NURS 5220 Test 1 Exam
Growth and Development
• Two hypothalamic hormones control growth hormone synthesis and secretion in the
anterior pituitary gland
➢ Growth hormone–releasing hormone (GHRH) stimulates the pituitary to release
growth hormone
➢ Somatostatin inhibits the secretion of both GHRH and thyroid-stimulating hormone
• Brain: peak fetus, early infancy
• Skeleton: peak fetus, infancy, adolescence
• Muscle: peak fetus, adolescence
• Adipose: peak infancy, adolescence
• Lymphoid: peak age 10 to 12 years
• Neural: peak age 4 to 14 years
• Genital: peak adolescence
• Fetus
➢ Head growth predominates
• Infant
➢ Trunk growth predominates
➢ Weight gain at rapid but decelerating rate
• Child
➢ Legs are fastest growing
➢ Weight gained at steady rate
• Adolescence
➢ Trunk and legs elongate.
➢ 50% of ideal weight is gained.
➢ Of adults who are obese
➢ 30% become obese during childhood
➢ 70% become obese during adolescence
➢ Skeletal mass and organ systems double
in size.
• Pregnant Women
➢ Progressive weight gain, fetus 6-8lbs is expected, rest of weigh is from maternal
tissue and fluids, weight gain is slow in 1st trimester, rapid in 2nd and slows in the 3rd
• Older adult
➢ Stature declines beginning at 50 (thinning of discs, kyphosis)
➢ Increase in overweight and obese older adults
➢ Decrease in weight for height and BMI among those over 60
➢ A loss of 5% of body weight over several years occurs accompanied with an increase
in body fat as skeletal muscle declines (due to decreased exercise and reduced
anabolic steroid secretion)
➢ Reduction in the size and weight of organs (liver, lungs, kidneys)
Page 1 of 148
,NURS 5220 Test 1 Exam
Related History
Page 2 of 148
,NURS 5220 Test 1 Exam
• History of present illness
➢ Weight loss and weight gain
• Undesired weight loss, anorexia, vomiting or diarrhea, difficulty swallowing,
excessive thirst, frequent urination, change in lifestyle, activity and stress
levels
• Medications: chemotherapy, diuretics, insulin, fluoxetine, diet pills, laxatives,
steroids, oral contraceptives
➢ Changes in body proportions
• Coarsening facial features, enlarging hands/feet, moon facies
• Change in fat distribution
• Medication: steroids
• Past medical history
➢ Chronic illness
• Gastrointestinal
• Renal
• Pulmonary
• Cardiac
• Cancer
• Human immunodeficiency virus or other infections
• Allergies
➢ Previous weight loss or gain efforts
• Weight at 21
• Maximum body weight
• Family history
➢ Obesity
• Constitutionally short or tall stature
• Precocious or delayed puberty
➢ Genetic or metabolic disorder
• Cystic fibrosis
• Dwarfism
• Personal and social history
➢ Usual weight and height
➢ Activity and exercise pattern
➢ Use of alcohol
➢ Use of illicit drugs
• Infants
➢ Estimated gestational age, birth weight, length, head circumference
➢ Following an established percentile growth curve
➢ Development: achieving milestones at appropriate ages
➢ Congenital anomaly or chronic illness
•
• Children and Adolescents
Page 3 of 148
, NURS 5220 Test 1 Exam
➢ Sexual maturation of girls: early (before 7 years) or delayed (beyond 13 years); signs
of breast development and pubic hair, age at menarche
➢ Sexual maturation of boys: early (before 9 years) or delayed (beyond 14 years); signs
of genital development and pubic hair
➢ Short or tall stature
➢ Medications: steroids, growth hormones
• Pregnant Women
➢ Pregnancy weight, dietary intake
➢ Age at menarche
➢ Date of last menstrual period, weight gain pattern, following established weight gain
curve for gestational course
➢ Eating disorders
➢ History of pica (eating laundry starch, ice, clay, raw rice)
➢ Nausea and vomiting
• Older adults
➢ Chronic debilitating illness
• Problems with meal preparation
• Difficulty feeding self, chewing, swallowing, poorly fitting dentures
• Ability to follow prescribed diet
• Difficulty with digestion
Examination and Findings
Equipment
• Standing platform scale with height attachment
• Skinfold thickness calipers
• Measuring tape
• Infant scale
• Recumbent measuring device (for infants)
• Stature-measuring device (for children)
Weight and standing height
• Weight
➢ Weight variations occur during the day and from day to day with changes in body
fluid and intestinal contents
➢ When monitoring a patient’s weight daily or weekly, weigh the patient at the same
time each day using the same scale
• Height
➢ Make the reading at the nearest centimeter or 1/2 inch
• Frame size
➢ Determined to assess the appropriateness of a person’s weight for age, height, and
Page 4 of 148
Growth and Development
• Two hypothalamic hormones control growth hormone synthesis and secretion in the
anterior pituitary gland
➢ Growth hormone–releasing hormone (GHRH) stimulates the pituitary to release
growth hormone
➢ Somatostatin inhibits the secretion of both GHRH and thyroid-stimulating hormone
• Brain: peak fetus, early infancy
• Skeleton: peak fetus, infancy, adolescence
• Muscle: peak fetus, adolescence
• Adipose: peak infancy, adolescence
• Lymphoid: peak age 10 to 12 years
• Neural: peak age 4 to 14 years
• Genital: peak adolescence
• Fetus
➢ Head growth predominates
• Infant
➢ Trunk growth predominates
➢ Weight gain at rapid but decelerating rate
• Child
➢ Legs are fastest growing
➢ Weight gained at steady rate
• Adolescence
➢ Trunk and legs elongate.
➢ 50% of ideal weight is gained.
➢ Of adults who are obese
➢ 30% become obese during childhood
➢ 70% become obese during adolescence
➢ Skeletal mass and organ systems double
in size.
• Pregnant Women
➢ Progressive weight gain, fetus 6-8lbs is expected, rest of weigh is from maternal
tissue and fluids, weight gain is slow in 1st trimester, rapid in 2nd and slows in the 3rd
• Older adult
➢ Stature declines beginning at 50 (thinning of discs, kyphosis)
➢ Increase in overweight and obese older adults
➢ Decrease in weight for height and BMI among those over 60
➢ A loss of 5% of body weight over several years occurs accompanied with an increase
in body fat as skeletal muscle declines (due to decreased exercise and reduced
anabolic steroid secretion)
➢ Reduction in the size and weight of organs (liver, lungs, kidneys)
Page 1 of 148
,NURS 5220 Test 1 Exam
Related History
Page 2 of 148
,NURS 5220 Test 1 Exam
• History of present illness
➢ Weight loss and weight gain
• Undesired weight loss, anorexia, vomiting or diarrhea, difficulty swallowing,
excessive thirst, frequent urination, change in lifestyle, activity and stress
levels
• Medications: chemotherapy, diuretics, insulin, fluoxetine, diet pills, laxatives,
steroids, oral contraceptives
➢ Changes in body proportions
• Coarsening facial features, enlarging hands/feet, moon facies
• Change in fat distribution
• Medication: steroids
• Past medical history
➢ Chronic illness
• Gastrointestinal
• Renal
• Pulmonary
• Cardiac
• Cancer
• Human immunodeficiency virus or other infections
• Allergies
➢ Previous weight loss or gain efforts
• Weight at 21
• Maximum body weight
• Family history
➢ Obesity
• Constitutionally short or tall stature
• Precocious or delayed puberty
➢ Genetic or metabolic disorder
• Cystic fibrosis
• Dwarfism
• Personal and social history
➢ Usual weight and height
➢ Activity and exercise pattern
➢ Use of alcohol
➢ Use of illicit drugs
• Infants
➢ Estimated gestational age, birth weight, length, head circumference
➢ Following an established percentile growth curve
➢ Development: achieving milestones at appropriate ages
➢ Congenital anomaly or chronic illness
•
• Children and Adolescents
Page 3 of 148
, NURS 5220 Test 1 Exam
➢ Sexual maturation of girls: early (before 7 years) or delayed (beyond 13 years); signs
of breast development and pubic hair, age at menarche
➢ Sexual maturation of boys: early (before 9 years) or delayed (beyond 14 years); signs
of genital development and pubic hair
➢ Short or tall stature
➢ Medications: steroids, growth hormones
• Pregnant Women
➢ Pregnancy weight, dietary intake
➢ Age at menarche
➢ Date of last menstrual period, weight gain pattern, following established weight gain
curve for gestational course
➢ Eating disorders
➢ History of pica (eating laundry starch, ice, clay, raw rice)
➢ Nausea and vomiting
• Older adults
➢ Chronic debilitating illness
• Problems with meal preparation
• Difficulty feeding self, chewing, swallowing, poorly fitting dentures
• Ability to follow prescribed diet
• Difficulty with digestion
Examination and Findings
Equipment
• Standing platform scale with height attachment
• Skinfold thickness calipers
• Measuring tape
• Infant scale
• Recumbent measuring device (for infants)
• Stature-measuring device (for children)
Weight and standing height
• Weight
➢ Weight variations occur during the day and from day to day with changes in body
fluid and intestinal contents
➢ When monitoring a patient’s weight daily or weekly, weigh the patient at the same
time each day using the same scale
• Height
➢ Make the reading at the nearest centimeter or 1/2 inch
• Frame size
➢ Determined to assess the appropriateness of a person’s weight for age, height, and
Page 4 of 148
