CHAPTER 17: Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford

Fundamentals of Nursing, 2nd Edition – Active Learning for Collaborative Practice by Yoost & Crawford Chapter 17: Human Development Conception Through Adolescence Multiple Choice Questions 1. When explaining the difference between growth and development to a parent, which statement by the nurse is most accurate? A. "Growth is physical while development relates to physical, emotional, and cognitive function." B. "There is no difference between the two since they occur simultaneously." C. "Development refers to musculoskeletal and nervous system abilities and growth is a change in height and weight." D. "Both refer to an increase in abilities and functions of the child that occur sequentially over time." Answer: A Explanation: Growth specifically refers to measurable physical changes like height/weight, while development encompasses broader functional improvements across physical, emotional, and cognitive domains. Why Other Options Are Wrong: B incorrectly equates distinct concepts. C oversimplifies development to specific systems. D is too vague to distinguish between the terms. 2. A patient questioning safer sexual practices states they believe in waiting until marriage due to moral concerns. Which Freudian component does this reflect? A. Id B. Ego C. Superego D. Anal Answer: C Explanation: The superego represents moral conscience, governing ethical decision-making like delaying sexual activity for marriage. Why Other Options Are Wrong: A drives instinctual urges. B mediates reality. D is a developmental phase unrelated to morality. 3. Parents express concern about their 4-year-old's masturbation. Which Freudian stage explains this behavior? A. Oral B. Phallic C. Anal D. Latency Answer: B Explanation: The phallic stage (3-6 years) involves genital focus and self-stimulation as normal exploration. Why Other Options Are Wrong: A involves oral fixation (infancy). C relates to toilet training. D represses sexual interest (6 years-puberty). 4. What guidance should a nurse provide to help an infant master Erikson's trust vs. mistrust stage? A. Consistently provide your child with food and attention. B. Ensure someone is able to feed your child on a schedule. C. Allow unrestricted crawling and exploring as the child develops. D. Provide firm guidelines for behavior and activities. Answer: A Explanation: Consistent caregiving builds foundational trust, while unmet needs foster mistrust. Why Other Options Are Wrong: B lacks personal consistency. C relates to autonomy (toddler stage). D applies to later discipline. 5. How should a nurse respond to a patient trying to conceive who drinks alcohol but plans to stop when pregnant? A. "Abstaining is best since most fetal development occurs before you realize you are pregnant." B. "Small amounts of alcohol are safe at any time during pregnancy." C. "Things will be okay if you quit drinking alcohol once you know you are pregnant." D. "Alcohol use should be avoided early in pregnancy but is acceptable past week 20." Answer: A Explanation: Critical organogenesis occurs in early pregnancy, often before pregnancy recognition, making preconception abstinence safest. Why Other Options Are Wrong: B and C underestimate fetal risks. D incorrectly suggests late pregnancy safety. 6. Before teaching child-rearing practices to a culturally unfamiliar patient, what should the nurse do first? A. Ensure the availability of written material to give the woman. B. Assess what practices are important to her cultural group. C. Determine if the woman is the primary family decision maker. D. Refer the woman to a prenatal educational class. Answer: B Explanation: Cultural competence requires understanding the patient's values before providing education to ensure relevance. Why Other Options Are Wrong: A assumes literacy/preference for written materials. C and D are secondary to cultural assessment. 7. During a well-baby visit, which finding requires immediate nursing intervention? A. Mother states she does not breastfeed but uses a recommended formula. B. Crib has colorful blankets and pillows for the baby to cuddle. C. A mobile is hanging well above the crib playing soft music. D. Several rattles and plush toys are available in different textures. Answer: B Explanation: Loose bedding increases suffocation risk and violates safe sleep guidelines. Why Other Options Are Wrong: A, C, and D are appropriate infant care practices. 8. To support trust development in a hospitalized infant, which nursing action is most effective? A. Provide calming music during quiet time so the infant can sleep. B. Give the family food vouchers for the hospital cafeteria. C. Arrange to have a cot or small bed placed in the infant's room. D. Do not allow unlicensed assistive personnel to care for the infant. Answer: C Explanation: Parental presence provides consistency, which is critical for trust development per Erikson. Why Other Options Are Wrong: A addresses sleep, not trust. B supports parents but not infant directly. D limits care continuity. 9. A nurse observes a parent serving a 3-year-old 1/2 cup of pureed meat. What action is priority? A. Document how well the child eats the serving of meat. B. Inquire if the child still drinks from a bottle between meals. C. Ask the parents what they serve the child for snacks. D. Provide teaching on the appropriate serving size for this child. Answer: D Explanation: Serving sizes should be 1 tablespoon per year of age (3 tbsp for this child); education prevents overfeeding. Why Other Options Are Wrong: A, B, and C are relevant but secondary to correcting portion size. 10. A preschooler blames eaten cookies on an imaginary horse. How should the nurse guide parents? A. "It is normal for children to have imaginary friends at this age." B. "This vivid imagination will lead the child to misbehave later on." C. "Lying is disobedient and should be punished consistently." D. "The child is obviously afraid of the parents' response." Answer: A Explanation: Imaginary companions are developmentally normal for preschoolers and help process experiences. Why Other Options Are Wrong: B pathologizes normal behavior. C misinterprets fantasy as deceit. D assumes unfounded fear. 11. A potty-trained toddler regresses to bedwetting during hospitalization. What nurse response is best? A. "Don't worry, this behavior will stop when he gets home." B. "Maybe he has a urinary tract infection; I'll get a urine sample." C. "I can call the Child Life Specialist for diversionary activities." D. "It is common for kids in the hospital to regress to earlier behaviors." Answer: D Explanation: Stress-induced regression is typical and reassures parents it's temporary without dismissing concerns. Why Other Options Are Wrong: A minimizes valid worry. B assumes pathology prematurely. C doesn't address the core issue. 12. During a newborn home visit, which observation requires nursing education? A. The caregiver warms the bottle and tests heat on the inside of the wrist. B. The parents state the infant is sleeping with them until they buy a crib. C. One parent states that when the child gets frustrating, the other parent takes over. D. Caregivers consistently wash their hands before holding the baby. Answer: B Explanation: Co-sleeping increases SIDS risk; infants need separate, safe sleep surfaces. Why Other Options Are Wrong: A, C, and D demonstrate appropriate newborn care. 13. Parents worry their 4-year-old wears the same clothing size as last year. What should the nurse do? A. Weigh and measure the child and compare with last visit. B. Reassure parents that their child is growing normally. C. Assess the child's eating and activity patterns. D. Encourage the parents to provide the child a multivitamin. Answer: A Explanation: Objective growth measurements (typically 5 lb/year) validate normal development better than reassurance alone. Why Other Options Are Wrong: B dismisses concerns without data. C and D are premature without growth assessment. 14. During a preschool screening, which child requires referral for further assessment? A. A 4-year-old who throws a ball over-handed but better under-handed. B. A 4-year-old who can skip across the room after being shown how. C. A 5-year-old who is able to ride a bicycle with training wheels. D. A 5-year-old who is unable to ride a tricycle without falling. Answer: D Explanation: Tricycle riding is expected by age 3; inability at age 5 suggests gross motor delay. Why Other Options Are Wrong: A, B, and C demonstrate age-appropriate skills. 15. A father complains his school-aged child is "sick all the time." How should the nurse respond? A. Encourage the father to give the child a multivitamin each day. B. Explain that illness is frequent in this age-group because of exposure to others. C. Encourage the father to discuss testing the child's immunity with the provider. D. Make sure the parents are washing their hands frequently in the home. Answer: B Explanation: Increased peer exposure in school-age children predictably raises minor illness frequency. Why Other Options Are Wrong: A and C overmedicalize normal development. D implies blame without evidence. 16. A school-aged child is nervous about a minor procedure. What nursing approach is best? A. Reassure the child the procedure is too minor to worry about. B. Read the child a pamphlet about what to expect during the procedure. C. Tell the child you will have the provider "put her to sleep" during the procedure. D. Explain the procedure and what to expect in simple terms. Answer: D Explanation: Concrete, age-appropriate explanations reduce anxiety by demystifying the experience. Why Other Options Are Wrong: A invalidates fears. B may be too complex. C uses frightening terminology. 17. An adolescent female grew 0.5" in 2 years post-menarche with no weight gain. What action is priority? A. Ask the teen to provide a 24-hour diet recall. B. Talk to the teen about healthy dietary practices. C. Reassure the teen she will have a growth spurt soon. D. Collaborate with the provider for endocrine testing. Answer: B Explanation: Most growth concludes within 2 years post-menarche; nutrition education addresses potential disordered eating. Why Other Options Are Wrong: A is too limited. C is inaccurate. D is unwarranted without further assessment. 18. Parents worry their 16-year-old withdraws to their room, avoiding formerly enjoyed family activities. What should the nurse do? A. Reassure the parent the teen is exerting independence. B. Ask the parent about the teen's friends and activities. C. Assess the teen for depression and possible suicide risk. D. Refer the family to the community depression support group. Answer: C Explanation: Withdrawal plus anhedonia (loss of interest in activities) warrants depression screening per DSM-5 criteria. Why Other Options Are Wrong: A ignores red flags. B gathers collateral data but doesn't assess the teen directly. D is premature. 19. A 4-month-old infant doesn't track moving objects with her eyes. What is the nurse's next step? A. Document the findings and continue the assessment. B. Refer the child and parent to a pediatric neurologist. C. Assess the child for other age-appropriate behaviors. D. Assess the child for signs of child abuse or neglect. Answer: C Explanation: Isolated delays require full developmental screening before escalation; tracking typically begins by 3 months. Why Other Options Are Wrong: A delays needed follow-up. B and D are unjustified without broader assessment. 20. A parent becomes frustrated when their toddler repeatedly throws a rattle from the high chair. How should the nurse respond? A. Teach the parent about age-appropriate discipline. B. Educate the parent on age-appropriate behaviors. C. Tell the parent to stop giving the rattle back to the child. D. Assess the child for signs of abuse or neglect. Answer: B Explanation: Object-throwing is normal toddler experimentation with cause-effect; education prevents misinterpretation as defiance. Why Other Options Are Wrong: A is unnecessary for normative behavior. C ignores learning opportunity. D is unjustified. Multiple Response Questions 21. Which activities help develop seriation skills in Piaget's concrete operational stage? (Select all that apply.) A. Separating toy horses by their functions. B. Exploring a space museum together. C. Making a scrapbook of leaves sorted by color. D. Using common objects for unconventional purposes. E. Describing an event from multiple perspectives. Answer: A, C Explanation: Seriation involves sorting by attributes (A, C), key to concrete operational thought (ages 7-11). Why Other Options Are Wrong: B lacks categorization. D and E are formal operational tasks (adolescence+). 22. Which milestones should a 12-month-old achieve? (Select all that apply.) A. Attempting to walk with help. B. Transferring objects between hands. C. Holding a bottle independently while rolling. D. Searching for hidden objects. E. Sitting unassisted from lying position. Answer: A, D, E Explanation: 12-month milestones include assisted walking (A), object permanence (D), and independent sitting (E). Why Other Options Are Wrong: B and C are 7-month and 4-6 month skills, respectively. 23. What risks should parents be taught about excessive social media use in school-aged children? (Select all that apply.) A. Increased bullying. B. Decreased physical activity. C. Impaired spatial reasoning. D. Weight loss and malnutrition. E. Increased aggressiveness. Answer: A, B, E Explanation: Social media correlates with cyberbullying (A), sedentary behavior (B), and aggression from violent content (E). Why Other Options Are Wrong: C is unrelated. D contradicts obesity risks from inactivity. 24. Which topics are priority for a high school junior health education session? (Select all that apply.) A. Drunk driving consequences. B. Depression/suicide screening. C. HIV prevention education. D. Puberty changes review. E. Bicycle helmet fittings. Answer: A, B, C, D Explanation: Adolescents need risk behavior education (A, C), mental health support (B), and puberty reinforcement (D). Why Other Options Are Wrong: E is developmentally inappropriate for teens. 25. What conditions does quad screening assess during pregnancy? (Select all that apply.) A. Blood clotting abnormalities. B. Neural tube defects. C. Heart abnormalities. D. Trisomy 18. E. Trisomy 21. Answer: B, D, E Explanation: Quad screening detects neural tube defects (B), Edwards syndrome (D), and Down syndrome (E). Why Other Options Are Wrong: A and C require other diagnostic tests.