Maternal Child Nursing 5th Edition by Mckinney – Test Bank

Complete Test Bank With Answers

Sample Questions Posted Below

Chapter 05: Health Promotion for the Developing Child
McKinney: Evolve Resources for Maternal-Child Nursing, 5th Edition

MULTIPLE CHOICE

1. Which statement best describes development in infants and children?

a. Development, a predictable and orderly process, occurs at varying rates within
normal limits.

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

occurring first.
d. Development is more easily and accurately measured than growth.

ANS: 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. An increase in the number and size of cells is a
definition for growth. Development proceeds in a proximodistal direction with fine muscle
organization occurring as a result of large muscle organization. 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.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 62 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

2. 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.

ANS: 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. Infancy is a dynamic time of development that
requires frequent evaluations to assess appropriate developmental progress. Infants in a
nurturing environment will develop appropriately and will not necessarily need stimulation
specific to their developmental stage. Normal growth and development is orderly and
proceeds in a predictable pattern based on each individual’s abilities and potentials.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 64 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

3. The nurse is assessing an infant’s growth and development. The parents want education on

how to stimulate this process. What action suggested by the nurse is inconsistent with
knowledge of this topic?

TestBankWorld.org

a. Have the family draw a three-generation family pedigree.
b. Show the family how to coo and babble with their child.
c. Encourage the parents to buy interactive toys for the child.
d. Involve the child in activities that are outside the home.

ANS: A
A family pedigree can help show relationships and health care problems but will not stimulate
growth and development. Activities that are stimulating for a child include the consistent use
of language by the parents, allowing play time with interactive toys (toys that make noises or
do something in response to the baby’s actions), and exposing the child to new sights and
sounds.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 66 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

4. 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.
a. sensorimotor
b. formal operations
c. concrete operations
d. preoperational

ANS: 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. 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. Formal
operations is a period in development in which new ideas are created through previous
thoughts. Analytic reason and abstract thought emerge in this period. The preoperational stage
is a period of egocentrism in which the child’s judgments are illogical and dominated by
magical thinking and animism.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 68 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

5. The theorist who viewed developmental progression as a lifelong series of conflicts that need

resolution is
a. Erikson.
b. Freud.
c. Kohlberg.
d. Piaget.

ANS: A

TestBankWorld.org

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. 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.
Lawrence Kohlberg described moral development as having three levels (preconventional,
conventional, and postconventional). His theory closely parallels Piaget’s.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 69 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

6. A nurse wants to assess a chronically ill child’s feelings regarding a lengthy hospitalization

and treatments. What action by the nurse is best?
a. Ask direct questions of the child as to feelings.
b. Watch the child play on several occasions.
c. Discuss the situation with the parents.
d. Refer the child to the child life specialist for assessment.

ANS: B
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. The nurse can best decipher the child’s
emotional state by observing this activity. Children often are threatened by direct questions,
especially if the questioner is not well known to the child. The nurse may want to discuss the
situation with the parents or enlist the help of the child life specialist, but these will not give
the nurse the rich data that can be obtained through watching the child play.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 73 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

7. 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

ANS: B
All children can be frightened by hospitalization. However, 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. Young
infants are not as likely to be as frightened as toddlers by hospitalization because they are not
as aware of the environment. The 9-year-old child’s cognitive ability is sufficient for the child
to understand the reason for hospitalization. The 15-year-old adolescent has the cognitive
ability to interpret the reason for hospitalization.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: Table 5.2 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

TestBankWorld.org

8. A nurse uses Erikson’s theory to guide nursing practice. What action by a hospitalized

4-year-old child would the nurse evaluate as developmentally appropriate?
a. Dressed and fed by the parents
b. Independently ask for play materials or other personal needs
c. Verbalizes an understanding of the reason for the hospitalization
d. Asks for a parent stay in the room at all times

ANS: 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. Parents need to foster appropriate developmental behavior in
the 4-year-old child. Dressing and feeding the child do not encourage independent behavior. 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. Parents staying with the child throughout a hospitalization is not a developmental
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.

PTS: 1 DIF: Cognitive Level: Evaluation/Evaluating
REF: Table 5.2 OBJ: Nursing Process: Evaluation
MSC: Client Needs: Health Promotion and Maintenance

9. A nurse wants to work to increase the number of immunized children. What action by the

nurse would best meet this goal?
a. Present a workshop to the local home-schooling parent support group.
b. Volunteer for a mass “back to school” immunization clinic.
c. Prepare welcome and information packets to college freshmen.
d. Work with the health department to bring immunizations to day cares.

ANS: A
Home-schooled children are often overlooked when it comes to immunizations, because they
are not in immunization-friendly systems such as day care, schools, and colleges where
immunizations are required. The best way for the nurse to help increase the number of
immunized children is to reach out to the home-schooled group.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 75 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

10. The parents of a preschool-aged child are in the clinic and report the child is seen playing with

the genitals frequently. What response by the nurse is best?
a. Reassure parents this is normal at this age.
b. Teach parents about behavior modification.
c. Refer parents and child to a psychologist.
d. Ask the provider to speak to the parents.

ANS: A

TestBankWorld.org

Preschool children are in the Phallic or Oedipal/Electra Stage of Freud’s theory during which
the genitals become the focus of curiosity and interest. The nurse should explain that this
behavior is normal at this stage. Teaching about disciplinary techniques and referrals to
psychotherapy are inappropriate. The nurse may well want the provider to speak to the
parents, but the nurse is responsible for patient/parent teaching and should provide education
him- or herself.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: Table 5.2 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

11. A nurse is teaching parents to avoid environmental injury to their 2-year-old child. What

information does the nurse include in teaching?
a. Avoiding sun exposure, secondhand smoke, and lead
b. Living in a middle-class neighborhood
c. Avoiding smoking and alcohol intake during pregnancy
d. Limiting breastfeeding to avoid toxins being passed through breast milk

ANS: 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. The nurse is unable to influence socioeconomic status, and the family may not want or
be able to move. 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. It is unlikely
that a 2-year-old child will still be breastfeeding.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 65 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

12. Which immunizations should be used with caution in children with an allergy to eggs?

a. HepB
b. DTaP
c. Hib
d. MMR

ANS: 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 vaccine. The other vaccines are safe for children
with an egg allergy.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 77 OBJ: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity

13. When counseling parents and children about the importance of increased physical activity, the

nurse will emphasize which of the following?
a. Anaerobic exercise should comprise a major component of the child’s daily

exercise.
TestBankWorld.org

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. Make exercise a fun and habitual activity.

ANS: D
It is important to make exercise a fun and habitual activity. Encourage parents to investigate
their community’s different activity programs. This includes recreation centers, parks, and the
YMCA. Aerobic exercise should comprise a major component of children’s daily exercise;
however, physical activity should also include muscle- and bone-strengthening activities.
Children and adolescents should be physically active for at least 1 hour daily. Encourage all
students to participate fully in any physical education classes.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: p. 80 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

14. A student nurse is preparing to administer an Hib vaccination to an infant. What action by the

student requires the registered nurse to intervene?
a. Gives the vaccine information statement prior to administering the vaccine
b. Wipes the dorsal gluteal area with alcohol prior to injection
c. Obtains written informed consent before giving the vaccine
d. Assesses the family’s beliefs and values about vaccinations

ANS: B
The anterolateral thigh is the preferred site for intramuscular administration of vaccines for
infants. When the student prepares the wrong site, the registered nurse should intervene.
Federal law requires parents be given vaccine information statements and sign informed
consent prior to the nurse’s administering vaccinations. The nurse should also assess the
family’s beliefs and values related to vaccination, which can help dispel myths and guide
teaching.

PTS: 1 DIF: Cognitive Level: Application/Applying
REF: p. 76 OBJ: Nursing Process: Implementation
MSC: Client Needs: Safe and Effective Care Environment

15. A nurse is planning to teach about injury prevention to a group of parents. What action by the

nurse would best ensure a successful event?
a. Have handouts listing community resources.
b. Provide free safety gear like bike helmets.
c. Group parents by child’s developmental stage.
d. Present the material in an interactive way.

ANS: C
When providing anticipatory guidance to prevent injury, the most important thing for the
nurse to know and understand is developmental levels of the children involved. Grouping
parents by their child’s developmental level allows the nurse to know this information about
the group and to provide teaching specific to the group. The other options will help but are not
as important as tailoring teaching to the specific needs of the children.

PTS: 1 DIF: Cognitive Level: Application/Applying

TestBankWorld.org

REF: p. 80 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

16. A nurse is assessing a 1-year-old’s food intake over the past 3 days. What information from

the parent leads the nurse to provide education on nutrition?
a. Child drinks 2 cups of 1% milk each day.
b. Child loves to snack on fruit throughout the day.
c. Child gets one 4-ounce cup of juice with breakfast.
d. Parent allows child to regulate own portions at meals.

ANS: A
A child this age should not be drinking low-fat milk. Snacking on fruit, 4 ounces of juice, and
not forcing the child to eat everything on the plate are appropriate activity and do not require
education.

PTS: 1 DIF: Cognitive Level: Comprehension/Understanding
REF: Box 5.6 OBJ: Integrated Process: Teaching-Learning
MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. The nurse preparing to administer the Denver Developmental Screening Test II (DDST-II)

should understand that it assesses which functional areas? (Select all that apply.)
a. Personal-functional
b. Fine motor
c. Intelligence
d. Language
e. Gross motor

ANS: A, B, D, E
The four functional areas assessed by this tool are personal-functional, fine motor, language,
and gross motor. It is not an intelligence test.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 72 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

2. An immunocompromised child is in the clinic for immunizations. Which vaccine

prescriptions should the nurse question? (Select all that apply.)
a. DTaP
b. HepA
c. IPV
d. Varicella
e. MMR

ANS: D, E
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. DTaP,
HepA, and IPV can be given safely.

TestBankWorld.org

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 77 OBJ: Nursing Process: Planning
MSC: Client Needs: Physiologic Integrity

3. A preschool aged child is in the clinic for a well-child checkup. Which statement identifies an

appropriate level of language development in this child? (Select all that apply.)
a. Vocabulary of 300 words
b. Relates elaborate tales
c. Uses correct grammar in sentences
d. Able to pronounce consonants clearly
e. Expresses abstract thought

ANS: B, C
The 4-year-old child is able to use correct grammar in sentence structure and can tell elaborate
tales and stories. A vocabulary of 300 words is appropriate for a 2-year-old. The 4-year-old
child typically has difficulty in pronouncing consonants. The use of language to express
abstract thought is developmentally appropriate for the adolescent.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 62 OBJ: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance

4. A 2-month-old child has not had any immunizations. Which ones should the nurse prepare to

give? (Select all that apply.)
a. Hib
b. HepB
c. MCV
d. Varicella
e. HPV

ANS: A, B, C, D
Hib, HepB, MCV, and varicella are all appropriate vaccinations for this child. HPV is for
adolescents.

PTS: 1 DIF: Cognitive Level: Knowledge/Remembering
REF: p. 75 OBJ: Nursing Process: Implementation
MSC: Client Needs: Health Promotion and Maintenance

TestBankWorld.org