Chapter 15: An Overview of Growth, Development, and Nutrition Nursing School Test Banks

Chapter 15: An Overview of Growth, Development, and Nutrition

MULTIPLE CHOICE

1. What type of development is the nurse assessing when an infant can lift his or her head before he or she can sit?
a. Specific to general
b. Proximodistal
c. Cephalocaudal
d. General to specific
ANS: C
Cephalocaudal development proceeds from head to toe.

DIF: Cognitive Level: Comprehension REF: Page 353, Figure 15-1
OBJ: 1 TOP: Cephalocaudal Development
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

2. What is a unique organization of characteristics that determines an individuals pattern of behavior?
a. Environment
b. Heredity
c. Personality
d. Experience
ANS: C
One definition of personality states that it is a unique organization of characteristics that determines the individuals typical or recurrent pattern of behavior.

DIF: Cognitive Level: Knowledge REF: Page 360 OBJ: 1
TOP: Personality Development KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

3. An infants birth weight is 7 pounds, 8 ounces. What can the nurse project the weight to be at 6 months?
a. 12 pounds
b. 15 pounds
c. 18 pounds
d. 22 pounds
ANS: B
An infant usually doubles his or her birth weight by 5 to 6 months.

DIF: Cognitive Level: Analysis REF: Page 353, Figure 15-1
OBJ: 4 TOP: Weight Prediction
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

4. What would the nurse further investigate when assessing patterns of growth in a child?
a. Previous weight was in the 75th percentile, and present weight is in the 25th percentile.
b. Height is in the 90th percentile, and weight is in the 75th percentile.
c. Last weight was in the 5th percentile, and present weight is in the 10th percentile.
d. Weight is in the 50th percentile, and siblings weight at the same age was in the 75th percentile.
ANS: A
The child showing a difference of two or more percentile levels from an established growth pattern should undergo further evaluation.

DIF: Cognitive Level: Analysis REF: Page 356 OBJ: 4
TOP: Growth KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

5. A mother reports that she and her husband have had one child together, but both have children from previous marriages living in their home. The nurse will base the care planning on what type of family?
a. Nuclear
b. Blended
c. Alternate
d. Extended
ANS: B
A blended family involves the remarriage of persons with children.

DIF: Cognitive Level: Comprehension REF: Page 359, Table 15-1
OBJ: 6 | 7 TOP: The Family KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

6. The mother of a 7-month-old reports that the first lower central incisor has erupted. She asks the nurse, How many teeth will he have by his first birthday? The nurse explains that the infant will have how many teeth by 1 year of age?
a. 2
b. 4
c. 6
d. 8
ANS: C
The 1-year-old infant usually has about 6 teeth, 4 above and 2 below.

DIF: Cognitive Level: Knowledge REF: Page 380 OBJ: 10
TOP: Dentition KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

7. At a well-baby visit, parents of a 6-month-old ask when to take the infant for the first dental visit. What is the nurses best response?
a. If the teeth are brushed regularly, the child should see a dentist by 3 years of age.
b. The first dental visit should be arranged after the first tooth erupts.
c. The child should have a dental examination when all deciduous teeth have erupted.
d. A dental visit by 1 year of age is recommended by the American Academy of Pediatric Dentistry.
ANS: D
The Academy of Pediatric Dentistry recommends that the first dental visit occur by 1 year of age.

DIF: Cognitive Level: Application REF: Page 380 OBJ: 10
TOP: Dentition KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of Disease

8. The nurse is planning anticipatory guidance for a caregiver of a preschool-age child. The nurse will explain that permanent teeth begin erupting at what age?
a. 4 years old
b. 6 years old
c. 8 years old
d. 10 years old
ANS: B
Permanent teeth do not erupt through the gums until the sixth year.

DIF: Cognitive Level: Knowledge REF: Page 381 OBJ: 10
TOP: Dentition KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

9. A mother asks the nurse how much food should be offered to her 2-year-old. What is a good rule of thumb for serving size (in tablespoons) per year of age?
a. 2
b. 3
c. 4
d. 5
ANS: A
The rule of thumb for serving sizes is to offer 1 tablespoon of each food group per year of age.

DIF: Cognitive Level: Comprehension REF: Page 380 OBJ: 9
TOP: Rule of Thumb for Serving Sizes KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

10. An assessment of a childs nutritional status reveals the child is alert, with shiny hair, firm gums, firm mucous membranes, and regular elimination. How would this childs nutritional status be described?
a. Overnourished
b. Undernourished
c. Well nourished
d. Borderline
ANS: C
Well-nourished children show steady gains in height and weight and have shiny hair, firm gums and mucous membranes, and regular elimination.

DIF: Cognitive Level: Analysis REF: Page 379 OBJ: 9
TOP: Nutrition KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Physiological Integrity: Physiological Adaptation

11. The nurse encourages a Puerto Rican family to bring food to a child because he is not eating the food served on his hospital tray. What can the nurse expect the child to eat?
a. Dried beans mixed with rice
b. Crisp vegetables
c. Spaghetti and meatballs
d. Wild berries, roots, and seeds
ANS: A
A common food choice of Americans of Puerto Rican descent is dried beans mixed with rice.

DIF: Cognitive Level: Comprehension REF: Page 372, Table 15-6
OBJ: 7 TOP: Feeding the Ill Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Basic Care and Comfort

12. The nurse observes that a 2-year-old is able to use a spoon steadily at mealtime. What does self-feeding help to develop in the toddler?
a. Good nutrition
b. A sense of independence
c. Adequate height and weight
d. Healthy teeth
ANS: B
By the end of the second year, toddlers can feed themselves. This helps them to develop a sense of independence.

DIF: Cognitive Level: Comprehension REF: Page 368, Table 15-3
OBJ: 2 TOP: Feeding the Healthy Child
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

13. What activity would the nurse choose to meet Eriksons developmental task of industry when caring for a 7-year-old?
a. Completing a 50-piece jigsaw puzzle
b. Looking at a comic book
c. Playing a game of I Spy with the nurse
d. Coloring a picture in a coloring book
ANS: A
In the developmental period of late childhood, children are striving to develop a sense of industry. The completion of a jigsaw puzzle is industrious play.

DIF: Cognitive Level: Analysis REF: Page 368, Table 15-3 | Page 370, Table 15-5
OBJ: 11 TOP: Personality Development
KEY: Nursing Process Step: Planning
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

14. What does the nurse recognize as an example of Piagets concrete operational thinking?
a. 2-year-old says, Its nighttime when his room is darkened.
b. 4-year-old refers to the hospital as my house.
c. 5-year-old coloring a picture of a puppy says, This is my puppy.
d. 7-year-old says, I am sick because I have germs in my chest.
ANS: D
The 7-year-olds remark reflecting the cause and effect of germs and illness is an example of operational thinking. All other options are examples of preoperational thought, which is egocentric and symbolic.

DIF: Cognitive Level: Analysis REF: Page 369, Table 15-4
OBJ: 8 TOP: Cognitive Development
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

15. The nurse has discussed with a mother the process of introducing solid foods to her 6-month-old infant. What statement by the mother leads the nurse to determine that learning has taken place?
a. I will give my infant rice cereal first.
b. I will give my infant yellow vegetables first.
c. I will give my infant egg yolks first.
d. I will give my infant fruits first.
ANS: A
Solid foods are usually introduced at about 6 months of age, starting with rice cereal, which is the least allergenic.

DIF: Cognitive Level: Comprehension REF: Page 375, Figure 15-9
OBJ: 9 TOP: Feeding the Healthy Child
KEY: Nursing Process Step: Evaluation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

16. What is the best nursing action when an 8-year-old child comes to the school nurse with his central incisor in his hand and reports he knocked his tooth out on the water fountain?
a. Give him an ice cube to suck on.
b. Have him wash his mouth out with peroxide and water.
c. Wrap the tooth in a clean tissue.
d. Wash off the tooth and place it in a container of milk.
ANS: D
The tooth should be washed off and put in a container of milk to preserve it for possible reimplantation.

DIF: Cognitive Level: Application REF: Page 383, Nursing Tip
OBJ: 10 TOP: Loss of Tooth
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Physiological Integrity: Reduction of Risk

17. The mother of a 7-month-old states, The baby is eating food now. Should I give him regular milk, too? What is the nurses best response?
a. You should give the baby low-fat milk.
b. Try the milk. See if he has any digestive problems.
c. Continue breast milk or iron-fortified formula until 1 year of age.
d. At this age, infants can tolerate lactose-free or soy-based milk.
ANS: C
Whole milk should not be introduced before 1 year of age. Low-fat milk should not be introduced before 2 years of age.

DIF: Cognitive Level: Application REF: Page 377, Nursing Tip
OBJ: 9 TOP: Nutrition and Health
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

18. When a small group of preschool-age children were playing house, each child was pretending to be a particular family member. What type of play does the nurse recognize these children are participating in?
a. Parallel
b. Cooperative
c. Symbolic
d. Fantasy
ANS: B
In cooperative play, children play with each other, each taking a specific role.

DIF: Cognitive Level: Analysis REF: Page 384, Table 15-10
OBJ: 11 TOP: Play KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

19. When the nurse asks a 10-year-old Native American if he is ready to go to therapy, he does not answer immediately. How does the nurse interpret this response?
a. Indecision
b. Considering the answer in silence
c. Shyness with strangers
d. Fear of medical personnel
ANS: B
Native Americans value silence. They need to sit and consider matters before replying to questions.

DIF: Cognitive Level: Analysis REF: Page 367, Table 15-2
OBJ: 7 TOP: Ethnic ConsiderationsAmerican Indian
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

20. A mother tells the nurse, My 11-month-old son is not as active as my other children were at this age. He is the youngest of four and the older children love to dote on him. Which factor is influencing this childs language development?
a. Heredity
b. Sex
c. Mothers health during pregnancy
d. Ordinal position
ANS: D
Motor development of the youngest child may be prolonged if the child is babied by others in the family.

DIF: Cognitive Level: Analysis REF: Page 357 OBJ: 5
TOP: Factors Influencing Development KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

21. A mother tells her 4-year-old child that balls should be played with outside and not inside the house. Why is the child likely to obey the rule?
a. The child does not want to be punished.
b. The child wants to please her mother.
c. The child respects authority figures.
d. The child believes that following the rules is right.
ANS: A
According to Kohlberg, children in the preconventional stage (4 to 7 years) are obedient to their parents for fear of punishment.

DIF: Cognitive Level: Comprehension REF: Page 368, Table 15-3
OBJ: 8 TOP: Moral Development
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

22. What should the nurse avoid when demonstrating a bath procedure to parents of Vietnamese origin?
a. Talking directly to the mother
b. Exposing the childs genitals
c. Touching the childs head
d. Using cool water
ANS: C
The Vietnamese are very sensitive about anyone touching a childs head because that is where consciousness lies.

DIF: Cognitive Level: Application REF: Page 363, Table 15-2
OBJ: 7 TOP: Ethnic ConsiderationsVietnamese
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Psychosocial Adaptation

23. What does the nurse calculate the basal metabolic index (BMI) of an 8-year-old child who is 48 inches tall (1.2 meters) and weighs 100 pounds (45.4 kg) to be?
a. 28.9
b. 32.4
c. 34.8
d. 37.6
ANS: B
The formula for BMI calculation is weight in kg divided by height in meters (squared):
45.4 (weight in kg) divided by 1.4 (1.2 squared) = 32.4. A BMI of over 30 is classified as obese.

DIF: Cognitive Level: Analysis REF: Page 379, Skill 15-2
OBJ: 9 TOP: Calculation of BMI
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

24. What toy is developmentally appropriate for the nurse to suggest to entertain a 5-year-old child?
a. Jack-in-the-box
b. Book of nursery rhymes
c. Model airport with toy planes
d. Model car construction kit
ANS: C
At this age children are into creative play. The model airport with toy planes is the most developmentally appropriate.

DIF: Cognitive Level: Application REF: Page 384, Table 15-10
OBJ: 11 TOP: Play Activities
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

25. The nurse caring for a 4-year-old postoperative patient instructs him to blow bubbles. What nursing intervention is the nurse most likely implementing by using this form of therapeutic play?
a. Providing pain relief
b. Encouraging deep breathing
c. Decreasing risk of infection
d. Maintaining body temperature
ANS: B
Play can also be therapeutic and aid in the recovery process. An example of therapeutic play is the game of having the child blow bubbles to promote deep breathing.

DIF: Cognitive Level: Application REF: Page 384 OBJ: 14
TOP: Therapeutic Play KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Health Promotion/Disease Prevention

26. The mother of a 7-year-old pediatric patient asks the nurse about her childs sleep requirement. What is the most accurate response by the nurse?
a. 7 to 10 hours a night
b. 5 to 7 hours a night with one daytime nap
c. 11 to 13 hours a night
d. 4 to 6 hours a night with two daytime naps
ANS: C
Sleep patterns vary with age. The neonate sleeps 8 to 9 hours per night and naps an equal amount of time during the day. The 2-year-old may sleep 10 hours during the night and have only one short daytime nap. The 7-year-old usually requires 11 to 13 hours of sleep and rarely has a daytime nap. These patterns may be altered by cultural practices.

DIF: Cognitive Level: Comprehension REF: Page 355 OBJ: 5
TOP: Sleep KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Health Promotion/Disease Prevention

MULTIPLE RESPONSE

27. How do children differ from adults? (Select all that apply.)
a. Higher metabolic rate
b. Greater surface area in relation to their weight
c. Less mature organ systems
d. More fluid reserves
e. Continuously changing growth and development pattern
ANS: A, B, C, E
Children are in a continuous growth and development pattern. Children have a greater surface area and a higher metabolic rate. All of their organ systems are not mature.

DIF: Cognitive Level: Comprehension REF: Page 350-351
OBJ: 3 TOP: Adult Versus Child
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

28. What approaches should the nurse suggest for introducing a toddler to new foods? (Select all that apply.)
a. Serve one food at a time.
b. Avoid showing personal likes or dislikes.
c. Offer foods in small amounts, less than a teaspoon.
d. Entice the toddler to eat with sweets.
e. Serve food warm.
ANS: A, B, C, E
Foods should be introduced in small, warm servings, one food at a time. Sweets and milk should not be offered until after solid food.

DIF: Cognitive Level: Comprehension REF: Page 376, Table 15-8, 377
OBJ: 9 TOP: Solid Food KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

29. Which healthy snack foods would the school nurse suggest to a group of adolescents? (Select all that apply.)
a. Bubble gum
b. Chocolate-covered peanuts
c. Raw vegetables
d. Cheese
e. Dried fruits
ANS: C, D
Cheese and raw vegetables are acceptable healthy snacks. Bubble gum, chocolate-covered peanuts, and dried fruits all contain high amounts of sugar.

DIF: Cognitive Level: Comprehension REF: Page 376, Table 15-8, 379
OBJ: 9 TOP: Healthy Snacks
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

30. The nurse suggests to the parents of an obese 10-year-old that they use the Portion Plate for Kids placemat. How does this tool help with selection of portion sizes? (Select all that apply.)
a. Cartoon characters eating healthy foods
b. Tips on healthy food choices
c. Portion measurement in tablespoons for common food
d. Calorie values for cup-size portions of common foods
e. Familiar objects such as a deck of cards to measure servings
ANS: B, E
The Portion Plate for Kids is a placemat that uses common objects such as a deck of playing cards or a baseball to measure serving portions.

DIF: Cognitive Level: Comprehension REF: Page 373 Figure 15-7
OBJ: 9 TOP: Portion Plate for Kids
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

31. An educational program is being presented to pediatric nurses on the relationship of play to childhood development. What information should be included in this presentation? (Select all that apply.)
a. Art play should be used sparingly.
b. Use of computer/video games is detrimental.
c. Understanding of child/parent relationships can be gained by observing play.
d. Play encourages self-expression.
e. Play provides a sense of accomplishment.
ANS: C, D, E
Art is an appropriate play activity at almost any age and provides an avenue for experimentation as well as for creative expression and a feeling of accomplishment in the child. Observing the child at play can aid in assessing growth and development and understanding the childs relationships with family members. Any plan of care for a hospitalized child of any age should include a play activity that either encourages growth and development or encourages the expression of thoughts and feelings. Computer programs are popular with all age groups, providing problem-solving skills, manipulative skills, and opportunities for new learning.

DIF: Cognitive Level: Comprehension REF: Page 383-384
OBJ: 12 | 15 TOP: Play KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

32. Parents attending a well visit for their 11-year-old son verbalize concern over his computer use. When asked about it, the boy states, I play games on my computer for 1 hour a day. The nurse knows that computer games can provide what opportunities to childhood development? (Select all that apply.)
a. Problem-solving skills
b. Gross motor development
c. Manipulative skills
d. Learning opportunities
e. Increased self-worth
ANS: A, C, D
Computer programs are popular with all age groups, providing problem-solving skills, manipulative skills, and opportunities for new learning.

DIF: Cognitive Level: Comprehension REF: Page 384 OBJ: 13
TOP: Computer Play KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

COMPLETION

33. The nurse includes in the care plan for a Hispanic family to encourage visits from the ____________ ____________, or _______________ for a healing ceremony.

ANS:
folk healer, curandero

Hispanics have faith in the effect of the curandero and are soothed by the ceremonies.

DIF: Cognitive Level: Knowledge REF: Page 361, Table 15-2
OBJ: 7 TOP: Folk Healer or Curandero
KEY: Nursing Process Step: Planning
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

34. The nurse assesses an unmet need in a hospitalized child who clings to his mother as she is about to leave. As described by Maslow, the basic needs that may be unmet in this case are __________ and ___________.

ANS:
love, belonging

The hospitalized child displaying these symptoms may feel a loss of love and a lack of belonging to the family unit.

DIF: Cognitive Level: Knowledge REF: Page 360, Figure 15-4
OBJ: 8 TOP: Maslows Hierarchy
KEY: Nursing Process Step: Data Collection
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation

35. The nurse cautions that children who are put to sleep with a bottle are at risk for a dental problem called ___________ _____________.

ANS:
nursing caries

The bactericidal effects of saliva decrease during sleep; therefore, when the saliva and the milk combine, they bathe the teeth in a mixture that encourages dental caries.

DIF: Cognitive Level: Knowledge REF: Page 382, Figure 15-14
OBJ: 9 TOP: Nursing Caries
KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

36. The correct term for the child aged 4 weeks to 1 year is ______________.

ANS:
infant

A child between the ages of 4 weeks and 1 year is termed an infant.

DIF: Cognitive Level: Knowledge REF: Page 352 OBJ: 1
TOP: Infant KEY: Nursing Process Step: N/A
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

37. __________ refers to standing measurement, whereas _______ refers to measurement while the infant is in a recumbent position.

ANS:
Height, length

Height refers to standing measurement, whereas length refers to measurement while the infant is in a recumbent position.

DIF: Cognitive Level: Knowledge REF: Page 353 OBJ: 1
TOP: Physical Development KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Growth and Development

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