Which developmental milestone would the nurse anticipate for a 24 month old child

1. The clinic nurse is preparing to discuss the concepts of Kohlberg's theory of moral development with a parent. What motivates good and bad actions for the child at the preconventional level? 
   1. Peer pressure 
   2. Social pressure 
   3. Parents' behavior 
   4. Punishment and reward

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   • Which statement describes the growth and development in a 24
   • Which toy is the most developmentally appropriate for an 18 to 24
   • Which characteristic is appropriate for motor skills of a 24
   • Which developmental milestones with the nurse anticipate for a 15 month old child?

   4. Punishment and reward

2. The maternity nurse is providing instructions to a new mother regarding the psychosocial development of the newborn infant. Using Erikson's psychosocial development theory, the nurse instructs the mother to take which measure? 
   1. Allow the newborn infant to signal a need. 
   2. Anticipate all the needs of the newborn infant. 
   3. Attend to the newborn infant immediately when crying. 
   4. Avoid the newborn infant during the first 10 minutes of crying.

   1. Allow the newborn infant to signal a need.

3. The mother of a 4-year-old child calls the clinic nurse and expresses concern because the child has been masturbating. Using Freud's psychosexual stages of development, the nurse should make which response? 
   1. "This is a normal behavior at this age." 
   2. "Children usually begin this behavior at age 8 years." 
   3. "The child is very young to begin this behavior and should be brought to the clinic." 
   4. "This is not normal behavior, and the child should be seen by the health care provider."

   1. "This is a normal behavior at this age."

4. The nursing instructor asks a nursing student to present a clinical conference to peers regarding Freud's psychosexual stages of development, specifically the anal stage. The student plans the conference, knowing that which characteristic relates to this stage of development? 
   1. This stage is associated with toilet training. 
   2. This stage is characterized by the gratification of self. 
   3. This stage is characterized by a tapering off of conscious biological and sexual urges. 
   4. This stage is associated with pleasurable and conflicting feelings about the genital organs.

   1. This stage is associated with toilet training.

5. The nursing instructor asks a nursing student to describe the formal operations stage of Piaget's cognitive developmental theory. The correct response by the nursing student is which statement? 
   1. "The child has the ability to think abstractly." 
   2. "The child begins to understand the environment." 
   3. "The child is able to classify, order, and sort facts." 
   4. "The child learns to think in terms of past, present, and future."

   1. "The child has the ability to think abstractly."

6. The mother of an 8-year-old child tells the clinic nurse that she is concerned about the child because the child seems to be more attentive to friends than anything else. Using Erikson's psychosocial development theory, the nurse should make which response? 
   1. "You need to be concerned." 
   2. "You need to monitor the child's behavior closely." 
   3. "At this age, the child is developing his own personality." 
   4. "You need to provide more praise to the child to stop this behavior."

   3. "At this age, the child is developing his own personality."

7. The nurse educator is preparing to conduct a teaching session for the nursing staff regarding the theories of growth and development and plans to discuss Kohlberg's theory of moral development. What information should the nurse include in the session? Select all that apply. 
   1. Individuals move through all six stages in a sequential fashion. 
   2. Moral development progresses in relationship to cognitive development. 
   3. A person's ability to make moral judgments develops over a period of time. 
   4. The theory provides a framework for understanding how individuals determine a moral code to guide their behavior. 
   5. In stage 1 (punishment-obedience orientation), children are expected to reason as mature members of society. 
   6. In stage 2 (instrumental-relativist orientation), the child conforms to rules to obtain rewards or have favors returned.

   • 2. Moral development progresses in relationship to cognitive development. 
   • 3. A person's ability to make moral judgments develops over a period of time. 
   • 4. The theory provides a framework for understanding how individuals determine a moral code to guide their behavior. 
   • 6. In stage 2 (instrumental-relativist orientation), the child conforms to rules to obtain rewards or have favors returned.

8. A parent of a 3-year-old tells a clinic nurse that the child is rebelling constantly and having temper tantrums. Using Erikson's psychosocial development theory, which instructions should the nurse provide to the parent? Select all that apply. 
   1. Set limits on the child's behavior. 
   2. Ignore the child when this behavior occurs. 
   3. Allow the behavior, because this is normal at this age period. 
   4. Provide a simple explanation of why the behavior is unacceptable. 
   5. Punish the child every time the child says "no" to change the behavior.

   • 1. Set limits on the child's behavior. 
   • 4. Provide a simple explanation of why the behavior is unacceptable.

9. A 4-year-old child diagnosed with leukemia is hospitalized for chemotherapy. The child is fearful of the hospitalization. Which nursing intervention should be implemented to alleviate the child's fears? 
   1. Encourage the child's parents to stay with the child. 
   2. Encourage play with other children of the same age. 
   3. Advise the family to visit only during the scheduled visiting hours. 
   4. Provide a private room, allowing the child to bring favorite toys from home.

   1. Encourage the child's parents to stay with the child.

10. A 16-year-old is admitted to the hospital for acute appendicitis and an appendectomy is performed. Which nursing intervention is most appropriate to facilitate normal growth and development postoperatively? 
    1. Encourage the child to rest and read. 
    2. Encourage the parents to room in with the child. 
    3. Allow the family to bring in the child's favorite computer games. 
    4. Allow the child to interact with others in his or her same age group.

    4. Allow the child to interact with others in his or her same age group.

11. Which car safety device should be used for a child who is 8 years old and is 4 feet tall? 
    1. Seat belt 
    2. Booster seat 
    3. Rear-facing convertible seat 
    4. Front-facing convertible seat

    2. Booster seat

12. The nurse assesses the vital signs of a 12-month-old infant with a respiratory infection and notes that the respiratory rate is 35 breaths/minute. On the basis of this finding, which action is most appropriate? 
    1. Administer oxygen. 
    2. Document the findings. 
    3. Notify the health care provider. 
    4. Reassess the respiratory rate in 15 minutes.

    2. Document the findings.

13. The nurse is monitoring a 3-month-old infant for signs of increased intracranial pressure. On palpation of the fontanels, the nurse notes that the anterior fontanel is soft and flat. On the basis of this finding, which nursing action is most appropriate? 
    1. Increase oral fluids. 
    2. Document the finding. 
    3. Notify the health care provider (HCP). 
    4. Elevate the head of the bed to 90 degrees.

    2. Document the finding.

14. The nurse is evaluating the developmental level of a 2-year-old. Which does the nurse expect to observe in this child? 
    1. Uses a fork to eat 
    2. Uses a cup to drink 
    3. Pours own milk into a cup 
    4. Uses a knife for cutting food

    2. Uses a cup to drink

15. The 2-year-old child is treated in the emergency department for a burn to the chest and abdomen. The child sustained the burn by grabbing a cup of hot coffee that was left on the kitchen counter. The nurse reviews safety principles with the parents before discharge. Which statement by the parents indicates an understanding of measures to provide safety in the home? 
    1. "We will be sure not to leave hot liquids unattended." 
    2. "I guess my children need to understand what the word hot means." 
    3. "We will be sure that the children stay in their rooms when we work in the kitchen." 
    4. "We will install a safety gate as soon as we get home so the children cannot get into the kitchen."

    1. "We will be sure not to leave hot liquids unattended."

16. A mother arrives at a clinic with her toddler and tells the nurse that she has a difficult time getting the child to go to bed at night. What measure is most appropriate for the nurse to suggest to the mother? 
    1. Allow the child to set bedtime limits. 
    2. Allow the child to have temper tantrums. 
    3. Avoid letting the child nap during the day. 
    4. Inform the child of bedtime a few minutes before it is time for bed.

    4. Inform the child of bedtime a few minutes before it is time for bed.

17. 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 is the most appropriatesuggestion to the mother? 
    1. Allow the bottle if it contains juice. 
    2. Allow the bottle if it contains water. 
    3. Do not allow the child to have the bottle. 
    4. Allow the bottle during naps but not at bedtime.

    2. Allow the bottle if it contains water.

18. The 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 is the most appropriate activity for this child? 
    1. A radio 
    2. A sports video 
    3. Large picture books 
    4. Crayons and a coloring book

    4. Crayons and a coloring book

19. A mother of a 3-year-old asks a clinic nurse about appropriate and safe toys for the child. The nurse should tell the mother that the most appropriate toy for a 3-year-old is which? 
    1. A wagon 
    2. A golf set 
    3. A farm set 
    4. A jack set with marbles

    1. A wagon

20. Which interventions are appropriate for the care of an infant? Select all that apply. 
    1. Provide swaddling. 
    2. Talk in a loud voice. 
    3. Provide the infant with a bottle of juice at nap time. 
    4. Hang mobiles with black and white contrast designs. 
    5. Caress the infant while bathing or during diaper changes. 
    6. Allow the infant to cry for at least 10 minutes before responding.

    • 1. Provide swaddling. 
    • 4. Hang mobiles with black and white contrast designs. 
    • 5. Caress the infant while bathing or during diaper changes.

21. The nurse is caring for a 4-year-old child with human immunodeficiency virus (HIV) infection. The nurse should plan care with the understanding that which childhood psychosocial need occurs at this age? 
    1. Expressing fear, withdrawal, and denial 
    2. Beginning to understand that something is wrong 
    3. Unable to grasp the concept of illness and death 
    4. Beginning to conceptualize the death process as involving physical harm

    4. Beginning to conceptualize the death process as involving physical harm

22. A 1-year-old child with hypospadias is scheduled for surgery to correct this condition. While preparing the nursing care plan for this child, which factor should the nurse take into consideration? 
    1. This surgery is taking place at a time when fears of separation are great. 
    2. This surgery is taking place at a time when sibling rivalry will cause regression to occur. 
    3. This surgery is taking place at a time when concern over size and function of the penis is present. 
    4. This surgery is taking place at a time when embarrassment about voiding irregularities is common.

    1. This surgery is taking place at a time when fears of separation are great.

23. The mother of a 16-year-old tells a nurse that she is concerned because her child sleeps about 8 hours every night and until noontime every weekend. Which nursing response is most appropriate? 
    1. "The child should not be staying up so late at night." 
    2. "Adolescents need that amount of sleep every night." 
    3. "If the child eats properly, that should not be happening." 
    4. "The child probably is anemic and should eat more foods containing iron."

    2. "Adolescents need that amount of sleep every night."

24. The clinic nurse provides information to the mother of a toddler regarding toilet training. Which statement by the mother indicates a need for further information regarding toilet training? 
    1. "Bladder control usually is achieved before bowel control." 
    2. "The child should not be forced to sit on the potty for long periods." 
    3. "The ability of the child to remove clothing is a sign of physical readiness." 
    4. "The child will not be ready to toilet train until the age of about 18 to 24 months."

    1. "Bladder control usually is achieved before bowel control."

25. The clinic nurse assesses the communication patterns of a 5-month-old infant. Which assessment finding should lead the nurse to determine that the infant is demonstrating the highest level of developmental achievement expected? 
    1. Coos when comforted 
    2. Links syllables together 
    3. Uses monosyllabic babbling 
    4. Uses simple words such as mama

    3. Uses monosyllabic babbling

26. A mother of a 4-year-old expresses concern because her hospitalized child has begun thumb sucking. The mother states that this behavior began 2 days after hospital admission. Which response by the nurse is most appropriate? 
    1. "It is best to ignore the behavior." 
    2. "Your child is acting like a baby." 
    3. "The doctor will need to be notified." 
    4. "A 4-year-old is too old for this type of behavior."

    1. "It is best to ignore the behavior."

27. 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. Which is the correct interpretation of the behavior? 
    1. The child is withdrawn. 
    2. The child is self-centered. 
    3. The child exhibits detachment. 
    4. The child has adjusted to the hospital setting.

    3. The child exhibits detachment.

28. Which statement indicates the "law and order orientation" found in level two of Kohlberg's theory of moral development? 
    1. "If I skip down the hall, will the teacher be mad at me?" 
    2. "We will spend time talking about the activities for the week." 
    3. "I don't like it when you yell while I am talking to my friend. Here are some activities to do until I am finished talking." 
    4. "If you do all of your classwork today without bothering others in the class, you will get an extra ‘seed' for your good behavior garden."

    1. "If I skip down the hall, will the teacher be mad at me?"

29. A 15-year-old is injured and sustains a fractured jaw. The fractured jaw has been surgically wired, and the health care provider has prescribed a full liquid diet. Which nursing action would best promote compliance and provide an adequate nutrient value with the full liquid diet for this teenager? 
    1. Offer chocolate milkshakes between meals. 
    2. Explain the importance of good nutrition to the teenager. 
    3. Offer commercial nutritional supplements four to six times per day. 
    4. Ask the teenager for food preferences and blenderize these foods into liquids.

    4. Ask the teenager for food preferences and blenderize these foods into liquids.

30. The nurse in the pediatric unit is admitting a 2½-year-old child. The nurse plans care, knowing that the child is in which stage of Erikson's psychosocial stages of development? 
    1. Trust versus Mistrust 
    2. Initiative versus Guilt 
    3. Industry versus Inferiority 
    4. Autonomy versus Shame and Doubt

    4. Autonomy versus Shame and Doubt

31. The nurse is admitting a 10-month-old infant who is being hospitalized for a respiratory infection. The nurse develops a plan of care for the infant and includes which most appropriate intervention? 
    1. Keeping the infant as quiet as possible 
    2. Restraining the infant to prevent dislodging of tubes 
    3. Placing small toys in the crib to provide stimulation for the infant 
    4. Providing a consistent routine with touching, rocking, and cuddling throughout hospitalization

    4. Providing a consistent routine with touching, rocking, and cuddling throughout hospitalization

32. The clinic nurse has provided instructions regarding dental care for toddlers to the mother of a 2-year-old child. Which statement, if made by the mother, indicates a need for further instruction? 
    1. "It is best to substitute sweets or snacks with food items such as cheese." 
    2. "Proper dental care is not necessary for a toddler until the permanent teeth erupt." 
    3. "My child should have the first dental exam at some point after the second birthday." 
    4. "I do not need to be concerned if the child swallows some toothpaste while brushing the teeth."

    2. "Proper dental care is not necessary for a toddler until the permanent teeth erupt."

33. The nurse is caring for a 14-year-old girl who is hospitalized and has been placed in traction using Crutchfield tongs. The child is having difficulty adjusting to the prolonged hospital confinement. Which nursing action would be most appropriate to meet the child's needs? 
    1. Let the child wear her own clothing when friends visit. 
    2. Allow the girl to have her hair dyed if the parent agrees. 
    3. Allow the child to play loud music in the hospital room. 
    4. Allow the child to keep the shades closed and the room darkened at all times.

    1. Let the child wear her own clothing when friends visit.

34. The nurse at a well-baby clinic is assessing the language and communication developmental milestones of a 4-month-old infant. On the basis of the age of the infant, what should the nurse expect to note as the highest-level developmental milestone? 
    1. Cooing sounds 
    2. Use of gestures 
    3. Babbling sounds 
    4. Increased interest in sounds

    3. Babbling sounds

35. The nurse at a well-baby clinic is providing nutrition instructions to the mother of a 1-month-old infant. What instruction should the nurse give to the mother? 
    1. To introduce strained fruits one at a time 
    2. That breast milk or formula is the main food 
    3. To introduce strained vegetables one at a time 
    4. To offer rice cereal mixed with breast milk or formula

    2. That breast milk or formula is the main food

36. The nurse at a well-baby clinic is assessing the motor development of a 24-month-old child. On the basis of the age of the child, the nurse expects to note what as the highest-level developmental milestone? 
    1. The child snaps large snaps. 
    2. The child builds a tower of two blocks. 
    3. The child puts on simple clothes independently. 
    4. The child opens a door by turning the doorknob.

    4. The child opens a door by turning the doorknob.

37. The pediatric nurse is caring for a hospitalized toddler. What does the nurse determine is the mostappropriate play activity for the toddler? 
    1. Listening to music 
    2. Playing peek-a-boo 
    3. Hand sewing a picture 
    4. Playing with a push-pull toy

    4. Playing with a push-pull toy

38. A 2-year-old child has been admitted to the hospital for management of pneumonia. The child is placed in an oxygen tent. Taking into consideration the child's age and developmental level and the treatment being administered, which statement is appropriate for the nurse to make to the parents? 
    1. "He can play in the tent with his blocks and plush stuffed animals." 
    2. "You can sit next to him and hold his hand through the tent, but he needs to remain inside of it." 
    3. "At his age, separation anxiety is high, so bringing in the wool blanket that he usually sleeps with is a good idea." 
    4. "Before you leave for the night, it is a good idea to rock him to sleep. He can be out of the tent for up to 30 minutes without any consequences."

    2. "You can sit next to him and hold his hand through the tent, but he needs to remain inside of it."

39. A mother tells the nurse in a pediatrician's office that she is concerned because her children must let themselves into the house after school each day while she is at work. The nurse explores which suggestion with the mother to decrease the children's sense of isolation and fear? 
    1. Instruct the children never to cook. 
    2. Let the children play in neighborhood homes. 
    3. Find community after-school programs or activities. 
    4. Have the children call the mother at work every hour.

    3. Find community after-school programs or activities.

40. A nurse is assigned to care for a hospitalized toddler. The nurse plans care, knowing that what should be the highest priority? 
    1. Providing a consistent caregiver 
    2. Protecting the toddler from injury 
    3. Adapting the toddler to the hospital routine 
    4. Allowing the toddler to participate in play and divisional activities

    2. Protecting the toddler from injury

41. A 10-year-old child has been diagnosed with type 1 diabetes mellitus, and the nurse prepares to educate the family. The child is very active socially and often is away from the parents. Which is the best focus of the nurse's teaching for this client? 
    1. The parents are instructed to always be available to monitor the child's insulin requirements. 
    2. The child is taught how to monitor insulin requirements and how to self-administer the insulin. 
    3. All of the friends and family involved with the child's activities should be involved in monitoring the child's insulin requirements. 
    4. The child's schoolteacher needs instruction on how to assist the child to monitor insulin requirements and how to oversee the child's self-administration of insulin.

    2. The child is taught how to monitor insulin requirements and how to self-administer the insulin.

42. The nurse in the well-baby clinic has provided instructions regarding dental care to the mother of a 10-month-old child. Which statement by the mother indicates a need for further instruction? 
    1. "I need to limit the amount of concentrated sweets." 
    2. "I need to use fluoride supplements if the water is not fluoridated." 
    3. "I need to start dental hygiene as soon as the primary teeth erupt." 
    4. "I can coat a pacifier with honey during the day so long as I do not give my child a bottle at nap or bedtime."

    4. "I can coat a pacifier with honey during the day so long as I do not give my child a bottle at nap or bedtime."

43. A 7-year-old child is hospitalized with a fracture of the femur and is placed in traction. In meeting the psychosocial needs of the child, the nurse most appropriately selects which play activity for the child? 
    1. A board game 
    2. A large puzzle 
    3. A finger-painting set 
    4. A coloring book with crayons

    1. A board game

44. The nurse prepares to take the blood pressure of a school-age child. To obtain an accurate measurement, how should the nurse position the blood pressure cuff? 
    1. One half of the distance between the antecubital fossa and the shoulder 
    2. One third of the distance between the antecubital fossa and the shoulder 
    3. Two thirds of the distance between the antecubital fossa and the shoulder 
    4. One quarter of the distance between the antecubital fossa and the shoulder

    3. Two thirds of the distance between the antecubital fossa and the shoulder

45. The mother of a 5-year-old child tells the nurse that the child scolds the floor or a table if she hurts herself on the object. According to Piaget's Theory of Cognitive Development, what term or phrase best describes this behavior? 
    1. Animism 
    2. Egocentric speech 
    3. Object permanence 
    4. Global organization

    1. Animism

46. With which age group should the nurse use "magical thinking" as a developmental strategy when administering medications? 
    1. Infant 
    2. Toddler 
    3. Preschool 
    4. School-age

    3. Preschool

47. The nurse is instructing the caregiver of a child about reprimanding the child. The nurse recognizes that additional teaching is needed if the caregiver makes which statement to the child? 
    1. "I like it when you obey." 
    2. "I need you to listen to me." 
    3. "You need to stop hitting your sister." 
    4. "I don't like it when you hit your sister."

    3. "You need to stop hitting your sister."

48. The nurse is caring for a 4-year-old child. When experiencing pain, the nurse anticipates which about the child? Select all that apply. 
    1. Views pain as a punishment 
    2. Verbalizes the reason for the pain 
    3. Blames someone else for the pain 
    4. Believes pain will disappear magically 
    5. Fears losing control during the painful episode 
    6. Will be able to explain the sequence of events leading to the pain

    • 1. Views pain as a punishment 
    • 3. Blames someone else for the pain 
    • 4. Believes pain will disappear magically

49. The nurse is observing a caregiver minimize misbehavior when a child is playing with an excessively noisy toy. The nurse recognizes that instruction is needed about the appropriate way to do this is needed if the caregiver takes which action? 
    1. Tells the child, "Put that toy down." 
    2. Instructs the child, "Don't touch that toy." 
    3. Interacts with the child in a quiet, calm voice. 
    4. Offers the child a quiet toy in exchange for the noisy one.

    2. Instructs the child, "Don't touch that toy."

50. A 6-month-old infant is admitted to the hospital. The nurse weighs the infant and notes that the infant weighs 14 pounds. Which statement by the mother indicates that further teaching is needed? 
    1. "His weight for his age is just right." 
    2. "I am so glad he is gaining the correct amount of weight for his age." 
    3. "I will have to increase his milk intake because he is not gaining enough weight." 
    4. "He weighed 7 pounds when he was born so he is at the correct weight for his age."

    3. "I will have to increase his milk intake because he is not gaining enough weight."

51. An infant is being seen in the pediatrician's office for a 2-month-old well-child visit. The nurse encourages the mother to allow the infant to suck on a pacifier during a routine immunization. The nurse explains to the mother that the child is in which stage of Piaget's cognitive development? 
    1. Trust development 
    2. Autonomy development 
    3. Sensorimotor development 
    4. Preconceptual development

    3. Sensorimotor development

52. Which would be the highest expected growth and development occurrences at 9 months of age for an infant who has had appropriate growth assessed at each well-child visit? Select all that apply. 
    1. Will smile spontaneously 
    2. Rolls over in both directions 
    3. Able to sit steadily unsupported 
    4. Should be able to say "mama" and "dada" 
    5. Will pull up and stand for several seconds holding on to furniture 
    6. Will be able to pick up small pieces of food when placed in a high chair

    • 4. Should be able to say "mama" and "dada" 
    • 5. Will pull up and stand for several seconds holding on to furniture 
    • 6. Will be able to pick up small pieces of food when placed in a high chair

53. Which would be the highest expected growth and development occurrence expected at 12 months of age for an infant who has had appropriate growth assessed at each well-child visit? 
    1. Imitates sounds 
    2. Smiles spontaneously 
    3. Sits steadily unsupported 
    4. Walks holding on to someone's hand

    4. Walks holding on to someone's hand

54. The nurse is preparing to perform a pediatric physical examination. The child refuses to sit on the examining table, screams when the nurse attempts to perform the assessment, and does not make eye contact. What is the most appropriate initial nursing action? 
    1. Refrain from complimenting the child. 
    2. Talk to the parent while ignoring the child. 
    3. Offer a prolonged explanation about the assessment. 
    4. Use a demanding approach when discussing expected behavior.

    2. Talk to the parent while ignoring the child.

55. The mother of a toddler informs the nurse that her child has frequent temper tantrums. The nurse should instruct the mother to implement which measure to deal with the temper tantrums? 
    1. Restrain the child. 
    2. Ignore the behavior. 
    3. Leave the child unattended. 
    4. Allow the child to bang his head.

    2. Ignore the behavior.

56. The nurse is developing a plan of care for a 4-year-old child scheduled for a renal biopsy. What developmental characteristic of this child should the nurse consider? 
    1. Masturbation is common in this age group. 
    2. Body image may be a concern for the child. 
    3. Fears of mutilation may be present in the child. 
    4. The urination pattern will cause embarrassment for the child.

    3. Fears of mutilation may be present in the child.

Which statement describes the growth and development in a 24

Which toy is the most developmentally appropriate for an 18 to 24

Which characteristic is appropriate for motor skills of a 24

Which developmental milestones with the nurse anticipate for a 15 month old child?