to about 3 hours so he will sleep through the night.” ANS: B Neonates sleep 15 to 20 hours a day in the first 3 to 4 weeks of life. By 4 weeks, some infants stay awake from one feeding to the next. DIF: Cognitive Level: Comprehension REF: p. 101 OBJ: 9 TOP: Neonatal sleep patterns KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 15. Parents of a newborn ask about the baby’s vision and specifically want to know what visual stimuli they should provide for the newborn. The most appropriate response is: a. “Babies can see very little until about age 3 months.” b. “It is important to shield the baby’s eyes. You should ask your physician what visual stimulation to offer your child.” c. “The baby’s eyes are immature and must be protected. Any visual stimuli should not contain bright or strong colors.” d. “Newborns have good near vision. A brightly colored mobile to hang over the crib is a good choice for your baby.” ANS: D The newborn can both see and hear. A musical mobile would capture the baby’s attention via hearing and vision. DIF: Cognitive Level: Application REF: p. 104 OBJ: 13 TOP: Visual stimuli KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 3 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 16. Characteristics of dizygotic twins include their being: a. of the same sex. b. formed from the same single ovum and sperm. c. always carried to full term. d. similar to each other as any sibling. ANS: D Dizygotic twins (fraternal) occur when two ova are released and both ova are fertilized by two different sperm. The two embryos are not necessarily of the same sex and will resemble each other no more than any other siblings. Many twins are born prematurely as the uterus becomes overdistended. DIF: Cognitive Level: Comprehension REF: p. 90 OBJ: 7 TOP: Dizygotic twins KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 17. A young, newly pregnant woman who led a sedentary life prior to pregnancy asks what sort of exercise would be beneficial. Helpful suggestions would be to engage in regular: a. aggressive exercise at a gym. b. jogging. c. lifting free weights. d. swimming. ANS: D Swimming is a good light exercise program to recommend to a previously sedentary pregnant woman. DIF: Cognitive Level: Application REF: p. 93 OBJ: 6 TOP: Exercise KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: physiological adaptation 18. Warnings that are appropriate to an exercising pregnant woman in her second trimester of pregnancy would include: a. limiting water while exercising to prevent hypertension. b. avoiding exercises that require the supine position. c. performing exaggerated range-of-motion exercises. d. exercising strenuously to supply extra heat and blood to the placenta. ANS: B Exercising should be moderated so that no supine positions are assumed after the second trimester to avoid cord compression. While exercising, adequate hydration should be maintained. Excessive heat increases the oxygen needs of the fetus and should be avoided. DIF: Cognitive Level: Comprehension REF: p. 93 OBJ: 6 TOP: Exercise KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: reduction of risk 19. The pH of the female reproductive tract and estrogen level have an effect on fertilization in that they: a. soften the ovum to enhance fertilization. b. can trap defective sperm. c. determine the sex of the fetus. d. affect the speed of the ova and sperm entering the fallopian tube. ANS: D Vaginal pH and the estrogen level of the female enhance the speed of the movement of the sperm and the ova into the fallopian tube where fertilization occurs. DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 2 TOP: Fetal development KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 20. The young pregnant woman with type 2 diabetes mellitus should get at least ____ minutes of exercise a day to control weight and blood glucose. a. 10 b. 15 c. 30 d. 60 ANS: C Thirty minutes per day of light exercise will help control weight and control glucose levels. DIF: Cognitive Level: Comprehension REF: pp. 92-93 OBJ: 4 | 6 TOP: Exercise during pregnancy KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: physiological adaptation 21. Development of neural tube defects seems to be more common in the fetuses of pregnant women whose diet is low in: a. iron. b. vitamin D. c. folic acid. d. essential amino acids. ANS: C Research has shown a higher incidence of neural tube defects in fetuses of women with folic acid deficiency. In 1992 the U.S. Public Health Service recommended that all women of childbearing years consume 0.4 mg of folic acid daily. DIF: Cognitive Level: Comprehension REF: p. 87 OBJ: 3 | 4 TOP: Folic acid KEY: Nursing Process Step: NA MSC: NCLEX: NA Copyright © 2022, Elsevier Inc. All rights reserved. 4 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 22. The term fetus refers to an embryo that is _____ weeks old. a. 2 b. 3 c. 6 d. 9 ANS: D From the 9th week of life, the embryo is called a fetus. DIF: Cognitive Level: Knowledge REF: p. 87 OBJ: 3 TOP: Fetus KEY: Nursing Process Step: NA MSC: NCLEX: NA 23. The Moro (startle) reflex, which is present at birth, disappears normally at the age of: a. 3 months. b. 4 months. c. 5 months. d. 6 months. ANS: A The Moro (startle) reflex disappears 1 to 3 months after birth. DIF: Cognitive Level: Comprehension REF: p. 103, Table 6-3 OBJ: NA TOP: Reflexes KEY: Nursing Process Step: NA MSC: NCLEX: NA 24. Good prenatal nutrition is stressed to an expectant mother because poor nutrition could increase the baby’s risk of _____________ in later life. a. diabetes b. kidney failure c. respiratory disorders d. coronary artery disease ANS: D Inadequate prenatal nutrition can alter the structure of the baby’s body and lead to coronary artery disease or stroke. DIF: Cognitive Level: Comprehension REF: pp. 90-91 OBJ: 4 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 25. The prenatal intervention that would be most helpful to a prospective father about his new role would be to: a. explain the physiological and psychological changes he can expect in the mother. b. demonstrate diapering and bathing techniques. c. let him verbalize his feelings about the pregnancy and fatherhood. d. encourage him to think about his role in the pregnancy. ANS: C Future changes in sleep patterns, household responsibility, and financial concerns are stressful to the father and may need to be verbalized. DIF: Cognitive Level: Application REF: p. 98 OBJ: 11 TOP: Paternal adaptations during the prenatal phase KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation 26. The single most important influence on appropriate growth and disease prevention at all stages of development is: a. nutrition. b. heredity. c. culture. d. environment. ANS: A Lack of proper nutrition during critical periods of fetal development can cause maldevelopment or malfunction of a specific organ or system that may not be manifested until adulthood. One of the goals of Health People 2020 is to prevent disease in the next generation by improving the nutrition of mothers and babies. DIF: Cognitive Level: Comprehension REF: p. 91 OBJ: 4 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 27. The most effective time for interaction between parents and the new baby is when the baby is in the state of: a. active alert. b. crying. c. drowsiness. d. quiet alert. ANS: D During the quiet alert state, the infant responds to the environment by staring at close-range objects and people. This is a good time for visual contact and conversation by the sibling. DIF: Cognitive Level: Comprehension REF: p. 101 OBJ: 11 TOP: Developmental tasks and responses KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 5 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 28. A woman delivered a baby 1 hour ago. The nurse is ready to assist her with breastfeeding. The woman states she cannot breastfeed until her “good” milk comes in. She says she is afraid the “thin” milk will harm the baby. The nurse’s best response is: a. “You should begin breastfeeding now or your milk will never come in.” b. “I understand that you believe this colostrum is unhealthy for the baby. Let’s talk about feeding alternatives until your milk comes in.” c. “If you don’t provide your baby with the benefits of colostrum, he will have more childhood illnesses than normal.” d. “Your baby will not learn to suck correctly if you don’t start breastfeeding now.” ANS: B In the provision of culturally competent care, the nurse needs to understand and respect the beliefs and practices of the families in his or her care. DIF: Cognitive Level: Application REF: p. 101 OBJ: NA TOP: Culturally competent care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: psychosocial adaptation 29. After the delivery of the newborn, the major focus for its well-being is to: a. initiate hydration. b. provide nutrition. c. prevent heat loss. d. stimulate bonding. ANS: C After delivery, the newborn is dried, placed in a prewarmed bed, and the head is covered to minimize heat loss. DIF: Cognitive Level: Application REF: p. 96 OBJ: NA TOP: Heat loss KEY: Nursing Process Step: NA MSC: NCLEX: NA 30. After delivery, the new father is staring intently at his newborn and lightly running his fingertips over the baby’s face. The father is beginning: a. parenting. b. engrossment. c. development. d. identification. ANS: B Fathers or significant others develop an intense focus on the newborn, called engrossment. Characteristics of engrossment include touch and eye-to-eye contact as the father seeks to identify features both unique to the newborn and similar to himself. An outstanding response is one of strong attachment to the infant and a sense of increased self-esteem. DIF: Cognitive Level: Knowledge REF: p. 98 OBJ: 11 TOP: Fathers or significant others KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 31. A woman rejects the plan for her to bring the newborn to the health clinic before the seventh day of life to repeat the test for phenylketonuria (PKU) stating that it is too early for her to come. The culturally competent health-care worker would ask: a. “Do you lack transportation to the clinic?” b. “Isn’t your baby’s health important enough to come to the clinic?” c. “Do you realize that the state requires this test to be done?” d. “Do you need more time to heal after your delivery?” ANS: D To provide culturally competent care, the health-care worker must understand that in some cultures the postpartum period may last 30 days or longer, with the woman forbidden from leaving the home. DIF: Cognitive Level: Analysis REF: p. 101 OBJ: 10 TOP: Culturally competent care KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation MULTIPLE RESPONSE 1. Methods of holding a neonate that are comforting and consoling to the baby and reinforce bonding include: (Select all that apply.) a. holding baby upright on parent’s knee. b. placing the nude baby on the naked chest of the parent. c. swaddling the baby. d. cuddling the baby. e. the football hold supporting baby with one arm. ANS: B, C, D Close, warm positions quiet and soothe a baby and encourage bonding. DIF: Cognitive Level: Comprehension REF: p. 102 OBJ: 11 TOP: Comfort and bonding KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 6 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 2. In speaking with a group of parents, the health-care worker informs them that in the case of a premature delivery, the fetus of 25 weeks gestation has many attributes that would help support extrauterine life. These include: (Select all that apply.) a. surfactant in the lungs. b. respiratory movements. c. a functioning central nervous system (CNS). d. smooth skin. e. subcutaneous fat. ANS: A, B The 2-week-old fetus is viable and has surfactant in the lungs and has begun respiratory movements, but the CNS is not fully functional. There is no subcutaneous fat; therefore, the skin is wrinkled. DIF: Cognitive Level: Analysis REF: p. 90, Table 6-1 OBJ: 3 TOP: Viability KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development COMPLETION 1. A complete set of DNA contained in all human cells is referred to as a(n) __________. ANS: genome A genome is a complete set of DNA that is contained in all cells. DIF: Cognitive Level: Knowledge REF: p. 84 OBJ: 1 TOP: Genome KEY: Nursing Process Step: NA MSC: NCLEX: NA 2. The _____________ is the cell formed by the union of the sperm and ovum. ANS: zygote The zygote is the cell formed by the union of the sperm and ovum. DIF: Cognitive Level: Knowledge REF: p. 87 OBJ: 3 TOP: Fetal development KEY: Nursing Process Step: NA MSC: NCLEX: NA Copyright © 2022, Elsevier Inc. All rights reserved. 7 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 Chapter 7: The Infant Leifer: Growth and Development Across the Lifespan, 3rd Edition MULTIPLE CHOICE 1. The 5-month-old should demonstrate: a. hand-to-mouth coordination. b. neat pincer grasp. c. building a tower of two cubes. d. ability to grasp an object voluntarily. ANS: D By 5 months, newborn reflexes have disappeared and the infant is able to shape the hand to voluntarily grasp an object. DIF: Cognitive Level: Comprehension REF: p. 117, Table 7-2 OBJ: 4 TOP: Motor development KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. According to Erikson, infancy is concerned with acquiring a sense of: a. trust. b. industry. c. initiative. d. autonomy. ANS: A Trust develops when infants learn their basic needs will be met, providing the foundation for all succeeding phases of development. Trust assists infants in experiencing unknown or unfamiliar situations with minimal fear. DIF: Cognitive Level: Knowledge REF: p. 110 OBJ: 7 TOP: Trust versus mistrust KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 3. Object permanence is: a. recognizing a familiar face, such as mother. b. recognizing a familiar object, such as bottle. c. actively searching for a hidden object. d. securing objects by pulling on a string. ANS: C By 9-10 months, infants have achieved the concept of object permanence, or the realization that objects that leave the visual field can still exist. DIF: Cognitive Level: Comprehension REF: p. 111 OBJ: 2 TOP: Object performance KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 4. A parent of an 8-month-old infant says that the baby cries and screams whenever she is left with her grandparents. The reply should be based on the fact that the: a. infant is most likely spoiled. b. infant is experiencing separation anxiety. c. infant should be left with another caretaker. d. grandparents’ home may be a frightening environment. ANS: B At around 6 months of age, the infant begins to have an awareness of self and parent as separate beings. This, coupled with the development of object permanence, causes the infant to become distressed at the absence of the parent. DIF: Cognitive Level: Comprehension REF: p. 112 OBJ: 8 TOP: Separation anxiety KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 5. The parents of a 2-month-old boy are concerned about spoiling their son by picking him up when he cries. The most informative response would be: a. “Allow him to cry for no longer than 15 minutes, then pick him up.” b. “Babies need comforting and cuddling. Meeting these needs will not spoil him.” c. “Babies this young cry when they are hungry. Try feeding him when he cries.” d. “If he isn’t soiled or wet, leave him and he’ll cry himself to sleep.” ANS: B Prompt attention to an infant’s crying promotes attachment and development of trust. DIF: Cognitive Level: Application REF: p. 112 OBJ: 9 TOP: Attachment KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 1 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 6. The parents of a 6-month-old infant say that they are worried about their baby’s thumb-sucking. The reply that is most informative would be: a. “A pacifier should be substituted for the thumb.” b. “Nonnutritive sucking may indicate unsatisfied hunger.” c. “Sucking should be interrupted by diverting the baby’s attention.” d. “Nonnutritive sucking during infancy is normal.” ANS: D Nonnutritive sucking in infancy is of benefit by providing a self-regulating source of comfort. DIF: Cognitive Level: Application REF: p. 121 OBJ: 3 TOP: Sucking KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 7. The health-care worker instructs the parents of an infant that they can expect the first tooth eruption at the age of: a. 2 months. b. 6 months. c. 8 months. d. 10 months. ANS: B Normal tooth eruption occurs between 5 to 7 months with the appearance of the central incisors. DIF: Cognitive Level: Comprehension REF: p. 122 OBJ: 3 TOP: Tooth eruption KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 8. The parent of a 12-month-old says, “He pushes the spoon right out of my hand and screams when I feed him. I can’t let him feed himself, he makes too much of a mess.” The best response is: a. “It’s important not to give in to this kind of temper tantrum at this age.” b. “Maybe you need to try a different type of spoon, one designed for children.” c. “He is old enough to try to feed himself. Let’s think of ways to limit the mess.” d. “You should continue to feed him. Self-feeding may interfere with adequate nutrition.” ANS: C Self-feeding is a developmental task that is part of the first year of life and the infant’s growing need for independence. DIF: Cognitive Level: Application REF: p. 110 OBJ: 2 TOP: Developmental tasks KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 9. A 4-month-old infant is brought to the clinic by her parents for a well-baby checkup. Because 4-month-old infants are developing very fast, the health-care worker reminds parents that they can help prevent an accident by: a. using a tray on highchair as restraint rather than the restraining strap. b. placing adjustable gates at the head of the stairs. c. placing the child on the stomach to sleep at night or at nap time. d. supporting child firmly during bath time. ANS: D Good support and never leaving child unattended at the bath time can prevent an accident. Straps should be used as restraints in highchairs. Gates are not yet needed for a 4-month-old. DIF: Cognitive Level: Comprehension REF: p. 123 OBJ: 12 TOP: Accident prevention KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 10. Regarding the introduction of solid foods during infancy, the nurse would advise: a. solid foods should not be introduced until 8 to 10 months of age when the extrusion reflex begins to disappear. b. foods should be introduced one at a time, at intervals of 4 to 7 days. c. solid foods should be mixed in a bottle to make the transition easier for the infant. d. fruits and vegetables should be introduced into the diet first. ANS: B Solid foods are introduced one at a time to help parents identify a food allergy response. DIF: Cognitive Level: Comprehension REF: p. 121 OBJ: 10 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 2 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 11. The health-care worker ensures doting parents that they will hear the first meaningful words from their infant when the baby is about ______ months old. a. 6 b. 8 c. 10 d. 12 ANS: C Although infants vocalize as early as 5 to 6 weeks, it is not until they are about 10 months old that cognitive and motor development enables them to use meaningful words. DIF: Cognitive Level: Comprehension REF: p. 114 OBJ: 6 TOP: Language development KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 12. The parents of a 6-month-old infant say, “She cries sometimes after we have put her down after we have played with her. We know she is dry and has recently been fed.” The most appropriate intervention is to suggest that the baby: a. is learning elementary language skills. b. may still be hungry. c. is uncomfortable. d. still wants parental stimulation. ANS: D If the adult turns away before the infant is ready, the infant will lean forward and attempt to get the adult’s attention with sound and movement and will eventually cry with frustration. DIF: Cognitive Level: Application REF: p. 111 OBJ: 9 TOP: Attachment KEY: Nursing Process Step: Implementation MSC: NCLEX: NA 13. Even infants can develop coping skills, which allow the infant to: a. enhance speech development. b. manage a stressful situation. c. manipulate his environment. d. increase parental bonding. ANS: B Infants are capable of dealing with a stressful situation by developing a coping skill. They may climb out of an infant seat to reach a toy or move self around in the crib to see into another room. DIF: Cognitive Level: Comprehension REF: p. 114 OBJ: 2 TOP: Development of coping skills KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation 14. The parents of a 3-month-old complain that they are exhausted because she still wakes up as often as every 1 to 2 hours during the night. When she awakens, they change her diaper, and her mother nurses her back to sleep. The best suggestion would be to: a. put her in parents’ bed to cuddle. b. give the baby a pacifier while the child is in a semi-awake state. c. let her cry herself back to sleep. d. give her a bottle of formula instead of breastfeeding her so often at night. ANS: B Giving a pacifier in the semi-awake state often will help the baby return to sleep and begin to develop self-regulatory habits. DIF: Cognitive Level: Application REF: p. 116 OBJ: 2 TOP: Sleep patterns KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 15. A mother is concerned that her 12-month-old is “getting fat.” She plans to switch the infant from formula to 2% low-fat milk. Based on knowledge of infant nutrition, the best response should be: a. “That’s an excellent idea. Preventing childhood obesity is a goal of Healthy People 2020.” b. “You should give your child low-calorie juices instead of milk to prevent excessive weight gain.” c. “Formula is necessary for 2 full years to ensure proper growth.” d. “Your child needs whole milk instead of low-fat milk to promote proper growth and development.” ANS: D Fats are necessary in children under age 2 to promote development of the nervous system. DIF: Cognitive Level: Application REF: p. 121 OBJ: 10 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 3 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 16. When the parents of a 6-month-old say that they see no reason to spend money for a car seat because the baby is happier sitting in someone’s lap. The best response is: a. “As long as the baby is being held securely by an adult there is no need for a car seat.” b. “The air bag will protect both adult and baby in the event of an accident.” c. “A rear-facing car seat placed in the back seat is the safest place for your baby.” d. “A front-facing car seat placed next to the driver should keep your baby safe and happy.” ANS: C A rear-facing car seat provides the best protection for the infant’s head and neck. The back seat is preferable to help protect the infant from being ejected from the car and from injury from a front seat air bag. DIF: Cognitive Level: Application REF: p. 123 OBJ: 12 TOP: Car seats KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 17. The usual initial age at which infants begin to demonstrate meaningful social smiles in response to parental interaction is at: a. 2 months. b. 3 months. c. 5 months. d. 6 months. ANS: A Positive infant responses to parents’ interaction efforts strengthen parent–infant attachment and usually are seen at the age of 2 months. DIF: Cognitive Level: Comprehension REF: p. 112 OBJ: 9 TOP: Attachment KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 18. An appropriate play activity to encourage sensorimotor stimulation in a 7-month-old would be: a. reading a story. b. playing peek-a-boo. c. showing how to clap hands. d. imitating animal sounds. ANS: B By 6 months to 1 year, play involves sensorimotor skills as described by Piaget. Infants need to be played with. A game of peek-a-boo provides visual stimulation and interaction with the parent. DIF: Cognitive Level: Comprehension REF: p. 120 OBJ: 7 TOP: Sensorimotor stimulating play KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 19. To support the development of language skills in their child, the parents should: a. talk to the infant in their native language. b. introduce common slang words. c. employ “baby talk” to get the infant’s attention. d. speak loudly. ANS: A Parents should talk to the infant in the native language. Use of slang or baby talk may confuse or delay language development. Loud speech is not necessary to the development of language. DIF: Cognitive Level: Comprehension REF: p. 114 OBJ: 6 TOP: Language development KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 20. If parents are concerned about the fact that their 14-month-old infant is not walking, the health-care worker should particularly evaluate whether the infant: a. pulls up on the furniture. b. uses a pincer grasp. c. transfers objects. d. has developed object permanence. ANS: A Infants generally start to walk about 4 to 5 months after they are able to pull themselves up to a standing position. DIF: Cognitive Level: Application REF: p. 117, Table 7-2 OBJ: 4 TOP: Motor development KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 4 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 21. According to Freud’s theory of development, the best toy for an infant would be a: a. colorful mobile. b. rattle. c. teething ring. d. baby swing. ANS: C A teething ring satisfies the need to examine the world through the mouth, which is a characteristic of Freud’s oral stage. DIF: Cognitive Level: Comprehension REF: p. 121 OBJ: 7 TOP: Oral stage KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 22. The information that should be given to the parents of a 12-month-old regarding appropriate play activities would include which of the following? a. Provide a stick horse to develop gross motor coordination. b. Give large push-pull toys for kinetic stimulation. c. Place cradle gym across the crib to facilitate fine motor skills. d. Provide finger paints to enhance fine motor skills. ANS: B Push-pull toys foster newly mastered walking skills. DIF: Cognitive Level: Application REF: p. 120 OBJ: 4 TOP: Role of play KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 23. A child who weighed 6 pounds at birth will weigh approximately ____ pounds at the age of 12 months. a. 15 b. 18 c. 21 d. 24 ANS: B Growth is an increase in size, measured by pounds and inches. By 1 year, birth weight is generally tripled. DIF: Cognitive Level: Knowledge REF: p. 109 OBJ: 3 TOP: Growth KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 24. A 2-month-old uses the preverbal speech technique of: a. nonnutritive sucking. b. grunting. c. pointing. d. smiling. ANS: D Crying and smiling are the preverbal options for a 2-month-old. DIF: Cognitive Level: Comprehension REF: pp. 114-115 OBJ: 6 TOP: Preverbal speech KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development 25. A hospitalized 11-month-old is crying and clinging to the parents as they attempt to leave the room at the termination of visiting hours. An appropriate intervention would be to: a. encourage the parents to leave right away to minimize the child’s distress. b. provide privacy until the infant has calmed down. c. arrange for a parent to room in with the infant. d. distract the infant with toys so the parents can leave unnoticed. ANS: C Because hospitalization is a unique experience of separation filled with strangers, pain, and fear of the unknown, it is strongly recommended that a parent room in with the child. DIF: Cognitive Level: Application REF: p. 112 OBJ: 7 | 8 TOP: Attachment/Separation anxiety KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 26. At what age would the health-care worker expect an infant to be able to say “mama” and “dada” with meaning? a. 4-5 months b. 5-6 months c. 9-10 months d. 12-14 months ANS: C By 7 or 8 months, syllables using the M and D sounds appear, and by 9 to 10 months, specific meaningful sounds are used to refer to objects or events. DIF: Cognitive Level: Comprehension REF: p. 114 OBJ: 6 TOP: Language development KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 5 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 27. Interactive physical activity between parents and their baby should be focused on: a. exploring developmental movement and the environment. b. ensuring that activity times do not interfere with sleep or nutrition. c. exposure to outdoors. d. interaction with other infants. ANS: A Interactive physical activity with an infant should be focused on exploring movement and the environment. DIF: Cognitive Level: Comprehension REF: p. 120, Box 7-1 OBJ: 5 TOP: Physical activity KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 28. What is a possible indication of child abuse on an 11-month-old? a. Excessive drooling b. Cooing and reaching for the parent c. Hyperactivity during physical assessment d. Bruises in various stages of healing ANS: D The appearance of bruises in various stages of healing should alert a caregiver to possible child abuse. DIF: Cognitive Level: Comprehension REF: p. 114, Figure 7-1 OBJ: 12 TOP: Child abuse KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development MULTIPLE RESPONSE 1. Which age-appropriate toy(s) for a 3-month-old infant should be recommended? (Select all that apply.) a. Crib mobile b. Squeeze toys c. Teething toys d. Soft or furry quilt e. Stuffed animals f. Strings of big beads ANS: A, D, E These toys assist the 3-month-old in the development of visual and tactile senses, as well as in the beginning of fine motor development. DIF: Cognitive Level: Application REF: p. 120 OBJ: 2 TOP: Role of play in growth and development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. The parents of a 2-month-old bring their infant to the well-child clinic for a checkup and immunizations. Based on knowledge of immunization schedules, the health-care worker instructs the parents that the infant should receive which vaccine(s)? (Select all that apply.) a. Polio b. HepB c. MMR d. Varicella e. DTaP f. Tetanus ANS: A, B, E At 2 months, the recommended immunizations for infants are HepB, DTaP, and IPV. Although many of the immunizations can be given at any age, the recommended primary schedule begins in infancy and is completed during early childhood. This practice has contributed to the decline of preventable infectious diseases. DIF: Cognitive Level: Application REF: p. 123 OBJ: 11 TOP: Immunizations KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 3. To assist parents in understanding normal growth and development during various stages of infancy, the health-care worker must understand age-appropriate motor development. Which gross and fine motor skill(s) would be appropriate for a 9-month-old? (Select all that apply.) a. Walks with one hand held b. Uses thumb and forefinger in crude pincer grasp c. Can turn pages in a book d. Can sit down from standing position without help e. Creeps on hands and knees f. Sits steadily on floor for prolonged time ANS: B, E, F A 9-month-old has a crude pincer grasp, creeps, and can sit alone. DIF: Cognitive Level: Comprehension REF: p. 117, Table 7-2 OBJ: 4 TOP: Motor development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 6 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 COMPLETION 1. Although the child protests when the parent leaves the room, the child will develop _________ when the parent consistently returns. ANS: trust Children learn that their parents return after a separation. This learning builds the developmental task of trust. DIF: Cognitive Level: Comprehension REF: p. 114 OBJ: 2 TOP: Trust KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. _____________________ growth refers to the progression of the growth pattern that proceeds from head to toe. For example, infants are able to lift their heads before they can sit, and they are able to sit before they can stand. ANS: Cephalocaudal Cephalocaudal growth refers to the progression of the growth pattern that proceeds from head to toe. For example, infants are able to lift their heads before they can sit, and they are able to sit before they can stand. DIF: Cognitive Level: Knowledge REF: p. 116 OBJ: 3 TOP: Physical development KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 7 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 Chapter 8: Early Childhood Leifer: Growth and Development Across the Lifespan, 3rd Edition MULTIPLE CHOICE 1. A 2-year-old should be able to: a. ride a tricycle. b. climb stairs reciprocally. c. run. d. hop on two feet. ANS: C The 2-year-old is able to run, but cannot climb stairs reciprocally, hop, or ride a tricycle. DIF: Cognitive Level: Comprehension REF: p. 128 OBJ: 2 TOP: Developmental tasks KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. Erik Erikson describes the major developmental task of the toddler to be: a. trust. b. initiative. c. autonomy. d. intimacy. ANS: C According to Erikson, the toddler, between 2 and 4 years of age, is in the stage of autonomy versus shame or doubt. DIF: Cognitive Level: Comprehension REF: p. 128 OBJ: 4 TOP: Erikson’s developmental tasks of early childhood KEY: Nursing Process Step: NA MSC: NCLEX: NA 3. A parent of a 24-month-old boy say that the child has frequent tantrums and that “no” is becoming his favorite word. This behavior: a. is a response to frustration in gaining autonomy. b. is an indication of regression. c. is a signal that he is not effectively coping with stress. d. shows that he needs more attention. ANS: A Negativism is typical of toddlers in their quest for autonomy. As toddlers attempt to express their will, they may become angry in their frustration. This frustration then leads to a desire to be loved and comforted by a parent. DIF: Cognitive Level: Comprehension REF: pp. 134-135 OBJ: 4 TOP: Developmental tasks of early childhood KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 4. According to Piaget, magical thinking is the belief that: a. events have cause and effect. b. God is like an imaginary friend. c. if the skin is broken, the insides will come out. d. dolls are real people. ANS: D Because of their egocentrism, preschoolers believe that inanimate objects have real life qualities. DIF: Cognitive Level: Comprehension REF: p. 132 OBJ: 3 TOP: Cognitive development KEY: Nursing Process Step: NA MSC: NCLEX: NA 5. Most children use sentences of five words by the age of ____ years. a. 2 b. 3 c. 4 d. 5 ANS: D In a preschool child, the number of words in a typical sentence is about equal to the child’s age. DIF: Cognitive Level: Comprehension REF: p. 131 OBJ: 4 TOP: Language development and communication skills KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 1 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 6. When preparing parents to teach their children about sexuality, the health-care worker should emphasize that they should: a. treat bodily functions as secret. b. expect some masturbatory behavior. c. correct all behavior that involves nudity. d. limit parental displays of hugging or kissing. ANS: B Children in early childhood engage in normal masturbatory behavior. Young children enjoy nudity. DIF: Cognitive Level: Comprehension REF: p. 138 OBJ: 3 TOP: Sexuality in early childhood KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 7. Although a 14-month-old girl received a shock from an electrical outlet recently, her mother finds her about to place a paper clip in another outlet. The repeated behavior is due to: a. cognitive development is delayed. b. memory deficit. c. inability to understand cause and effect. d. desire for attention. ANS: C Reasoning skills are still quite underdeveloped and children at this age do not understand cause and effect. DIF: Cognitive Level: Comprehension REF: p. 142, Table 8-5 OBJ: 2 TOP: Cognitive development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 8. When a toddler snatches a toy from another toddler, this behavior is: a. representative of the aggressive nature of toddlers. b. typical behavior because toddlers are egocentric. c. a primitive attempt at sharing. d. a deliberate behavior the toddler knows to be wrong. ANS: B Toddlers see, experience, and live every event in relation to themselves. They are unable to envision situations from perspectives other than their own. They feel their point of view is the same as everyone else’s. DIF: Cognitive Level: Comprehension REF: pp. 133-134 OBJ: 2 TOP: Cognitive development KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development 9. When a 3-year-old spills his milk at the dinner table, he can be expected to: a. clean the spill up immediately. b. cry because he expects punishment. c. play in the spilled milk. d. blame his sibling for the accident. ANS: D Children of the age of 3 can differentiate an accident from an intentional act but are quick to assign blame. DIF: Cognitive Level: Comprehension REF: p. 135 OBJ: 3 TOP: Moral development KEY: Nursing Process Step: NA MSC: NCLEX: NA 10. Which nutritional recommendation will ensure the caloric and nutritional needs of young children are met? a. Use food as a reward. b. Provide nutrient dense foods. c. Limit complex carbohydrates. d. Encourage a high fiber diet. ANS: B Adequate nutrition is essential for optimal physical and mental development in young children. The U.S. Department of Agriculture recommends the consumption of nutrient-dense foods during early childhood to ensure nutritional and caloric needs are met. DIF: Cognitive Level: Comprehension REF: pp. 130-131 OBJ: 5 TOP: Nutrition KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 11. According to Kohlberg, the moral task of childhood is learning to: a. take responsibility. b. share with others. c. cooperate with others. d. recognize religion. ANS: B According to Kohlberg, the moral task of childhood is learning to share. DIF: Cognitive Level: Comprehension REF: p. 135 OBJ: 4 TOP: Moral development KEY: Nursing Process Step: NA MSC: NCLEX: NA Copyright © 2022, Elsevier Inc. All rights reserved. 2 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 12. When a toddler acquires receptive language skills, the child is able to: a. understand abstract information. b. understand simple messages. c. converse at length. d. respond with appropriate language. ANS: B The mastery of receptive language allows the toddler to understand simple messages but not abstractions. Appropriate response and lengthy conversations would indicate mastery of expressive language. DIF: Cognitive Level: Comprehension REF: p. 131 OBJ: 4 | 6 TOP: Receptive language KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 13. In the clinic waiting room, a parent is showing an 18-month-old how to build a tower out of blocks. Toddlers: a. use blocks at this age primarily for throwing. b. are too young to imitate the behavior of others. c. are capable of building a tower of blocks. d. are unable to concentrate long enough to build a tower. ANS: C During toddlerhood, imitation is one of the most distinguishing characteristics of play. By this age, toddlers have a well-developed reach, grasp, and release and are able to build a tower of three to four blocks. DIF: Cognitive Level: Comprehension REF: p. 138 OBJ: 2 TOP: Play KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 14. In the instruction about considerations relative to the use of car seats, the health-care worker lists that before a chi ld should be allowed to sit in the front seat of a car, the child should be at least ____ years of age. a. 8 b. 10 c. 12 d. 13 ANS: D The American Academy of Pediatrics (AAP) recommends that children under the age of 13 should not ride in the front seat of a vehicle. DIF: Cognitive Level: Knowledge REF: p. 140 OBJ: 10 TOP: Safety KEY: Nursing Process Step: Implementation MSC: NCLEX: Physiological Integrity: reduction of risk 15. A “time-out” for unacceptable behavior may be effective discipline for children between 1 and 6 years of age if the time-out period is no more than ____ minute(s) per year of child’s age. a. 1 b. 2 c. 3 d. 4 ANS: A Time-outs of 1 minute per each year of the child’s age place a child in a safe place with time to regain self-control. Short lengths of time are more appropriate than longer periods of time because of the short attention spans of children in this age-group. DIF: Cognitive Level: Comprehension REF: p. 135 OBJ: 11 TOP: Discipline KEY: Nursing Process Step: NA MSC: NCLEX: NA 16. A 5-year-old boy has been having increasingly more frequent angry outbursts in preschool. For the past 8 to 10 weeks, he had seven episodes of aggressiveness toward the other children and the teachers. The best advice would be to: a. encourage the parent to try more consistent and firm discipline. b. explain that this is normal in preschoolers, especially boys. c. take the child for a professional psychosocial assessment. d. deprive him of some special treat each time he is aggressive at school. ANS: C By age 4, impulse control is usually achieved with minor relapses in times of stress. Generally, the difference between “normal” and “problematic” behavior is not the behavior itself but the number of occurrences, severity, onset (especially a sudden change in behavior), and duration (at least 4 weeks). DIF: Cognitive Level: Application REF: p. 132 OBJ: 3 TOP: Cognitive development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 17. An example of parallel play is a toddler: a. sitting by himself playing with blocks. b. sharing a box of crayons with another toddler as they color in the same book. c. sitting with another toddler playing with toys without interaction. d. sitting in a circle of other toddlers passing a ball from one to another. ANS: C DIF: Cognitive Level: Comprehension REF: p. 138 OBJ: 9 TOP: Parallel play KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 3 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 18. Dental evaluations should start at the age of ____ months. a. 12 b. 18 c. 24 d. 30 ANS: A The American Academy of Pediatric Dentistry (AAPD) recommends that children aged 1 year be introduced to the dentist. DIF: Cognitive Level: Knowledge REF: p. 144 OBJ: NA TOP: Dental care KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 19. Toilet training is dependent on: a. developing sphincter control. b. child’s desire to stay dry. c. being rewarded for using the toilet. d. children using the family toilet when first learning. ANS: A Toilet training occurs as sphincter control develops and the child masters some form of communication to indicate the need to use the toilet. The process cannot be hurried and may not be complete before 3 years of age. Using the family toilet may be frightening, as child may feel like he will fall in or be flushed away. DIF: Cognitive Level: Comprehension REF: p. 130 OBJ: 4 TOP: Toilet training KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 20. During the preschool period, the emphasis of injury prevention should be placed on: a. constant vigilance and protection. b. punishment for unsafe behaviors. c. education for safety and potential hazards. d. limitation of physical activities. ANS: C Children as young as 3 years can be taught safety measures regarding potential hazards. Accident prevention techniques should be discussed with parents. DIF: Cognitive Level: Comprehension REF: p. 140 OBJ: 10 TOP: Safety and accident prevention KEY: Nursing Process Step: NA MSC: NCLEX: NA 21. The toddler is vulnerable to ear infections because: a. respirations are abdominal. b. pulse and respiratory rates are slower than in infancy. c. defense mechanisms are less efficient than during infancy. d. there is a short, straight internal ear canal leading to the oropharynx. ANS: D The internal structures of the ear and throat are short and straight, and lymphoid tissue of the tonsils and adenoids continues to be large. As a result, ear, throat, and upper respiratory infections are common. DIF: Cognitive Level: Comprehension REF: p. 129 OBJ: 2 TOP: Ear infections KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: prevention and early detection of disease 22. The preschool child learns socially acceptable behavior through the use of: a. punishment. b. positive reinforcement. c. restricting privileges. d. comparing child to role model. ANS: B Rewarding good behavior is the positive and most effective technique of discipline as well as consistency in parental response. DIF: Cognitive Level: Comprehension REF: p. 137, Table 8-3 OBJ: 11 TOP: Discipline KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance: growth and development 23. Age-appropriate literacy skills for a 24-month-old include the child taking a book and: a. holding it. b. looking at pictures. c. carrying it around the house. d. pointing at pictures with one finger. ANS: C The 24-month-old should carry the book around the house and turn one page at a time. DIF: Cognitive Level: Comprehension REF: p. 132, Table 8-1 OBJ: 2 TOP: Literacy milestone KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 4 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 24. A parent has a 2-year-old in the clinic for a well-child checkup. Which statement by the parent would indicate the need for more instruction regarding child safety? a. “We locked all the medicines in the bathroom cabinet.” b. “We turned the thermostat down on our hot water heater.” c. “We placed gates at the top and bottom of our stairs.” d. “We’re using the car seat belt instead of the car seat now that the baby is older.” ANS: D Children should use specially designed car restraints until they weigh at least 60 pounds or are 8 years old. DIF: Cognitive Level: Application REF: p. 141, Figure 8-7 OBJ: 10 TOP: Safety and accident prevention KEY: Nursing Process Step: Evaluation MSC: NCLEX: Safe Effective Care Environment: safety and infection control 25. The parents of a 30-month-old say that their daughter is not talking in short sentences. The most appropriate response is: a. “Let’s make an appointment with your pediatrician for an evaluation.” b. “Children of that age are too young to use short sentences.” c. “You don’t need to worry until your child is at least 48 months old.” d. “Your child should have started talking in short sentences by 18 months old.” ANS: A Language milestones can be used to assess a child’s development. By 30 months, a child should be talking in short sentences. DIF: Cognitive Level: Application REF: p. 132, Table 8-1 OBJ: 2|6 TOP: Language development and communication skills KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 26. Complete myelinization of the brain does not occur until the age of: a. 5 years. b. 7 years. c. 10 years. d. 12 years. ANS: B Compete myelinization of the brain does not occur until the age of 7 years. DIF: Cognitive Level: Knowledge REF: p. 128 OBJ: 3 TOP: Myelinization of the brain KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 27. The child is involved in fantasy play when the child: a. puts a string on a toy dog and takes it for a walk. b. looks at the pictures in a book over and over. c. uses the sandbox as a sailboat. d. colors the picture of an apple purple. ANS: C Fantasy play is seen in early childhood as one object becomes another. DIF: Cognitive Level: Application REF: p. 134 OBJ: 9 TOP: Fantasy play KEY: Nursing Process Step: NA MSC: NCLEX: Health Promotion and Maintenance: growth and development 28. Children learn to cope by: a. imitating others. b. experiencing new situations. c. asking for help. d. following parental direction. ANS: B Through experience, toddlers and preschoolers learn how to problem-solve, which provides them with a sense of mastery over their own lives and reinforces the fact that they have the ability to handle whatever comes their way. If parents solve all of their problems, this mastery will not be learned and may leave them with feelings of insecurity and stress at their inability to cope. DIF: Cognitive Level: Comprehension REF: p. 132 OBJ: 4 TOP: Cognitive development KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 29. To prepare a preschooler for better human interaction, the parents should help the child learn to: a. be autonomous. b. express feelings verbally rather than acting out. c. avoid conflict. d. rely on others. ANS: B Helping a child to learn to express his feelings rather than acting out is important for success in school and later life. DIF: Cognitive Level: Comprehension REF: p. 128 OBJ: 4 TOP: Developmental tasks KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity: coping and adaptation Copyright © 2022, Elsevier Inc. All rights reserved. 5 Downloaded by kaka max ([email protected])  lOMoARcPSD|26218436 30. The activity that is most appropriate for a hospitalized 5-year-old who is allowed to go to the playroom is: a. joining a group of boys and girls who are playing house. b. looking at a coin collection that belongs to an 8-year-old. c. playing alone with a racing car. d. building a block tower next to another child who is also playing with blocks. ANS: A Children in the preschool years engage most often in creative or dramatic play with others. DIF: Cognitive Level: Application REF: pp. 138-139 OBJ: 9 TOP: Play KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development MULTIPLE RESPONSE 1. The home health-care worker would assess the indication of sexual abuse in a preschool child if assessments were made of the child’s: (Select all that apply.) a. positioning dolls in sexual positions. b. excessive sexual curiosity. c. removing clothes to play nude. d. playing “doctor.” e. drawing genitals on dolls. ANS: A, B, E Recreating sexual positions with dolls or in play, demonstrating excessive sexual curiosity, and drawing genitals on dolls or other images suggest sexual abuse. DIF: Cognitive Level: Application REF: p. 137, Table 8-4 OBJ: 4 TOP: Sexual abuse KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. The health-care worker guiding parents in selecting a day care facility for their child would emphasize the importance of: (Select all that apply.) a. licensure. b. location. c. student-to-staff ratio. d. discipline techniques. e. staff education. ANS: A, C, D, E Characteristics of a day care center are important to ensure well-being and continued support of growth and development. DIF: Cognitive Level: Comprehension REF: p. 139 OBJ: 7 TOP: Day care centers KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development COMPLETION 1. Preschool children need a minimum of ____ minutes a day of age-appropriate active play. ANS: 60 Children should be physically active for a minimum of 60 minutes a day in age-appropriate activities such as running, jumping, and climbing. DIF: Cognitive Level: Knowledge REF: pp. 138-139 OBJ: 8 TOP: Play KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance: growth and development 2. Regular toothbrushing twice daily with a soft toothbrush and age-appropriate toothpaste should be routine by age ______. ANS: two Regular toothbrushing twice daily with a soft toothbrush and age-appropriate toothpaste should be routine by age two. DIF: Cognitive Level: Knowledge REF: p. 140 OBJ: 4 TOP: Developmental tasks KEY: Nursing Process Step: Assessment MSC: NCLEX: Health Promotion and Maintenance: growth and development Copyright © 2022, Elsevier Inc. All rights reserved. 6 Downloaded by kaka max ([email protected])