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Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 11: Developmental Theories MULTIPLE CHOICE 1. A nurse who wants to apply a theory that relates to moral development should read more from the work of: 1. Gould 2. Freud 3. Erikson 4. Kohlberg ANS: 4 Kohlberg developed a theory on moral development. Gould developed a theory on psychosocial development. Freud developed a theory on psychosexual development. Erikson developed a theory on psychosocial development. DIF: A REF: 144 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 2. The nurse using Erikson’s theory to assess a 20-year-old client’s developmental status expects to find which of the following behaviors? 1. Coping with physical and social losses 2. Enjoys participating in the community 3. Applying self to learning skills 4. Overcoming a sense of guilt or frustration ANS: 2 According to Erikson, the young adult is in the intimacy versus isolation stage of development. This is the time in which the young adult can become fully participative in the community, enjoying adult freedom and responsibility. Coping with physical and social losses is found in Erikson’s integrity versus despair stage (old age) of development. Applying themselves to learning productive skills is a consistent behavior found in Erikson’s industry versus inferiority stage (6 to 11 years) of development. According to Erikson, overcoming a sense of guilt or frustration is in the initiative versus guilt stage (3 to 6 years) of development. DIF: A REF: 140 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 3. The nurse recognizes that Freud’s theory approaches development by looking at: 1. Moral reasoning. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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2. Logical maturity 3. Psychosexual aspects 4. Cognitive development ANS: 3 Freud’s theory of personality development approaches development by looking at psychosexual aspects. Kohlberg’s theory approaches development by looking at moral reasoning. Gould’s theory approaches development by looking at logical maturity. Piaget’s theory approaches development by looking at cognitive development. DIF: A REF: 138 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 4. According to Piaget, a preschool child (3 to 5 years old) who comes to the clinic is expected by the nurse to exhibit which of the following behaviors? 1. Far-reaching problem-solving 2. Exploration of the environment 3. Cooperation and sharing with others 4. Thinking with the use of symbols and images ANS: 4 According to Piaget, the preoperational child (age 2 to 7 years) is learning to think with the use of symbols and mental images. Organization of thoughts and far-reaching problem-solving are noted in Piaget’s formal operations (11 years to adulthood) stage of cognitive development. According to Piaget, the child explores the environment in the sensorimotor stage (birth to 2 years) of cognitive development. Cooperation and sharing are seen in Piaget’s concrete operations (age 7 to 11 years) stage of cognitive development. DIF: A REF: 142 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 5. For an older adult client, an example of a common behavioral task or critical event is: 1. Selecting a mate 2. Rearing children 3. Finding a congenial social group 4. Adjusting to decreasing physical strength ANS: 4 A common behavioral task of the older adult client is adjusting to decreasing physical strength. Selecting a mate is a developmental task commonly seen in the early adult. Rearing children is a developmental task of the middle-early adult. Finding a congenial social group is a developmental task of the middle-early adult. Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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DIF: A REF: 137 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 6. The nurse working in an adult medical clinic wishes to learn more about a developmental theory that focuses on the adult years. The nurse investigates different possibilities and selects the theory proposed by: 1. Gould 2. Piaget 3. Freud 4. Chess and Thomas ANS: 1 Gould’s theory of psychosocial development specifically focuses on the adult years. Piaget’s theory focused on cognitive development throughout the life span. Freud’s psychosexual theory focused on personality development throughout the life span. The theory of Chess and Thomas focused on development from childhood to early adulthood. DIF: A REF: 142 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 7. The nurse recognizes that which one of the following statements about growth and development is correct? 1. Development ends with adolescence. 2. Growth refers to qualitative events. 3. Developmental tasks are age-related achievements. 4. Cognitive theories focus on emotional development. ANS: 3 “Developmental tasks are age-related achievements” is a correct statement about growth and development. Human growth and development are orderly, predictable processes beginning with conception and continuing until death. Growth refers to quantitative events. Development refers to qualitative events. Cognitive theories focus on reasoning and thinking processes. DIF: A REF: 137 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 8. In Kohlberg’s Moral Development theory, an individual who reaches level II (conventional thought) is expected to exhibit: 1. Absolute obedience to authority

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2. Reasoning based on personal gain 3. Personal internalization of other’s expectations 4. Self-chosen ethical principles, universality, and impartiality ANS: 3 At level II—conventional thought, the person sees moral reasoning based on his or her own personal internalization of societal and others’ expectations. In stage 1, the child’s response to a moral dilemma is in terms of absolute obedience to authority and rules. At level I—preconventional thought—the person reflects on moral reasoning based on personal gain. According to Kohlberg, stage 6 is when a person has self-chosen ethical principles, universality, and impartiality. DIF: A REF: 144 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 9. According to Piaget, the infant is in the first period of development, which is characterized by: 1. Concrete operations 2. Preoperational thought 3. Sensorimotor intelligence 4. Identity versus role confusion ANS: 3 According to Piaget, the infant is in the first period of development, which is characterized by sensorimotor intelligence. According to Piaget, children ages 7 to 11 are in the concrete operations period of development, which is characterized by having the ability to perform mental operations, while children ages 2 to 7 are in the preoperational period of development, which is characterized by the child learning to think with the use of symbols and mental images. Identity versus role confusion is a developmental stage (puberty) according to Erikson. DIF: A REF: 142 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 10. A child’s understanding of the concept of ice becoming water, Piaget’s stage of cognitive development, is seen in: 1. Sensorimotor 2. Preoperational 3. Formal operations 4. Concrete operations ANS: 4

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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During Piaget’s concrete operations stage of cognitive development, the child is able to understand that objects or quantities remain the same despite a change in their physical appearance, such as when ice becomes water. During Piaget’s sensorimotor stage of cognitive development, the child is exploring the environment but is unable to understand the concept of ice becoming water. During Piaget’s preoperational stage of cognitive development, the child is learning to think with the use of symbols and mental images but is not able to understand the concept of ice becoming water. According to Piaget’s formal operations stage of cognitive development, the individual’s thinking moves to abstract and theoretical subjects. DIF: A REF: 142-143 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 11. The nurse in a pediatric health care setting is using Kohlberg’s developmental theory. A child is evaluated as having reached level I, the preconventional level, if the child: 1. Makes sure that he or she is not late for school 2. Cleans the blackboards after school for the teacher 3. Runs for school council in order to change policies 4. Stays away from peer groups that harass other children ANS: 1 According to Kohlberg’s developmental theory of moral development, at level I, the preconventional level, the child’s reasoning is based on personal gain. The moral reason for acting relates to the consequences the person believes will occur. The child who makes sure not to be late for school may do so out of fear of punishment. Cleaning the blackboards after school for the teacher is an example of Kohlberg’s stage 3, good boynice girl orientation. The child desires to win the teacher’s approval. Running for school council to change policies is an example of Kohlberg’s stage 5 social contract orientation. Staying away from gangs at school that harass other children is an example of Kohlberg’s stage 4 society-maintaining orientation. DIF: A REF: 144 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 12. In applying Gould’s developmental theory, the nurse anticipates that a client will have a greater concern for one’s health within the following theme and age-group: 1. First theme (20s) 2. Second theme (early 30s) 3. Fourth theme (40s) 4. Fifth theme (50s) ANS: 4

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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During the fifth theme (50s), Gould finds a realization of mortality with a concern for one’s state of health. During the first theme (20s), Gould finds individuals wanting to get away from their parents. During the second theme (30s), Gould finds young adults working to accept who they are and to accept their growing children as being unique and separate. During the fourth theme (40s), Gould finds resignation and the belief that possibilities are limited. DIF: A REF: 142 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 13. The nurse is working with a new mother who will require surgery. The follow-up treatment will interfere with bonding. In applying Freud’s theory, the nurse recognizes that the stage of development that may be affected is the: 1. Oral stage 2. Anal stage 3. Phallic stage 4. Latent stage ANS: 1 According to Freud, disruption in the physical or emotional availability of the parent for the newborn (e.g., undergoing surgery) will affect the oral stage of development; the anal stage is from 12 to 18 months to 3 years, when the child is toilet-training; the phallic stage is from 3 to 6 years of age, when the child becomes interested in the genital organs; and the latent stage is from 6 to 12 years, when the child represses sexual urges and channels them into productive activities that are socially acceptable. DIF: A REF: 138 OBJ: Comprehension TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 14. In accordance with Erikson’s theory, it is expected by the nurse that a middle-aged adult client will be involved in the process of: 1. Developing a sense of identity 2. Searching for meaning in life 3. Enhancing one’s capability to love others 4. Expanding personal and social involvement ANS: 4

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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In accordance with Erikson’s theory, the middle-aged adult client is involved in the process of expanding one’s personal and social involvement. Middle-aged adults should be able to see beyond their needs and accomplishments to the needs of society. Developing a sense of identity is in accordance with Erikson’s identity versus role confusion (puberty) stage of development. Searching for meaning in life is in accordance with Erikson’s integrity versus despair (old age) stage of development. Enhancing one’s capability to love others is in accordance with Erikson’s intimacy versus isolation (young adult) stage of development. DIF: A REF: 140 OBJ: Knowledge TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 15. The primary purpose for the nurse to understand human growth and development is to be best able to: 1. Identify deviations from normal 2. Select effective nursing interventions 3. Be sensitive to age-appropriate needs 4. Enhance nurse-client communication ANS: 1 Understanding normal growth and development helps nurses predict, prevent, and detect any deviations from clients’ normal expected patterns. While being familiar with the characteristics of the various stages of human growth and development and being able to apply that knowledge to the individual client do have a positive impact on determining the most appropriate nursing interventions, the primary purpose is to predict, prevent, and detect any deviations from the client’s normal expected patterns. Although being familiar with the characteristics of the various stages of human growth and development and being able to apply that knowledge to the individual client do have a positive impact on identifying age-appropriate needs, the primary purpose is to predict, prevent, and detect any deviations from the client’s normal expected patterns. While being familiar with the characteristics of the various stages of human growth and development and being able to apply that knowledge to the individual client do have a positive impact on the nurse’s ability to communicate with the client in an appropriate manner, the primary purpose is to predict, prevent, and detect any deviations from the client’s normal expected patterns. DIF: C REF: 137 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 16. Which of the following should the nurse consider first when assessing the cognitive ability of an older adult? 1. A life-long bachelor 2. Orphaned at age 12 3. History of a chronic disease process

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4. Recent immigration to the United States ANS: 4 Cognitive processes comprise changes in intelligence, ability to understand and use language, and the development of thinking that shapes an individual’s attitudes, beliefs, and behaviors. Recent immigration to the United States would present language and life experiences that should be considered by the nurse. Socioemotional processes consist of the variations that occur in an individual’s personality, emotions, and relationships with others during their lifetime. Being a bachelor and not having experienced a marital relationship should be considered by the nurse. Socioemotional processes consist of the variations that occur in an individual’s personality, emotions, and relationships with others during their lifetime. Being orphaned at a young age should be considered by the nurse. Biological processes produce changes in an individual’s physical growth and development. A chronic disease process should be considered by the nurse. DIF: C REF: 142 OBJ: Analysis TOP: Nursing Process: Assessment MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 17. A nurse caring for a 78-year-old client recently diagnosed with pneumonia will find Erikson’s psychosocial development theory most helpful in determining: 1. Which needs the client will typically develop 2. Which coping mechanisms the client will likely use 3. How the client will respond to the respiratory problem 4. How the client and his family will adjust to the stressors ANS: 3 Developmental theories are important in helping nurses assess and treat a person’s response to an illness. Understanding and being able to apply the concepts of the theory will enable the nurse to determine a variety of generalized information that will assist in providing appropriate nursing care. The other options are only one area of information that is made available when applying Erikson’s psychosocial development theory. DIF: C REF: 140 OBJ: Analysis TOP: Nursing Process: Assessment/Planning MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 18. As described by Freud, the nurse recognizes that a young adult best shows a welldeveloped superego when he: 1. Tells a friend that he’ll help him stop smoking 2. Returns a lost wallet to a stranger who dropped it 3. Arranges for a cab ride home after consuming alcohol 4. Has 10% of his salary automatically transferred to savings ANS: 3

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

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Components of the human personality develop through Freud’s developmental stages. Freud believed that the functions of these components regulate behavior. These components are the id, the ego, and the superego. The superego performs regulating, restraining, and prohibiting actions. Often referred to as the conscience, the superego is influenced by the standards of outside social forces (i.e., the law). The ego represents the reality component mediating conflicts between the environment and the forces of the id. The ego helps us judge reality accurately, regulate impulses, and make good decisions. DIF: C REF: 139 OBJ: Analysis TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 19. A nurse is preparing to discharge an 11-month-old child after a hospitalization for a viral infection. The nurse uses anticipatory guidance most effectively when: 1. Encouraging the parents to limit visitors for 14 days 2. Providing the parents with written discharge instructions 3. Arranging the follow-up pediatrician appointment for the parents 4. Informing the parents that the child may cry when taken to daycare ANS: 4 A nurse’s use of anticipatory guidance (derived from an understanding of the characteristics shown by clients in the trust versus mistrust phase of development) will help parents cope with the hospitalization of an infant and the infant’s behaviors when discharged to home. The child’s sense of trust may be challenged during hospitalization and may need support from parents when returning home. Encouraging the parents to limit visitors for 14 days is more educational and related to the child’s physical recovery. Providing the parents with written discharge instructions is more educational and designed to reinforce the information. Arranging the follow-up pediatrician appointment for the parents is an action included in the discharge planning. DIF: C REF: 139 OBJ: Analysis TOP: Nursing Process: Implementation MSC: NCLEX® test plan designation: Safe, Effective Care Environment/Staff Education 20. Which of the followi...