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MATERNITY/ NUR106; unfolding case studies (answered) with rationales_ 2021

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Human Growth and Development Unfolding Case Study #1-1 Maddie Maddie is a 6-month-old infant whose birth weight was 7 pounds 5 ounces, head circumference was 16 inches, and her length wa... s 21 inches. She presents to the clinic with her parents for a well child visit. Exercise 1-1: Calculation You weigh Maddie at her visit and document her weight as 15 pounds, head circumference as 16 inches, and length as 25 inches. You plot her measurements on the chart and determine her percentiles for height and weight. What percentile is she in terms of weight and length? Exercise 1-2: Fill-in How would you interpret these findings in relation to her percentile and other female infants of the same age? ____________________________________________________________________________ You also listen to Maddie's heart and lungs and assess Maddie's gross motor development during her visit. Exercise 1-3: Multiple-choice question Which findings would indicate that Maddie has met gross motor age-appropriate milestones? A. Maddie is able to pull herself to a stand. B. Maddie can sit alone without support. C. Maddie can roll from her back to her abdomen. D. Maddie can grasp a rattle with her fingers. Maddie's father asks you for suggestions about appropriate play for her. Exercise 1-4: Select all that apply Based on an understanding of growth and development, and safety, select all toys that would meet Maddie's needs. ❑ Brightly colored latex balloons ❑ Push-pull toys ❑ Teething toys ❑ Books with bright pictures ❑ Brightly colored soft toys ❑ Stacking blocks Maddie's parents are very attentive to your teaching and you provide them with literature about age-appropriate activity. You also review with them home safety for a 6-month-old. Their next visit is established in another 3 months when Maddie will be 9 months old. At that time, you will prepare them for safety issues that involve a child that is more mobile. Unfolding Case Study #1-2 Omar You go out to the waiting room to call in your next patient, Omar, and notice two toddlers are sitting side by side in the playroom, each is playing with a truck. There is little interaction between the two children. Exercise 1-5: Multiple-choice question The scenario described in Unfolding Case Study #1-2 is an example of: A. Stranger anxiety B. Regressive behaviors C. Cooperative play D. Parallel play Fifteen-month-old Omar is taken to the examination room with his father. You know his mom is a nurse and works days, so you have established a rapport with Omar's father from the previous visits. Omar's father is unemployed and stays home with the children. Exercise 1-6: Select all that apply Which findings would indicate that Omar has met gross motor age-appropriate milestones? ❑ Walks well ❑ Stoops and recovers a ball ❑ Walks up steps ❑ Builds a tower of two cubes ❑ Jumps Omar's dad asks you, "When should I introduce a cup for him to drink his whole milk?" Exercise 1-7: Multiple-choice question Based on an understanding of growth and development of a 15-month-old, you state: A. "Omar should only be drinking low-fat milk." B. "Omar can begin to drink from a cup now." C. "Omar should still be drinking formula from a bottle." D. "Omar will not have the necessary fi ne motor skills until he is 2." You do parent teaching regarding development from 15 to 18 months with Omar's father and provide him with written information. Omar's father is of Indian descent but was educated in English in his native country and can read and write English well. Exercise 1-8: Select all that apply Which of the following teaching points should you make in your instruction? ❑ Potty training should be completed during this time. ❑ Offer the child push-pull toys. ❑ Allow the child to dress himself. ❑ Use child-resistant covers and cupboard closures. ❑ Gradually introduce table foods. In order for you to provide the best instruction for parents who come to the clinic with their children, you realize that you must fully understand the psychosocial milestones in human growth and development. You are also asked to precept a student nurse today. The student's name is Harold, and he is a second-degree student that is back to nursing school after a career as a chiropractor. Exercise 1-9: Matching Match the psychosocial milestone in Column A with the correct stage of development in Column B. Column A Column B _______ The child takes pleasure in completing tasks _______ The child begins to form attachment to the parents. _______ The child asserts free will to initiate a task. _______ The child engages in imaginative play and interactions. A. Infancy: Trust versus mistrust B. Toddler: Autonomy versus shame and doubt C. Preschool: Initiative versus guilt D. School age: Industry versus inferiority E. Adolescent: Identity versus role diffusion _______ The child's focus turns to the importance of acceptance. Harold observed that a child in the waiting room started crying when his mother left the room to go to the restroom. He has some additional questions about separation anxiety. What teaching would you provide? You and Harold continue to discuss developmental levels of children before you call for the next patient. Harold is very thankful because he knows this will help him on his next pediatric test. Exercise 1-10: Matching Match the cognitive milestone in Column A with the correct stage of development according to Piaget in Column B. Column A Column B _______ Child looks for a ball that is hidden under a pillow. _______ Child is able to conserve mass. _______ Child is able to understand a hypothesis. A. Sensorimotor B. Preoperational C. Concrete operations D. Formal operations _______ Child is egocentric and believes everyone sees three mountains in the same way as he or she does. You tell Harold that your next patients are 4- and 5-year-olds and they are good ages to review developmental activity. You call the next patient to the examination room. Unfolding Case Study #1-3 Ethan and Annie The next patients you see are 4-year-old Ethan and his 5-year-old cousin, Annie. They are brought in by their grandmother since their parents' work. Ethan and Annie are developing well and are cared for in a multigenerational home in which the grandmother takes responsibility for childcare when her children, the parents of Ethan and Annie, are at work. The grandmother takes good care of the children but speaks Spanish and limited English. Exercise 1-11: Select all that apply You and Harold perform a Denver Developmental Screening on 4-year-old Ethan. Which of the following tasks should Ethan be able to demonstrate? ❑ S kips and hops on one foot ❑ J umps rope ❑ R ides a tricycle ❑ Uses scissors ❑ Roller-skates Annie shows you a cut on her finger that she got in preschool and tells you the story about how it happened. She is a very social little child who speaks clearly in English and both she and Ethan can speak in Spanish also. While Annie is waiting for you to finish Ethan's examination, Annie unloads her "pocketbook" and she cuts figures from a piece of construction paper and hands the figure to Harold and instructs him to glue a design on it. Exercise 1-12: Multiple-choice question The type of play that Annie is portraying is known as: A. Parallel play B. Dramatic play C. Solitary play D. Associative play Ethan and Annie's grandmother has a handwritten note from Annie's mother that asks about immunization needed for Annie to start kindergarten in the fall. Exercise 1-13: Select all that apply Which of the following immunizations are recommended by the CDC for the 5-year-old school-age child? ❑ Y early seasonal influenza vaccine ❑ Pertussis vaccine (Tdap) ❑ Human papillomavirus ❑ Inactivated polio vaccine ❑ Hepatitis B You write the answers on the paper that the grandmother presents so she can take them home to the family. You also give her an appointment to see Annie 1 month before the start of kindergarten to get all her immunizations up to date. Ethan needs a 5-year-old appointment in a year. You and Harold continue to discuss immunizations. You tell Harold that there are many resources available that he can download onto his mobile device that can be accessed from the CDC's website. Unfolding Case Study #1-4 Jessica The next patient that you see is Jessica who is a developing 10-year-old. Jessica is with her mother and is not happy about being at the clinic. Jessica believes the clinic is for "babies." Her mother has been taking her to the clinic since birth and you have watched Jessica grow and meet all of her milestones. This is important since you know that Jessica was 9 weeks preterm at birth. Today you want to assess her gross cognitive development. Exercise 1-14: Multiple-choice question Which of the following assessments would indicate that the child is in the concrete operations stage of cognitive development? A. The child is using formal logic to problem solve. B. The child is able to set priorities based on problem solving. C. The child is able to conserve mass. D. The child moves from egocentric thought and develops awareness of others. Jessica's mother states that she would like to talk about Jessica's sexual development since she is prepubescent and showing signs of breast development. You ask Jessica's mom if she is comfortable speaking about this with Harold in the room and if she would prefer him to wait outside. Jessica looks annoyed that her mother has even brought this subject up. While you are outside the examination room with Harold you ask him to review female and male maturation stages and give him two case studies to review. One case is about a 16-year-old girl with heavy bleeding and the second is about male development. Exercise 1-15: Ordering Order the steps of sexual maturation in females from 1 to 4, beginning with the fi rst stage and ending with the last stage. Menarche Development of breast buds Pubic hair growth Axillary hair growth Exercise 1-16: Ordering Order the steps of sexual maturation in males (from 1 to 4) beginning with the fi rst stage and ending with the last stage. Deepening of the voice Facial hair growth Pubic hair growth Enlargement of the testes Exercise 1-17: Multiple-choice question Also, in the clinic is a 16-year-old female who has a history of heavy bleeding with her menstrual cycles. As a result, she is experiencing iron deficiency. Which of the following foods should be encouraged to increase her iron levels? A. Dark leafy green vegetables and citrus fruits B. Peanut butter, jelly, and bananas C. Seafood and yellow vegetables D. Beans and dairy products Exercise 1-18: Multiple-choice question Another patient, Andy, a 16-year-old boy, views himself as competitive, athletic, and masculine. This image of oneself is known as: A. Gender schemes B. Androgyny C. Gender identity D. Gender stereotype Talking to Jessica's mother with Jessica in the room was beneficial and Jessica did ask questions about what she can expect next in her development. Jessica does not need another appointment for a year unless there are concerns between that time frame. After the appointment with Jessica, Harold discusses his exercise and case study answers with you. Harold is happy that you are reviewing material he will need for his upcoming pediatrics test. You and Harold call the next patient from the waiting room. Unfolding Case Study #1-5 Frankie Six-year-old Frankie is being seen for a follow-up visit. He had his arm cast removed a week ago and you are checking the movement in his wrist. He had sustained a wrist break by falling off a piece of playground equipment at school. Exercise 1-19: True or false _______ Prior to puberty, the child's bones are soft and flexible, which predisposes them to fractures. Exercise 1-20: Select all that apply Which findings would indicate that Frankie has met fi ne motor age-appropriate milestones? ❑ Ties shoelace ❑ Cuts with scissors ❑ Prints first name ❑ Plays a musical instrument ❑ Weaves potholders on small looms Exercise 1-21: Select all that apply Which of the following strategies facilitate social development in the school-age child? ❑ Reinforce competitive behaviors in organized sports. ❑ Encourage children to select activities based upon their own interests. ❑ Emphasize teamwork and fair play in organized sports. ❑ Limit involvement to one organized sport. [Show More]

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