This document contains questions and answers related to human growth and development across the lifespan. Key points addressed include: - Toddlers have the greatest potential for regression when sick due to their developmental stage. - Major concerns in drug therapy for older adults include reduced hepatic clearance and difficulty swallowing large tablets. - The leading cause of death in the first month of life is congenital abnormalities. - Adolescence is the most unstable period regarding identity development. - Adolescents are most at risk for eating disorders. - When assessing older adults, nurses should expect an increase in urine residual. - According to Erikson, caregivers should allow newborn infants to signal their needs

1. Growth and Development
1. Which age group has the greatest potential to demonstrate regression when they
are sick?
A. Adolescent
B. Young Adult
C. Toddler
D. Infant
2. Which is a major concern when providing drug therapy for older adults?
1. Alcohol is used by older adults to cope with the multiple problems of aging
2. Hepatic clearance is reduced in older adults
3. Older adults have difficulty in swallowing large tablets
4. Older adults may chew on tablets instead of swallowing them.
3. One of the participants attending a parenting class asks the teacher “what is the
leading cause of death during the first month of life?
1. Congenital Abnormalities
2. Low birth weight
3. SIDS
4. Infection
4. Which stage of development is most unstable and challenging regarding
development of personal identity?
1. Adolescence
2. Toddler hood
3. Childhood
4. Infancy
5. Which age group would have a tendency towards eating disorders?

2. A. Adolescence
B. Toddler hood
C. Childhood
D. Infancy
6. When assessing an older adult. The nurse may expect an increase in:
1. Nail growth
2. Skin turgor
3. Urine residual
4. Nerve conduction
7. A maternity nurse is providing instruction to a new mother regarding the
psychosocial development of the newborn infant. Using Erikson’s psychosocial
development theory, the nurse would instruct the mother to
1. Allow the newborn infant to signal a need
2. Anticipate all of the needs of the newborn infant
3. Avoid the newborn infant during the first 10 minutes of crying
4. Attend to the newborn infant immediately when crying
8. A mother of a 3-year-old tells a clinic nurse that the child is rebelling constantly and
having temper tantrums. The nurse most appropriately tells the mother to:
1. Punish the child every time the child says “no”, to change the behavior
2. Allow the behavior because this is normal at this age period
3. Set limits on the child’s behavior
4. Ignore the child when this behavior occurs
9. The parents of a 2-year-old arrive at a hospital to visit their child. The child is in the
playroom when the parents arrive. When the parents enter the playroom, the child does
not readily approach the parents. The nurse interprets this behavior as indicating that:

3. 1. The child is withdrawn
2. The child is self-centered
3. The child has adjusted to the hospitalized setting
4. This is a normal pattern
10. The mother of a 3-year-old is concerned because her child still is insisting on a
bottle at nap time and at bedtime. Which of the following is the most appropriate
suggestion to the mother?
1. Do not allow the child to have the bottle
2. Allow the bottle during naps but not at bedtime
3. Allow the bottle if it contains juice
4. Allow the bottle if it contains water
11. A nurse is evaluating the developmental level of a 2-year-old. Which of the following
does the nurse expect toobserve in this child?
1. Uses a fork to eat
2. Uses a cup to drink
3. Uses a knife for cutting food
4. Pours own milk into a cup
12. The nurse is providing an educational session to new employees, and the topic is
abuse to the older client. The nurse tells the employees that which client is most
characteristic of a victim of abuse
1. A 90-year-old woman with advanced Parkinson’s disease
2. A 68-year-old man with newly diagnosed cataracts
3. A 70-year-old woman with early diagnosed Lyme’s disease
4. A 74-year-old man with moderate hypertension
13. The home care nurse is visiting an older female client whose husband died 6 months
ago. Which behavior, by the client, indicates ineffective coping?
1. Visiting her husband’s grave once a month
2. Participating in a senior citizens program

4. 3. Looking at old snapshots of her family
4. Neglecting her personal grooming
14. A clinic nurse assesses the communication patterns of a 5-month-old infant. The
nurse determines that the infant is demonstrating the highest level of developmental
achievement expected if the infant:
1. Uses simple words such as “mama”
2. Uses monosyllabic babbling
3. Links syllables together
4. Coos when comforted
15. A nurse is preparing to care for a 5-year-old who has been placed in traction
following a fracture of the femur. The nurse plans care, knowing that which of the
following is the most appropriate activity for this child?
1. Large picture books
2. A radio
3. Crayons and coloring book
4. A sports video
16. A 16-year-old is admitted to the hospital for acute appendicitis, and an
appendectomy is performed. Which of the following nursing interventions is most
appropriate to facilitate normal growth and development?
1. Allow the family to bring in the child’s favorite computer games
2. Encourage the parents to room-in with the child
3. Encourage the child to rest and read
4. Allow the child to participate in activities with other individuals in the same age
group when the condition permits
17. The mother of a toddler asks a nurse when it is safe to place the car safety seat in a
face-forward position. The best nursing response is which of the following?
1. When the toddler weighs 20 lbs

5. 2. The seat should not be placed in a face-forward position unless there are safety
locks in the car
3. The seat should never be place in a face-forward position because the risk of the
child unbuckling the harness
4. When the weight of the toddler is greater than 40 lbs
18. The nurse is caring for an agitated older client with Alzheimer’s disease. Which
nursing intervention most likely would calm the client?
1. Playing a radio
2. Turning the lights out
3. Putting an arm around the client’s waist
4. Encouraging group participation
19. The nurse who volunteers at a senior citizens center is planning activities for the
members who attend the center. Which activity would best promote health and
maintenance for these senior citizens?
1. Gardening every day for an hour
2. Cycling 3 times a week for 20 minutes
3. Sculpting once a week for 40 minutes
4. Walking 3 to 5 times a week for 30 minutes
1. C.
2. B.
3.
4. A.
5. A.
6. C.

6. 7. A. According to Erikson, the caregiver should not try toanticipate the newborn
infant’s needs at all times but must allow the newborn infant to signal needs. If a
newborn is not allowed to signal a need, the newborn will not learn how to control the
environment. Erikson believed that a delayed or prolonged response to a newborn’s
signal would inhibit the development of trust and lead to mistrust of others.
8. C. According to Erikson, the child focuses on independence between ages 1 and 3
years. Gaining independence often means that the child has to rebel against the parents’
wishes. Saying things like “no” or “mine” and having temper tantrums are common
during this period of development. Being consistent and setting limits on the child’s
behavior are the necessary elements.
9. D. The phases through which young children progress when separated from their
parents include protest, despair, and denial or detachment. In the stage of protest,
when the parents return, the child readily goes to them. In the stage of despair, the
child may not approach them readily or may cling to a parent. In denial or detachment,
when the parents return, the child becomes cheerful, interested in the environment and
new persons (seemingly unaware of the lost parents), friendly with the staff, and
interested in developing superficial relationships.
10. D. A toddler should never be allowed to fall asleep with a bottle containing milk,
juice, soda, or sweetened water because of the risk or nursing caries. If a bottle is
allowed at nap time or bedtime, it should contain only water.
11. B. By age 2 years, the child can use a cup and can use a spoon correctly but with
some spilling. By ages 3 to 4, the child begins to use a fork. By the end of the preschool
period, the child should be able to pour milk into a cup and begin to use a knife for
cutting.
12. A. The typical abuse victim is a woman of advanced age with few social contacts and
at least one physical or mental impairment that limits the ability to perform activities of
daily living. In addition, the client usually lives alone or with the abuser and depends on
the abuser for care.
13. D. Coping mechanisms are behaviors used to decrease stress and anxiety. In
response to a death, ineffective coping is manifested by an extreme behavior that in

7. some instances may be harmful to the individual physically or psychologically. Option
D is indicative of a behavior that indentifies an ineffective coping behavior in the
grieving process.
14. B. Using monosyllabic babbling occurs between 3 and 6 months of age. Using
simple words such as “mama” occurs between 9 and 12 months. Linking syllables
together when communicating occurs between 6 and 9 months. Cooing begins at birth
and continues until 2 months.
15. C. In the preschooler, play is simple and imaginative and includes activities such as
crayons and coloring books, puppets, felt and magnetic boards, and Play-Doh. Large
picture books are most appropriate for the infant. A radio and a sports video are most
appropriate for the adolescent.
16. D. Adolescents often are not sure whether they want their parents with them when
they are hospitalized. Because of the importance of the peer group, separation from
friends is a source of anxiety. Ideally, the members of the peer group will support their
ill friend. Options a, b, and c isolate the child from the peer group.
17. A. The transition point for switching to the forward facing position is defined by the
manufacturer of the convertible car safety seat but is generally at a body weight of 9 kg
or 20 lb and 1 year of age. Convertible car safety seats are used until the child weighs at
least 40 lb. Options b, c, and d are incorrect
18. C. Nursing interventions for the client with Alzheimer’s disease who is angry,
frustrated, or hostile include decreasing environmental stimuli, approaching the client
calmy and with assurance, not demanding anything from the client, and distracting the
client. For the nurse to reach out, touch, hold a hand, put an arm around the waist, or in
some way maintain physical contact is important. Playing a radio may increase stimuli,
and turning the lights out may produce more agitation. The client with Alzheimer’s
disease would not be a candidate for group work if the client is agitated.
19. D. Exercise and activity are essential for health promotion and maintenance in the
older adult and to achieve an optimal level of functioning. About half of the physical
deterioration of the older client is caused by disuse rather that by the aging process or

8. disease. One of the best exercises for an older adult is walking, progressing to 30
minutes session 3 to 5 times each week. Swimming and dancing are also beneficial.

9. Erikson's 8 Stages of Development
Page history last edited by Jerry Carley 5 years, 4 months ago
Stages
Conflict to Be
Resolved:
Examples:
Oral-Sensory
(Birth to 1
Year)
Trust
vs
Mistrust
Babies learn to trust <OR> to mistrust that others will care for their basic needs, including
nourishment, sucking, warmth, cleanliness, and phy sical contact.
Musculo-Anal
(1-3 Years)
Autonomy
vs
Shame & Doubt
C hildren learn to either be self-sufficient in many activ ities, including toileting, feeding.
walking, and talking <OR> to doubt their own abilities.
Locomotor-
Genital
(3-5 Years)
Initiative
vs
Guilt
C hildren want to undertake many adultlike activ ities, sometimes ov erstepping the limits set by
parents--causing guilt.
Latency
(6 -11 Years)
Industry
vs
Inferiority
C hildren busily learn to be competent and productiv e <OR> feel inferior and unable to do
any thing well.
Adolescence
(12-18 Years)
Identity
vs
A dolescents try to figure out "Who am I?" They establish sexual, ethnic, and career
identiies <OR> are confused about what future roles to play .

10. Role Confusion
Young
Adulthood
(19-35 Years)
Intimacy
vs
Isolation
Young adults seek companionship and lov e with another person, <OR> become isolated from
others.
Adulthood
(19-35 Years)
Generativity
vs
Stagnation
Middle aged adults are productiv e, performing meaningful work, and raising a family <OR>
become stagnant and inactiv e.
Maturity
(50+ Years)
Integrity
vs
Despair
O lder adults try to make sense out of their liv es, either seeing life as a meaningful
whole <OR> despairing at goals nev er reached and questions nev er answered.
Nursing Care: Growth and Development
Critical Concepts
Growth: Quantitative aspects; e.g. Height

11. Development: Qualitative aspects; e.g. Social behavior/skills
Maturation:
Integrated process: Combines quantitative & qualitative aspects
Critical Periods:
Necessary Factors: Sensory stimulation, timing, & readiness
General Principles
Orderly sequence & direction
Complex, predictable patterns
Unique to individuals
Periods of conflict & adaptation with tasks, change, & challenge
Influenced by heredity, temperament, and environment
Theories: Erikson (Psychosocial)
Goal: Self-actualization
Life Span Considerations
Developmental perspective is organized and systematic
Developmental assessment/needs are critical to plan of care

12. Nurse must understand normal growth and development
Nurse assesses cognitive development, physical growth, and psychosocial development
Erikson's Developmental Stages
Infancy: First year of life
Erikson: Trust vs Mistrust
Rapid, steady physical growth: length, weight, head circumference, nutrition, reflexive to purposeful
behavior
Caregiver-child bonding based on personal interactions
Environment provides sensory stimulation for learning
Toddler: 1-3 years
Erikson: Autonomy vs Shame & Doubt
Psychomotor skills: Gross to fine
Egocentric, no right/wrong
Wants independence but fears separation

13. Health Concerns: Accidents (ingestion of poison, drowning), ear and upper respiratory infections
Preschooler: 3-6 years
Erikson: Initiative vs Guilt
lower physical growth with increased muscle coordination
Concrete thinking: Ask "why?"
Fear bodily harm
Pretend play: Parallel to cooperative
Health Concerns: Accidents, speech disorders
School-age: 6-11 years
Erikson: Industry vs Inferiority
Fine tuning of body systems
Intense cognitive development
Moving toward abstract thinking
Developing problem solving: "What if?"
Independence: same sex peers
Developing moral code: Right/Wrong

14. Health Concerns: Accidents, learning disabilities, infectious disease, cancer
Adolescence: 13 - 21 years
Erikson: Identity vs Role Confusion
Sexual maturation: Primary and secondary sex characteristics
Logical decision-making
Internalized moral code
Need close peer relationships
Health Concerns: Accidents, substance abuse, pregnancy, STDs, eating disorders
Young Adult: Late teens - mid 30s
Erikson: Intimacy vs Isolation
Physical growth completed
Focus on personal & social tasks: career choice, social and intimate relationships, self-concept, adult
relationship with family
Health Concerns: Accidents, violence, STDs, job & family stress, unhealthy lifestyle practices (ETOH,
smoking).
Need to learn & practice SBE, TSE

15. Middle Adult: 35 - 65 years
Erikson: Generativity vs Stagnation
Changes in physical state: Menopause, andropause
Focus on family, work, aging parents (Sandwich Generation)
Health Concerns: Health screening (mammograms, PSA), stress reduction, healthy lifestyle strategies,
adjustment to life transitions
Older Adult: 65 and older
"Old-old" and "Frail-old": 75 and older
"Elite-old": 85 and older
Erikson: Ego integrity vs Despair
Ageism: a concern for nurses
Aging is a normal, healthy process that begins at birth
System-wide physical changes
Cognitive changes due to illness not aging
Numerous lifestyle changes
Goals:
Remain independent, accept aging, transitions, and loss.
Strategies:

16. Reminiscence/life review (Storytelling)
Exercise, nutrition, sensory stimulation