Chapter 32: Developmental Influences on Child Health Promotion
MULTIPLE CHOICE
1. What is the term for head-to-tail direction of growth?
a. Cephalocaudal
b. Proximodistal
c. Mass to specific
d. Sequential
ANS: A
The first pattern of development is in the head-to-tail, or cephalocaudal, direction. The head
end of the organism develops first and is large and complex, whereas the lower end is smaller
and simpler, and development takes place at a later time. Proximodistal, or near-to-far, is the
second pattern of development. Limb buds develop before fingers and toes. Postnatally, the
child has control of the shoulder before achieving mastery of the hands. Mass to specific is not
a pattern of development. In all dimensions of growth, a definite, sequential pattern is
followed.
DIF: Cognitive Level: Comprehension REF: p. 872
OBJ: Nursing Process: Assessment
2. Which refers to those times in an individual’s life when he or she is more susceptible to positive
or negative influences?
a. Sensitive period
b. Sequential period
c. Terminal points
d. Differentiation points
ANS: A
Sensitive periods are limited times during the process of growth when the organism will
interact with a particular environment in a specific manner. These times make the organism
more susceptible to positive or negative influences. The sequential period, terminal points, and
differentiation points are developmental times that do not make the organism more
susceptible to environmental interaction.
DIF: Cognitive Level: Comprehension REF: p. 873 OBJ: Nursing Process: Planning
,3. If an infant weighed 3 kg at birth, how much would he or she be expected to weigh at age 1
year?
a. 6
b. 9
c. 12
d. 15
ANS: B
In general, birth weight triples by the end of the first year of life. For an infant who was 3 kg at
birth, 9 kg would be the anticipated weight at the first birthday. A weight of 6 kg is below what
one would anticipate, and weights of 12 and 15 kg are above what would be expected for an
infant with a birth weight of 3 kg.
DIF: Cognitive Level: Comprehension REF: pp. 874-875 OBJ: Nursing
Process: Assessment
4. How does the onset of the pubertal growth spurt compare in girls and boys?
a. It occurs earlier in boys.
b. It occurs earlier in girls.
c. It is about the same in both boys and girls.
d. In both boys and girls it depends on
their growth in infancy.
ANS: B
Girls seem to be more advanced in physiological growth at all ages than boys. There does not
appear to be a relation to growth during infancy.
DIF: Cognitive Level: Comprehension REF: p. 873
OBJ: Nursing Process: Assessment
5. How is a child’s skeletal age best determined?
a. Assessment of dentition
b. Assessment of height over time
c. Facial bone development
d. Radiographs of the hand and wrist
ANS: D
The most accurate measure of skeletal age is radiological examinations of the growth plates.
These are the epiphyseal cartilage plates. Radiographs of the hand and wrist provide the most
useful screening to determine skeletal age. Age of tooth eruption varies considerably in
children, so it would not be a good determinant of skeletal age. Assessment of height over time
, will provide a record of the child’s height, not skeletal age. Facial bone development does not
reflect the child’s skeletal age, which is determined by radiographic assessment.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing
Process: Assessment
6. Trauma to which site can result in a growth problem for children’s long bones?
a. Matrix
b. Connective tissue
c. Calcified cartilage
d. Epiphyseal cartilage plate
ANS: D
This is the area of active growth. Bone injury at the epiphyseal plate can significantly affect
subsequent growth and development. Trauma or infection can result in deformity.
The matrix, connective tissue, and calcified cartilage are not areas of active growth. Trauma at
these sites will not result in growth problems for the long bones.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing Process: Diagnosis
7. Which is true about lymphoid tissues such as lymph nodes?
a. They reach adult size by age 1 year.
b. They reach adult size by age 13.
c. They reach half their adult size by age 5.
d. They are twice their adult size by age
10 to 12.
ANS: D
Lymph nodes grow rapidly and reach adult size at approximately age 6 years. They continue
growing until they reach maximal development at age 10 to 12 years, which is twice their adult
size. A rapid decline in lymph node size occurs until they reach adult size by the end of
adolescence.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing
Process: Assessment
8. Which is true about the basal metabolic rate (BMR) in children?
MULTIPLE CHOICE
1. What is the term for head-to-tail direction of growth?
a. Cephalocaudal
b. Proximodistal
c. Mass to specific
d. Sequential
ANS: A
The first pattern of development is in the head-to-tail, or cephalocaudal, direction. The head
end of the organism develops first and is large and complex, whereas the lower end is smaller
and simpler, and development takes place at a later time. Proximodistal, or near-to-far, is the
second pattern of development. Limb buds develop before fingers and toes. Postnatally, the
child has control of the shoulder before achieving mastery of the hands. Mass to specific is not
a pattern of development. In all dimensions of growth, a definite, sequential pattern is
followed.
DIF: Cognitive Level: Comprehension REF: p. 872
OBJ: Nursing Process: Assessment
2. Which refers to those times in an individual’s life when he or she is more susceptible to positive
or negative influences?
a. Sensitive period
b. Sequential period
c. Terminal points
d. Differentiation points
ANS: A
Sensitive periods are limited times during the process of growth when the organism will
interact with a particular environment in a specific manner. These times make the organism
more susceptible to positive or negative influences. The sequential period, terminal points, and
differentiation points are developmental times that do not make the organism more
susceptible to environmental interaction.
DIF: Cognitive Level: Comprehension REF: p. 873 OBJ: Nursing Process: Planning
,3. If an infant weighed 3 kg at birth, how much would he or she be expected to weigh at age 1
year?
a. 6
b. 9
c. 12
d. 15
ANS: B
In general, birth weight triples by the end of the first year of life. For an infant who was 3 kg at
birth, 9 kg would be the anticipated weight at the first birthday. A weight of 6 kg is below what
one would anticipate, and weights of 12 and 15 kg are above what would be expected for an
infant with a birth weight of 3 kg.
DIF: Cognitive Level: Comprehension REF: pp. 874-875 OBJ: Nursing
Process: Assessment
4. How does the onset of the pubertal growth spurt compare in girls and boys?
a. It occurs earlier in boys.
b. It occurs earlier in girls.
c. It is about the same in both boys and girls.
d. In both boys and girls it depends on
their growth in infancy.
ANS: B
Girls seem to be more advanced in physiological growth at all ages than boys. There does not
appear to be a relation to growth during infancy.
DIF: Cognitive Level: Comprehension REF: p. 873
OBJ: Nursing Process: Assessment
5. How is a child’s skeletal age best determined?
a. Assessment of dentition
b. Assessment of height over time
c. Facial bone development
d. Radiographs of the hand and wrist
ANS: D
The most accurate measure of skeletal age is radiological examinations of the growth plates.
These are the epiphyseal cartilage plates. Radiographs of the hand and wrist provide the most
useful screening to determine skeletal age. Age of tooth eruption varies considerably in
children, so it would not be a good determinant of skeletal age. Assessment of height over time
, will provide a record of the child’s height, not skeletal age. Facial bone development does not
reflect the child’s skeletal age, which is determined by radiographic assessment.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing
Process: Assessment
6. Trauma to which site can result in a growth problem for children’s long bones?
a. Matrix
b. Connective tissue
c. Calcified cartilage
d. Epiphyseal cartilage plate
ANS: D
This is the area of active growth. Bone injury at the epiphyseal plate can significantly affect
subsequent growth and development. Trauma or infection can result in deformity.
The matrix, connective tissue, and calcified cartilage are not areas of active growth. Trauma at
these sites will not result in growth problems for the long bones.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing Process: Diagnosis
7. Which is true about lymphoid tissues such as lymph nodes?
a. They reach adult size by age 1 year.
b. They reach adult size by age 13.
c. They reach half their adult size by age 5.
d. They are twice their adult size by age
10 to 12.
ANS: D
Lymph nodes grow rapidly and reach adult size at approximately age 6 years. They continue
growing until they reach maximal development at age 10 to 12 years, which is twice their adult
size. A rapid decline in lymph node size occurs until they reach adult size by the end of
adolescence.
DIF: Cognitive Level: Knowledge REF: p. 875 OBJ: Nursing
Process: Assessment
8. Which is true about the basal metabolic rate (BMR) in children?
