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Chapter 06: Growth and Measurement
Test Bank—Nursing
MULTIPLE CHOICE
1. The gonads begin to secrete estrogen and testosterone during:
a. infancy.
b. puberty.
c. pregnancy.
d. early adulthood.
ANS: B
At puberty, the gonads secrete testosterone and estrogen. As a result, secondary sex
characteristics (e.g., genitalia growth) begin to appear. Maturation occurs at a mean age of
11.5 years in females and 13.5 years in males.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 79
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
2. Developmental changes of puberty are caused mainly by the interaction of the pituitary gland,
gonads, and:
a. hypothalamus.
b. islet cells.
c. thalamus.
d. thymus.
ANS: A
Under the influence of the hypothalamus, pituitary gland, and gonads, developmental changes
of puberty are established.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 79
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
3. After 50 years of age, stature:
a. becomes fixed.
b. begins a barely perceptible secondary increase.
c. increases at a rate of 0.5 cm/ year.
d. declines.
ANS: D
As the individual reaches 50 years of age, the intervertebral disk begins to thin and become
more compressed, which leads to a decline in stature.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 82
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
4. By 10 to 12 years of age, lymphatic tissues are about:
a. 25% of adult size.
b. 50% of adult size.
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full file at http://testbankcorner.eu
c. the same as adult size.
d. twice the size of those in the adult.
ANS: D
Lymphatic tissues are small compared with total body size, but they are almost fully
developed at birth. They grow fast and are about twice the adult size by age 10 to 12 years.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
5. Mrs. Jones has brought her 24-month-old child for a well visit. Which organ(s) completes
physical development more quickly than any other body part?
a. Brain
b. Kidneys
c. Heart
d. Lungs
ANS: A
Along with the skull, eyes, and ears, the brain completes development more quickly than any
other part of the body; its most rapid growth occurs from conception to age 2 years.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
6. During adolescence, the head size normally increases as a result of:
a. sinus development.
b. brain mass increase.
c. evolution of lymphatic tissue.
d. hypertrophy of myelin.
ANS: A
As the facial sinuses grow, the head size enlarges its surface area to accommodate their
growth.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 81
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
7. Fifty percent of an individual’s ideal weight is gained during:
a. pregnancy.
b. preschool years.
c. adolescence.
d. early adulthood.
ANS: C
During adolescence, the trunk and legs grow the most, causing the organs and the skeletal
mass to double in size. In pregnancy, weight gain is accounted for by the growing fetus and
pregnancy organs (placenta and uterus). In preschool years, weight is gained at a steady rate,
with fat tissue increasing slowly until about 7 years of age. In preschool years, weight is
gained at a steady rate, with fat tissue increasing slowly until about 7 years of age. In early
adulthood, there is a reduction in size and weight.
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full file at http://testbankcorner.eu
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 81
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
8. Gender-specific skeletal differences first occur during:
a. the second stage of fetal development.
b. late infancy.
c. early childhood.
d. adolescence.
ANS: D
During adolescence, females develop a wider pelvis and males develop broad shoulders;
males transition from a slight increase in body fat to more lean muscle mass in later puberty,
whereas females maintain an increase in adipose tissue throughout adolescence.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
9. Mrs. Layton is a 33-year-old patient who is obese. Most adult obesity begins:
a. in adolescence.
b. in childhood.
c. after the skeletal growth is completed.
d. once sexual maturation is complete.
ANS: A
Seventy percent of adult obesity begins in adolescence, before skeletal growth or sexual
maturation is complete.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
10. The legs are the fastest growing body part during:
a. early infancy.
b. late infancy.
c. childhood.
d. early adulthood.
ANS: C
Legs grow the fastest during childhood, whereas the trunk grows fastest in infancy and the
skeletal muscles and organs grow fastest in early adulthood.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 81
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
11. Skeletal mass and organ systems double in size during:
a. infancy.
b. early childhood.
c. adolescence.
d. early adulthood.
ANS: C
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During puberty, sex steroids stimulate secretion of growth hormone, causing the organs and
skeletal mass to double in size.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
12. Optimal infant birth weight is difficult for pregnant adolescents to obtain because:
a. they have not completed their own growth spurt.
b. there are insufficient uterine supporting structures.
c. the amniotic fluid is variable in pregnant adolescents.
d. blood volume has not reached adult proportions.
ANS: A
Pregnant adolescents younger than 16 years, or less than 2 years from menarche, may still be
in their growth spurt. They may require higher weight gains during pregnancy to achieve an
optimal infant birth weight. There are sufficient uterine supporting structures in the pregnant
adolescent. The amnionic fluid is not variable in pregnant adolescents. Blood volume has
reached adult proportions in the pregnant adolescent.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 90
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
13. How much of the weight gained during a normal pregnancy is accounted for by the fetus?
a. Less than 5 pounds
b. 6 to 8 pounds
c. 9 to 12 pounds
d. 13 to 30 pounds
ANS: B
The growing fetus accounts for only 6 to 8 pounds of the total weight gained. The remainder
results from an increase in maternal tissues (e.g., placenta, amniotic fluid, uterus, blood and
fluid volume, breasts, and fat reserves).
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
14. The rate of weight gain during pregnancy is expected to be:
a. greatest in the first trimester.
b. greatest in the second trimester.
c. greatest in the third trimester.
d. about the same in each trimester.
ANS: B
The rate of weight gain is slow during the first trimester, rapid during the second trimester,
and less rapid during the third trimester. Maternal tissue growth accounts for most of the
weight gained in the first and second trimesters, whereas fetal growth accounts for weight
gained during the third trimester.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 80
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
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full file at http://testbankcorner.eu
15. During a preventive health care visit, Ms. G, an older patient, states that she is getting shorter.
She says that her son mentioned that her change in stature became noticeable to him during
his last visit with her. Her posture appears straight and aligned. When addressing Ms. G.’s
present concerns, it is most important to inquire about:
a. the number of pregnancies.
b. her parents’ heights.
c. a history of scoliosis.
d. her usual height and weight.
ANS: D
Stature declines after 50 years of age because of progressive thinning of the intervertebral
disks, so it is important to determine the patient’s height and weight at this age as a baseline
for future trending.
DIF: Cognitive Level: Applying (Application)
REF: p. 82
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
16. Over the past 2 decades, there has been a trend toward:
a. increased osteoporosis.
b. preservation of height.
c. obesity in older adults.
d. preservation of muscle mass.
ANS: C
An increase in overweight and obese older adults has been documented over the past 15 to 20
years. A decrease in weight for height and body mass index has been found with increasing
age in patients between 70 and 89 years of age.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 82
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
17. Milestone achievements are data most likely to appear in the history of:
a. adolescents.
b. infants.
c. school-age children.
d. young adults.
ANS: B
As part of developmental assessment in infants, milestone achievements at certain ages, such
as crawling, laughing, picking up their head, and turning over, are recorded.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 82
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
18. To estimate an individual’s frame size, the examiner should measure:
a. skull circumference.
b. the length from the olecranon process to the acromion process.
c. elbow breadth.
d. hip circumference.
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ANS: C
With the patient’s right arm extended and the elbow flexed to 90 degrees, measure the elbow
breadth using a measuring device or skinfold calipers, held on the same plane as the upper
arm, on the two most prominent bones of the elbow.
DIF: Cognitive Level: Applying (Application)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
19. Which cultural group tends to have a wide variation in birth weights?
a. Native Americans
b. Filipinos
c. Norwegians
d. Puerto Ricans
ANS: A
As much as a 362-g difference in mean birth weight exists among several Native American
tribes. African American, Asian, Filipino, Hawaiian, and Puerto Rican infants generally weigh
less than white infants. Filipinos, Norwegians, and Puerto Ricans do not have a wide variation
in birth weights.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
20. Healthy term babies generally double their birth weight by what age?
a. 3 months
b. 5 months
c. 9 months
d. 12 months
ANS: B
In general, healthy infants double their birth weight by 4 to 5 months of age and triple their
birth weight by 12 months of age. Formula-fed infants are heavier after the first 6 months of
life than breast-fed infants; they grow faster in the first 6 months of life and experience slower
growth in the second 6 months of the first year.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 84
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
21. Infants born to the same parents are normally within which range of weight of each other?
a. 6 ounces
b. 12 ounces
c. 1 pound
d. 2 pounds
ANS: A
Siblings born at term to the same parents usually weigh within 6 ounces of each other.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 83
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
22. A marker for nutritional status is the:
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full file at http://testbankcorner.eu
a.
b.
c.
d.
head circumference.
waist-to-hip ratio.
standing height.
triceps skinfold thickness.
ANS: D
The measurement of skinfold or fatfold thickness provides another parameter to evaluate the
nutritional status of the patient. The jaws of skinfold thickness calipers must be correctly
placed to obtain an accurate reading.
DIF: Cognitive Level: Applying (Application)
REF: p. 83
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
23. To measure head circumference, the tape is wrapped snugly around the child’s head at the
occipital protuberance and the:
a. supraorbital prominence.
b. brow line.
c. nasal bridge.
d. chin.
ANS: A
The measuring tape should be snugly wrapped around the child’s head at the occipital
protuberance and supraorbital prominence, thereby documenting the largest circumference.
Care should be taken to ensure that the tape does not cut the skin. Make the reading to the
nearest 0.5 cm or
inch, and remember to remeasure the head circumference at least once
to check the accuracy of your measurement.
DIF: Cognitive Level: Applying (Application)
REF: p. 84
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
24. Between 5 and 24 months of life, the infant’s chest circumference is normally:
a. about equal to the head circumference.
b. greater than head circumference by 2 inches.
c. smaller than head circumference by about 4 inches.
d. at least 2 inches smaller than head circumference.
ANS: A
Between the ages of 5 months and 2 years, the infant’s chest circumference should closely
approximate the head circumference; the ratio should be monitored so that possible
microcephaly can be identified.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 85
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
25. In clinical practice, the Ballard Assessment Tool is used to assess a newborn’s:
a. length.
b. weight.
c. lung maturity.
d. gestational age.
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ANS: D
The Ballard Assessment Tool assesses six physical and six neuromuscular characteristics and
is administered within 36 hours of birth to confirm the newborn’s gestational age.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 85
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
26. Which of the following situations poses the most concern?
a. The child whose weight and height ratios have remained at the 50th percentile
b. The child whose weight and height ratios have stayed between the 90th and 95th
percentiles
c. The child whose weight and height ratios have never been above the 50th
percentile
d. The child whose weight and height ratios have dropped 15 percentiles since the
last visit
ANS: D
Over time, interval measurements should demonstrate that the child has established a growth
pattern, indicated by consistently following a percentile curve on the growth chart. Greatest
concern is for the child who is trending down in a more dramatic fashion. Children who
suddenly fall below or rise above their established percentile growth curve should be
examined more closely to determine the cause.
DIF: Cognitive Level: Analyzing (Analysis)
REF: p. 82
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
27. The upper-to-lower segment ratio should be calculated:
a. bimonthly for the first year of life.
b. annually for the first 5 years.
c. only when a child is suspected of having a growth problem or unusual body
proportions.
d. in children of first-generation immigrants.
ANS: C
The upper-to-lower segment ratio is calculated when a child is suspected of having a growth
problem or unusual body proportions.
DIF: Cognitive Level: Applying (Application)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
28. A Mexican American mother brings her 12-year-old daughter to the clinic because this child
is not maturing as quickly as her classmates. You examine the daughter and determine that her
growth and physical findings are within normal limits. You should explain to the family that:
a. Mexican Americans may develop more slowly than other ethnic groups.
b. more tests should be conducted because the family appears so worried.
c. the daughter should drink more juices and eat more fruit.
d. there is a serious problem with the daughter’s development.
ANS: A
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Mexican Americans typically are taller than Asian children but shorter than Native American,
white, and African American children. This child’s growth pattern should be similar to other
children of similar ethnicity. More tests are not required. The daughter does not need to drink
more juices and eat more fruit. There is no problem with the daughter’s development.
DIF: Cognitive Level: Applying (Application)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
29. Which of following statements regarding female pubertal changes is true?
a. Most adolescent girls will develop breasts before they develop pubic hair.
b. Peak height velocity should occur after menarche.
c. Breast asymmetry is an abnormal finding.
d. Menarche should occur by Tanner breast stage 2.
ANS: A
In two thirds of the population of girls, breasts begin to develop before pubic hair. Peak height
velocity actually occurs about 1 year before menarche, breast asymmetry is common, and
menarche occurs after Tanner breast stage 2. Peak height velocity will not occur after
menarche. Breast asymmetry is not an abnormal finding. Menarche does not generally occur
by Tanner breast stage 2.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
30. At what age does peak height growth velocity occur in boys?
a. 10 years
b. 12 years
c.
years
d.
years
ANS: C
Peak height velocity occurs at an average age of
years in boys.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
31. What is the youngest age at which pubic hair growth in the male may be considered normal?
a. 7 years
b. 8 years
c. 9 years
d. 10 years
ANS: C
In males, sexual development before 9 years of age is precocious puberty and is considered an
abnormal finding; sexual development after 9 years of age is considered normal puberty.
DIF: Cognitive Level: Applying (Application)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
32. Which Tanner stage is marked by the most significant growth in penis length?
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full file at http://testbankcorner.eu
a.
b.
c.
d.
Stage 1
Stage 2
Stage 3
Stage 4
ANS: C
Tanner stage 3 is marked by enlargement of the penis, especially in length.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 90
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
33. Which Tanner stage corresponds to a secondary areola mound development above the breast?
a. Stage 2
b. Stage 3
c. Stage 4
d. Stage 5
ANS: C
Tanner stage 4 depicts the stage at which the areola forms a second mound above the breast.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 88
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
34. A pregnant woman of normal prepregnancy weight should be expected to gain how much
weight per week during the second and third trimesters of pregnancy?
a. 1 pound
b.
pounds
c. 2 pounds
d.
pounds
ANS: A
Expected weight gain in the first trimester is variable, between 1 and 2 kg (2 to 4 pounds);
however, in the second and third trimesters, weekly weight gain should be approximately 0.45
kg (1 pound) per week.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 89
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
35. A prominent forehead, large nose, large jaw, and elongation of the facial bones and
extremities are signs of:
a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.
ANS: B
A prominent forehead, large nose, large jaw, and elongation of the facial bones and
extremities are all prominent characteristics of acromegaly; a prominent forehead can also
occur with achondroplasia, but hypoplasia of the midface differentiates the two.
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full file at http://testbankcorner.eu
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 92
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
36. Round face, preauricular fat, hyperpigmentation, and “buffalo hump” in the posterior cervical
area are associated with:
a. infantile hydrocephalus.
b. acromegaly.
c. Cushing syndrome.
d. achondroplasia.
ANS: C
Round face, preauricular fat, hyperpigmentation, and a buffalo hump in the posterior cervical
area are all commonly associated with Cushing syndrome; the buffalo hump distinguishes
Cushing syndrome from the other choices.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 92
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
COMPLETION
1. A woman with a normal prepregnancy body mass index (BMI) should gain approximately
_____ pounds during pregnancy.
ANS:
30
Women of normal BMI should expect to gain between 25 and 35 pounds during pregnancy.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 89
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
2. An 11-year-old boy is brought in for an annual physical examination by his mother. You
suspect _______________ when you measure his arm span at 65 inches and his height at 60
inches.
ANS:
Marfan syndrome
Arm span that is greater than a child’s height is associated with Marfan syndrome. Children
with Marfan syndrome can have cardiovascular problems and should be thoroughly evaluated.
DIF: Cognitive Level: Understanding (Comprehension)
REF: p. 87
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
3. Infants normally increase their birth length by ____% during the first year of life.
ANS:
50
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Infant length generally increases by 50% in the first year of life.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 84
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
4. The term large for gestational age (LGA) indicates that an infant is larger than ____% of
infants born at the same number of weeks’ gestation.
ANS:
90
LGA corresponds to an infant whose weight is classified as greater than the 90th percentile.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 86
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
MULTIPLE RESPONSE
1. Which of the following are signs and symptoms of hydrocephalus? (Select all that apply.)
a. Early closed suture lines
b. Hyperreflexia
c. Irritable, poor feeding
d. Does not meet expected height and weight
e. Difficulty holding head up
f. Rapidly increasing head circumference
ANS: B, C, E, F
Signs and symptoms of hydrocephalus include enlarged head, difficulty holding head up,
irritable, lack of energy, and poor feeding. Rapidly increasing head circumference, tense, full,
or bulging fontanel, increased tone, or hyperreflexia do not indicate hydrocephalus.
DIF: Cognitive Level: Remembering (Knowledge)
REF: p. 93
OBJ: Nursing process—assessment
MSC: Physiologic Integrity: Physiologic Adaptation
full file at http://testbankcorner.eu