The nurse is conducting developmental screening for children in the pediatric clinic. A parent expresses concern that the 14-month-old is not yet walking independently, and their adult sibling's child is walking at 10 months of age.
Which concept should the nurse use to provide information to the parent?
The underlying stimuli for physiologic changes are based on aggressive energies and the libido.
Development occurs in a series of subconscious stages that are impacted by social experiences.
Each child's pattern of biological development is unique, yet proceeds according to a genetic blueprint.
Intelligence proceeds when new information is adapted to the child's preexisting stage of development.
The Correct Answer is C
Choice A rationale
This rationale describes a Freudian psychoanalytic theory of development, which focuses on psychosexual stages and the unconscious mind. This theory is not the basis for explaining individual differences in the timing of physical milestones such as walking. Motor development is a biologically driven process, not a result of psychosexual energies.
Choice B rationale
This rationale describes Erikson's theory of psychosocial development, which posits that individuals progress through a series of stages based on social interactions. While this theory is important for understanding social and emotional development, it does not explain variations in the timing of physical milestones like walking.
Choice C rationale
Motor development follows a predictable sequence, but the exact timing of milestones is influenced by a combination of genetic factors and environmental influences. Each child has a unique biological timetable for maturation, and the range for achieving milestones like walking is broad. The nurse should reassure the parent that a 14-month-old not walking is within the normal developmental range.
Choice D rationale
This rationale describes Piaget's theory of cognitive development, which focuses on how children construct knowledge through adaptation and assimilation. This theory is centered on intellectual and cognitive processes and does not provide an explanation for variations in the timing of gross motor skills such as walking.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
The let-down reflex is primarily mediated by oxytocin's effect on myoepithelial cells surrounding the alveoli in the mammary glands. This action causes milk ejection, not activation of the reflex itself. Prolactin is the hormone primarily responsible for milk production, while oxytocin's role is specifically in the mechanical release of the milk.
Choice B rationale
Involution, the process of the uterus returning to its pre-pregnancy size, is a gradual process that occurs over several weeks. While oxytocin's uterine contractions contribute to this process by compressing blood vessels and promoting uterine tone, it is not the immediate and primary outcome. This long-term process is influenced by many hormonal and physiological changes.
Choice C rationale
Oxytocin is a neuropeptide and a potent uterotonic agent. It works by binding to specific receptors on the smooth muscle cells of the myometrium, leading to increased intracellular calcium concentrations. This cascade of events triggers strong, rhythmic contractions, which are essential for labor induction and postpartum hemorrhage prevention.
Choice D rationale
While oxytocin-induced uterine contractions are crucial for the third stage of labor, which involves placental expulsion, the direct and primary action of the administered hormone is the stimulation of those contractions. The expulsion of the placenta is the clinical outcome resulting from the physiological action of the uterine muscle contracting.
Correct Answer is A
Explanation
Choice A rationale
A prolapsed umbilical cord is an obstetric emergency where the cord descends through the cervix into the vagina ahead of the presenting fetal part. This can cause compression of the cord, leading to fetal hypoxia and death. Placing the client in a Trendelenburg position or a knee-chest position uses gravity to relieve pressure on the cord.
Choice B rationale
Administering oxygen via face mask at 8-10 L/min is a supportive measure for fetal distress. It helps to increase maternal oxygen saturation, which may improve fetal oxygenation. However, it does not address the underlying problem of cord compression, which is the immediate threat to the fetus. Relieving the pressure on the cord is the top priority.
Choice C rationale
Notifying the operating room team is necessary for an emergent cesarean section, which is the definitive treatment for a prolapsed cord. However, the nurse must first take immediate action to relieve pressure on the cord to prevent fetal harm while waiting for the surgical team to prepare. A delay in pressure relief can have devastating consequences for the fetus.
Choice D rationale
Administering a fluid bolus of 500 mL can help to improve maternal blood volume and placental perfusion. This is a supportive measure for fetal distress and hypovolemia. However, it does not directly address the mechanical compression of the umbilical cord. The immediate, life-saving intervention is to relieve the pressure on the cord to restore blood flow.
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