Test Bank Concepts for Nursing Practice 4th Edition by Jean Foret Giddens | Nursing
Test Bank 2025/2026 | Fundamentals & Concept-Based Nursing Practice | Clinical
Judgment, Patient Safety, Fluid & Electrolytes, Perfusion, Gas Exchange,
Pharmacology, Communication, Leadership, Care Coordination & NCLEX-Style
Practice Questions with Answers and Rationales
Question 1: A nurse is providing anticipatory guidance to the parents of a 24-month-old
toddler. The parents express concern that their child is constantly exploring cabinets and
climbing on furniture. Which recommendation by the nurse is most appropriate based on the
child's developmental stage?
A. "Consistently use time-outs in a designated chair for any climbing behavior."
B. "Install safety gates at stairways and use locks on cabinets containing hazardous items."
C. "Provide detailed explanations about the long-term consequences of getting injured."
D. "Restrict the child's play to a playpen to ensure a completely safe environment."
CORRECT ANSWER: B. "Install safety gates at stairways and use locks on cabinets containing
hazardous items."
Rationale: During the toddler stage (ages 1-3), children are in Piaget's sensorimotor to
preoperational stage, characterized by intense exploration and motor development. A primary
task is autonomy vs. shame and doubt (Erikson). The nurse's role is to promote safety while
supporting healthy exploration. Securing the environment (gates, locks) allows for safe
exploration and aligns with injury prevention, the leading health concern for this age group.
Time-outs are less effective for toddlers who do not yet fully connect actions with prolonged
consequences. Toddlers have a concrete and present-oriented understanding, so detailed
explanations about future consequences are developmentally inappropriate. While safe,
confinement to a playpen is overly restrictive and inhibits motor and cognitive development
gained through supervised exploration .
Question 2: A nurse is caring for a 16-year-old admitted with newly diagnosed Type 1
Diabetes Mellitus. The adolescent is resistant to parental instructions and states, "My parents
need to stop hovering. I can handle this myself." Which nursing action best supports the
adolescent's developmental needs?
A. Advocate for the parents to room-in to closely supervise all diabetic care and dietary choices.
B. Schedule separate education sessions with the adolescent to foster independent self-
management skills.
C. Explain to the adolescent that their parents have the ultimate legal authority over their
treatment plan.
D. Defer all diabetes education until the adolescent demonstrates a more cooperative attitude.
CORRECT ANSWER: B. Schedule separate education sessions with the adolescent to foster
independent self-management skills.
,Rationale: The central developmental task of adolescence (Erikson's identity vs. role confusion)
is establishing independence and a personal identity. For chronic illness management, the goal
is a gradual transition from parent-directed to self-directed care. Providing private education
sessions validates the adolescent's need for autonomy, builds competence, and is a key nursing
strategy to improve adherence. Having parents supervise all care undermines the adolescent's
striving for autonomy, increases conflict, and can lead to rebellion and non-adherence. While
legally true, reminding the adolescent of parental authority is confrontational and dismissive of
their developmental needs. Deferring all education does not support the adolescent's need to
gain competence and can lead to poorer health outcomes .
Question 3: A nurse is preparing a teaching plan for a preschooler. According to Piaget, the
expected stage of development for a preschooler is which of the following?
A. Concrete operational
B. Formal operational
C. Preoperational
D. Sensorimotor
CORRECT ANSWER: C. Preoperational
Rationale: The expected stage of development for a preschooler (3-4 years old) is
preoperational. This stage is characterized by egocentric thinking, magical thinking, and the use
of symbols but a lack of logical reasoning. Concrete operational describes the thinking of a
school-age child (7-11 years old), where logical thinking begins but is tied to concrete objects.
Formal operational describes the thinking of an individual after about 11 years of age,
characterized by abstract and hypothetical reasoning. Sensorimotor describes the earliest
pattern of thinking from birth to 2 years old, where infants learn about the world through their
senses and motor activities .
Question 4: The school nurse is talking with a high school class about the difference between
growth and development. The nurse would best describe growth as which of the following?
A. Processes by which early cells specialize.
B. Psychosocial and cognitive changes.
C. Qualitative changes associated with aging.
D. Quantitative changes in size or weight.
CORRECT ANSWER: D. Quantitative changes in size or weight.
Rationale: Growth is a quantitative change in which an increase in cell number and size results
in an increase in overall size or weight of the body or any of its parts. This is a measurable,
physical change. The processes by which early cells specialize are referred to as differentiation.
Psychosocial and cognitive changes are referred to as development, which encompasses
qualitative changes. Qualitative changes associated with aging are referred to as maturation,
which involves the process of becoming fully grown or developed .
,Question 5: A mother asks the nurse what the Denver II does. What is the most appropriate
response by the nurse?
A. "It can diagnose developmental disabilities."
B. "It identifies a need for physical therapy."
C. "It is a developmental screening tool."
D. "It provides a framework for health teaching."
CORRECT ANSWER: C. "It is a developmental screening tool."
Rationale: The Denver II is the most commonly used measure of developmental status used by
healthcare professionals; it is a screening tool. Screening tools do not provide a diagnosis; they
are used to identify children who may be at risk for developmental delays and require further
evaluation. Diagnosis requires a thorough neurodevelopment history and physical examination.
The need for any therapy would be identified with a comprehensive evaluation, not a screening
tool. While some providers use the Denver II as a framework for teaching about expected
development, this is not the primary purpose of the tool .
Question 6: A nurse is assessing a 3-year-old toddler in a community clinic. The parent
expresses concern that the child is not yet toilet-trained. Which factor is most important for
the nurse to assess first regarding this developmental milestone?
A. The child's ability to follow two-step commands.
B. The parent's expectations and methods used for toilet training.
C. Whether there is a family history of late toilet training.
D. The child's primary method of communication.
CORRECT ANSWER: B. The parent's expectations and methods used for toilet training.
Rationale: Toilet training readiness depends on physiological, cognitive, and emotional
development, typically occurring between 24-48 months. Assessing parental expectations and
methods first is crucial because it helps identify unrealistic pressures or ineffective approaches
that may hinder progress. While the ability to follow commands is part of readiness, it is not the
first priority; understanding the context of training is more important. Family history is less
directly relevant than current practices, and while communication is important, it's not the
primary factor for this specific milestone .
Question 7: A 10-year-old patient with cystic fibrosis refuses chest physiotherapy, stating,
"It's not fair I have to do this when my brother doesn't." Based on Kohlberg's theory, the
child is demonstrating reasoning characteristic of which stage?
A. Preconventional (Punishment/Obedience)
B. Preconventional (Individualism/Exchange)
C. Conventional (Good Boy/Nice Girl)
D. Conventional (Law and Order)
, CORRECT ANSWER: B. Preconventional (Individualism/Exchange)
Rationale: The child is focused on the fairness of an exchange ("I do this, he doesn't"), which is
characteristic of the Individualism, Instrumental Purpose, and Exchange orientation of the
Preconventional level. In this stage, individuals act to satisfy their own needs and recognize that
others have needs too, leading to a sense of fairness. The Punishment/Obedience orientation is
driven by avoiding punishment, not fairness. The Good Boy/Nice Girl orientation is driven by
seeking approval from others. The Law and Order orientation involves following rules for the
sake of social order .
Question 8: A 45-year-old patient asks the nurse during a physical exam, "What health
screenings should I be thinking about now?" The nurse's response should be based on
knowledge of which primary developmental task for middle adulthood?
A. Establishing intimate relationships
B. Adjusting to physiological changes of aging
C. Achieving generativity through work or family
D. Re-evaluating life goals and accomplishments
CORRECT ANSWER: C. Achieving generativity through work or family
Rationale: According to Erikson, the primary psychosocial task for middle adulthood (ages 40-
65) is generativity versus stagnation. This involves contributing to society, guiding the next
generation, and being productive through work and family. Health screenings and preventive
care are important to maintain the ability to fulfill these roles. Establishing intimate
relationships is the primary task of young adulthood. Adjusting to physiological changes is a task
of middle adulthood, but generativity is the core psychosocial conflict. Re-evaluating life goals is
more characteristic of the transition into later adulthood .
Question 9: A previously independent 82-year-old client is admitted to a rehabilitation facility
after a hip fracture. The client refuses to participate in physical therapy, stating, "What's the
use? My life is pretty much over anyway." Based on Erikson's theory of psychosocial
development, which developmental conflict is this client most likely experiencing?
A. Integrity vs. Despair
B. Generativity vs. Stagnation
C. Intimacy vs. Isolation
D. Autonomy vs. Shame and Doubt
CORRECT ANSWER: A. Integrity vs. Despair
Rationale: Erikson's stage for older adulthood (65+ years) is Ego Integrity vs. Despair. The
client's statement reflects despair, a feeling that life has been wasted and time is too short to
start over. The goal of nursing care is to help clients achieve integrity by finding meaning in
Test Bank 2025/2026 | Fundamentals & Concept-Based Nursing Practice | Clinical
Judgment, Patient Safety, Fluid & Electrolytes, Perfusion, Gas Exchange,
Pharmacology, Communication, Leadership, Care Coordination & NCLEX-Style
Practice Questions with Answers and Rationales
Question 1: A nurse is providing anticipatory guidance to the parents of a 24-month-old
toddler. The parents express concern that their child is constantly exploring cabinets and
climbing on furniture. Which recommendation by the nurse is most appropriate based on the
child's developmental stage?
A. "Consistently use time-outs in a designated chair for any climbing behavior."
B. "Install safety gates at stairways and use locks on cabinets containing hazardous items."
C. "Provide detailed explanations about the long-term consequences of getting injured."
D. "Restrict the child's play to a playpen to ensure a completely safe environment."
CORRECT ANSWER: B. "Install safety gates at stairways and use locks on cabinets containing
hazardous items."
Rationale: During the toddler stage (ages 1-3), children are in Piaget's sensorimotor to
preoperational stage, characterized by intense exploration and motor development. A primary
task is autonomy vs. shame and doubt (Erikson). The nurse's role is to promote safety while
supporting healthy exploration. Securing the environment (gates, locks) allows for safe
exploration and aligns with injury prevention, the leading health concern for this age group.
Time-outs are less effective for toddlers who do not yet fully connect actions with prolonged
consequences. Toddlers have a concrete and present-oriented understanding, so detailed
explanations about future consequences are developmentally inappropriate. While safe,
confinement to a playpen is overly restrictive and inhibits motor and cognitive development
gained through supervised exploration .
Question 2: A nurse is caring for a 16-year-old admitted with newly diagnosed Type 1
Diabetes Mellitus. The adolescent is resistant to parental instructions and states, "My parents
need to stop hovering. I can handle this myself." Which nursing action best supports the
adolescent's developmental needs?
A. Advocate for the parents to room-in to closely supervise all diabetic care and dietary choices.
B. Schedule separate education sessions with the adolescent to foster independent self-
management skills.
C. Explain to the adolescent that their parents have the ultimate legal authority over their
treatment plan.
D. Defer all diabetes education until the adolescent demonstrates a more cooperative attitude.
CORRECT ANSWER: B. Schedule separate education sessions with the adolescent to foster
independent self-management skills.
,Rationale: The central developmental task of adolescence (Erikson's identity vs. role confusion)
is establishing independence and a personal identity. For chronic illness management, the goal
is a gradual transition from parent-directed to self-directed care. Providing private education
sessions validates the adolescent's need for autonomy, builds competence, and is a key nursing
strategy to improve adherence. Having parents supervise all care undermines the adolescent's
striving for autonomy, increases conflict, and can lead to rebellion and non-adherence. While
legally true, reminding the adolescent of parental authority is confrontational and dismissive of
their developmental needs. Deferring all education does not support the adolescent's need to
gain competence and can lead to poorer health outcomes .
Question 3: A nurse is preparing a teaching plan for a preschooler. According to Piaget, the
expected stage of development for a preschooler is which of the following?
A. Concrete operational
B. Formal operational
C. Preoperational
D. Sensorimotor
CORRECT ANSWER: C. Preoperational
Rationale: The expected stage of development for a preschooler (3-4 years old) is
preoperational. This stage is characterized by egocentric thinking, magical thinking, and the use
of symbols but a lack of logical reasoning. Concrete operational describes the thinking of a
school-age child (7-11 years old), where logical thinking begins but is tied to concrete objects.
Formal operational describes the thinking of an individual after about 11 years of age,
characterized by abstract and hypothetical reasoning. Sensorimotor describes the earliest
pattern of thinking from birth to 2 years old, where infants learn about the world through their
senses and motor activities .
Question 4: The school nurse is talking with a high school class about the difference between
growth and development. The nurse would best describe growth as which of the following?
A. Processes by which early cells specialize.
B. Psychosocial and cognitive changes.
C. Qualitative changes associated with aging.
D. Quantitative changes in size or weight.
CORRECT ANSWER: D. Quantitative changes in size or weight.
Rationale: Growth is a quantitative change in which an increase in cell number and size results
in an increase in overall size or weight of the body or any of its parts. This is a measurable,
physical change. The processes by which early cells specialize are referred to as differentiation.
Psychosocial and cognitive changes are referred to as development, which encompasses
qualitative changes. Qualitative changes associated with aging are referred to as maturation,
which involves the process of becoming fully grown or developed .
,Question 5: A mother asks the nurse what the Denver II does. What is the most appropriate
response by the nurse?
A. "It can diagnose developmental disabilities."
B. "It identifies a need for physical therapy."
C. "It is a developmental screening tool."
D. "It provides a framework for health teaching."
CORRECT ANSWER: C. "It is a developmental screening tool."
Rationale: The Denver II is the most commonly used measure of developmental status used by
healthcare professionals; it is a screening tool. Screening tools do not provide a diagnosis; they
are used to identify children who may be at risk for developmental delays and require further
evaluation. Diagnosis requires a thorough neurodevelopment history and physical examination.
The need for any therapy would be identified with a comprehensive evaluation, not a screening
tool. While some providers use the Denver II as a framework for teaching about expected
development, this is not the primary purpose of the tool .
Question 6: A nurse is assessing a 3-year-old toddler in a community clinic. The parent
expresses concern that the child is not yet toilet-trained. Which factor is most important for
the nurse to assess first regarding this developmental milestone?
A. The child's ability to follow two-step commands.
B. The parent's expectations and methods used for toilet training.
C. Whether there is a family history of late toilet training.
D. The child's primary method of communication.
CORRECT ANSWER: B. The parent's expectations and methods used for toilet training.
Rationale: Toilet training readiness depends on physiological, cognitive, and emotional
development, typically occurring between 24-48 months. Assessing parental expectations and
methods first is crucial because it helps identify unrealistic pressures or ineffective approaches
that may hinder progress. While the ability to follow commands is part of readiness, it is not the
first priority; understanding the context of training is more important. Family history is less
directly relevant than current practices, and while communication is important, it's not the
primary factor for this specific milestone .
Question 7: A 10-year-old patient with cystic fibrosis refuses chest physiotherapy, stating,
"It's not fair I have to do this when my brother doesn't." Based on Kohlberg's theory, the
child is demonstrating reasoning characteristic of which stage?
A. Preconventional (Punishment/Obedience)
B. Preconventional (Individualism/Exchange)
C. Conventional (Good Boy/Nice Girl)
D. Conventional (Law and Order)
, CORRECT ANSWER: B. Preconventional (Individualism/Exchange)
Rationale: The child is focused on the fairness of an exchange ("I do this, he doesn't"), which is
characteristic of the Individualism, Instrumental Purpose, and Exchange orientation of the
Preconventional level. In this stage, individuals act to satisfy their own needs and recognize that
others have needs too, leading to a sense of fairness. The Punishment/Obedience orientation is
driven by avoiding punishment, not fairness. The Good Boy/Nice Girl orientation is driven by
seeking approval from others. The Law and Order orientation involves following rules for the
sake of social order .
Question 8: A 45-year-old patient asks the nurse during a physical exam, "What health
screenings should I be thinking about now?" The nurse's response should be based on
knowledge of which primary developmental task for middle adulthood?
A. Establishing intimate relationships
B. Adjusting to physiological changes of aging
C. Achieving generativity through work or family
D. Re-evaluating life goals and accomplishments
CORRECT ANSWER: C. Achieving generativity through work or family
Rationale: According to Erikson, the primary psychosocial task for middle adulthood (ages 40-
65) is generativity versus stagnation. This involves contributing to society, guiding the next
generation, and being productive through work and family. Health screenings and preventive
care are important to maintain the ability to fulfill these roles. Establishing intimate
relationships is the primary task of young adulthood. Adjusting to physiological changes is a task
of middle adulthood, but generativity is the core psychosocial conflict. Re-evaluating life goals is
more characteristic of the transition into later adulthood .
Question 9: A previously independent 82-year-old client is admitted to a rehabilitation facility
after a hip fracture. The client refuses to participate in physical therapy, stating, "What's the
use? My life is pretty much over anyway." Based on Erikson's theory of psychosocial
development, which developmental conflict is this client most likely experiencing?
A. Integrity vs. Despair
B. Generativity vs. Stagnation
C. Intimacy vs. Isolation
D. Autonomy vs. Shame and Doubt
CORRECT ANSWER: A. Integrity vs. Despair
Rationale: Erikson's stage for older adulthood (65+ years) is Ego Integrity vs. Despair. The
client's statement reflects despair, a feeling that life has been wasted and time is too short to
start over. The goal of nursing care is to help clients achieve integrity by finding meaning in
