Pediatrics EXAM 1 (Ch 1-7)
. Authoritarian.
A parent setting rules for a child and expecting the child to follow them without asking
questions or complaining is displaying an authoritarian parenting style. - ANS A parent
sets rules for a child and expects the child to follow them without asking questions or
complaining. What style of parenting is this parent displaying?
a. Authoritarian
b. Authoritative
c. Permissive
d. Rejecting-neglecting
\A. bend over without falling. The 3-year-old should be able to bend over without falling.
RATIONALE: At age 4, the preschooler hops on one foot and stands on one foot up to 5
seconds. At 5 years old the preschooler stands on one foot for 10 seconds, may skip,
and may learn to skate and swim. - ANS The nurse is assessing a 3-year-old for gross
motor skill development. Which of the following would the nurse expect this preschooler
to have accomplished?
a. bend over without falling
b. standing on one foot for 10 seconds
c. skipping
d. Swimming
\ADOLESCENT: Development Theory ERIKSON - ANS IDENTITY vs ROLE
CONFUSION/DIFFUSION
Focus on body changes; importance of peer culture become primary
\ADOLESCENT: Development Theory KOHLBERG - ANS PRECONVENTIONAL LEVEL III
Initially adopts parental/societal morals; moves to internalized moral codes
\ADOLESCENT: Development Theory PIAGET - ANS FORMAL OPERATION
Moves toward greater abstract thinking and less egocentricity
\ADOLESCENT: Growth & Development - ANS •Rapid physical growth in body size and
proportions second only to growth in infancy
•Sexual characteristics and reproductive maturity occur
•Puberty begins in girls around 9 to 10 years old and in boys around 10 to 11 years old
•Cognitive and emotional development are dramatic
•Adolescents represent varying levels of identity formation
-Male or Female, Sexual orientation
•Risk Takers - drinking, drug use, sexual activity/reckless behavior
,•Spans the years of transition from childhood to adulthood
•Ages 11-20
\ADOLESCENT: Moral & Spiritual Development - ANS •Develop their own set of values
and morals
•Begin to question the status quo
•Choices are based on emotions, while they question societal standards
\ADOLESCENT: Safety Concerns - ANS •Unintentional injuries
•Internet safety - a big concern now.
•Motor vehicle safety (as a driver and as a passenger)
•All states have enacted the "graduate driving license (GDL)
•Avoiding substance abuse - huge issue with teens
•Firearm safety
•Water safety - mainly from "no fear" and possibly alcohol use
\ADOLESCENT: Social & Emotional Development - ANS •The adolescent is striving for
self-identity and increased independence. He or she spends more time with peers and
less time with family
• ***State of disequilibrium - when adolescents attempting to establish some level of
independence and the family is "learning to let go", while focusing on aging parents,
marriage and other children.****
\ADOLSCENT: Body piercings and tattoos - ANS •Non-sterile vs sterile; parts of the body
pierced or tattooed
•Tattoo is permanent, risks include infection, hepatitis B&C, HIV, skin infections lead to
scarring - especially keloid formation
\ADOLSCENT: Fine Motor Skills - ANS •Computers increase skills
•Improved handwriting
•Precise eye to hand coordination
\ADOLSCENT: Nutritional Assessment - ANS •Assess what the adolescent eats each day
with open-ended questions as well as the access to food at home and outside
•Inquire about the preferences from the different food groups
•Ask the number of times that fast foods, snacks, and other lower nutrition value foods
are eaten per week
•Engage the teen in identifying healthy fast-food options
•Provide education to the teen regarding nutritional value of favorite foods and suggest
better alternatives for those with lower nutritional value
•Emphasize the role of physical activity in maintaining healthy weight; provide healthy
physical activity options not related to sports (60 minutes per day is recommended)
\ADOLSCENT: Organ System Maturation - ANS •NEUROLOGIC system:
,-Growth of myelin sheath enables faster neural processing; cognitive growth increases
•Brain growth "fatter with information" but not in size
•RESPIRATORY system:
-Increase in diameter and length of the lungs; respiratory volume and vital capacity
increase
•RR 15-20/bpm
•CARDIOVASCULAR system:
-Size and strength of heart increases; systolic blood pressure increases and heart rate
decreases
•GASTROINTESTINAL system:
-Full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge
•With exception of wisdom teeth - age 17-20
•MUSCULOSKELETAL system:
-Linear growth is not complete until late adolescence in boys and occurs earlier in girls
-Growth plates (which promote linear growth) begin to close at puberty. Adult height is
attained when growth plates have closed in late adolescence
•During middle adolescence - shoulders, chest and hip breadth increases
•INTEGUMENTARY system:
-Skin is thick and tough; sebaceous glands are more active; sweat glands function at
adult level
\ADOLSECENT: Gross Motor Skills - ANS •Concentration has increased
•Endurance develops
•Coordination a problem
•Speed and accuracy increases
•More competitive
\Advance Directives - ANS -Parents are generally the surrogate decision makers for
children; need to take into consideration the views of the child when possible
AND (Allow Natural Death) and DNAR (Do Not Attempt Resuscitation)
\ANSWER: C "Acknowledge her fear and help her develop a strategy for dealing with it" -
ANS A nurse is caring for a 4-year-old girl. The mother says that the girl is afraid of cats
and dogs and does not like to go to the playground anymore because she wants to avoid
dogs that are often being walked in the park. What should the nurse tell the mother?
A. "It is best to avoid the playground until she outgrows the fear".
B. "She needs to face her fears head-on; take her to the park as much as possible.
C. "Acknowledge her fear ad help her develop a strategy for dealing with it"
D. "Try to minimize her fears and insist that she go to the park".
, \Areas of Focus to Encourage Growth and Development in the Adolescent - ANS •Sports
and physical fitness
•Learning and participation in school activities
•Safety issues
•Proper nutrition and healthy eating habits
•Healthy sleep hygiene and adequate rest
•Personal care
•Healthy sexual life
•Appropriate discipline
•Mental health resources
\Assessing Nutrition in School-Age Child - ANS •Check height and weight compared to
previous measurements; assess BMI for age
•Nutrition history including a 24-hour recall of what was consumed (if underweight)
•Inquire about family meals and the social aspects of eating including who prepares the
meals
•Solicit from both parent and child
•Identify any knowledge gaps relating to nutrition
\Autonomy - ANS Freedom to choose and make decisions
\b. An 8-oz serving of apple juice has about 24 g of sugar—the equivalent of 3 teaspoons
of sugar, with none of the fruit fiber that would be available in a whole apple
RATIONALE: Children need both fruit and fiber daily as part of a healthy diet. Apple juice,
while made from apples, concentrates the sugar and takes out the fiber. Water and milk
are good alternatives for beverages. - ANS The nurse obtains a nutrition history for a
school-age child. The parent indicates the child's favorite beverage is apple juice and
consumes three large glasses per day. The mother asks if this is a good thing.
Which of the following would be the best response for the nurse to reply to the mother?
a. Apple juice is very healthy. Keep up the good work!
b. Apple juice has quite a bit of sugar and no fiber. Could you substitute an apple for one
of those servings?
c. As long as your child drinks plenty of fluids, she will be fine.
\b. Freud
Freud's theory focuses on the satisfaction and/or frustration of expelling feces (anal
stage).
Rationale: Piaget's theory focuses on development of the senses of the toddler;
Erickson's theory focuses on achievement of autonomy and self-control; Kohlberg's
theory focuses on the moral development of the toddler. - ANS The nurse praises a
. Authoritarian.
A parent setting rules for a child and expecting the child to follow them without asking
questions or complaining is displaying an authoritarian parenting style. - ANS A parent
sets rules for a child and expects the child to follow them without asking questions or
complaining. What style of parenting is this parent displaying?
a. Authoritarian
b. Authoritative
c. Permissive
d. Rejecting-neglecting
\A. bend over without falling. The 3-year-old should be able to bend over without falling.
RATIONALE: At age 4, the preschooler hops on one foot and stands on one foot up to 5
seconds. At 5 years old the preschooler stands on one foot for 10 seconds, may skip,
and may learn to skate and swim. - ANS The nurse is assessing a 3-year-old for gross
motor skill development. Which of the following would the nurse expect this preschooler
to have accomplished?
a. bend over without falling
b. standing on one foot for 10 seconds
c. skipping
d. Swimming
\ADOLESCENT: Development Theory ERIKSON - ANS IDENTITY vs ROLE
CONFUSION/DIFFUSION
Focus on body changes; importance of peer culture become primary
\ADOLESCENT: Development Theory KOHLBERG - ANS PRECONVENTIONAL LEVEL III
Initially adopts parental/societal morals; moves to internalized moral codes
\ADOLESCENT: Development Theory PIAGET - ANS FORMAL OPERATION
Moves toward greater abstract thinking and less egocentricity
\ADOLESCENT: Growth & Development - ANS •Rapid physical growth in body size and
proportions second only to growth in infancy
•Sexual characteristics and reproductive maturity occur
•Puberty begins in girls around 9 to 10 years old and in boys around 10 to 11 years old
•Cognitive and emotional development are dramatic
•Adolescents represent varying levels of identity formation
-Male or Female, Sexual orientation
•Risk Takers - drinking, drug use, sexual activity/reckless behavior
,•Spans the years of transition from childhood to adulthood
•Ages 11-20
\ADOLESCENT: Moral & Spiritual Development - ANS •Develop their own set of values
and morals
•Begin to question the status quo
•Choices are based on emotions, while they question societal standards
\ADOLESCENT: Safety Concerns - ANS •Unintentional injuries
•Internet safety - a big concern now.
•Motor vehicle safety (as a driver and as a passenger)
•All states have enacted the "graduate driving license (GDL)
•Avoiding substance abuse - huge issue with teens
•Firearm safety
•Water safety - mainly from "no fear" and possibly alcohol use
\ADOLESCENT: Social & Emotional Development - ANS •The adolescent is striving for
self-identity and increased independence. He or she spends more time with peers and
less time with family
• ***State of disequilibrium - when adolescents attempting to establish some level of
independence and the family is "learning to let go", while focusing on aging parents,
marriage and other children.****
\ADOLSCENT: Body piercings and tattoos - ANS •Non-sterile vs sterile; parts of the body
pierced or tattooed
•Tattoo is permanent, risks include infection, hepatitis B&C, HIV, skin infections lead to
scarring - especially keloid formation
\ADOLSCENT: Fine Motor Skills - ANS •Computers increase skills
•Improved handwriting
•Precise eye to hand coordination
\ADOLSCENT: Nutritional Assessment - ANS •Assess what the adolescent eats each day
with open-ended questions as well as the access to food at home and outside
•Inquire about the preferences from the different food groups
•Ask the number of times that fast foods, snacks, and other lower nutrition value foods
are eaten per week
•Engage the teen in identifying healthy fast-food options
•Provide education to the teen regarding nutritional value of favorite foods and suggest
better alternatives for those with lower nutritional value
•Emphasize the role of physical activity in maintaining healthy weight; provide healthy
physical activity options not related to sports (60 minutes per day is recommended)
\ADOLSCENT: Organ System Maturation - ANS •NEUROLOGIC system:
,-Growth of myelin sheath enables faster neural processing; cognitive growth increases
•Brain growth "fatter with information" but not in size
•RESPIRATORY system:
-Increase in diameter and length of the lungs; respiratory volume and vital capacity
increase
•RR 15-20/bpm
•CARDIOVASCULAR system:
-Size and strength of heart increases; systolic blood pressure increases and heart rate
decreases
•GASTROINTESTINAL system:
-Full set of permanent teeth; liver, spleen, kidneys, and digestive tract enlarge
•With exception of wisdom teeth - age 17-20
•MUSCULOSKELETAL system:
-Linear growth is not complete until late adolescence in boys and occurs earlier in girls
-Growth plates (which promote linear growth) begin to close at puberty. Adult height is
attained when growth plates have closed in late adolescence
•During middle adolescence - shoulders, chest and hip breadth increases
•INTEGUMENTARY system:
-Skin is thick and tough; sebaceous glands are more active; sweat glands function at
adult level
\ADOLSECENT: Gross Motor Skills - ANS •Concentration has increased
•Endurance develops
•Coordination a problem
•Speed and accuracy increases
•More competitive
\Advance Directives - ANS -Parents are generally the surrogate decision makers for
children; need to take into consideration the views of the child when possible
AND (Allow Natural Death) and DNAR (Do Not Attempt Resuscitation)
\ANSWER: C "Acknowledge her fear and help her develop a strategy for dealing with it" -
ANS A nurse is caring for a 4-year-old girl. The mother says that the girl is afraid of cats
and dogs and does not like to go to the playground anymore because she wants to avoid
dogs that are often being walked in the park. What should the nurse tell the mother?
A. "It is best to avoid the playground until she outgrows the fear".
B. "She needs to face her fears head-on; take her to the park as much as possible.
C. "Acknowledge her fear ad help her develop a strategy for dealing with it"
D. "Try to minimize her fears and insist that she go to the park".
, \Areas of Focus to Encourage Growth and Development in the Adolescent - ANS •Sports
and physical fitness
•Learning and participation in school activities
•Safety issues
•Proper nutrition and healthy eating habits
•Healthy sleep hygiene and adequate rest
•Personal care
•Healthy sexual life
•Appropriate discipline
•Mental health resources
\Assessing Nutrition in School-Age Child - ANS •Check height and weight compared to
previous measurements; assess BMI for age
•Nutrition history including a 24-hour recall of what was consumed (if underweight)
•Inquire about family meals and the social aspects of eating including who prepares the
meals
•Solicit from both parent and child
•Identify any knowledge gaps relating to nutrition
\Autonomy - ANS Freedom to choose and make decisions
\b. An 8-oz serving of apple juice has about 24 g of sugar—the equivalent of 3 teaspoons
of sugar, with none of the fruit fiber that would be available in a whole apple
RATIONALE: Children need both fruit and fiber daily as part of a healthy diet. Apple juice,
while made from apples, concentrates the sugar and takes out the fiber. Water and milk
are good alternatives for beverages. - ANS The nurse obtains a nutrition history for a
school-age child. The parent indicates the child's favorite beverage is apple juice and
consumes three large glasses per day. The mother asks if this is a good thing.
Which of the following would be the best response for the nurse to reply to the mother?
a. Apple juice is very healthy. Keep up the good work!
b. Apple juice has quite a bit of sugar and no fiber. Could you substitute an apple for one
of those servings?
c. As long as your child drinks plenty of fluids, she will be fine.
\b. Freud
Freud's theory focuses on the satisfaction and/or frustration of expelling feces (anal
stage).
Rationale: Piaget's theory focuses on development of the senses of the toddler;
Erickson's theory focuses on achievement of autonomy and self-control; Kohlberg's
theory focuses on the moral development of the toddler. - ANS The nurse praises a
