Chapter 4: Growth and Development Flashcards
Increase in physical size – height, weight, blood pressure, number of words in vocabulary.
growth
Increase in capabilities or function – ability to sit without support, throw ball overhand.
development
the process by which development proceeds from the head downward through the body and toward the feet
cephalocaudal development
the process by which development proceeds from the center of the body outward to the extremities
proximodistal development
the process of understanding upcoming developmental needs and then teaching caretakers to meet those needs
anticipatory guidance
In normal __________ growth, the child gains control of the head and neck before the trunk and limbs.
a. cephalocaudal
b. proximodistal
a. cephalocaudal
In normal __________ growth, the child controls arm movements before hand movements.
a. cephalocaudal
b. proximodistal
b. proximodistal
Name this age group.
includes infants or babies up to 1 year of age, all of whom require a high level of care in daily activities
a. infancy; birth-12 months
b. toddlerhood; 1-3 years
c. preschool; 3-6 years
d. school age; 6-12 years
e. adolescence; 12-18 years
a. infancy; birth-12 months
Name this age group.
characterized by increased motor ability and independent behavior
a. infancy; birth-12 months
b. toddlerhood; 1-3 years
c. preschool; 3-6 years
d. school age; 6-12 years
e. adolescence; 12-18 years
b. toddlerhood; 1-3 years
Name this age group.
refines gross and fine motor ability and language skills and often participates in a learning program
a. infancy; birth-12 months
b. toddlerhood; 1-3 years
c. preschool; 3-6 years
d. school age; 6-12 years
e. adolescence; 12-18 years
c. preschool; 3-6 years
Name this age group.
begins with entry into a school system and is characterized by growing intellectual skills, physical ability, and independence
a. infancy; birth-12 months
b. toddlerhood; 1-3 years
c. preschool; 3-6 years
d. school age; 6-12 years
e. adolescence; 12-18 years
d. school age; 6-12 years
Name this age group.
mature cognitive thought, formation of identity, and influence of peers are important characteristics
a. infancy; birth-12 months
b. toddlerhood; 1-3 years
c. preschool; 3-6 years
d. school age; 6-12 years
e. adolescence; 12-18 years
e. adolescence; 12-18 years
Which physician believed that “early childhood experiences form the unconscious motivation for actions in later life”?
a. Sigmund Freud
b. Erik Erikson
c. Jean Piaget
d. Lawrence Kohlberg
a. Sigmund Freud
Which physician believed that “sexual energy is centered in specific parts of the body at certain ages”?
a. Sigmund Freud
b. Erik Erikson
c. Jean Piaget
d. Albert Bandura
a. Sigmund Freud
the basic sexual energy that is present at birth and drives the individual to seek please
a. id
b. ego
c. superego
a. id
the realistic part of the person, which develops during infancy and searches for acceptable methods of meeting impulses
a. id
b. ego
c. superego
b. ego
moral/ethical system, which develops in childhood and contains a set of values and a conscience
a. id
b. ego
c. superego
c. superego
techniques used by the ego to unconsciously change reality, thereby protecting itself from excessive anxiety
defense mechanisms
Name the stages of Sigmund Freud’s theory in order from youngest to oldest.
oral (birth to 1 year)
anal (1 to 3 years)
phallic (3 to 6 years)
latency (6 to 12 years)
genital (12 years to adulthood)
Name this stage of Sigmund Freud’s theory.
derives pleasure largely from the mouth, with sucking and eating as primary desires
a. oral (birth to 1 year)
b. anal (1 to 3 years)
c. phallic (3 to 6 years)
d. latency (6 to 12 years)
e. genital (12 years to adulthood)
a. oral (birth to 1 year)
Name this stage of Sigmund Freud’s theory.
pleasure is centered in the anal area, with contorl over body secretions as a prime force in behavior
a. oral (birth to 1 year)
b. anal (1 to 3 years)
c. phallic (3 to 6 years)
d. latency (6 to 12 years)
e. genital (12 years to adulthood)
b. anal (1 to 3 years)
Name this stage of Sigmund Freud’s theory.
sexual energy becomes centered in the genitalia as the child works out relationships with parents of the same and opposite sexes
a. oral (birth to 1 year)
b. anal (1 to 3 years)
c. phallic (3 to 6 years)
d. latency (6 to 12 years)
e. genital (12 years to adulthood)
c. phallic (3 to 6 years)
Name this stage of Sigmund Freud’s theory.
sexual energy is at rest in the passage between earlier stages and adolescence
a. oral (birth to 1 year)
b. anal (1 to 3 years)
c. phallic (3 to 6 years)
d. latency (6 to 12 years)
e. genital (12 years to adulthood)
d. latency (6 to 12 years)
Name this stage of Sigmund Freud’s theory.
mature sexuality is achieved as physical growth is completed and relationships with others occur
a. oral (birth to 1 year)
b. anal (1 to 3 years)
c. phallic (3 to 6 years)
d. latency (6 to 12 years)
e. genital (12 years to adulthood)
e. genital (12 years to adulthood)
Name this developmental theory physician.
Child’s view of world influenced by age/maturational ability. Give nurturing experiences, child’s ability to think matures naturally.
a. Sigmund Freud
b. Lawrence Kohlberg
c. Jean Piaget
d. Albert Bandura
c. Jean Piaget
Name this developmental theory physician.
Developmental challenges throughout life.
a. Sigmund Freud
b. Erik Erikson
c. Jean Piaget
d. Albert Bandura
b. Erik Erikson
Name this development stage of Erik Erikson’s psychoanalytic theory.
the task is to establish trust in the people providing care; trust is fostered by provision of food, clean clothing, touch, and comfort; if basic needs are not met, this age group will eventually learn to mistrust others
a. Trust vs Mistrust (Birth to 1 Year)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
c. Initiative vs Guilt (3 to 6 Years)
d. Industry vs inferiority (6 to 12 Years)
e. Identity vs Role Confusion (12 to 18 Years)
a. Trust vs Mistrust (Birth to 1 Year)
Name this development stage of Erik Erikson’s psychoanalytic theory.
sense of autonomy or independence is shown by controlling bodily excretions, saying no when asked to do something, and directing motor activity and play; children who are consistently criticized for expressions of autonomy or for lack of control will develop a sense of shame about themselves and doubt their actions.
a. Trust vs Mistrust (Birth to 1 Year)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
c. Initiative vs Guilt (3 to 6 Years)
d. Industry vs inferiority (6 to 12 Years)
e. Identity vs Role Confusion (12 to 18 Years)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
Name this development stage of Erik Erikson’s psychoanalytic theory.
characterized by development of new interests and by involvement in activities; takes pride in accomplishments in sports, school, home, and community; if they cannot accomplish what is expected, they will not feel good enough
a. Trust vs Mistrust (Birth to 1 Year)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
c. Initiative vs Guilt (3 to 6 Years)
d. Industry vs inferiority (6 to 12 Years)
e. Identity vs Role Confusion (12 to 18 Years)
d. Industry vs inferiority (6 to 12 Years)
Name this development stage of Erik Erikson’s psychoanalytic theory.
initiatives new activities and considers new ideas; this interest in exploring the world creates someone who is involved and busy; constant criticism leads to feelings of guilt and lack of purpose
a. Trust vs Mistrust (Birth to 1 Year)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
c. Initiative vs Guilt (3 to 6 Years)
d. Industry vs inferiority (6 to 12 Years)
e. Identity vs Role Confusion (12 to 18 Years)
c. Initiative vs Guilt (3 to 6 Years)
Name this development stage of Erik Erikson’s psychoanalytic theory.
as the body matures and thought processes become more complex, a new sense of self is establish; the self, family, peer group, and community are all examined and redefined; the one who is unable to create a meaningful definition of self will experience hard times in one or more areas of life
a. Trust vs Mistrust (Birth to 1 Year)
b. Autonomy vs Shame and Doubt (1 to 3 Years)
c. Initiative vs Guilt (3 to 6 Years)
d. Industry vs inferiority (6 to 12 Years)
e. Identity vs Role Confusion (12 to 18 Years)
e. Identity vs Role Confusion (12 to 18 Years)
Name Erik Erikson’s developmental stages in order from youngest to oldest. (pediatric ages only)
Trust vs Mistrust (Birth to 1 Year)
Autonomy vs Shame and Doubt (1 to 3 Years)
Initiative vs Guilt (3 to 6 Years)
Industry vs inferiority (6 to 12 Years)
Identity vs Role Confusion (12 to 18 Years)
Which physician believed that “sexual energy is centered in specific parts of the body at certain ages”?
a. Lawrence Kohlberg
b. Erik Erikson
c. Jean Piaget
d. John Watson
c. Jean Piaget
the process of incorporating new experiences into an individual’s cognitive awareness; the process of incorporating traits of the new culture within one’s practice
assimilation
the process of changing one’s cognitive structures to include data from recent experiences
accommodation
the knowledge that something continues to exist even when out of sight
object permanence
Name this stage of Jean Piaget’s developmental theory.
learn about the world by input obtained through the senses and by their motor activity. Six substages are characteristic of this stage
a. sensorimotor (Birth to 2 Years)
b. preoperational (2 to 7 Years)
c. concrete operational (7 to 11 Years)
d. formal operational (11 Years to Adulthood)
a. sensorimotor (Birth to 2 Years)
Name this stage of Jean Piaget’s developmental theory.
can reason quite well if concrete objects are used in teaching or experimentation
a. sensorimotor (Birth to 2 Years)
b. preoperational (2 to 7 Years)
c. concrete operational (7 to 11 Years)
d. formal operational (11 Years to Adulthood)
c. concrete operational (7 to 11 Years)
Name this stage of Jean Piaget’s developmental theory.
fully mature intellectual thought has now been attained
a. sensorimotor (Birth to 2 Years)
b. preoperational (2 to 7 Years)
c. concrete operational (7 to 11 Years)
d. formal operational (11 Years to Adulthood)
d. formal operational (11 Years to Adulthood)
Name Lawrence Kohlberg’s developmental stages in order from youngest to oldest.
preconventional (4 to 7 Years)
conventional (7 to 12 Years
postconventional (12 Years and Older)
Name this stage of Lawrence Kohlberg’s developmental theory.
decisions are based on the desire to please others and to avoid punishment
a. preconventional (4 to 7 Years)
b. conventional (7 to 12 Years
c. postconventional (12 Years and Older)
a. preconventional (4 to 7 Years)
Name this stage of Lawrence Kohlberg’s developmental theory.
conscience, or an intersal set of standards, becomes important; rules are important and must be followed to please other people and “be good”
a. preconventional (4 to 7 Years)
b. conventional (7 to 12 Years
c. postconventional (12 Years and Older)
b. conventional (7 to 12 Years
Name this stage of Lawrence Kohlberg’s developmental theory.
the individual has internalized ethical standards on which to base decisions; social responsibility is recognized; the value in each of two differing moral approaches can be considered and a decision is made
a. preconventional (4 to 7 Years)
b. conventional (7 to 12 Years
c. postconventional (12 Years and Older)
c. postconventional (12 Years and Older)
T/F
Behaviorism has been criticized for being simplistic and for its denial of people’s inherent capacity to respond willfully to events in the environment.
true
behaviorism
a. Sigmund Freud
b. John Watson
c. Jean Piaget
d. Albert Bandura
b. John Watson
T/F
Both nature and nurture are important in determining individual patterns of development.
true
By what age does teeth begin to erupt?
a. right away at birth
b. 1 month
c. 6 months
d. 9 months
c. 6 months
T/F
Physical growth is not associated with type and quality of feeding.
false; it is closely associated
T/F
Reflexes help infant receive input, nourishment, comfort.
true
when infants play by themselves
solitary play
The play of infants begins in a __________ manner.
reflexive
T/F
When an infant moves extremities or grasps objects, the foundations of play are established.
true
T/F
Play is not a reflection of every aspect of development, as well as a method for enhancing learning and maturation.
false; play IS a reflection
Match the milestone with the correct age group.
physical growth
- gains 5 to 7 oz in a week
- grows 1.5 cm in the first month
- head circumferences increased 1.5 cm a month
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
a. birth to 1 month
Match the milestone with the correct age group.
fine motor ability
- holds hand in fist
- draws arms and legs to body when crying
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
a. birth to 1 month
Match the milestone with the correct age group.
gross motor ability
- inborn reflexes such as startle and rooting are predominant activity
- may lift head briefly if prone
- alerts to high-pitched voices
- comforts with touch
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
a. birth to 1 month
Match the milestone with the correct age group.
sensory ability
- prefers to look at faces and black-and-white geometric designs
- follows objects in line of vision
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
a. birth to 1 month
Match the milestone with the correct age group.
physical growth
- gains 140–200 g/week
- grows 1.5 c m month
- head Head circumference increases 1.5 c m month
- posterior fontanelle closes
- ingests 120 mL/k g/24 hr
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
b. 2 to 4 months
Match the milestone with the correct age group.
fine motor ability
- holds rattle and other objects when placed in hand
- looks at and plays with own fingers
- brings hands to midline
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
b. 2 to 4 months
Match the milestone with the correct age group.
gross motor ability
- moro reflex fading in strength
- can turn from side to back and then return
- decrease in head lag when pulled to sitting position; sits with head held in midline with some bobbing
- when prone, holds head and supports weight on forearms
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
b. 2 to 4 months
Match the milestone with the correct age group.
sensory ability
- follows objects 180 degrees
- turns head to look for voices and sounds
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
b. 2 to 4 months
Match the milestone with the correct age group.
physical growth
- Gains 140–200 g/week
- doubles birth weight at 5–6 months
- grows 1.5 cm month
- head circumference increases 1.5 c m one half inches month
- teeth may begin erupting by 6 months
- ingests 100 mL/k g/24 hr
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
c. 4 to 6 months
Match the milestone with the correct age group.
fine motor ability
- grasps rattles/other objects at will; drops to pick up another offered object
- mouths objects
- holds feet and pulls to mouth
- holds bottle
- grasps with whole hand
- manipulates objects
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
c. 4 to 6 months
Match the milestone with the correct age group.
gross motor ability
- head held steady when sitting
- no head lag when pulled to sitting
- turns from abdomen to back by 4 months and then back to abdomen by 6 months
- when held standing supports much of own weight
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
c. 4 to 6 months
Match the milestone with the correct age group.
sensory ability
- examines complex visual images
- watches the course of a falling object
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
c. 4 to 6 months
Match the milestone with the correct age group.
physical growth
- gains 85–140 g/week
- grows 1 cm/month
- growth rate slower than first 6 months
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 - 12 months
d. 6 to 8 months
Match the milestone with the correct age group.
fine motor ability
- bangs objects held in hands
- transfers objects from one hand to the other
- beginning pincer grasp at times
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
d. 6 to 8 months
Match the milestone with the correct age group.
gross motor ability
- most inborn reflexes extinguished
- sits alone steadily without support by 8 months
- likes to bounce on legs when held in standing position
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
d. 6 to 8 months
Match the milestone with the correct age group.
sensory ability
- responds readily to sounds
- recognizes own name and responds by looking and smiling
- enjoys small and complex objects at play
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
d. 6 to 8 months
Match the milestone with the correct age group.
physical growth
- gains 85–140 g (3–5 oz)/week
- grows 1 cm/month
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
e. 8 to 10 months
Match the milestone with the correct age group.
fine motor ability
- picks up small objects
- uses pincer grasp well
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
e. 8 to 10 months
Match the milestone with the correct age group.
gross motor ability
- crawls or pulls whole body along floor by arms
- creeps by using hands and knees to keep trunk off floor
- pulls self to standing and sitting by 10 months
- recovers balance when sitting
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
e. 8 to 10 months
Match the milestone with the correct age group.
sensory ability
- understands words such as “no” and “cracker”
- may say one word in addition to “mama” and “dada”
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
e. 8 to 10 months
Match the milestone with the correct age group.
physical growth
- gains 85–140 g/week
- grows 1 cm/month
- head circumference equals chest circumference
- triples birth weight by 1 year
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
f. 10 to 12 months
Match the milestone with the correct age group.
fine motor ability
- may hold crayon or pencil and make mark on paper
- places objects into containers through holes
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
f. 10 to 12 months
Match the milestone with the correct age group.
gross motor ability
- stands alone
- walks holding onto furniture
- sits down from standing
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
f. 10 to 12 months
Match the milestone with the correct age group.
sensory ability
- plays peek-a-boo and patty cake
a. birth to 1 month
b. 2 to 4 months
c. 4 to 6 months
d. 6 to 8 months
e. 8 to 10 months
f. 10 to 12 months
f. 10 to 12 months
__________ is sometimes called the first adolescence.
toddlerhood
Two toddlers tend to play with similar objects side by side, occasionally trading toys and words.
parallel play
__________ communication includes pointing, pulling an adult over to a room or object, and speaking in expressive jargon.
toddler
using unintelligible words with normal speech intonations as if truly communicating in words
expressive jargon
T/F
Sometimes an upset toddler responds well to holding, rocking, and stroking.
true
T/F
The nurse shouldn’t allow the toddler to cry. Do not acknoelwdge the fear.
false
Match the milestone with the correct age group.
physical growth
- gains 227 g or more per month
- grows 9-12 cm during the year
- anterior fontanelle closes
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
a. 1 to 2 years
What is the correct way to restrain a toddler?
above or below joints
Match the milestone with the correct age group.
fine motor ability
- by end of second year, builds a tower of 4 blocks
- scribbles on paper
- can undress self
- throws a ball
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
a. 1 to 2 years
Match the milestone with the correct age group.
gross motor skills
- runs
- shows growing ability to walk and finally walks with ease
- walks up and down stairs a few months after learning to walk with ease
- likes push-and-pull toys
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
a. 1 to 2 years
Match the milestone with the correct age group.
physical growth
- gains 1.4-2.3 kg/year
- grows 5.6 cm/year
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
b. 2 to 3 years
Match the milestone with the correct age group.
fine motor ability
- draws a circle and other rudimentary forms
- learns to pour learning to dress self
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
b. 2 to 3 years
Match the milestone with the correct age group.
gross motor ability
- jumps
- kicks ball
- throws ball overhand
a. 1 to 2 years
b. 2 to 3 years
c. 3 to 4 years
d. 4 to 5 years
b. 2 to 3 years
Match the milestone with the correct age group.
plays and toys
- refines fine motor skills by use of cloth books, large pencil and paper, wooden puzzles
- facilitates imitative behavior by playing kitchen, grocery shopping, toy telephone
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
b. 1 to 3 years
Match the milestone with the correct age group.
play and toys
- learns gross motor activities by riding Big Wheel tricycle, playing with soft ball and bat, molding water and sand, tossing ball or bean bag
- cognitive skills develop with exposure to educational television, shows, music, stories, and books
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
b. 1 to 3 years
Match the milestone with the correct age group.
communication
- increasingly enjoys talking
- exponential growth of vocabulary, especially when spoken and read to
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
b. 1 to 3 years
Match the milestone with the correct age group.
communication
- needs to release stress by pounding board, frequent gross motor activities, and occasional temper tantrums
- likes contact with other children and learns from interpersonal skills
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
b. 1 to 3 years
Match the milestone with the correct age group.
physical growth
- gains 1.5-2.5 kg/year
- grows 4-6 cm/year
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
fine motor ability
- uses scissors
- draws circle, square, cross
- draws at least a six-part person
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
fine motor ability
- enjoys art projects such as pasting, stringing beads, using clay
- learns to tie shoes at end of preschool years
- buttons clothes
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
fine motor ability
- brushes teeth
- uses spoon, fork, knife
- eats three meals with snacks
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
gross motor ability
- throws a ball overhand
- climbs wall
- rides bicycle
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
sensory ability
- visual acuity continues to improve
- can focus on and learn letters and numbers
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Where does the most growth occur in preschool children?
a. the short bones of the arms and legs
b. the long bones of the hands and feets
c. the long bones of the arms and legs
d. the shorts bones of the hands and feet
c. the long bones of the arms and legs
The preschool exhibits characteristics of __________ thought.
a. sensorimotor
b. preoperational
c. concrete operational
d. formal operational
b. preoperational
ability to see things only from one’s point of view
a. egocentrism
b. transductive reasoning
c. centration
d. animism
a. egocentrism
connecting two events in a cause-and-effect relationship simply because they occur together in time
a. egocentrism
b. transductive reasoning
c. centration
d. animism
b. transductive reasoning
focusing on only one particular aspect of a situation
a. egocentrism
b. transductive reasoning
c. centration
d. animism
c. centration
giving lifelike qualities to nonliving things
a. egocentrism
b. transductive reasoning
c. centration
d. animism
d. animism
T/F
preschoolers do not interact with others during play
false
when children interact with one another, engaging in similar activities and participating in groups
associative play
a child acts out the drama of daily life or in which medical situations encountered are reenacted by the child
dramatic play
Match the milestone with the correct age group.
play and toys
- associative play is facilitated by simple games, puzzles, nursery rhymes, songs
- dramatic play is fostered by dolls and doll clothes, play houses and hospitals, dress-up clothes, puppers
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
play and toys
- stress is relieved by pens, paper, glue, scissors
- cognitive growth is fostered by educational television shows, music, stories, and books
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Match the milestone with the correct age group.
communication
- all parts of speech are developed and used, occasionally incorrectly
- communicates with a widening array of people
- play with other children is a favorite activity
a. infant to 1 year
b. 1 to 3 years
c. 3 to 6 years
d. 6 to 9 years
c. 3 to 6 years
Which of the following physical changes are typically observed in school-age children? (Select all that apply.)
A. Increase in muscle mass and a leaner appearance
B. Rapid growth in height for both boys and girls equally at age 12
C. Loss of deciduous teeth and eruption of permanent teeth beginning around age 6
D. Decrease in size and body proportions compared to pre-school years
E. Maturation of the immune system leading to fewer illnesses
A. Increase in muscle mass and a leaner appearance
C. Loss of deciduous teeth and eruption of permanent teeth beginning around age 6
E. Maturation of the immune system leading to fewer illnesses
A school-age child is being evaluated for appropriate physical development. Which of the following findings would be considered normal?
A. Permanent molars have all erupted by age 10.
B. The child’s urinary system adjusts to changes in fluid status efficiently.
C. Deciduous teeth are still intact at age 8 without any permanent teeth erupting.
D. The child demonstrates limited fine motor skills compared to a toddler.
B. The child’s urinary system adjusts to changes in fluid status efficiently.
Rationale: By the school-age period, the urinary system is more developed and can effectively handle changes in fluid status.
During a well-child check-up, the nurse teaches parents about proper dental care for their 7-year-old. Which of the following instructions are appropriate? (Select all that apply.)
A. Ensure fluoride supplementation if the water supply is not fluoridated.
B. Monitor for loose teeth prior to events like surgery.
C. Focus exclusively on brushing; flossing is unnecessary at this age.
D. Regularly schedule dental examinations to assess tooth alignment.
E. Avoid fluoride treatments to prevent enamel damage.
A. Ensure fluoride supplementation if the water supply is not fluoridated.
B. Monitor for loose teeth prior to events like surgery.
D. Regularly schedule dental examinations to assess tooth alignment.
A nurse is assessing a school-age child’s growth and development. Which finding indicates that the child may be experiencing a normal growth spurt?
A. Increased complaints of muscle pain and fatigue
B. Loss of appetite
C. Stable height with no changes over a year
D. Rapid increase in weight with no change in height
A. Increased complaints of muscle pain and fatigue
Rationale: Growth spurts often lead to muscle pain and fatigue as bones and muscles grow rapidly.
Which of the following statements accurately describes a typical characteristic of school-age children’s physical growth and development?
A. Boys typically start their growth spurt around age 8.
B. Permanent teeth begin to replace deciduous teeth around age 6.
C. The immune system of school-age children is still immature, causing frequent illnesses.
D. School-age children generally have shorter limbs compared to earlier stages of development.
B. Permanent teeth begin to replace deciduous teeth around age 6.
A nurse is educating parents about nutritional needs during a growth spurt for school-age children. Which statement by the parents indicates a need for further teaching?
A. “We will increase the amount of protein in our child’s diet during this period.”
B. “Our child does not need any more calories than before since their size is similar.”
C. “We’ll make sure our child has access to healthy snacks throughout the day.”
D. “We’ll ensure our child eats meals that are rich in essential vitamins and minerals.”
B. “Our child does not need any more calories than before since their size is similar.”
Rationale: Nutritional needs, including caloric intake, increase during growth spurts due to rapid physical changes.
During a health assessment of a 9-year-old child, which finding is expected based on typical development during the school-age period?
A. Immature urinary system unable to handle fluid changes
B. Complete set of all 30 permanent teeth
C. Ability to participate in complex sports and refined physical activities
D. Decreased muscle mass with an increase in fat distribution
C. Ability to participate in complex sports and refined physical activities
Rationale: Physical skills are refined during this period, allowing children to engage in complex sports and physical activities.
A 10-year-old child is scheduled for surgery. What preoperative dental-related care should the nurse prioritize?
A. Assessing the alignment of all permanent molars
B. Ensuring any loose teeth are identified and documented
C. Providing additional fluoride supplementation
D. Recommending a follow-up appointment for orthodontic care
B. Ensuring any loose teeth are identified and documented
Which of the following cognitive abilities is typically developed during the school-age years?
A. Abstract thinking and hypothetical reasoning
B. Mastery of the concept of conservation
C. Complete independence from concrete experiences for understanding
D. Inability to consider alternative solutions to problems
B. Mastery of the concept of conservation
Rationale: School-age children learn the concept of conservation, understanding that matter remains the same even when its form changes.
A nurse is explaining a procedure to an 8-year-old child. Which statement reflects the child’s cognitive development stage?
A. “The procedure will change how your arm works permanently.”
B. “Your arm will look the same after the cast is removed.”
C. “This treatment will alter your identity.”
D. “You should be able to imagine how your arm will feel after surgery.”
B. “Your arm will look the same after the cast is removed.”
Rationale: The concept of conservation allows a school-age child to understand that despite a temporary change (e.g., a cast), the arm will look and function as it did before.
A school-age child asks why their incision will heal. Based on the cognitive stage of development, which of the following nursing explanations is most appropriate?
A. “Your body will change forever, but you’ll adapt.”
B. “The healing process is like your body’s way of fixing itself, and soon it will look like it did before.”
C. “You need to imagine that it never happened.”
D. “Your body can’t fully return to how it was, but you can learn to manage.”
B. “The healing process is like your body’s way of fixing itself, and soon it will look like it did before.”
Rationale: This explanation aligns with the child’s ability to understand that changes like incisions can heal and revert back to their original form, consistent with the concept of conservation.
A nurse wants to explain a treatment plan to a school-age child. Which of the following approaches should the nurse use? Select all that apply.
A. Provide concrete examples and use visuals to explain concepts.
B. Ask the child to imagine hypothetical outcomes of the treatment.
C. Allow the child to handle equipment when safe.
D. Use abstract reasoning to discuss complex treatment scenarios.
E. Compare the treatment process to everyday experiences familiar to the child.
A. Provide concrete examples and use visuals to explain concepts.
C. Allow the child to handle equipment when safe.
E. Compare the treatment process to everyday experiences familiar to the child.
A 7-year-old child struggles with the concept of conservation. Which scenario would best help the nurse evaluate if the child has mastered this concept?
A. Observing if the child understands complex mathematics involving fractions
B. Asking the child if a pile of coins spread out is still the same amount when gathered together
C. Discussing how characters change over time in a story
D. Asking the child about their favorite abstract piece of art
B. Asking the child if a pile of coins spread out is still the same amount when gathered together
Rationale: Testing with a concrete example, such as recognizing the unchanged quantity of coins when spread out versus grouped, is an effective way to evaluate mastery of conservation.
Which of the following is a characteristic of cooperative play in school-age children?
A. Individual play without regard for rules
B. Play focused solely on winning, disregarding cooperation
C. Cooperation with others and adherence to rules in team-based activities
D. Role-playing imaginary characters with no rules or structure
C. Cooperation with others and adherence to rules in team-based activities
Rationale: School-age children engage in cooperative play, working together in team-based activities with a focus on following rules and fulfilling their roles.
The nurse observes a group of school-age children playing a game together. Which behavior would the nurse expect to see?
A. Frequent arguments about rule changes
B. Cooperative role fulfillment and adherence to rules
C. Inability to maintain attention on the game
D. Playing independently with minimal social interaction
B. Cooperative role fulfillment and adherence to rules
What is a common psychosocial impact of hospitalization on a school-age child?
A. Complete indifference to separation from friends
B. Increased desire to interact with hospital staff
C. Feelings of sadness and purposelessness due to separation from playmates
D. Total contentment as long as television and video games are available
C. Feelings of sadness and purposelessness due to separation from playmates
Which statement about the impact of screen time on school-age children’s play is accurate?
A. Increased screen time has no effect on physical play.
B. Television viewing enhances cooperative play with peers.
C. Increased screen time is linked to poor nutritional status and high rates of overweight.
D. Screen time improves socialization skills among children.
C. Increased screen time is linked to poor nutritional status and high rates of overweight.
A nurse is planning care for a hospitalized school-age child. Which intervention would best support their psychosocial development?
A. Restricting visits from friends to reduce noise and distraction
B. Encouraging solitary activities such as reading
C. Allowing frequent visits or calls from friends
D. Providing only passive forms of entertainment, such as movies
C. Allowing frequent visits or calls from friends
Rationale: Visits or calls from friends help mitigate feelings of sadness and maintain social connections during hospitalization.
Which of the following would be an appropriate intervention when discharging a school-age child with a cast?
A. Informing the child that they cannot engage in any activities
B. Allowing all activities regardless of safety concerns
C. Discussing which activities are safe and which to avoid
D. Encouraging only passive play with minimal movement
C. Discussing which activities are safe and which to avoid
The desire of school-age children to spend playtime with friends demonstrates which aspect of their development?
A. Independence from social interaction
B. Preference for solitary play
C. Importance of structured and cooperative play
D. Inability to understand social rules
C. Importance of structured and cooperative play
Which behavior is typical of school-age children during team sports? Select all that apply.
A. Arguing over every rule
B. Cooperating to achieve a common goal
C. Taking turns and following rules
D. Struggling to understand team roles
E. Insisting on precise adherence to rules
B. Cooperating to achieve a common goal
C. Taking turns and following rules
E. Insisting on precise adherence to rules
A school-age child expresses frustration when another child breaks a game rule. What does this behavior reflect?
A. A lack of social maturity
B. The child’s need for structure and order
C. Poor understanding of game mechanics
D. Disinterest in cooperative activities
B. The child’s need for structure and order
A nurse observes a 6-year-old attempting to play baseball. What is a typical behavior for a child of this age?
A. Mastery of complex game strategies
B. Limited ability to hold the bat properly
C. Disinterest in rules of the game
D. Cooperation in understanding and fulfilling a team role
D. Cooperation in understanding and fulfilling a team role
Rationale: By age 6, children develop the ability to hold a bat, cooperate with teammates, and begin to understand game rules.
The nurse is providing education to the parents of a child classified as “difficult” in temperament. Which recommendation should the nurse make?
A. Create a quiet environment for completing homework
B. Ignore any problematic behaviors and avoid correction
C. Enroll the child in multiple activities to prevent boredom
D. Limit rewards for focused effort to avoid dependence
A. Create a quiet environment for completing homework
Which strategy would best support a “slow-to-warm-up” child in school?
A. Expect the child to adapt quickly without assistance
B. Encourage participation in new activities and group experiences
C. Discourage trying new activities to avoid discomfort
D. Place the child in highly competitive situations to build confidence
B. Encourage participation in new activities and group experiences
A school-age child classified as “easy” in temperament is starting a new school. What behavior would the nurse expect?
A. Difficulty forming new friendships
B. High levels of anxiety and fear of change
C. Quick adaptation to the new environment
D. Resistance to change in routine
C. Quick adaptation to the new environment
Which of the following are key considerations when discussing sexuality with school-age children? Select all that apply.
A. Provide factual, age-appropriate information
B. Assume children have limited interest in sexual topics
C. Avoid discussions to prevent embarrassment
D. Ask questions to gauge the child’s understanding
E. Encourage healthy self-image and body awareness
A. Provide factual, age-appropriate information
D. Ask questions to gauge the child’s understanding
E. Encourage healthy self-image and body awareness
A nurse is teaching school-age children about body changes during puberty. Which approach is most appropriate?
A. Avoid the topic until the child raises questions
B. Use simple and factual explanations
C. Provide complex medical terminology
D. Give vague information to protect their innocence
B. Use simple and factual explanations
Rationale: Clear and factual explanations are best to foster a positive self-image and correct any misconceptions.
A school-age child enjoys keeping a journal of their hospital experiences. This activity primarily supports which developmental need?
A. Physical activity
B. Cognitive development through creative expression
C. Social interaction with peers
D. Avoidance of new experiences
B. Cognitive development through creative expression
Rationale: Journaling allows for cognitive development through writing and creative expression, helping to process experiences.
What is an appropriate communication strategy for a school-age child who makes grammatical errors?
A. Ignore the errors to avoid embarrassment
B. Correct errors gently and provide examples
C. Expect mastery of advanced grammar
D. Discourage writing activities until speech improves
B. Correct errors gently and provide examples
The nurse is assessing a school-age child’s vocabulary. Which finding is typical at this age?
A. Limited understanding of new words
B. Declining interest in communication
C. Ability to understand parts of speech
D. Reliance solely on literal meanings of words
C. Ability to understand parts of speech
Parents are advised to encourage a child with a “difficult” temperament to focus during homework. Which strategy should be recommended?
A. Avoid any form of rewards for concentration
B. Allow homework completion in a noisy setting
C. Offer a reward, such as screen time, after completing homework
D. Limit homework time to prevent stress
C. Offer a reward, such as screen time, after completing homework
A child classified as “slow-to-warm-up” is hesitant to engage in a new sport. Which approach should the nurse suggest?
A. Insist on immediate participation
B. Encourage gradual involvement with support
C. Limit exposure to avoid discomfort
D. Focus on individual activities without social interaction
B. Encourage gradual involvement with support
Which factor can contribute to sexual misconceptions in school-age children? Select all that apply.
A. Friends
B. Accurate information from parents
C. Television shows
D. Siblings
E. School lessons
A. Friends
C. Television shows
D. Siblings
Why is it important for school-age children to understand the changes occurring in their bodies?
A. To develop a healthy self-image
B. To prevent curiosity about sexuality
C. To avoid discussions about puberty
D. To reduce interactions with peers
A. To develop a healthy self-image
The nurse is working with a school-age child on improving communication. What activity might be recommended?
A. Passive screen time with minimal engagement
B. Keeping a journal of daily experiences
C. Avoiding written expression due to errors
D. Focusing only on verbal communication
B. Keeping a journal of daily experiences
A parent is concerned about their school-age child’s difficulty adapting to a new classroom environment. The child was described as having a “slow-to-warm-up” temperament. Which nursing recommendation is most appropriate?
A. Encourage immediate involvement in all group activities
B. Limit interactions to only one peer to avoid overstimulation
C. Provide opportunities for gradual exposure and support new experiences
D. Expect the child to quickly overcome their adaptation difficulties without intervention
C. Provide opportunities for gradual exposure and support new experiences
During adolescence, which of the following physical changes is typically the last to occur in girls?
A. Growth of pubic hair
B. Menstruation
C. Increase in breast size
D. Onset of growth spurt
B. Menstruation
Which statement best describes the prepubescent growth spurt in boys?
A. It typically begins at an average age of 10 years.
B. It occurs concurrently with the onset of menstruation.
C. It usually starts around 13 years of age.
D. It is characterized solely by an increase in weight.
C. It usually starts around 13 years of age.
Rationale: The prepubescent growth spurt in boys typically begins at around 13 years of age. In girls, it tends to start earlier, at around 10 years.
The nurse is assessing an adolescent’s growth and development. Which of the following changes should be expected? (Select all that apply)
A. Deepening of the voice in boys
B. Completion of all body organ maturation
C. Decrease in muscle mass
D. Onset of pubic hair growth in boys and girls
A. Deepening of the voice in boys
B. Completion of all body organ maturation
D. Onset of pubic hair growth in boys and girls
A nurse is educating parents of adolescents about physical changes during puberty. Which statement would be appropriate to include?
A. “Physical changes occur uniformly among all adolescents.”
B. “Boys generally begin their growth spurt earlier than girls.”
C. “Adolescents must adapt to changes in height, weight, and body proportions.”
D. “Hormonal changes do not contribute significantly to identity formation.”
C. “Adolescents must adapt to changes in height, weight, and body proportions.”
Which of the following characteristics is a hallmark of identity formation during adolescence?
A. Avoidance of social relationships
B. Role confusion and purposelessness
C. Physical changes with minimal psychological impact
D. Developing a sense of self-worth
D. Developing a sense of self-worth
Rationale: D. Developing a sense of self-worth and identity is a hallmark of adolescence. Role confusion may occur if a healthy identity is not formed.
An adolescent expresses concerns about their body odor and increased sweating. The nurse explains that this is due to maturation of which glands?
A. Sebaceous and thyroid glands
B. Apocrine and eccrine glands
C. Endocrine and adrenal glands
D. Parotid and lymphatic glands
B. Apocrine and eccrine glands
Rationale: The maturation of apocrine and eccrine glands during adolescence leads to increased sweating and body odor.
A nurse is counseling an adolescent who feels insecure about physical differences with peers. Which of the following responses is appropriate?
A. “All adolescents mature at the same rate.”
B. “It is normal for adolescents to experience variability in the timing of physical changes.”
C. “You should try to accelerate your growth.”
D. “These changes will be permanent.”
B. “It is normal for adolescents to experience variability in the timing of physical changes.”
Rationale: Adolescents experience great variability in the timing and progression of physical changes. This reassurance helps normalize their feelings.
What is the expected outcome for adolescents who fail to establish a healthy sense of self-identity?
A. Increased interest in sports
B. Improved academic performance
C. Role confusion and purposeless struggling
D. Strong peer relationships
C. Role confusion and purposeless struggling
Rationale: Failure to develop a healthy self-identity can lead to role confusion and a lack of direction or purpose.
The nurse is discussing the concept of puberty with a group of adolescents. Which of the following statements is true about puberty in boys?
A. Facial hair growth occurs before pubic hair growth.
B. Puberty ends with an increase in breast size.
C. The size of the penis and testes increases during puberty.
D. Boys generally experience puberty before girls
C. The size of the penis and testes increases during puberty.
A parent asks about how to help their adolescent develop a healthy self-image during puberty. Which suggestion by the nurse is best?
A. “Avoid discussing physical changes with your child.”
B. “Provide factual information about bodily changes and sexual health.”
C. “Limit their social interactions to reduce peer pressure.”
D. “Do not address questions about sexuality.”
B. “Provide factual information about bodily changes and sexual health.”
Which of the following best describes the cognitive abilities of an adolescent in Piaget’s stage of formal operational thought?
A. Reliance on concrete experiences for reasoning
B. Limited understanding of abstract concepts
C. Ability to reason abstractly about concepts like justice and power
D. Complete dependence on parental guidance for decision-making
C. Ability to reason abstractly about concepts like justice and power
An adolescent’s newfound ability to reason abstractly is most likely to result in which of the following behaviors?
A. Increased dependence on parents for decisions
B. Disinterest in social and moral issues
C. More frequent engagement in debates and discussions about values
D. Avoidance of challenging societal norms
C. More frequent engagement in debates and discussions about values
The nurse understands that the desire for independence in adolescents is primarily driven by which of the following?
A. A lack of parental support
B. The need to establish their own identity and values
C. Immaturity in cognitive development
D. Fear of responsibility
B. The need to establish their own identity and values
Which of the following behaviors is consistent with cognitive development in adolescents according to Piaget’s theory? (Select all that apply)
A. An ability to think concretely and focus only on physical objects
B. Understanding complex concepts such as beauty and justice
C. Experimenting with risky behaviors to establish identity
D. Complete reliance on authority figures for moral guidance
B. Understanding complex concepts such as beauty and justice
C. Experimenting with risky behaviors to establish identity
The nurse is providing education to parents about changes in cognitive development during adolescence. Which statement by the nurse is appropriate?
A. “Adolescents tend to think only in literal terms.”
B. “You should expect your child to challenge your beliefs and values.”
C. “Your child will always prioritize parental views over peer influence.”
D. “Concrete reasoning skills decrease during adolescence.”
B. “You should expect your child to challenge your beliefs and values.”
Rationale: Adolescents often challenge parental beliefs and values as they explore their identity and develop their own set of principles, which is a normal part of cognitive development in this stage.
A nurse is discussing psychosocial development with the parents of a teenager. Which of the following activities should the nurse emphasize as a key component of adolescent socialization and identity formation?
A. Spending time primarily with family
B. Isolating themselves from social interactions
C. Engaging in peer group activities and social events
D. Limiting interactions to academic settings
C. Engaging in peer group activities and social events
Rationale: Peer group activities play a crucial role in adolescent development by helping teens establish their identity, learn social skills, and develop meaningful relationships. These interactions are central to their psychosocial development.
An adolescent patient expresses interest in joining extracurricular school activities. The nurse understands that participation in these activities primarily contributes to which of the following aspects of adolescent development?
A. Increased dependence on parental guidance
B. Avoidance of peer pressure
C. Development of social skills and independence
D. Isolation from peers
C. Development of social skills and independence
A nurse is educating parents on adolescent behavior. Which of the following statements by the parents indicates understanding of psychosocial changes during adolescence?
A. “Our child should continue to spend most of their time with family to avoid peer influence.”
B. “Peer interactions are important for our child’s social development and identity.”
C. “Adolescents do not benefit much from sports or group activities.”
D. “Our child should focus solely on academic activities to prepare for the future.”
B. “Peer interactions are important for our child’s social development and identity.”
A nurse is discussing temperament with the parents of a teenage patient. Which of the following statements by the parents indicates a need for further teaching?
A. “Our teen’s temperament is likely to change drastically during adolescence.”
B. “Our teen’s personality traits are likely consistent with their early childhood temperament.”
C. “Our child may display more independence and potentially challenging behaviors during adolescence.”
D. “Understanding our teen’s personality type can help us provide structure and support.”
A. “Our teen’s temperament is likely to change drastically during adolescence.”
Rationale: While adolescence may bring changes in behavior, temperament is relatively stable from childhood to the teenage years. Changes may reflect responses to developmental challenges but do not typically indicate a drastic change in overall temperament.
The nurse is counseling parents on managing their adolescent’s temperament. Which approach is recommended to support the adolescent’s development?
A. Providing structure while supporting the adolescent’s individuality
B. Ignoring any differences in personality type
C. Enforcing strict discipline with little room for autonomy
D. Expecting the adolescent to adopt the same temperament as their peers
A. Providing structure while supporting the adolescent’s individuality
Which of the following is an example of how temperament may manifest in an adolescent who was an easily stimulated infant?
A. Maintaining a perfectly organized and quiet study space
B. Preferring routine and fixed schedules
C. Avoiding new and challenging activities
D. Displaying a chaotic schedule, messy room, and interest in various activities
D. Displaying a chaotic schedule, messy room, and interest in various activities
Rationale: An adolescent who was an easily stimulated infant may show similar characteristics as a teenager, such as having a busy schedule, a messy room, and engagement in multiple interests, reflecting their early temperament traits
A nurse is caring for an adolescent patient with a chronic health condition. Which of the following interventions is most effective in promoting the adolescent’s adherence to care?
A. Providing repeated strict instructions on managing the condition
B. Allowing parents to handle all aspects of the condition management
C. Introducing the adolescent to peers who manage the same condition successfully
D. Focusing solely on educational pamphlets and handouts
C. Introducing the adolescent to peers who manage the same condition successfully
A healthcare provider is taking a health history from an adolescent. To promote accurate disclosure of information, which of the following actions should the nurse take?
A. Ensure a parent is present at all times
B. Guarantee that the adolescent will not speak with the provider alone
C. Provide an opportunity for the adolescent to speak privately with the healthcare provider
D. Allow only group interviews with peers present
C. Provide an opportunity for the adolescent to speak privately with the healthcare provider
Which developmental milestone is expected during the infancy period?
A. Mastery of abstract reasoning
B. Rapid physical growth and emerging cognitive skills
C. Increasing independence and social skill mastery
D. Significant social role experimentation
B. Rapid physical growth and emerging cognitive skills
What does resiliency theory primarily focus on when assessing children and families?
A. The effect of genetic predispositions
B. Risk and protective factors during crises
C. Cognitive development milestones
D. Language and social skills
B. Risk and protective factors during crises
In applying Bronfenbrenner’s ecologic theory, which of the following influences should a nurse consider as part of the child’s microsystem?
A. Mass media
B. Societal norms
C. Cultural beliefs
D. Family relationships
D. Family relationships
When using Piaget’s theory of cognitive development, which stage is characteristic of a school-age child?
A. Concrete operational
B. Preoperational
C. Sensorimotor
D. Formal operational
A. Concrete operational
According to Erikson’s psychosocial theory, which developmental task should be mastered during adolescence?
A. Trust versus mistrust
B. Industry versus inferiority
C. Identity versus role confusion
D. Initiative versus guilt
C. Identity versus role confusion
During a routine visit, an adolescent reports engaging in sexual activity but denies using any form of birth control or protection. Which is the nurse’s priority action?
A. Reprimand the adolescent for their behavior
B. Provide education on contraceptive options and STI prevention
C. Instruct the adolescent to avoid further sexual encounters
D. Inform the parents immediately without consent
B. Provide education on contraceptive options and STI prevention
A 12-year-old male patient comes in for a wellness check. The nurse notes that the patient’s pubic hair has started to spread laterally and shows increased pigmentation. Which additional assessment finding is consistent with early adolescence in males?
A) Trunk growth outpacing extremity growth
B) Enlargement of testes and lengthening of the penis
C) Development of axillary hair
D) Growth of facial hair on the chin
B) Enlargement of testes and lengthening of the penis
Rationale: During early adolescence (10-13 years), males experience pubic hair spread, increased pigmentation, testicular enlargement, and penile growth. Trunk growth, axillary hair, and facial hair typically occur later.
A nurse is teaching parents about the physical changes their 11-year-old son will experience during early adolescence. Which statement by the parents indicates understanding?
A) “We can expect his shoulders to broaden significantly during this time.”
B) “He will likely experience voice deepening within the next year.”
C) “Facial hair growth will start during this stage.”
D) “His extremities will grow faster than his trunk, giving him a lanky appearance.”
D) “His extremities will grow faster than his trunk, giving him a lanky appearance.”
Rationale: During early adolescence, extremity growth outpaces trunk growth, giving the characteristic “lanky” appearance. Broad shoulders and significant voice deepening occur in later adolescence.
Which finding should the nurse expect during the physical exam of a 13-year-old male entering early adolescence? Select all that apply.
A) Pubic hair begins to curl and pigmentation increases
B) Testicular enlargement
C) Facial hair on the upper lip
D) Extremities growing faster than the trunk
E) Deepening of the voice
A) Pubic hair begins to curl and pigmentation increases
B) Testicular enlargement
D) Extremities growing faster than the trunk
Rationale: Early adolescence is marked by pubic hair changes, testicular enlargement, and rapid extremity growth. Facial hair and significant voice deepening occur in mid to late adolescence.
A parent of a 10-year-old male asks the nurse about the physical changes their child might soon experience. Which change would the nurse explain as occurring first in early adolescence?
A) Growth of pubic hair with increased pigmentation
B) Significant height gain from trunk elongation
C) Broadening of the chest and shoulders
D) Development of a deepened voice
A) Growth of pubic hair with increased pigmentation
Rationale: One of the first signs of early adolescence in males is the lateral spread, curling, and increased pigmentation of pubic hair, along with testicular enlargement.
During a growth assessment, a nurse notices that a 12-year-old male appears taller and his arms and legs seem disproportionately longer than his trunk. How should the nurse interpret this finding?
A) A possible growth hormone deficiency
B) A delayed sign of puberty
C) A normal sign of early adolescence growth
D) An indication of scoliosis
C) A normal sign of early adolescence growth
Rationale: In early adolescence, extremities grow faster than the trunk, leading to a “lanky” or elongated appearance. This is a normal growth pattern during this stage.
A nurse is assessing a 15-year-old male during a routine wellness check. Which physical change would the nurse expect during middle adolescence?
A) Pubic hair is fine and sparsely distributed.
B) The penis has reached its full adult size.
C) The skin around the scrotum has darkened.
D) Voice deepening is complete.
C) The skin around the scrotum has darkened.
Rationale: During middle adolescence, the scrotal skin darkens as part of ongoing pubertal development. Pubic hair becomes coarse, and the penis and testes continue to grow but may not yet reach full adult size. Voice changes begin during this stage but may not be complete until later adolescence.
A 14-year-old male reports tenderness around his chest area during a physical exam. The nurse explains this is likely due to which process?
A) Gynecomastia, a temporary condition during puberty
B) An abnormal hormonal imbalance requiring further evaluation
C) Muscle strain from physical activity
D) Fat accumulation due to weight gain
A) Gynecomastia, a temporary condition during puberty
Rationale: Gynecomastia, or temporary breast enlargement, is common in middle adolescence due to hormonal fluctuations. It typically resolves without intervention. Persistent or significant cases may require further evaluation.
Which findings are typical during a physical assessment of a 16-year-old male in middle adolescence? Select all that apply.
A) Coarse pubic hair with adult distribution
B) Enlarged glands penis
C) Fully developed voice deepening
D) Scrotal skin darkening
E) Reduction in breast tissue enlargement
A) Coarse pubic hair with adult distribution
B) Enlarged glands penis
D) Scrotal skin darkening
Rationale: Middle adolescence is characterized by coarser pubic hair, darkened scrotal skin, and development of the glands penis. Voice deepening and gynecomastia may continue into late adolescence.
A nurse is counseling a parent about their 14-year-old son’s pubertal changes. The parent asks why their son’s voice cracks frequently. What is the best response by the nurse?
A) “This is due to his voice box enlarging and vocal cords thickening.”
B) “It happens because of uneven growth of his vocal cords.”
C) “This indicates a need to consult an endocrinologist for evaluation.”
D) “It’s caused by temporary irritation from hormonal changes.”
A) “This is due to his voice box enlarging and vocal cords thickening.”
Rationale: Voice changes during middle adolescence occur as the larynx enlarges and the vocal cords thicken. Cracking is a normal part of this process as the voice matures.
During an exam, the nurse notices that a 15-year-old male’s pubic hair distribution matches that of an adult. Which other findings would support this stage of puberty?
A) The testes and penis are fully developed.
B) The scrotal skin is darkened, and the glands penis has developed.
C) Pubic hair is coarse and curly but not yet in adult distribution.
D) There is minimal scrotal pigmentation.
B) The scrotal skin is darkened, and the glands penis has developed.
Rationale: Adult distribution of pubic hair, scrotal darkening, and development of the glands penis are indicative of middle adolescence. The testes and penis continue to grow but are not yet fully developed.
A nurse is assessing pubertal changes in a 14-year-old male. Which observation should prompt further evaluation?
A) Absence of facial hair
B) Sparse, fine pubic hair
C) No testicular enlargement
D) Mild breast enlargement
C) No testicular enlargement
Rationale: Testicular enlargement is one of the first signs of puberty and should have occurred before age 14. The absence of this change warrants evaluation for delayed puberty.
A 15-year-old male patient reports embarrassment due to mild breast enlargement. The nurse provides education about this finding. Which statement by the patient indicates a need for further teaching?
A) “This is caused by hormonal changes and will likely go away.”
B) “It’s uncommon for boys my age to experience this.”
C) “If it doesn’t go away, I might need to see a doctor.”
D) “This doesn’t mean I have a health problem.”
B) “It’s uncommon for boys my age to experience this.”
Rationale: Gynecomastia is common in middle adolescence due to hormonal fluctuations. While it typically resolves, persistent cases may require medical evaluation. The statement about its rarity reflects a misunderstanding.
A 16-year-old male reports concerns about ongoing voice changes. Which nursing intervention is most appropriate?
A) Reassure the patient that voice maturation can continue through late adolescence.
B) Recommend an ENT specialist evaluation for vocal cord damage.
C) Suggest voice therapy to accelerate the process.
D) Advise limiting vocal strain to avoid further voice cracking.
A) Reassure the patient that voice maturation can continue through late adolescence.
Rationale: Voice changes, including cracking, are normal during middle adolescence and may continue into late adolescence. Unless accompanied by other symptoms, no intervention is typically needed.
A nurse is performing a physical assessment of a 19-year-old male. Which finding is consistent with late adolescence?
A) Testes and penis continue to grow.
B) Mature pubic hair distribution and coarseness.
C) Breast enlargement with tenderness.
D) The scrotum appears pale and underdeveloped.
B) Mature pubic hair distribution and coarseness.
Rationale: During late adolescence, pubic hair reaches its mature distribution and texture. The testes, scrotum, and penis have reached adult size and shape by this stage, and breast enlargement (gynecomastia) has typically resolved.
The nurse is counseling a parent of a 17-year-old male. The parent is concerned because their son had mild breast enlargement at 15, but it has now disappeared. What is the best response by the nurse?
A) “This could indicate a hormonal imbalance and requires further evaluation.”
B) “Your son should be screened for gynecomastia as this is unusual.”
C) “Weight loss is likely the reason for the disappearance of breast enlargement.”
D) “Breast enlargement during puberty is normal and often resolves by late adolescence.”
D) “Breast enlargement during puberty is normal and often resolves by late adolescence.”
Rationale: Gynecomastia is common during middle adolescence due to hormonal changes and typically resolves without treatment by late adolescence.
During a physical exam of an 18-year-old male, the nurse observes darkened scrotal skin. Which other finding would be consistent with late adolescence?
A) Pubic hair spread laterally with sparse pigmentation.
B) Tenderness and swelling of the scrotum.
C) Fully developed adult size and shape of the testes and penis.
D) Continued enlargement of the glands penis.
C) Fully developed adult size and shape of the testes and penis.
Rationale: By late adolescence, the male reproductive organs have reached their adult size and shape, and the scrotal skin is fully darkened. Pubic hair becomes coarse and distributed in an adult pattern.
Which assessment finding in a 19-year-old male requires further investigation?
A) Absence of facial hair
B) Darkened scrotal skin
C) Mature pubic hair distribution
D) Adult-sized testes and penis
A) Absence of facial hair
Rationale: By late adolescence, males typically develop facial hair as part of secondary sexual characteristics. The absence of facial hair in a 19-year-old warrants evaluation for delayed puberty or hormonal imbalance.
A 17-year-old male asks the nurse about the resolution of breast enlargement he experienced at age 15. What explanation should the nurse provide?
A) “Breast enlargement in males is caused by excessive estrogen and may persist into adulthood.”
B) “It’s a normal part of puberty, and most cases resolve by late adolescence without intervention.”
C) “The enlargement resolves because testosterone levels remain stable after puberty.”
D) “This is likely due to weight changes rather than hormonal shifts.”
B) “It’s a normal part of puberty, and most cases resolve by late adolescence without intervention.”
Rationale: Breast enlargement (gynecomastia) during puberty is caused by hormonal fluctuations and typically resolves by late adolescence as hormone levels stabilize.
A nurse is assessing a 20-year-old male during a routine exam. Which findings are expected at this stage of puberty? Select all that apply.
A) Fully developed testes, scrotum, and penis
B) Coarse pubic hair in an adult distribution
C) Pale scrotal skin with minimal pigmentation
D) Absence of breast enlargement
E) Continued voice cracking
A) Fully developed testes, scrotum, and penis
B) Coarse pubic hair in an adult distribution
D) Absence of breast enlargement
Rationale: By late adolescence, the male reproductive organs reach their adult size and shape, pubic hair is coarse and distributed in an adult pattern, and breast enlargement resolves. Voice changes and scrotal pigmentation occur earlier during puberty.
A 12-year-old female comes in for her annual physical exam. She reports starting her first menstrual period two months ago. Which physical change is consistent with her current developmental stage?
A) Full breast development with separation of the breasts.
B) Pubic hair that is coarse and extends to the thighs.
C) Breast buds with no separation of the breasts.
D) Absence of pubic hair.
C) Breast buds with no separation of the breasts.
Rationale: During early adolescence, the areola enlarges, but there is no separation of the breasts yet. Pubic hair begins to curl and spread but has not reached full adult distribution or coarseness.
During a health education session, a 10-year-old female asks about when she might expect her first menstrual period. What is the most accurate response by the nurse?
A) “Most girls get their period around age 15.”
B) “The average age for the first menstrual period is 12 years.”
C) “You will start your period as soon as your breasts are fully developed.”
D) “Menstrual periods begin before any pubic hair growth starts.”
B) “The average age for the first menstrual period is 12 years.”
Rationale: Menarche (the first menstrual period) typically occurs around age 12, but it can range from 9 to 16 years. Menstrual periods begin after the initial development of pubic hair and breast budding.
Which findings would a nurse expect during an assessment of an 11-year-old female in early adolescence? Select all that apply.
A) Breast buds with no separation of the breasts
B) Coarse pubic hair extending to the thighs
C) Pubic hair beginning to curl and spread over the mons pubis
D) First menstrual period
E) Fully developed areola and breast mound
A) Breast buds with no separation of the breasts
C) Pubic hair beginning to curl and spread over the mons pubis
D) First menstrual period
Rationale: Early adolescence is marked by breast budding, pubic hair curling and spreading, and the onset of menarche. Coarse pubic hair extending to the thighs and fully developed breasts occur in later stages of puberty.
A nurse is teaching parents about the physical changes their 12-year-old daughter is experiencing. Which statement by the parents indicates a need for further education?
A) “Her menstrual period is likely to begin soon.”
B) “Her breasts are fully developed, which is why there is no separation.”
C) “Her pubic hair is starting to curl and spread.”
D) “We should teach her about proper hygiene during her period.”
B) “Her breasts are fully developed, which is why there is no separation.”
Rationale: In early adolescence, breast buds develop, and the areola enlarges, but the breasts are not fully developed. Full breast development, including separation, occurs later in adolescence.
The parents of a 13-year-old female express concern because their daughter has not yet started her period. What should the nurse explain as the most important factor in determining normal pubertal development?
A) The presence of pubic hair and breast buds
B) The age of her peers when they started menstruating
C) Her weight and nutritional status
D) Her chronological age
A) The presence of pubic hair and breast buds
Rationale: The development of secondary sexual characteristics, such as breast buds and pubic hair, indicates normal pubertal progression. Menarche usually follows within 2-3 years after the onset of breast budding.
During a health education session, a 10-year-old female asks why her breasts have started to feel tender and grow. How should the nurse respond?
A) “This is unusual at your age and may require medical evaluation.”
B) “Breast tenderness is a sign of full breast development.”
C) “This is normal because your body is beginning puberty, and your breasts are starting to develop.”
D) “Breast development only begins after your period starts.”
C) “This is normal because your body is beginning puberty, and your breasts are starting to develop.”
Rationale: Breast tenderness and budding are common during early adolescence and signal the onset of puberty. Breast development begins before menarche, not after.
During an assessment of a 15-year-old female, the nurse observes that the pubic hair is coarse in texture and the areola and papilla have separated from the contour of the breasts to form a secondary mound. What should the nurse document regarding the patient’s stage of development?
A) Early adolescence
B) Middle adolescence
C) Late adolescence
D) Tanner Stage 5
B) Middle adolescence
Rationale: Middle adolescence is characterized by coarser pubic hair and the formation of a secondary breast mound. Tanner Stage 5 represents full adult maturity, which typically occurs in late adolescence.
Which developmental change should the nurse expect to assess in a 16-year-old female during middle adolescence?
A) Pubic hair that begins to curl and spread over the mons pubis.
B) Breast buds without separation of the areola.
C) Complete breast development with no secondary mound.
D) Pubic hair coarseness and increased amount.
D) Pubic hair coarseness and increased amount.
Rationale: By middle adolescence, pubic hair becomes coarse, and its amount increases. Breast buds and lack of areolar separation are features of early adolescence, while complete breast development occurs in late adolescence.
A mother expresses concern that her 14-year-old daughter’s breasts appear uneven, with the areola forming a distinct mound on one side but not the other. What is the best response by the nurse?
A) “Uneven breast development at this stage is common and typically resolves as puberty progresses.”
B) “This may indicate an underlying hormonal imbalance and should be evaluated.”
C) “Your daughter is likely experiencing late adolescence, and this is unusual.”
D) “This suggests a problem with breast tissue development and requires imaging.”
A) “Uneven breast development at this stage is common and typically resolves as puberty progresses.”
Rationale: Uneven breast development, including the formation of a secondary mound, is normal during middle adolescence. This asymmetry often resolves as puberty continues.
Which findings should the nurse expect when assessing a 15-year-old female in middle adolescence? Select all that apply.
A) Pubic hair that is coarse in texture.
B) Areola and papilla forming a secondary mound.
C) Fully developed breasts with no distinct mound.
D) Sparse, fine pubic hair that has not yet spread.
E) Increased amount of pubic hair compared to early adolescence.
A) Pubic hair that is coarse in texture.
B) Areola and papilla forming a secondary mound.
E) Increased amount of pubic hair compared to early adolescence.
Rationale: During middle adolescence, pubic hair becomes coarse and its amount increases, and the areola and papilla form a secondary mound. Fully developed breasts and sparse pubic hair are associated with late and early adolescence, respectively.
The parents of a 14-year-old female ask about changes in their daughter’s breasts. They report that the areola now appears more prominent. What explanation should the nurse provide?
A) “This is an indication of early adolescence and breast budding.”
B) “This is a normal part of middle adolescence as the areola separates from the breast contour to form a secondary mound.”
C) “This is unusual and may require hormonal therapy for proper breast development.”
D) “This is a sign that your daughter has completed breast development.”
B) “This is a normal part of middle adolescence as the areola separates from the breast contour to form a secondary mound.”
Rationale: The formation of a secondary mound from the areola and papilla is a hallmark of middle adolescence and normal breast development at this stage.
A 16-year-old female reports feeling self-conscious about her pubic hair and breast changes. How should the nurse respond?
A) “These changes are part of normal puberty and indicate that your body is maturing as expected.”
B) “You are likely experiencing late adolescence and nearing the end of puberty.”
C) “These changes suggest that your hormones may be imbalanced.”
D) “The changes you are describing are unusual and should be evaluated further.”
C) C) “These changes suggest that your hormones may be imbalanced.”
Rationale: Coarser pubic hair, increased hair amount, and the formation of a secondary breast mound are normal developmental changes during middle adolescence. Providing reassurance helps support the patient’s body image and self-esteem.
During a physical assessment of a 19-year-old female, the nurse observes that her pubic hair is coarse and evenly distributed in an adult pattern. How should the nurse interpret this finding?
A) A sign of delayed puberty
B) Normal development for late adolescence
C) An indication of hormonal imbalance
D) A feature of early adolescence
B) Normal development for late adolescence
Rationale: By late adolescence, females typically have mature pubic hair that is coarse and evenly distributed in an adult pattern. Delayed puberty and hormonal imbalances would present with other findings, such as sparse or absent pubic hair.
The nurse is assessing pubertal development in an 18-year-old female. Which finding would indicate normal development for her age?
A) Pubic hair is beginning to curl and spread over the mons pubis.
B) Pubic hair is sparse and fine.
C) Pubic hair is coarse and distributed in an adult pattern.
D) Pubic hair is absent.
C) Pubic hair is coarse and distributed in an adult pattern.
Rationale: By late adolescence, pubic hair should have reached full maturity, with a coarse texture and adult distribution. Sparse or absent pubic hair would indicate delayed puberty, while curling and spreading are features of early adolescence.
A 17-year-old female asks the nurse why her pubic hair now looks different compared to a few years ago. What is the most appropriate response?
A) “Your pubic hair will continue to grow and develop its adult pattern throughout late adolescence.”
B) “The changes you’re noticing are likely related to hormonal fluctuations that occur during middle adolescence.”
C) “Your pubic hair changes indicate a possible hormonal imbalance requiring further evaluation.”
D) “Pubic hair becomes coarse and reaches its adult distribution during late adolescence, which is a normal part of development.”
D) “Pubic hair becomes coarse and reaches its adult distribution during late adolescence, which is a normal part of development.”
Rationale: Mature pubic hair distribution and coarseness are hallmarks of late adolescence. This explanation provides reassurance and accurate education about normal developmental changes.
A nurse is assessing the pubertal development of a 9-year-old girl. Breast buds are palpable below a slightly enlarged areola, and no pubic hair is present. How should the nurse document these findings?
A) Delayed pubertal development
B) Normal progression of puberty
C) Precocious puberty
D) Advanced breast development
B) Normal progression of puberty
Rationale: Breast budding (thelarche) typically begins between 8-10 years of age and is the first sign of puberty in girls. The absence of pubic hair is also normal at this stage, as breast development usually precedes pubic hair development.
During an assessment, the nurse observes that a 7-year-old girl has small amounts of pubic hair and palpable breast buds. What is the priority nursing action?
A) Document the findings as normal development.
B) Monitor growth over the next year for progression.
C) Notify the healthcare provider for further evaluation.
D) Reassure the parents that these changes are typical for her age.
C) Notify the healthcare provider for further evaluation.
Rationale: The presence of pubic hair or breast development before 8 years of age may indicate precocious puberty and requires further evaluation to rule out hormonal imbalances or other underlying conditions.
A nurse is educating parents about normal breast development in their 10-year-old daughter. Which statement by the parents indicates a need for further teaching?
A) “Breast development usually happens before other signs of puberty.”
B) “Her breasts might develop unevenly, and that’s normal.”
C) “Pubic hair typically appears before breast development.”
D) “Her breasts might feel tender during this stage.”
C) “Pubic hair typically appears before breast development.”
Rationale: Breast development (thelarche) is usually the first sign of puberty in girls and precedes pubic hair development. This statement indicates a misunderstanding of the normal sequence of pubertal changes.
Which findings should the nurse expect during the physical exam of a preadolescent girl? Select all that apply.
A) No breast development
B) Lightly pigmented, sparse pubic hair along the labia majora
C) Palpable glandular breast tissue under the areola
D) Symmetric breast development
E) Absence of pubic hair
A) No breast development
E) Absence of pubic hair
Rationale: Preadolescent girls have no breast development (Tanner Stage 1) and no pubic hair. Breast budding and initial pubic hair are seen during early adolescence (Tanner Stage 2).
A mother reports that her 8-year-old daughter has recently developed breast buds. How should the nurse respond?
A) “This is early and will require further evaluation.”
B) “This is within the normal range for breast development.”
C) “This indicates that her menstrual cycle will begin soon.”
D) “This is a sign of delayed puberty and requires hormonal therapy.”
B) “This is within the normal range for breast development.”
Rationale: Breast budding typically begins between 8-10 years of age. Development at 8 years is still within the normal range and does not indicate a need for intervention unless accompanied by other unusual findings.
A nurse is assessing a 6-year-old girl and observes breast budding. What action should the nurse take?
A) Document the findings as normal development.
B) Perform an endocrine panel to assess for hormonal imbalances.
C) Refer the child for further evaluation for possible precocious puberty.
D) Reassure the parents that this is typical for some children
C) Refer the child for further evaluation for possible precocious puberty.
Rationale: Breast development before 8 years of age may indicate precocious puberty and requires further evaluation to determine the cause and appropriate intervention.
Which finding would indicate a need for further evaluation in a 5-year-old girl?
A) Palpable glandular tissue under the areola
B) Absence of pubic hair
C) Symmetric breast development
D) No signs of breast development
A) Palpable glandular tissue under the areola
Rationale: Breast development before 6 years of age is unusual and requires evaluation for precocious puberty or other endocrine disorders. The absence of pubic hair or breast development is normal in preadolescent children.
At what age do boys typically begin to experience the initial signs of pubertal development, including testicular enlargement and thinning of the scrotum?
a) 8-9 years
b) 9-10 years
c) 10-11 years
d) 11-12 years
b) 9-10 years
Rationale: Pubertal development in boys typically begins with the enlargement of the testicles and thinning of the scrotum at a mean age of 9 to 10 years.
At what age is the first appearance of straight, downy pubic hair at the base of the penis typically observed in boys?
a) 8-9 years
b) 9-10 years
c) 10-11.5 years
d) 11-12 years
c) 10-11.5 years
Rationale: Straight, downy pubic hair typically appears at the base of the penis at a mean age of 10 to 11.5 years in boys, depending on ethnicity.
What is the mean age for boys in the United States to complete pubertal development?
a) 12 years
b) 13 years
c) 14 years
d) 15 years
d) 15 years
Rationale: The mean age for boys in the United States to complete pubertal development and reach Tanner stage 5 is around 15 years.
A 9-year-old male patient presents with noticeable testicular enlargement and thinning of the scrotum. Based on the signs of pubertal development, what is the expected next physical change in this adolescent?
a) Enlargement of the penis
b) Development of straight, downy pubic hair
c) Deepening of the voice
d) Broadening of the shoulders
b) Development of straight, downy pubic hair
Rationale: After the initial signs of testicular enlargement and thinning of the scrotum, the next physical change in boys typically includes the appearance of straight, downy pubic hair at the base of the penis.
While in the pediatrician’s office for their child’s 12-month well-child exam, the parents ask
the nurse for advice on age-appropriate toys for their child. Based on the child’s developmental
level, which types of toys would the nurse suggest? Select all that apply.
- Soft toys that can be manipulated
- Small toys that can pop apart and go back together
- Jack-in-the-box toys
- Toys with black and white patterns
- Push-and-pull toys
- Soft toys that can be manipulated
- Jack-in-the-box toys
- Push-and-pull toys
A mother of a school-age client who recently had surgery for the removal of tonsils and
adenoids complains that the child has begun sucking his thumb again. Which coping mechanisms
is the child using to cope with the surgery and hospitalization?
- Repression
- Rationalization
- Regression
- Fantasy
- Regression
Rationale: The correct answer is regression, which is a return to an earlier behavior. Repression is the
involuntary forgetting of uncomfortable situations, rationalization is an attempt to make
unacceptable feelings acceptable, and fantasy is a creation of the mind to help deal with an
unacceptable fear.
While being comforted in the emergency department, a young school-age sibling of a
pediatric trauma victim blurts out to the nurse,
“It’s my fault! When we were fighting yesterday, I
told him I wished he was dead!” Which response is most appropriate by the nurse?
- Asking the child if she would like to sit down and drink some water
- Sitting the child down in an empty room with markers and paper so that she can draw a picture
- Calmly discussing the catheters, tubes, and equipment that the patient requires and explaining
to the sibling why the patient needs them - Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens
- Reassuring the child that it is normal to get angry and say things that we do not mean but that we have no control over whether or not an accident happens
Rationale: “Magical thinking” is the belief that events occur because of one’s thoughts or actions, and the
most therapeutic way to respond to this is to correct any misconceptions that children may have
and reassure them that they are not to blame for any accidents or illness.
While assessing the development of a 9-month-old infant, the nurse asks the mother if the
child actively looks for toys when they are placed out of sight. Which developmental task is the
nurse assessing this infant for?
- Object permanence
- Centration
- Transductive reasoning
- Conservation
- Object permanence
Rationale: A child who has developed object permanence has the ability to understand that
even though something is out of sight, it still exists. In centration, a child focuses only on a
particular aspect of a situation. Transductive reasoning happens when a child connects two
events in a cause-effect relationship because they have occurred at the same time. Conservation
describes when a child knows that matter is not changed when its form is altered.
The nurse is counseling the parents of a 6-1/2-month-old infant. Which age-appropriate toy is
most appropriate for the nurse to suggest to these parents?
- Soft, fluid-filled ring that can be chilled in the refrigerator
- Colorful rattle
- Jack-in-the-box toy
- Push-and-pull toy
- Soft, fluid-filled ring that can be chilled in the refrigerator
Rationale: Teething toys would be appropriate for this age. The rattle might be better
enjoyed by a 3- to 6-month-old infant, and the jack-in-the-box and push-and-pull toys are better
suited for a 9- to 12-month-old child.
A nurse is assessing language development in all the infants presenting at the doctor’s office
for well-child visits. At which age range would the nurse expect a child to verbalize the words
“dada” and “mama”?
- 3 and 5 months
- 6 and 8 months
- 9 and 12 months
- 13 and 18 months
- 9 and 12 months
Rationale: Children should be able to verbalize “mama” or “dada” to identify their parents by 1 year of age.
The parents of an 8-year-old state that their son seems very interested in trying new activities.
When the parents ask for suggested activities for this age child, the nurse recommends scouts as
an activity that will foster growth and development. In which stage of Erikson’s “psychosocial
stages of development” is this child?
- Trust versus mistrust
- Initiative versus guilt
- Industry versus inferiority
- Identity versusrole confusion
- Industry versus inferiority
Rationale: Trust versus mistrust (birth to 1 year)—The task of the first year of life is to establish trust
in the people providing care. Trust is fostered by provision of food, clean clothing, touch, and
comfort. If basic needs are not met, the infant will eventually learn to mistrust others. Initiative
versus guilt (3 to 6 years)—The young child initiates new activities and considers new ideas.
This interest in exploring the world creates a child who is involved and busy. Constant criticism,
on the other hand, leads to feelings of guilt and a lack of purpose. Identity versus role
confusion (12 to 18 years)—In adolescence, as the body matures and thought processes become
more complex, a new sense of identity or self is established. The self, family, peer group, and
community are all examined and redefined. The adolescent who is unable to establish a
meaningful definition of self will experience confusion in one or more roles of life. Industry
versus inferiority (6 to 12 years)—The middle years of childhood are characterized by
development of new interests and by involvement in activities. The child takes pride in
accomplishments in sports, school, home, and community. If the child cannot accomplish what is
expected, however, the result will be a sense of inferiority.
Two 3-year-olds are playing in a hospital playroom together. One is working on a puzzle
while the other is stacking blocks. Which type of play are these children exhibiting?
- Cooperative play
- Associative play
- Parallel play
- Solitary play
- Parallel play
Parallel play describes when two or more children play together, each engaging in their own
activities. Cooperative play happens when children demonstrate the ability to cooperate with
others and play a part in order to contribute to a unified whole. Associative play is characterized
by children interacting in groups and participating in similar activities. In solitary play, a child
plays alone.
The nurse, talking with the parents of a toddler who is struggling with toilet training, reassures
them that their child is demonstrating a typical developmental stage. According to Erikson,
which developmental stage will the nurse document in the medical record for this toddler?
- Trust versus mistrust
- Autonomy versus shame and doubt
- Initiative versus guilt
- Industry versus inferiority
- Autonomy versus shame and doubt
Rationale: Erikson’s stage of “autonomy versus shame and doubt” marks a period of time when the
toddler is trying to gain some independence while still wanting to please adults.
While trying to inform a young school-age client about what will occur during an upcoming
CT scan, the nurse notices that the child is engaged in a collective monologue, talking about a
new puppy. Which response by the nurse is the most appropriate in this situation?
- “Please stop talking about your puppy. I need to tell you about your CT scan.”
- Ignore the child’s responses and continue discussing the procedure.
- “I’ll come back when you are ready to talk with me more about your CT scan.”
- “You must be so excited to have a new puppy! They are so much fun. Now, let me tell you again about going downstairs in a wheelchair to a special room.”
- “You must be so excited to have a new puppy! They are so much fun. Now, let me tell you again about going downstairs in a wheelchair to a special room.”
Rationale: When a child becomes engaged in a collective monologue, it is best to respond to the content of his or her conversation and then attempt to reinsert facts about the content that needs to be
covered.
An adolescent client with cystic fibrosis suddenly becomes noncompliant with the
medication regime. Which intervention by the nurse will most likely improve compliance for this
client?
- Give the child a computer-animated game that presents information on the management of
cystic fibrosis. - Arrange for the physician to sit down and talk to the child about the risks related to noncompliance with medications.
- Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.
- Discuss with the child’s parents the privileges that can be taken away, such as cell phone, if compliance fails to improve.
- Set up a meeting with some older teens with cystic fibrosis who have been managing their disease effectively.
Rationale: Providing an adolescent with positive role models who are in his peer group is the intervention
most likely to improve compliance. Interest in games may begin to wane, adults’ opinions may
be viewed negatively and challenged, and threatening punishment may further incite rebellion.
A neonatal nurse who encourages parents to hold their baby and provides opportunities for
Kangaroo Care most likely is demonstrating concern for which aspect of the infant’s
psychosocial development?
- Attachment
- Assimilation
- Centration
- Resilience
- Attachment
Rationale: Attachment is a strong emotional bond between a parent and child that forms the
foundation for the fulfillment of the basic need of trust in the infant. Assimilation describes the
child’s incorporation of new experiences, centration is the ability to consider only one aspect of a
situation at a time, and resilience is the ability to maintain healthy function even under
significant stress and adversity.
Which statement by the nurse is most appropriate prior to giving an intramuscular injection
to a 2-1/2-year-old child?
- “We will give you your shot when your mommy comes back.”
- “This is medicine that will make you better. First we will hold your leg, then I will wipe it off
with this magic cloth that kills the germs on your leg right here, then I will hold the needle like
this and say ‘one, two, three . . . go’ and give you your shot. Are you ready?” - “It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker.”
- “This is a magic sword that will give you your medicine and make you all better.”
- “It is all right to cry, I know that this hurts. After we are done you can go to the box and pick out your favorite sticker.”
Rationale: The most appropriate response would be to acknowledge the child’s feelings and give her
something to look forward to (picking out a sticker). Waiting for the mother to come back would
be inappropriate because toddlers do not have an understanding of time. Giving elaborate
descriptions and using colorful language are inappropriate. The instructions should not end with
a “are you ready” statement because the toddler will say no. You also don’t want to frighten
and/or confuse the child by using statements such as use of a magic sword.
The parents of a 1-year-old infant are concerned that this baby seems more shy and scared of
new situations than their other child and ask the nurse if this is normal. The nurse knows that the
infant is exhibiting a characteristic of the “slow-to-warm-up.” Which statement to the parents is
most appropriate by the nurse?
- “Your infant is showing a regularity in patterns of eating.”
- “Your infant displays a predominately negative mood.”
- “Your infant initially reacts to new situations by withdrawing.”
- “Your infant has intense reactions to the environment.”
- “Your infant initially reacts to new situations by withdrawing.”
Rationale: “Slow-to-warm-up” children adapt slowly to new situations and initially will withdraw.
Showing regularity in patterns of eating is a characteristic of an “easy” child, and displaying a
predominately negative mood and commonly having intense reactions to the environment are
characteristics of “difficult” children.
The nurse educator is presenting a lecture about risks to developmental progression. Which
items will the educator include in the lecture?
Select all that apply.
- Family support
- Access to the Internet
- Recent loss of employment
- Terminal illness of a family member
- Hazards within the home environment
- Recent loss of employment
- Terminal illness of a family member
- Hazards within the home environment
The nurse is assessing a toddler’s development of communication skills. The nurse
recognizes that a toddler communicates in what ways?
Select all that apply.
- Expressive jargon
- Interpersonal skills and contact with other children
- Uses all parts of speech
- Temper tantrums
- Enjoys talking
- Expressive jargon
- Interpersonal skills and contact with other children
- Temper tantrums
- Enjoys talking
T/F
Menstruation comes last in female puberty.
true
