TEST BANK - Pediatric Physical
Examination: An Illustrated Handbook
4th Edition by Karen G. Duderstadt,
Victoria F. Keeton
ACCURATE ANSWERS WITH
RATIONALES| ALL CHAPTERS 1-20
Ar
ch
Do
1
c
, 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.
ACCURATE ANSWER: A
Development, a continuous orderly process, provides the basis for increases in the child’s 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.
ACCURATE ANSWER: 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.
Ar
ch
Do
2
c
,3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
ACCURATE ANSWER: 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
ACCURATE ANSWER: 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 child’s
judgments are illogical and dominated by magical thinking and animism.
Ar
5. The theorist who viewed developmental progression as a lifelong series of conflicts that need
resolution is:
ch
a. Erikson.
Do
3
c
, b. Freud.
c. Kohlberg.
d. Piaget.
ACCURATE ANSWER: 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 theory closely parallels Piagets. Jean
Piagets cognitive theory interprets how children learn and think and how this thinking progresses and
differs from adult thinking. Stages of his theory include sensorimotor, preoperations, concrete
operations, and formal operations.
6. What does the nurse need to know when observing chronically ill children at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Childrens play is an indication of a child’s response to treatment.
d. Play is to be discouraged because it tires hospitalized children.
ACCURATE ANSWER: C
Play for all children is an activity woven with meaning and purpose and is a mechanism for
mastering their environment. For chronically ill children, play can indicate their state of wellness and
response to treatment. Play is important to all children in all environments. Although childrens play
activities appear unorganized and at times chaotic, play has purpose and meaning. Imposing structure
on play interferes with the tasks being worked on. Children who have fewer energy reserves still
require play. For these children, less-active play activities will be important.
7. Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
Ar
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
ch
ACCURATE ANSWER: B
Do
4
c
Examination: An Illustrated Handbook
4th Edition by Karen G. Duderstadt,
Victoria F. Keeton
ACCURATE ANSWERS WITH
RATIONALES| ALL CHAPTERS 1-20
Ar
ch
Do
1
c
, 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.
ACCURATE ANSWER: A
Development, a continuous orderly process, provides the basis for increases in the child’s 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.
ACCURATE ANSWER: 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.
Ar
ch
Do
2
c
,3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
ACCURATE ANSWER: 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
ACCURATE ANSWER: 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 child’s
judgments are illogical and dominated by magical thinking and animism.
Ar
5. The theorist who viewed developmental progression as a lifelong series of conflicts that need
resolution is:
ch
a. Erikson.
Do
3
c
, b. Freud.
c. Kohlberg.
d. Piaget.
ACCURATE ANSWER: 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 theory closely parallels Piagets. Jean
Piagets cognitive theory interprets how children learn and think and how this thinking progresses and
differs from adult thinking. Stages of his theory include sensorimotor, preoperations, concrete
operations, and formal operations.
6. What does the nurse need to know when observing chronically ill children at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Childrens play is an indication of a child’s response to treatment.
d. Play is to be discouraged because it tires hospitalized children.
ACCURATE ANSWER: C
Play for all children is an activity woven with meaning and purpose and is a mechanism for
mastering their environment. For chronically ill children, play can indicate their state of wellness and
response to treatment. Play is important to all children in all environments. Although childrens play
activities appear unorganized and at times chaotic, play has purpose and meaning. Imposing structure
on play interferes with the tasks being worked on. Children who have fewer energy reserves still
require play. For these children, less-active play activities will be important.
7. Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
Ar
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
ch
ACCURATE ANSWER: B
Do
4
c
