,Concept 01: Development
b b
Giddens: Concepts for Nursing Practice, 3rd Edition
b b b b b b
MULTIPLE CHOICE b
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized the
b b b b b b b b b b b b b b
purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is
b b b b b b b b b b b b b b b
used to assess for needs related to
b b b b b b b
a. anticipatory guidance. b
b. low-risk adolescents. b
c. physical development. b
d. sexual development. b
ANS: A b
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which
b b b b b b b b b b b
assesses home, education, activities, drugs, sex, and suicide for the purpose of identifying high-
b b b b b b b b b b b b b b
risk adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-
b b b b b b b b b b b b b b b
risk, adolescents. Physical development is assessed with anthropometric data.
b b b b b b b b
Sexual development is assessed using physical examination.
b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the
b b b b b b b b b b b b b b
expected stage of development for a preschooler is
b b b b b b b b
a. concrete operational. b
b. formal operational. N b
c. preoperational.
d. sensorimotor.
ANS: C b
The expected stage of development for a preschooler (3–4 years old) is pre-operational. Concrete
b b b b b b b b b b b b b
operational describes the thinking of a school-age child (7–11 years old). Formal operational
b b b b b b b b b b b b b
describes the thinking of an individual after about 11 years of age. Sensorimotor describes the
b b b b b b b b b b b b b b b
earliest pattern of thinking from birth to 2 years old.
b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
3. The school nurse talking with a high school class about the difference between growth and
b b b b b b b b b b b b b b
development would best describe growth as
b b b b b b
a. processes by which early cells specialize. b b b b b
b. psychosocial and cognitive changes. b b b
c. qualitative changes associated with aging. b b b b
d. quantitative changes in size or weight. b b b b b
b ANS: D b
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, Growth is a quantitative change in which an increase in cell number and size results in an
b b b b b b b b b b b b b b b b
increase in overall size or weight of the body or any of its parts. The processes by which early
b b b b b b b b b b b b b b b b b b b
cells specialize are referred to as differentiation. Psychosocial and cognitive changes are
b b b b b b b b b b b b
referred to as development. Qualitative changes associated with aging are referred to as
b b b b b b b b b b b b b
maturation.
b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
4. The most appropriate response of the nurse when a mother asks what the Denver II does is that it
b b b b b b b b b b b b b b b b b b
a. can diagnose developmental disabilities.
b b b
b. identifies a need for physical therapy. b b b b b
c. is a developmental screening tool.
b b b b
d. provides a framework for health teaching. b b b b b
ANS: C b
The Denver II is the most commonly used measure of developmental status used by healthcare
b b b b b b b b b b b b b b
professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosis requires
b b b b b b b b b b b b b b b
a thorough neurodevelopment history and physical examination.
b b b b b b b
Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. The need b b b b b b b b b b b b b b
for any therapy would be identified with a comprehensive evaluation, not a screening tool. Some
b b b b b b b b b b b b b b b
providers use the Denver II as a framework for teaching about expected development, but this is
b b b b b b b b b b b b b b b b
not the primary purpose of the tool.
b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
5. Toplanearly interventiona n Nd careforan infantwithDown syndrome, thenurseconsiders
b b b b b b b b b b b b b b
knowledge of other physical development exemplars such as
b b b b b b b b
a. cerebral palsy. b
b. autism.
c. attention-deficit/hyperactivity disorder (ADHD). b b
d. failure to thrive. b b
ANS: D b
Failure to thrive is also a physical development exemplar. Cerebral palsy is an exemplar of
b b b b b b b b b b b b b b
motor/developmental delay. Autism is an exemplar of social/emotional developmental delay.
b b b b b b b b b b
ADHD is an exemplar of a cognitive disorder.
b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
6. To plan early intervention and care for a child with a developmental delay, the nurse would
b b b b b b b b b b b b b b b
consider knowledge of the concepts most significantly impacted by development, including
b b b b b b b b b b b
a. culture.
b. environment.
c. functional status. b
d. nutrition.
bANS: C b
, Function is one of the concepts most significantly impacted by development. Others include
b b b b b b b b b b b b
sensory-perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these
b b b b b b b b b
concepts can help the nurse anticipate areas that need to be addressed. Culture is a concept that is
b b b b b b b b b b b b b b b b b b
considered to significantly affect development; the difference is the concepts that affect
b b b b b b b b b b b b
development are those that represent major influencing factors (causes); hence determination
b b b b b b b b b b b
of development would be the focus of preventive interventions. Environment is considered to
b b b b b b b b b b b b b
significantly affect development. Nutrition is considered to significantly affect development.
b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
7. A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to
b b b b b b b b b b b b b b b b
her toys and makes up stories. The mother wants her child to have a psychological evaluation.
b b b b b b b b b b b b b b b b
The nurse’s best initial response is to
b b b b b b b
a. refer the child to a psychologist immediately.b b b b b b
b. explain that playing make believe is normal at this age. b b b b b b b b b
c. complete a developmental screening using a validated tool. b b b b b b b
d. separate the child from the mother to get more information. b b b b b b b b b
ANS: B b
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at
b b b b b b b b b b b b b b b b b b b b b
this age. A referral to a psychologist would be premature based only on the complaint of the
b b b b b b b b b b b b b b b b b
mother. Completing a developmental screening would be very appropriate but not the initial
b b b b b b b b b b b b b
response. The nurse would certainly want to get more information, but separating the child from
b b b b b b b b b b b b b b b
the mother is not necessary at this time.
b b b b b b b b
OBJ: NCLEX Client NeedsNCategory: Health Promotion and Maintenance b b b b b b
8. A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so
b b b b b b b b b b b b b b b b
needy and acting like a child. The best response of the nurse is that in the hospital, adolescents
b b b b b b b b b b b b b b b b b b
a. have separation anxiety. b b
b. rebel against rules. b b
c. regress because of stress. b b b
d. want to know everything. b b b
ANS: C b
Regression to an earlier stage of development is a common response to stress. Separation
b b b b b b b b b b b b b
anxiety is most common in infants and toddlers. Rebellion against hospital rules is usually not an
b b b b b b b b b b b b b b b b
issue if the adolescent understands the rules and would not create childlike behaviors. An
b b b b b b b b b b b b b b
adolescent may want to “know everything” with their logical thinking and deductive reasoning,
b b b b b b b b b b b b b
but that would not explain why they would act like a child.
b b b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
WWW.NURSYLAB.COM
b b
Giddens: Concepts for Nursing Practice, 3rd Edition
b b b b b b
MULTIPLE CHOICE b
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized the
b b b b b b b b b b b b b b
purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is
b b b b b b b b b b b b b b b
used to assess for needs related to
b b b b b b b
a. anticipatory guidance. b
b. low-risk adolescents. b
c. physical development. b
d. sexual development. b
ANS: A b
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which
b b b b b b b b b b b
assesses home, education, activities, drugs, sex, and suicide for the purpose of identifying high-
b b b b b b b b b b b b b b
risk adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-
b b b b b b b b b b b b b b b
risk, adolescents. Physical development is assessed with anthropometric data.
b b b b b b b b
Sexual development is assessed using physical examination.
b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, the
b b b b b b b b b b b b b b
expected stage of development for a preschooler is
b b b b b b b b
a. concrete operational. b
b. formal operational. N b
c. preoperational.
d. sensorimotor.
ANS: C b
The expected stage of development for a preschooler (3–4 years old) is pre-operational. Concrete
b b b b b b b b b b b b b
operational describes the thinking of a school-age child (7–11 years old). Formal operational
b b b b b b b b b b b b b
describes the thinking of an individual after about 11 years of age. Sensorimotor describes the
b b b b b b b b b b b b b b b
earliest pattern of thinking from birth to 2 years old.
b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
3. The school nurse talking with a high school class about the difference between growth and
b b b b b b b b b b b b b b
development would best describe growth as
b b b b b b
a. processes by which early cells specialize. b b b b b
b. psychosocial and cognitive changes. b b b
c. qualitative changes associated with aging. b b b b
d. quantitative changes in size or weight. b b b b b
b ANS: D b
WWW.NURSYLAB.COM
, Growth is a quantitative change in which an increase in cell number and size results in an
b b b b b b b b b b b b b b b b
increase in overall size or weight of the body or any of its parts. The processes by which early
b b b b b b b b b b b b b b b b b b b
cells specialize are referred to as differentiation. Psychosocial and cognitive changes are
b b b b b b b b b b b b
referred to as development. Qualitative changes associated with aging are referred to as
b b b b b b b b b b b b b
maturation.
b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
4. The most appropriate response of the nurse when a mother asks what the Denver II does is that it
b b b b b b b b b b b b b b b b b b
a. can diagnose developmental disabilities.
b b b
b. identifies a need for physical therapy. b b b b b
c. is a developmental screening tool.
b b b b
d. provides a framework for health teaching. b b b b b
ANS: C b
The Denver II is the most commonly used measure of developmental status used by healthcare
b b b b b b b b b b b b b b
professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosis requires
b b b b b b b b b b b b b b b
a thorough neurodevelopment history and physical examination.
b b b b b b b
Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. The need b b b b b b b b b b b b b b
for any therapy would be identified with a comprehensive evaluation, not a screening tool. Some
b b b b b b b b b b b b b b b
providers use the Denver II as a framework for teaching about expected development, but this is
b b b b b b b b b b b b b b b b
not the primary purpose of the tool.
b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
5. Toplanearly interventiona n Nd careforan infantwithDown syndrome, thenurseconsiders
b b b b b b b b b b b b b b
knowledge of other physical development exemplars such as
b b b b b b b b
a. cerebral palsy. b
b. autism.
c. attention-deficit/hyperactivity disorder (ADHD). b b
d. failure to thrive. b b
ANS: D b
Failure to thrive is also a physical development exemplar. Cerebral palsy is an exemplar of
b b b b b b b b b b b b b b
motor/developmental delay. Autism is an exemplar of social/emotional developmental delay.
b b b b b b b b b b
ADHD is an exemplar of a cognitive disorder.
b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
6. To plan early intervention and care for a child with a developmental delay, the nurse would
b b b b b b b b b b b b b b b
consider knowledge of the concepts most significantly impacted by development, including
b b b b b b b b b b b
a. culture.
b. environment.
c. functional status. b
d. nutrition.
bANS: C b
, Function is one of the concepts most significantly impacted by development. Others include
b b b b b b b b b b b b
sensory-perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these
b b b b b b b b b
concepts can help the nurse anticipate areas that need to be addressed. Culture is a concept that is
b b b b b b b b b b b b b b b b b b
considered to significantly affect development; the difference is the concepts that affect
b b b b b b b b b b b b
development are those that represent major influencing factors (causes); hence determination
b b b b b b b b b b b
of development would be the focus of preventive interventions. Environment is considered to
b b b b b b b b b b b b b
significantly affect development. Nutrition is considered to significantly affect development.
b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
7. A mother complains to the nurse at the pediatric clinic that her 4-year-old child always talks to
b b b b b b b b b b b b b b b b
her toys and makes up stories. The mother wants her child to have a psychological evaluation.
b b b b b b b b b b b b b b b b
The nurse’s best initial response is to
b b b b b b b
a. refer the child to a psychologist immediately.b b b b b b
b. explain that playing make believe is normal at this age. b b b b b b b b b
c. complete a developmental screening using a validated tool. b b b b b b b
d. separate the child from the mother to get more information. b b b b b b b b b
ANS: B b
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at
b b b b b b b b b b b b b b b b b b b b b
this age. A referral to a psychologist would be premature based only on the complaint of the
b b b b b b b b b b b b b b b b b
mother. Completing a developmental screening would be very appropriate but not the initial
b b b b b b b b b b b b b
response. The nurse would certainly want to get more information, but separating the child from
b b b b b b b b b b b b b b b
the mother is not necessary at this time.
b b b b b b b b
OBJ: NCLEX Client NeedsNCategory: Health Promotion and Maintenance b b b b b b
8. A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so
b b b b b b b b b b b b b b b b
needy and acting like a child. The best response of the nurse is that in the hospital, adolescents
b b b b b b b b b b b b b b b b b b
a. have separation anxiety. b b
b. rebel against rules. b b
c. regress because of stress. b b b
d. want to know everything. b b b
ANS: C b
Regression to an earlier stage of development is a common response to stress. Separation
b b b b b b b b b b b b b
anxiety is most common in infants and toddlers. Rebellion against hospital rules is usually not an
b b b b b b b b b b b b b b b b
issue if the adolescent understands the rules and would not create childlike behaviors. An
b b b b b b b b b b b b b b
adolescent may want to “know everything” with their logical thinking and deductive reasoning,
b b b b b b b b b b b b b
but that would not explain why they would act like a child.
b b b b b b b b b b b b
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
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