CONCEPTS FOR NURSING
PRACTICE
4TH EDITION
• AUTHOR(S)JEAN FORET
GIDDENS
TEST BANK
Question 1
Reference: Ch. 1 — Development — Autism Spectrum Disorder
(Clinical Exemplar)
Question Stem: A nurse in a pediatric clinic is conducting a well-
child visit for an 18-month-old toddler. The parent expresses
concern, stating, "My child doesn't respond when I call their
name, doesn't point to things they want, and prefers to play
alone with a spinning toy for long periods." The child makes
,minimal eye contact. Based on these assessment findings,
which action should the nurse prioritize?
• A. Reassure the parent that this is a normal variation of
toddler development and schedule the next routine visit.
• B. Administer a standardized developmental screening tool
specifically for autism spectrum disorder.
• C. Immediately refer the child to a pediatric neurologist for
a comprehensive diagnostic workup.
• D. Advise the parent to increase social interaction by
enrolling the child in daycare immediately.
Correct Answer: B
Rationales:
• Correct (B): The described behaviors (lack of response to
name, lack of joint attention like pointing, repetitive play,
limited eye contact) are red flags for autism spectrum
disorder (ASD). The nurse's priority, based on
developmental surveillance, is to conduct a formal,
evidence-based screening. This is a crucial nursing action
that facilitates early identification and intervention, which
is vital for developmental outcomes.
• Incorrect (A): The cluster of findings is not typical of
normal toddler development. Dismissing these specific
concerns delays essential screening and potential early
intervention services.
, • Incorrect (C): While referral to a specialist may be an
eventual step, the nurse's first and most appropriate action
is to perform a standardized screening. Jumping to an
immediate specialist referral bypasses the nurse's essential
role in systematic developmental assessment.
• Incorrect (D): This advice is premature and may
overwhelm the child and family. The priority is assessment,
not intervention. Forcing social interaction without
understanding the child's needs is not supportive or
evidence-based.
Teaching Point: In developmental surveillance, clusters of
specific behavioral red flags warrant standardized
screening, not just observation.
Citation: Giddens, J. F. (2025). Concepts for Nursing
Practice (4th ed.). Chapter 1, Development.
Question 2
Reference: Ch. 1 — Development — Nocturnal Enuresis (Clinical
Exemplar)
Question Stem: The parent of a 7-year-old child reports to the
school nurse that the child has started wetting the bed at night
again, after being dry for over a year. This began two weeks
after the family moved to a new city. The child is withdrawn in
class and no longer plays with friends at recess. What is the
nurse's best initial response?
• A. Inform the parent that nocturnal enuresis at this age is
always pathological and requires a urology referral.
, • B. Teach the parent to implement a reward system for dry
nights and restrict fluids after dinner.
• C. Assess the child for their feelings about the move and
any other stressors at home or school.
• D. Explain that this is a normal regression and advise
waking the child to use the bathroom at midnight.
Correct Answer: C
Rationales:
• Correct (C): The scenario describes secondary enuresis
(recurrence after a period of dryness) coinciding with a
major psychosocial stressor (moving). The child's
withdrawn behavior further suggests emotional distress.
The nurse's first action should be to assess the context and
the child's perception, as emotional stress is a common
trigger. This aligns with a holistic, developmentally focused
nursing assessment.
• Incorrect (A): This statement is inaccurate and alarming.
Secondary enuresis is often related to stress or life
changes, not necessarily a medical pathology. Starting with
a specialist referral is not the priority nursing action.
• Incorrect (B): Behavioral strategies may be part of
management, but initiating them without first exploring
the potential underlying emotional cause is premature and
ineffective if the root cause is unaddressed.
PRACTICE
4TH EDITION
• AUTHOR(S)JEAN FORET
GIDDENS
TEST BANK
Question 1
Reference: Ch. 1 — Development — Autism Spectrum Disorder
(Clinical Exemplar)
Question Stem: A nurse in a pediatric clinic is conducting a well-
child visit for an 18-month-old toddler. The parent expresses
concern, stating, "My child doesn't respond when I call their
name, doesn't point to things they want, and prefers to play
alone with a spinning toy for long periods." The child makes
,minimal eye contact. Based on these assessment findings,
which action should the nurse prioritize?
• A. Reassure the parent that this is a normal variation of
toddler development and schedule the next routine visit.
• B. Administer a standardized developmental screening tool
specifically for autism spectrum disorder.
• C. Immediately refer the child to a pediatric neurologist for
a comprehensive diagnostic workup.
• D. Advise the parent to increase social interaction by
enrolling the child in daycare immediately.
Correct Answer: B
Rationales:
• Correct (B): The described behaviors (lack of response to
name, lack of joint attention like pointing, repetitive play,
limited eye contact) are red flags for autism spectrum
disorder (ASD). The nurse's priority, based on
developmental surveillance, is to conduct a formal,
evidence-based screening. This is a crucial nursing action
that facilitates early identification and intervention, which
is vital for developmental outcomes.
• Incorrect (A): The cluster of findings is not typical of
normal toddler development. Dismissing these specific
concerns delays essential screening and potential early
intervention services.
, • Incorrect (C): While referral to a specialist may be an
eventual step, the nurse's first and most appropriate action
is to perform a standardized screening. Jumping to an
immediate specialist referral bypasses the nurse's essential
role in systematic developmental assessment.
• Incorrect (D): This advice is premature and may
overwhelm the child and family. The priority is assessment,
not intervention. Forcing social interaction without
understanding the child's needs is not supportive or
evidence-based.
Teaching Point: In developmental surveillance, clusters of
specific behavioral red flags warrant standardized
screening, not just observation.
Citation: Giddens, J. F. (2025). Concepts for Nursing
Practice (4th ed.). Chapter 1, Development.
Question 2
Reference: Ch. 1 — Development — Nocturnal Enuresis (Clinical
Exemplar)
Question Stem: The parent of a 7-year-old child reports to the
school nurse that the child has started wetting the bed at night
again, after being dry for over a year. This began two weeks
after the family moved to a new city. The child is withdrawn in
class and no longer plays with friends at recess. What is the
nurse's best initial response?
• A. Inform the parent that nocturnal enuresis at this age is
always pathological and requires a urology referral.
, • B. Teach the parent to implement a reward system for dry
nights and restrict fluids after dinner.
• C. Assess the child for their feelings about the move and
any other stressors at home or school.
• D. Explain that this is a normal regression and advise
waking the child to use the bathroom at midnight.
Correct Answer: C
Rationales:
• Correct (C): The scenario describes secondary enuresis
(recurrence after a period of dryness) coinciding with a
major psychosocial stressor (moving). The child's
withdrawn behavior further suggests emotional distress.
The nurse's first action should be to assess the context and
the child's perception, as emotional stress is a common
trigger. This aligns with a holistic, developmentally focused
nursing assessment.
• Incorrect (A): This statement is inaccurate and alarming.
Secondary enuresis is often related to stress or life
changes, not necessarily a medical pathology. Starting with
a specialist referral is not the priority nursing action.
• Incorrect (B): Behavioral strategies may be part of
management, but initiating them without first exploring
the potential underlying emotional cause is premature and
ineffective if the root cause is unaddressed.
