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Basic Nursing Concepts Skills And

Reasoning 1st Edition Treas Test Bank


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Treas Fundamentals TTB09-1
Test Bank

Chapter 9. Development: Infancy Through Middle Age

Multiple Choice

Identify the choice that best completes the statement or answers the question.

____ 1. The nurse is providing prenatal counseling for a couple who is trying to
become pregnant. The priority for the nurse is to include which of the following pieces of
information?
1)
Stages of growth and development of the fetus
2)
Recommended schedule of visits to her healthcare provider
3)
Recommended average weight gain during pregnancy
4)
Healthy eating habits before and during pregnancy

ANS: 4
Maternal nutrition is vital to the healthy growth of the fetus. Poor maternal nutrition leads
to an undergrown placenta. A small, poorly functioning placenta and smaller than normal
umbilical cord are the causes for small-for-gestational age (otherwise known as small-
for-dates) babies. The other options are all things the prospective mother needs to know,
but they would not have an immediate impact on fetal health.

PTS: 1 DIF: Moderate REF: p. 166


KEY: Nursing process: Planning | Client need: HPM | Cognitive level: Analysis

____ 2. Which of the following would indicate a 4-year-old child has successfully
gone through Erikson’s Stage 3 (Initiative Versus Guilt)? The child
1)
Refrains from hitting a friend
2)
Plays cooperatively with friends
3)
Is able to develop friendships
4)
Is able to express his feelings

ANS: 1
Stage 3 is Initiative Versus Guilt, in which the child becomes responsible for his behavior,
develops self-discipline, and is able to manage his impulses. Cooperation and expressing
feelings are tasks for Stage 2. Children develop friendships during the preschool age.
Treas Fundamentals TTB09-2
Test Bank
PTS: 1 DIF: Moderate REF: pp. 163-164
KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 3. The nurse is preparing to assess a toddler. To make the assessment go


smoothly, before examining the child the nurse should first
1)
Talk to the mother before talking to the child
2)
Ask the child about his favorite toy
3)
Get the child’s height and weight
4)
Ask the mother to undress the child

ANS: 2
Toddlers have a fear of strangers, so it would be important to establish rapport before
examining the child. Although talking to the mother before the child prior to a physical
assessment does not lead to distrust, the action simply does not contribute to building a
rapport with the child. Undressing the child before a trusting relationship is established
often creates anxiety in the child, leading to uncooperativeness, fear, or withdrawal.
Obtaining the child’s height and weight would not help the child feel secure.

PTS: 1 DIF: Moderate REF: p. 175


KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Application

____ 4. According to Erikson, a behavior demonstrating an important


psychosocial task for a toddler would be for the child to
1)
Act defiantly by refusing to hold her mother’s hand while crossing the street
2)
Recognize that it is wrong to take a toy away from someone else
3)
Be able to understand the concept of time in hours
4)
Express to his parents and playmates that he does not like something

ANS: 1
The primary task during Erikson’s stage 2, Autonomy Versus Shame and Doubt, is
establishing an identity as separate from the parent/caregiver. A child between 18 months
and 3 years typically tests the boundaries as part of exercising his will to control his
environment. “No” is a declaration of independence and a bid for increased autonomy.
Acts of independence and autonomy (e.g., refusing to hold her mother’s hand) are normal
Treas Fundamentals TTB09-3
Test Bank
during this developmental stage. The toddler should be able to tolerate time away from
her parents, delay gratification, and have elimination control. The other tasks are
accomplished during the preschool stage.

PTS: 1 DIF: Moderate REF: p. 163


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

____ 5. A mother comes to the clinic with her infant for a newborn checkup at 1
week of age. The mother tells the nurse, “My baby looks yellow to me.” The nurse’s best
response is which of the following?
1)
“What type of detergent are you using to wash the baby clothes?”
2)
“Is there a possibility you had hepatitis during your pregnancy?”
3)
“The color is from the breakdown of maternal red blood cells.”
4)
“There is a cream you can use to reduce the yellowing.”

ANS: 3
Jaundice results from the breakdown of the maternal red blood cells that are in the baby’s
system after birth, which elevates the bilirubin in the serum. If detergent caused a
reaction, the reaction would commonly present as a rash. Although hepatitis B virus may
pass through the placenta to the fetus, the infant does not typically show signs at 1 week
of life. If treatment becomes necessary, the infant would receive phototherapy; there is no
cream to reduce the yellow appearance related to newborn jaundice.

PTS: 1 DIF: Moderate REF: p. 170


KEY: Nursing process: Implementation | Client need: PHSI | Cognitive level:
Application

____ 6. A father brings his toddler to the clinic for well-child care. Which of the
following would be most important for the nurse to assess?
1)
How successful the child is with potty training
2)
How the child acts when you enter the room
3)
Whether the child is using eating utensils
4)
Whether the home is child-proofed
Treas Fundamentals TTB09-4
Test Bank
ANS: 4
Although all of these areas address important developmental tasks during the toddler
period, safety is the highest priority at this age because the child has increased dexterity,
mobility, and determination and is becoming more independent. Potty training is
typically accomplished between 18 months and 3 years of age but is not a safety concern.
It would be normal for a child at this age to be afraid of strangers. The child should be
using utensils for most foods, but again it is not a safety concern.

PTS: 1 DIF: Moderate REF: pp. 174-175


KEY: Nursing process: Assessment | Client need: SECE | Cognitive level: Analysis

____ 7. Which comment made by a woman in her early 50s would be a cue
indicating the need for further assessment for a problem?
1)
“My skin is so dry I need to use lotion every day after I bathe.”
2)
“I have episodes when I feel really hot even when others are not.”
3)
“It’s getting harder to lift those big bags of dog food.”
4)
“I have to write myself notes because I’m getting so forgetful.”

ANS: 4
Memory in middle adulthood should remain intact. There is a normal decrease in skin
moisture and muscle tone in middle adulthood. The perimenopausal period occurs during
this time, hallmarked by hot flashes and night sweats.

PTS: 1 DIF: Moderate REF: pp. 189-191


KEY: Nursing process: Diagnosis | Client need: PHSI | Cognitive level: Analysis

____ 8. The nurse has instructed a group of parents on common adolescent


behavior. Which comment by the parent would indicate the most urgent need for further
discussion?
1)
“I guess my daughter won’t be asking my opinion very much.”
2)
“I’m really going to watch my daughter’s eating habits.”
3)
“We are really going to have to think about rules we want to enforce after he gets his
driver’s license.”
4)
Treas Fundamentals TTB09-5
Test Bank
“We don’t keep alcohol in the house, so that’s at least one thing we don’t need to worry
about.”

ANS: 4
Concerns about alcohol intake during adolescence is highest priority, regardless of
whether or not it is stored in the home. Alcohol-related injury and death are a risk that
should be avoided in every circumstance. Not having alcohol in the house does not
guarantee the teenager won’t consume it with his friends. During the teen years, the
relationships among peers strengthen and strongly influence adolescent behavior.
Although the parents typically still maintain influence on the core values in the home,
teens seek peers’ opinions for matters about social life or concerns of everyday living. As
teens are developmentally concerned with appearance and social relationships, there can
be an overemphasis on body image, leading to obesity, as well as eating disorders. Motor
vehicle accidents are the leading cause of death for teenagers, typically due to
distractibility, inattention, impulsiveness, and inexperience in various driving situations.

PTS: 1 DIF: Moderate REF: p. 183


KEY: Nursing process: Evaluation | Client need: SECE | Cognitive level: Analysis

____ 9. Which of the following would be the priority for most adolescents? Being
1)
A good student
2)
Sexually active
3)
Picked to be on the soccer team
4)
Able to function independently

ANS: 3
The developmental task during adolescence is to establish personal identity. Socially,
preteens and teens are driven by a need to belong to a group. School-age children need to
receive positive reinforcement for accomplishments and desired behavior, such as being
good students. Although a small number of preadolescents are sexually active, it is not
the major focus for this age. Functioning independently is a task for the young adult.

PTS: 1 DIF: Moderate REF: p. 182


KEY: Nursing process: Diagnosis | Client need: HPM | Cognitive level: Analysis

____ 10. During adolescence, it would be most important to encourage the teen to
eat plenty of
1)
Treas Fundamentals TTB09-6
Test Bank
Grains
2)
Dairy products
3)
Vegetables
4)
Fruit

ANS: 2
Both males and females experience a growth spurt during adolescence. Although the
child’s diet should include adequate amounts of all the food groups, peak bone mass is
attained during this stage, so the child needs to consume adequate calcium, vitamin D,
iron, and protein. These nutrients are found in dairy products.

PTS: 1 DIF: Easy REF: pp. 181-182


KEY: Nursing process: Implementation | Client need: HPM | Cognitive level:
Application

____ 11. According to Erikson, which of the following must a middle-aged adult do
to be prepared for the final stages of life?
1)
Accept the fact that she is getting older.
2)
Reconcile that death is a part of life.
3)
Feel she has made a contribution to society.
4)
Have had a meaningful and intimate relationship.

ANS: 3
Generativity Versus Stagnation is the stage Erikson describes for the middle adult.
During this stage, a mature adult either continues to gain skills, be productive, and pass
on his or her knowledge to the next generation or stagnates. During the middle years,
many adults are realistic and insightful about age-related physical and emotional changes.
Others experience difficulty coping with passing youth and advancing age. Accepting
death as a part of the continuum of life is a task for the older adult. Developing
meaningful relationships is a task most influential for the young adult.

PTS: 1 DIF: Moderate REF: p. 190


KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Recall
Treas Fundamentals TTB09-7
Test Bank
____ 12. The nurse teaches a mother of a preschool-age child about expected
development. Which comment by the parent indicates that she understands the
information?
1)
“She understands the monsters in books are not real.”
2)
“When I mention that her birthday is in a week, she understands.”
3)
“I am saving to buy her the roller skates she’s been asking for.”
4)
“I can’t expect her to understand when a friend doesn’t agree with her.”

ANS: 3
Preschoolers’ hand-eye coordination develops markedly during this period. They can hop
on one foot, skip, and begin to learn to skate. The imagination of a preschool-age child is
typically active, whereby they have fears of mythical figures, such as monsters. They
have a limited ability to understand the concept of time or to tell time. A preschooler has
the ability to consider simple viewpoints of other people.

PTS: 1 DIF: Moderate REF: p. 176


KEY: Nursing process: Evaluation | Client need: HPM | Cognitive level: Application

____ 13. A mother has brought her 8-month-old daughter to the healthcare clinic
for a well-child appointment and any needed immunizations. To assess the child’s
physical development with age-appropriate norms, which of the following questions
should the nurse ask?
1)
“Is your child able to walk while holding onto furniture?”
2)
“Is your child able to crawl on her hands and knees?”
3)
“Is your child able to pick up food with her fingers?”
4)
“Is your child able to sit up without support?”

ANS: 4
At 7 months, most children can sit up by themselves. Cruising usually occurs around 8 to
12 months. At about 7 to 10 months, a child begins to crawl. Infants develop a pincer
grasp around 10 months.

PTS: 1 DIF: Moderate REF: p. 171


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application
Treas Fundamentals TTB09-8
Test Bank

____ 14. A mother comes to the healthcare clinic for a regular health examination
for her 5-year-old son prior to kindergarten admission. Which comment by the mother
would indicate the need for follow-up questions to the mother?
1)
“He’s not a good boy like my other son.”
2)
“I’ve had to treat him for lice a couple of times.”
3)
“He has an imaginary friend he calls Buddy.”
4)
“He’s so funny when he imitates his dad doing things.”

ANS: 1
Negative comments or comparisons with another child can be an indicator of or potential
for child abuse. The nurse needs to determine whether this is an actual problem. Head
lice are a common health problem for children of this age because of close physical
contact with play. The mother seems to have a healthy attitude about the infestations and
to be knowledgeable in the treatment. Imaginary play, magical thinking, and belief in
mythical figures are normal at age 5. A child this age will normally imitate the same-sex
parent.

PTS: 1 DIF: Difficult REF: p. 177


p. 82
KEY: Nursing process: Diagnosis | Client need: HPM | Cognitive level: Analysis

____ 15. Which behavior by the mother is most likely to help the infant to develop
trust?
1)
Talking to the infant
2)
Breastfeeding instead of bottle-feeding
3)
Promptly responding to the infant’s crying
4)
Having the infant sleep in the same room with the parent

ANS: 3
Because the infant is totally dependent on the parents, quickly responding to his cries
promotes attachment and trust. Although all options may promote attachment, they are
not absolutely necessary for bonding to occur. Mother-infant attachment is complex and
involves all senses—not simply hearing the mother talk to him. There are physical and
emotional benefits to breastfeeding, but it is not necessary for mother-infant attachment.
Treas Fundamentals TTB09-9
Test Bank
Sleeping in the same room may help the parent respond more quickly to the infant’s
needs but is not the basis for attachment.

PTS: 1 DIF: Moderate REF: p. 171


KEY: Nursing process: N/A | Client need: HPM | Cognitive level: Comprehension

____ 16. The nurse is talking to a class of children, ages 9 to 11 years. For this age
group, it would be most important for the nurse to discuss
1)
Safe sex practices
2)
Healthy food choices
3)
Use of seat belts and safety equipment
4)
The importance of getting enough sleep

ANS: 3
All are important topics to discuss with this age, but children of this age are very active,
and injuries are common. Motor vehicle accidents are the most common cause of injury.
They are just starting puberty, so sexual activity is still not usual. The discussion of
appropriate food choices and getting enough sleep should be done throughout the child’s
developmental stages; it is not peculiar to ages 10 to 12 years. The preteen years are
particularly important for adequate sleep and rest primarily because of the physical
changes, active social lives, and increasingly complex demands on their lives.

PTS: 1 DIF: Moderate REF: p. 181


KEY: Nursing process: Planning | Client need: SECE | Cognitive level: Analysis

____ 17. A 38-year-old client comes into the clinic for a health examination.
Knowing the psychosocial development tasks and common health problems for this age
group, it would be most important for the nurse to ask
1)
If the client has episodes of feeling depressed
2)
Whether the client practices safe sex
3)
About the client’s exercise habits
4)
About the health history of the client’s parents

ANS: 1
Treas Fundamentals TTB09-10
Test Bank
Striving to be self-sufficient and successful and to establish a career and family are the
tasks for this age. These tasks are demanding and can be emotionally difficult and
potentially cause depression. Untreated depression is a leading cause of death among
young adults. Sexually transmitted infections are a risk for this age group but are not as
severe a threat as depression. Exercise is important to overall health but is not a source of
stress. There are genetic health problems that can impact the client, but the question is
asking about psychosocial development and common health problems.

PTS: 1 DIF: Difficult REF: p. 187-188


KEY: Nursing process: Assessment | Client need: PSI | Cognitive level: Application

____ 18. A mother watches the nurse perform an assessment on her newborn and
asks the nurse why she is doing things like “stroking the bottom of his feet.” The nurse
should respond in which of the following ways?
1)
“I’m checking the blood flow to your baby’s feet to make sure it’s normal.”
2)
“I’m testing to see if your baby’s neuromuscular system is fully developed.”
3)
“I’m checking to see if your baby has the reflex responses we anticipate.”
4)
“I’m testing to see if your baby has normal sensation in his feet.”

ANS: 3
The Babinski reflex is elicited by stroking upward of the side of the sole of the foot. This
is one of several reflexes that should be present at birth. Stoking the bottom of the foot is
not an assessment of circulation to the feet. The neuromuscular system is not fully
developed at birth, but reflexes are present. Because an infant is not able to report
sensation, which is a subjective finding, this is not the purpose of the nurse’s action.

PTS: 1 DIF: Moderate REF: p. 168


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

____ 19. The nurse conducts a class on health promotion to a group of young adults.
Which of the following comments would indicate the teaching was effective?
1)
“I need to get screened for colon cancer.”
2)
“I’ll start doing testicular self-exams.”
3)
“I have to have my prostate checked.”
4)
Treas Fundamentals TTB09-11
Test Bank
“I don’t need to do breast self-exams until I am 40.”

ANS: 2
Men may choose to perform monthly testicular exams until they are 40 years old. Colon
cancer screening begins at age 50. Prostate exams are part of an annual health exam for
middle adults. Even young adults should perform breast self-examination (although some
practitioners question recommending it routinely). Whatever screening method is chosen,
young adults do develop breast cancer; it is not a problem only for those past age 40.

PTS: 1 DIF: Easy REF: p. 186


KEY: Nursing process: Evaluation | Client need: HPM | Cognitive level: Application

____ 20. Which of the following is an example of a school-aged child’s meeting


psychosocial development tasks? The child
1)
Wants to show off the latest trick he can do on his bike
2)
Becomes interested in friendships with the opposite sex
3)
Starts to see the value of making good decisions
4)
Wants to buy the same jacket his friend has

ANS: 4
Peers are increasingly more important to the school-age child. The child wants to have
what his friends have. Pride in showing off new skills and possessions is normal for all
stages of development, particularly during the preschool period. Friendships are typically
between those the same sex at this age. A value system does not start to develop until
adolescence.

PTS: 1 DIF: Moderate REF: p. 179


KEY: Nursing process: Evaluation | Client need: HPM | Cognitive level: Analysis

____ 21. Which of the following would be the most important health assessment
focus for middle adulthood?
1)
Cancer screening with the annual health examinations
2)
Seeking information about consistent use of seat belts
3)
Screening for eating disorders
4)
Treas Fundamentals TTB09-12
Test Bank
Mental status exam for cognitive changes

ANS: 1
Chronic diseases, including cancer, are major health problems for adults in the middle
years. Habits for seat belt use should have already been established; although it may be
important to reinforce seat belt use, the most important assessment is cancer screening.
Eating disorders are more common in adolescence. In general, cognitive changes such as
memory loss and dementia do not develop until older adulthood.

PTS: 1 DIF: Difficult REF: p. 190


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level:
Comprehension

____ 22. A mother and father have brought their school-age child to the emergency
department with injuries that cause the nurse to suspect child abuse. The nurse wishes to
assess further for abuse and neglect. Which of the following should the nurse do?
1)
Interview the parents together and the child separately.
2)
Have one parent in the room to reassure the child during the interview.
3)
Interview the child and each parent separately.
4)
Request that a sexual assault nurse examiner (SANE) interview the family members.

ANS: 3
Interviewing each family member separately allows the suspected victim more freedom
to express concerns. An abused person may be afraid to talk with the abuser present and
may even support the abuser’s version of events. If two adults accompany a child, the
situation still does not allow such freedom, because it may be that one of the adults is
abusing both the partner and child. The nurse should separate the caregivers and child to
be certain they all tell the same story. A SANE is needed to perform the physical
examination only if sexual abuse is suspected from the interview.

PTS: 1 DIF: Difficult REF: p. 180


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level:
Comprehension

Matching

Match the developmental milestones with the appropriate age group. There may be more
than one answer for each age group.
Treas Fundamentals TTB09-13
Test Bank
1)
Infant
2)
Toddler
3)
Preschool
4)
School age
5)
Adolescent

1. Bones have reached maximum strength

____ 2. Puts toys into toy box

____ 3. Ties her tennis shoes

____ 4. Matches colors and shapes

____ 5. Compares balls with blocks

6. Writes sentences using appropriate grammar

____ 7. Understands that characters in cartoons are not real

____ 8. Finds toys that are hidden

____ 9. Applies reason to his thinking

____ 10. Puts a simple jigsaw puzzle together

____ 11. Tells someone his name, age, and address

____ 12. Understands how much a dollar is

____ 13. Understands what “no” means

1. ANS: 5 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

2. ANS: 1 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

3. ANS: 4 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application
Treas Fundamentals TTB09-14
Test Bank
4. ANS: 2 PTS: 1 DIF: Moderate REF: pp. 171-187

KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

5. ANS: 3 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

6. ANS: 4 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

7. ANS: 3 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

8. ANS: 2 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

9. ANS: 5 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

10. ANS: 1 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

11. ANS: 3 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

12. ANS: 4 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

13. ANS: 1 PTS: 1 DIF: Moderate REF: pp. 171-187


KEY: Nursing process: Assessment | Client need: HPM | Cognitive level: Application

Match the growth and development theory with the appropriate theorist.

1)
Human behavior and personality development are driven by instincts; there are four
forces and five stages that influence a person’s personality.
2)
Cognitive development is progressive and sequential through four stages; the person must
have the basic abilities of assimilation, accommodation, and adaptation.
3)
There are eight stages of personality development with tasks that must be accomplished
at each stage; the greater the achievement of the tasks, the more adjusted the personality.
4)
Humans are born with instinctive needs; lower-level needs must be met before higher-
level needs and the ability to achieve self-actualization is developed.
Treas Fundamentals TTB09-15
Test Bank
5)
People interact with their social environment in a process of lifelong learning; there are
six stages, each with tasks that must be accomplished during that stage.

____ 14. Erikson

____ 15. Freud

____ 16. Havighurst

____ 17. Piaget

14. ANS: 3 PTS: 1 DIF: Moderate REF: pp. 160-165


KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall

15. ANS: 1 PTS: 1 DIF: Moderate REF: pp. 160-165


KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall

16. ANS: 5 PTS: 1 DIF: Moderate REF: pp. 160-165


KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall

17. ANS: 2 PTS: 1 DIF: Moderate REF: pp. 160-165


KEY: Nursing process: N/A | Client need: N/A | Cognitive level: Recall
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