TEST BANK FOR PEDIATRIC PHYSICAL
EXAMINATION AN ILLUSTRATED
HANDBOOK 3RD EDITION DUDERSTADT-
latest-2023
Pediatric Physical Examination 3rd Edition Duderstadt TESTBANK
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.
,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
, 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
,theory closely parallels Piagets. Jean Piagets cognitive theory interprets how children learn and
think and how this thinking progresses and differs from adult thinking. Stages of his theory
include sensorimotor, preoperations, concrete operations, and formal operations.
6. What does the nurse need to know when observing chronically ill children at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Childrens play is an indication of a childs response to treatment.
d. Play is to be discouraged because it tires hospitalized children.
ANS: C
Play for all children is an activity woven with meaning and purpose and is a mechanism for
mastering their environment. For chronically ill children, play can indicate their state of wellness
and response to treatment. Play is important to all children in all environments. Although
childrens play activities appear unorganized and at times chaotic, play has purpose and meaning.
Imposing structure on play interferes with the tasks being worked on. Children who have fewer
energy reserves still require play. For these children, less-active play activities will be important.
7. Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
ANS: B
Toddlers are most likely to be frightened by hospitalization because their thought processes are
egocentric, magical, and illogical. They feel very threatened by unfamiliar people and strange
environments. Young infants are not as likely to be frightened as toddlers by hospitalization
because they are not as aware of the environment. The 9-year-old childs cognitive ability is
,sufficient enough for the child to understand the reason for the hospitalization. The 15-year-old
adolescent has the cognitive ability to interpret the reason for the hospitalization.
8. Which statement made by a 15-year-old adolescent with a diagnosis of neurofibromatosis (an
autosomal dominant genetic disorder) best demonstrates an understanding of the mechanism of
inheritance for the disease?
a. My babies will probably not have neurofibromatosis.
b. My babies have a 50% chance of having neurofibromatosis.
c. Whether my babies have problems depends on the father.
d. My babies have a 25% chance of having neurofibromatosis.
ANS: B
Neurofibromatosis is an autosomal dominant genetic disorder that occurs when the abnormal
gene is carried on the affected chromosome with a normal gene. Because the abnormal gene is
dominant, an individual with the defective gene has a 50% chance of transmitting the defect to
an infant with each pregnancy. Neurofibromatosis is not a sex-linked genetic disease; therefore,
either the father or the mother genetically transfers it to the infant. A parent with the defective
gene will genetically transfer either a normal or abnormal gene to an infant. Because the
defective gene is dominant, there is a 50% probability of the child inheriting the disease.
9. During a routine healthcare visit, a parent asks the nurse why her 9-month-old infant is not
walking as her older child did at the same age. Which response by the nurse best demonstrates an
understanding of child development?
a. Shes a little slow.
b. If she is pulling up, you can help her by holding her hand.
c. Babies progress at different rates. Your infants development is within normal
limits.
d. Maybe she needs to see a behavioral specialist.
ANS: C
,Ninety percent of infants walk by 14 months of age. The infant is within normal developmental
limits. It is inappropriate for the nurse to state that the infant is a little slow. Infants will walk
when they are developmentally ready. Hurrying an infant does not result in the developmental
task being achieved at an earlier time period. Consulting a behavioral specialist for diagnostic
evaluation is indicated when a child demonstrates developmental delays. The child has no
evidence of a delay.
10. Which expected outcome would be developmentally appropriate for a hospitalized 4-year-
old child?
a. The child will be dressed and fed by the parents.
b. The child will independently ask for play materials or other personal needs.
c. The child will be able to verbalize an understanding of the reason for the
hospitalization.
d. The child will have a parent stay in the room at all times.
ANS: B
Erikson identifies initiative as a developmental task for the preschool child. Initiating play
activities and asking for play materials or assistance with personal needs demonstrate
developmental appropriateness. Parents need to foster appropriate developmental behavior in
the 4-year-old child. Dressing and feeding the child do not encourage independent behavior. A
4- year-old child cannot be expected to cognitively understand the reason for his or her
hospitalization. Expecting the child to verbalize an understanding for the hospitalization is an
inappropriate outcome. Parents staying with the child throughout a hospitalization is an
inappropriate outcome. Although children benefit from parental involvement, parents may not
have the support structure to stay in the room with the child at all times.
11. A nurse has completed a teaching session with parents of preschool aged children. Which
statement made by the parent identifies an appropriate level of language development for a 4-
year-old child?
a. The child has a vocabulary of 300 words and uses simple sentences.
b. The child uses correct grammar in sentences.
, c. The child is able to pronounce consonants clearly.
d. The child uses language to express abstract thought.
ANS: B
The 4-year-old child is able to use correct grammar in sentence structure and typically has
difficulty in pronouncing consonants. Simple sentences and a 300-word vocabulary are
appropriate for a 2-year-old child. The use of language to express abstract thought is
developmentally appropriate for the adolescent.
12. Which should the nurse evaluate before administering the Denver Developmental
Screening Test II (DDST-II)?
a. The childs height and weight
b. The parents ability to comprehend the results
c. The childs mood
d. The parentchild interaction
ANS: C
The results of the screening test are valid if the child acted in a normal and expected manner. The
childs height and weight are not relevant to the DDST-II screening process. The parents ability to
understand the results of the screening is not relevant to the validity of the test. The parentchild
interaction is not significantly relevant to the test results.
13. Which children are at greater risk for not receiving immunizations?
a. Children who attend licensed day care programs
b. Children entering school
c. Children who are home schooled
d. Young adults entering college
ANS: C
EXAMINATION AN ILLUSTRATED
HANDBOOK 3RD EDITION DUDERSTADT-
latest-2023
Pediatric Physical Examination 3rd Edition Duderstadt TESTBANK
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.
,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
, 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
,theory closely parallels Piagets. Jean Piagets cognitive theory interprets how children learn and
think and how this thinking progresses and differs from adult thinking. Stages of his theory
include sensorimotor, preoperations, concrete operations, and formal operations.
6. What does the nurse need to know when observing chronically ill children at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Childrens play is an indication of a childs response to treatment.
d. Play is to be discouraged because it tires hospitalized children.
ANS: C
Play for all children is an activity woven with meaning and purpose and is a mechanism for
mastering their environment. For chronically ill children, play can indicate their state of wellness
and response to treatment. Play is important to all children in all environments. Although
childrens play activities appear unorganized and at times chaotic, play has purpose and meaning.
Imposing structure on play interferes with the tasks being worked on. Children who have fewer
energy reserves still require play. For these children, less-active play activities will be important.
7. Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
ANS: B
Toddlers are most likely to be frightened by hospitalization because their thought processes are
egocentric, magical, and illogical. They feel very threatened by unfamiliar people and strange
environments. Young infants are not as likely to be frightened as toddlers by hospitalization
because they are not as aware of the environment. The 9-year-old childs cognitive ability is
,sufficient enough for the child to understand the reason for the hospitalization. The 15-year-old
adolescent has the cognitive ability to interpret the reason for the hospitalization.
8. Which statement made by a 15-year-old adolescent with a diagnosis of neurofibromatosis (an
autosomal dominant genetic disorder) best demonstrates an understanding of the mechanism of
inheritance for the disease?
a. My babies will probably not have neurofibromatosis.
b. My babies have a 50% chance of having neurofibromatosis.
c. Whether my babies have problems depends on the father.
d. My babies have a 25% chance of having neurofibromatosis.
ANS: B
Neurofibromatosis is an autosomal dominant genetic disorder that occurs when the abnormal
gene is carried on the affected chromosome with a normal gene. Because the abnormal gene is
dominant, an individual with the defective gene has a 50% chance of transmitting the defect to
an infant with each pregnancy. Neurofibromatosis is not a sex-linked genetic disease; therefore,
either the father or the mother genetically transfers it to the infant. A parent with the defective
gene will genetically transfer either a normal or abnormal gene to an infant. Because the
defective gene is dominant, there is a 50% probability of the child inheriting the disease.
9. During a routine healthcare visit, a parent asks the nurse why her 9-month-old infant is not
walking as her older child did at the same age. Which response by the nurse best demonstrates an
understanding of child development?
a. Shes a little slow.
b. If she is pulling up, you can help her by holding her hand.
c. Babies progress at different rates. Your infants development is within normal
limits.
d. Maybe she needs to see a behavioral specialist.
ANS: C
,Ninety percent of infants walk by 14 months of age. The infant is within normal developmental
limits. It is inappropriate for the nurse to state that the infant is a little slow. Infants will walk
when they are developmentally ready. Hurrying an infant does not result in the developmental
task being achieved at an earlier time period. Consulting a behavioral specialist for diagnostic
evaluation is indicated when a child demonstrates developmental delays. The child has no
evidence of a delay.
10. Which expected outcome would be developmentally appropriate for a hospitalized 4-year-
old child?
a. The child will be dressed and fed by the parents.
b. The child will independently ask for play materials or other personal needs.
c. The child will be able to verbalize an understanding of the reason for the
hospitalization.
d. The child will have a parent stay in the room at all times.
ANS: B
Erikson identifies initiative as a developmental task for the preschool child. Initiating play
activities and asking for play materials or assistance with personal needs demonstrate
developmental appropriateness. Parents need to foster appropriate developmental behavior in
the 4-year-old child. Dressing and feeding the child do not encourage independent behavior. A
4- year-old child cannot be expected to cognitively understand the reason for his or her
hospitalization. Expecting the child to verbalize an understanding for the hospitalization is an
inappropriate outcome. Parents staying with the child throughout a hospitalization is an
inappropriate outcome. Although children benefit from parental involvement, parents may not
have the support structure to stay in the room with the child at all times.
11. A nurse has completed a teaching session with parents of preschool aged children. Which
statement made by the parent identifies an appropriate level of language development for a 4-
year-old child?
a. The child has a vocabulary of 300 words and uses simple sentences.
b. The child uses correct grammar in sentences.
, c. The child is able to pronounce consonants clearly.
d. The child uses language to express abstract thought.
ANS: B
The 4-year-old child is able to use correct grammar in sentence structure and typically has
difficulty in pronouncing consonants. Simple sentences and a 300-word vocabulary are
appropriate for a 2-year-old child. The use of language to express abstract thought is
developmentally appropriate for the adolescent.
12. Which should the nurse evaluate before administering the Denver Developmental
Screening Test II (DDST-II)?
a. The childs height and weight
b. The parents ability to comprehend the results
c. The childs mood
d. The parentchild interaction
ANS: C
The results of the screening test are valid if the child acted in a normal and expected manner. The
childs height and weight are not relevant to the DDST-II screening process. The parents ability to
understand the results of the screening is not relevant to the validity of the test. The parentchild
interaction is not significantly relevant to the test results.
13. Which children are at greater risk for not receiving immunizations?
a. Children who attend licensed day care programs
b. Children entering school
c. Children who are home schooled
d. Young adults entering college
ANS: C
