TEST BANK
,Advanced Practice Nursing: Doing What Has to Be Done-Radicals, Renegades,
andRebels
1. The nurse manager of a pediatric clinic could confirm that the new nurse
recognized the purposeof the HEADSS Adolescent Risk Profile when the new nurse
responds that it is used to assess for needs related to
a. anticipatory guidance.
b. low-risk adolescents.
c. physical development.
d. sexual development.
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool
which assesseshome, education, activities, drugs, sex, and suicide for the purpose
of identifying high-risk adolescents and the need for anticipatory guidance. It is
used to identify high-risk, not low-risk, adolescents. Physical development is
assessed with anthropometric data. Sexual development is assessed using physical
examination.
REF: 6 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
2. The nurse preparing a teaching plan for a preschooler knows that, according
to Piaget, theexpected stage of development for a preschooler is
,a. concrete operational.
b. formal operational.
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old) is
preoperational. Concreteoperational describes the thinking of a school-age child (7
to 11 years old). Formal operational
,describes the thinking of an individual after about 11 years of age. Sensorimotor
describes theearliest pattern of thinking from birth to 2 years old.
REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
3. The school nurse talking with a high school class about the difference
between growth anddevelopment would best describe growth as
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.
ANS: D
Growth is a quantitative change in which an increase in cell number and size results
in an increasein overall size or weight of the body or any of its parts. The processes
by which early cells specialize are referred to asdifferentiation. Psychosocial and
cognitive changes are referred to as development. Qualitative changes associated
with aging are referred to as maturation.
REF: 2 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
4. The most appropriate response of the nurse when a mother asks what the Denver II
does is that it
a. can diagnose developmental disabilities.
,b. identifies a need for physical therapy.
c. is a developmental screening tool.
d. provides a framework for health teaching.
ANS: C
The Denver II is the most commonly used measure of developmental status used by
health care professionals; it is a screening tool. Screening tools do not provide a
diagnosis. Diagnosis requires athorough neurodevelopment history and physical
examination. Developmental delay, which is suggested by screening, is a symptom,
not a diagnosis. The need for any therapy would be identified with a comprehensive
evaluation, not a screening tool. Some providers use the Denver II as a framework
for teaching about expected development, but this is not the primary purpose of the
tool.
,REF: 4 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
5. To fplan fearly fintervention fand fcare ffor fan finfant fwith fDown fsyndrome,
the fnurse fconsidersknowledge fof fother fphysical fdevelopment fexemplars
f
f such fas
a. cerebral fpalsy.
b. failure fto fthrive.
c. fetal falcohol fsyndrome.
d. hydrocephaly.
ANS: fD
Hydrocephaly fis falso fa fphysical fdevelopment fexemplar. fCerebral fpalsy fis fan
f exemplar fof fadaptivedevelopmental fdelay. fFailure fto fthrive fis fan fexemplar fof
f social/emotional fdevelopmental fdelay.
Fetal falcohol fsyndrome fis fan fexemplar fof fcognitive fdevelopmental fdelay.
REF: f9 fOBJ: fNCLEX fClient fNeeds fCategory: fHealth fPromotion fand fMaintenance
6. To fplan fearly fintervention fand fcare ffor fa fchild fwith fa fdevelopmental fdelay,
f the fnurse fwouldconsider fknowledge fof fthe fconcepts fmost fsignificantly
impacted fby fdevelopment, fincluding
f
a. culture.
b. environment.
, c. functional fstatus.
,Advanced Practice Nursing: Doing What Has to Be Done-Radicals, Renegades,
andRebels
1. The nurse manager of a pediatric clinic could confirm that the new nurse
recognized the purposeof the HEADSS Adolescent Risk Profile when the new nurse
responds that it is used to assess for needs related to
a. anticipatory guidance.
b. low-risk adolescents.
c. physical development.
d. sexual development.
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool
which assesseshome, education, activities, drugs, sex, and suicide for the purpose
of identifying high-risk adolescents and the need for anticipatory guidance. It is
used to identify high-risk, not low-risk, adolescents. Physical development is
assessed with anthropometric data. Sexual development is assessed using physical
examination.
REF: 6 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
2. The nurse preparing a teaching plan for a preschooler knows that, according
to Piaget, theexpected stage of development for a preschooler is
,a. concrete operational.
b. formal operational.
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old) is
preoperational. Concreteoperational describes the thinking of a school-age child (7
to 11 years old). Formal operational
,describes the thinking of an individual after about 11 years of age. Sensorimotor
describes theearliest pattern of thinking from birth to 2 years old.
REF: 5 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
3. The school nurse talking with a high school class about the difference
between growth anddevelopment would best describe growth as
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.
ANS: D
Growth is a quantitative change in which an increase in cell number and size results
in an increasein overall size or weight of the body or any of its parts. The processes
by which early cells specialize are referred to asdifferentiation. Psychosocial and
cognitive changes are referred to as development. Qualitative changes associated
with aging are referred to as maturation.
REF: 2 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
4. The most appropriate response of the nurse when a mother asks what the Denver II
does is that it
a. can diagnose developmental disabilities.
,b. identifies a need for physical therapy.
c. is a developmental screening tool.
d. provides a framework for health teaching.
ANS: C
The Denver II is the most commonly used measure of developmental status used by
health care professionals; it is a screening tool. Screening tools do not provide a
diagnosis. Diagnosis requires athorough neurodevelopment history and physical
examination. Developmental delay, which is suggested by screening, is a symptom,
not a diagnosis. The need for any therapy would be identified with a comprehensive
evaluation, not a screening tool. Some providers use the Denver II as a framework
for teaching about expected development, but this is not the primary purpose of the
tool.
,REF: 4 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
5. To fplan fearly fintervention fand fcare ffor fan finfant fwith fDown fsyndrome,
the fnurse fconsidersknowledge fof fother fphysical fdevelopment fexemplars
f
f such fas
a. cerebral fpalsy.
b. failure fto fthrive.
c. fetal falcohol fsyndrome.
d. hydrocephaly.
ANS: fD
Hydrocephaly fis falso fa fphysical fdevelopment fexemplar. fCerebral fpalsy fis fan
f exemplar fof fadaptivedevelopmental fdelay. fFailure fto fthrive fis fan fexemplar fof
f social/emotional fdevelopmental fdelay.
Fetal falcohol fsyndrome fis fan fexemplar fof fcognitive fdevelopmental fdelay.
REF: f9 fOBJ: fNCLEX fClient fNeeds fCategory: fHealth fPromotion fand fMaintenance
6. To fplan fearly fintervention fand fcare ffor fa fchild fwith fa fdevelopmental fdelay,
f the fnurse fwouldconsider fknowledge fof fthe fconcepts fmost fsignificantly
impacted fby fdevelopment, fincluding
f
a. culture.
b. environment.
, c. functional fstatus.
