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PEDS: Chapter 5: Health Promotion for the Developing Child
Terms in this set (20)
Which statement best describes development in infants and children?
a. Development, a predictable and orderly process, occurs at varying rates within
b. Development is primarily related to the growth in the number and size of cells.
c. Development occurs in a proximodistal direction with fine muscle development
d. Development is more easily and accurately measured than growth.
A Development, a continuous and orderly process, provides the basis for increases
in the child's function and complexity of behavior. The increases in rate of
function and complexity can vary normally within limits for each child.
B An increase in the number and size of cells is a definition for growth.
C Development proceeds in a proximodistal direction with fine muscle
organization occurring as a result of large muscle organization.
D Development is a more complex process that is affected by many factors;
therefore, it is less easily and accurately measured. Growth is a predictable
process with standard measurement methods.
Frequent developmental assessments are important for which reason?
a. Stable developmental periods during infancy provide an opportunity to identify
any delays or deficits.
b. Infants need stimulation specific to the stage of development.
c. Critical periods of development occur during childhood.
d. Child development is unpredictable and needs monitoring.
A Infancy is a dynamic time of development that requires frequent evaluations to
assess appropriate developmental progress.
B Infants in a nurturing environment will develop appropriately and will not
necessarily need stimulation specific to their developmental stage.
C Critical periods are blocks of time during which children are ready to master
specific developmental tasks. The earlier those delays in development are
discovered and intervention initiated, the less dramatic their effect will be.
D Normal growth and development is orderly and proceeds in a predictable pattern
based on each individual's abilities and potentials.
Which factor has the greatest influence on child growth and development?
A Culture is a significant factor that influences how children grow toward
adulthood. Culture influences both growth and development but does not
eliminate inborn genetic influences.
B Environment has a significant role in determining growth and development both
before and after birth. The environment can influence how and to which extent
genetic traits are manifested, but environmental factors cannot eliminate the
effect of genetics.
C Genetic factors (heredity) determine each individual's growth and developmental
rate. Although factors such as environment, culture, nutrition, and family can
influence genetic traits, they do not eliminate the effect of the genetic
endowment, which is permanent.
D Nutrition is critical for growth and plays a significant role throughout childhood.
The nurse is planning a teaching session for a young child and her parents. According to
Piaget's theory, the period of cognitive development in which the child is able to
distinguish between concepts related to fact and fantasy, such as human beings are
incapable of flying like birds, is the _______ period of cognitive development.
b. Formal operations
c. Concrete operations
A The sensorimotor stage occurs in infancy and is a period of reflexive behavior.
During this period, the infant's world becomes more permanent and organized.
The stage ends with the infant demonstrating some evidence of reasoning.
B Formal operations is a period in development in which new ideas are created
through previous thoughts. Analytic reason and abstract thought emerge in this
C Concrete operations is the period of cognitive development in which children's
thinking is shifted from egocentric to being able to see another's point of view.
They develop the ability to distinguish fact from fantasy.
D The preoperational stage is a period of egocentrism in which the child's
judgments are illogical and dominated by magical thinking and animism.
The theorist who viewed developmental progression as a lifelong series of conflicts that
need resolution is
A Erik Erikson viewed development as a series of conflicts affected by social and
cultural factors. Each conflict must be resolved for the child to progress
emotionally, with unsuccessful resolution leaving the child emotionally disabled.
B Sigmund Freud proposed a psychosexual theory of development. He proposed
that certain parts of the body assume psychological significance as foci of sexual
energy. The foci shift as the individual moves through the different stages (oral,
anal, phallic, latency, and genital) of development.
C Lawrence Kohlberg described moral development as having three levels
(preconventional, conventional, and postconventional). His theory closely
D Jean Piaget's cognitive theory interprets how children learn and think and how
this thinking progresses and differs from adult thinking. Stages of his theory
include sensorimotor, preoperations, concrete operations, and formal operations.
What does the nurse need to know when observing a chronically ill child at play?
a. Play is not important to hospitalized children.
b. Children need to have structured play periods.
c. Children's play is a form of communication.
d. Play is to be discouraged because it tires hospitalized children.
A Play is important to all children in all environments. Play for children is a
mechanism for mastering their environment.
B Although children's play activities appear to be unorganized and at times
chaotic, play has purpose and meaning. Imposing structure on play interferes
with the tasks being worked on.
C Play for all children is an activity woven with meaning and purpose. For
chronically ill children, play can indicate their state of wellness and response to
treatment. It is a way to express joy, fear, anxiety, and disappointments.
D Children who have fewer energy reserves still require play. For these children,
less-active play activities will be important.
Which child is most likely to be frightened by hospitalization?
a. A 4-month-old infant admitted with a diagnosis of bronchiolitis
b. A 2-year-old toddler admitted for cystic fibrosis
c. A 9-year-old child hospitalized with a fractured femur
d. A 15-year-old adolescent admitted for abdominal pain
A Young infants are not as likely to be as frightened as toddlers by hospitalization
because they are not as aware of the environment.
B Toddlers are most likely to be frightened by hospitalization because their thought
processes are egocentric, magical, and illogical. They feel very threatened by
unfamiliar people and strange environments.
C The 9-year-old child's cognitive ability is sufficient enough for the child to
understand the reason for hospitalization.
D The 15-year-old adolescent has the cognitive ability to interpret the reason for
Which expected outcome is developmentally appropriate for a hospitalized 4-year-old
a. The child will be dressed and fed by the parents.
b. The child will independently ask for play materials or other personal needs.
c. The child will be able to verbalize an understanding of the reason for the
d. The child will have a parent stay in the room at all times.
A Parents need to foster appropriate developmental behavior in the 4-year-old
child. Dressing and feeding the child do not encourage independent behavior.
B Erikson identifies initiative as a developmental task for the preschool child.
Initiating play activities and asking for play materials or assistance with personal
needs demonstrates developmental appropriateness.
C A 4-year-old child cannot be expected to cognitively understand the reason for
hospitalization. Expecting the child to verbalize an understanding for
hospitalization is an inappropriate outcome.
D Parents staying with the child throughout a hospitalization is an inappropriate
outcome. Although children benefit from parental involvement, parents may not
have the support structure to stay in the room with the child at all times.
A preschool aged child will be receiving immunizations. Which statement identifies an
appropriate level of language development for a 4-year-old child?
a. The child has a vocabulary of 300 words and uses simple sentences.
b. The child uses correct grammar in sentences.
c. The child is able to pronounce consonants clearly.
d. The child uses language to express abstract thought.
A Simple sentences and a 300-word vocabulary are appropriate for a 2-year-old
B The 4-year-old child is able to use correct grammar in sentence structure.
C The 4-year-old child typically has difficulty in pronouncing consonants.
D The use of language to express abstract thought is developmentally appropriate
for the adolescent
Which children are at greater risk for not receiving immunizations?
a. Children who attend licensed daycare programs
b. Children entering school
c. Children who are home schooled
d. Young adults entering college
A All states require immunizations for children in daycare programs.
B All states require immunizations for children entering school.
C Home-schooled children are at risk for being underimmunized and need to be
D Most colleges require a record of immunizations as part of a health history.
Which developmental assessment instrument is appropriate to assess a 5-year-old child?
a. Brazelton Behavioral Scale
b. Denver Developmental Screening Test II (DDST-II)
c. Dubowitz Scale
d. New Ballard Scale
A The Brazelton Behavioral Scale is used for newborn assessment.
B The DDST-II is used for infants and children between birth and 6 years of age.
C The Dubowitz Scale is used for estimation of gestational age.
D The New Ballard Scale is used for newborn screening.
A 2-month-old child has not received any immunizations. Which immunizations should
the nurse give?
a. DTaP, Hib, HepB, MCV, varicella
b. DTaP, Hib, HepB, HPV, IPV, Rota
c. DTaP, Hib, HepB, PCV, Rota
d. DTaP, Hib, HepB, PCV, HepA
A Meningococcal vaccine should be administered to children at 11 to 12 years of
B Human papillomavirus vaccine is administered to adolescent girls only.
C DTaP, Hib, HepB, PCV, IPV, and Rota are appropriate immunizations for an
unimmunized 2-month-old child.
D HepA is recommended for all children at 1 year of age.
The environment, both physical and psychosocial, is a significant determinate of growth
and development outcomes before and after birth. Nurses can assist parents in preventing
environmental injury for their 2-year-old toddler by teaching them to avoid the most
common sources of exposure. This anticipatory guidance includes teaching related to
a. Avoiding sun exposure, secondhand smoke, and lead
b. Socioeconomic status, primarily poverty
c. Maternal smoking and alcohol intake during pregnancy
d. The passing of environmental toxins through breast milk
A Lead can be present in the home and in toys made overseas. Environmental
injury can also be the result of mercury, pesticides (flea and tick collars), radon,
and exposure to the sun and secondhand smoke. It is important for the nurse to
provide health teaching related to these factors.
B The nurse is unable to influence socioeconomic status.
C It is too late for the nurse to instruct the mother regarding smoking or alcohol
intake during pregnancy. This should have been included in prenatal teaching.
D It is unlikely that a 2-year-old child will still be breastfeeding.
Which immunizations should be used with caution in children with an allergy to eggs?
A HepB is safe for children with an egg allergy.
B DTaP is safe for children with an egg allergy.
C Hib is safe for children with an egg allergy.
D Live measles vaccine is produced by using chick embryo cell culture, so there is
a remote possibility of anaphylactic hypersensitivity in children with egg
allergies. Most reactions are actually the result of other components in the
When counseling parents and children about the importance of increased physical activity,
the nurse can emphasize
a. Anaerobic exercise should comprise a major component of the child's daily
b. All children should be physically active for at least 2 hours per day.
c. It is not necessary to participate in physical education classes at school if a student
is taking part in other activities.
d. Making exercise fun and a habitual activity.
A Aerobic exercise should comprise a major component of children's daily
exercise; however, physical activity should also include muscle and bone
B Children and adolescents should be physically active for at least 1 hour daily.
C Encourage all student to participate fully in any physical education classes.
D It is important to make exercise a fun and a habitual activity. Encourage parents
to investigate their community's different activity programs. This includes
recreation centers, parks, and the YMCA.
Which is the preferred site for administration of the Hib vaccine to an infant?
b. Anterolateral thigh
c. Upper, outer aspect of the arm
d. Dorsal gluteal region
A The deltoid muscle is not used for infants.
B The anterolateral thigh is the preferred site for intramuscular administration of
vaccines for infants.
C Subcutaneous injections can be given in the upper arm. The HIB vaccine is given
by the intramuscular route.
D The dorsal gluteal site is never used for vaccines.
What should the nurse evaluate before administering the Denver Developmental Screening
Test II (DDST-II)? Select all that apply.
a. The child's height and weight
b. The parent's ability to comprehend the results
c. The child's mood
d. The parent-child interaction
e. The child's chronologic age
ANS: C, E
Correct: The results of the screening test are valid if the child acted in a normal and
expected manner. The child's chronologic age in years, months, and days
must be calculated in order to draw the age line. This is necessary in order
to perform an accurate DDST-II. Reliability and validity of the test can be
altered if the child is not feeling well or is under the influence of
Incorrect: The child's height and weight are not relevant to the DDST-II screening
process. The parent's ability to understand the results of the screening is
not relevant to the validity of the test. The parent-child interaction is not
significantly relevant to the test results.
You are preparing immunizations for a 12-month-old child who is immunocompromised.
Which immunizations cannot be given? Select all that apply.
ANS: D, E
Correct: Children who are immunologically compromised should not receive live
viral vaccines. Varicella is a live vaccine and should not be given except in
special circumstances. MMR is a live vaccine and should not be given to
immunologically compromised children.
Incorrect: DTaP, HepA, and IPV can be given safely.
Breastfeeding is the ideal method for providing nutrition to the human infant and is
recommended by the American Heart Association, the American Academy of Pediatrics,
and the World Health Organization. Infants should be exclusively breastfed for a minimum
of 4 months and preferably 6 months. Is this statement true or false?
This statement is correct. Solid food should not be introduced until 4 to 6 months of age.
Breastfeeding should accompany solid food introduction until 1 year of age.
A type of play that allows children to act out roles and experiences that may have
happened to them, that they fear may happen, or that they have observed in others is
known as ______ play.
This type of play can be spontaneous or guided and often includes medical or nursing
equipment. It is especially valuable for children who have had or will have multiple
procedures or hospitalizations.
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