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Chapter 1: Approach to Care and Assessment of Children and Adolescents
MULTIPLE CHOICE
1. A nurse is reviewing developmental concepts for infants and children. Which statement best
describes development in infants and children?
a. Development, a predictable and orderly process, occurs at varying rates within
normal limits.
b. Development is primarily related to the growth in the number and size of cells.
c. Development occurs in a proximodistal direction with fine muscle development
occurring first.
d. Development is more easily and accurately measured than growth.
ANS: A
Development, a continuous orderly process, provides the basis for increases in the childs
function and complexity of behavior. The increases in rate of function and complexity can vary
normally within limits for each child. An increase in the number and size of cells is a definition
for growth. Development proceeds in a proximodistal direction with fine muscle organization
occurring as a result of large muscle organization. Development is a more complex process that
is affected by many factors; therefore, it is less easily and accurately measured. Growth is a
predictable process with standard measurement methods.
2. Frequent developmental assessments are important for which reason?
a. Stable developmental periods during infancy provide an opportunity to identify
any delays or deficits.
b. Infants need stimulation specific to the stage of development.
c. Critical periods of development occur during childhood.
d. Child development is unpredictable and needs monitoring.
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ANS: C
Critical periods are blocks of time during which children are ready to master specific
developmental tasks. Children can master these tasks more easily during particular periods of
time in their growth and developmental process. Infancy is a dynamic time of development that
requires frequent evaluations to assess appropriate developmental progress. Infants in a nurturing
environment will develop appropriately and will not necessarily need stimulation specific to their
developmental stage. Normal growth and development are orderly and proceed in a predictable
pattern on the basis of each individuals abilities and potentials.
3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
ANS: C
Genetic factors (heredity) determine each individuals growth and developmental rate. Although
factors such as environment, culture, nutrition, and family can influence genetic traits, they do
not eliminate the effect of the genetic endowment, which is permanent. Culture is a significant
factor that influences how children grow toward adulthood. Culture influences both growth and
development but does not eliminate inborn genetic influences. Environment has a significant role
in determining growth and development both before and after birth. The environment can
influence how and to which extent genetic traits are manifested, but environmental factors cannot
eliminate the effect of genetics. Nutrition is critical for growth and plays a significant role
throughout childhood.
4. A nurse is planning a teaching session with a child. According to Piagetian theory, the period
of cognitive development in which the child is able to distinguish fact from fantasy is the
period of cognitive development.
a. sensorimotor
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b. formal operations
c. concrete operations
d. preoperational
ANS: C
Concrete operations is the period of cognitive development in which childrens thinking is shifted
from egocentric to being able to see anothers point of view. They develop the ability to
distinguish fact from fantasy. The sensorimotor stage occurs in infancy and is a period of
reflexive behavior. During this period, the infants world becomes more permanent and
organized. The stage ends with the infant demonstrating some evidence of reasoning. Formal
operations is a period in development in which new ideas are created through previous thoughts.
Analytic reason and abstract thought emerge in this period. The preoperational stage is a period
of egocentrism in which the childs judgments are illogical and dominated by magical thinking
and animism.
5. The theorist who viewed developmental progression as a lifelong series of conflicts that need
resolution is:
a. Erikson.
b. Freud.
c. Kohlberg.
d. Piaget.
ANS: A
Erik Erikson viewed development as a series of conflicts affected by social and cultural factors.
Each conflict must be resolved for the child to progress emotionally, with unsuccessful
resolution leaving the child emotionally disabled. Sigmund Freud proposed a psychosexual
theory of development in which certain parts of the body assume psychological significance as
foci of sexual energy. The foci shift as the individual moves through the different stages (oral,
anal, phallic, latency, and genital) of development. Lawrence Kohlberg described moral
development as having three levels (preconventional, conventional, and postconventional). His
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Chapter 1: Approach to Care and Assessment of Children and Adolescents
MULTIPLE CHOICE
1. A nurse is reviewing developmental concepts for infants and children. Which statement best
describes development in infants and children?
a. Development, a predictable and orderly process, occurs at varying rates within
normal limits.
b. Development is primarily related to the growth in the number and size of cells.
c. Development occurs in a proximodistal direction with fine muscle development
occurring first.
d. Development is more easily and accurately measured than growth.
ANS: A
Development, a continuous orderly process, provides the basis for increases in the childs
function and complexity of behavior. The increases in rate of function and complexity can vary
normally within limits for each child. An increase in the number and size of cells is a definition
for growth. Development proceeds in a proximodistal direction with fine muscle organization
occurring as a result of large muscle organization. Development is a more complex process that
is affected by many factors; therefore, it is less easily and accurately measured. Growth is a
predictable process with standard measurement methods.
2. Frequent developmental assessments are important for which reason?
a. Stable developmental periods during infancy provide an opportunity to identify
any delays or deficits.
b. Infants need stimulation specific to the stage of development.
c. Critical periods of development occur during childhood.
d. Child development is unpredictable and needs monitoring.
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ANS: C
Critical periods are blocks of time during which children are ready to master specific
developmental tasks. Children can master these tasks more easily during particular periods of
time in their growth and developmental process. Infancy is a dynamic time of development that
requires frequent evaluations to assess appropriate developmental progress. Infants in a nurturing
environment will develop appropriately and will not necessarily need stimulation specific to their
developmental stage. Normal growth and development are orderly and proceed in a predictable
pattern on the basis of each individuals abilities and potentials.
3. Which factor has the greatest influence on child growth and development?
a. Culture
b. Environment
c. Genetics
d. Nutrition
ANS: C
Genetic factors (heredity) determine each individuals growth and developmental rate. Although
factors such as environment, culture, nutrition, and family can influence genetic traits, they do
not eliminate the effect of the genetic endowment, which is permanent. Culture is a significant
factor that influences how children grow toward adulthood. Culture influences both growth and
development but does not eliminate inborn genetic influences. Environment has a significant role
in determining growth and development both before and after birth. The environment can
influence how and to which extent genetic traits are manifested, but environmental factors cannot
eliminate the effect of genetics. Nutrition is critical for growth and plays a significant role
throughout childhood.
4. A nurse is planning a teaching session with a child. According to Piagetian theory, the period
of cognitive development in which the child is able to distinguish fact from fantasy is the
period of cognitive development.
a. sensorimotor
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b. formal operations
c. concrete operations
d. preoperational
ANS: C
Concrete operations is the period of cognitive development in which childrens thinking is shifted
from egocentric to being able to see anothers point of view. They develop the ability to
distinguish fact from fantasy. The sensorimotor stage occurs in infancy and is a period of
reflexive behavior. During this period, the infants world becomes more permanent and
organized. The stage ends with the infant demonstrating some evidence of reasoning. Formal
operations is a period in development in which new ideas are created through previous thoughts.
Analytic reason and abstract thought emerge in this period. The preoperational stage is a period
of egocentrism in which the childs judgments are illogical and dominated by magical thinking
and animism.
5. The theorist who viewed developmental progression as a lifelong series of conflicts that need
resolution is:
a. Erikson.
b. Freud.
c. Kohlberg.
d. Piaget.
ANS: A
Erik Erikson viewed development as a series of conflicts affected by social and cultural factors.
Each conflict must be resolved for the child to progress emotionally, with unsuccessful
resolution leaving the child emotionally disabled. Sigmund Freud proposed a psychosexual
theory of development in which certain parts of the body assume psychological significance as
foci of sexual energy. The foci shift as the individual moves through the different stages (oral,
anal, phallic, latency, and genital) of development. Lawrence Kohlberg described moral
development as having three levels (preconventional, conventional, and postconventional). His
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