Infancy (Birth to 1 Year)
A nurse is assessing a 6-month-old infant during a routine well-child visit. According to Erikson, which psychosocial stage is this infant experiencing, and what behavior is expected?
A. Autonomy vs. Shame and Doubt; the infant is learning to control bodily functions and say "no."
B. Trust vs. Mistrust; the infant expects their needs (feeding, comfort, warmth) to be met by responsive caregivers.
C. Initiative vs. Guilt; the infant is exploring the environment through active play.
D. Sensorimotor stage; the infant understands object permanence completely.
Correct Answer: B
Rationale: During infancy (Birth to 1 year), Erikson’s stage is Trust vs. Mistrust. It means the infant learns whether they can trust the world based on the consistency and promptness of caregiver responses. Expected behaviors include crying when hungry or wet, calming to a parent's voice, and bonding (attachment). It's important to meet basic needs, soothe, and calm promptly.
The parents of a 2-year-old toddler express frustration that their child throws temper tantrums and insists on doing everyday tasks independently (like dressing or feeding). According to Erikson, how should the nurse interpret this stage?
A. Autonomy vs. Shame and Doubt; the toddler is striving for independence and self-control, and negativism is a normal expectation.
B. Initiative vs. Guilt; the child is experimenting with new roles and experiences deep remorse.
C. Trust vs. Mistrust; the toddler is experiencing separation anxiety from lack of secure attachment.
D. Industry vs. Inferiority; the child is trying to master academic skills.
Correct Answer: A
Rationale: The toddler stage (1–3 years) is defined by Erikson as Autonomy vs. Shame and Doubt. This means children want to exert control and independence. Expected behaviors include frequent use of the word "no" (negativism), ritualism (needing routines), and parallel play (playing alongside, not with, other children)
A nurse is observing a 4-year-old child playing dress-up as a doctor and talking to a stuffed animal. According to Erikson, what stage and expected behavior are being demonstrated?
A. Trust vs. Mistrust; seeking basic physical security.
B. Industry vs. Inferiority; learning to build and construct complex projects.
C. Initiative vs. Guilt; the child is eager to try new things, show leadership, and use imagination, but may feel guilt if they overstep limits.
D. Identity vs. Role Confusion; exploring career options.
Correct Answer: C
Rationale: Preschoolers (3–6 years) experience Initiative vs. Guilt (Erikson). This means they take the initiative to plan activities, invent games, and explore their world through active imagination. Expected behaviors include associative play, asking endless "why" questions, and magical thinking (believing their thoughts or wishes can cause events to happen).
A 9-year-old child takes immense pride in getting good grades, joining the soccer team, and completing art projects to show their parents and peers. According to Erikson, what stage is this child in?
A. Autonomy vs. Shame and Doubt
B. Identity vs. Role Confusion
C. Industry vs. Inferiority
D. Intimacy vs. Isolation
Correct Answer: C
Rationale: School-age children (6–12 years) are in the Industry vs. Inferiority stage (Erikson). This means they want to master social, physical, and academic skills to feel competent ("industrious"). Expected behaviors include forming peer groups, enjoying rule-based games, collecting items, and striving for a sense of accomplishment.
An 15-year-old adolescent spends hours in front of the mirror, fluctuates between acting like a child and demanding adult privileges, and struggles with peer group acceptance. According to Erikson, what stage is this?
A. Industry vs. Inferiority
B. Identity vs. Role Confusion
C. Intimacy vs. Isolation
D. Generativity vs. Stagnation
Correct Answer: B
Rationale: Adolescents (12–18+ years) experience Identity vs. Role Confusion (Erikson). This means they are trying to answer the question "Who am I?" by integrating past experiences with future goals. Expected behaviors include body image preoccupation, peer group dependency, mood swings, and testing boundaries.
According to Jean Piaget’s theory of cognitive development, an 8-month-old infant is in which cognitive stage?
A. Preoperational stage, characterized by magical thinking.
B. Concrete operational stage, characterized by logical thought about concrete objects.
C. Sensorimotor stage, where learning occurs through sensory experiences and motor actions (such as exploring objects with the mouth).
D. Formal operational stage, marked by abstract reasoning.
Correct Answer: C
Rationale: Piaget's Sensorimotor stage spans from birth to 2 years. Infants learn through their senses and motor activity. A key expected milestone achieved during this stage (around 8–12 months) is the development of object permanence (knowing an object still exists even when out of sight).
According to Piaget, a 2-year-old toddler is transitioning into which cognitive sub-stage where they begin to use symbols and language?
A. Concrete operations
B. Sensorimotor (late preoperational transition / symbolic thought)
C. Post-conventional reasoning
D. Formal operations
Correct Answer: B
Rationale: Toddlers are at the tail end of the Sensorimotor stage and entering early Preoperational thought (starting around age 2). This means they begin to use language and mental symbols (pretend play on a basic level), though their thinking remains egocentric and focused on the present.
According to Piaget, a 4-year-old preschooler displays "egocentrism" and "centration." What does this mean in terms of expected behavior?
A. The child can successfully see situations from another person's complete perspective.
B. The child focuses on only one detail of a situation at a time and assumes everyone experiences the world exactly as they do.
C. The child uses advanced deductive logic to solve mathematical problems.
D. The child relies entirely on innate reflexes rather than learned behavior.
Correct Answer: B
Rationale: Piaget's Preoperational stage (ages 2–7) includes egocentrism (inability to step outside their own viewpoint) and centration (focusing on a single striking feature, like the height of water in a glass, ignoring width). Expected behaviors include literal thinking, magical thinking, and animism (giving life-like qualities to inanimate objects).
According to Piaget, a 10-year-old school-age child is in which cognitive stage, and what is expected?
A. Sensorimotor stage; learning through physical reflexes.
B. Preoperational stage; engaging in magical thinking and egocentrism.
C. Concrete Operational stage; the child can use logical thought processes, understand conservation (mass/volume stay the same despite shape changes), and master classification.
D. Formal Operational stage; capable of advanced abstract and theoretical reasoning.
Correct Answer: C
Rationale: School-age children operate in Piaget’s Concrete Operational stage (7–11 years). This means they can think logically about concrete (real, tangible) events, understand cause-and-effect, grasp the concept of conservation, and organize objects into categories.
According to Piaget and Kohlberg, how does cognitive and moral reasoning typically evolve during adolescence?
A. Piaget's Formal Operations (abstract, hypothetical thinking) and Kohlberg's Post-Conventional or late Conventional morality (evaluating laws based on principles and social contracts).
B. Piaget's Preoperational thought and Kohlberg's Pre-conventional obedience/punishment orientation.
C. Piaget's Sensorimotor stage and Kohlberg's intuitive stage.
D. Piaget's Concrete operations with strict adherence to literal rules.
Correct Answer: A
Rationale: Adolescents enter Piaget’s Formal Operational stage (around 11–12 years onward), allowing for abstract reasoning, problem-solving, and future planning. In Kohlberg’s moral development framework, they transition from conventional rules toward questioning social norms and establishing personal ethical standards (Post-Conventional).
The nurse notes that an infant born at 32 weeks is at risk for___?
A. respiratory failure
B. clotting abnormalities
C. anemia
D. skeletal deformaties
Answer: C
Rationale: maternal iron is transferred to the fetus during the last 3 months gestation. when a baby is born premature, they do not receive sufficient amounts of maternal iron
When educating a parent about the correct fit for a helmet, the nurses should say
A. it should fit 2 fingers above the eyebrows, the "y" strap should fit snug, and nothing should be worn under the helmet
B. nothing should be worn under the helmet, it should rest/fit at eyebrow level, and should be replaced every 6-8yrs
C. nothing should be worn under the helmet, it should fit 3-4 fingers above the eyebrows, and should be replaced every year
D. nothing should be worn under the helmet, the "y" straps should be loose and the chin strap should be tight
Answer: A
Rationale:
it should fit 2 fingers above the eyebrows, the "y" strap should fit snug, and nothing should be worn under the helmet. The helmet should be replaced every 5 years or sooner if it is damaged or if the child outgrows it
True or false
preschoolers are magical thinkers who understand the concept of time
Answer: false
Rationale:
Preschoolers are magical and literal thinkers but they do not understand the concept of time. instead of telling the preschooler you will be back at 1:30pm or in 2 hours, tell them you will be back after they eat lunch
An 8-year-old child who has been hospitalized for two weeks expresses frustration and sadness, stating, "I'm missing my soccer team, and my friends are all moving ahead of me in school." According to Erikson, what psychosocial stage is this child trying to master?
A. Autonomy vs. Shame and Doubt
B. Initiative vs. Guilt
C. Industry vs. Inferiority
D. Identity vs. Role Confusion
Correct Answer: C
Rationale: School-age children (6–12 years) experience Erikson’s stage of Industry vs. Inferiority. Their primary drive is to achieve a sense of personal competence through school, sports, and peer interaction. Hospitalization disrupts this need, making schoolwork and peer contact crucial interventions.
A 15-year-old adolescent admitted for an acute asthma exacerbation insists on wearing their own street clothes instead of a hospital gown and asks the parents to leave the room during the nursing assessment. How should the nurse evaluate this behavior?
A. As a sign of abnormal regression to childhood dependence.
B. As a normal manifestation of adolescent autonomy, privacy, and identity formation.
C. As pathological separation anxiety requiring psychological intervention.
D. As defiant behavior indicating a lack of clear parental boundaries.
Correct Answer: B
Rationale: Adolescents (12–18+ years) are navigating Erikson's stage of Identity vs. Role Confusion. Establishing privacy, wearing personal clothing, and desiring confidential time away from parents are normal developmental behaviors essential for developing an independent identity.
During a well child visit, the parent asks when should they expect the step, suck, and root reflexes to disappear. What would you tell the parent?
A. Step disappears between 4-8wks, suck disappears between 2-5mo, and root disappears by 3mo.
B. Step disappears by 8-12wks, suck by 3-9mo, and root by 4wks.
C. Step disappears by 3-6mo, suck by 4-12wks, and root by 6wks.
D. Step disappears by 4-6mo, suck by 6-9mo, and root by 6mo.
Answer: A
Rationale: infants are born with primitive reflexes and they disappear at different ages.
True or false
During a tantrum, the parent should put the child in time out and restart their time every time they get up.
Answer: false
Rationale: short 2-3min max time out is ok for children aged 2.5-3 years old. During a tantrum, the parent should ensure safety, ignore the actual tantrum, and do not give in to the toddler
A 4-year-old hospitalized preschooler tells the nurse, "I got sick and had to come to the hospital because I was angry at my baby brother yesterday." How should the nurse interpret this statement according to Piaget’s preoperational stage?
A. The child is experiencing formal operational abstract reasoning.
B. The child is displaying egocentrism and magical thinking (transductive reasoning).
C. The child is demonstrating conservation of mass and volume.
D. The child has progressed to concrete operational logic.
Correct Answer: B
Rationale: Preschoolers are in Piaget’s preoperational stage, characterized by egocentrism and magical thinking (believing that their thoughts or wishes can directly cause external events, such as getting sick because they were angry). Nurses must offer reassurance and clarify that they did nothing wrong to cause their illness.
A nurse is teaching a safety class for a group of 9-year-old school-age children. Which safety recommendation is most critical for this age group due to their expanding physical independence and motor skill development?
A. Installing safety gates at the top and bottom of all stairwells.
B. Wearing a properly fitted bicycle helmet and protective gear during outdoor sports and riding.
C. Keeping all household cleaning supplies locked in high cabinets.
D. Supervising children continuously within arm's reach while walking in a grocery store.
Correct Answer: B
Rationale: School-age children engage in active outdoor play, bike riding, and sports. Head injuries from bicycle accidents are a major risk in this age group, making properly fitted helmet use a critical safety priority.
A nurse is preparing to conduct a private lifestyle and health history interview (using the HEEADSSS framework) with a 16-year-old adolescent patient. What is the priority nursing action regarding confidentiality?
A. Inform the adolescent that all information discussed will be reported verbatim to the parents immediately.
B. Conduct the interview privately while assuring the adolescent of confidentiality, with safety exceptions such as risk of self-harm, harm to others, or abuse.
C. Have the parents remain in the room during the entire interview to ensure accuracy.
D. Refuse to ask sensitive questions regarding substance use or sexual health due to legal restrictions.
Correct Answer: B
Rationale: Adolescents are more likely to be honest about sensitive health topics (mental health, substance use, sexual health) if assured of privacy. Nurses must establish a confidential environment while clearly explaining the legal limits of confidentiality (harm to self/others, abuse).
A nurse is performing a neurological and developmental assessment on a 7-month-old infant. Which of the following assessment findings should the nurse identify as an abnormal finding that requires further evaluation?
A. Absence of the Moro reflex
B. Absence of the tonic neck (fencing) reflex
C. Presence of the palmar grasp reflex
D. Presence of the plantar grasp reflex
Answer: C
Rationale:
Correct Choice (C): The palmar grasp reflex should disappear by 4-6mo. If the palmar grasp is still present at 7 months it is abnormal; the persistence of primitive reflexes past their expected age can indicate CNS/neurological impairment.
Incorrect Choice (A): The Moro (startle) reflex normally disappears by 4-6mo. If it is absent in a 7-month-old, it is normal.
Incorrect Choice (B): The tonic neck reflex ("fencing posture") normally disappears by 4-6 months. Therefore, its absence at 7 months is a normal finding.
Incorrect Choice (D): The plantar grasp reflex doesn't disappear until 9-12mo. Therefore, finding it present in a 7-month-old infant is a normal finding.
True or false
The 3 stages of separation anxiety in order are, protest, detachment, and despair
Answer: false
Rationale:
1. protest ~ the child pretests; scream, cry, wont let go of caregiver, hard to calm down
2. despair ~ quiet, no crying, sad, depressed, wants to be held when caregiver returns
3. detachment ~ detaches from caregiver to "cope," and they appear happy/adjusted. they are withdrawn from their caregiver when they return
A nurse is preparing a 5-year-old preschooler for a scheduled intravenous (IV) catheter insertion. Which approach represents the best developmental strategy for preparation?
A. Explain the entire medical procedure using precise anatomical terms 2 days in advance.
B. Avoid telling the child about the procedure until the needle is right in front of them to prevent anticipatory anxiety.
C. Use a doll or puppet to demonstrate the procedure shortly before it happens, using simple, concrete terms.
D. Tell the child that the procedure will not hurt at all so they stay completely calm.
Correct Answer: C
Rationale: Preschoolers learn best through play-based and concrete explanations. Using a doll or medical play shortly before a procedure helps reduce fear, and nurses should always be honest that it will feel like a "quick pinch."
A nurse is preparing a 10-year-old child for an upcoming appendectomy. How should the nurse structure the explanation of the surgery?
A. Use picture books with animal characters and fairy tales to explain the surgery.
B. Provide a step-by-step explanation using anatomical diagrams and medical equipment a day or two before the procedure.
C. Give minimal information to prevent the child from overthinking or asking complex questions.
D. Tell the child they are going to sleep and will wake up with everything magically fixed.
Correct Answer: B
Rationale: School-age children possess concrete operational thinking and a capacity for logical reasoning. They benefit from detailed, logical explanations, diagrams, and advance preparation (1–2 days prior) so they can process the information and ask questions.
A nurse is providing health counseling to the parents of a 14-year-old adolescent. When discussing health promotion and injury prevention, the nurse should emphasize that the leading cause of morbidity and mortality in this age group is:
A. Congenital cardiac anomalies.
B. Motor vehicle crashes and unintentional injuries.
C. Sudden infant death syndrome (SIDS).
D. Infectious gastroenteritis.
Correct Answer: B
Rationale: Unintentional injuries—predominantly motor vehicle accidents (as drivers or passengers), drowning, and firearm-related injuries—represent the leading cause of death and serious injury among adolescents, making safety education regarding driving, seatbelts, and risk behaviors vital.