Test bank For Concepts for Nursing Practice, 3rd Edition by Jean Foret Giddens / Concepts for Nursing Practice Third Edition Test Bank / Concepts for Nursing Practice 3e Test Bank / Jean Foret Giddens, 9780323581936, Test Bank.
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which reviews
home, education, activities, drugs, sex, and suicide for the purpose of identifying high-risk
adolescents and the need for anticipatory guidance. It is used to identify high-risk, not low-risk,
adolescents. Physical development is reviewed with anthropometric data. Sexual development is
reviewed using physical examination.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
2. ANS: C
The expected stage of development for a preschooler (3–4 years old) is pre-operational. Concrete
operational describes the thinking of a school-age child (7–11 years old). Formal operational
describes the thinking of an individual after about 11 years of age. Sensorimotor describes the
earliest pattern of thinking from birth to 2 years old.
, OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
3. ANS: D
Growth is a quantitative change in which an increase in cell number and size results in an increase
in overall size or weight of the body or any of its parts. The processes by which early cells
specialize are referred to as differentiation. Psychosocial and cognitive changes are referred to as
development. Qualitative changes associated with aging are referred to as maturation.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
4. ANS: C
The Denver II is the most commonly used measure of developmental status used by healthcare
professionals; it is a screening tool. Screening tools do not provide a diagnosis. Diagnosis requires
a thorough neurodevelopment history and physical examination. Developmental delay, which is
suggested by screening, is a symptom, not a diagnosis. The need for any therapy would be
identified with a comprehensive evaluation, not a screening tool. Some providers use the Denver II
as a framework for teaching about expected development, but this is not the primary purpose of the
tool.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
5. ANS: D
Hydrocephaly is also a physical development exemplar. Cerebral palsy is an exemplar of adaptive
developmental delay. Failure to thrive is an exemplar of social/emotional developmental delay.
Fetal alcohol syndrome is an exemplar of cognitive developmental delay.
, OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
6. ANS: C
Function is one of the concepts most significantly impacted by development. Others include
sensory-perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these concepts
can help the nurse anticipate areas that need to be addressed. Culture is a concept that is considered
to significantly affect development; the difference is the concepts that affect development are those
that represent major influencing factors (causes); hence determination of development would be
the focus of preventive interventions. Environment is considered to significantly affect
development. Nutrition is considered to significantly affect development.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
7. ANS: B
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at
this age. A referral to a psychologist would be premature based only on the complaint of the
mother. Completing a developmental screening would be very appropriate but not the initial
response. The nurse would certainly want to get more information, but separating the child from
the mother is not necessary at this time.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
8. ANS: C
, Regression to an earlier stage of development is a common response to stress. Separation anxiety
is most common in infants and toddlers. Rebellion against hospital rules is usually not an issue if
the adolescent understands the rules and would not create childlike behaviors. An adolescent may
want to “know everything” with their logical thinking and deductive reasoning, but that would not
explain why they would act like a child.
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance
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