Solutions.
2.1
Which is an example of cephalocaudal development?
A. A child crawls before he walks; walks before he runs; runs before he jumps
B. A child lifts his head before lifting his shoulders; sits with support before sitting without
support
C. A child rakes before developing pincer grasps; develops pincer grasps before feeding
himself with a spoon
D. A child first develops reflexive behaviors; then develops imitative behaviors - Correct
Answer B. A child lifts his head before lifting his shoulders; sits with support before sitting
without support
Cephalocaudal development states that a child develops from head to toe
2.2
When assessing a school ages child's development, the nurse understands that a primary
developmental task of his group is:
A. Developing friends
B. Learning to read
C. Learning to trust others
D. Developing independence - Correct Answer A. Developing friends
Erikson's stage of a school age child is industry vs. inferiority; the primary job of a school
age child is to develop competence through achievement in school and development of
friendships; important nursing assessment of children in this stage is adjustment and
success in school setting as well as the formation of friendships
2.3
Which nursing action would be most important in the psychosocial support of a 2 year old
who is having an invasive procedure performed?
,A. Assuring her that it is not her fault
B. Providing for parental presence
C. Providing adequate pain control
D. Performing the procedure quickly - Correct Answer B. Providing for parental presence
2 year olds are in Erikson's stage of autonomy vs. shame and doubt and Piaget's
sensorimotor stage; toddlerhood is a time of heightened separation anxiety with fear of
strangers; the most appropriate psychosocial support is to promote presence of the
primary caregiver
2.4
Which of the following would be most helpful when assessing a child's bone age?
A. Birth date
B. Body mass index
C. Blood test
D. X-rays - Correct Answer D. X-rays
Bone age is preformed by taking an x-ray of the child's hands and wrists for comparison
against an atlas of standard x-rays categorized by age; the test predicts the remaining
height growth based on bone age; typically a child's bone age should match their
chronological age
Delayed bone age: increased height growth prediction
advanced bone age: decreased height growth prediction
2.5
Which of the following assessments would be most concerning in a 3 month old?
A. Closed posterior fontanel
B. In ability to roll over
C. Failure to track object through visual fields
,D. Failure to laugh - Correct Answer C. Failure to track object through visual fields
Infants develop the ability to track objects by 3 months
The posterior fontanel closes by 2-3 months
Infants do not roll over till 4 months
Laughing typically occurs at 4 months
2.6
Which of the following developmental milestones of the 5 month old best reflects the
principle of proximodistal growth and development?
A. Babbling
B. Raking objects
C. Rolling over
D. Eating solid foods - Correct Answer B. Raking objects
Proximodistal growth and development states children develop from the trunk to the tips
of the extremities; raking objects develops at 4 months, pincer grasps develops at 9
months
2.7
You are the nurse at a community health clinic; the mother of a 2 year old male expresses
concern to you that her previously healthy child is nonverbal; which of the following
responses is most appropriate?
A "Try not to worry, language milestones vary, boys have tendency to lag behind girls"
B. "Given your son's age, we should probably test his hearing to be sure that is the source
of his delayed language skills"
C. "Autism is the most frequent reason why children as old as 2 years of age - Correct
Answer B. "Given your son's age, we should probably test his hearing to be sure that is the
source of his delayed language skills"
2 year olds should be speaking 2-3 word sentences; hearing deficits are the most
common cause for failure to speech development
birth order does not affect failure to develop speech
, autism could explain failure to develop speech, but is far less common than a hearing
deficit and would include over behavior abnormalities
2.8
The 5 year old uses how many words in a sentence?
A. 3-4
B. 4-5
C. 5-6
D. 6-7 - Correct Answer C. 5-6
5 year olds typically use 5-6 word sentences
typically preschool age children will speak a sentence in the number of words equal to the
child's age to one more word than their age
2.9
The nurse would expect a 4 month old to:
A. Sit alone
B. Attempt to roll over
C. Begin to crawl
D. Grasp feet and pull them to mouth - Correct Answer B. Attempt to roll over
Infants begin to roll over at 4 months (first from stomach to back then from back to
stomach)
Infants sit with support at 5 months and sit without support at 8 months
Infants will push up from their stomach onto hands and knees at 6 months
Crawling begins at 9 months
Grasping feet and pulling to month begins at 5 months
2.10
A healthy 6 month old infant brought to the well-baby clinic for checkup; when assessing
the infant's anterior fontanel, the nurse expects it to be: