Growth and Development

1.A student nurse who works in a pediatric clinic is assisting with an assessment on a young child who is not yet walking. She knows that it is considered a delayed gross motor ability if the child does not walk by _____ months.

a.
16
b.
18
c.
20
d.
22

ANS: C

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569

OBJ: Describe the growth and development changes that occur in individuals from conception through old age. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

2.According to one growth and development theorist, individuals need to accomplish a particular task before successfully completing the stage of growth and development. Each task is framed with opposing conflicts, such as trust versus mistrust. Who developed this theory?

a.
Sigmund Freud
b.
Jean Piaget
c.
Erik Erikson
d.
Lawrence Kohlberg

ANS: C

Erik Erikson divided life into eight stages, known as Erikson’s eight stages of development. According to this theory, individuals need to accomplish a particular task before successfully completing each stage. Each task is framed with opposing conflicts, such as trust versus mistrust. Each stage builds upon the successful attainment of the previous developmental conflict. Freud’s psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and instinctive forces. Each of the five stages is associated with a pleasurable zone, serving as the focus of gratification. Jean Piaget (1896-1980) developed the theory of cognitive development, which describes children’s intellectual organization and how they think, reason, and perceive the world. The theory includes four periods: sensorimotor, preoperational, concrete operations and formal operations. Lawrence Kohlberg (1927-1987) expanded on Piaget’s work. According to Kohlberg (1964), moral development is one component of psychosocial development. It involves the reasons an individual makes a decision about right and wrong behaviors within a culture.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569 | 570

OBJ: Compare the frameworks for growth and development as described by major developmental theorists. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

3.This model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and aggressive energies. Who is responsible for developing this theory?

a.
Sigmund Freud
b.
Jean Piaget
c.
Erik Erikson
d.
Lawrence Kohlberg

ANS: A

Sigmund Freud (1856-1939) provided the first formal structured theory of personality development. Freud’s psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and aggressive energies. Jean Piaget (1896-1980) developed the theory of cognitive development, which describes children’s intellectual organization and how they think, reason, and perceive the world. The theory includes four periods: sensorimotor, preoperational, concrete operations, and formal operations. Erik Erikson divided life into eight stages, known as Erikson’s eight stages of development. According to this theory, individuals need to accomplish a particular task before successfully completing each stage. Each task is framed with opposing conflicts, such as trust versus mistrust. Each stage builds upon the successful attainment of the previous developmental conflict. Lawrence Kohlberg (1927-1987) expanded on Piaget’s work. According to Kohlberg (1964), moral development is one component of psychosocial development. It involves the reasons an individual makes a decision about right and wrong behaviors within a culture.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569 | 570

OBJ: Compare the frameworks for growth and development as described by major developmental theorists. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

4.Which of the following people developed the theory of cognitive development that describes children’s intellectual organization and how they think, reason, and perceive the world?

a.
Sigmund Freud
b.
Jean Piaget
c.
Erik Erikson
d.
Lawrence Kohlberg

ANS: B

Jean Piaget (1896-1980) developed the theory of cognitive development, which describes children’s intellectual organization and how they think, reason, and perceive the world. Sigmund Freud (1856-1939) provided the first formal structured theory of personality development. Freud’s psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and aggressive energies. Erik Erikson divided life into eight stages, known as Erikson’s eight stages of development. According to this theory, individuals need to accomplish a particular task before successfully completing each stage. Each task is framed with opposing conflicts, such as trust versus mistrust. Each stage builds upon the successful attainment of the previous developmental conflict. Lawrence Kohlberg (1927-1987) expanded on Piaget’s work. According to Kohlberg (1964), moral development is one component of psychosocial development. It involves the reasons an individual makes a decision about right and wrong behaviors within a culture.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569 | 570

OBJ: Compare the frameworks for growth and development as described by major developmental theorists. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

5.According to one theorist, moral development depends on the child’s ability to accept social responsibility and to integrate personal principles of justice and fairness. Which of the following individuals is responsible for the theory of moral development?

a.
Sigmund Freud
b.
Jean Piaget
c.
Erik Erikson
d.
Lawrence Kohlberg

ANS: D

According to Kohlberg (1964), moral development is one component of psychosocial development. It involves the reasons an individual makes a decision about right and wrong behaviors within a culture. Moral development depends on the child’s ability to accept social responsibility and to integrate personal principles of justice and fairness. Sigmund Freud (1856-1939) provided the first formal structured theory of personality development. Freud’s psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and aggressive energies. Jean Piaget (1896-1980) developed the theory of cognitive development, which describes children’s intellectual organization and how they think, reason, and perceive the world. Erik Erikson divided life into eight stages, known as Erikson’s eight stages of development. According to this theory, individuals need to accomplish a particular task before successfully completing each stage. Each task is framed with opposing conflicts, such as trust versus mistrust. Each stage builds upon the successful attainment of the previous developmental conflict. Lawrence Kohlberg (1927-1987) expanded on Piaget’s work.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569 | 570

OBJ: Compare the frameworks for growth and development as described by major developmental theorists. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

6.A patient is experiencing incisional pain after an operation. When using Maslow’s hierarchy of needs, the nurse realizes that for the patient to return to a prehospitalized status, the patient needs to progress beyond which of the following?

a.
Belonging
b.
Self-esteem
c.
Self-actualization
d.
Safety and security

ANS: D

Maslow described an ordering (hierarchy) of needs that motivate human behavior. This ordering is often depicted as a pyramid composed of five levels. When the most basic needs, such as hunger and oxygen, are met, the person strives to satisfy those needs for safety and security on the next highest level. Disturbances at lower levels interfere with the highest level, self-actualization or the realization of one’s potential. Individuals need to satisfy each level before moving on to the next. Belonging occupies the third stage, where threats to relationships create anticipatory loneliness and alienation. Self-esteem occupies the fourth stage, and threats create alienation. Self-actualization is the highest level that one can achieve—the realization that one has reached his or her highest potential. Safety and security occupies the second stage, and threats to security (such as pain) produce feelings of insecurity.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:570 | 588

OBJ: Use knowledge of growth and development to enhance use of the nursing process for individuals across the life span. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

7.The nurse is providing prenatal education to a patient whose pregnancy has been confirmed. This is the patient’s first pregnancy and she is in her first trimester. The nurse instructs the patient that she should stop smoking, avoid alcohol, and avoid eating king mackerel because of the high mercury content in the fish. Although this advice should be followed during the entire pregnancy, the fetus is most vulnerable to adverse effects in the _____ trimester.

a.
first
b.
second
c.
third
d.
final

ANS: A

Exposure to potential teratogens can affect fetal development during any of the trimesters; however, vulnerability is increased during the first trimester when fetal cells are differentiating and organs are forming.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:571

OBJ:Identify specific nursing interventions for the health promotion of patients across the life span.TOP:Nursing Process: Diagnosis

MSC: NCLEX: Health Promotion and Maintenance

8.A pregnant teenager asks the clinic nurse why she cannot smoke during the first trimester. Remembering growth and development, what is the nurse’s best response?

a.
“Smoking is a bad habit, but it probably won’t affect the baby.”
b.
“Smoking may affect organ systems that are beginning to develop.”
c.
“Smoking will only affect the baby in the third trimester.”
d.
“Smoking mothers usually produce overweight babies”

ANS: B

PTS:1DIF:Cognitive Level: Applying (Application)

REF:571

OBJ:Use critical judgment to determine appropriate teaching topics for individual patients across the life span.TOP:Nursing Process: Implementation

MSC:NCLEX: Reduction of Risk Potential

9.A student nurse is in her community health clinical rotation. She is visiting a family with a new baby. Which of the following statements made by the mother of a 1-month-old infant indicates the need for client education?

a.
“My baby should double his birth weight by the time he is 6 months old.”
b.
“I shouldn’t give my baby any cow’s milk until he is at least a year old.”
c.
“My baby has been fussy lately; I believe he is probably cutting his teeth.”
d.
“I shouldn’t put my baby on a fluffy pillow to sleep.”

ANS: C

The first tooth to erupt is usually one of the lower central incisors at the average age of 7 months. Most babies have six teeth by their first birthday. Typically infants double their birth weight by 5 to 6 months and triple it by 12 months. Infants should not have any type of cow’s milk during the first year because the high protein content may increase the chance of food allergies. The American Academy of Pediatrics recommends infants not sleep with a blanket until they are a year old.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:572 | 573

OBJ:Use critical judgment to determine appropriate teaching topics for individual patients across the life span.TOP:Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

10.The mother of a toddler is concerned that her son is not eating enough, although he has not lost any weight. She tells the nurse that her son used to have a very good appetite, but now does not eat as much as he did a couple of months ago. What is the best response for the nurse to provide?

a.
“You need to make him eat. At this stage, he is growing too fast to not eat.”
b.
“I could show you a growth chart, but each child is different so it doesn’t mean much.”
c.
“Toddlers have periods when they aren’t growing as fast and they don’t need to eat as much.”
d.
“Make him eat with a spoon and don’t feed him snacks. He will be hungrier at meal time.”

ANS: C

Slower growth rates often occur with a decrease in caloric needs and a smaller food intake. Confirming the child’s pattern of growth with standard growth charts is reassuring to parents concerned about their toddler’s decreased appetite (physiological anorexia). Encourage parents to offer a variety of nutritious foods, in reasonable servings, for mealtime and snacks. Finger foods allow the toddler to be independent.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:573

OBJ: Specify the physical and psychosocial health concerns of infants, children, adolescents, and adults. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

11.A nurse is caring for a 5-year-old child who is hospitalized for stabilization of asthma. To provide age-specific care, which of the following is the most appropriate action by the nurse?

a.
Allow the child to handle medical equipment.
b.
Have a parental presence at all times.
c.
Have the child lie flat and still during procedures.
d.
Tell the child as little as possible about expectations and care.

ANS: A

These strategies can be used to reduce preschoolers’ fears when they are hospitalized: allowing children to sit up when performing assessments and procedures; allowing the child to see and handle equipment; allowing the child to assist with the procedure if appropriate; giving simple and factual information to these children because they have a great sense of imagination. Although preschoolers have developed object permanence and recognize their parents still exist when out of sight, most tolerate only short absences without becoming distressed. Encourage parents to tell the child when they are leaving and when they will return in terms the child can understand (e.g., “I am leaving and will be back after lunch.”).

PTS:1DIF:Cognitive Level: Applying (Application)

REF:575

OBJ:Identify specific nursing interventions for the health promotion of patients across the life span.TOP:Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity

12.An 11-year-old boy is being seen at the clinic for his annual check-up. As part of anticipatory guidance, the nurse instructs the boy’s father that accidents and injuries are major health problems affecting school-age children and that the number one cause of death is in this age group is which of the following?

a.
Drowning
b.
Motor vehicle accidents
c.
Fire
d.
Firearms

ANS: B

Accidents and injuries are major health problems affecting school-age children and are the causative factor in a large number of deaths in this age group. Motor vehicle accidents, followed by drowning, fires, burns, and firearms are the most frequent fatal accidents.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:576

OBJ:Identify specific nursing interventions for the health promotion of patients across the life span.TOP:Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

13.The mother of an 8-year-old girl has brought her daughter to the health clinic for her annual check-up. She is concerned about the high blood pressure in her family and asks the nurse if there is some way to know if the child is at risk for hypertension. What is the nurse’s best response?

a.
“Blood pressure elevation in childhood is the single best predictor of adult hypertension.”
b.
“Well let’s take her blood pressure and see if it’s up. If it is, she has hypertension.”
c.
“She looks pretty plump to me, and that indicates good health. As long as she’s eating, she should be OK.”
d.
“If you think that she’s gaining weight, put her on an exercise program, but wait until she’s in her teens.”

ANS: A

Blood pressure elevation in childhood is the single best predictor of adult hypertension. This recognition has reinforced the significance of making blood pressure measurement a part of every annual assessment of the child. Measure on at least three separate occasions with the appropriate-size cuff and in a relaxed situation before concluding that the child’s blood pressure is elevated and needs further medical attention. Childhood obesity is a prominent health problem, which increases the child’s risk for hypertension, diabetes, coronary artery disease, and other chronic health problems. Daily exercise and maintaining normal body weight are important as both interventions and prevention even while in the preteen years.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:576

OBJ:Identify specific nursing interventions for the health promotion of patients across the life span.TOP:Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity

14.The transition from childhood to adulthood, in terms of the psychological maturation of the individual, is known as which of the following?

a.
Puberty
b.
Adolescence
c.
Menarche
d.
Preadolescence

ANS: B

The term adolescence refers to the psychological maturation of the individual, whereas pubertyrefers to the point at which reproduction is possible. Menarche refers to the onset of menstruation. The transitional period between childhood and adolescence is preadolescence. Others refer to this period as late childhood, early adolescence, pubescence, and transescence.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:577

OBJ: Describe the growth and development changes that occur in individuals from conception through old age. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

15.A recent graduate nurse has been assigned to be a primary nurse on a geriatric unit. After completing a review of development and aging, the nurse recalls that changes during the climacteric signify which of the following?

a.
A characteristic of young adulthood
b.
The increased reproductive ability of the older adult
c.
A time of significant change in cognitive performance in middle age
d.
A decline of reproductive capacity caused by a decrease in sexual hormones

ANS: D

Climacteric is a term used to describe the decline of reproductive capacity and accompanying changes brought about by the decrease in sexual hormones. This affects men and women differently. Men begin to experience decreased fertility, but they are able to continue to father children. Menopause, when a woman stops ovulating and menstruating, occurs only when 12 months have passed since the last menstrual flow. Climacteric is a characteristic of middle adulthood usually referring to those years between 40 and 65. Changes in the cognitive function of middle-age adults are few except during illness or trauma.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:580

OBJ: Use knowledge of growth and development to enhance use of the nursing process for individuals across the life span. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

16.The nurse is caring for an older adult who seems depressed and states that “I hate going to Bingo. I’d really like to get back in shape. Maybe if I could join a health club, I could get back to feeling like myself.” The nurse should do which of the following?

a.
Inform the patient that at his age it’s probably not a good idea to join a health club.
b.
Recommend that the patient have a complete physical examination.
c.
Explain that physical impairments would prevent any worthwhile exercising.
d.
Tell the patient that at his age he would probably hurt himself.

ANS: B

It is not too late for an older person to begin an exercise program; however, older adults need to have a complete physical examination, which usually includes a stress cardiogram or stress test. Assessment of activity tolerance will help you and the patient plan a program that meets physical needs while allowing for physical impairments. Most older adults are capable of taking charge of their lives and assume responsibility for preventing disability.

PTS:1DIF:Cognitive Level: Applying (Application)

REF:585

OBJ:Use critical judgment to determine appropriate teaching topics for individual patients across the life span.TOP:Nursing Process: Implementation

MSC: NCLEX: Physiological Integrity

17.______ is the measurable aspect of a person’s increase in physical dimensions.

a.
Growth
b.
Development
c.
Maturation
d.
The latency stage of development

ANS: A

Growth is the measurable aspect of a person’s increase in physical dimensions. Measurable growth indicators include changes in height, weight, teeth and bone, and sexual characteristics. Development is an interaction of biological, sociological and psychological forces. It occurs gradually and refers to changes in skill and capacity to function. These changes are qualitative in nature and difficult to measure in exact units. Maturation is the biological plan for the predictable milestones for growth and development. Physical growth and motor development are a function of maturation. The latency stage of development is part of Freud’s psychoanalytic model of personality development. In the latency stage, Freud believed that the sexual urges from the earlier phallic stage are repressed and channeled into productive activities that are socially acceptable.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:568 | 569

OBJ: Specify the physical and psychosocial health concerns of infants, children, adolescents, and adults. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

18.______ is an interaction of biological, sociological, and psychological forces.

a.
Growth
b.
Development
c.
Maturation
d.
The latency stage of development

ANS: B

Development is an interaction of biological, sociological, and psychological forces. It occurs gradually and refers to changes in skill and capacity to function. These changes are qualitative in nature and difficult to measure in exact units. Growth is the measurable aspect of a person’s increase in physical dimensions. Measurable growth indicators include changes in height, weight, teeth and bone, and sexual characteristics. Maturation is the biological plan for the predictable milestones for growth and development. Physical growth and motor development are a function of maturation. The latency stage of development is part of Freud’s psychoanalytic model of personality development. In the latency stage, Freud believed that the sexual urges from the earlier phallic stage are repressed and channeled into productive activities that are socially acceptable.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:568 | 569

OBJ: Specify the physical and psychosocial health concerns of infants, children, adolescents, and adults. TOP: Nursing Process: Assessment

MSC: NCLEX: Health Promotion and Maintenance

19.A specific phase or period when the presence of a function or reasoning has its greatest effect on a specific aspect of development is referred to as:

a.
Freud’s psychoanalytic model of personality.
b.
a critical period of development.
c.
Erikson’s stages of development.
d.
Piaget’s theory of cognitive development.

ANS: B

A critical period of development refers to a specific phase or period when the presence of a function or reasoning has its greatest effect on a specific aspect of development. For example, if a child does not walk by 20 months, there is delayed gross motor ability, which slows exploration and manipulation of the environment. Freud’s psychoanalytic model of personality development is grounded in the belief that two internal biological forces drive the psychological change in a child: sexual (libido) and instinctive forces. Erik Erikson (1902-1994) expanded Freud’s psychoanalytic stages into a psychosocial model that covered the whole life span. In this theory, Erikson divided life into eight stages, known as Erikson’s eight stages of development. Jean Piaget (1896-1980) developed the theory of cognitive development, which describes children’s intellectual organization and how they think, reason, and perceive the world.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:569 | 570

OBJ: Use knowledge of growth and development to enhance use of the nursing process for individuals across the life span. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

20.Preconception counseling is a growing trend in health care with the goal being to secure the best outcome for mother, fetus, and significant others through good prenatal care and teaching that:

a.
teratogens can affect fetal development during any trimester.
b.
the placenta prevents teratogens from passing to the fetus.
c.
teratogens are all man-made, preventable, and do not include viruses or bacteria.
d.
smoking has been shown to have no effect on fetal development.

ANS: A

Teratogens are chemical or physiological agents capable of having adverse effects on the fetus. Exposure to potential teratogens can affect fetal development during any of the trimesters; however, vulnerability is increased during the first trimester when fetal cells are differentiating and organs are forming. Because the placenta is extremely porous, teratogens pass easily from mother to fetus. Some examples of teratogens are viruses, drugs (prescribed, over-the-counter, and street drugs), alcohol, and environmental pollutants, such as lead. The fetal effect of these harmful agents depends on the developmental stage in which exposure takes place. In addition, there is evidence that mothers who smoke deliver infants with lower birth weights than nonsmoking mothers.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:571

OBJ: Identify factors that promote or interfere with normal growth and development of individuals at each stage of life. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

21.Postmenopausal women are at risk for skeletal changes. When developing a plan of care for postmenopausal women, a nurse should remember which of the following?

a.
Exercise provides little benefit for the middle-age adult.
b.
Middle-age women should avoid dietary calcium to prevent osteoporosis.
c.
Exercise and fitness clubs have limited activities.
d.
Physical activities help improve balance and coordination.

ANS: D

When middle-age adults seek health care, nurses need to develop goals for positive health behaviors. Simple things like increasing dietary calcium and calcium supplements are effective. In addition, exercise and fitness clubs, for example, give men and women the opportunity to participate in many physical activities. These activities help improve balance, coordination, and activity tolerance.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:582

OBJ: Identify factors that promote or interfere with normal growth and development of individuals at each stage of life. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

22.A 90-year-old patient constantly tells the nurse stories about life many years ago. The nurse encourages this behavior because reminiscence or life review is:

a.
a technique that prepares the individual for the end of life.
b.
a review of dispelling past experiences as meaningless.
c.
helpful although it is unnatural in the older adult.
d.
a way for the elderly to realize that conflicts cannot be reconciled.

ANS: A

Reminiscence, or life review, is a technique that facilitates the individual’s preparation for the end of life. It is an adaptive function of older adults that allows them to recall the past for the purpose of assigning new meaning to past experiences. Reminiscence is the natural way older adults revive their past in an attempt to establish order and meaning and to reconcile conflicts and disappointments as they prepare for death.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:585

OBJ:Identify specific nursing interventions for the health promotion of patients across the life span.TOP:Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

23.Polypharmacy is:

a.
the use of unprescribed medication for recreational use.
b.
the prescription, use, or administration of more medications than are needed.
c.
very rare in older adults.
d.
rarely a problem as long as the medications are taken together.

ANS: B

Polypharmacy, the prescription, use, or administration of more medications than are indicated clinically, is a common problem of older adults. The combined use of multiple drugs causes serious problematic effects.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:586

OBJ: Identify factors that promote or interfere with normal growth and development of individuals at each stage of life. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

MULTIPLE RESPONSE

1.A nurse is caring for a group of 6 and 7 year olds. The nurse remembers that, according to Kohlberg, moral development is a component of psychosocial development. Moral development depends on the child’s ability to do which of the following? (Select all that apply.)

a.
Accept social responsibility.
b.
Respect the integrity and rights of others.
c.
Integrate principles of justice and fairness.
d.
Use symbols and objects on the way to abstract thinking.
e.
Perform repetitive motion responses.

ANS: A, B, C

Moral development depends on the child’s ability to accept social responsibility and integrate personal principles of justice and fairness. In addition, the child’s knowledge of right and wrong and behavioral expression of this knowledge must be founded on respect and regard for the integrity and rights of others. Piaget’s theory, not Kohlberg’s, states that as the child grows from infancy into adolescence, the intellectual development progresses, starting with reflex and repetitive motion responses, to the use of symbols and objects from the child’s point of view, to logical thinking, and finally to abstract thinking.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:570

OBJ: Compare the frameworks for growth and development as described by major developmental theorists. TOP: Nursing Process: Diagnosis

MSC: NCLEX: Physiological Integrity

2.The patient has been diagnosed with progressive Alzheimer’s disease. Characteristics of this disease include which of the following? (Select all that apply.)

a.
Delirium
b.
Agnosia
c.
Apraxia
d.
Aphasia
e.
Amnesia

ANS: B, C, D, E

Alzheimer’s disease is the most common form of dementia. Alzheimer’s disease is a progressive loss of memory (amnesia), loss of ability to recognize objects (agnosia), loss of the ability to perform familiar tasks (apraxia), and loss of language skills (aphasia). As the disease progresses, some patients also experience changes in personality and behavior, such as anxiety, suspiciousness, or agitation, as well as delusions or hallucinations. Delirium is an acute confusional state and requires prompt assessment. It is a potentially reversible cognitive impairment that is often a result of physiological causes. Some of these causes include electrolyte imbalance, hypoglycemia, infection, and medications.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:584

OBJ: Specify the physical and psychosocial health concerns of infants, children, adolescents, and adults. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity

3.A nurse is performing an admission assessment on a middle-age patient. A normal change seen in this age group includes which of the following? (Select all that apply.)

a.
A progressive decrease in skin turgor
b.
Decreased visual acuity
c.
Decreased ability to solve practical problems
d.
Decreased strength of abdominal muscles
e.
Loss of accommodation

ANS: A, B, D, E

Middle adulthood usually refers to those years between 40 and 65. Expected physical changes include a slow, progressive decrease in skin turgor, decreased abdominal strength, decreased visual acuity, and loss of accommodation of lens to focus light on near objects. The ability to solve practical problems based on experience peaks at midlife because of the ability for integrative thinking.

PTS: 1 DIF: Cognitive Level: Remembering (Knowledge)

REF:580 | 581

OBJ: Describe the growth and development changes that occur in individuals from conception through old age. TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity