Growth And Development NCLEX Questions (Practice Mode) By Rnpedia.Com

1. A woman who is six months pregnant is seen in antepartal clinic. She states she is having trouble with constipation. To minimize this condition, the nurse should instruct her to

Increase her fluid intake to three liters/day.

Request a prescription for a laxative from her physician.

Stop taking iron supplements.

Take two tablespoons of mineral oil daily.

In pregnancy, constipation results from decreased gastric motility and increased water reabsorption in the colon caused by increased levels of progesterone. Increasing fluid intake to three liters a day will help prevent constipation. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated. Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. Iron supplements are necessary during pregnancy, as ordered, and should not be discontinued. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated. Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. Mineral oil is especially bad to use as a laxative because it decreases the absorption of fat-soluble vitamins (A, D, E, K) if taken near mealtimes.

Explanation

In pregnancy, constipation results from decreased gastric motility and increased water reabsorption in the colon caused by increased levels of progesterone. Increasing fluid intake to three liters a day will help prevent constipation. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated. Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. Iron supplements are necessary during pregnancy, as ordered, and should not be discontinued. The client should increase fluid intake, increase roughage in the diet, and increase exercise as tolerated. Laxatives are not recommended because of the possible development of laxative dependence or abdominal cramping. Mineral oil is especially bad to use as a laxative because it decreases the absorption of fat-soluble vitamins (A, D, E, K) if taken near mealtimes.

2. The nurse is assessing a four month-old infant. The nurse would anticipate finding that the infant would be able to

Hold a rattle

Bang two blocks

Drink from a cup

Wave “bye-bye”

The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.

Explanation

The age at which a baby will develop the skill of grasping a toy with help is 4 to 6 months.

3. A client telephones the clinic to ask about a home pregnancy test she used this morning. The nurse understands that the presence of which hormone strongly suggests a woman is pregnant?

Estrogen

HCG

Alpha-fetoprotein

Progesterone

Human chorionic gonadotropin (HCG) is the biologic marker on which pregnancy tests are based. Reliability is about 98%, but the test does not positively confirm pregnancy.

Explanation

Human chorionic gonadotropin (HCG) is the biologic marker on which pregnancy tests are based. Reliability is about 98%, but the test does not positively confirm pregnancy.

4. The nurse prepares for a Denver Screening test with a 3 year-old child in the clinic. The mother asks the nurse to explain the purpose of the test. The BEST response is to tell her that the test

Measures potential intelligence

Assesses a child’s development

Evaluates psychological responses

Diagnoses specific problems

The Denver Developmental Test II is a screening test to assess children from birth through 6 years in personal/social, fine motor adaptive, language and gross motor development. A child experiences the fun of play during the test.

Explanation

The Denver Developmental Test II is a screening test to assess children from birth through 6 years in personal/social, fine motor adaptive, language and gross motor development. A child experiences the fun of play during the test.

5. The nurse is assessing a six-month-old child. Which developmental skills are normal and should be expected?

Speaks in short sentences.

Sits alone.

Can feed self with a spoon.

Pulling up to a standing position.

The child develops language skills between the ages of one and three. A six-month-old child is learning to sit alone. The child begins to use a spoon at 12-15 months of age. The baby pulls himself to a standing position about ten months of age.

Explanation

The child develops language skills between the ages of one and three. A six-month-old child is learning to sit alone. The child begins to use a spoon at 12-15 months of age. The baby pulls himself to a standing position about ten months of age.

6. When caring for an elderly client it is important to keep in mind the changes in color vision that may occur. What colors are apt to be most difficult for the elderly to distinguish?

Red and blue.

Blue and gold.

Red and green.

Blue and green.

The elderly are better able to distinguish between red and blue because of the difference in wavelengths. The elderly are better able to distinguish between blue and gold because of the difference in wavelengths. The elderly are better able to distinguish between red and green because of the difference in wavelengths. Red and green color blindness is an inherited disorder that is unrelated to age. The elderly have poor blue-green discrimination. The effects of age are greatest on short wavelengths. These changes are related to the yellowing of the lens with age.

Explanation

The elderly are better able to distinguish between red and blue because of the difference in wavelengths. The elderly are better able to distinguish between blue and gold because of the difference in wavelengths. The elderly are better able to distinguish between red and green because of the difference in wavelengths. Red and green color blindness is an inherited disorder that is unrelated to age. The elderly have poor blue-green discrimination. The effects of age are greatest on short wavelengths. These changes are related to the yellowing of the lens with age.

7. When caring for an elderly client it is important to keep in mind the changes in color vision that may occur. What colors are apt to be most difficult for the elderly to distinguish?

Red and blue.

Blue and gold.

Red and green.

Blue and green.

The elderly are better able to distinguish between red and blue because of the difference in wavelengths. Red and green color blindness is an inherited disorder that is unrelated to age. The elderly have poor blue-green discrimination. The effects of age are greatest on short wavelengths. These changes are related to the yellowing of the lens with age.

Explanation

The elderly are better able to distinguish between red and blue because of the difference in wavelengths. Red and green color blindness is an inherited disorder that is unrelated to age. The elderly have poor blue-green discrimination. The effects of age are greatest on short wavelengths. These changes are related to the yellowing of the lens with age.

8. The nurse is caring for the mother of a newborn. The nurse recognizes that the mother needs more teaching regarding cord care because she

Keeps the cord exposed to the air.

Washes her hands before sponge bathing her baby.

Washes the cord and surrounding area well with water at each diaper change.

Checks it daily for bleeding and drainage.

Exposure to air helps dry the cord. Good hand washing is the prime mechanism for preventing infection. Washing the surrounding area is fine but wetting the cord keeps it moist and predisposes it to infection. It is important to check for complications of bleeding and drainage that might occur.

Explanation

Exposure to air helps dry the cord. Good hand washing is the prime mechanism for preventing infection. Washing the surrounding area is fine but wetting the cord keeps it moist and predisposes it to infection. It is important to check for complications of bleeding and drainage that might occur.

9. The nurse is caring for a pregnant client. The client asks how the doctor could tell she was pregnant ‘just by looking inside.’ The nurse tells her the most likely explanation is that she had a positive Chadwick’s sign, which is a

Bluish coloration of the cervix and vaginal walls

Pronounced softening of the cervix

Clot of very thick mucous that obstructs the cervical canal

Slight rotation of the uterus to the right

Chadwick’s sign is a bluish-purple coloration of the cervix and vaginal walls, occurring at 4 weeks of pregnancy, that is caused by vasocongestion.

Explanation

Chadwick’s sign is a bluish-purple coloration of the cervix and vaginal walls, occurring at 4 weeks of pregnancy, that is caused by vasocongestion.

10. While giving nursing care to a hospitalized adolescent, the nurse should be aware that the MAJOR threat felt by the hospitalized adolescent is

Pain management

Restricted physical activity

Altered body image

Separation from family

The hospitalized adolescent may see each of these as a threat, but the major threat that they feel when hospitalized is the fear of altered body image, because of the emphasis on physical appearance.

Explanation

The hospitalized adolescent may see each of these as a threat, but the major threat that they feel when hospitalized is the fear of altered body image, because of the emphasis on physical appearance.

11. While teaching a 10 year-old child about their impending heart surgery, the nurse should

Provide a verbal explanation just prior to the surgery

Provide the child with a booklet to read about the surgery

Introduce the child to another child who had heart surgery three days ago

Explain the surgery using a model of the heart

According to Piaget, the school age child is in the concrete operations stage of cognitive development. Using something concrete, like a model will help the child understand the explanation of the heart surgery.

Explanation

According to Piaget, the school age child is in the concrete operations stage of cognitive development. Using something concrete, like a model will help the child understand the explanation of the heart surgery.

12. The nurse is observing children playing in the hospital playroom. She would expect to see 4 year-old children playing

Competitive board games with older children

With their own toys along side with other children

Alone with hand held computer games

Cooperatively with other preschoolers

Cooperative play is typical of the preschool period.

Explanation

Cooperative play is typical of the preschool period.

13. A pregnant woman is advised to alter her diet during pregnancy by increasing her protein and Vitamin C to meet the needs of the growing fetus. Which diet BEST meets the client’s needs?

Scrambled egg, hash browned potatoes, half-glass of buttermilk, large nectarine

3oz. chicken, ½ C. corn, lettuce salad, small banana

1 C. macaroni, ¾ C. peas, glass whole milk, medium pear

Beef, ½ C. lima beans, glass of skim milk, ¾ C. strawberries

Beef and beans are an excellent source of protein as is skim milk. Strawberries are a good source of Vitamin C.

Explanation

Beef and beans are an excellent source of protein as is skim milk. Strawberries are a good source of Vitamin C.

14. The nurse is planning care for an 18 month-old child. Which of the following should be included the in the child’s care?

Hold and cuddle the child often

Encourage the child to feed himself finger food

Allow the child to walk independently on the nursing unit

Engage the child in games with other children

According to Erikson, the toddler is in the stage of autonomy versus shame and doubt. The nurse should encourage increasingly independent activities of daily living.

Explanation

According to Erikson, the toddler is in the stage of autonomy versus shame and doubt. The nurse should encourage increasingly independent activities of daily living.

15. The nurse’s FIRST step in nutritional counseling/teaching for a pregnant woman is to

Teach her how to meet the needs of self and her family

Explain the changes in diet necessary for pregnant women

Question her understanding and use of the food pyramid

Conduct a diet history to determine her normal eating routines

Assessment is always the first step in planning teaching for any client.

Explanation

Assessment is always the first step in planning teaching for any client.

16. The nurse is evaluating a new mother feeding her newborn. Which observation indicates the mother understands proper feeding methods for her newborn?

Holding the bottle so the nipple is always filled with formula.

Allowing her seven – pound baby to sleep after taking 1 ½ ounces from the bottle.

Burping the baby every ten minutes during the feeding.

Warming the formula bottle in the microwave for 15 seconds and giving it directly to the baby.

Holding the bottle so the nipple is always filled with formula prevents the baby from sucking air. Sucking air can cause gastric distention and intestinal gas pains. A seven-pound baby should be getting 50 calories per pound: 350 calories per day. Standardized formulas have 20 calories per ounce. This seven-pound baby needs 17.5 ounces per day. 17.5 ounces per day divided by 6-8 feedings equals 2-3 ounces per feeding. A normal newborn without feeding problems could be burped halfway through the feeding and again at the end. If burping needs to be at intervals, it should be done by ounces or half ounces, not minutes. Microwaving is not recommended as a method of warming due to the uneven heating of the formula. If used, the formula should be shaken after warming and the temperature then checked with a drop on the wrist. The recommended method of warming is to place the bottle in a pan of hot water to warm, and then check the temperature on the wrist before feeding.

Explanation

Holding the bottle so the nipple is always filled with formula prevents the baby from sucking air. Sucking air can cause gastric distention and intestinal gas pains. A seven-pound baby should be getting 50 calories per pound: 350 calories per day. Standardized formulas have 20 calories per ounce. This seven-pound baby needs 17.5 ounces per day. 17.5 ounces per day divided by 6-8 feedings equals 2-3 ounces per feeding. A normal newborn without feeding problems could be burped halfway through the feeding and again at the end. If burping needs to be at intervals, it should be done by ounces or half ounces, not minutes. Microwaving is not recommended as a method of warming due to the uneven heating of the formula. If used, the formula should be shaken after warming and the temperature then checked with a drop on the wrist. The recommended method of warming is to place the bottle in a pan of hot water to warm, and then check the temperature on the wrist before feeding.

17. A woman who is 32 years old and 35 weeks pregnant has had rupture of membranes for eight hours and is 4 cm dilated. Since she is a candidate for infection, the nurse should include which of the following in the care plan?

Universal precautions.

Oxytocin administration

Frequent temperature monitoring.

More frequent vaginal examinations.

Universal precautions are necessary for all clients but a specific assessment of the client’s temperature will give an indication the client is becoming infected. Oxytocin may be needed to induce labor if it is not progressing, but it is not done initially.Temperature elevation will indicate beginning infection. This is the most important measure to help assess the client for infections, since the lost mucous plug and the ruptured membranes increase the potential for ascending bacteria from the reproductive tract. This will infect the fetus, membranes, and uterine cavity. More frequent vaginal examinations are not recommended, as frequent vaginal exams can increase chances of infection.

Explanation

Universal precautions are necessary for all clients but a specific assessment of the client’s temperature will give an indication the client is becoming infected. Oxytocin may be needed to induce labor if it is not progressing, but it is not done initially.Temperature elevation will indicate beginning infection. This is the most important measure to help assess the client for infections, since the lost mucous plug and the ruptured membranes increase the potential for ascending bacteria from the reproductive tract. This will infect the fetus, membranes, and uterine cavity. More frequent vaginal examinations are not recommended, as frequent vaginal exams can increase chances of infection.

18. The nurse in an infertility clinic is discussing the treatment routine. The nurse advises the couple that the major stressor for couples being treated for infertility is usually

Having to tell their families.

The cost of the interventions.

The inconvenience of multiple tests.

The right scheduling of sexual intercourse.

Having to tell families may also be a factor contributing to stress but is not the major stressor. Cost may also be a contributing factor to stress but is not usually the major factor. The inconvenience of multiple tests may also be a factor contributing to stress but is not usually the major factor. Sexual activity "on demand” is the major cause of stress for most infertile couples.

Explanation

Having to tell families may also be a factor contributing to stress but is not the major stressor. Cost may also be a contributing factor to stress but is not usually the major factor. The inconvenience of multiple tests may also be a factor contributing to stress but is not usually the major factor. Sexual activity "on demand” is the major cause of stress for most infertile couples.

19. A 27-year-old woman has Type I diabetes mellitus. She and her husband want to have a child so they consulted her diabetologist, who gave her information on pregnancy and diabetes. Of primary importance for the diabetic woman who is considering pregnancy should be

A review of the dietary modifications that will be necessary.

Early prenatal medical care.

Adoption instead of conception.

Understanding that this is a major health risk to the mother.

A review of dietary modifications is important once the woman is pregnant. However, it is not of primary importance when considering pregnancy. Pregnancy makes metabolic control of diabetes more difficult. It is essential that the client start prenatal care early so that potential complications can be controlled or minimized by the efforts of the client and health care team. The alternative of adoption is not necessary just because the client is a diabetic. Many diabetic women have pregnancies with successful outcomes if they receive good care. While there is some risk to the pregnant diabetic woman, it is not considered a major health risk. The greater risk is to the fetus.

Explanation

A review of dietary modifications is important once the woman is pregnant. However, it is not of primary importance when considering pregnancy. Pregnancy makes metabolic control of diabetes more difficult. It is essential that the client start prenatal care early so that potential complications can be controlled or minimized by the efforts of the client and health care team. The alternative of adoption is not necessary just because the client is a diabetic. Many diabetic women have pregnancies with successful outcomes if they receive good care. While there is some risk to the pregnant diabetic woman, it is not considered a major health risk. The greater risk is to the fetus.

20. The nurse is caring for residents in a long term care setting for the elderly. Which of the following activities will be MOST effective in meeting the growth and development needs for persons in this age group?

Aerobic exercise classes

Transportation for shopping trips

Reminiscence groups

Regularly scheduled social activities

According to Erikson”s theory, older adults need to find and accept the meaningfulness of their lives, or they may become depressed, angry, and fear death. Reminiscing contributes to successful adaptation by maintaining self-esteem, reaffirming identity, and working through loss.

Explanation

According to Erikson”s theory, older adults need to find and accept the meaningfulness of their lives, or they may become depressed, angry, and fear death. Reminiscing contributes to successful adaptation by maintaining self-esteem, reaffirming identity, and working through loss.