NR605 Week 8 Questions and Answers
1. Psychotherapy with older adults considerations: -higher prevalence of de-
mentia
•raises need for neuropsychological screening
-higher prevalence of medical disorders
• req careful consideration of physical causes of symptoms & effects of meds
2. Child Development:: -Physical Development
• by three months, infants can lift their heads and clasp their hands
• by six months, they may roll over, sit with support, and reach for objects and transfer
them from hand to hand
• by one year, infants can stand and start to take steps
• by one year, birth weight triples and height increases by 50%
-Cognitive and Language Development
• by two months, infants start to coo
• by six months, infants begin to babble
• by nine months, infants imitate sounds and know their name
• by one year, infants begin to say words and can follow one-step commands
-Psychosocial Development
• by four months, infants socially smile
• by six months, infants enjoy their reflection in a mirror.
• by nine months, infants enjoy peekaboo and often develop stranger anxiety
-Health History
• obtain information from the parent or caregiver observation and report of infant
behavior and activity
-Physical Exam
• perform as much of the exam with the infant in parent or caregiver's lap as possible
• keep familiar toys or blankets with infant
• feed hungry infants before examining them
• use a toy or object or play for distraction
-Health Promotion
• administer immunizations per the recommended schedule
• newborn screens: genetic and metabolic screening; hearing screen, screen for
congenital heart disease; bilirubin screening
• anticipatory guidance: illness prevention; anticipated growth and development; and
when to call for advice
3. Child Development: Toddler (1 to 4 years): -Physical Development
• after age 2, growth is about 5 centimeters (cm) and gain about 2-3 kilograms (kg)
per year
• gross motor skills develop from walking to running, jumping, climbing, and riding a
, NR605 Week 8 Questions and Answers
tricycle
• fine motor skills develop from beginning to feed self, to scribbling, to drawing a
person and writing letters
-Cognitive and Language Development
• by two years, toddlers can speak in two to three-word sentences and have a
vocabulary of up to 300 words
• by four years, preschoolers form complex sentences
-Psychosocial Development
• toddlers develop from pretend play, to parallel play, to actual play
• toddlers have a desire for independence
• toddlers are impulsive with poor self-regulation and may have temper tantrums
-Health History
• obtain information from the parent or caregiver observation and report of toddler
behavior and activity
• during the health history assessment, the nurse practitioner (NP) can establish
rapport with the child and parent or caregiver
-Physical Exam
• toddlers may be alarmed at the examiner and may be uncooperative
• engage children in age-appropriate conversation to gain trust
• complete most of the exam with the child in the parent or caregiver's lap
• when examining siblings during the same appointment, approach the oldest child
first because they may be more cooperative
• conduct the exam with the least distressing procedures (i.e., eyes and neck) to the
most distressing procedures (i.e., throat and ears)
• utilize patience, distraction, and play
-Health Promotion
• administer immunizations per the recommended schedule
• injury and illness prevention: use of car seats, tobacco exposure, supervision
• nutrition and exercise: obesity assessment, healthy meals, and snacks
• oral health: teeth brushing and dental visits
• screening tests: vision starting at age 3; hearing starting at age 4; hematocrit and
lead (if high risk)
4. Child Development: Children (5 to 10 years): -Physical Development
• develops enhanced strength and coordination
• growth is steady but slower
-Cognitive Development
• become more "concrete operational" and are capable of limited logic and more
complex learning
• focus on the present and achievement of knowledge and skills
, NR605 Week 8 Questions and Answers
-Psychosocial Development
• desire to "fit in" evolving self-identity and self-esteem
• development of belief in their ability to thrive in different situations
-Health History
• obtain information from both the child and the parent or caregiver
• during the health history assessment, the NP can establish rapport with the child
and parent or caregiver
• engage in conversation by discussing what interests them, such as favorite toys,
books, or television shows
-Physical Exam
• parents or caregivers of children younger than 11 should stay in the room
-Health Promotion
• administer immunizations per the recommended schedule
• discuss experience at school, with peers, and social activities
• healthy habits: nutrition, exercise, reading, sleep, screen time5
5. Child Development: Adolescents (11 years to adult): -Physical Development
• age of onset and duration of puberty vary widely; however, the stages follow the
same sequence
• puberty typically occurs for girls around age 10 through 14 years
• puberty typically occurs for boys around age 11 through 16 years
-Cognitive Development
• progress from concrete to formal operational thinking
• can reason logically and abstractly to consider the future implications of actions
-Psychosocial Development
• the transition from primarily family influences to more autonomy and influence by
friends
• challenges related to identity, independence, and intimacy
• establishing a supportive and nonjudgmental relationship may all lesbian, gay,
bisexual, transgender, or queer youths to openly discuss sexual identity and/or
concerns
-Health History
• utilize a comfortable and confidential environment
• informally discuss friends, school, and activities using specific questions to build
trust and rapport, then transition to more open-ended questions
• a valuable technique to elicit questions about important or sensitive topics is to say,
"other kids your age often have questions about..."
• use the mnemonic HEADSSS to recall parts of a psychosocial assessment:
# Home environment
# Education, employment, eating
1. Psychotherapy with older adults considerations: -higher prevalence of de-
mentia
•raises need for neuropsychological screening
-higher prevalence of medical disorders
• req careful consideration of physical causes of symptoms & effects of meds
2. Child Development:: -Physical Development
• by three months, infants can lift their heads and clasp their hands
• by six months, they may roll over, sit with support, and reach for objects and transfer
them from hand to hand
• by one year, infants can stand and start to take steps
• by one year, birth weight triples and height increases by 50%
-Cognitive and Language Development
• by two months, infants start to coo
• by six months, infants begin to babble
• by nine months, infants imitate sounds and know their name
• by one year, infants begin to say words and can follow one-step commands
-Psychosocial Development
• by four months, infants socially smile
• by six months, infants enjoy their reflection in a mirror.
• by nine months, infants enjoy peekaboo and often develop stranger anxiety
-Health History
• obtain information from the parent or caregiver observation and report of infant
behavior and activity
-Physical Exam
• perform as much of the exam with the infant in parent or caregiver's lap as possible
• keep familiar toys or blankets with infant
• feed hungry infants before examining them
• use a toy or object or play for distraction
-Health Promotion
• administer immunizations per the recommended schedule
• newborn screens: genetic and metabolic screening; hearing screen, screen for
congenital heart disease; bilirubin screening
• anticipatory guidance: illness prevention; anticipated growth and development; and
when to call for advice
3. Child Development: Toddler (1 to 4 years): -Physical Development
• after age 2, growth is about 5 centimeters (cm) and gain about 2-3 kilograms (kg)
per year
• gross motor skills develop from walking to running, jumping, climbing, and riding a
, NR605 Week 8 Questions and Answers
tricycle
• fine motor skills develop from beginning to feed self, to scribbling, to drawing a
person and writing letters
-Cognitive and Language Development
• by two years, toddlers can speak in two to three-word sentences and have a
vocabulary of up to 300 words
• by four years, preschoolers form complex sentences
-Psychosocial Development
• toddlers develop from pretend play, to parallel play, to actual play
• toddlers have a desire for independence
• toddlers are impulsive with poor self-regulation and may have temper tantrums
-Health History
• obtain information from the parent or caregiver observation and report of toddler
behavior and activity
• during the health history assessment, the nurse practitioner (NP) can establish
rapport with the child and parent or caregiver
-Physical Exam
• toddlers may be alarmed at the examiner and may be uncooperative
• engage children in age-appropriate conversation to gain trust
• complete most of the exam with the child in the parent or caregiver's lap
• when examining siblings during the same appointment, approach the oldest child
first because they may be more cooperative
• conduct the exam with the least distressing procedures (i.e., eyes and neck) to the
most distressing procedures (i.e., throat and ears)
• utilize patience, distraction, and play
-Health Promotion
• administer immunizations per the recommended schedule
• injury and illness prevention: use of car seats, tobacco exposure, supervision
• nutrition and exercise: obesity assessment, healthy meals, and snacks
• oral health: teeth brushing and dental visits
• screening tests: vision starting at age 3; hearing starting at age 4; hematocrit and
lead (if high risk)
4. Child Development: Children (5 to 10 years): -Physical Development
• develops enhanced strength and coordination
• growth is steady but slower
-Cognitive Development
• become more "concrete operational" and are capable of limited logic and more
complex learning
• focus on the present and achievement of knowledge and skills
, NR605 Week 8 Questions and Answers
-Psychosocial Development
• desire to "fit in" evolving self-identity and self-esteem
• development of belief in their ability to thrive in different situations
-Health History
• obtain information from both the child and the parent or caregiver
• during the health history assessment, the NP can establish rapport with the child
and parent or caregiver
• engage in conversation by discussing what interests them, such as favorite toys,
books, or television shows
-Physical Exam
• parents or caregivers of children younger than 11 should stay in the room
-Health Promotion
• administer immunizations per the recommended schedule
• discuss experience at school, with peers, and social activities
• healthy habits: nutrition, exercise, reading, sleep, screen time5
5. Child Development: Adolescents (11 years to adult): -Physical Development
• age of onset and duration of puberty vary widely; however, the stages follow the
same sequence
• puberty typically occurs for girls around age 10 through 14 years
• puberty typically occurs for boys around age 11 through 16 years
-Cognitive Development
• progress from concrete to formal operational thinking
• can reason logically and abstractly to consider the future implications of actions
-Psychosocial Development
• the transition from primarily family influences to more autonomy and influence by
friends
• challenges related to identity, independence, and intimacy
• establishing a supportive and nonjudgmental relationship may all lesbian, gay,
bisexual, transgender, or queer youths to openly discuss sexual identity and/or
concerns
-Health History
• utilize a comfortable and confidential environment
• informally discuss friends, school, and activities using specific questions to build
trust and rapport, then transition to more open-ended questions
• a valuable technique to elicit questions about important or sensitive topics is to say,
"other kids your age often have questions about..."
• use the mnemonic HEADSSS to recall parts of a psychosocial assessment:
# Home environment
# Education, employment, eating
