,Concept 01: Development
f6 f6
Giddens: Concepts for Nursing Practice, 3rd Edition
f6 f6 f6 f6 f6 f6
MULTIPLE CHOICE f6
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
is used to assess for needs related to
f6 f6 f6 f6 f6 f6 f6 f6
a. anticipatory guidance. f6
b. low-risk adolescents. f6
c. physical development. f6
d. sexual development. f6
ANS: A f 6
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
assesses home, education, activities, drugs, sex, and suicide for the purpose of identifying
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
high-risk adolescents and the need for anticipatory guidance. It is used to identify high-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
risk, not low-risk, adolescents. Physical development is assessed with anthropometric data.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
Sexual development is assessed using physical examination.
f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e expected stage of development for a preschooler is
f6 f6 f6 f6 f6 f6 f6 f6
a. concrete operational. f6
b. formal operational. N f6
c. preoperational.
d. sensorimotor.
ANS: C f 6
The expected stage of development for a preschooler (3–4 years old) is pre-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
operational. Concrete operational describes the thinking of a school-age child (7–
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
11 years old). Formal operational describes the thinking of an individual after about 11 years
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
of age. Sensorimotor describes the earliest pattern of thinking from birth to 2 years old.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
3. The school nurse talking with a high school class about the difference between growth and
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
development would best describe growth as
f6 f6 f6 f6 f6 f6
a. processes by which early cells specialize. f6 f6 f6 f6 f6
b. psychosocial and cognitive changes. f6 f6 f6
c. qualitative changes associated with aging. f6 f6 f6 f6
d. quantitative changes in size or weight. f6 f6 f6 f6 f6 f
6 ANS: D f 6
WWW.NURSYLAB.COM
, Growth is a quantitative change in which an increase in cell number and size results in an i
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ncrease in overall size or weight of the body or any of its parts. The processes by which ea
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
rly cells specialize are referred to as differentiation. Psychosocial and cognitive changes ar
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e referred to as development. Qualitative changes associated with aging are referred to as m
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
aturation.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
4. The most appropriate response of the nurse when a mother asks what the Denver II does i
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
s that it
f6 f6
a. can diagnose developmental disabilities.
f6 f6 f6
b. identifies a need for physical therapy. f6 f6 f6 f6 f6
c. is a developmental screening tool.
f6 f6 f6 f6
d. provides a framework for health teaching. f6 f6 f6 f6 f6
ANS: C f 6
The Denver II is the most commonly used measure of developmental status used by healthc
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
are professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosi
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
s requires a thorough neurodevelopment history and physical examination.
f6 f6 f6 f6 f6 f6 f6 f6
Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. The n
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
eed for any therapy would be identified with a comprehensive evaluation, not a screening to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ol. Some providers use the Denver II as a framework for teaching about expected developm
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ent, but this is not the primary purpose of the tool.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
5. To plan early intervention a n Nd care for an infant with Down syndrome, the nurse considers
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
knowledge of other physical development exemplars such asf6 f6 f6 f6 f6 f6 f6
a. cerebral palsy. f6
b. autism.
c. attention-deficit/hyperactivity disorder (ADHD). f6 f6
d. failure to thrive. f6 f6
ANS: D f 6
Failure to thrive is also a physical development exemplar. Cerebral palsy is an exemplar of
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
motor/developmental delay. Autism is an exemplar of social/emotional developmental del f6 f6 f6 f6 f6 f6 f6 f6 f6
ay. ADHD is an exemplar of a cognitive disorder.
f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
6. To plan early intervention and care for a child with a developmental delay, the nurse woul
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
d consider knowledge of the concepts most significantly impacted by development, includi
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ng
a. culture.
b. environment.
c. functional status. f6
d. nutrition.
ANS: C
f6 f 6
, Function is one of the concepts most significantly impacted by development. Others include
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
sensory-
f6
perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these concepts
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
can help the nurse anticipate areas that need to be addressed. Culture is a concept that is co
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
nsidered to significantly affect development; the difference is the concepts that affect devel
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
opment are those that represent major influencing factors (causes); hence determination of
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
development would be the focus of preventive interventions. Environment is considered to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
significantly affect development. Nutrition is considered to significantly affect developmen
f6 f6 f6 f6 f6 f6 f6 f6 f6
t.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
7. A mother complains to the nurse at the pediatric clinic that her 4-year-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
old child always talks to her toys and makes up stories. The mother wants her child to have
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a psychological evaluation. The nurse‘s best initial response is to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a. refer the child to a psychologist immediately.
f6 f6 f6 f6 f6 f6
b. explain that playing make believe is normal at this age.f6 f6 f6 f6 f6 f6 f6 f6 f6
c. complete a developmental screening using a validated tool. f6 f6 f6 f6 f6 f6 f6
d. separate the child from the mother to get more information. f6 f6 f6 f6 f6 f6 f6 f6 f6
ANS: B f 6
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is nor
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
mal at this age. A referral to a psychologist would be premature based only on the complain
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
t of the mother. Completing a developmental screening would be very appropriate but not th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e initial response. The nurse would certainly want to get more information, but separating th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e child from the mother is not necessary at this time.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client NeedsNCategory: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6
8. A 17-year- f6
old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so needy
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
and acting like a child. The best response of the nurse is that in the hospital, adolescents
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a. have separation anxiety. f6 f6
b. rebel against rules. f6 f6
c. regress because of stress. f6 f6 f6
d. want to know everything. f6 f6 f6
ANS: C f 6
Regression to an earlier stage of development is a common response to stress. Separation a
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
nxiety is most common in infants and toddlers. Rebellion against hospital rules is usually n
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ot an issue if the adolescent understands the rules and would not create childlike behaviors.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
An adolescent may want to ―know everything‖ with their logical thinking and deductive re
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
asoning, but that would not explain why they would act like a child.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
WWW.NURSYLAB.COM
f6 f6
Giddens: Concepts for Nursing Practice, 3rd Edition
f6 f6 f6 f6 f6 f6
MULTIPLE CHOICE f6
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
is used to assess for needs related to
f6 f6 f6 f6 f6 f6 f6 f6
a. anticipatory guidance. f6
b. low-risk adolescents. f6
c. physical development. f6
d. sexual development. f6
ANS: A f 6
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
assesses home, education, activities, drugs, sex, and suicide for the purpose of identifying
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
high-risk adolescents and the need for anticipatory guidance. It is used to identify high-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
risk, not low-risk, adolescents. Physical development is assessed with anthropometric data.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
Sexual development is assessed using physical examination.
f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e expected stage of development for a preschooler is
f6 f6 f6 f6 f6 f6 f6 f6
a. concrete operational. f6
b. formal operational. N f6
c. preoperational.
d. sensorimotor.
ANS: C f 6
The expected stage of development for a preschooler (3–4 years old) is pre-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
operational. Concrete operational describes the thinking of a school-age child (7–
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
11 years old). Formal operational describes the thinking of an individual after about 11 years
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
of age. Sensorimotor describes the earliest pattern of thinking from birth to 2 years old.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
3. The school nurse talking with a high school class about the difference between growth and
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
development would best describe growth as
f6 f6 f6 f6 f6 f6
a. processes by which early cells specialize. f6 f6 f6 f6 f6
b. psychosocial and cognitive changes. f6 f6 f6
c. qualitative changes associated with aging. f6 f6 f6 f6
d. quantitative changes in size or weight. f6 f6 f6 f6 f6 f
6 ANS: D f 6
WWW.NURSYLAB.COM
, Growth is a quantitative change in which an increase in cell number and size results in an i
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ncrease in overall size or weight of the body or any of its parts. The processes by which ea
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
rly cells specialize are referred to as differentiation. Psychosocial and cognitive changes ar
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e referred to as development. Qualitative changes associated with aging are referred to as m
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
aturation.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
4. The most appropriate response of the nurse when a mother asks what the Denver II does i
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
s that it
f6 f6
a. can diagnose developmental disabilities.
f6 f6 f6
b. identifies a need for physical therapy. f6 f6 f6 f6 f6
c. is a developmental screening tool.
f6 f6 f6 f6
d. provides a framework for health teaching. f6 f6 f6 f6 f6
ANS: C f 6
The Denver II is the most commonly used measure of developmental status used by healthc
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
are professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosi
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
s requires a thorough neurodevelopment history and physical examination.
f6 f6 f6 f6 f6 f6 f6 f6
Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. The n
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
eed for any therapy would be identified with a comprehensive evaluation, not a screening to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ol. Some providers use the Denver II as a framework for teaching about expected developm
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ent, but this is not the primary purpose of the tool.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
5. To plan early intervention a n Nd care for an infant with Down syndrome, the nurse considers
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
knowledge of other physical development exemplars such asf6 f6 f6 f6 f6 f6 f6
a. cerebral palsy. f6
b. autism.
c. attention-deficit/hyperactivity disorder (ADHD). f6 f6
d. failure to thrive. f6 f6
ANS: D f 6
Failure to thrive is also a physical development exemplar. Cerebral palsy is an exemplar of
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
motor/developmental delay. Autism is an exemplar of social/emotional developmental del f6 f6 f6 f6 f6 f6 f6 f6 f6
ay. ADHD is an exemplar of a cognitive disorder.
f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
6. To plan early intervention and care for a child with a developmental delay, the nurse woul
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
d consider knowledge of the concepts most significantly impacted by development, includi
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ng
a. culture.
b. environment.
c. functional status. f6
d. nutrition.
ANS: C
f6 f 6
, Function is one of the concepts most significantly impacted by development. Others include
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
sensory-
f6
perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these concepts
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
can help the nurse anticipate areas that need to be addressed. Culture is a concept that is co
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
nsidered to significantly affect development; the difference is the concepts that affect devel
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
opment are those that represent major influencing factors (causes); hence determination of
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
development would be the focus of preventive interventions. Environment is considered to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
significantly affect development. Nutrition is considered to significantly affect developmen
f6 f6 f6 f6 f6 f6 f6 f6 f6
t.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
7. A mother complains to the nurse at the pediatric clinic that her 4-year-
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
old child always talks to her toys and makes up stories. The mother wants her child to have
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a psychological evaluation. The nurse‘s best initial response is to
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a. refer the child to a psychologist immediately.
f6 f6 f6 f6 f6 f6
b. explain that playing make believe is normal at this age.f6 f6 f6 f6 f6 f6 f6 f6 f6
c. complete a developmental screening using a validated tool. f6 f6 f6 f6 f6 f6 f6
d. separate the child from the mother to get more information. f6 f6 f6 f6 f6 f6 f6 f6 f6
ANS: B f 6
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is nor
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
mal at this age. A referral to a psychologist would be premature based only on the complain
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
t of the mother. Completing a developmental screening would be very appropriate but not th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e initial response. The nurse would certainly want to get more information, but separating th
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
e child from the mother is not necessary at this time.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client NeedsNCategory: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6
8. A 17-year- f6
old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so needy
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
and acting like a child. The best response of the nurse is that in the hospital, adolescents
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
a. have separation anxiety. f6 f6
b. rebel against rules. f6 f6
c. regress because of stress. f6 f6 f6
d. want to know everything. f6 f6 f6
ANS: C f 6
Regression to an earlier stage of development is a common response to stress. Separation a
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
nxiety is most common in infants and toddlers. Rebellion against hospital rules is usually n
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
ot an issue if the adolescent understands the rules and would not create childlike behaviors.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
An adolescent may want to ―know everything‖ with their logical thinking and deductive re
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
asoning, but that would not explain why they would act like a child.
f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6 f6
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
f6 f6 f6 f6 f6 f6 f6
WWW.NURSYLAB.COM
