Pediatric Physical Examination (4th Edition) – Duderstadt – Test Bank and Practice Questions with Answers for Pediatric Assessment and Development

Pediatric Physical Examination An
Illustrated Handbook 4th Edition
Duderstadt Test Bank

,Chapter 1: Approach to Care and Assessment of Children and Adolescents
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MULTIPLECHOICE I




1. Anurse is reviewing developmentalconcepts for infants and children. Which statement best
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describes development in infants and children?
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a. Development, a predictable and orderly process, occurs at varying rates within I I I I I I I I I I I




normal limits. I




b. Development is primarilyrelated tothe growth in the number and size ofcells. I I I I I I I I I I I I I




c. Development occurs in a proximodistal direction with fine muscle development I I I I I I I I I I




occurring first. I




d. Development is more easilyand accuratelymeasured than growth. I I I I I I I I




ANS: A I




Development, a continuous orderly process, provides the basis for increases in the childs function
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and complexity of behavior. The increases in rate of function and complexity can vary normally
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within limits for each child. An increase in the number and size of cells is a definition for growth.
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Development proceeds in a proximodistal direction with fine muscle organization occurring as a
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result of large muscle organization. Development is a more complex process that is affected by
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many factors; therefore, it is less easily and accurately measured. Growth is a predictable process
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with standard measurement methods.
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2. Frequent developmental assessments are important for which reason?
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a. Stable developmental periods during infancy provide an opportunity to identify
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any delays or deficits.I I I




b. Infants need stimulation specific to the stage ofdevelopment.
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c. Criticalperiods ofdevelopment occur during childhood. I I I I I I




d. Childdevelopment is unpredictable and needs monitoring.
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,ANS: C I




Critical periods are blocks of time during which children are ready to master specific
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developmental tasks. Children can master these tasks more easily during particular periods of time
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in their growth and developmental process. Infancy is a dynamic time of development that requires
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frequent evaluations to assess appropriate developmental progress. Infants in a nurturing
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environment will develop appropriately and will not necessarily need stimulation specific to their
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developmental stage. Normal growth and development are orderly and proceed in a predictable
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pattern on the basis of each individuals abilities and potentials.
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3. Which factor has the greatest influence on child growth and development?
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a. Culture

b. Environment

c. Genetics

d. Nutrition


ANS: C I




Genetic factors (heredity) determine each individuals growth and developmental rate. Although
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factors such as environment, culture, nutrition, and family can influence genetic traits, they do not
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eliminate the effect of the genetic endowment, which is permanent. Culture is a significant factor
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that influences how children grow toward adulthood. Culture influences both growth and
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development but does not eliminate inborn genetic influences. Environment has a significant role in
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determining growth and development both before and after birth. The environment can influence
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how and to which extent genetic traits are manifested, but environmental factors cannot eliminate the
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effect of genetics. Nutrition is critical for growth and plays a significant role throughout childhood.
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4. A nurse is planning a teaching session with a child. According to Piagetian theory, the period of
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cognitive development in which the child is able to distinguish fact from fantasy is
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the period of cognitive development.
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a. sensorimotor

, b. formaloperations I




c. concreteoperations I




d. preoperational


ANS: C I




Concreteoperations is the periodofcognitive development inwhich childrens thinking is shifted
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from egocentric to being able to see anothers point of view. They develop the ability to distinguish
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fact from fantasy. The sensorimotor stage occurs in infancy and is a period of reflexive behavior.
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During this period, the infants world becomes more permanent and organized. The stage ends with
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the infant demonstrating some evidence of reasoning. Formal operations is a period in
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development in which new ideas are created through previous thoughts. Analytic reason and
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abstract thought emerge in this period. The preoperational stage is a period of egocentrism in
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which the childs judgments are illogical and dominated by magical thinking and animism.
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5. Thetheorist who viewed developmentalprogression as a lifelong series ofconflicts that need
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resolution is: I




a. Erikson.

b. Freud.

c. Kohlberg.

d. Piaget.


ANS: A I




Erik Erikson viewed development as a series of conflicts affected by social and cultural factors.
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Each conflict must be resolved for the child to progress emotionally, with unsuccessful resolution
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leaving the child emotionally disabled. Sigmund Freud proposed a psychosexual theory of
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development in which certain parts of the body assume psychological significance as foci of
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sexual energy. The foci shift as the individual moves through the different stages (oral, anal,
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phallic, latency, and genital) of development. Lawrence Kohlberg described moral development
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as having three levels (preconventional, conventional, and postconventional). His
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