Question 1

While giving care to a 2 year-old client, the nurse should remember that the toddler's tendency to say "no" to almost everything is an indication of what psychosocial skill?

Accepted Answer

Answer reason: shame and doubt stage, where developing independence is the key psychosocial task. Frequent saying “no” reflects practicing autonomy, setting boundaries, and exerting choice in a safe environment. This behavior is expected and healthy when supported with consistent limits and appropriate options. Labeling it as mere stubbornness misses the developmental purpose, and it is not primarily driven by rejecting parents or being frustrated with adults.

Question 2

While planning care for a 2 year-old hospitalized child, which situation would the nurse expect to most likely affect the behavior?

Accepted Answer

Answer reason: Separation can trigger protest behaviors (crying, clinging, resisting care) or later withdrawal and regression (sleep, toileting, feeding). This factor typically has a stronger, more immediate impact on behavior than environmental novelty alone. Addressing it through parental presence and consistent caregiving is central to minimizing distress and improving cooperation with care.

Question 3

While explaining an illness to a 10 year-old, what should the nurse keep in mind about the cognitive development at this age?

Accepted Answer

Answer reason: Teaching should therefore use clear, factual explanations with step-by-step cause-and-effect links and concrete examples they can relate to. Egocentric interpretations are more characteristic of the preoperational stage (younger children), making that distractor less appropriate for a 10-year-old. Practical demonstrations and checking understanding with the child’s own words align well with their ability to classify, sequence, and organize facts.

Question 4

A parent tells the nurse that their 6 year-old child who normally enjoys school, has not been doing well since the grandmother died 2 months ago. Which statement most accurately describes thoughts on death and dying at this age?

Accepted Answer

Answer reason: They may externalize death into a frightening figure or “monster,” and may also see death as temporary or reversible rather than final. Understanding irreversibility is more characteristic of older school-age children, making that distractor less accurate for this age. Worry about personal death and more realistic, biologic understanding tends to strengthen later as cognitive development becomes more logical and concrete.

Question 5

The nurse is planning care for an 8 year-old child. Which of the following should be included in the plan of care?

Accepted Answer

Answer reason: Including them in conversations and inviting their views supports coping, trust, and adherence by giving appropriate control. At this age, promoting play is beneficial but is less central than developmentally appropriate communication and shared decision-making. Frequent reassurance and cuddling is more consistent with toddler/preschool needs and may feel infantilizing to an 8-year-old.

Question 6

The nurse is discussing negativism with the parents of a 30 month-old child. How should the nurse tell the parents to best respond to this behavior?

Accepted Answer

Answer reason: A patient, light approach helps de-escalate and allows the child to save face while still moving the situation forward. Excessively punitive responses (e.g., long time-outs for a 30-month-old) can intensify oppositional behavior and are often disproportionate to typical “no” behavior. Pure permissiveness fails to provide structure, while “asserting authority” risks turning routine autonomy-seeking into a control battle rather than guiding behavior with age-appropriate expectations.

Question 7

The nurse is preparing a 5 year-old for a scheduled tonsillectomy and adenoidectomy. The parents are anxious and concerned about the child's reaction to impending surgery. Which nursing intervention would be best to prepare the child?

Accepted Answer

Answer reason: A brief preoperative tour familiarizes the child with the environment and expected sequence (going to the OR, waking in recovery), which helps reduce anxiety and promotes cooperation. Explaining surgery a full week in advance is often too early for a 5-year-old’s time perception and may increase anticipatory anxiety. Bringing a favorite toy is supportive for comfort but is not as effective as structured, developmentally appropriate preoperative preparation.

Question 8

When teaching a 10 year-old child about their impending heart surgery, which form of explanation meets the developmental needs of this age child?

Accepted Answer

Answer reason: School-age children (around 6–12 years) learn best with concrete, visual, hands-on teaching that matches their growing ability to understand body structures and cause-and-effect. A heart model makes the procedure tangible, reduces misconceptions, and supports questions, which improves comprehension and coping. Teaching only right before surgery increases anxiety and limits time for processing and clarification. Peer introduction so soon after another child’s surgery is unreliable and may increase fear depending on that child’s experience and current condition.

Question 9

The nurse caring for a 14 year-old boy with severe Hemophilia A, who was admitted after a fall while playing basketball. In understanding his behavior and in planning care for this client, what must the nurse understand about adolescents with hemophilia?

Accepted Answer

Answer reason: This behavior is especially relevant in hemophilia because participation in contact sports increases the risk of bleeding and injury, making anticipatory guidance and safer activity planning essential. The nurse should incorporate realistic counseling, protective strategies, and alternative activities rather than assuming avoidance. A common pitfall is expecting consistent risk-avoidant behavior after a bleeding event; many teens will still return to the same peer-valued activities without targeted education and support.

Question 10

The mother of a 2 year-old hospitalized child asks the nurse's advice about the child's screaming every time the mother gets ready to leave the hospital room. What is the best response by the nurse?

Accepted Answer

Answer reason: " Toddlers commonly demonstrate separation anxiety and protest behaviors when a primary caregiver leaves, especially in an unfamiliar, stressful setting like hospitalization. Normalizing the behavior provides accurate developmental teaching and supports the parent’s coping without giving false reassurance. Suggesting “sneaking out” can worsen anxiety by undermining trust when the child wakes and discovers the parent is gone. Telling the parent the behavior will stop in a few days is nontherapeutic and not evidence-based because the response can persist throughout the hospitalization depending on stressors and routines.

Question 11

A 15 year-old client with a lengthy confining illness is at risk for altered growth and development of which task?

Accepted Answer

Answer reason: A lengthy confining illness can force reliance on others for basic needs, decision-making, and mobility, which interferes with normal progression toward independence. This dependency can delay psychosocial maturation by limiting peer interaction, role exploration, and self-management skills. By contrast, lack of trust is primarily an infancy task, making it a less developmentally appropriate risk focus for a 15-year-old. Nursing care should therefore prioritize age-appropriate choice, self-care participation, and peer/education engagement to support autonomy.

Question 12

Which playroom activities should the nurse organize for a small group of 7 year-old hospitalized children?

Accepted Answer

Answer reason: Rule-based games fit their cognitive stage, supporting following directions, turn-taking, fair play, and peer interaction while still being enjoyable in a hospital setting. In contrast, finger painting/water play and dress-up are more typical for preschoolers where imaginative and sensory play predominates. Chess/television tends to be more solitary or passive and does not optimize group participation and peer bonding for this age.

Question 13

At what age does a child typically develop a pincer grasp?

Accepted Answer

Answer reason: A neat pincer grasp typically emerges around 9–12 months, with many exam references placing it at about 10–12 months. Earlier months (4–7) are characterized more by palmar grasp and raking movements rather than precise opposition. Knowing this milestone helps nurses anticipate age-appropriate feeding and choking-risk counseling as infants begin to pick up small foods and objects.

Question 14

A baby can hold neck, can sit with support but cannot sit without support. The age of the baby is?

Accepted Answer

Answer reason: By about 3–4 months, infants typically have good head (neck) control and can sit with support, but they are not yet able to sit steadily without support. Independent sitting usually develops later, around 6 months. Therefore the described abilities align best with the 4-month developmental stage.

Question 15

Cognitive development theory given by?

Accepted Answer

Answer reason: This framework is attributed to Jean Piaget, and among the choices the intended match is the option that approximates his name. Pavlov is associated with classical conditioning (behaviorism), and Freud with psychosexual development, making them mismatched to cognitive-stage theory. Maslow describes a hierarchy of needs (motivation) rather than cognitive developmental stages. Therefore, the best answer is the option representing Piaget.

Question 16

A parent brings a toddler, age 19 months, to the clinic for a regular check-up. When palpating the toddler’s fontanels, what should the nurse expect to find?

Accepted Answer

Answer reason: The posterior fontanel typically closes by about 2–3 months of age, so it should be closed well before toddlerhood. The anterior fontanel usually closes by about 12–18 months, so by 19 months it is expected to be closed in a healthy child. An “open posterior” option is a strong red flag for abnormality rather than a normal expected finding at this age.

Question 17

Which of the following parenting styles is described as highly controlling, expecting to always be obeyed, and inflexible with the rules?

Accepted Answer

Answer reason: This parenting style is defined by high demands and low responsiveness, emphasizing obedience and strict rule enforcement. The description of being highly controlling and inflexible aligns with rigid boundaries and unilateral decision-making by the parent. In contrast, permissive parenting is typically warm but has few limits, and indifferent (uninvolved) parenting lacks both structure and emotional engagement. Recognizing these patterns is important in developmental assessment because such environments can influence a child’s autonomy, coping skills, and behavior over time.

Question 18

The parent of a 3-year-old states, “My child gets upset about small changes in routine.” What is the nurse’s best response?

Accepted Answer

Answer reason: ” Preschool-aged children commonly rely on routines and rituals to create a sense of predictability and control as autonomy and initiative develop. Becoming upset with small changes can be a typical developmental pattern when overall communication, social interaction, and play are age-appropriate. Escalating directly to autism based on this single feature is premature because restricted routines must be persistent and accompanied by core social-communication deficits. Separation anxiety is more specifically distress related to separation from attachment figures rather than distress over minor routine changes, and advising ignoring is not the most supportive anticipatory guidance for normal development.

Question 19

A child diagnosed with intellectual disability (ID) is under the supervision of Nurse Tasha. The nurse is aware that the signs and symptoms of mild ID include which of the following?

Accepted Answer

Answer reason: A broad, observable pattern of developmental delay aligns with this presentation and is consistent with how mild cases are often first recognized (e.g., school performance and adaptive skills). Very limited communication skills and a “mental age of a toddler” are more consistent with more severe levels of intellectual disability. Isolated lateness in walking is a nonspecific motor milestone delay and does not best distinguish mild intellectual disability from other developmental or neurologic conditions.

Question 20

At which age develop the social smile in the infant?

Accepted Answer

Answer reason: The social smile is a purposeful, responsive smile typically emerging around 6–8 weeks as visual tracking and social engagement mature. At about 1 month, smiles are more likely reflexive and not consistently triggered by social stimuli. Smiling as part of broader social reciprocity becomes more established later, but the initial social smile is expected by about 2 months.

Question 21

When selecting activities to help develop a child’s fine motor skills, which of the following would BEST meet this goal?

Accepted Answer

Answer reason: This activity requires repeated pincer/tripod grasping, controlled placement, and visual discrimination of shapes, directly strengthening dexterity and precision. In contrast, jumping rope and riding a tricycle primarily target gross motor skills (balance, coordination, and large muscle groups). Turning pages involves some fine motor use, but the added singing/music component makes it less specifically focused on repetitive, graded hand manipulation than sorting and matching shapes.

Question 22

Which of the following would be an expected finding in an age assessment of a 2 year old?

Accepted Answer

Answer reason: A vocabulary in the low hundreds is consistent with typical 2-year language acquisition as children rapidly expand word use and begin combining words. Fine motor skills at this age commonly include turning pages in a book (often one at a time, though not always perfectly). Gross motor running at 2 years is often still somewhat unsteady with a wider base of support compared with older children, making each listed finding an expected age-appropriate observation.

Question 23

What type of play does a nurse expect when observing a toddler in a playroom with other children?

Accepted Answer

Answer reason: This reflects normal psychosocial development as autonomy and motor exploration dominate, while true turn-taking and collaboration are still emerging. Cooperative play generally develops later in preschool-age children when shared rules, roles, and group goals become developmentally realistic. Solitary play is more typical of infants/early toddlers when not in a group context, and competitive play requires more advanced social-cognitive skills seen in older children.

Question 24

A nurse is supportive of a child receiving long-term rehabilitation in the home rather than in a health care facility. Why is living with the family so important to a child's emotional development?

Accepted Answer

Answer reason: Emotional development is strongly shaped through primary socialization, where the child forms a stable sense of self through consistent attachment, role modeling, and predictable interactions. The family is the child’s first and most influential social system, teaching roles, values, and boundaries that become internalized as identity. Long-term rehabilitation at home preserves these continuous relationships and routines, reducing disruption that can impair coping and self-concept. Options focused on discipline or broader societal norms are secondary influences compared with the direct role-definition and identity formation that occur in the family environment.

Question 25

The nurse is caring for a client who is two years old. The nurse should plan care knowing that this client is in which stage of Erikson's stages of psychosocial development?

Accepted Answer

Answer reason: Autonomy vs. Shame and Doubt Erikson’s toddler stage (about 1–3 years) centers on developing independence through choice-making and self-control over basic activities like feeding, dressing, and toileting. A 2-year-old is therefore working on autonomy, and nursing care should support safe opportunities to do tasks independently while setting consistent limits. If caregivers are overly critical or restrictive, the child is more likely to experience shame and doubt about their abilities. By contrast, initiative vs guilt is primarily preschool age (3–6 years), and trust vs mistrust is infancy (0–1 year).

Question 26

Which of the following acts can a one year old child perform?

Accepted Answer

Answer reason: This directly matches the developmental expectation being tested. Some gross-motor skills like controlled sitting down from standing and fine-motor skills like drinking from a cup can emerge around this period but are more variable and often occur closer to 12–15 months depending on support and practice. One option is not an action at all but a lab/electrolyte abnormality, making it clearly incorrect for a developmental milestone question.

Question 27

A nurse is a guest speaker lecturing on accident prevention in school-age children. Which statement by the attendees indicates an understanding of the topic?

Accepted Answer

Answer reason: School-age children have improved cognitive skills and can follow rules and anticipate consequences when safety guidance is clearly explained. This developmental ability supports accident prevention strategies that rely on teaching, reasoning, and setting concrete expectations. The distractors are inconsistent with typical development: school-age children remain active and exploratory, and their self-control is generally better than that of preschoolers. Also, many injuries in this age group occur outside the home (e.g., sports, bicycles, streets), so home is not inherently the safest setting.

Question 28

A nurse is teaching a parenting class. What should the nurse suggest about managing the behavior of a young school-age child?

Accepted Answer

Answer reason: Young school-age children benefit from predictable structure and clear, consistently enforced limits because this supports self-control and reduces confusion. Consistent rules help the child understand expectations and consequences, which improves behavior and decreases power struggles. Answering questions should not be avoided; children in this stage ask many questions and need calm, nonjudgmental responses. Letting the child fully plan the day or providing a long list of expectations can be developmentally overwhelming and may worsen nonadherence.

Question 29

The nurse understands a patient needs to have sufficient food, water, shelter, and safety before being able to work on relationships with others. This is explained by which theory?

Accepted Answer

Answer reason: The stem specifically describes needing basic survival and safety met before working on interpersonal connections, which maps directly to this hierarchy. Kohlberg focuses on moral reasoning stages rather than prioritization of human needs. Piaget addresses cognitive development stages, not the sequencing of basic needs preceding social belonging.

Question 30

The nurse discusses developmental milestones with the caregivers of several clients. Which finding reported by a caregiver requires follow-up by the nurse?

Accepted Answer

Answer reason: At 22 months, producing only a few single words is below expected communication milestones and warrants further developmental screening and possible referral (e.g., hearing evaluation and speech-language assessment). Frequent falls while running at 19 months can be typical due to immature coordination and risk-taking in this age group. Building a 3-block tower at 18 months and engaging in parallel play at 24 months are expected developmental findings.

Question 31

A nurse observes school-age children playing. Playing with which toy is typical of this age group?

Accepted Answer

Answer reason: This option is a structured, rule-based board game that requires sustained attention and precise hand-eye control, aligning with typical school-age play. In contrast, toys more typical of preschoolers focus on simpler pretend play and less structured activities. Rule-governed games also support the developmental task of industry, where children enjoy mastering tasks and demonstrating competence.

Question 32

During a routine examination, the mother of a 3-month-old child asks the nurse, “How soon will she have her first tooth?” Which response by the nurse would be the most accurate as to the age by which the first tooth usually erupts?

Accepted Answer

Answer reason: This makes it the most accurate anticipatory guidance for a parent of a 3-month-old infant. Earlier months (4–5) can occur but are less common as a “usual” age and would risk giving overly optimistic expectations. A later estimate such as 7 months is still within normal variation, but it is less accurate than the standard milestone used for routine counseling.

Question 33

What is the most appropriate toy for a nurse to give to an 8-month-old infant admitted for repair of a diaphragmatic hernia?

Accepted Answer

Answer reason: A lightweight rattle fits expected fine-motor skills (palmar grasp transferring hand-to-hand) and supports development without requiring advanced coordination. Large building blocks and pull toys are more appropriate for older infants/toddlers with better sitting/standing balance and gross-motor planning, and they can pose safety issues if the child is weak post-op. A black-and-white mobile is primarily for younger infants with limited visual acuity and is less engaging for an 8-month-old who benefits more from interactive, manipulable objects.

Question 34

When preparing a class to teach children, the nurse reviews Piaget’s stages of development. With which age group do concrete operations roughly correspond?

Accepted Answer

Answer reason: This stage typically spans ages about 7 to 11 years, which aligns with the school-age period. Preschool-age children are generally in the preoperational stage, where thinking is more egocentric and not yet capable of true conservation. Adolescents transition to formal operations, characterized by abstract and hypothetical reasoning.

Question 35

A nurse assesses an 18-month-old toddler. Which activity would indicate to the nurse that the child is exhibiting normal growth and development patterns?

Accepted Answer

Answer reason: This activity aligns with expected motor milestones for the late toddler period. In contrast, jumping down from a chair is more consistent with older toddlers (closer to 2–3 years) who have better coordination and depth judgment. Naming specific colors and stating a full name are language/cognitive milestones that generally occur later than 18 months.

Question 36

The nurse is helping an adolescent deal with diabetes. What is the most important factor about the adolescent for the nurse to consider in her approach?

Accepted Answer

Answer reason: Planning the nursing approach around peer-related concerns improves rapport and anticipates high-risk situations for nonadherence (school, sports, social events). Interventions such as problem-solving around discreet self-care, negotiating realistic routines, and normalizing diabetes management in social contexts are most effective when this principle is prioritized. Wanting autonomy is also important, but peer influence more specifically predicts day-to-day decision-making and risk-taking that can destabilize glycemic control.

Question 37

The nurse is performing an admission assessment on a 6-month-old infant being admitted for intestinal obstruction. The nurse is most concerned when the assessment reveals which finding?

Accepted Answer

Answer reason: The Moro reflex typically disappears by about 4–6 months, so finding it at 6 months is abnormal and warrants concern, especially during an acute illness where neuro status must be accurately assessed. A positive Babinski response can be normal in infants up to around 12–24 months due to incomplete myelination. First tooth eruption and rolling milestones fall within common developmental ranges and are not as concerning as a retained primitive reflex.

Question 38

A nurse is planning care for a 14-year-old client following surgical repair of a ruptured appendix. What is the most important intervention?

Accepted Answer

Answer reason: Adolescents are in Erikson’s identity vs role confusion stage, so nursing care should prioritize supporting autonomy, privacy, and age-appropriate decision-making even while recovering from surgery. Postoperative care should be delivered in ways that preserve the teen’s control (e.g., involving them in scheduling activities, teaching self-care, and including them directly in education). Options focused on trust are more consistent with infancy, and emphasizing future plans is more aligned with young adulthood’s intimacy tasks. Reducing parent–teen conflict may help overall coping, but it is not the primary developmental priority for a 14-year-old in this context.

Question 39

In young adulthood, the expected developmental tasks include?

Accepted Answer

Answer reason: Young adulthood is characterized by Erikson’s psychosocial task of intimacy versus isolation, where the key developmental work is forming close, committed, reciprocal relationships. This option reflects the ability to invest in another person with mutual trust, emotional availability, and commitment, which signals successful intimacy development. “Satisfying and supporting the next generation” aligns with generativity versus stagnation, a primary focus of middle adulthood rather than young adulthood. “Developing peer relationships” is more characteristic of school-age and adolescence, and “formulating a sense of oneself” aligns more with identity formation in adolescence/early adulthood rather than the central young-adult task.

Question 40

A 2-year-old client is seen in the clinic for a wellchild visit. Which denotes an abnormal finding for an average client of this age?

Accepted Answer

Answer reason: At age 2 years, expected gross motor skills include running, climbing, and going up/down stairs with support; pulling a toy on a string is more typical of a younger toddler (around 15–18 months). Language of 1–2 word phrases is appropriate for this age as vocabulary and two-word combinations rapidly expand. Toddlers commonly display negativism/defiance as part of autonomy development, which is normal behaviorally. Imitation of others is also a normal social-development milestone in this period.

Question 41

The definition of “family” has evolved as society has changed. The most comprehensive definition of the term includes?

Accepted Answer

Answer reason: Modern nursing uses an inclusive, functional definition of family that centers on relationships, roles, and mutual support rather than legal/biologic ties or shared residence. This option captures the broadest scope because it includes nontraditional family structures (e.g., partners, close friends, chosen family) that commonly participate in health decisions and caregiving. Definitions limited to marriage/adoption/blood exclude many legitimate support systems relevant to patient-centered care. Proximity or constant change describes possible family characteristics but does not define what makes a family clinically meaningful for assessment and care planning.

Question 42

A nurse is assessing an infant’s growth and development. Which action by the nurse indicates the best understanding of a 4-month old’s stage of growth and development?

Accepted Answer

Answer reason: Peekaboo is developmentally appropriate because it leverages early social engagement and visual tracking while fostering caregiver–infant interaction. A social smile is typically established earlier (about 6–8 weeks), so it is not the best match for specifically assessing a 4-month developmental level. Holding a bottle and sitting without support generally occur later as fine and gross motor control mature further.

Question 43

The nurse caring for the postpartum client who is 15 years old is concerned about this client's ability to parth a newborn. Which behavior is characteristic of the developmental level of the 15-year-old that justifies the nurse's concern?

Accepted Answer

Answer reason: This developmental trait can interfere with reliably prioritizing a newborn’s constant needs, interpreting infant cues, and sustaining the repetitive caregiving required in the postpartum period. A nurse’s concern is therefore justified because immature perspective-taking can increase risk for inconsistent feeding, safety lapses, and delayed help-seeking. By contrast, following rules established by others is more typical of younger school-age development rather than mid-adolescence. Supportive teaching, supervision, and involving trusted caregivers can help mitigate this risk.

Question 44

Which statement by the parent of a 16-month-old child with cystic fibrosis should alert a nurse to investigate further?

Accepted Answer

Answer reason: " By about 12–15 months, most toddlers can stand alone and walk independently, so absence of walking at 16 months is a gross-motor red flag that warrants further developmental assessment. Children with cystic fibrosis may have poorer growth and reduced energy reserves, which can contribute to delayed attainment of motor milestones. In contrast, separation anxiety with crying when a parent leaves is developmentally typical in this age range. Saying a few words/early phrases and limited peer interaction at 16 months can be within normal variability, but lack of independent walking is the most time-sensitive concern to evaluate.

Question 45

As individuals move through life, predictable changes occur. When the nurse assists the client in understanding these predictable changes, the client?

Accepted Answer

Answer reason: Understanding predictable developmental changes supports successful adaptation to life transitions by helping the client revise expectations and set realistic, age-appropriate objectives. Anticipatory guidance promotes coping and mastery, allowing the person to reframe losses or role changes into new opportunities for meaning and achievement. Reduced chronic illness risk is not a direct or assured outcome of understanding developmental change, since disease risk depends on many modifiable and nonmodifiable factors. Similarly, acceptance of biologic aging or enthusiasm for retirement may occur for some individuals but are not universal developmental outcomes across the lifespan.

Question 46

To enhance adaptive language skills in a young client, the nurse educates parents to foster appropriate language in social situations. An example is?

Accepted Answer

Answer reason: Adaptive language skills (pragmatics) focus on using language appropriately within social contexts, including politeness, tone, and persuasive wording to match the situation and listener. This option directly targets socially appropriate communication choices that help a child function better in everyday interactions. In contrast, correcting pronunciation or grammar primarily addresses speech production and syntax rather than social use. Teaching parents to model and reinforce polite vs impolite phrasing is a practical way to improve a child’s social communication competence.

Question 47

The nurse is caring for multiple clients preparing for placement of an external diversional urinary system. Which client has the greatest need for interventions to promote a positive body image?

Accepted Answer

Answer reason: An external urinary diversion device is visible and can strongly affect perceived attractiveness, intimacy, and concerns about stigma, increasing the need for anticipatory guidance and coping support. Sexual activity adds immediate relevance to fears about partner reactions, odor/leakage, and altered sexual functioning, so targeted counseling and resources are critical. In contrast, infants and many toddlers have limited body image awareness, and school-age concerns are present but typically less intense and less sexuality-centered than in adolescence.

Question 48

The most accurate information to give parents regarding when to engage a child in an organized athletic activity is?

Accepted Answer

Answer reason: Organized sports require a baseline of coordination, balance, ability to follow rules, and attention span consistent with early school-age development. Around 6–7 years, most children can participate safely in structured activities with simple rules and short, supervised practices. Readiness is not determined by a single gross-motor milestone like running without falling, and participation should be guided by developmental level rather than waiting for the child to initiate. Visual impairment alone is not a blanket contraindication; many children can participate with appropriate sport selection, protective equipment, and supervision.

Question 49

A school nurse is screening for hearing and vision with a group of 11- to 13-year-old students. Which technique is used to communicate effectively with this age group?

Accepted Answer

Answer reason: Early adolescents value respect, privacy, and being treated as individuals, and they communicate best when the nurse is attentive and nonjudgmental. One-on-one focus helps build rapport, encourages honest responses, and supports cooperation during screenings. Having parents present can inhibit disclosure and autonomy, while allowing peers to hear histories violates confidentiality and increases embarrassment. Puppets or dolls are developmentally appropriate for younger children, not typical 11- to 13-year-olds.

Question 50

When providing care for a school-age client with diabetes insipidus, the nurse understands that which behavior might be difficult related to this child’s growth and development?

Accepted Answer

Answer reason: Needing to take a medication dose during the school day may be hard due to stigma, embarrassment, limited privacy, or difficulty coordinating with school staff and schedules. In contrast, taking medication at home (e.g., at bedtime) generally fits better with routines and requires less public disclosure. Options involving injections are less typical for current DI management compared with DDAVP, and the developmental issue being tested is the social/independence challenge of school-time dosing.

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