Physical Examination
An Illustrated
rd
Handbook 3 Edition
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. Sensorimotorformal Operations
b. Concrete Operations
c. 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.