Contemporary Pediatrics

Question 1

Challenges of peds nursing (

Answer 1

1. Everything is fragile and sensitive
2. Variety of reasoning strategies are necessary for interventions
3. Two levels and directions of discussion (kids and parents)
4. Kids see nurses as a threat
5. Kids crash quicker
6. Increased pressure to have things go right
7. Ethical dilemmas
8. Difficult for caretakes to care for children emotionally

Question 2

Cephalocaudal direction

Answer 2

Growth development from head to toe, moving in 3 mon increments and after 2 years in 6 mon increments, then in increments of 12 mon in the next 2 years

Question 3

3 month development milestones

Answer 3

Maintain head upright (head)

Question 4

6 month development milestones

Answer 4

Sitting upright (trunk)

Question 5

9 month development milestones

Answer 5

crawling (legs)

Question 6

12 month milestones (feet)

Answer 6

Walking/Standing 2-3 steps

Question 7

18 month milestones

Answer 7

run “run away from home”

Question 8

2 year development milestones

Answer 8

Jump “two feet leave the ground”

Question 9

3 year development milestones

Answer 9

tricycle “tri = 3”

Question 10

4 year development milestones

Answer 10

Hop on one foot

Question 11

• A 5-year-old boy has always been one of the shortest children in class. His
  mother tells the school nurse that her husband is 6’ tall and she is 5/7”. What should the nurse tell the child’s mother?
  1. He is expected to grow about 2 inches every year from ages 6 to 9 years
  2. He is expected to grow about 3 inches every year from age 6 to 9
  3. He should be seen by an endocrinologist for growth-hormone injections
  4. His growth should be re-evaluated when he is 7 years old

Answer 11

1. He is expected to grow about 2 inches every year from ages 6 to 9 years

Question 12

• Which statements would indicate to the nurse that a school age child is not
  developmentally on track for age? Select all that apply
  1. The child is able to follow a four-to-five step command
  2. The child started wetting the bed on admission to the hospital
  3. The child has an imaginary friend named Kelly
  4. The child enjoys playing board games with her sister
  5. The child is not able to follow rules

Answer 12

3. The child has an imaginary friend named Kelly (this is more often in children 3
   and 4 years old)
4. The child is not able to follow rules

Question 13

Theorists and their developmental theories

Answer 13

• Sigmund FREUD’s theory of psychosexual development
• Jean PIAGET’s theory of cognitive development
• Erik ERIKSON’s psychosocial theory
• Lawrence KOHLBERG’s theory of moral development

Question 14

Erickson’s stages of development

Answer 14

• Infancy (trust vs. mistrust)
• early childhood (autonomy vs. shame)
• preschool (initiative vs. guilt)
• school age (industry vs. inferiority)
• Adolescence (identity vs. role confusion)
• Young adult (intimacy vs. isolation)
• Middle adulthood (generatively vs. stagnation)
• Maturity (ego integrity vs. despair)

Question 15

Ericksons psychosocial development definition

Answer 15

• Occurs through a life-long series of crises affected by social and cultural factors
• Each psychosocial crisis needs to be resolved for the child or adult to progress emotionally. Unsuccessful resolution can leave the person emotionally disabled.

Question 16

Kohlberg moral development definition

Answer 16

• Moral development is sequential
  *Stages or levels of moral development cannot be
  skipped

Question 17

Kohlberg stages

Answer 17

• Pre conventional level (no internalization of right/wrong)
  Stage 1: Avoiding punishment
  Stage 2: Aiming at a reward
• Conventional level (Intermediate internalization of right/wrong)
  Stage 3: Good boy & good girl
  Stage 4: Loyalty to law and order
  *Post conventional level
  Stage 5: Justice and the spirit of the law
  Stage 6: Universal principles of ethics

Question 18

1. A nurse instructor is preparing to conduct a seminar about Piaget’s Theory of Cognitive
   Development. The current topic is the concrete operational stage. Which of the following
   milestones during this stage should be included in the discussion, except?
   A. Ability to think logic about objects and events.
   B. Ability to understand that an object does not affect its number, length, volume, or mass when it changes appearance or shape.
   C. Increased classification skills.
   D. Ability to exhibit propositional thought.
   E. Ability to perform mathematical problems in both addition and subtraction

Answer 18

D. Ability to exhibit propositional thought.

Question 19

2. A maternity nurse is providing instruction to a new mother regarding the psychosocial development of the newborn infant. Using Erikson’s psychosocial development theory, the nurse would instruct the mother to:
   A. Allow the newborn infant to signal a need.
   B. Anticipate all of the needs of the newborn infant.
   C. Avoid the newborn infant during the first 10 minutes of crying.
   D. Allow the infant to cry, once lessen, then attend to the infant.

Answer 19

A. Allow the newborn infant to signal a need.

Question 20

Stages of separation anxiety

Answer 20

Stage 1: Protest
Stage 2: Despair
Stage 3: Denial or detachment

Question 21

Stage 1 of separation anxiety behaviors

Answer 21

*loud inconsolable crying
*Clinging
*Attempts to force parents to stay
*Lasts variable lengths of time

Question 22

Stage 2 of separation anxiety behaviors

Answer 22

*Physical (wt loss, prone to minor illnesses, insomnia)
*other behaviors (inactivity, disinterest, may appear sad, may wail not cry, regression to earlier behaviors)