Deck 25: Development

Question 1

The nurse notes that an infant does not seem to respond to noises in the environment and has difficulty following the movement of toys.Which diagnostic tools does the nurse anticipate will be used to further assess this client? Select all that apply.

A)CT scan of the brain
B)Vision test
C)Abdominal x-rays
D)Nerve conduction studies
E)Audiology testing

Answer 1

Vision test
Audiology testing

Question 2

The nurse is assessing a 20-month-old and learns that he is unable to stand alone.Which aspect of development does the nurse identify as altered?

A)Behavior
B)Height
C)Motor
D)Growth

Answer 2

Motor

Question 3

According to Bandura's social learning theory,which of the following should the nurse advise the parent of a preschool-aged child to do in order to help the child become independent in activities of daily living?

A)Punish the child if he does not complete the personal care tasks independently.
B)Refuse to help the child with the tasks and insist he do them on his own.
C)Model the tasks and positively reinforce the child for completing the tasks independently.
D)Wait until the child reaches the concrete operational phase before asking him to complete the tasks.

Answer 3

Model the tasks and positively reinforce the child for completing the tasks independently.

Question 4

The nurse is teaching the family of a child who is prescribed amphetamine mixed salts sustained release (Adderall XR)for attention-deficit/hyperactivity disorder (ADHD).Which of the following should the nurse teach the family is the best time to administer the medication?

A)Just before lunch
B)At bedtime
C)With the evening meal
D)Early in the morning

Question 5

The nurse is caring for a family with four children whose third child has been diagnosed with attention-deficit/hyperactivity disorder (ADHD).Which statement made by the mother suggests that the family may have difficulty coping with this diagnosis?

A)"I don't know how to tell the rest of the family,and I'm not sure how we will manage the other children."
B)"We need to alert the teachers at school as soon as possible so they can work with us to develop a plan that meets my son's needs."
C)"What does this mean for my son's health in the future?"
D)"Given this diagnosis,I'm not sure if we should let our son act in the school play."

Question 6

The nurse is performing developmental assessments on several children in a pediatric clinic setting.The nurse should recognize that which child is exhibiting a delay in meeting the expected developmental milestones? Select all that apply.

A)A 2-year-old who is unable to cut with scissors
B)A 2-year-old who cannot recite her phone number
C)A 3-year-old who is unable to speak in sentences
D)A 5-year-old who is unable to button his shirt
E)A 6-year-old who is unable to sit still for a short story

Question 7

The nurse is assessing a child who was last seen in the clinic 2 years earlier.Which of the following should the nurse anticipate as having remained relatively stable over time?

A)The child's behavior
B)The child's physical characteristics
C)The child's temperament
D)The child's home environment

Question 8

The school nurse is talking to a child with attention-deficit/hyperactivity disorder (ADHD)who wants to play soccer.Which action is most appropriate for the school nurse to take?

A)Recommend that the child become active in an individual sport,rather than a team sport.
B)Encourage the child to play soccer.
C)Discourage the child from playing a sport.
D)Ask the child's mother to get permission from the child's physician to play soccer.

Question 9

A nurse is caring for a 76-year-old client.The nurse suspects that the client may be minimizing her pain.Which should the nurse recognize as a common reason for this behavior in older adults?

A)Older adults see pain as a natural progression of aging,causing them to downplay the extent of their pain.
B)Older adults fear that admitting the extent of pain will result in administration of potentially addictive pain killers.
C)Older adults think that admitting the extent of their pain increases the likelihood they will be sent to a rehabilitation hospital prior to returning home.
D)Older adults have usually lost some degree of sensation in their appendages which makes it difficult for them to sense the full extent of their pain.

Question 10

The nurse is caring for an adolescent with a chronic illness who suddenly becomes noncompliant with the medication regimen.Which intervention should the nurse choose to help improve medication compliance for this client?

A)Give the client a computer-animated game that presents information on the management of the condition.
B)Recommend to the client's parents that certain privileges should be taken away,such as cell phone use and texting,if compliance fails to improve.
C)Arrange for the physician to discuss the risks related to noncompliance with medications to the client.
D)Set up a meeting with some older teens with the same condition who have been managing their disease effectively.

Question 11

A 6-month-old is in the clinic for a well-child visit.As part of the visit,the nurse will assess his development using the Ages and Stages Questionnaire (ASQ).Which will the nurse rely on to make her assessment?

A)Observation of the child's skills in a variety of areas
B)Parent reports of communication and motor skills,social skills,and problem-solving ability
C)Parental reports and observation of the child's skills in a variety of areas
D)Childcare provider reports of communication and motor skills,social skills,and problem-solving ability

Question 12

The school nurse cares for students with physical challenges and suspects that the needs for physical safety are not being adequately met for several students in the home environment.Which of the following assessment findings support the nurse's concern? Select all that apply.

A)Wearing the same clothes to school several days of the week
B)Limited arm range of motion
C)Scrapes on knees caused by falling from a bicycle
D)Hand burn from touching a hot stove
E)Lunch contains leftovers from previous evening dinner

Question 13

What activity should the nurse implement for a 6-month-old client with gross motor delays?

A)Pull the child to a sitting position and prop the child in that position.
B)Encourage the child to hold a rattle or play patty-cake.
C)Talk to the child and play music.
D)Encourage the child to pull up to a standing position.

Question 14

The nurse is interviewing the mother of a child who is being evaluated for attention-deficit/hyperactivity disorder (ADHD).When assessing the child's health history,which of the following should the nurse identify as a risk factor for ADHD?

A)The measles,mumps,and rubella (MMR)vaccine
B)The immune response of the child
C)Young parental age at conception
D)Smoking during pregnancy

Question 15

A community nurse is planning an educational program supports the developmental tasks of adults ages 50 to 60.According to Gould's theory,which task should be emphasized?

A)Engaging in self-reflection
B)Viewing personality as set
C)Adjusting to decreasing physical capacities
D)Undergoing a period of transformation

Question 16

The nurse is teaching a school-aged client how to use a peak flow meter to monitor asthma.Which approach by the nurse is most likely to result in the desired outcome?

A)Providing positive reinforcement after every attempt
B)Explaining that asthma can be fatal if not monitored and treated
C)Telling the client he cannot play until he learns to use the meter correctly
D)Using colloquialisms and slang when describing how to use the meter

Question 17

The nurse is caring for a young school-age child who was recently diagnosed with attention-deficit/hyperactivity disorder (ADHD).Which statement by the child's mother requires follow up teaching?

A)"I will let my child do homework while watching a favorite television show."
B)"I will give my child ADHD medication with meals."
C)"I will take my child to the doctor every 3 months for a weight and height check."
D)"I will stick to the same routine each day after school."

Question 18

The nurse is conducting a psychoeducation group with male and female clients.The nurse observes what appear to be differences in moral perspectives between the men and women.Which observation is most consistent with Gilligan's theory of moral development?

A)The men are focused on human-made rules governing morality.
B)The women have difficulty looking at moral issues objectively.
C)The men believe that morality is tied to relationships and caring.
D)The women believe that it is most important not to inflict harm.

Question 19

Which activities should the nurse emphasize when teaching parents about how to foster development in preschool-aged children?

A)Providing time for playing sports,such as basketball,to increase gross motor skills
B)Helping them develop skills needed in the adult world,such as allowance budgeting
C)Allowing "pretend" time,such as dress-up or role-playing activities
D)Presenting diversity in culture and practices as part of home-based study

Question 20

A nurse is caring for a school-age client who is scheduled to have a tonsillectomy the next day.The nurse has planned a preoperative teaching session for the child,who has a history of attention-deficit/hyperactivity disorder (ADHD).Which teaching technique is most appropriate for this client?

A)Play a video describing the procedure to the child.
B)Ask other children who have had this procedure to talk to the child.
C)Allow the child to lead the teaching session to gain a sense of control.
D)Give instructions verbally and use a picture pamphlet,repeating points more than once.

Question 21

The nurse is caring for an adult client with ASD.He indicates that he struggles with finding and maintaining employment.Which action by the nurse best addresses the client's needs?

A)Give the client information about state subsidies that will help him get by without a job.
B)Suggest the client work for a business owned by a family member or family friend.
C)Ask the client what his strengths are and identify types of jobs based on those strengths.
D)Encourage the client to seek opportunities that do not require communication with others.

Question 22

A nurse is providing education to the caregiver of a child with autism spectrum disorder (ASD).Which commonly associated behavioral problem should be identified in this teaching?

A)Depression in relation to feelings of inadequacy
B)Episodes of self-injury
C)Strong tendency toward hypoactivity
D)Hostility when faced with structured environments or repetitive activities

Question 23

A nurse is caring for a child who has been diagnosed with attention-deficit/hyperactivity disorder (ADHD).The client's healthcare provider has prescribed amphetamine-dextroamphetamine (Adderall)to treat the child's disorder.Which of the following statements regarding the use of this medication is appropriate for the nurse to include in the medication teaching?

A)"Your child's liver function should be monitored with this medication."
B)"Your child's growth will need to be monitored on this medication."
C)"This medication may increase the risk of psychosis."
D)"This medication has less abuse tendency because it is not a stimulant."

Question 24

A parent of a high school student with high-functioning ASD asks whether the child will ever be able to work.Which response by the nurse is best?

A)"There are job training programs that assist adults with ASD."
B)"Most adults with high-functioning ASD need to be supported by the state."
C)"You should plan to provide care for your child for the rest of your life."
D)"Individuals with high-functioning ASD usually grow out of the disorder."

Question 25

A pediatric nurse is performing an assessment on a toddler who is suspected of having autism spectrum disorder (ASD).Which of the following questions to the parents would be least useful in gathering the information necessary to appropriately assess the toddler for this disorder?

A)"Does your child have manic or depressed episodes?"
B)"Tell me about your child's social interactions."
C)"Does your child perform ritualistic behaviors when performing activities?"
D)"Is your child able to name objects?"

Question 26

The nurse is caring for a 9-month-old client diagnosed with ataxic cerebral palsy (CP).Which of the following clinical manifestations does the nurse anticipate when assessing this client? Select all that apply.

A)Muscle instability
B)Hypotonia
C)Hemiplegia
D)Hypertonia
E)Tremors

Question 27

Assuming approximately the same birth weight,level of prenatal care,and level of genetic predisposition,which of the following infants is least likely to develop ADHD during childhood?

A)An infant born at 35 weeks' gestation
B)An infant born at 36 weeks' gestation
C)An infant born at 38 weeks' gestation
D)An infant born at 34 weeks' gestation

Question 28

The nurse is caring for a child diagnosed with autism spectrum disorder (ASD)who is being admitted to the hospital with dehydration.Which action by the nurse is appropriate when the child arrives to the care area?

A)Take the child on a tour of the pediatric unit.
B)Take the child to the playroom for arts and crafts.
C)Quietly orient the child to a single-bed hospital room.
D)Orient the child to a four-bed unit.

Question 29

A community health nurse is educating pregnant clients about the risk factors associated with the development of attention-deficit/hyperactivity disorder (ADHD).Which statement will the nurse include in the educational session?

A)"ADHD has not been linked to prenatal exposure or disease."
B)"ADHD has been linked to a specific gene,and genetic testing may help to diagnose this."
C)"ADHD has been linked to prenatal exposure to cigarette smoke."
D)"ADHD has been linked to childhood exposure to folate."

Question 30

Which clinical manifestation of ADHD is more commonly observed in school-aged girls than in school-aged boys?

A)Aggression
B)Anxiety
C)Sleep disturbances
D)Impulsiveness

Question 31

An individual with ASD who demonstrates marked distress on switching activities (such as responding with loud verbalizations and behaviors that could result in self-harm)is demonstrating which level of clinical manifestations of the disorder?

A)Level I clinical manifestation
B)Level II clinical manifestation
C)Level III clinical manifestation
D)Level IV clinical manifestation

Question 32

The nurse is providing education to the parents of a child diagnosed with ASD.Which of the following healthcare professionals should the nurse tell the parents will take part in their child's care? Select all that apply.

A)Social services
B)Laboratory
C)Speech therapy
D)Play therapy
E)Public health agency

Question 33

The parent of a child with autism spectrum disorder (ASD)asks why family therapy has been prescribed.Which response by the nurse is most appropriate?

A)"Family therapy will help you learn how to assess your child's potential."
B)"Family therapy will provide your child with an opportunity to learn problem-solving skills."
C)"Family therapy will help you interact with your child."
D)"Family therapy will help you learn how to cope with your child's diagnosis."

Question 34

The nurse is caring for a child newly diagnosed with autism spectrum disorder (ASD).Which of the following is the most appropriate overall outcome for this child?

A)To function more effectively in social and emotional interactions
B)To stay on task
C)To acknowledge the effects of personal behavior on others
D)To acknowledge personal strengths

Question 35

A nurse is completing a psychosocial assessment of an adult client.Which finding is most consistent with an adult who has ADHD?

A)"The client stated that he has many friends and an active social life,and he thrives in fast-paced environments."
B)"The client stated that at times he feels tired and listless,struggling to get out of bed and complete basic self-care tasks."
C)"The client stated that he feels confident when completing job tasks and is punctual and effective at work,even though he has difficulty getting along with coworkers."
D)"The client stated that he struggles with alcohol use and often engages in unprotected sex and recreational drug use."

Question 36

A nurse is assessing a child who shows marked abnormalities in speech patterns.These includes using you in place of I,parroting words and phrases,and repeating questions rather than answering them.The nurse should recognize that these are characteristic of which condition?

A)Cerebral palsy
B)Autism spectrum disorder
C)Attention-deficit/hyperactivity disorder (ADHD)
D)Failure to thrive

Question 37

Which should the nurse identify as risk factors for a pregnant client having a baby with autism? Select all that apply.

A)Employed as a computer programmer
B)Smokes one pack per day of cigarettes
C)Drinks two glasses of wine on the weekends
D)Age 40
E)Rides a stationary bicycle four times a week for 30 minutes

Question 38

The parents of a child with autism spectrum disorder (ASD)observe that the child has difficulty making friends and are concerned about social expectations for their child.Which of the following is the priority diagnosis for this child based on the parents' concern?

A)Ineffective Coping
B)Deficient Diversional Activity
C)Social Isolation
D)Impaired Social Interaction

Question 39

The nurse is providing teaching to a client who is concerned about giving birth to a child with cerebral palsy.Which would the nurse include as risk factors for the condition? Select all that apply.

A)Cesarean delivery
B)Severe jaundice following birth
C)Infection and fever during pregnancy
D)Preterm labor
E)Birth weight of 9 pounds or above

Question 40

A community health nurse is teaching a group of women about the dangers of smoking.Which of the following child health problems should the nurse mention as associated with smoking during pregnancy?

A)Benzodiazepine withdrawal
B)Attention-deficit/hyperactivity disorder (ADHD)
C)Vision impairment
D)Personality disorders

Question 41

An infant is diagnosed with congenital CP caused by a meningitis infection.Based on this diagnosis,the nurse understands that the pathway for cellular damage is

A)genetic mutation to the brain cells prompted by infection with the causative agent.
B)accumulation of causative agents in the blood stream that gradually build up in the brain.
C)stretching and shearing of the neural pathways and brain tissue.
D)consumption of brain tissue and production of lactic acid by the causative pathogen.

Question 42

The parents of an infant report that the baby is often withdrawn and lethargic and does not eat or sleep well.The nurse notes that the child is underweight and small for its age.Which action by the nurse is most appropriate?

A)Giving the baby medicine for colic
B)Drawing blood for laboratory work
C)Feeding the baby
D)Observing interactions between the parents and the infant

Question 43

What does a nonorganic cause of failure to thrive (FTT)mean?

A)The FTT is not the result of a disease process or medical condition.
B)The FTT is the result of inborn errors in metabolism.
C)The FTT is the result of congenital disease.
D)The FTT is the result of a congenital anomaly such as cleft palate.

Question 44

The nurse is planning care for a child who is diagnosed with cerebral palsy (CP).Which of the following are appropriate nursing diagnoses for this child? Select all that apply.

A)Impaired Mobility
B)Risk for Injury
C)Anxiety
D)Caregiver Role Strain
E)Deficient Diversional Activity

Question 45

A nurse is teaching a mother of an infant who has been diagnosed with failure to thrive (FTT)about the treatment for the condition.Which statement by the nurse is appropriate?

A)"Appetite stimulant medications will be prescribed to help your child gain weight."
B)"If your child is breastfeeding,you must stop and feed your child formula."
C)"A home care nurse will be visiting to see how your child eats."
D)"A home care nurse will be visiting to insert a nasogastric feeding tube in your child."

Question 46

A nurse is caring for a pregnant client who has a history of depression.When including information to decrease the client's risk for having an infant diagnosed with failure to thrive (FTT),which of the following rationales is appropriate?

A)Women with mental illness have a decreased breast-milk supply,increasing the risk of FTT.
B)Women with mental illness may be socially isolated,increasing the risk of FTT.
C)Women with mental illness take medications that pass through the breast milk,increasing the risk of FTT.
D)Women with mental illness lack the knowledge required to provide adequate nutrition,increasing the risk of FTT.

Question 47

Which of the following best describes the relationship of nutrition,immunity,and geriatric failure to thrive (GFTT)?

A)Illness leads to decreased appetite,which leads to decreased nutrition.This leads to decreased ability to recover from illness.Illness increases susceptibility to GFTT.
B)Decreased nutrition leads to increased appetite.If appetite is so great that it cannot be satiated,GFTT develops.Once GFTT develops,risk of illness and infection increases.
C)Decreased appetite leads to decreased in nutrition.This leads to decreased ability to recover from infection,which increases susceptibility to illness.Illness increases susceptibility to GFTT.
D)GFTT leads to decreased appetite.This leads to imbalanced nutrition and increased susceptibility to illness.This increases the likelihood that GFTT will become chronic.

Question 48

The nurse is planning care for a family with five children,one of whom has been diagnosed with cerebral palsy (CP).The child is being cared for in the home,has a tracheostomy,and is on a home ventilator.Which intervention best supports the needs of needs of the family?

A)Meals-on-Wheels
B)Food stamps
C)Psychologic counseling
D)Respite care

Question 49

Which of the following sets of symptoms would the nurse identify in an infant exhibiting hypotonia?

A)Tense muscles and uncoordinated,awkward,stiff movements
B)Increased range of motion of joints,diminished reflex response,floppiness
C)Constant involuntary writhing motions that are more severe distally.
D)Paralysis of one side of the body,with greater upper extremity dysfunction

Question 50

Which statement made by a parent would cause the nurse to suspect that the infant may have a developmental condition like cerebral palsy (CP)?

A)"My 6-month-old baby is rolling from back to prone now."
B)"My 8-month-old cannot sit without support."
C)"My 10-month-old is not walking."
D)"My 3-month-old smiles at me all the time."

Question 51

The nurse caring for a child recently diagnosed with cerebral palsy (CP)is discussing the plan of care with the parents.Which should the nurse identify as a major goal of therapy for this child?

A)Promoting optimal global development
B)Increasing the child's IQ level
C)Reversing the degenerative processes that have occurred
D)Curing the underlying defect

Question 52

Which of the following would the nurse anticipate observing in the client with geriatric failure to thrive (GFTT)?

A)Decreased salivation and slowed gastrointestinal (GI)motility
B)Neurologic disease or condition
C)Excessive caloric expenditure
D)Congenital errors of metabolism

Question 53

Which of the following statements should the nurse include in a teaching session for an adult client with cerebral palsy (CP)?

A)"Adults with CP are at increased risk of bladder infections,which may result in incontinence."
B)"It's important to undergo regular depression screenings,because undiagnosed depression can contribute to incontinence."
C)"Clients with CP are prone to incontinence as they age."
D)"If you experience urinary incontinence,you will likely need to be assessed by a neurologist to see if the problem is related to nerve function."

Question 54

During a home visit,the nurse suspects that a newborn is at risk for failure to thrive (FTT).Which statement by the child's mother supports this assessment?

A)"I do not like to cook."
B)"I needed help at first learning to breastfeed my baby."
C)"I have a glass of wine with dinner once a week."
D)"I have been feeling depressed for the past several weeks."

Question 55

A child with cerebral palsy (CP)is scheduled for casting of the lower extremities.When instructing the parents about the purpose of the casts,which of the following will the nurse include in the teaching session? Select all that apply.

A)Promote skeletal alignment
B)Maintain stability
C)Improve muscle tone
D)Improve muscle function
E)Control involuntary movements

Question 56

The nurse sees several adult clients between the ages of 30 and 40 for annual checkups,one of whom has CP.Which of the following client statements represents a common consequence of the stress state caused by CP?

A)"My muscles seem to always hurt all over,and my joints are sore a lot,too."
B)"I have a really hard time socializing and understanding nonverbal communication.
C)"There are times when I just cannot control my anger and I hurt other people."
D)"I just have no appetite lately,and I seem to get dehydrated a lot."

Question 57

The nurse suggests that the mother of an infant with failure to thrive (FTT)see a lactation specialist to assist with breastfeeding.Which goal is appropriate when planning care for this family?

A)Increase the number of well-child checkups for the child.
B)Convince the mother to use formula instead of continuing with breastfeeding.
C)Improve the parent-child relationship.
D)Prevent complications associated with poor nutrition.

Question 58

The nurse is caring for a child with intellectual deficits who has been diagnosed with failure to thrive (FTT).The family is expressing difficulty with managing the child's care needs.Which nursing diagnosis would be appropriate for this situation?

A)Impaired Parenting related to poor parenting skills
B)Dysfunctional Family Processes related to a child with intellectual disability
C)Hopelessness related to terminal condition of the child
D)Compromised Family Coping related to the child's developmental variations

Question 59

While conducting a well-child assessment,the nurse suspects that a 2-month-old has failure to thrive (FTT).Which of the following height and weight measurement parameters should the nurse use to help diagnose this health problem?

A)Height and weight below the 50th percentile
B)Height and weight below the 15th percentile
C)Height and weight below the 5th percentile
D)Height and weight below the 10th percentile