Chapter 01: Advanced Practice Nursing:
Doing What Has to Be Done-Radicals,
Renegades, and Rebels
MULTIPLE CHOICE
1. The school nurse talking with a high school class about the difference
between growth and development would best describe growth as
a. processes by which earl y cells specialize.
b. psychosocial and cognitive changes.
c. qualitative changes associated with aging.
d. quantitative changes in size or weight.
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 earl y cells specialize are
referred to asdifferentiation. Psychosocial and cognitive changes are
referred to as development. Qualitative changes associated with aging
are referred to as maturation.
REF: 2 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
2. The most appropriate response of the nurse when a mother asks what the
Denver II does is that it
a. can diagnose developmental disabilitie s.
b. identifies a need for physical therapy.
, c. is a developmental screening tool.
d. provides a framework for health teaching.
ANS: C
The Denver II is the most commonl y used measure of developmental
status used by health care 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 expe cted development, but
this is not the primary purpose of the tool.
REF: 4 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
3. To plan earl y intervention and care for an infant with Down syndrome, the
nurse considers knowledge of other phy sical development exemplars such
as
a. cerebral palsy.
b. failure to thrive.
c. fetal alcohol syndrome.
d. hydrocephal y.
ANS: D
Hydrocephal y is also a physical development exemplar. Cerebral palsy
is an exemplar of adaptive developmental delay. Failure to thriv e is an
exemplar of social/emotional developmental delay. Fetal alcohol
s yndrome is an exemplar of cognitive developmental delay.
, REF: 9 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
4. To plan earl y intervention and care for a child w ith a developmental
delay, the nurse would consider knowledge of the concepts most
significantl y impacted by development, including
a. culture.
b. environment.
c. functional status.
d. nutrition.
ANS: C
Function is one of the concepts most significantl y impacte d by
development. Others include sensory-perceptual, cognition, mobilit y,
reproduction, and sexualit y. Knowledge of these concepts can help the
nurse anticipate areas that need to be addressed. Culture is a concept
that is considered to significantl y affec t development; the difference is
the concepts that affect development are those that represent major
influencing factors (causes), hence determination of development and
would be the focus of preventive interventions. Environment is
considered to significa ntl y affect development. Nutrition is considered
to significantl y affect development.
REF: 1 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
5. The nurse manager of a pediatric clinic could confirm that the new nurse
recognized the purpose of the HEADSS Adolescent Risk Profile when the
new nurse responds that it is used to assess for needs related to
a. anticipatory guidance.
b. low-risk adolescents.
c. physical development.
, d. sexual development.
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment
screening tool which assesses home, education, activities, drugs, sex,
and suicide for the purpose of identifying high -risk adolescents and the
need for anticipatory guid ance. It is used to identify high -risk, not low -
risk, adolescents. Physical development is assessed with
anthropometric data. Sexual development is assessed using physical
examination.
REF: 6 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
6. The nurse preparing a teaching plan for a preschooler knows that,
according to Piaget, the expected stage of development for a preschooler
is
a. concrete operational.
b. formal operational.
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old)
is preoperational. Concrete operational describes the thinking of a
school-age child (7 to 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.
REF: 5 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
Doing What Has to Be Done-Radicals,
Renegades, and Rebels
MULTIPLE CHOICE
1. The school nurse talking with a high school class about the difference
between growth and development would best describe growth as
a. processes by which earl y cells specialize.
b. psychosocial and cognitive changes.
c. qualitative changes associated with aging.
d. quantitative changes in size or weight.
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 earl y cells specialize are
referred to asdifferentiation. Psychosocial and cognitive changes are
referred to as development. Qualitative changes associated with aging
are referred to as maturation.
REF: 2 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
2. The most appropriate response of the nurse when a mother asks what the
Denver II does is that it
a. can diagnose developmental disabilitie s.
b. identifies a need for physical therapy.
, c. is a developmental screening tool.
d. provides a framework for health teaching.
ANS: C
The Denver II is the most commonl y used measure of developmental
status used by health care 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 expe cted development, but
this is not the primary purpose of the tool.
REF: 4 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
3. To plan earl y intervention and care for an infant with Down syndrome, the
nurse considers knowledge of other phy sical development exemplars such
as
a. cerebral palsy.
b. failure to thrive.
c. fetal alcohol syndrome.
d. hydrocephal y.
ANS: D
Hydrocephal y is also a physical development exemplar. Cerebral palsy
is an exemplar of adaptive developmental delay. Failure to thriv e is an
exemplar of social/emotional developmental delay. Fetal alcohol
s yndrome is an exemplar of cognitive developmental delay.
, REF: 9 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
4. To plan earl y intervention and care for a child w ith a developmental
delay, the nurse would consider knowledge of the concepts most
significantl y impacted by development, including
a. culture.
b. environment.
c. functional status.
d. nutrition.
ANS: C
Function is one of the concepts most significantl y impacte d by
development. Others include sensory-perceptual, cognition, mobilit y,
reproduction, and sexualit y. Knowledge of these concepts can help the
nurse anticipate areas that need to be addressed. Culture is a concept
that is considered to significantl y affec t development; the difference is
the concepts that affect development are those that represent major
influencing factors (causes), hence determination of development and
would be the focus of preventive interventions. Environment is
considered to significa ntl y affect development. Nutrition is considered
to significantl y affect development.
REF: 1 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
5. The nurse manager of a pediatric clinic could confirm that the new nurse
recognized the purpose of the HEADSS Adolescent Risk Profile when the
new nurse responds that it is used to assess for needs related to
a. anticipatory guidance.
b. low-risk adolescents.
c. physical development.
, d. sexual development.
ANS: A
The HEADSS Adolescent Risk Profile is a psychosocial assessment
screening tool which assesses home, education, activities, drugs, sex,
and suicide for the purpose of identifying high -risk adolescents and the
need for anticipatory guid ance. It is used to identify high -risk, not low -
risk, adolescents. Physical development is assessed with
anthropometric data. Sexual development is assessed using physical
examination.
REF: 6 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
6. The nurse preparing a teaching plan for a preschooler knows that,
according to Piaget, the expected stage of development for a preschooler
is
a. concrete operational.
b. formal operational.
c. preoperational.
d. sensorimotor.
ANS: C
The expected stage of development for a preschooler (3 to 4 years old)
is preoperational. Concrete operational describes the thinking of a
school-age child (7 to 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.
REF: 5 OBJ: NC LEX Client Needs Category: Health Promotion
and Maintenance
