,Concept 1: Development
kk hj
Test Bank
hj h j
MULTIPLE CHOICE hj
1. The nurse manager of a pediatric clinic could confirm that the new nurse
h j h j h j h j hj h j hj h j h j h j h j hj
h j recognized the purpose of the HEADSS Adolescent Risk Profile when the
hj h j hj hj h j hj h j h j h j h j
h j new nurse responds that it is used to assess for needs related to
h j h j hj h j h j h j h j h j h j h j h j h j
a. anticipatory guidance. hj
b. low-risk adolescents. hj
c. physical development. hj
d. sexual development. hj
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening
h j hj h j h j h j h j hj h j h j
tool which assesses home, education, activities, drugs, sex, and suicide for
h j hj hj h j h j h j h j h j h j h j h j
the purpose of identifying high-risk adolescents and the need for
h j h j h j hj h j h j h j h j h j h j
anticipatory guidance. It is used to identify high- risk, not low-risk,
h j h j h j h j h j h j hj h j h j h j
adolescents. Physical development is assessed with anthropometric data.
h j h j hj h j h j h j hj h j
Sexual development is assessed using physical examination.
h j h j h j h j h j h j h j
REF: 6 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
2. The nurse preparing a teaching plan for a preschooler knows that,
h j h j h j h j h j h j h j h j h j hj
according to Piaget, the expected stage of development for a
hj h j hj h j h j h j h j h j h j h j
preschooler is
h j h j
a. concrete operational. h j
b. formal operational. hj
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old)
h j h j h j h j h j h j h j h j h j h j h j h j
is preoperational. Concrete operational describes the thinking of a school-age
h j hj h j h j h j h j hj hj hj h j
child (7 to 11 years old).
h j h j h j hj h j h j
Formal operational describes the thinking of an individual after about 11 years
hj hj h j hj h j hj hj h j h j h j hj
of age. Sensorimotor describes the earliest pattern of thinking from birth
h j hj hj h j h j h j h j h j h j h j h j
to 2 years old.
h j h j h j h j
REF: 5 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
3. The school nurse talking with a high school class about the difference
h j hj hj h j h j h j h j hj h j hj hj
h j between growth and development would best describe growth as
hj h j h j h j h j h j h j h j
a. processes by which early cells specialize. h j hj h j hj h j
b. psychosocial and cognitive changes. hj hj hj
c. qualitative changes associated with aging. hj hj hj hj
d. quantitative changes in size or weight. h j h j hj h j h j
ANS: D
Growth is a quantitative change in which an increase in cell number and
h j h j h j h j h j h j h j h j h j h j hj h j
size results in an increase in overall size or weight of the body or any
h j h j hj hj h j h j h j h j h j h j h j h j h j hj h j
of its parts. The processes by which early cells specialize are referred to
hj h j h j h j h j h j hj h j h j h j h j h j h j
as differentiation. Psychosocial and cognitive changes are referred to as
h j h j h j h j hj h j h j h j h j h j
development. Qualitative changes associated with aging are referred to as
h j h j h j h j h j hj h j h j h j h j
maturation.
h j
, REF: 2 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance
h j hj hj hj
4. The most appropriate response of the nurse when a mother asks
h j h j h j h j hj h j h j hj h j hj
hj what the Denver II does is that it
h j hj h j h j h j h j h j
a. can diagnose developmental disabilities.
hj hj hj
b. identifies a need for physical therapy. hj hj h j hj hj
c. is a developmental screening tool.
hj h j hj h j
d. provides a framework for health teaching.
hj h j h j h j h j
ANS: C
The Denver II is the most commonly used measure of developmental status
h j h j hj h j h j h j hj h j h j h j h j
used by health care professionals; it is a screening tool. Screening tools
h j hj hj h j h j h j h j h j h j h j h j h j
do not provide a diagnosis.
h j h j h j h j hj
Diagnosis requires a thorough neurodevelopment history and physical
h j h j h j h j h j h j h j
examination. Developmental delay, which is suggested by screening, is a
h j hj h j h j h j h j h j h j h j h j
symptom, not a diagnosis. The need for any therapy would be identified
h j h j h j hj h j h j h j h j h j h j h j h j
with a comprehensive evaluation, not a
h j h j h j screening tool. Some providers hj h j h j h j hj hj
use the Denver II as a framework for teaching about expected
h j hj h j h j h j hj h j hj h j h j h j
development, but this is not the primary purpose of
h j h j h j h j h j h j h j h j h j
the tool. h j
REF: 4 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance
h j hj hj kk
5. To plan early intervention and care for an infant with Down
hj hj hj h j h j hj h j h j h j hj
syndrome, the nurse considers knowledge of other physical
hj h j hj h j h j h j h j h j
development exemplars such as
h j h j kk hj
a. cerebral palsy. hj
b. failure to thrive. h j h j
c. fetal alcohol syndrome. hj h j
d. hydrocephaly.
ANS: D
Hydrocephaly is also a physical development exemplar. Cerebral palsy is an
h j h j h j h j h j kk h j h j hj h j
exemplar of adaptive developmental delay. Failure to thrive is an exemplar
h j hj h j h j h j hj h j kk h j h j hj
of social/emotional developmental delay. Fetal alcohol syndrome is an exemplar
h j h j hj hj kk kk hj h j h j h j
of cognitive developmental delay.
h j hj hj h j
REF: 9 OBJ: NCLEX® h j Client Needs hj h j Category: Health Promotion and Maintenance h j hj h j hj
6. To plan early intervention and care for a child with a developmental delay, the
hj hj kk kk kk hj hj hj hj hj hj hj hj
nurse would considerxknowledge of the concepts most significantly impacted by
hj hj hj hj hj hj hj hj hj hj
development, including
hj h j
a. culture.
b. environment.
c. functional status. kk
d. nutrition.
ANS: C
, Function is one of the concepts most significantly impacted by development.
h j hj hj h j h j h j h j h j h j h j
Others include sensory-perceptual, cognition, mobility, reproduction, and
h j hj h j h j h j h j h j
sexuality.
h j
Knowledge of these concepts can help the nurse anticipate areas that
h j h j h j h j h j h j h j h j h j h j
need to be addressed. Culture is a concept that is considered to
h j h j h j hj hj h j hj hj h j h j hj h j
significantly affect development; the difference is the concepts that affect
h j hj h j hj h j h j h j h j h j h j
development are those that represent major influencing factors (causes),
h j h j h j h j h j hj h j h j h j
hence determination of development and would be the focus of
h j h j h j h j h j h j hj h j h j h j
preventive interventions. Environment is considered to significantly affect
h j h j h j h j h j h j h j hj
development. Nutrition is considered to significantly affect development.
h j h j h j h j h j h j h j h j
REF: 1 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
7. A mother complains to the nurse at the pediatric clinic that her 4-year-old
hj hj h j h j hj hj h j hj h j h j h j h j
child always talks to her toys and makes up stories. The mother wants
h j hj hj h j h j h j h j h j h j h j h j h j h j
her child to have a psychologic evaluation.
h j h j h j h j h j hj h j
The nurse’s best initial response is to
hj h j h j hj h j hj
a. refer the child to a psychologist.
h j h j h j h j h j
b. explain that playing make believe with dolls and people is normal at this age.
hj h j h j hj h j hj h j h j h j hj hj h j hj
c. complete a developmental screening. hj hj hj
d. separate the child from the mother to get more information.
hj h j h j hj h j h j h j h j h j
ANS: B
By the end of the fourth year, it is expected that a child will engage in
hj hj hj hj hj hj hj hj hj hj hj hj kk hj hj
fantasy, xso this is normal at this age. A referral to a psychologist
h j kk kk hj hj h j h j h j h j h j h j h j h j h j
would be premature based only on the complaint of the mother. Completing
h j kk hj h j h j h j hj h j h j hj h j h j
a developmental screening would be very appropriate but not the initial
h j h j h j h j hj hj hj h j h j h j h j
response. The nurse would certainly want to get more information, but
h j h j h j hj h j h j hj h j h j hj h j
separating the child from the mother is not necessary at this time.
h j h j h j h j h j kk h j h j hj h j h j h j
REF: 5 OBJ: NCLEX® h j Client NeedsxCategory: Health Promotion and Maintenance
h j h j hj h j hj
8. A 17-year-old girl is hospitalized for appendicitis, and herxmother asks the
kk hj hj h j h j h j h j kk h j h j
nurse why she is so needy and acting like a child. The best response of the
hj hj hj h j h j h j hj h j h j h j kk h j hj kk hj hj
nurse is that in the hospital, adolescents
h j h j h j h j h j hj h j
a. have separation anxiety.hj hj
b. rebel against rules. hj h j
c. regress because of stress. hj h j kk
d. want to know everything. h j h j h j
ANS: C
Regression to an earlier stage of development is a common response to
h j h j h j h j h j kk h j h j h j h j h j
stress. Separation anxiety is most xcommon in infants and toddlers. Rebellion
h j hj kk hj hj kk hj hj hj hj hj
against hospital rules is usually not an issue xif the adolescent understands the
hj hj hj h j kk h j hj kk kk h j h j hj h j
rules and would not create childlike behaviors. An adolescent may want to
h j h j h j h j hj h j h j h j h j hj h j h j
“know everything” with their logical thinking and deductive reasoning, but
h j h j h j h j hj h j h j kk h j hj
that would not explain why they would act like a child.
h j h j h j h j h j h j h j hj h j h j h j
REF: 4 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
kk hj
Test Bank
hj h j
MULTIPLE CHOICE hj
1. The nurse manager of a pediatric clinic could confirm that the new nurse
h j h j h j h j hj h j hj h j h j h j h j hj
h j recognized the purpose of the HEADSS Adolescent Risk Profile when the
hj h j hj hj h j hj h j h j h j h j
h j new nurse responds that it is used to assess for needs related to
h j h j hj h j h j h j h j h j h j h j h j h j
a. anticipatory guidance. hj
b. low-risk adolescents. hj
c. physical development. hj
d. sexual development. hj
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening
h j hj h j h j h j h j hj h j h j
tool which assesses home, education, activities, drugs, sex, and suicide for
h j hj hj h j h j h j h j h j h j h j h j
the purpose of identifying high-risk adolescents and the need for
h j h j h j hj h j h j h j h j h j h j
anticipatory guidance. It is used to identify high- risk, not low-risk,
h j h j h j h j h j h j hj h j h j h j
adolescents. Physical development is assessed with anthropometric data.
h j h j hj h j h j h j hj h j
Sexual development is assessed using physical examination.
h j h j h j h j h j h j h j
REF: 6 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
2. The nurse preparing a teaching plan for a preschooler knows that,
h j h j h j h j h j h j h j h j h j hj
according to Piaget, the expected stage of development for a
hj h j hj h j h j h j h j h j h j h j
preschooler is
h j h j
a. concrete operational. h j
b. formal operational. hj
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old)
h j h j h j h j h j h j h j h j h j h j h j h j
is preoperational. Concrete operational describes the thinking of a school-age
h j hj h j h j h j h j hj hj hj h j
child (7 to 11 years old).
h j h j h j hj h j h j
Formal operational describes the thinking of an individual after about 11 years
hj hj h j hj h j hj hj h j h j h j hj
of age. Sensorimotor describes the earliest pattern of thinking from birth
h j hj hj h j h j h j h j h j h j h j h j
to 2 years old.
h j h j h j h j
REF: 5 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
3. The school nurse talking with a high school class about the difference
h j hj hj h j h j h j h j hj h j hj hj
h j between growth and development would best describe growth as
hj h j h j h j h j h j h j h j
a. processes by which early cells specialize. h j hj h j hj h j
b. psychosocial and cognitive changes. hj hj hj
c. qualitative changes associated with aging. hj hj hj hj
d. quantitative changes in size or weight. h j h j hj h j h j
ANS: D
Growth is a quantitative change in which an increase in cell number and
h j h j h j h j h j h j h j h j h j h j hj h j
size results in an increase in overall size or weight of the body or any
h j h j hj hj h j h j h j h j h j h j h j h j h j hj h j
of its parts. The processes by which early cells specialize are referred to
hj h j h j h j h j h j hj h j h j h j h j h j h j
as differentiation. Psychosocial and cognitive changes are referred to as
h j h j h j h j hj h j h j h j h j h j
development. Qualitative changes associated with aging are referred to as
h j h j h j h j h j hj h j h j h j h j
maturation.
h j
, REF: 2 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance
h j hj hj hj
4. The most appropriate response of the nurse when a mother asks
h j h j h j h j hj h j h j hj h j hj
hj what the Denver II does is that it
h j hj h j h j h j h j h j
a. can diagnose developmental disabilities.
hj hj hj
b. identifies a need for physical therapy. hj hj h j hj hj
c. is a developmental screening tool.
hj h j hj h j
d. provides a framework for health teaching.
hj h j h j h j h j
ANS: C
The Denver II is the most commonly used measure of developmental status
h j h j hj h j h j h j hj h j h j h j h j
used by health care professionals; it is a screening tool. Screening tools
h j hj hj h j h j h j h j h j h j h j h j h j
do not provide a diagnosis.
h j h j h j h j hj
Diagnosis requires a thorough neurodevelopment history and physical
h j h j h j h j h j h j h j
examination. Developmental delay, which is suggested by screening, is a
h j hj h j h j h j h j h j h j h j h j
symptom, not a diagnosis. The need for any therapy would be identified
h j h j h j hj h j h j h j h j h j h j h j h j
with a comprehensive evaluation, not a
h j h j h j screening tool. Some providers hj h j h j h j hj hj
use the Denver II as a framework for teaching about expected
h j hj h j h j h j hj h j hj h j h j h j
development, but this is not the primary purpose of
h j h j h j h j h j h j h j h j h j
the tool. h j
REF: 4 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance
h j hj hj kk
5. To plan early intervention and care for an infant with Down
hj hj hj h j h j hj h j h j h j hj
syndrome, the nurse considers knowledge of other physical
hj h j hj h j h j h j h j h j
development exemplars such as
h j h j kk hj
a. cerebral palsy. hj
b. failure to thrive. h j h j
c. fetal alcohol syndrome. hj h j
d. hydrocephaly.
ANS: D
Hydrocephaly is also a physical development exemplar. Cerebral palsy is an
h j h j h j h j h j kk h j h j hj h j
exemplar of adaptive developmental delay. Failure to thrive is an exemplar
h j hj h j h j h j hj h j kk h j h j hj
of social/emotional developmental delay. Fetal alcohol syndrome is an exemplar
h j h j hj hj kk kk hj h j h j h j
of cognitive developmental delay.
h j hj hj h j
REF: 9 OBJ: NCLEX® h j Client Needs hj h j Category: Health Promotion and Maintenance h j hj h j hj
6. To plan early intervention and care for a child with a developmental delay, the
hj hj kk kk kk hj hj hj hj hj hj hj hj
nurse would considerxknowledge of the concepts most significantly impacted by
hj hj hj hj hj hj hj hj hj hj
development, including
hj h j
a. culture.
b. environment.
c. functional status. kk
d. nutrition.
ANS: C
, Function is one of the concepts most significantly impacted by development.
h j hj hj h j h j h j h j h j h j h j
Others include sensory-perceptual, cognition, mobility, reproduction, and
h j hj h j h j h j h j h j
sexuality.
h j
Knowledge of these concepts can help the nurse anticipate areas that
h j h j h j h j h j h j h j h j h j h j
need to be addressed. Culture is a concept that is considered to
h j h j h j hj hj h j hj hj h j h j hj h j
significantly affect development; the difference is the concepts that affect
h j hj h j hj h j h j h j h j h j h j
development are those that represent major influencing factors (causes),
h j h j h j h j h j hj h j h j h j
hence determination of development and would be the focus of
h j h j h j h j h j h j hj h j h j h j
preventive interventions. Environment is considered to significantly affect
h j h j h j h j h j h j h j hj
development. Nutrition is considered to significantly affect development.
h j h j h j h j h j h j h j h j
REF: 1 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
7. A mother complains to the nurse at the pediatric clinic that her 4-year-old
hj hj h j h j hj hj h j hj h j h j h j h j
child always talks to her toys and makes up stories. The mother wants
h j hj hj h j h j h j h j h j h j h j h j h j h j
her child to have a psychologic evaluation.
h j h j h j h j h j hj h j
The nurse’s best initial response is to
hj h j h j hj h j hj
a. refer the child to a psychologist.
h j h j h j h j h j
b. explain that playing make believe with dolls and people is normal at this age.
hj h j h j hj h j hj h j h j h j hj hj h j hj
c. complete a developmental screening. hj hj hj
d. separate the child from the mother to get more information.
hj h j h j hj h j h j h j h j h j
ANS: B
By the end of the fourth year, it is expected that a child will engage in
hj hj hj hj hj hj hj hj hj hj hj hj kk hj hj
fantasy, xso this is normal at this age. A referral to a psychologist
h j kk kk hj hj h j h j h j h j h j h j h j h j h j
would be premature based only on the complaint of the mother. Completing
h j kk hj h j h j h j hj h j h j hj h j h j
a developmental screening would be very appropriate but not the initial
h j h j h j h j hj hj hj h j h j h j h j
response. The nurse would certainly want to get more information, but
h j h j h j hj h j h j hj h j h j hj h j
separating the child from the mother is not necessary at this time.
h j h j h j h j h j kk h j h j hj h j h j h j
REF: 5 OBJ: NCLEX® h j Client NeedsxCategory: Health Promotion and Maintenance
h j h j hj h j hj
8. A 17-year-old girl is hospitalized for appendicitis, and herxmother asks the
kk hj hj h j h j h j h j kk h j h j
nurse why she is so needy and acting like a child. The best response of the
hj hj hj h j h j h j hj h j h j h j kk h j hj kk hj hj
nurse is that in the hospital, adolescents
h j h j h j h j h j hj h j
a. have separation anxiety.hj hj
b. rebel against rules. hj h j
c. regress because of stress. hj h j kk
d. want to know everything. h j h j h j
ANS: C
Regression to an earlier stage of development is a common response to
h j h j h j h j h j kk h j h j h j h j h j
stress. Separation anxiety is most xcommon in infants and toddlers. Rebellion
h j hj kk hj hj kk hj hj hj hj hj
against hospital rules is usually not an issue xif the adolescent understands the
hj hj hj h j kk h j hj kk kk h j h j hj h j
rules and would not create childlike behaviors. An adolescent may want to
h j h j h j h j hj h j h j h j h j hj h j h j
“know everything” with their logical thinking and deductive reasoning, but
h j h j h j h j hj h j h j kk h j hj
that would not explain why they would act like a child.
h j h j h j h j h j h j h j hj h j h j h j
REF: 4 OBJ: NCLEX® h j Client Needs h j h j Category: Health Promotion and Maintenance h j hj hj hj
