Pediatric Physical Examination: An Illustrated Handbook
KAREN G. DUDERSTADT
3rd Edition
,Pediatric Physical Examination 3rd Edition Duderstadt TESTBANK
Chapter 1: Approach to Care and Assessment of Children and Adolescents
MULTIPLE CHOICE
1. A nurse is reviewing developmental concepts for infants and children. Which
statement best describes development in infants and children?
a. Development, a predictable and orderly process, occurs at varying
rates within normal limits.
b. Development is primarily related to the growth in the number and size of cells.
c. Development occurs in a proximodistal direction with fine muscle
development occurring first.
d. Development is more easily and accurately measured than growth.
ANS: A
Development, a continuous orderly process, provides the basis for increases in the
childs function and complexity of behavior. The increases in rate of function and
complexity can vary normally within limits for each child. An increase in the number
and size of cells is a definition for growth. Development proceeds in a proximodistal
direction with fine muscle organization occurring as a result of large muscle
organization. Development is a more complex process that is affected by many factors;
therefore, it is less easily and accurately measured. Growth is a predictable process
with standard measurement methods.
2. Frequent developmental assessments are important for which reason?
a. Stable developmental periods during infancy provide an opportunity to
identify any delays or deficits.
b. Infants need stimulation specific to the stage of development.
c. Critical periods of development occur during childhood.
d. Child development is unpredictable and needs monitoring.
1|Page
,ANS: C
Critical periods are blocks of time during which children are ready to master specific
developmental tasks. Children can master these tasks more easily during particular
periods of time in their growth and developmental process. Infancy is a dynamic time of
development that requires frequent evaluations to assess appropriate developmental
progress. Infants in a nurturing environment will develop appropriately and will not
necessarily need stimulation specific to their developmental stage. Normal growth and
development are orderly and proceed in a predictable pattern on the basis of each
individuals abilities and potentials.
3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
ANS: C
Genetic factors (heredity) determine each individuals growth and developmental rate.
Although factors such as environment, culture, nutrition, and family can influence
genetic traits, they do not eliminate the effect of the genetic endowment, which is
permanent. Culture is a significant factor that influences how children grow toward
adulthood. Culture influences both growth and development but does not eliminate
inborn genetic influences. Environment has a significant role in determining growth and
development both before and after birth. The environment can influence how and to
which extent genetic traits are manifested, but environmental factors cannot eliminate
the effect of genetics. Nutrition is critical for growth and plays a significant role
throughout childhood.
4. A nurse is planning a teaching session with a child. According to Piagetian theory,
the period of cognitive development in which the child is able to distinguish fact from
fantasy is the period of cognitive development.
a. sensorimotor
, b. formal operations
c. concrete operations
d. preoperational
ANS: C
Concrete operations is the period of cognitive development in which childrens thinking
is shifted from egocentric to being able to see anothers point of view. They develop the
ability to distinguish fact from fantasy. The sensorimotor stage occurs in infancy and is
a period of reflexive behavior. During this period, the infants world becomes more
permanent and organized. The stage ends with the infant demonstrating some
evidence of reasoning. Formal operations is a period in development in which new
ideas are created through previous thoughts. Analytic reason and abstract thought
emerge in this period. The preoperational stage is a period of egocentrism in which the
childs judgments are illogical and dominated by magical thinking and animism.
5. The theorist who viewed developmental progression as a lifelong series of conflicts
that need resolution is:
a. Erikson.
b. Freud.
c. Kohlberg.
d. Piaget.
ANS: A
Erik Erikson viewed development as a series of conflicts affected by social and cultural
factors. Each conflict must be resolved for the child to progress emotionally, with
unsuccessful resolution leaving the child emotionally disabled. Sigmund Freud
proposed a psychosexual theory of development in which certain parts of the body
assume psychological significance as foci of sexual energy. The foci shift as the
individual moves through the different stages (oral, anal, phallic, latency, and genital)
of development. Lawrence Kohlberg described moral development as having three
levels (preconventional, conventional, and postconventional). His