,Concept 01: Development
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Giddens: Concepts for Nursing Practice, 4TH Edition
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MULTIPLE CHOICE j
1. The nurse manager of a pediatric clinic could confirm that the new nurse recognized thepurp
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ose of the HEADSS Adolescent Risk Profile when the new nurse responds that it isused to ass
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ess for needs related to
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a. anticipatory guidance. j
b. low-risk adolescents. j
c. physical development. j
d. sexual development. j
ANS: A j
The HEADSS Adolescent Risk Profile is a psychosocial assessment screening tool which assess
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es home, education, activities, drugs, sex, and suicide for the purpose of identifying high-
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risk adolescents and the need for anticipatory guidance. It is used to identify high-risk,not low-
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risk, adolescents. Physical development is assessed with anthropometric data.
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Sexual development is assessed using physical examination.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
2. The nurse preparing a teaching plan for a preschooler knows that, according to Piaget, theexpe
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cted stage of development for a preschooler is
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a. concrete operational. j
b. formal operational. N j
c. preoperational.
d. sensorimotor.
ANS: C j
The expected stage of development for a preschooler (3–4 years old) is pre-
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operational. Concrete operational describes the thinking of a school-age child (7–
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11 years old). Formal operational describes the thinking of an individual after about 11 years of ag
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e. Sensorimotordescribes the earliest pattern of thinking from birth to 2 years old.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
3. The school nurse talking with a high school class about the difference between growth anddevel
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opment would best describe growth as j j j j j
a. processes by which early cells specialize. j j j j j
b. psychosocial and cognitive changes. j j j
c. qualitative changes associated with aging. j j j j
d. quantitative changes in size or weight.A j j j j j j
NS: D j
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, Growth is a quantitative change in which an increase in cell number and size results in an increas
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e in overall size or weight of the body or any of its parts. The processes by which early cells speci
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alize are referred to as differentiation. Psychosocial and cognitive changes are referred to as dev
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elopment. Qualitative changes associated with aging are referred to asmaturation.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
4. The most appropriate response of the nurse when a mother asks what the Denver II does isthat it
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a. can diagnose developmental disabilities. j j j
b. identifies a need for physical therapy. j j j j j
c. is a developmental screening tool.
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d. provides a framework for health teaching. j j j j j
ANS: C j
The Denver II is the most commonly used measure of developmental status used by healthcare
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professionals; it is a screening tool. Screening tools do not provide a diagnosis.Diagnosis requi j j j j j j j j j j j j j j
res a thorough neurodevelopment history and physical examination.
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Developmental delay, which is suggested by screening, is a symptom, not a diagnosis. Theneed j j j j j j j j j j j j j j j
for any therapy would be identified with a comprehensive evaluation, not a screeningtool. Som
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e providers use the Denver II as a framework for teaching about expected development, but this i
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s not the primary purpose of the tool.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
5. To plan early intervention anN
j d care for an infant with Down syndrome, the nurse considers know
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ledge of other physical development exemplars such as
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a. cerebral palsy. j
b. autism.
c. attention-deficit/hyperactivity disorder (ADHD). j j
d. failure to thrive. j j
ANS: D j
Failure to thrive is also a physical development exemplar. Cerebral palsy is an exemplar ofmoto
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r/developmental delay. Autism is an exemplar of social/emotional developmental delay. ADH j j j j j j j j j j
D is an exemplar of a cognitive disorder.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
6. To plan early intervention and care for a child with a developmental delay, the nurse wouldconsi
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der knowledge of the concepts most significantly impacted by development, including
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a. culture.
b. environment.
c. functional status. j
d. nutrition. j
ANS: C j
, Function is one of the concepts most significantly impacted by development. Others includesens
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ory-
perceptual, cognition, mobility, reproduction, and sexuality. Knowledge of these concepts can h
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elp the nurse anticipate areas that need to be addressed. Culture is a concept that is considered to si
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gnificantly affect development; the difference is the concepts that affect development are those t
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hat represent major influencing factors (causes); hence determination of development would be t
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he focus of preventive interventions. Environment is considered to significantly affect developm
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ent. Nutrition is considered to significantly affect development.
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OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
7. A mother complains to the nurse at the pediatric clinic that her 4-year-
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old child always talksto her toys and makes up stories. The mother wants her child to have a psych
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ological evaluation. The nurse‘s best initial response is to j j j j j j j j
a. refer the child to a psychologist immediately. j j j j j j
b. explain that playing make believe is normal at this age. j j j j j j j j j
c. complete a developmental screening using a validated tool. j j j j j j j
d. separate the child from the mother to get more information. j j j j j j j j j
ANS: B j
By the end of the fourth year, it is expected that a child will engage in fantasy, so this is normal at t
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his age. A referral to a psychologist would be premature based only on the complaint of the moth
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er. Completing a developmental screening would be very appropriatebut not the initial response
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. The nurse would certainly want to get more information, but separating the child from the moth
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er is not necessary at this time.
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OBJ: NCLEXClient NeedsNCategory: Health Promotion and Maintenance j j j j j j
8. A 17-year-
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old girl is hospitalized for appendicitis, and her mother asks the nurse why she isso needy and acti
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ng like a child. The best response of the nurse is that in the hospital, adolescents
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a. have separation anxiety. j j
b. rebel against rules. j j
c. regress because of stress. j j j
d. want to know everything. j j j
ANS: C j
Regression to an earlier stage of development is a common response to stress. Separation anxiety i
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s most common in infants and toddlers. Rebellion against hospital rules is usually not an issue if th
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e adolescent understands the rules and would not create childlike behaviors.An adolescent may w
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ant to ―know everything‖ with their logical thinking and deductive reasoning, but that would not e
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xplain why they would act like a child. j j j j j j j
OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance j j j j j j j
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