Peds Growth and development

For which pediatric client should the nurse use the Age and Stages Questionnaire (ASQ) as a developmental screening tool during a health maintenance assessment?
1
A 2-week old newborn client
2
A 15-month-old toddler client
3
A 6-year-old school-age client
4
A 14-year-old adolescent client

2 The ASQ developmental screening tool is appropriate to use for pediatric clients from 1 month to 4.5 years of age. The nurse would use this screening tool for the 15-month-old toddler. The other clients are not within the age range for the use of the ASQ screening tool.

Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action?
1
Highly active in childhood
2
Absent around the umbilicus
3
Widely distributed throughout the body
4
Grow in conjunction with axillary hair follicles

4 The apocrine sweat glands secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action. These glands grow in conjunction with hair follicles around the axillae. The apocrine glands are inactive during childhood and reach their secretory potential at the time of puberty. The apocrine glands are situated around the umbilicus. They have limited distribution and are found only around the axillae, areolae, external auditory canal, and anal and genital regions. Eccrine sweat glands, not the apocrine glands, have wide distribution throughout the body.

The nurse is instructing the parents of a 6-month-old infant about sleeping patterns and the best sleeping positions for their child. Which instruction regarding sleep position is most important?
1
"Place the infant in a supine position for sleep."
2
"Avoid positioning the head on alternating sides."
3
"A prone position is more beneficial for sleeping."
4
"If the infant is restless, place it on one side to sleep."

1 The nurse instructs the parent to place the infant in a supine position so the infant does not roll over to a prone position. When the infant is less than 6 months old, the infant is placed in a supine position and the head is positioned on alternating sides to prevent positional plagiocephaly. There is a risk for sudden infant death syndrome (SIDS) if the infant is placed in a prone position. If the infant is restless, it should be assessed, but not put to sleep on one side, because the infant can easily roll over to the prone position if placed on the side.

Which statement correctly describes the initiative versus guilt stage?
1
Individuals like to pretend and try out new roles.
2
Individuals are more accomplished in some basic self-care activities.
3
Individuals show marked preoccupation with appearance and body image.
4
Individuals are eager to apply themselves to learning socially productive skills and tools.

1 During the initiative versus guilt stage, a child likes to pretend and try out new roles. A child is more accomplished in some basic self-care activities during the autonomy versus sense of shame and doubt stage. During the identity versus role confusion stage, an individual shows marked preoccupation with appearance and body image. During the industry versus inferiority stage, a child is eager to apply himself or herself to learning socially productive skills and tools.

In which age range would the nurse expect a client to understand the concept of conservation related to liquids and numbers when conducting a developmental assessment?
1
5 to 7 years
2
6 to 7 years
3
9 to 10 years
4
9 to 12 years

1 Mastering the concept of conservation related to liquids and numbers occurs at 5 to 7 years of age. Conservation related to length is expected at 6 to 7 years of age. Conservation related to weight and area occurs at 9 to 10 years of age. Conservation related to volume occurs at 9 to 12 years of age.

Which fine motor skill should the nurse expect when assessing the development of an infant between 10 and 12 months of age?
1
Holds a crayon
2
Walks with assistance
3
Stands independently
4
Sits from a standing position

1 The ability to hold a crayon is a fine motor skill that the nurse should expect when conducting a developmental assessment for an infant between 10 to 12 months of age. Walking with assistance, standing alone, and sitting from a standing position are all gross motor skills the nurse would anticipate for this infant.

Which safeguards should the school nurse teach parents to assess for prior to allowing school-age clients to participate in athletic programs? Select all that apply.
1
A life-long enjoyment of fitness
2
The use of appropriate equipment
3
The development of basic motor skills
4
A physical examination every two years
5
Participation in warm-up exercises prior to physical activity

245 Safeguards prior to participation in athletic programs include a physical examination every two years, the use of appropriate equipment, and participating in warm-up exercise prior to physical activity. A life-long enjoyment of fitness and the development of basic motor skills are goals related to the participation in athletic programs, not safeguards.

What is true about the instrumental relativist orientation stage?
1
An individual recognizes that there is more than one correct point of view.
2
An individual finds a balance between societal rules and basic human rights and obligations.
3
An individual response to a moral dilemma is in terms of absolute obedience to authority and rules.
4
An individual sees moral reasoning based on own personal internalization of societal and other’s expectations.

1 During the instrumental relativist orientation stage, an individual finds that there is more than one correct point of view. During the postconventional reasoning stage, a person finds a balance between societal rules and basic human rights and obligations. During the punishment and obedience orientation stage, a child’s response to a moral dilemma is in terms of absolute obedience to authority and rules. During the conventional reasoning stage, the person sees moral reasoning based on his or her own personal internalization of societal and other’s expectations.

Which school-age children require close supervision when using a skateboard? Select all that apply.
1
5-year-old
2
6-year-old
3
7-year-old
4
8-year-old
5
9-year-old

2345 School-age children who are 6 years, 7 years, 8 years, or 9 years all require close supervision when using a skateboard. The 5-year-old school-age client should not be allowed to ride a skateboard due to the high risk for injury.

The mother of a 2-year-old girl expresses concern that her daughter’s growth rate has slowed. What should the nurse explain to the mother about the growth of toddlers?
1
"This growth pattern is typical at this age."
2
"Toddlers are too busy exploring their world to eat."
3
"This growth pattern can’t be interpreted for another year."
4
"Toddlers usually lose their taste for foods they liked when younger."

1 As the child gets older, growth slows. Toddlers develop physiologic anorexia because their appetite decreases along with their growth rate. Although the toddler may be too busy to eat, this is not why the growth rate slows. This growth pattern may be interpreted now. Although a toddler may lose his or her taste for a particular food, it is not common in this age group.

According to Freud, which must occur before an individual is able to have a mature adult sexual relationship?
1
Puberty
2
Conflict resolution
3
Acquisition of new skills
4
Loss of self in another person

2 According to Freud, an individual must resolve conflict prior to having a mature adult sexual relationship. Puberty is required for sexual function but not a mature adult sexual relationship. The acquisition of new skills and losing self in another person are characteristics of Erikson’s theory of psychosocial development.

Which fine motor skill should be seen in a 10-month-old infant?
1
Picking up finger foods
2
Releasing a cube in a cup
3
Building towers of two blocks
4
Turning many pages in a book

1 When an infant is 10 months old, the pincer grasp is well established, which helps the infant pick up finger foods. When an infant is 11 months, the infant should have a neat pincer grasp and be able to release a cube in a cup. One-year-old infants can build a tower of two blocks and turn many pages in a book.

During which week of pregnancy does placental development occur?
1
First
2
Third
3
Fifth
4
Seventh

2 Placental development begins during the third week of pregnancy. The other answer options, first, fifth, and seventh, are not when placental development occurs.

During which stage of development should the nurse anticipate sibling relationships that fluctuate between open bickering and supportive relationships?
1
Preschool
2
Early school-age
3
Late adolescence
4
Middle school-age

4 During middle school-age the nurse would anticipate that the sibling relationship will fluctuate between open bickering and a supportive relationship. This behavior is not anticipated during the preschool, early school-age, or late adolescent stages of development.

Which physiologic body functions decrease in response to certain pubertal changes? Select all that apply.
1
Pulse rate
2
Blood volume
3
Strength of the heart
4
Basal heat production
5
Systolic blood pressure

14 Pubertal changes induce physiologic changes. The physiologic functions that decrease in response to pubertal changes include pulse rate and basal heat production. Blood volume, strength of the heart, and systolic blood pressure increase with changes occurring during puberty. Pubertal changes herald adulthood, and therefore the heart increases in size and strength and the systolic blood pressure increases to reach the adult rate.

An 8-year-old child is being prepared for surgery the next day. How should the nurse present preoperative instructions to this child?
1
By repeating instructions often
2
By providing time for needle play
3
By using several abstract examples
4
By focusing on simple anatomic diagrams

4 According to Piaget, an 8-year-old child’s level of development is in the stage of concrete operations; the child will benefit from simple, concrete examples. The preschooler and younger child, not the school-age child, require repetition. Therapeutic needle play is more appropriate if and when the child is to receive an injection. The child who is in the period of concrete operations cannot think in the abstract; the ability to do this develops during adolescence.

The nurse is teaching hygiene practices to a 16-year-old client who has recently had her first menstrual flow. Under which phase of development does the nurse classify the client?
1
Prepubescence
2
Postpubescence
3
Late adolescence
4
Middle adolescence

4 Adolescence is a period of psychological, social, and maturational growth. There are subphases of adolescence. Middle adolescence occurs between the ages of 15 and 17 years. Prepubescence occurs 2 years before the onset of puberty. However, this client has already achieved puberty and had her first menstrual flow. Postpubescence extends for 1 to 2 years after puberty. The client has recently had her first menstrual flow and is at the point of puberty. Late adolescence occurs between the ages of 18 and 20 years.

According to Piaget’s theory, which of these statements about the period of concrete operations is true?
1
A child develops a scheme for dealing with the environment.
2
A child is able to describe a process without actually doing it.
3
A child has the capacity to reason with respect to possibilities.
4
A child believes that everyone experiences the world exactly as he or she does.

2 According to Piaget’s theory, a child is able to describe a process without actually carrying it out in the concrete operations period. A child develops a scheme for dealing with the environment during the sensorimotor period. A child gains the capacity to reason with respect to possibilities during the formal operations period. A child believes that everyone experiences the world exactly as he or she does during the preoperational period.

Which should the nurse encourage for the adolescent client diagnosed with a chronic illness to achieve independence from family?
1
Using coping skills
2
Wearing make-up
3
Buying stylish clothes
4
Socializing with peers

4 Socialization with peers should be encouraged [1] [2] for adolescent clients diagnosed with a chronic illness to achieve independence from family. Use of coping skills helps the adolescent develop a personal identity. Wearing make-up and buying stylish clothes allows the adolescent to learn through abstract thinking.

Which statement describes the latency stage of Freud’s psychoanalytic model of personality development?
1
During this stage, genital organs are the focus of pleasure.
2
During this stage, sexual urges are repressed and channeled into productive activities.
3
During this stage, an infant begins to think that his or her parent is separate from the self.
4
During this stage, sexual urges reawaken and are directed to an individual outside the family circle.

2 During the latency stage, Freud believed that sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable. During the phallic stage, the genital organs are the focus of pleasure. During the oral stage, infants begin to think that the parent is something separate from the self. During the genital stage, sexual urges reawaken and are directed to an individual outside the family circle.

Which stage of Piaget’s theory of growth and development does an infant develops an action pattern to deal with the environment?
1
Sensorimotor
2
Preoperational
3
Formal operations
4
Concrete operations

1 In Piaget’s theory, child development is divided into four periods. During the sensorimotor period, an infant develops a schema or action pattern for dealing with the environment. During the preoperational period, children learn to think with the use of symbols and mental images. During the formal operations period, egocentric thought prevails. During the concrete operations period, the child thinks about a recently performed physical action.

Which school-age client should the nurse assess for symptoms related to burnout?
1
7-year-old
2
8-year-old
3
9-year-old
4
10-year-old

4 The school-age client between the ages of 10 to 12 years often becomes overinvolved with activities leading to burnout; therefore, the nurse should assess the 10-year-old client for clinical manifestations associated with burnout. The other school-age clients (7 years, 8 years, and 9 years) do not often become overinvolved in activities leading to burnout.

Which statement is true about Piaget’s theory of cognitive development?
1
Piaget’s theory includes five periods that are related to age.
2
In the late preoperational stage, the children experience animism.
3
In the preoperational stage, children are able to perform mental operations.
4
During the sensorimotor stage, infants develop an action pattern for dealing with their environment.

4 According to Piaget’s theory, during the sensorimotor stage, infants develop a schema or action pattern for dealing with the environment. Piaget’s theory includes four periods which are related to age. In the early preoperational stage, children experience animism. During the concrete operations stage, children are able to perform mental operations.

Who should the nurse include as the authority when providing education to the parents of a 7-year-old client related to moral development?
1
The school-age child
2
The school-age child’s peers
3
Any higher power the child believes in
4
Any adult with authority over the child

4 When a school-age child and an adult differ in judging an act, the adult is right. The school-age child, the child’s peers, and a higher power that the child believes in are not authorities to moral development of the school-age client.

Who completes the developmental questionnaire for a pediatric client who is being assessed using the Developmental (ASQ-3) screening?
1
Child
2
Parent
3
Nurse
4
Physician

2 The parent completes the questionnaire portion of the Development (ASQ-3) assessment. A health care professional, such as the nurse or physician, scores the assessment. The child’s stage of development is assessed using this process.

According to Kohlberg’s theory, which stage comes before the society-maintaining orientation stage?
1
Social contract orientation
2
Good boy-nice girl orientation
3
Instrumental relativist orientation
4
Punishment and obedience orientation

2 According to Kohlberg’s theory, the "good boy-nice girl orientation" phase (stage 3) occurs before the "society-maintaining orientation" phase (stage 4). "Social contract orientation" is the fifth stage. "Instrumental relativist orientation" is the second stage.

Which nursing action is most accurate when assessing the chest circumference of a newborn during the initial physical assessment?
1
Measuring during expiration only
2
Taking three measurements and recording the average
3
Measuring during inspiration and plotting this data on the growth chart
4
Placing the measuring tape around the rib cage at the nipple line

4 The most accurate nursing action when assessing the chest circumference of a newborn during the initial physical assessment is to place the measuring tape round the rib cage at the nipple line. Two measurements should be performed, one during inspiration and one during expiration. The average of these two measurements is then plotted on the growth chart.

A parent is worried about the infant’s excessive dependence on nonnutritive sucking. Which intervention will help decrease this dependence?
1
Prolonging the feeding time
2
Using infant formulas frequently
3
Using a pacifier as soon as the crying begins
4
Wrapping the infant snugly most of the time

1 An infant’s dependence on nonnutritive sucking can be reduced by prolonging the feeding time, so that the sucking pleasure is increased. Using infant formulas will not help prevent nonnutritive sucking, because the child needs the pleasure of sucking. Using a pacifier as soon as the crying begins increases the child’s dependence on nonnutritive sucking, because it reinforces a pattern of distress-relief. Wrapping the infant snugly most of the time may not be possible, because it may cause the infant to feel uncomfortable.

While performing the physical assessment of an infant, the nurse notices the infant has developed a color preference for red and yellow. What is most likely to be the age of the infant?
1
4 weeks
2
8 weeks
3
15 weeks
4
20 weeks

4 An infant develops a color preference for yellow and red between 20 to 28 weeks of age. At 4 weeks, the infant can follow a range of 90 degrees. Between 6 to 12 weeks of age, the infant develops peripheral vision to 180 degrees. Between 12 to 20 weeks of age, the infant is able to accommodate to near objects.

Which stage of the development should the nurse document for an infant when using Freud’s theory of psychosocial development?
1
Oral
2
Anal
3
Phallic
4
Latent

1 According to Freud, an infant is in the oral stage of development. The toddler is in the anal stage of development. The preschool-age child is in the phallic stage of development. The middle childhood client is in the latent stage of development.

How many teeth does a 10-month-old infant usually have? Record your answer using a whole number. ____________

According to a quick guide to assessment of deciduous teeth, the number of teeth in a child during the first 2 years is calculated using the formula [Age of the child in months] – 6 = [Number of teeth]. The age of child is 10 months; therefore, the number of teeth is 10 – 6 = 4 teeth.

Which formula is most preferable for a child who has lactose intolerance?
1
Soy-based formula
2
Whey hydrolysate formula
3
Cow’s milk-based formula
4
Amino acid-based formula

1 Soy-based formula is a commercially available formula that has a high amount of protein but does not contain lactose. Amino acid-based formula is preferable for a child who has food allergies. However, it is not the most preferable formula for the child with lactose intolerance. Whey hydrolysate formula and cow’s milk-based formula contain high amounts of lactose.

According to Freud, which is a source of pleasure for a toddler-age client that the nurse should educate parents about in regards to normal growth and development?
1
Mouth
2
Anal zone
3
Sexual urges
4
Genital organs

2 The toddler-age client, according to Freud, finds a source of pleasure in the anal zone. The mouth is a source of pleasure during infancy. Sexual urges reawaken during adolescence. The genital organs are a source of pleasure during the preschool stage of development.

What is the average monthly increase in height of an infant in the first six months? Record your answer using one decimal place.__________ centimeters

The average monthly increase in height of an infant for first six months of life is 2.5 cm.

How many hours of sleep should the nurse recommend for the 11-year-old client?
1
9
2
10
3
11
4
12

9 A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client. A 5-year-old school-age client requires 11.5 hours of sleep per night; however, 11 and 12 hours of sleep is not recommended for an 11-year-old school-age client.

To which client should the nurse provide education regarding the pubertal growth spurt?
1
An 8-year-old school-age male client
2
A 16-year-old adolescent male client
3
A 12-year-old school-age female client
4
An 18-year-old adolescent female client

3 The pubertal growth spurt reaches a peak for female clients at 12 years of age; therefore, the nurse should provide education to this client regarding expected growth during this time period. The 8-year-old male client would not be expected to experience the pubertal growth spurt until the age of 14 years. The 16-year-old and the 18-year-old adolescent clients would have already experienced the pubertal growth spurt.

Which action related to gender is often expected in regards to socialization for school-age girls within the community setting?
1
Expressing feelings openly
2
Being insensitive to others
3
Trying out for the football team at school
4
Taking the most challenging classes in school

4 Health professionals have long been aware that boys and girls are socialized differently by parents and teachers. Girls are encouraged to express their emotions openly. Girls are also expected to be sensitive and responsive to others. Girls are often ostracized if they want to play a sport that is historically associated with the male gender, such as football. Taking the most challenging classes in school is an expectation for males, not females.

The nurse is measuring the body temperature of four neonates born at term in a pediatric health setting. Which neonate has normal body temperature?
1
Neonate 1
2
Neonate 2
3
Neonate 3
4
Neonate 4

3 The normal body temperature of term neonates is in the range of 36.5° C to 37.5° C. Therefore a body temperature of 37.1° C is a normal finding. The body temperatures of 35.5° C and 36.0° C in neonates 1 and 2 indicate hypothermia. The body temperature of 38.5° C in neonate 4 indicates hyperthermia.

The nurse is using Piaget’s theory to assess the cognitive development in a child. What is most likely to be the age of the child who has reached a developmental milestone by grasping the concept of conservation of numbers for the first time?
1
5 years
2
7 years
3
9 years
4
12 years

1 There appears to be a developmental sequence in children’s capacity to conserve matter. Children usually grasp conservation of numbers between the ages of 5 and 6 years. So, in this scenario, the child who is most likely to have grasped the concept of conservation of numbers for the first time is likely to 5 years old. Conservation of liquids, mass, and length usually is accomplished at about ages 6 to 7 years old. Conservation of weight is understood sometime later, around ages 9 to 10 years old. The child begins to understand conservation of volume or displacement last, between ages 9 and 12 years old.

How many stages of life are there according to Erikson’s theory of psychosocial development? Record your answer using a whole number. ___________

8 There are eight stages of life according to Erikson’s theory of psychosocial development.

According to Freud’s theory, in what order do the stages of child development occur?
1.
Anal

2.
Oral

3.
Genital

4.
Oedipal

5.
Latency

Freud’s theory sets forth five stages of child development. The oral stage (stage 1) spans the period from birth to 12 to 18 months. The anal stage (stage 2) occurs between the ages of 18 months and 3 years. The Oedipal stage (stage 3) occurs between 3 and 6 years of age. The latency stage (stage 4) occurs between the ages of 6 and 12 years. Finally, the genital stage (stage 5) lasts from puberty through adulthood.

Which should the nurse anticipate, according to Erikson, when assessing a preschool-age child?
1
Being engaged in tasks
2
Questioning sexual identity
3
Having highly imaginative thoughts
4
Wanting to participate in organized activities

3 The nurse would anticipate that a preschool-age child would have highly imaginative thoughts [1] [2], according to Erikson. Being engaged in tasks and wanting to participate in organized activities is expected for the school-age child. Questioning sexual identity is expected for the adolescent.

The parents of a preschooler inform the nurse that their child often develops diarrhea and ask whether there might be anything wrong with the child’s stomach. Upon assessment, the nurse also finds that the child has poor oral care and is at risk for dental caries. What is the most probable cause for the child’s health issues?
1
The family often consumes fast foods.
2
The parents neglect the child’s dietary needs.
3
The family does not follow hygienic practices.
4
The child consumes excessive amounts of fruit juice.

4 If the child consumes excessive fruit juice or sweetened beverages, it increases the risk for dental caries and gastrointestinal conditions, such as chronic diarrhea. Consuming fast foods often result in childhood obesity, because fast foods are high in fats and starches. Neglecting the dietary needs or not following hygienic practices may cause gastrointestinal problems or make the child susceptible to infections.

If hearing loss is detected early, proper intervention can help a child achieve normal language development. What is the latest age that hearing loss should be detected to ensure that a child achieves normal language development? Record your answer using a whole number. ______________ months

If a healthcare provider detects hearing loss before the child is three months old and an intervention is initiated within six months, the child can achieve normal language development.

Which is a common attribute that the nurse assesses in an "easy" child?
1
Passive resistance
2
Predictable habits
3
Intense mood expressions
4
Slow adaptation to change

2 The nurse anticipates that the "easy" child will have predictable habits. Passive resistance is a trait assessed in the "slow to warm up" child. Intense mood expressions and slow adaptation to change are characteristics of the "difficult" child.

Which theory states that a child’s growth pattern is related to gene activity?
1
Gesell’s theory
2
Piaget’s theory
3
Erikson’s theory
4
Havinghurst’s theory

1 Gesell’s theory of development states that each child’s pattern of growth is unique and that this pattern is directed by gene activity. Piaget’s theory of cognitive development comprises four periods related to age: sensorimotor, preoperational, concrete operations, and formal operations. Erikson’s theory of psychosocial development states that an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Havinghurst’s theory of stage crisis is based on developmental tasks. This theory incorporates three primary sources for developmental tasks: tasks that surface because of physical maturation, tasks that evolve from personal values, and tasks that are a result of pressures from society.

What is the longest time after birth that the Apgar test is conducted for the second time? Record your answer using a whole number. _______ minutes

Apgar assessments are generally conducted 5 minutes after birth.

At which age should the nurse assess the school-age client for mastery of the concept of conservation of volume?
1
6 years
2
7 years
3
8 years
4
9 years

4 Mastery of the concept of conservation of volume occurs between the ages of 9 and 12 years; therefore, the nurse would include this in the assessment for the 9-year-old school-age client. Volume conservation is not assessed for the 6-, 7-, or 8-year-old school-age child.

A community health nurse makes a home visit to a disabled 13-year-old client who has a 6-month-old infant sister. The infant lies quietly in her crib and rarely smiles or vocalizes; it appears that the infant barely has her basic needs met. What is the nurse’s most appropriate intervention?
1
Advise the parent that the infant will be retarded if not stimulated.
2
Ask the disabled client to spend more time playing with the sister.
3
Encourage purchasing toys that are appropriate for the infant’s age level.
4
Determine whether there is anyone who can help with chores and the infant’s care.

4 Recruiting someone to help with chores and infant care will allow the parent time to rest and will provide the infant with care and attention. Making the parent feel guilty is not therapeutic and will increase anxiety. The disabled sibling requires attention, and this responsibility may cause jealousy, rivalry, and resentment. Toys need not be employed for sensory stimulation; household objects and quality human contact can serve as well.

According to Kohlberg’s theory of moral development, which statement about conventional reasoning is true?
1
A person wants to fulfill family expectations.
2
A child’s thinking is mostly based on likes and pleasures.
3
A child recognizes that there is more than one correct view.
4
An individual moves away from moral decisions based on authority.

1 During the "convention reasoning" level, a person wants to fulfill the expectations of his or her family, group, or nation. During the "preconventional reasoning" level, a child’s thinking is mostly based on likes and pleasures. During this stage, the child also recognizes that there is more than one correct view. During the "postconventional stage," individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles.

Which statement is true regarding the physical development of a preschooler?
1
Children gain about 3 lbs (1.36 kg) per year.
2
Preschoolers grow 6.2 to 7.5 cm per year.
3
Preschoolers grow three times their length at around 4 years.
4
The average weight of the child at four years is 32 lbs (14.51 kg).

2 Preschoolers grow 6.2 to 7.5 cm per year. Preschoolers gain about 5 lbs (2.26 kg) per year. They also grow double their length at around 4 years old. The average weight of a 4 year old is 37 lbs (16.78 kg).

Which stage is a part of postconventional reasoning?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Punishment and obedience orientation

1 The social contract orientation stage is a part of postconventional reasoning. Society-maintaining orientation is part of the conventional/role conformity reasoning level. The instrumental relativist orientation stage and the punishment and obedience orientation stage are parts of the preconventional reasoning level.

From which client does the nurse expect dramatic physical growth and marked development?
1
9-month-old infant
2
24-month-old toddler
3
4-year-old preschool-age child
4
10-year-old school-age child

1 The nurse can anticipate the infant to have both dramatic physical growth and marked development. The toddler, preschool-age, and school-age children will all continue to experience physical growth and development; however, these age groups do not experience growth and development as rapid as that of the infant.

What is true about the preoperational period of Piaget’s theory?
1
The child develops a scheme for dealing with the environment.
2
The child is able to describe a process without actually doing it.
3
The child has the capacity to reason with respect to possibilities.
4
The child believes that everyone experiences the world exactly as he or she does.

4 According to Piaget’s theory, children believe that everyone experiences the world exactly as they do during the preoperational period. Children develop a scheme for dealing with the environment during the sensorimotor period. Children are able to describe a process without actually doing it during the concrete operations period. Children have the capacity to reason with respect to possibilities during the formal operations period.

Which stage of Kohlberg’s theory is an individual in if he or she wants to modify a law if it is not fair to a particular group?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrument relativist orientation
4
Universal ethical principle orientation

4 The universal ethical principle orientation stage is associated with a person who wants to modify a law if it does not seem just. According to the social contract orientation stage, a person tends to follow a law even if it is not fair. During the society-maintaining stage, an individual shows concerns for his or her society and makes decisions in accordance to his or her society. During the instrument relativist orientation stage, a child recognizes that there is more than one correct view.

The nurse is preparing to assess several clients at a pediatric clinic. Which client would require a developmental screening versus developmental surveillance during a scheduled health maintenance visit?
1
A 9-month-old infant
2
A 2-week-old newborn
3
A 15-month-old toddler
4
A 4-year-old preschooler

1 The nurse would conduct a developmental screening for the 9-month-old infant during a scheduled health maintenance visit. The 2-week-old newborn, the 15-month-old toddler, and the 4-year-old preschooler would all require developmental surveillance during a health maintenance visit.

Which of these statements about the transition from intrauterine to extrauterine life is true?
1
Hyperthermia is observed in the newborn.
2
Newborns are susceptible to heat loss and cold stress.
3
Apgar assessments are conducted 5 and 10 minutes after birth.
4
Physiological changes in the newborn occur during the first 12 hours of life.

2 During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.

By which age do children develop binocularity?
1
8 to 9 weeks
2
3 to 4 months
3
7 to 8 months
4
9 to 12 months

2 Children develop binocularity (the ability to fixate on one visual field with both eyes simultaneously) by 3 to 4 months. Children are not able to fixate on one visual field with both eyes simultaneously as early as 8 to 9 weeks. Children learn to fixate on one visual field with both eyes simultaneously earlier than 7 to 8 months, or 9 to 12 months.

At which stage of Kohlberg’s theory does an individual want to fulfill the expectations of one’s immediate group?
1
Good boy-nice girl orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

1 The good boy-good girl orientation stage involves an individual who wants to win the approval and maintain the expectations of one’s immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. The instrumental relativist orientation stage involves a child who wants to follow his or her parent’s rules. The universal ethical principle orientation stage defines "right" by the decision of conscience according to self-chosen ethical principles.

A child watches an older sibling playing with a ball, but makes no effort to participate in the play. What social character of play is the child exhibiting?
1
Parallel play
2
Pretend play
3
Onlooker play
4
Associative play

3 In onlooker play a child actively observes other children playing and does not attempt to enter into the activity; the child is interested only in observation and not in participation. In parallel play children play independently among other children. In pretend play children act out any event of daily life and practice the roles and identities as established in their surroundings. In associative play children play together and are engaged in a similar or identical activity.

According to Piaget’s theory, which period describes a child’s stage of egocentrism?
1
Sensorimotor
2
Preoperational
3
Formal operations
4
Concrete operations

2 During the preoperational period, children learn to think with the use of symbols and mental images. They exhibit egocentrism where they see all objects and persons as their own. The sensorimotor period occurs between birth and two years. During this period, infants develop an action pattern for dealing with the environment. The formal operations period lasts from 11 years of age into adulthood. During this period, the person is self-conscious and thinks he or she is invulnerable and tends to show risk-taking behaviors. The concrete operations period occurs between seven to 11 years of age. During this period, children are able to perform mental operations.

What is the correct order of the stages according to Kohlberg’s theory of moral development?
1.
Social contract orientation

2.
Good boy-nice girl orientation

3.
Society-maintaining orientation

4.
Instrumental relativist orientation

5.
Universal ethical principle orientation

6.
Punishment and obedience orientation

According to Kohlberg’s theory of moral development, the first stage is the punishment and obedience orientation. The second stage is the instrumental relativist orientation. Good boy-nice girl orientation is the third stage. Society-maintaining orientation stage is the fourth stage. Social contract orientation is the fifth stage. The sixth stage is the universal ethical principle orientation stage.

According to the Erikson’s theory, which stage in a young adult describes the development of the sense of caring for others?
1
Initiative versus guilt
2
Integrity versus despair
3
Intimacy versus isolation
4
Identity versus role confusion

3 The development of a sense of caring for others in a young adult occurs at the stage of intimacy versus isolation. During the initiative versus guilt stage, a child likes to pretend and try out new roles. At the integrity versus despair stage, many older adults view their lives with a sense of satisfaction. During the identity versus role confusion stage, a child’s identity development begins with the goal of achieving some perspective or direction.

Which instruction should the nurse give to parents to help their child get accustomed to a new babysitter?
1
"Ask the babysitter to stand very close to the child."
2
"Ask the babysitter to hold out arms and smile broadly."
3
"Stay close and allow the child to observe the babysitter."
4
"Discourage the child from clinging in front of the babysitter."

3 Children need to explore and get used to babysitters or any stranger at their own rate. Therefore the parents should stay close to the child and allow the child to observe the babysitter. The babysitter needs to maintain a safe distance from the child so that the child is not scared. The stranger needs to talk softly and avoid sudden gestures, such as smiling broadly or holding out arms, which may scare the child. The parents should not discourage the child from clinging, because it is necessary for the child’s optimal emotional development.

Which period of Piaget’s theory covers the prevalence of egocentrism in adolescents?
1
Sensorimotor
2
Preoperational
3
Formal operations
4
Concrete operations

3 Formal operations is the fourth period of Piaget’s theory. During this period, there is a prevalence of egocentric thought. This egocentricity leads adolescents to demonstrate feelings and behaviors characterized by self-consciousness. The sensorimotor period is the first period of Piaget’s theory. In this period, infants develop a schema or action pattern for dealing with the environment. The preoperational period is the second period. During this time, children learn to think with the use of symbols and mental images. Concrete operations is the third period of Piaget’s theory. During this period, children are able to coordinate two concrete perspectives in social and scientific thinking.

The nurse is discussing the neurologic reflexes seen in an infant with the parents. Which reflex will the nurse state as being present indefinitely?
1
Landau
2
Parachute
3
Body righting
4
Neck righting

2 The parachute reflex appears at 7 to 9 months and persists indefinitely. The Landau reflex appears at 6 to 8 months and lasts until 12 to 24 months. Body righting appears at 6 months and lasts until 24 to 36 months. Neck righting appears at 3 months and lasts until 24 to 36 months.

What should the nurse teach the parent of an infant who is at risk for infections?
1
"You must avoid placing the infant in bright sunlight."
2
"Breast-feeding will provide protection against bacteria."
3
"Use soy-based infant formulas to help prevent infection."
4
"The infant will be less susceptible to infections later in life."

2 Breast milk contains immunoglobulin G (IgG) that protects the infant against many bacteria, such as Escherichia coli. The nurse instructs the parent to avoid placing the infant in bright sunlight for a long period of time to prevent burns, but not to prevent infections. Soy-based infant formulas are used only if the infant is allergic to lactose in the breast milk and is not used to prevent the risk for infections. Later, susceptibility would be dependent on multiple factors, including nutrition and exposure to infections.

According to the Piaget’s theory, which behavior does a nine-year-old child show?
1
Logical reasoning
2
Concrete thinking
3
Object permanence
4
Imaginary audience

2 A child of nine years of age will exhibit concrete thinking. Logical reasoning is observed in individuals starting from the age of 11. Object permanence is observed in children between birth and two years old. The idea of being constantly observed by an imaginary audience is observed in individuals starting from the age of 11.

What type of development is described under Freud’s theory?
1
Cognition development
2
Psychosocial development
3
Psychosexual development
4
Moral reasoning development

3 Freud’s psychoanalytic model of personality development sets forth five stages of psychosexual development. Each stage is characterized by sexual pleasure in a part of the body: the mouth, the anus, and the genitals. Piaget’s theory of cognitive development includes four periods that are related to age and demonstrate specific categories of knowing and understanding. According to Erikson’s theory of psychosocial development, an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Kohlberg’s theory of moral development expands on Piaget’s cognitive theory.

During testing of the neurologic reflexes of an infant, which reflex should the nurse expect to appear at 3 months and persist until 24 to 36 months of age?
1
Neck righting
2
Body righting
3
Otolith righting
4
Labyrinth righting

1 While the infant is supine, if the head is turned to one side, the shoulder, trunk, and finally pelvis will turn toward that side. This reflex appears at 3 months, and persists until 24 to 36 months of age. Body righting is a modification of the neck-righting reflex in which turning hips and shoulders to one side causes all other body parts to follow; it appears at 6 months, and persists until 24 to 36 months of age. When the body of an erect infant is tilted, the head is returned to an upright, erect position; this is known as otolith righting, which appears at 7 to 12 months of age, and persists indefinitely. When an infant in prone or supine position is able to raise head, it is known as labyrinth righting. It appears at 2 months, and is strongest at 10 months of age.

The nurse is providing care to the family of a preschool-age child who is diagnosed with sickle cell disease. Which statement made by the sibling would initiate a teaching session with the parents regarding discipline?
1
"I really wish my brother wasn’t sick all the time."
2
"I am afraid that I caused my brother to get sick again because I was mad at him."
3
"When I lied to my parents, I was punished for a week and my brother never gets punished."
4
"I never get to go over to my friends’ houses because we are always taking my brother to the doctor."

3 A critical component of any child’s development is discipline. Applying appropriate discipline to the child who is chronically ill or disabled can also limit the resentment and hostility that can develop among siblings if parents apply different standards to each child. The nurse’s responsibility is to help parents learn successful methods of guiding the child. The statements regarding wishing that the brother wasn’t sick, fears of having caused the illness, and missing play dates may require further assessment and family teaching, but the teaching would not be related to discipline.

According to Erikson’s theory, at which stage does a child start to have fantasies and an active imagination?
1
Trust versus mistrust
2
Initiative versus guilt
3
Identity versus role confusion
4
Autonomy versus sense of shame and doubt

2 The initiative versus guilt stage is characterized by a child having fantasies and imaginations that motivate the child to explore the environment. The stage from birth to one year old when an infant develops trust towards his or her parents or caregivers is known as the trust versus mistrust stage. The identity versus role confusion stage begins after adolescence; during this stage, an individual tries to figure out his or her own identity. Between the ages of one to three years old, a child starts walking, feeding, using the toilet, and handling some basic self-care activities. This stage is one of autonomy versus sense of shame and doubt.

In which stage of Kohlberg’s theory of moral development does the nurse anticipate a client to expand focus from relationships with others to societal concerns?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

4 Level II, conventional reasoning, stage 4 is when the nurse anticipates a client will expand focus from the relationship with others to societal concerns. In level I, preconventional reasoning, stage 1, the nurse anticipates absolute obedience to authority and rules. In level I, preconventional reasoning stage 2, the nurse anticipates that the client will realize there is more than one right view. In level II, preconventional reasoning stage 3, the client wants to win approval and maintain expectations of his or her immediate group.

The nurse observes that a child fails to make eye contact and has poor impulse control. Upon further assessment, the nurse finds that the parent is an alcoholic and often neglects the child. What can be said about the child?
1
The child needs to be screened for autism.
2
The child is experiencing separation anxiety.
3
The child feels solitary because of the parent’s behavior.
4
The child has developed reactive attachment disorder (RAD).

4 RAD is a psychological and developmental disorder that occurs in children who are neglected by their primary caregivers. Children with RAD are not cuddly with parents and fail to make eye contact. They also exhibit poor impulse control and may be destructive to themselves and others. Poor eye contact is seen in autistic children as well, but in this case, there is parental neglect that indicates RAD. Separation anxiety is indicated by crying and screaming when the parent leaves the child. Feelings of solitariness do not result in poor impulse control or eye contact.

Which psychosocial change does a 2-year-old child exhibit?
1
Achieves full independence
2
Engages in temper tantrums
3
Exhibits weak determination
4
Performs very few muscular activities

2 A 2 year old engages in temper tantrums when parents start restricting certain activities to prevent harm. At 2 years of age, a child has a strong will and determination, which may result in negative behavior. The child strives for independence by using the developing muscles to do everything for himself or herself.

At what age does an infant achieve permanent eye color?
1
2 weeks
2
30 months
3
2 months
4
6 months

4 Permanent eye color is usually established between 6 and 12 months of age. Two weeks and 2 months are too early to have developed permanent eye color. A child of age 30 months has long developed permanent eye color.

According to Erikson’s stages of life, what is the stage when a child begins walking, feeding, and using the toilet?
1
Trust versus mistrust
2
Initiative versus guilt
3
Identity versus role confusion
4
Autonomy versus sense of shame and doubt

4 At one to three years of age, the child starts walking, feeding, and using the toilet on his or her own. This stage is one of autonomy versus sense of shame and doubt. The stage from birth to one year when the infant develops trust toward parents or the caregiver is known as the trust versus mistrust stage. The initiative versus guilt stage is marked by the child’s fantasies and imaginations motivating the child to explore the environment. The identity versus role confusion stage begins after adolescence. During this stage, an individual tries to find out his or her own identity.

A child wants to be on time for a family dinner. According to Kohlberg’s theory, what stage of development is the child going through?
1
Good boy-nice girl orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

3 When a child wants to be on time for a family dinner, this thought exemplified the instrumental relativist orientation stage. A child at this stage follows his or her parent’s rules. During the good boy-nice girl orientation stage, a child wants to win the approval of and maintain the expectations of one’s immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. During the universal ethical principle orientation stage, the concept of "rightness" is defined by self-chosen ethical principles.

Which component of the human personality, according to Freud, allows an individual to judge reality accurately?
1
Id
2
Ego
3
Superego
4
Oedipus complex

2 According to Freud the ego allows an individual to judge reality accurately. The id is basic instinctual impulses driven to achieve pleasure. The superego is often referred to as the conscience. The Oedipus complex is a belief that a female child fantasizes about her father as a love interest.

The student nurse is learning about the developmental characteristics of vision. Which major developmental characteristics does an infant start exhibiting around age 6 weeks? Select all that apply.
1
Having binocular vision
2
Having doll’s eye reflex
3
Having visual acuity 20/40 to 20/60
4
Having peripheral vision to 180 degree
5
Having strabismus if binocular vision is absent

14 Beginning at age 6 weeks, the infant has binocular vision, which becomes well established by age 4 months. Within 6 to 12 weeks, the infant has peripheral vision to 180 degrees. An infant has doll’s eye reflex at birth, and it disappears within age 6 to 12 weeks. Visual acuity of 20/40 to 20/60 does not develop until age 44 to 52 weeks. Lack of binocular vision indicates strabismus at age 28 to 44 weeks. While binocular vision generally develops by age 6 weeks, a lack of this development at this age is not indicative of strabismus.

Which is a goal for organized athletics for school-age children?
1
A life-long enjoyment of fitness.
2
A physical examination every two years.
3
The use of appropriate safety equipment.
4
Participation in warm-up exercises prior to physical activity.

1 A goal for organized athletics for school-age children is a life-long enjoyment of fitness. A physical examination every two years, the use of appropriate safety equipment, and participating in warm-up exercises prior to physical activity are all safe guards for athletic programs.

What is the expected average weight for a 6-month-old child?
1
680 g (1.5 lb)
2
7.26 kg (16 lb)
3
11.34 kg (25 lb)
4
9.75 kg (21.5 lb)

2 The average weight of a 6-month-old child is 7.26 kg (16 lb). The average weight gain in an infant is 680 g (1.5 lb) per month until age 5 months, when the birth weight has at least doubled. The average weight of a 6-month-old child is not as high as 11.34 kg (25 lb). The average weight of a 1-year-old child is 9.75 kg (21.5 lb).

What is the correct order of the different stages in Piaget’s theory of cognitive development?
1.
Formal operations

2.
Sensorimotor

3.
Preoperational

4.
Concrete operations

According to Piaget’s theory of cognitive development, the first stage is the sensorimotor stage, which starts from birth and lasts until two years. After this stage, the child moves to the preoperational stage, which lasts from two years of age until seven years of age. The next stage is the concrete operations stage, which lasts and continues from seven to eleven years. The last stage is the formal operations stage, which lasts from eleven years to adulthood.

Which stage describes the Oedipus complex, according to Freud’s theory?
1
Stage 2
2
Stage 3
3
Stage 4
4
Stage 5

2 According to Freud’s theory, there are five stages in a child’s development. Stage 3 is the Oedipal stage, which is also known as the phallic stage. Stage 2 is the anal stage. Stage 4 is the latency stage. Stage 5 is the genital stage.

A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate?
1
Domestic mimicry
2
Causal relationship
3
Spatial relationship
4
Object permanence

3 The toddler’s ability to recognize the shapes of objects and fit smaller boxes in larger boxes indicates awareness of spatial relationships. If the toddler is acutely aware of others’ actions and attempts to copy them in gestures and words, it indicates domestic mimicry. When the toddler explores an object each time it appears in a new place, it indicates an awareness of causal relationships. If the toddler understands that objects continue to exist even when they cannot be observed in the same place, it indicates an awareness of object permanence.

At what age does a child start to crawl?
1
3 months
2
5 months
3
7 months
4
9 months

4 At the age of 9 months, a child starts to crawl along the floor and can pull himself or herself to a standing or sitting position. At the age of 3 months, a child can lift his or her head and chest and is able to sit erect with support. At the age of 5 months, a child can support much of his or her own weight when pulled to stand. At the age of 7 months, a child can sit alone without support, can bear his or her full weight on his or her feet, and can hold on to furniture.

According to Piaget during which developmental state is the pediatric client egocentric?
1
Infancy
2
Adolescence
3
Early childhood
4
Middle childhood

3 According to Piaget, the early childhood (toddler) and preschool-age child are both egocentric [1] [2]. Infancy, adolescence, and middle childhood are not characterized as being egocentric, according to Piaget.

What should the nurse anticipate, according to Erikson, when assessing a school-age child? Select all that apply.
1
Being engaged in tasks
2
Questioning sexual identity
3
Having highly imaginative thoughts
4
Wanting to participate in organized activities
5
Struggling with self-control and independence

14 The nurse would anticipate that the school-age child would want to be engaged in tasks and participate in organized activities. Questioning sexual identity is expected for the adolescent. The nurse would anticipate that a preschool-age child would have highly imaginative thoughts, according to Erikson. Struggling with self-control and independence is expected for the toddler-age child.

The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics and hypogenitalism. Which chromosomal notation is associated with the child’s condition?
1
45,XO
2
47,XXX
3
47,XYY
4
48,XXXY

4 The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.

The parents of a preschooler tell the nurse that they try to inculcate good eating habits by asking the child to be at the table until the "plate is clean." What condition is the child at risk for?
1
Anorexia
2
Depression
3
Aggression
4
Poor eating habits

4 Asking the child to be at the table until the "plate is clean" results in overeating and develops poor eating habits later in life. Anorexia is seen if the child does not consume the required amount of food. Depression may be seen in a child if there are any psychological issues. Aggression occurs from sociocultural and familial influences on the child.

When should the nurse anticipate that the school-age client will have all primary teeth?
1
5 years of age
2
6 years of age
3
7 years of age
4
8 years of age

2 The nurse anticipates that the school-age client will have all primary teeth by the age of 6 years. The nurse would not anticipate this for a 5-year-old client. The nurse would anticipate that the 7- and 8-year-old client will begin losing primary teeth; therefore, these clients would not have all of their primary teeth.

How does an adolescent establish group identity during psychosocial development?
1
By evaluating his or her own health with a feeling of well-being
2
By fostering his or her independence with balanced family structure
3
By building close peer relationships to achieve acceptance in the society
4
By achieving marked physical changes with masculine and feminine behaviors

3 By building close peer relationships, adolescents develop a sense of belonging, approval, and the opportunity to learn acceptable behavior. This behavior establishes the group identity. By evaluating his or her own health with a feeling of well-being, an adolescent establishes health identity. An individual establishes family identity by fostering their independence with balanced family structure. The sound and healthy growth of an adolescent with marked physical changes helps to build sexual identity.

In which settings should the nurse prepare to administer developmental assessment for pediatric clients? Select all that apply.
1
Home
2
School
3
Hospital
4
Daycare center
5
Assisted living center

1234 Pediatric developmental assessments are performed in many settings, including the home, school, hospital, and daycare center environments. It is unlikely that a pediatric developmental assessment would be performed in an assisted living center.

Which type of prehension is exhibited by a 5-month-old infant?
1
The grasp is palmar.
2
Hands are mostly open.
3
The grasp is a crude pincer.
4
Hands are predominantly closed.

1 A 5-month-old infant is able to voluntarily grasp an object using the whole hand; this is called a palmar grasp. At 3 months of age, the hands are mostly open. By 8 to 9 months of age the infant uses a crude pincer grasp, using the thumb and index finger. At 1 month of age the hands are predominantly closed.

Which statement describes stage 2 of Kohlberg’s theory?
1
The child recognizes that there is more than one correct view.
2
An adolescent chooses to avoid a party where they know beer will be served.
3
An individual wants to win the approval of and maintain the expectations of one’s immediate group.
4
A child’s response to a moral dilemma is in terms of absolute obedience to authority and rules.

1 According to stage 2 of Kohlberg’s theory, a child recognizes that there is more than one correct view. An adolescent who chooses not to attend a party where beer will be served because they know this is wrong is acting according to stage 4. Stage 3 states that an individual wants to win the approval of and maintain the expectations of one’s immediate group. During stage 1, a child’s response to a moral dilemma is in terms of absolute obedience to authority and rules.

Which difficulties faced by an adolescent diagnosed with a chronic illness are attributed to normal development? Select all that apply.
1
Risk taking
2
Rebelliousness
3
Peer socialization
4
Lack of cooperation
5
Hostility toward authority

1245 Risk taking, rebelliousness, lack of cooperation, and hostility toward authority are attributes of normal personal adolescent development. Peer socialization is something that should be encouraged to achieve independence from family.

In which stage of Kohlberg’s theory of moral development does the nurse anticipate a client to realize there is more than one right point of view?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

2 Level I, preconventional reasoning, stage 2, is when the nurse anticipates that the client will realize there is more than one right view. In level I, stage 1, the nurse would anticipate absolute obedience to authority and rules. In level II, conventional reasoning, stage 3, the child wants to win approval and maintain expectations of his or her immediate group. Level II, stage 4, is when the client expands focus from the relationship with others to societal concerns.

Which actions demonstrate fine motor skills? Select all that apply.
1
Crawling
2
Creeping
3
Sitting erect
4
Holding a rattle
5
Picking up objects
6
Holding a baby bottle

456 Holding a rattle, picking up objects, and holding a baby bottle are demonstrations of fine-motor skills. Gross-motor skills include crawling, creeping, and sitting erect.

According to Erikson’s theory of psychosocial development, what is the correct order of a child’s behavior as they age?
1.
The child concentrates on work and play.

2.
The child develops autonomy by making choices.

3.
The child is concerned about appearance and body image.

4.
The child develops feelings of superego or conscience.

According to Erikson’s theory, a toddler develops his or her autonomy by making choices. The child moves on to the next stage and develops a superego or conscience. During the industry versus inferiority stage, the child learns to work and play with their peers. During the identity versus role confusion stage, an adolescent can be seen having a marked preoccupation with his or her appearance and body image.

The nurse is explaining to the mother of two teenage children why her daughter’s height is comparatively less than her son’s height. What is the reason for lower overall height in girls compared with boys?
1
Increase in muscle mass
2
Hypertrophy of the laryngeal mucosa
3
Maturation of structural appendages of the skin
4
Closure of epiphyses because of estrogen secretion

4 The difference in skeletal growth between girls and boys at puberty is because of the influence of hormones. The secretion of high levels of estrogen in girls causes early closure of the epiphyseal ends of the bones. Therefore girls generally have an overall lower height compared with boys. Boys have a longer period of growth before puberty and slower rate of epiphyseal closure. At puberty, boys have an increase in muscle mass both quantitatively and qualitatively. This increased lean mass results in high blood volume in pubertal boys. The hypertrophy of laryngeal mucosa along with elongation of the larynx and vocal cords results in voice changes in both boys and girls at puberty. Hormonal influence during puberty results in maturation of structural appendages of the skin such as sweat glands; this maturation is not related to the height difference between girls and boys.

Which stage of Kohlberg’s theory of moral development does the nurse anticipate in a client who exhibits absolute obedience to authority and rules?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

1 Level I, preconventional reasoning, includes stage 1, punishment and obedience training. It is during this stage the nurse would anticipate absolute obedience to authority and rules. Stage 2, also in level I, is when the nurse anticipates that the child will realize there is more than one right view. In stage 3, level II, the child wants to win approval and maintain expectations of his or her immediate group. In stage 4, also in level II, the client expands focus from the relationship with others to societal concerns.

How much does the head circumference increase per month from 4 to 6 months of age?
1
1 cm (0.4 inch)
2
2 cm (0.75 inch)
3
0.5 cm (0.2 inch)
4
3.5 cm (1.38 inch)

1 Head circumference increases approximately 1 cm (0.4 inch) per month from 4 to 6 months of age. Head circumference increases approximately 2 cm (0.75 inch) per month from birth to 3 months of age. It increases approximately 0.5 cm (0.2 inch) per month during the second 6 months. It does not increase as fast as by 3.5 cm (1.38 inch) at any time during infancy.

The nurse is assessing an 8-month-old child’s gross motor development. Which action by the child indicates late development?
1
The child is unable to stand by holding onto furniture.
2
The child cannot change from a prone to a sitting position.
3
The child cannot sit down from a standing position without help.
4
The child cannot sit steadily on the floor for a prolonged period of time.

1 At 8 months of age the child should be able to stand by holding onto furniture, because the child readily bears weight on the legs when supported. When a child is 10 months old, the child can change from a prone to a sitting position. When a child is 12 months old, the child is able to sit down from a standing position without any help. When a child is at least 9 months old, the child can sit steadily on the floor for a prolonged period of time.

What stage of Kohlberg’s theory of moral development defines "right" by the decision of the conscience?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

4 Kohlberg’s theory of moral development consists of six stages. Universal ethical principle orientation is the sixth stage. It defines "right" by the decision of the conscience in accordance with self-chosen ethical principles. Social contract orientation is the fifth stage of Kohlberg’s theory. During this stage, an individual follows societal law but recognizes the possibility of changing the law to improve society. Society-maintaining orientation stage is the fourth stage. Individuals expand their focus from a relationship with others to societal concerns during this stage. Instrumental relativist orientation is the second stage. In this stage, the child recognizes that there is more than one right view.

Of what does the nurse expect the primary health care provider to advise the parents after their child is diagnosed with a mitochondrial disorder?
1
"There is no risk of recurrence of this disease in the next child."
2
"You may need to use a donor egg or sperm for future children."
3
"There are more chances of miscarriage in the next pregnancy."
4
"You can find additional information of this disease on the Internet."

2 The nurse informs the parents about alternative options, such as the use of a donor egg or sperm for the next pregnancy. This is because there is an increased risk for mitochondrial disorder in future children. The diagnosis of mitochondrial disorder in this child does not carry an increased chance of miscarriage for the mother in future pregnancies. It is not a good idea to encourage the parents to look for additional information on the Internet, because some information may be inaccurate.

Which behaviors should the nurse anticipate when conducting a developmental assessment for a newborn? Select all that apply.
1
Sucking on a pacifier
2
Grasping a parents finger
3
Discovering hands and feet
4
Swallowing while breastfeeding
5
Rooting when the cheek is stroked

1245 Developmental behaviors for a newborn are mostly reflective, including sucking, grasping, swallowing, and rooting. The nurse would not anticipate hands and feet to be discovered until 1 to 4 months of age.

What gross motor skill is observed in children between 8 and 10 months old?
1
The child can creep on his or her hands and knees.
2
The child has predominant inborn reflexes.
3
The child can sit alone without any kind of support.
4
The child can bear his or her weight on forearms when prone.

1 A child between 8 and 10 months old can creep on his or her hands and knees. A child between birth and 1 month old has predominant inborn reflexes. A child between 6 and 8 months old can sit alone without support. A child between 2 and 4 months old can bear his or her weight on his or her forearms when in the prone position.

How many days is the neonatal period? Record your answer using whole numbers. __________ days

The neonatal period is the first 28 days of life.

Which feelings are enhanced in the school-age child through the use of positive reinforcement of success by adults? Select all that apply.
1
Happiness
2
Likeability
3
Feeling worthwhile to others
4
Feeling disrespected by others
5
Capability of valuable contributions

1235 Feelings of happiness, likability, worthwhileness to others, and the capability of valuable contributions are enhanced in the school-age child through the use of positive reinforcement of successes by adults. Feelings of disrespect are decreased, not enhanced, through the use of positive reinforcement of successes by adults.

At which stage of Kohlberg’s theory is the child afraid of punishment?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

1 According to Kohlberg’s theory of moral development, at stage 1 a child is afraid of punishment. At stage 2, the child recognizes that there is more than one correct viewpoint. At stage 3, an individual seeks the approval of and maintains the expectations of one’s immediate group. At stage 4, an individual expands focus from a relationship with others to societal concerns.

Which auditory test is appropriate for infants?
1
Play audiometry
2
Pure tone audiometry
3
Behavioral audiometry
4
Auditory brainstem response (ABR)

3 Behavioral audiometry is used for infants. Play audiometry is used for toddlers. Pure tone audiometry is used for children and adolescents. ABR is used for newborns.

According to Piaget, which statement describes the concrete operation stage?
1
During this stage, children have egocentric thoughts.
2
During this stage, children are able to perform mental operations.
3
During this stage, children learn to think with the use of symbols and mental images.
4
During this stage, children develop an action pattern for dealing with the environment.

2 During the concrete operation stage, children are able to perform mental operations. During the formal operations stage, there is prevalence of egocentric thoughts. During the preoperational stage, children learn to think with the use of symbols and mental images. During the sensorimotor stage, children develop an action pattern for dealing with the environment.

A child who is recently admitted to school is introverted and prefers being alone at the school. What is the temperament of the child according to Stella Chess and Alexander Thomas’s longitudinal study?
1
The easy child
2
The difficult child
3
The hyperactive child
4
The slow to warm-up child

4 The child will be categorized as a slow to warm-up child. These children are uneasy or cautious in new situations or with unfamiliar people. They react negatively with mild intensity to new stimuli. An easy child is open and adaptable to change and displays a mild-to-moderately intense mood that is typically positive. A difficult child adapts slowly to new routines, people, or situations. This type of child has intense mood expressions with negative behavior. A hyperactive child usually has problems concentrating and paying attention.

What gross motor skill is found in children between two to four months of age?
1
The child can creep on its hands and knees.
2
The child has predominant inborn reflexes.
3
The child can sit alone without any kind of support.
4
The child can bear weight on forearms when prone.

4 A child between two and four months of age is able to bear his or her weight on the forearms when in the prone position. A child between eight and 10 months of age can creep on their hands and knees. A child between birth and one month has predominant inborn reflexes. A child between six and eight months of age can sit alone without support.

A child has been diagnosed with hemophilia type A after experiencing excessive bleeding from a minor trauma. The mother states that the toddler being seen for the trauma is very active and is difficult, constantly saying no. What would be an appropriate response?
1
"Toddlers are curious, trying to make decisions and be independent."
2
"Saying no at this stage is a signal that the child may need some therapy."
3
"You must show the child from a young age that you are the boss and in charge."
4
"Responsible parenting means you must protect the child from all future injuries."

1 Toddlers are curious, trying to make decisions and being independent, and learning autonomy, which is a normal developmental stage for this age group. Saying no is the toddler’s means of developing independence rather than a need for therapy. The developmental task according to Erikson is autonomy verses shame, so caregivers need to allow some independence. No person can protect absolutely another individual from all injuries.

Which of these skills should be present in a seven month old child?
1
The child pulls himself or herself to stand or sit.
2
The child is able to pick small objects.
3
The child can sit alone without support.
4
The child can place objects into containers.

3 A child of seven months of age should be able to sit alone without support. A child after 8 months of age should be able to pick up small objects, place objects in containers, and pull himself or herself up to stand or sit.

What is the similarity between Havinghurst’s stage-crisis theory and Erikson’s psychosocial development theory?
1
Both theories are based on developmental tasks.
2
Both theories incorporate eight stages of development.
3
Both theories are based on psychosexual development.
4
Both theories emphasize that a child’s growth is directed by gene activity.

1 Both stage-crisis theory and psychosocial development theory are based on developmental tasks. Both theories teach that the successful resolution of a developmental task is essential for a successful progression through life. The stage-crisis theory has six stages whereas the psychosocial development theory has eight stages of development. Freud’s theory is based on psychosexual development. Gesell’s theory of development suggests that development of child is directed by gene activity.

The nurse is learning about the shift in total body fluid that occurs from infancy to adulthood. What percentage of body weight is the weight of extracellular fluid (ECF) in an infant at term?
1
10%
2
20%
3
44%
4
78%

3 The amount of ECF is 44% of the body weight at term. The initial birth weight of a term newborn can decrease by 10% in the first 5 days of life due to ECF compartment contraction, enhanced renal tubular function, and rapidly increasing glomerular filtration rate. The amount of ECF is 20% in adulthood. At birth, 78% of the infant’s body weight is water—ECF occupies a significant part of it.

What is the reason for calculating a body mass index (BMI)-for-age during a health maintenance assessment for school-age clients?
1
Assessing for bulimia nervosa
2
Monitoring for failure to thrive
3
Monitoring for anorexia nervosa
4
Assessing for obesity or overweight

4 Due to the increasing number of overweight children in the United States, the BMI charts are a critical component of children’s physical assessment. BMI-for-age may be used to identify children and adolescents at the upper end of the distribution who are either overweight (at or above 95th percentile) or at risk for being overweight (at or above the 85th percentile and below the 95th percentile). Assessing for bulimia nervosa and anorexia nervosa is more appropriate for an adolescent versus a school-age child. Assessing for failure to thrive (FTT) is more appropriate for the infant, toddler, and preschool-age child.

Which period of Piaget’s theory explains animism in a child?
1
Period I
2
Period II
3
Period III
4
Period IV

2 During period II of Piaget’s theory, children demonstrate animism, in which they personify objects. During period I, infants develop a schema or action pattern for dealing with the environment. During period III, a child is able to think about an action that previously was performed physically. During period IV, adolescents demonstrate feelings and behaviors characterized by self-consciousness.

Which client may have concerns related to sexuality when hospitalized with a chronic illness?
1
An 8-year-old
2
A 10-year-old
3
A 12-year-old
4
An 18-year-old

4 An 18-year-old client is an adolescent, which is the stage of development where concerns about sexuality may occur when hospitalized with a chronic illness. The other clients are not developmentally characterized as adolescents; therefore, the nurse would not anticipate an 8-year-old, 10-year-old, or 12-year-old to have this concern.

Which component of the human personality, according to Freud, allows an individual to judge reality accurately?
1
Id
2
Ego
3
Superego
4
Oedipus complex

2 According to Freud the ego allows an individual to judge reality accurately. The id is basic instinctual impulses driven to achieve pleasure. The superego is often referred to as the conscience. The Oedipus complex is a belief that a female child fantasizes about her father as a love interest.

Which psychosocial change does a 2-year-old child exhibit?
1
Achieves full independence
2
Engages in temper tantrums
3
Exhibits weak determination
4
Performs very few muscular activities

2 A 2 year old engages in temper tantrums when parents start restricting certain activities to prevent harm. At 2 years of age, a child has a strong will and determination, which may result in negative behavior. The child strives for independence by using the developing muscles to do everything for himself or herself.

How many days is the neonatal period? Record your answer using whole numbers. __________ days

The neonatal period is the first 28 days of life.

A child wants to be on time for a family dinner. According to Kohlberg’s theory, what stage of development is the child going through?
1
Good boy-nice girl orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

3 When a child wants to be on time for a family dinner, this thought exemplified the instrumental relativist orientation stage. A child at this stage follows his or her parent’s rules. During the good boy-nice girl orientation stage, a child wants to win the approval of and maintain the expectations of one’s immediate group. During the society-maintaining orientation stage, an individual expands focus from a relationship with others to societal concerns. During the universal ethical principle orientation stage, the concept of "rightness" is defined by self-chosen ethical principles.

Who completes the developmental questionnaire for a pediatric client who is being assessed using the Developmental (ASQ-3) screening?
1
Child
2
Parent
3
Nurse
4
Physician

2 The parent completes the questionnaire portion of the Development (ASQ-3) assessment. A health care professional, such as the nurse or physician, scores the assessment. The child’s stage of development is assessed using this process.

How many hours of sleep should the nurse recommend for the 11-year-old client?
1
9
2
10
3
11
4
12

1 A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client. A 5-year-old school-age client requires 11.5 hours of sleep per night; however, 11 and 12 hours of sleep is not recommended for an 11-year-old school-age client.

What developmental skills does a preschooler exhibit? Select all that apply.
1
Personal identity
2
Specific reasoning
3
Increased curiosity
4
Magical thinking
5
Understanding of others

234 Preschoolers begin to engage in specific reasoning and become curious. Preschoolers’ thinking is often described as magical thinking. Between the ages of 12 and 36 months, toddlers start thinking of the self as separate from the mother. School-age children around the age of 12 years start concentrating on more than one aspect of a situation. They also start understanding different points of view.

Which symptoms present in a child indicate Turner syndrome? Select all that apply.
1
Webbed neck
2
Impaired language
3
Tall stature with long legs
4
Low position of posterior hairline
5
Shield-shaped chest with wide space between the nipples

145 Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.

Which is a goal for organized athletics for school-age children?
1
A life-long enjoyment of fitness.
2
A physical examination every two years.
3
The use of appropriate safety equipment.
4
Participation in warm-up exercises prior to physical activity.

1 A goal for organized athletics for school-age children is a life-long enjoyment of fitness. A physical examination every two years, the use of appropriate safety equipment, and participating in warm-up exercises prior to physical activity are all safe guards for athletic programs.

Which result does the nurse anticipate when providing care to a preschool-age child who successfully completes tasks associated with this stage of Erikson’s theory of psychosocial development?
1
Faith and optimism
2
Devotion and fidelity
3
Direction and purpose
4
Self-control and willpower

3 Successful resolution of initiative versus guilt, which happens between the ages of 3 and 6 according to Erikson, results in direction and purpose. Resolution of trust versus mistrust (birth to 1 year) results in faith and optimism. The resolution of identify versus role confusion (puberty) results in devotion and fidelity. The resolution of autonomy versus shame and doubt (1 to 3 years) leads to self-control and willpower.

According to the Erikson’s theory, which stage in a young adult describes the development of the sense of caring for others?
1
Initiative versus guilt
2
Integrity versus despair
3
Intimacy versus isolation
4
Identity versus role confusion

3 The development of a sense of caring for others in a young adult occurs at the stage of intimacy versus isolation. During the initiative versus guilt stage, a child likes to pretend and try out new roles. At the integrity versus despair stage, many older adults view their lives with a sense of satisfaction. During the identity versus role confusion stage, a child’s identity development begins with the goal of achieving some perspective or direction.

Which stage of Lawrence Kohlberg’s theory of moral development is associated with a person following a law even if it is discriminatory to a racial group?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

1 A person in the social contract orientation stage follows laws even if they are not fair to a certain racial group. During the society-maintaining orientation stage, an individual expands his or her focus from a relationship with others to societal concerns. During the instrumental relativist orientation stage, the decision to do something morally right is based on satisfying one’s own needs and occasionally the needs of others. An individual in the universal ethical principle orientation stage may not follow a law if it does not seem fair to a particular racial group.

A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate?
1
Domestic mimicry
2
Causal relationship
3
Spatial relationship
4
Object permanence

3 The toddler’s ability to recognize the shapes of objects and fit smaller boxes in larger boxes indicates awareness of spatial relationships. If the toddler is acutely aware of others’ actions and attempts to copy them in gestures and words, it indicates domestic mimicry. When the toddler explores an object each time it appears in a new place, it indicates an awareness of causal relationships. If the toddler understands that objects continue to exist even when they cannot be observed in the same place, it indicates an awareness of object permanence.

Which is an inborn error of metabolism that affects growth and development?
1
Cystic fibrosis
2
Achondroplasia
3
Turner syndrome
4
Hunter syndrome

4 Hunter syndrome is an inborn error of metabolism that hinders development and results in altered physical appearance and impaired mental development. Cystic fibrosis is a genetic disorder that results in accumulation of mucus in the lungs and pancreas. Achondroplasia is a congenital disorder that is a common cause for the structural defect called dwarfism. Turner syndrome is a chromosomal abnormality associated with webbed neck and low-set ears.

In which stage of Kohlberg’s theory of moral development does the nurse anticipate a client to realize there is more than one right point of view?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

2 Level I, preconventional reasoning, stage 2, is when the nurse anticipates that the client will realize there is more than one right view. In level I, stage 1, the nurse would anticipate absolute obedience to authority and rules. In level II, conventional reasoning, stage 3, the child wants to win approval and maintain expectations of his or her immediate group. Level II, stage 4, is when the client expands focus from the relationship with others to societal concerns.

The student nurse is learning about the developmental characteristics of vision. Which major developmental characteristics does an infant start exhibiting around age 6 weeks? Select all that apply.
1
Having binocular vision
2
Having doll’s eye reflex
3
Having visual acuity 20/40 to 20/60
4
Having peripheral vision to 180 degree
5
Having strabismus if binocular vision is absent

14 Beginning at age 6 weeks, the infant has binocular vision, which becomes well established by age 4 months. Within 6 to 12 weeks, the infant has peripheral vision to 180 degrees. An infant has doll’s eye reflex at birth, and it disappears within age 6 to 12 weeks. Visual acuity of 20/40 to 20/60 does not develop until age 44 to 52 weeks. Lack of binocular vision indicates strabismus at age 28 to 44 weeks. While binocular vision generally develops by age 6 weeks, a lack of this development at this age is not indicative of strabismus.

By which age do children develop binocularity?
1
8 to 9 weeks
2
3 to 4 months
3
7 to 8 months
4
9 to 12 months

2 Children develop binocularity (the ability to fixate on one visual field with both eyes simultaneously) by 3 to 4 months. Children are not able to fixate on one visual field with both eyes simultaneously as early as 8 to 9 weeks. Children learn to fixate on one visual field with both eyes simultaneously earlier than 7 to 8 months, or 9 to 12 months.

The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics and hypogenitalism. Which chromosomal notation is associated with the child’s condition?
1
45,XO
2
47,XXX
3
47,XYY
4
48,XXXY

4 The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.

The parents of a preschooler are worried, because the child is often seen talking to imaginary friends. The parents admit that they often scold the child for such behavior. Of what does the nurse inform the parents?
1
"The child may develop severe psychological problems."
2
"You must involve the child in some spiritual activities."
3
"There may be some neurologic or developmental issue."
4
"The behavior is normal at this age and it will help counter loneliness."

4 Sometimes children create imaginary friends to help counter the feelings of loneliness. Therefore the nurse should tell the parents that it is a normal behavior. Speaking to imaginary friends is a habit that children overcome later in life and, therefore, there is no risk for developing any psychological problems. It is not necessary to involve the child in any spiritual activity if the parents do not desire to do so. A neurologic problem is suspected if the child exhibits jerking movements or experiences fainting spells.

The mother of a 2-year-old girl expresses concern that her daughter’s growth rate has slowed. What should the nurse explain to the mother about the growth of toddlers?
1
"This growth pattern is typical at this age."
2
"Toddlers are too busy exploring their world to eat."
3
"This growth pattern can’t be interpreted for another year."
4
"Toddlers usually lose their taste for foods they liked when younger."

1 As the child gets older, growth slows. Toddlers develop physiologic anorexia because their appetite decreases along with their growth rate. Although the toddler may be too busy to eat, this is not why the growth rate slows. This growth pattern may be interpreted now. Although a toddler may lose his or her taste for a particular food, it is not common in this age group.

How many hours of sleep should the nurse recommend for the 11-year-old client?
1
9
2
10
3
11
4
12

1 A school-age client who is 11 years of age would require 9 hours of sleep each night. Ten hours of sleep is not recommended for the school-age client. A 5-year-old school-age client requires 11.5 hours of sleep per night; however, 11 and 12 hours of sleep is not recommended for an 11-year-old school-age client.

Which behavior is seen in children at the undifferentiated stage of spiritual development, as propounded by Fowler?
1
Children have no concept of right or wrong to guide their behaviors.
2
Children imitate the religious behaviors without comprehending any meaning.
3
Children reason and question some of the established parental religious standards.
4
Children have a reverence for religious matters and are able to articulate their faith.

1 The first stage of spiritual development, as described by Fowler, is the undifferentiated stage. During this stage children have no concept of right or wrong to guide their behaviors. The beginnings of faith are established as they develop trust in their parents or primary caregivers. Imitation of religious behavior without comprehending any meaning takes place in the intuitive-projective stage during toddlerhood. As children grow older and approach adolescence, they reason and question some of the established parental religious standards. They realize that prayers are not always answered and so they abandon some practices. A reverence for religious matters and articulation of faith takes place in the mythical-literal stage during the school-age years.

Which symptoms present in a child indicate Turner syndrome? Select all that apply.
1
Webbed neck
2
Impaired language
3
Tall stature with long legs
4
Low position of posterior hairline
5
Shield-shaped chest with wide space between the nipples

145 Turner syndrome is a chromosomal abnormality seen in females in which an X chromosome is partly or completely absent. The clinical manifestations of Turner syndrome include a webbed neck, low posterior hairline, and shield-shaped chest with wide space between the nipples. Impaired language skills are seen in clients with triple X or superfemale syndrome. The client with Turner syndrome has short stature. Tall stature with long legs is a finding in Klinefelter syndrome.

Which stage is a part of postconventional reasoning?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Punishment and obedience orientation

1 The social contract orientation stage is a part of postconventional reasoning. Society-maintaining orientation is part of the conventional/role conformity reasoning level. The instrumental relativist orientation stage and the punishment and obedience orientation stage are parts of the preconventional reasoning level.

According to Erikson’s theory, at which stage does a child start to have fantasies and an active imagination?
1
Trust versus mistrust
2
Initiative versus guilt
3
Identity versus role confusion
4
Autonomy versus sense of shame and doubt

2 The initiative versus guilt stage is characterized by a child having fantasies and imaginations that motivate the child to explore the environment. The stage from birth to one year old when an infant develops trust towards his or her parents or caregivers is known as the trust versus mistrust stage. The identity versus role confusion stage begins after adolescence; during this stage, an individual tries to figure out his or her own identity. Between the ages of one to three years old, a child starts walking, feeding, using the toilet, and handling some basic self-care activities. This stage is one of autonomy versus sense of shame and doubt.

Which statement describes the latency stage of Freud’s psychoanalytic model of personality development?
1
During this stage, genital organs are the focus of pleasure.
2
During this stage, sexual urges are repressed and channeled into productive activities.
3
During this stage, an infant begins to think that his or her parent is separate from the self.
4
During this stage, sexual urges reawaken and are directed to an individual outside the family circle.

2 During the latency stage, Freud believed that sexual urges from the earlier Oedipal stage are repressed and channeled into productive activities that are socially acceptable. During the phallic stage, the genital organs are the focus of pleasure. During the oral stage, infants begin to think that the parent is something separate from the self. During the genital stage, sexual urges reawaken and are directed to an individual outside the family circle.

What is the average monthly increase in height of an infant in the first six months? Record your answer using one decimal place.__________ centimeters

The average monthly increase in height of an infant for first six months of life is 2.5 cm.

What type of development is described under Freud’s theory?
1
Cognition development
2
Psychosocial development
3
Psychosexual development
4
Moral reasoning development

3 Freud’s psychoanalytic model of personality development sets forth five stages of psychosexual development. Each stage is characterized by sexual pleasure in a part of the body: the mouth, the anus, and the genitals. Piaget’s theory of cognitive development includes four periods that are related to age and demonstrate specific categories of knowing and understanding. According to Erikson’s theory of psychosocial development, an individual needs to accomplish a particular task before mastering the stage and progressing to the next one. Kohlberg’s theory of moral development expands on Piaget’s cognitive theory.

What stage of Kohlberg’s theory of moral development defines "right" by the decision of the conscience?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Universal ethical principle orientation

4 Kohlberg’s theory of moral development consists of six stages. Universal ethical principle orientation is the sixth stage. It defines "right" by the decision of the conscience in accordance with self-chosen ethical principles. Social contract orientation is the fifth stage of Kohlberg’s theory. During this stage, an individual follows societal law but recognizes the possibility of changing the law to improve society. Society-maintaining orientation stage is the fourth stage. Individuals expand their focus from a relationship with others to societal concerns during this stage. Instrumental relativist orientation is the second stage. In this stage, the child recognizes that there is more than one right view.

At which stage of Kohlberg’s theory is the child afraid of punishment?
1
Stage 1
2
Stage 2
3
Stage 3
4
Stage 4

1 According to Kohlberg’s theory of moral development, at stage 1 a child is afraid of punishment. At stage 2, the child recognizes that there is more than one correct viewpoint. At stage 3, an individual seeks the approval of and maintains the expectations of one’s immediate group. At stage 4, an individual expands focus from a relationship with others to societal concerns

Which is a common attribute that the nurse assesses in an "easy" child?
1
Passive resistance
2
Predictable habits
3
Intense mood expressions
4
Slow adaptation to change

2 The nurse anticipates that the "easy" child will have predictable habits. Passive resistance is a trait assessed in the "slow to warm up" child. Intense mood expressions and slow adaptation to change are characteristics of the "difficult" child.

A community health nurse makes a home visit to a disabled 13-year-old client who has a 6-month-old infant sister. The infant lies quietly in her crib and rarely smiles or vocalizes; it appears that the infant barely has her basic needs met. What is the nurse’s most appropriate intervention?
1
Advise the parent that the infant will be retarded if not stimulated.
2
Ask the disabled client to spend more time playing with the sister.
3
Encourage purchasing toys that are appropriate for the infant’s age level.
4
Determine whether there is anyone who can help with chores and the infant’s care.

4 Recruiting someone to help with chores and infant care will allow the parent time to rest and will provide the infant with care and attention. Making the parent feel guilty is not therapeutic and will increase anxiety. The disabled sibling requires attention, and this responsibility may cause jealousy, rivalry, and resentment. Toys need not be employed for sensory stimulation; household objects and quality human contact can serve as well.

Which statement describes stage 2 of Kohlberg’s theory?
1
The child recognizes that there is more than one correct view.
2
An adolescent chooses to avoid a party where they know beer will be served.
3
An individual wants to win the approval of and maintain the expectations of one’s immediate group.
4
A child’s response to a moral dilemma is in terms of absolute obedience to authority and rules.

1 According to stage 2 of Kohlberg’s theory, a child recognizes that there is more than one correct view. An adolescent who chooses not to attend a party where beer will be served because they know this is wrong is acting according to stage 4. Stage 3 states that an individual wants to win the approval of and maintain the expectations of one’s immediate group. During stage 1, a child’s response to a moral dilemma is in terms of absolute obedience to authority and rules.

Which nursing action is most accurate when assessing the chest circumference of a newborn during the initial physical assessment?
1
Measuring during expiration only
2
Taking three measurements and recording the average
3
Measuring during inspiration and plotting this data on the growth chart
4
Placing the measuring tape around the rib cage at the nipple line

4 The most accurate nursing action when assessing the chest circumference of a newborn during the initial physical assessment is to place the measuring tape round the rib cage at the nipple line. Two measurements should be performed, one during inspiration and one during expiration. The average of these two measurements is then plotted on the growth chart.

In which age range would the nurse expect a client to understand the concept of conservation related to liquids and numbers when conducting a developmental assessment?
1
5 to 7 years
2
6 to 7 years
3
9 to 10 years
4
9 to 12 years

1 Mastering the concept of conservation related to liquids and numbers occurs at 5 to 7 years of age. Conservation related to length is expected at 6 to 7 years of age. Conservation related to weight and area occurs at 9 to 10 years of age. Conservation related to volume occurs at 9 to 12 years of age.

Which client may have concerns related to sexuality when hospitalized with a chronic illness?
1
An 8-year-old
2
A 10-year-old
3
A 12-year-old
4
An 18-year-old

4 An 18-year-old client is an adolescent, which is the stage of development where concerns about sexuality may occur when hospitalized with a chronic illness. The other clients are not developmentally characterized as adolescents; therefore, the nurse would not anticipate an 8-year-old, 10-year-old, or 12-year-old to have this concern.

What should the nurse suggest when parents ask what to do about their preschooler’s stuttering?
1
Speak clearly and do not complete the child’s sentences.
2
Avoid looking at the child when he experiences difficulty forming words.
3
Help the child by supplying the correct word when he experiences a block.
4
Stop the conversation and tell the child to speak slowly when starting again.

1 During the preschool years speech dysfluency is a typical characteristic of language development; it will resolve if the child is spoken to clearly and is not corrected. Avoiding eye contact, supplying the correct word, or drawing attention to the stuttering is demeaning ; it may decrease the child’s self-esteem and worsen the stuttering.

Which instruction should the nurse give to parents to help their child get accustomed to a new babysitter?
1
"Ask the babysitter to stand very close to the child."
2
"Ask the babysitter to hold out arms and smile broadly."
3
"Stay close and allow the child to observe the babysitter."
4
"Discourage the child from clinging in front of the babysitter."

3 Children need to explore and get used to babysitters or any stranger at their own rate. Therefore the parents should stay close to the child and allow the child to observe the babysitter. The babysitter needs to maintain a safe distance from the child so that the child is not scared. The stranger needs to talk softly and avoid sudden gestures, such as smiling broadly or holding out arms, which may scare the child. The parents should not discourage the child from clinging, because it is necessary for the child’s optimal emotional development.

What is the expected average weight for a 6-month-old child?
1
680 g (1.5 lb)
2
7.26 kg (16 lb)
3
11.34 kg (25 lb)
4
9.75 kg (21.5 lb)

2 The average weight of a 6-month-old child is 7.26 kg (16 lb). The average weight gain in an infant is 680 g (1.5 lb) per month until age 5 months, when the birth weight has at least doubled. The average weight of a 6-month-old child is not as high as 11.34 kg (25 lb). The average weight of a 1-year-old child is 9.75 kg (21.5 lb).

Which feelings are enhanced in the school-age child through the use of positive reinforcement of success by adults? Select all that apply.
1
Happiness
2
Likeability
3
Feeling worthwhile to others
4
Feeling disrespected by others
5
Capability of valuable contributions

1235 Feelings of happiness, likability, worthwhileness to others, and the capability of valuable contributions are enhanced in the school-age child through the use of positive reinforcement of successes by adults. Feelings of disrespect are decreased, not enhanced, through the use of positive reinforcement of successes by adults.

The mother of a 2-year-old girl expresses concern that her daughter’s growth rate has slowed. What should the nurse explain to the mother about the growth of toddlers?
1
"This growth pattern is typical at this age."
2
"Toddlers are too busy exploring their world to eat."
3
"This growth pattern can’t be interpreted for another year."
4
"Toddlers usually lose their taste for foods they liked when younger."

1 As the child gets older, growth slows. Toddlers develop physiologic anorexia because their appetite decreases along with their growth rate. Although the toddler may be too busy to eat, this is not why the growth rate slows. This growth pattern may be interpreted now. Although a toddler may lose his or her taste for a particular food, it is not common in this age group.

In which age range would the nurse expect a client to understand the concept of conservation related to liquids and numbers when conducting a developmental assessment?
1
5 to 7 years
2
6 to 7 years
3
9 to 10 years
4
9 to 12 years

1 Mastering the concept of conservation related to liquids and numbers occurs at 5 to 7 years of age. Conservation related to length is expected at 6 to 7 years of age. Conservation related to weight and area occurs at 9 to 10 years of age. Conservation related to volume occurs at 9 to 12 years of age.

According to Piaget, which statement describes the concrete operation stage?
1
During this stage, children have egocentric thoughts.
2
During this stage, children are able to perform mental operations.
3
During this stage, children learn to think with the use of symbols and mental images.
4
During this stage, children develop an action pattern for dealing with the environment.

2 During the concrete operation stage, children are able to perform mental operations. During the formal operations stage, there is prevalence of egocentric thoughts. During the preoperational stage, children learn to think with the use of symbols and mental images. During the sensorimotor stage, children develop an action pattern for dealing with the environment.

What is the average monthly increase in height of an infant in the first six months? Record your answer using one decimal place.__________ centimeters

The average monthly increase in height of an infant for first six months of life is 2.5 cm.

The nurse is assessing the development of a male child and finds that the child is tall, with deficient secondary sex characteristics and hypogenitalism. Which chromosomal notation is associated with the child’s condition?
1
45,XO
2
47,XXX
3
47,XYY
4
48,XXXY

4 The male child is tall, with deficient secondary sex characteristics and hypogenitalism, indicating Klinefelter syndrome. The chromosomal abnormality present in the child is denoted as 48,XXXY. The chromosomal complement 45,XO is seen in children with Turner syndrome. A child with Turner syndrome will have short stature and a webbed neck. The 47,XXX chromosomal complement indicates that the child has triple X, or superfemale, chromosomal abnormality. This condition is associated with impaired language and mental capacity. A child with the chromosomal complement 47,XYY has Jacobs XYY chromosomal abnormality, which is associated with normal sexual development and aggressive sexual tendencies.

According to Kohlberg’s theory of moral development, which statement about conventional reasoning is true?
1
A person wants to fulfill family expectations.
2
A child’s thinking is mostly based on likes and pleasures.
3
A child recognizes that there is more than one correct view.
4
An individual moves away from moral decisions based on authority.

1 During the "convention reasoning" level, a person wants to fulfill the expectations of his or her family, group, or nation. During the "preconventional reasoning" level, a child’s thinking is mostly based on likes and pleasures. During this stage, the child also recognizes that there is more than one correct view. During the "postconventional stage," individuals move away from moral decisions based on authority or conformity to groups to define their own moral values and principles.

Which is a characteristic of the glands that secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action?
1
Highly active in childhood
2
Absent around the umbilicus
3
Widely distributed throughout the body
4
Grow in conjunction with axillary hair follicles

4 The apocrine sweat glands secrete a thick substance in response to emotional stimulation and become odoriferous because of bacterial action. These glands grow in conjunction with hair follicles around the axillae. The apocrine glands are inactive during childhood and reach their secretory potential at the time of puberty. The apocrine glands are situated around the umbilicus. They have limited distribution and are found only around the axillae, areolae, external auditory canal, and anal and genital regions. Eccrine sweat glands, not the apocrine glands, have wide distribution throughout the body.

From which client does the nurse expect dramatic physical growth and marked development?
1
9-month-old infant
2
24-month-old toddler
3
4-year-old preschool-age child
4
10-year-old school-age child

1 The nurse can anticipate the infant to have both dramatic physical growth and marked development. The toddler, preschool-age, and school-age children will all continue to experience physical growth and development; however, these age groups do not experience growth and development as rapid as that of the infant.

Which stage is a part of postconventional reasoning?
1
Social contract orientation
2
Society-maintaining orientation
3
Instrumental relativist orientation
4
Punishment and obedience orientation

1 The social contract orientation stage is a part of postconventional reasoning. Society-maintaining orientation is part of the conventional/role conformity reasoning level. The instrumental relativist orientation stage and the punishment and obedience orientation stage are parts of the preconventional reasoning level.

What is the correct order of the stages according to Kohlberg’s theory of moral development?
1.
Punishment and obedience orientation

2.
Instrumental relativist orientation

3.
Good boy-nice girl orientation

4.
Society-maintaining orientation

5.
Social contract orientation

6.
Universal ethical principle orientation

According to Kohlberg’s theory of moral development, the first stage is the punishment and obedience orientation. The second stage is the instrumental relativist orientation. Good boy-nice girl orientation is the third stage. Society-maintaining orientation stage is the fourth stage. Social contract orientation is the fifth stage. The sixth stage is the universal ethical principle orientation stage.

Which statement correctly describes the initiative versus guilt stage?
1
Individuals like to pretend and try out new roles.
2
Individuals are more accomplished in some basic self-care activities.
3
Individuals show marked preoccupation with appearance and body image.
4
Individuals are eager to apply themselves to learning socially productive skills and tools.

1 During the initiative versus guilt stage, a child likes to pretend and try out new roles. A child is more accomplished in some basic self-care activities during the autonomy versus sense of shame and doubt stage. During the identity versus role confusion stage, an individual shows marked preoccupation with appearance and body image. During the industry versus inferiority stage, a child is eager to apply himself or herself to learning socially productive skills and tools.

According to Erikson, what should the nurse anticipate when assessing an adolescent?
1
Being engaged in tasks
2
Questioning sexual identity
3
Having highly imaginative thoughts
4
Wanting to participate in organized activities

2 The nurse would anticipate the adolescent to question sexual identity, according to Erikson. Being engaged in tasks and wanting to participate in organized activities is expected for the school-age child. The nurse would anticipate that a preschool-age child would have highly imaginative thoughts.

Which is a common attribute that the nurse assesses in an "easy" child?
1
Passive resistance
2
Predictable habits
3
Intense mood expressions
4
Slow adaptation to change

2 The nurse anticipates that the "easy" child will have predictable habits. Passive resistance is a trait assessed in the "slow to warm up" child. Intense mood expressions and slow adaptation to change are characteristics of the "difficult" child.

The nurse assesses a client and determines that she has achieved thelarche. What clinical finding prompted the nurse’s report?
1
Appearance of breast buds
2
Occurrence of gynecomastia
3
Growth of hair on mons pubis
4
Occurrence of menstrual cycle

1 The appearance of breast buds is considered to be an initial indication of puberty and is known as thelarche. A few months after thelarche, growth of pubic hair on the mons pubis occurs. This is known as adrenarche. The occurrence of the first menstrual cycle is known as menarche. Temporary gynecomastia is seen in some boys during mid-puberty.

According to Freud, which is a source of pleasure for a toddler-age client that the nurse should educate parents about in regards to normal growth and development?
1
Mouth
2
Anal zone
3
Sexual urges
4
Genital organs

2 The toddler-age client, according to Freud, finds a source of pleasure in the anal zone. The mouth is a source of pleasure during infancy. Sexual urges reawaken during adolescence. The genital organs are a source of pleasure during the preschool stage of development.

Who completes the developmental questionnaire for a pediatric client who is being assessed using the Developmental (ASQ-3) screening?
1
Child
2
Parent
3
Nurse
4
Physician

2 The parent completes the questionnaire portion of the Development (ASQ-3) assessment. A health care professional, such as the nurse or physician, scores the assessment. The child’s stage of development is assessed using this process.

What of these stages should the nurse include when explaining Piaget’s theory of child development to a parent? Select all that apply.
1
Phallic stage
2
Latency stage
3
Sensorimotor stage
4
Formal operations stage
5
Punishment orientation stage

34 Piaget’s theory includes the sensorimotor stage and formal operations stage. The phallic stage and latency stage are described in Freud’s psychoanalytic model of personality development. The punishment orientation stage is explained under preconventional reasoning in Kohlberg’s theory of moral development.

What is the expected average weight for a 6-month-old child?
1
680 g (1.5 lb)
2
7.26 kg (16 lb)
3
11.34 kg (25 lb)
4
9.75 kg (21.5 lb)

2 The average weight of a 6-month-old child is 7.26 kg (16 lb). The average weight gain in an infant is 680 g (1.5 lb) per month until age 5 months, when the birth weight has at least doubled. The average weight of a 6-month-old child is not as high as 11.34 kg (25 lb). The average weight of a 1-year-old child is 9.75 kg (21.5 lb).

According to Freud’s theory, in what order do the stages of child development occur?
1.
Anal

2.
Oral

3.
Genital

4.
Oedipal

5.
Latency

Freud’s theory sets forth five stages of child development. The oral stage (stage 1) spans the period from birth to 12 to 18 months. The anal stage (stage 2) occurs between the ages of 18 months and 3 years. The Oedipal stage (stage 3) occurs between 3 and 6 years of age. The latency stage (stage 4) occurs between the ages of 6 and 12 years. Finally, the genital stage (stage 5) lasts from puberty through adulthood.

During testing of the neurologic reflexes of an infant, which reflex should the nurse expect to appear at 3 months and persist until 24 to 36 months of age?
1
Neck righting
2
Body righting
3
Otolith righting
4
Labyrinth righting

1 While the infant is supine, if the head is turned to one side, the shoulder, trunk, and finally pelvis will turn toward that side. This reflex appears at 3 months, and persists until 24 to 36 months of age. Body righting is a modification of the neck-righting reflex in which turning hips and shoulders to one side causes all other body parts to follow; it appears at 6 months, and persists until 24 to 36 months of age. When the body of an erect infant is tilted, the head is returned to an upright, erect position; this is known as otolith righting, which appears at 7 to 12 months of age, and persists indefinitely. When an infant in prone or supine position is able to raise head, it is known as labyrinth righting. It appears at 2 months, and is strongest at 10 months of age.

Which of these statements about the transition from intrauterine to extrauterine life is true?
1
Hyperthermia is observed in the newborn.
2
Newborns are susceptible to heat loss and cold stress.
3
Apgar assessments are conducted 5 and 10 minutes after birth.
4
Physiological changes in the newborn occur during the first 12 hours of life.

2 During the transition from intrauterine to extrauterine life, newborns are susceptible to heat loss and cold stress. Newborns are susceptible to hypothermia, not hyperthermia. Apgar assessments are generally conducted between 1 and 5 minutes after birth. Physiological changes in the newborn are seen during the first 24 hours of life.

A child has been diagnosed with hemophilia type A after experiencing excessive bleeding from a minor trauma. The mother states that the toddler being seen for the trauma is very active and is difficult, constantly saying no. What would be an appropriate response?
1
"Toddlers are curious, trying to make decisions and be independent."
2
"Saying no at this stage is a signal that the child may need some therapy."
3
"You must show the child from a young age that you are the boss and in charge."
4
"Responsible parenting means you must protect the child from all future injuries."

1 Toddlers are curious, trying to make decisions and being independent, and learning autonomy, which is a normal developmental stage for this age group. Saying no is the toddler’s means of developing independence rather than a need for therapy. The developmental task according to Erikson is autonomy verses shame, so caregivers need to allow some independence. No person can protect absolutely another individual from all injuries.

According to Piaget, which statement describes the concrete operation stage?
1
During this stage, children have egocentric thoughts.
2
During this stage, children are able to perform mental operations.
3
During this stage, children learn to think with the use of symbols and mental images.
4
During this stage, children develop an action pattern for dealing with the environment.

2 During the concrete operation stage, children are able to perform mental operations. During the formal operations stage, there is prevalence of egocentric thoughts. During the preoperational stage, children learn to think with the use of symbols and mental images. During the sensorimotor stage, children develop an action pattern for dealing with the environment.

The nurse is learning about the shift in total body fluid that occurs from infancy to adulthood. What percentage of body weight is the weight of extracellular fluid (ECF) in an infant at term?
1
10%
2
20%
3
44%
4
78%

3 The amount of ECF is 44% of the body weight at term. The initial birth weight of a term newborn can decrease by 10% in the first 5 days of life due to ECF compartment contraction, enhanced renal tubular function, and rapidly increasing glomerular filtration rate. The amount of ECF is 20% in adulthood. At birth, 78% of the infant’s body weight is water—ECF occupies a significant part of it.

Which formula is most preferable for a child who has lactose intolerance?
1
Soy-based formula
2
Whey hydrolysate formula
3
Cow’s milk-based formula
4
Amino acid-based formula

1 Soy-based formula is a commercially available formula that has a high amount of protein but does not contain lactose. Amino acid-based formula is preferable for a child who has food allergies. However, it is not the most preferable formula for the child with lactose intolerance. Whey hydrolysate formula and cow’s milk-based formula contain high amounts of lactose.

Which physiologic body functions decrease in response to certain pubertal changes? Select all that apply.
1
Pulse rate
2
Blood volume
3
Strength of the heart
4
Basal heat production
5
Systolic blood pressure

14 Pubertal changes induce physiologic changes. The physiologic functions that decrease in response to pubertal changes include pulse rate and basal heat production. Blood volume, strength of the heart, and systolic blood pressure increase with changes occurring during puberty. Pubertal changes herald adulthood, and therefore the heart increases in size and strength and the systolic blood pressure increases to reach the adult rate.

According to Kohlberg’s theory, which stage comes before the society-maintaining orientation stage?
1
Social contract orientation
2
Good boy-nice girl orientation
3
Instrumental relativist orientation
4
Punishment and obedience orientation

2 According to Kohlberg’s theory, the "good boy-nice girl orientation" phase (stage 3) occurs before the "society-maintaining orientation" phase (stage 4). "Social contract orientation" is the fifth stage. "Instrumental relativist orientation" is the second stage.

The nurse assesses a client and determines that she has achieved thelarche. What clinical finding prompted the nurse’s report?
1
Appearance of breast buds
2
Occurrence of gynecomastia
3
Growth of hair on mons pubis
4
Occurrence of menstrual cycle

1 The appearance of breast buds is considered to be an initial indication of puberty and is known as thelarche. A few months after thelarche, growth of pubic hair on the mons pubis occurs. This is known as adrenarche. The occurrence of the first menstrual cycle is known as menarche. Temporary gynecomastia is seen in some boys during mid-puberty.

A 14-month-old toddler is able to recognize the shapes of objects and fit smaller boxes into larger boxes. Which type of cognitive development does this action indicate?
1
Domestic mimicry
2
Causal relationship
3
Spatial relationship
4
Object permanence

3 The toddler’s ability to recognize the shapes of objects and fit smaller boxes in larger boxes indicates awareness of spatial relationships. If the toddler is acutely aware of others’ actions and attempts to copy them in gestures and words, it indicates domestic mimicry. When the toddler explores an object each time it appears in a new place, it indicates an awareness of causal relationships. If the toddler understands that objects continue to exist even when they cannot be observed in the same place, it indicates an awareness of object permanence.

What of these stages should the nurse include when explaining Piaget’s theory of child development to a parent? Select all that apply.
1
Phallic stage
2
Latency stage
3
Sensorimotor stage
4
Formal operations stage
5
Punishment orientation stage

34 Piaget’s theory includes the sensorimotor stage and formal operations stage. The phallic stage and latency stage are described in Freud’s psychoanalytic model of personality development. The punishment orientation stage is explained under preconventional reasoning in Kohlberg’s theory of moral development.

How much does the head circumference increase per month from 4 to 6 months of age?
1
1 cm (0.4 inch)
2
2 cm (0.75 inch)
3
0.5 cm (0.2 inch)
4
3.5 cm (1.38 inch)

1 Head circumference increases approximately 1 cm (0.4 inch) per month from 4 to 6 months of age. Head circumference increases approximately 2 cm (0.75 inch) per month from birth to 3 months of age. It increases approximately 0.5 cm (0.2 inch) per month during the second 6 months. It does not increase as fast as by 3.5 cm (1.38 inch) at any time during infancy.

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