Online Practice Test 20

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Site Title: Kozier & Erb's Fundamentals of Nursing Book Title: Kozier & Erb's Fundamentals of Nursing Location on Site: Chapter 20 > NCLEX® Review Date/Time Submitted: July 12, 2012 at 2:34 PM (UTC/GMT)

Summary of Results 60% Correct of 10 Scored items: 6 Correct:  60% 4 Incorrect:  40% More information about scoring

1.		A mother complains that her 13-year-old has started to grow rapidly, and asks the nurse if this is normal and how long it will last. The best nursing response is: Your Answer: "This is normal, but growth should be completed by about age 15 or 16." Correct Answer: "This is normal and can last until about age 20."
		Objective: Differentiate between the terms growth and development. Rationale: Growth rate is normally rapid during the adolescent years from ages 12-20. It can be expected to occur throughout this entire time span, not just for a few months or years. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
2.		A 21-year-old who has just graduated from college has had a serious automobile accident and faces many months of hospitalization and rehabilitation. The nurse, in planning care, recognizes that according to Havighurst, this client may delay or have difficulty with successful accomplishment of which developmental task? Your Answer: Selecting a mate and getting started in an occupation
		Objective: Identify developmental tasks associated with Havighurst's six age periods. Rationale: Havighurst identifies two developmental tasks of early adulthood: selecting a mate and getting started in an occupation. Exhibiting socially responsible behavior, developing an ethical system of behavior, selecting an occupation, and developing intellectual skills necessary for civic competence are tasks of adolescence, and should already have been accomplished. Developing a conscience and developing appropriate masculine or feminine social roles are tasks of middle childhood, and also should already have been accomplished. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
3.		A mother is frustrated because her 2½-year-old is not toilet trained and will not use the potty when placed on it. What suggestion by the nurse is most appropriate? Your Answer: Make up a game to encourage the child to want to use the potty.
		Objective: Describe characteristics and implications of Freud's five stages of development. Rationale: The child is at Freud's anal stage of development (1½ to 3 years). The major conflict of this stage is toilet training. The child needs to be able to maintain a sense of control, and training should be a pleasurable experience. That can be accomplished by making toilet training a game. Punishment and forcing a child to sit on the potty do not support the child's sense of control. Laxatives are not appropriate unless recommended by the physician for constipation. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
4.		An 82-year-old client complains that he is "sick, old, and useless," and that people are "no good and don't care." The nurse recognizes that these statements at this age indicate negative resolution of which task, according to Erikson? Your Answer: Integrity versus despair
		Objective: Identify Erikson's eight stages of development. Rationale: The central task of maturity (65 years to death), according to Erikson, is integrity versus despair. Unsuccessful resolution results in a sense of loss and contempt for others. Identity versus role confusion is a task of adolescence. Generativity versus stagnation is a task of adulthood, and intimacy versus isolation is a task of young adulthood. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
5.		The nurse is developing a teaching plan for a 9-year-old female client who is diabetic. Which actions would be appropriate, according to Piaget? Your Answer: Teaching size of food portions and importance of timing snacks and meals
		Objective: Explain Piaget's theory of cognitive development. Rationale: This child is at the concrete operations phase (ages 7-11), characterized by the ability to understand size relationships, solve concrete problems, understand left and right, and recognize viewpoints. Developmentally, the child should be able to understand portion size and timing of meals and snacks. The child is still focused on the here and now, so discussing future pregnancy hazards is not appropriate. Use of hypothetical problem situations is more appropriate to the formal operations phase (ages 11-18 years), and use of hand puppets is more appropriate for younger children. Nursing Process: Planning Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
6.		A client is hesitant to have needed surgery because of multiple family, social, and church obligations, saying, "I hate to let everybody down." The nurse recognizes that this client's moral dilemma is a result of the client operating at which level of Kohlberg's stages of moral development? Your Answer: (blank)
7.		A 68-year-old female client of a spouse with Alzheimer's disease has been taking caregiver classes. The nurse determines that caregiver education has been effective and that the client has progressed to Stage 3 in Gilligan's moral development levels when the client exhibits which behavior(s)?  Your Answer: Has the backyard fenced in so that the spouse can go outside safely Correct Answer: Arranges for a "sitter" weekly so that the client can take a yoga class
		Objective: Compare Kohlberg's and Gilligan's theories of moral development. Rationale: A characteristic of Stage 3 in Gilligan's moral development levels is a balance between caring for others and caring for self. The client demonstrated this level by scheduling time for self while arranging for care for the spouse during that time. The other choices only center on care or needs of the spouse (Stage 2). Nursing Process: Evaluation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
8.		A client expresses fear over a complex, painful, sterile procedure, and asks that the minister be allowed to stay in the room and close by while it is being performed. The best nursing action would be to: Your Answer: Explain that the procedure is sterile, and that the minister cannot stay, but can return as soon as it is completed Correct Answer: Place the minister in sterile apparel and allow him to be close to the client during the procedure
		Objective: Compare Fowler's and Westerhoff's stages of spiritual development. Rationale: The client's faith and religious beliefs provide strength and trust during times of illness and stress. The client's wishes should be honored without compromising the sterility of the procedure. Allowing the minister to stay in the room, but providing sterile apparel, accomplishes this. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
9.		A mother expresses concern to the nurse regarding her 5-year-old child's development. She says: "I read Erikson and Piaget, and my child does not seem to be on target. Also, my neighbor's child seems more advanced. My doctor says not to worry, but I do." The best nursing response is: Your Answer: "Tell me exactly what your child is or is not doing that causes you concern."
		Objective: Describe the stages of growth and development according to various theorists. Rationale: More information is needed. Human development is complex. A limitation of developmental theories is that they do not account for individual variations. Individual differences are to be expected. Unless the child is markedly delayed in development, the variation is normal. If the child is markedly delayed, more evaluation is indicated. Nursing Process: Implementation Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.
10.		A nurse who works in a long-term care facility notices that the elderly clients seem depressed, and that they have little interest in life. They spend their days watching television. When they attend crafts, they are disinterested in drawing pictures or coloring. Based on these observations, and guided by Peck's theory on older adult development, the nurse determines that: Your Answer: Activities such as gardening and baking may be indicated for these clients
		Objective: Compare Peck's and Gould's stages of adult development. Rationale: One developmental task identified by Peck is ego differentiation versus work-role preoccupation. Identities and feelings of older adults are highly dependent on their work roles. Activities such as gardening or baking that can replace the work role will be a source of self-esteem for elders. Elders especially need activities that relate to their interests and talents. Observational or "busy work" activities do not accomplish this. Nursing Process: Assessment Client Need: Health Promotion and Maintenance Cognitive Level: Application Strategy: Use nursing knowledge and the process of elimination to make a selection.