b b
FOR CONCEPTS FOR NURSING PRACTICE 3RD EDITION BY GIDDENS
b b b b b b b b
,Concept 01:Development
b b
Giddens: Concepts for Nursing Practice, 3rdEdition
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
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purpose of the HEADSS Adolescent Risk Profile when the new nurse responds that it is used
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to review for needs related to
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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
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reviews home, education, activities, drugs, sex, and suicide for the purpose of identifying high-
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risk adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-
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risk, adolescents. Physical development is reviewed with anthropometric data.
b b b b b b b b
Sexual development is reviewed using physical examination.
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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
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expected stage of development for a preschooler is
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a. concrete operational. b
b. formaloperational. b
c. preoperational.
d. sensorimotor.
ANS: C b
The expected stage of development for a preschooler (3–4 years old) is pre-operational.
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Concrete operational describes the thinking of a school-age child (7–11 years old). Formal
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operational describes the thinking of an individual after about 11 years of age. Sensorimotor
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describes the earliest pattern of thinking from birth to 2 years old.
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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
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development would best describe growth as
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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 insize or weight. b b b b b
b ANS: D b
, Growth is a quantitative change in which an increase in cell number and size results in an
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increase in overall size or weight of the body or any of its parts. The processes by which early
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cells specialize are referred to as differentiation. Psychosocial and cognitive changes are
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referred to as development. Qualitative changes associated with aging arereferred to as
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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 amother asks what the Denver II does is that it
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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
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professionals; it is a screening tool. Screening tools do not provide adiagnosis. Diagnosis
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requires a thorough neurodevelopment history and physical examination.
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Developmental delay, which is suggested by screening, is a symptom, not adiagnosis. 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
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providers use the Denver II as a framework for teaching about expected development, but this
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is not the primary purpose of the tool.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b
5. Toplan earlyintervention a n Nd U
b caRreSfIoN
b r aGnTinBf.
anCt OwMith Down syndrome, thenurse considers
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knowledge of other physical development exemplars such as
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a. cerebral palsy. b
b. failure to thrive. b b
c. fetal alcohol syndrome. b b
d. hydrocephaly.
ANS: D b
Hydrocephaly is also a physical development exemplar. Cerebral palsy is an exemplar of b b b b b b b b b b b b
adaptive developmental delay. Failure to thrive is an exemplar of social/emotional
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developmental delay. Fetal alcohol syndrome is an exemplar of cognitive developmental delay.
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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
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consider knowledge of the concepts most significantly impacted by development, including
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a. culture.
b. environment.
c. functional status. b
d. nutrition.
ANS: C b
, Function is one of the concepts most significantly impacted by development. Others include
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sensory-perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these
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concepts can help the nurse anticipate areas that need to be addressed. Culture is a concept that
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is considered to significantly affect development; the difference is the concepts that affect
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development are those that represent major influencing factors (causes); hence determination
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of development would be the focus of preventive interventions. Environment is considered to
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significantly affect development. Nutrition is considered to significantly affect development.
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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 her
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toys and makes up stories. The mother wants her child to have a psychological evaluation. The
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nurse’s best initial response is to
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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
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this age. A referral to a psychologist would be premature based only on the complaint of the
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mother. Completing a developmental screening would be very appropriate but not the initial
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response. The nurse would certainly want to get more information, but separating the child
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from the mother is not necessary at this time.
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OBJ: NCLEX Client NeedsNCUaRteSgI
o rNy:GHTeBal.thCPOrM
omotion and Maintenance b b b b
8. A 17-year-old girl is hospitalized for appendicitis, and her mother asks the nurse why she is so
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needy and acting like a child. The best response of the nurse is that in the hospital, adolescents
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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. Separationb 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
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an issue if the adolescent understands the rules and would not create childlike behaviors. An
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adolescent may want to “know everything” with their logical thinking and deductive reasoning,
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but that would not explain why they would act like a child.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance b b b b b b b