Download Developmentally Appropriate Care of the Pediatric

HealthStream Regulatory Script
Developmentally Appropriate Care of the Pediatric Patient
Release Date: August 2010
HLC Version: 603
Lesson 1:
Lesson 2:
Lesson 3:
Lesson 4:
Lesson 5:
Lesson 6:
Lesson 7:
Lesson 8:
Introduction
Age-Specific Competencies
Infants
Toddlers
Preschoolers
Schoolchildren
Adolescents
Development and Assessment of Competencies
Lesson 1: Introduction
1001
Introduction
Welcome to the introductory lesson on developmentally
appropriate care of the pediatric patient.
This lesson gives the course rationale, goals, and outline.
As your partner, HealthStream strives to provide its customers with excellence
in regulatory learning solutions. As new guidelines are continually issued by
regulatory agencies, we work to update courses, as needed, in a timely
manner. Since responsibility for complying with new guidelines remains with
your organization, HealthStream encourages you to routinely check all relevant
regulatory agencies directly for the latest updates for clinical/organizational
guidelines.
If you have concerns about any aspect of the safety or quality of patient care in
your organization, be aware that you may report these concerns directly to The
Joint Commission.
Point 1 of 4
2
1002
Course Rationale
Healthcare professionals are committed to providing quality
patient care. To do so, they must understand a patient’s agespecific:
• Characteristics
• Needs
• Challenges
This will allow you to better meet your patient’s needs.
Point 2 of 4
1003
Course Goals
After completing this course, you should be able to:
• Define the term “competency”
• Discuss needs, characteristics, and related medical
care practices for the:
• Infant
• Toddler
• Preschooler
• Schoolchild
• Adolescent
• Describe how age-specific competencies are acquired
and assessed
NO IMAGE
Point 3 of 4
1004
Course Outline
This lesson provided the course rationale and goals.
Lesson 2 will discuss age-specific competencies.
Lesson 3 will describe infants.
Lesson 4 will focus on toddlers.
Lesson 5 will describe preschoolers.
Lesson 6 will focus on schoolchildren.
Lesson 7 will describe adolescents.
Lesson 8 will discuss development and assessment of
competencies.
Point 4 of 4
Lesson 2: Age-Specific Competencies
2001
Introduction
Welcome to the lesson on age-specific competencies.
This lesson will define age-specific competency. This will
include why age-specific competencies are important.
Point 1 of 10
2002
What Is a Competency?
A “competency” is a set of:
• Knowledge
• Skills
• Abilities
This skill set allows a person to perform a task.
Healthcare staff must develop and demonstrate competencies
related to patient care.
Point 2 of 10
2003
What Are Age-Specific Competencies?
Age-specific competencies are one type of competency.
Caregivers must be able to provide care according to a
patient’s:
• Chronological age
• Developmental age
• Maturity level
Point 3 of 10
2004
Why Develop Age-Specific Competencies?
Age-specific competencies:
• Improve the quality of patient care
• Enable your facility to meet accreditation requirements
Let’s take a closer look at each of these goals.
Point 4 of 10
2005
Importance of Age-Specific Competencies: Quality Patient Care
At each stage of life, human beings exhibit predictable:
• Characteristics
• Needs
• Developmental challenges
• Milestones
If you understand these features you can provide
developmentally appropriate care. Providing developmentally
appropriate care will allow you to meet the patient’s needs.
Point 5 of 10
2006
Importance of Age-Specific Competencies: The Joint Commission Standards
The Joint Commission believes that age-specific competency is
important. They require accredited institutions to:
• Develop age-specific competencies
• Evaluate competencies
Competency training and assessment must be documented.
Point 6 of 10
2007
The Joint Commission Standards: Assessment of Age-Specific Competencies
An employee is competent if he or she knows how human
beings grow and develop.
The employee can demonstrate this knowledge by:
• Using patient data to determine a patient’s status
• Interpreting patient information to identify needs
• Providing care appropriate to a patient’s age and
development
Point 7 of 10
2008
Pediatric Age Groups
Pediatric patients can be divided into five groups (see table to
the right).
Remember, features presented in this course are not
absolutes. They are guidelines to consider when providing
care.
Use this framework as a general guide to developmentally
appropriate care. Consult your supervisor for facility-specific
differences.
Point 8 of 10
2009
Review
Select the answer that best fits the question.
Correct answer: B
The Joint Commission believes that age-specific care is
important. However, they do not require employees to
demonstrate age-specific competencies.
a. True
b. False
Feedback for A. Incorrect. The Joint Commission requires staff
to demonstrate age-specific competencies. Institutions must
train and assess staff.
Feedback for B. Correct. The Joint Commission requires staff
to demonstrate age-specific competencies. Institutions must
train and assess staff.
Point 9 of 10
2010
Summary
You have completed the lesson on age-specific competencies.
NO IMAGE
Remember:
• A competency is a set of knowledge, skills, and abilities
needed to perform a task.
• Age-specific competencies:
o Improve patient care
o Allow an institution to meet accreditation
requirements
Point 10 of 10
Lesson 3: Infants
3001
Introduction
Welcome to the lesson on the infant.
This lesson will describe the characteristics and needs of infants
from birth to one year of age. This will include a discussion of care
practices appropriate for the infant.
Point 1 of 17
3002
Physical Characteristics and Changes: Neonatal
In the hours and days immediately following birth, the infant’s
physical health is evaluated by looking for:
• The presence of normal reflexes (startle, grasp, and gag
reflexes)
• Good APGAR scores[glossary]
• Appropriate vital signs
Point 2 of 17
3003
Physical Characteristics and Changes: Year One
During their first year of life, infants establish patterns for physical
body functions:
• Digestion
• Temperature regulation
• Sleeping
They also develop the ability to:
• Respond to light and sounds
• Respond to familiar faces and voices
• Raise head
• Roll over
• Bring hand to mouth
• Crawl
• Stand
• Walk alone or with help
Point 3 of 17
3004
Physical Characteristics and Changes: Developmentally Appropriate Care
You can attend to the physical needs of infants by educating
parents.
For example, teach parents:
• How to help the infant establish regular sleeping patterns
and positions
• How to keep the infant warm
Also ask parents:
• If the infant’s motor skills appear to be developing normally
• If they have noticed any signs of hearing or vision
problems
Provide hospitalized infants safe, age-appropriate toys to promote
motor skills.
Point 4 of 17
3005
Nutritional Needs and Related Care
Infants grow at a rapid rate. Adequate intake of calories and
nutrients must be maintained.
During the first several months, infants should receive breast milk
or iron-fortified formula. Fluoride supplements may be necessary.
At four to six months, strained foods may be introduced. It is best
to try one new food each week. Monitor the infant’s tolerance to
each new item.
After an infant begins to cut teeth, tooth decay can result. Formula
or juice should not contact teeth for extended periods of time.
Infants should not be put to bed with a bottle.
Educate parents about these nutritional needs and issues.
Point 5 of 17
3006
Psychosocial and Developmental Characteristics
Infants are entirely dependent on others for care.
The infant faces the primary task of developing trust in his or her
caregiver and the environment.
An infant who fails to develop trust may demonstrate failure to
thrive[glossary].
Additional characteristics of the infant are summarized in the table
on the next screen.
Point 6 of 17
3007
Psychosocial and Developmental Characteristics: Table
CUDDLING AND TOUCHING
ACTIVITIES
FINGER-SUCKING
EXPLORING WORLD THROUGH TASTE AND TOUCH
CHANGES
AND
DEVELOPMENTS
ABILITY TO DIFFERENTIATE PRIMARY CAREGIVER FROM OTHERS
(LEADING TO “STRANGER ANXIETY”)
CAREGIVERS
IMPORTANT
RELATIONSHIPS
SIBLINGS
OTHER FAMILY MEMBERS
FEARS
SEPARATION FROM PRIMARY CAREGIVER(S)
Point 7 of 17
3008
Psychosocial and Developmental Challenges: Developmentally Appropriate Care
Promote trust and healthy infant-parent bonds. Encourage parents
to hug, cuddle, and touch their infants.
Staff members should meet the needs of infants promptly by
providing close contact.
Minimize the infant’s fear of separation by:
• Encouraging the primary caregiver(s) to participate in the
examination and treatment of the infant
• Keeping the primary caregiver(s) in the infant’s line of sight
at all times
To minimize stranger anxiety, limit the number of staff members
involved in the care of each infant.
For hospitalized infants, provide safe, age-appropriate toys for
touching and tasting.
Point 8 of 17
3009
Cognitive Abilities
Infants have limited verbal skills.
Initially, communication is limited to crying out of hunger or pain.
During the first year, most infants learn to:
• Mimic sounds
• Speak a few words
• Follow simple commands
Infants also learn to manipulate and move objects.
Learning is by imitation.
Point 9 of 17
3010
Cognitive Abilities: Developmentally Appropriate Care
All teaching should be directed to the primary caregiver(s).
Provide caregivers information on:
• Preventive healthcare, including immunizations
• Proper infant nutrition
• The importance of caregiver-infant bonding
• Safety issues for the infant
Allow caregivers time to ask questions and return-demonstrate
childcare procedures.
Point 10 of 17
3011
Safety Needs
Safety is a significant issue for infants because they:
• Lack the mental and physical skills to keep themselves safe
• Are eager to explore the world through taste and touch
• Are not aware of potential consequences
Point 11 of 17
3012
Safety Needs: Developmentally Appropriate Care
Ensuring safety requires attention to the infant and environment:
• Infants should be supervised at all times. They may be
unattended only when in a crib or playpen.
• Medications, small objects, and other unsafe items should
be kept out of the reach of infants at all times.
• All medical equipment should be removed from the infant’s
reach after use.
• Appropriate infant car seats should be used.
• For sleeping, infants should be placed on their backs.
• Other safety precautions should be taken:
o Covering electrical outlets
o Removing access to cords
o Installing infant gates
o Locking toilets, etc
Point 12 of 17
3013
Pharmacology and Related Care
For infants, oral administration of medication is preferred.
Medication dosage is based on body weight.
Absorption and metabolism of medication are unpredictable.
Monitor infants closely after the administration of medication.
Point 13 of 17
3014
Other Care Considerations
When caring for an infant, always use appropriately sized
equipment.
Protect infants from infection. The immune system is still developing
at this stage.
Allow for religious and cultural beliefs (as expressed by the infant’s
primary caregivers).
Report suspected child abuse or neglect to your supervisor
immediately.
Point 14 of 17
3015
Review
Select the answer that best fits the question.
Correct answer: B
If an infant is slow to roll over, crawl, or reach other milestones of
physical development, this is a sign of a serious problem.
Feedback for A: Incorrect. Children develop at different
speeds. If an infant is slow to reach milestones of physical
development, this may not be anything to worry about.
a. True
b. False
Feedback for B: Correct. Children develop at different
speeds. If an infant is slow to reach milestones of physical
development, this may not be anything to worry about.
Point 15 of 17
3016
Review
Select the answer that best fits the question.
Correct answer: D
Infants enjoy which of the following activities?
a. Finger-sucking
b. Cuddling and touching
c. Exploring through taste and touch
d. All of these
e. None of these
Feedback for A: Not quite. The correct answer is D.
Infants enjoy all of these activities.
Feedback for B: Not quite. The correct answer is D.
Infants enjoy all of these activities.
Feedback for C: Not quite. The correct answer is D.
Infants enjoy all of these activities.
Feedback for D: Correct. Infants enjoy all of these
activities.
Feedback for E: Incorrect. The correct answer is D.
Infants enjoy all of these activities.
Point 16 of 17
3017
Summary
You have completed the lesson on infants.
NO IMAGE
Remember:
• During the first year of life, infants establish body
functions. They develop physical skills and abilities such
as responding to light and sound, rolling over, crawling,
and standing.
• Infants grow at a rapid rate. Adequate intake of calories
and nutrients must be maintained.
• Infants are entirely dependent on others for care and face
the primary challenge of developing trust.
• Infants have limited verbal skills. They learn by imitation.
• Infants tend to put themselves in unsafe situations. They
are eager to explore and unable to recognize danger.
• Absorption and metabolism of medication are
unpredictable in infants.
• Consider these characteristics when caring for infants.
Point 17 of 17
Lesson 4: Toddlers
4001
Introduction
Welcome to the lesson on the toddler.
This lesson will focus on the needs and characteristics of children
ages one to three. Developmentally appropriate care also will be
discussed.
Point 1 of 14
4002
Physical Characteristics, Changes, and Related Care
Toddlers develop many physical skills. Over the course of two
years, they learn to:
• Walk, run, and climb
• Throw and drop toys
• Stack blocks
• Scribble
• Use certain fine motor skills
• Control the bladder and bowel
Toddlers are active and energetic. They must be monitored closely
to ensure safety.
Point 2 of 14
4003
Nutrition Needs and Related Care
Toddlers develop tolerance for a variety of foods. They tend to like
finger foods. They may continue to bottle/breastfeed. They may
begin to use utensils for eating.
They require fewer calories but more protein than infants. They
should drink whole milk (not low-fat or nonfat) until the age of two.
Risk of cavities increases in toddlers.
Educate primary caregivers about:
•
Nutritional needs
•
Importance of dental hygiene
Point 3 of 14
4004
Psychosocial and Developmental Characteristics
Toddlers face the primary challenge of autonomy[glossary] vs.
shame and doubt.
As a toddler develops autonomy, he or she begins to:
• Establish a core identity
• Depend less on the primary caregiver(s)
• Tolerate brief separation from the primary caregiver(s)
If the toddler struggles with autonomy, shame and doubt may
develop. He or she may show:
• Low tolerance for frustration
• Lack of self-confidence
Additional characteristics of the toddler are summarized in the
table on the next screen.
Point 4 of 14
4005
Psychosocial and Developmental Characteristics: Table
FRUSTRATION
ANGER
EMOTIONS
AND
BEHAVIORS
JEALOUSY
AFFECTION
AGGRESSION/NEGATIVITY (“TERRIBLE TWOS”)
IMPULSIVITY
IMPORTANT
RELATIONSHIPS
FEARS
PRIMARY CAREGIVER(S)
SEPARATION FROM PRIMARY CAREGIVER(S)
Point 5 of 14
4006
Psychosocial and Developmental Characteristics: Developmentally Appropriate Care
Encourage close contact between toddlers and caregivers.
Also encourage caregivers to set safe rules, limits, and
boundaries. This will counter the toddler’s impulsivity and lack of
self-control.
Support and promote the toddler’s developing autonomy:
• If safe and possible, allow the toddler to make choices
about medical procedures and examinations.
• Explain all medical procedures before starting. Use a firm,
direct approach. Emphasize what will require the toddler’s
cooperation.
To decrease separation anxiety, encourage caregivers to
participate in examination/treatment of the toddler.
Point 6 of 14
4007
Cognitive Abilities
Toddlers are eager learners. They explore the world through:
• Tasting
• Touching
• Looking
• Listening
• Smelling
They learn through discovery and imitation.
Verbal skills improve. Vocabulary increases.
Toddlers understand concrete explanations. They follow simple
commands.
They also have short attention spans. Time for the toddler does not
extend beyond the immediate. Space does not extend beyond
what is within sight.
The toddler is able to differentiate between familiar people and
strangers.
Point 7 of 14
4008
Cognitive Abilities: Developmentally Appropriate Care
Education of caregivers is important for the toddler. However,
toddlers are able to learn about and participate in certain aspects
of their own care.
When educating caregivers:
• Emphasize preventive healthcare, nutrition, and safety
• Allow time for questions and return-demonstration
When instructing the toddler:
• Keep all explanations short, simple, and concrete
• Give one direction at a time
• Use words that the toddler can understand
• Use puppets, dolls, and storybooks
• Use praise to encourage correct behavior
Point 8 of 14
4009
Safety Needs and Related Care
Toddlers are exploratory, impulsive, and energetic. They are
unable to recognize danger. They are likely to end up in unsafe
situations if not monitored closely.
Accidents and injuries may occur as autonomy increases.
Choking and poisoning are threats. All of the following should be
kept out of reach:
• Medications
• Small objects
• Chemicals
• Cleansers
Point 9 of 14
4010
Pharmacology and Related Care
Absorption and metabolism of medication can be unpredictable.
Carefully monitor the effects of all medications.
Oral medication is preferable.
Medication dosage is based on body weight.
Point 10 of 14
4011
Other Care Considerations
Use distraction to take the focus off of pain or medical procedures.
Use a pediatric pain assessment scale if the toddler is in pain.
Plan procedures in advance. This will minimize the toddler’s
waiting time.
Other care considerations include:
• Use medical items of an appropriate size
• Report suspected abuse or neglect to your supervisor
immediately
• Allow for religious and cultural beliefs (as expressed by the
toddler’s primary caregivers)
Point 11 of 14
4012
Review
Select the answer that best fits the question.
Correct answer: D
Which of the following statements is (are) true?
a. Healthcare workers should support and promote the
toddler’s developing autonomy.
b. Caregivers must set safe rules, limits, and boundaries for
the toddler, to counter the toddler’s impulsivity and lack of
self-control.
c. Whenever possible and appropriate, the toddler should be
allowed to make choices related to medical procedures
and examinations.
d. All of these are true.
e. None of these is true.
Feedback for A: Not quite. The correct answer is D. All of these
are true. Rules, limits, and boundaries are necessary. At the
same time, it is important to support and promote the toddler’s
developing autonomy.
Feedback for B: Not quite. The correct answer is D. All of these
are true. Rules, limits, and boundaries are necessary. At the
same time, it is important to support and promote the toddler’s
developing autonomy.
Feedback for C: Not quite. The correct answer is D. All of these
are true. Rules, limits, and boundaries are necessary. At the
same time, it is important to support and promote the toddler’s
developing autonomy.
Feedback for D: Correct. All of these are true. Rules, limits, and
boundaries are necessary. At the same time, it is important to
support and promote the toddler’s developing autonomy.
Feedback for E: Incorrect. The correct answer is D. All of these
are true. Rules, limits, and boundaries are necessary. At the
same time, it is important to support and promote the toddler’s
developing autonomy.
Point 12 of 14
4013
Review
When caring for a toddler, it is important to educate his or her
primary caregiver(s). At the same time, however, toddlers are able
to learn about and participate in certain aspects of their own care.
What are some of the guidelines for communication that can help
you teach a toddler most effectively?
Type your thoughts in the box below, then click Submit to compare
your answer to ours.
When teaching or instructing a toddler:
•
•
•
•
Keep all explanations short, simple, and concrete.
Give one direction at a time, using vocabulary that
the toddler can understand.
Use puppets, dolls, and storybooks to help explain
medical procedures, and decrease anxiety.
Use praise to encourage correct behavior.
Point 13 of 14
4014
Summary
You have completed the lesson on toddlers.
NO IMAGE
Remember:
• Toddlers can walk, run, climb, stack blocks, and scribble.
• Toddlers develop tolerance for a variety of foods. They
tend to prefer finger foods.
• The toddler faces the primary challenge of autonomy vs.
shame and doubt.
• Toddlers are eager learners. But, they have short attention
spans.
• Toddlers are exploratory, impulsive, energetic, and unable
to recognize danger.
• Absorption and metabolism of medication can be
unpredictable.
• Consider these characteristics when caring for toddlers.
Point 14 of 14
Lesson 5: Preschoolers
5001
Introduction
Welcome to the lesson on the preschooler.
This lesson will describe the characteristics and needs of children
ages three to five. Care practices also will be discussed.
Point 1 of 15
5002
Physical Characteristics, Changes, and Related Care
Preschoolers gain in fine motor skills and coordination.
They develop the ability to:
• Walk on tiptoe
• Stand on one foot
• Hop
• Dress themselves
• Feed themselves
Recognize and encourage the physical accomplishments of the
preschooler.
Point 2 of 15
5003
Nutritional Needs and Related Care
Preschoolers begin to develop food likes and dislikes. They may
be allowed to make some food choices.
Promote good nutrition by encouraging healthy choices.
Point 3 of 15
5004
Psychosocial and Developmental Characteristics
Preschoolers face the challenge of initiative [glossary] vs. guilt.
Preschoolers who develop initiative gain in:
• Self-confidence
• The ability to act with direction and purpose
Guilt may appear in the form of:
• Fear of punishment
• Limited ability to act with purpose and direction
Additional characteristics of the preschooler are summarized in the
table on the next screen.
Point 4 of 15
5005
Psychosocial and Developmental Characteristics: Table
TOLERANCE FOR SEPARATION FROM PRIMARY CAREGIVER(S)
CHANGES
AND
DEVELOPMENTS
INCREASED INDEPENDENCE
INCREASED AWARENESS OF SELF VS. OTHERS
INCREASED AWARENESS OF OTHERS’ FEELINGS
BETTER IMPULSE CONTROL
PEER-GROUP SOCIALIZATION AND PLAY
ACTIVITIES
AND
INTERESTS
IMPORTANT
RELATIONSHIPS
RITUALS AND ROUTINES
INTEREST IN SEXUAL DIFFERENCES
FAMILY
UNKNOWN
DARK
FEARS
BEING ALONE
NIGHTMARES
INJURY
Point 5 of 15
5006
Psychosocial and Developmental Challenges: Developmentally Appropriate Care (1)
Preschoolers fear bodily injury and mutilation. Injury and disease
can be very upsetting.
Provide accurate, age-appropriate information to the preschooler:
• Explain healthcare issues clearly
• Explain what you are going to do, firmly and directly
• Be honest if a procedure will hurt, but explain that it will not
hurt for long
• Use toys, games, puppets, dolls, and/or storybooks
• Use talking, singing, and other distractions
Point 6 of 15
5007
Psychosocial and Developmental Challenges: Developmentally Appropriate Care (2)
Preschoolers have better impulse control than toddlers. Caregivers
and healthcare workers still must establish clear boundaries, limits,
and rules. Appropriate behavior should be rewarded with praise.
Within safe limits, promote the preschooler’s growing
independence by allowing choices. Allow the preschooler to control
his or her hospital environment as much as possible.
Encourage preschoolers to:
• Ask questions and communicate openly
• Talk about their feelings and fears
• Play with other children
To the extent possible in the hospital environment, allow the
preschooler to maintain comforting routines.
Point 7 of 15
5008
Cognitive Abilities
Preschoolers learn through:
• Exploration
• Discovery
• Asking questions (the “why” phase)
Verbal skills improve dramatically:
• Speech becomes more intelligible
• Vocabulary increases to approximately 1000 words
• Sentences of four to six words are common
Other cognitive advances include the ability to:
• Reason logically
• Use abstract thought
• Distinguish between right and wrong
• Maintain attention for longer periods
• Learn from and tell stories
• Learn and remember home address and phone number
Imagination also increases during this stage.
Point 8 of 15
5009
Cognitive Abilities: Developmentally Appropriate Care
It is possible to provide the preschooler with more detailed
healthcare information:
• Explain unfamiliar objects
• Use correct terminology
Caregiver education also remains important. When teaching
caregivers, continue to emphasize:
• Preventive care
• Nutrition
• Parenting skills
• Safety issues
Allow time for both preschoolers and their caregivers to ask
questions and return-demonstrate procedures.
Point 9 of 15
5010
Safety Needs and Related Care
Preschoolers still have a limited ability to recognize danger. They
require close supervision.
Both preschoolers and their caregivers should be reminded of
safety issues and safety habits. Encourage caregivers to promote
good safety habits.
Be sure to discuss:
• Use of safety equipment
• Match and fire safety
• Pool safety
• Car safety
• Use of car safety seats or seatbelts
Point 10 of 15
5011
Pharmacology Needs and Related Care
The oral route of administration is preferred.
Medication dosage is based on body weight.
Keep all medications out of the reach of preschoolers.
Point 11 of 15
5012
Other Care Considerations
Additional considerations include:
• Promote close contact between the preschooler and his or
her primary caregiver(s)
• Promote caregiver participation
• Plan procedures in advance
• Use medical items of an appropriate size
• Reported suspected abuse or neglect to your supervisor
immediately
• Allow for religious and cultural beliefs (as expressed by the
preschooler’s primary caregivers)
Point 12 of 15
5013
Review
Select the answer that best fits the question.
Correct answer: B
The preschooler’s greatest fear is separation from his or her
primary caregiver(s).
a. True
b. False
Feedback for A: Incorrect. The preschooler’s greatest fears
are: the unknown, the dark, being alone, nightmares, and
bodily injury/mutilation.
Feedback for B: Correct. The preschooler’s greatest fears
are: the unknown, the dark, being alone, nightmares, and
bodily injury/mutilation.
Point 13 of 15
5014
Review
Select the answer that best fits the question.
Correct answer: D
When educating the preschool patient, all of the following are best
practices EXCEPT:
a. Explain unfamiliar objects.
b. Allow time for the preschooler to ask questions.
c. Have the preschooler return-demonstrate procedures.
d. Use easily understood “nicknames” for body parts, medical
equipment, and procedures.
Feedback for A: Incorrect. A, B, and C all are best
practices. The correct answer is D. Use correct
terminology.
Feedback for B: Incorrect. A, B, and C all are best
practices. The correct answer is D. Use correct
terminology.
Feedback for C: Incorrect. A, B, and C all are best
practices. The correct answer is D. Use correct
terminology.
Feedback for D: Correct. Use correct terminology.
Point 14 of 15
5015
Summary
You have completed the lesson on preschoolers.
NO IMAGE
Remember:
• Preschoolers gain in fine motor skills and coordination.
• Preschoolers begin to develop food likes and dislikes.
• Preschoolers face the challenge of initiative vs. guilt.
• Preschoolers learn through exploration, discovery, and
asking questions. Cognitive advances include the ability to
reason logically and use abstract thought.
• Safety is an issue for preschoolers. They still have a
limited ability to recognize danger.
• Consider these characteristics when treating preschoolers.
Point 15 of 15
Lesson 6: Schoolchildren
6001
Introduction
Welcome to the lesson on schoolchildren.
This lesson will focus on the characteristics and needs of children
ages five to twelve. This will include developmentally appropriate
care.
Point 1 of 16
6002
Physical Characteristics and Changes
Schoolchildren grow relatively slowly until a spurt at puberty.
Note: The onset of puberty varies widely. In many pediatric
patients it may not occur until the adolescent stage.
Schoolchildren are very active, and increase in:
• Neuromuscular [glossary] skills
• Balance
• Muscular strength
Point 2 of 16
6003
Physical Characteristics and Changes: Developmentally Appropriate Care
For schoolchildren who enter puberty, provide reassurance that:
• The physical changes they are experiencing are normal.
• Clumsy and awkward sensations will resolve.
Respond honestly to any questions about secondary sexual
characteristics.
Point 3 of 16
6004
Nutritional Needs and Related Care
Schoolchildren tend to prefer fast food and eating with friends.
Discuss proper nutrition. Encourage healthy food choices.
Point 4 of 16
6005
Psychosocial and Developmental Characteristics
The schoolchild faces the primary developmental task of industry
[glossary] vs. inferiority.
Children who succeed in developing industry tend to display:
• Competency
• Achievement
• Self-confidence
Those who do not show signs of inferiority:
• Feelings of inadequacy
• Fear of not meeting the expectations of others
Additional characteristics of the schoolchild are summarized in the
table on the next screen.
Point 5 of 16
6006
Psychosocial and Developmental Characteristics: Table
HOUSEHOLD CHORES
ACTIVITIES
SCHOOLWORK
AND
BEHAVIORS
MORAL AND ETHICAL BEHAVIOR
GENDER-SPECIFIC THOUGHT AND ACTION
INDEPENDENCE FROM PARENTS
CHALLENGES
DEPENDENCE ON SELF
IMPORTANT
RELATIONSHIPS
PEERS
LOSING CONTROL
FEARS
NOT MEETING EXPECTATIONS
Point 6 of 16
6007
Psychosocial and Developmental Challenges: Developmentally Appropriate Care
Be aware that the schoolchild’s desire for independence may result
in rebellious feelings. Rebellion may affect compliance with
recommended medical regimes.
When treating schoolchildren:
• Provide opportunities for decision-making and self-care
• Encourage questions and verbalization of feelings
• Recognize the need for privacy
• Recognize the child’s achievements
During long periods of hospitalization:
• Provide for schooling
• Encourage peer contact
Point 7 of 16
6008
Cognitive Abilities
Schoolchildren are avid learners. They love to share their
knowledge.
Cognitive developments include the ability to:
• Use logic and deductive reasoning to arrive at conclusions
• Understand cause-and-effect
• Recognize the existence of past and future
• Understand death and its finality
• Read and write
• Use math skills
Schoolchildren still have limited understanding of:
• Aanatomy
• Bodily functions
• Illness
Point 8 of 16
6009
Cognitive Abilities: Developmentally Appropriate Care
Provide the schoolchild with more detailed healthcare information:
• Explain medical procedures in straightforward terms
• Use correct terminology
• Allow the schoolchild to explore medical equipment ahead
of time
When educating schoolchildren:
• Consider the child’s attention span
• Use rewards and praise
• Provide privacy, if necessary
Point 9 of 16
6010
Safety Needs
Safety issues for the schoolchild are related to:
• Peer pressure
• Substance abuse
• Sexuality
• Conflict resolution
• Preventive healthcare
Point 10 of 16
6011
Safety Needs: Developmentally Appropriate Care
Peer pressure may lead to poor choices for schoolchildren.
Guide the schoolchild toward healthy choices. Discuss and provide
accurate information regarding:
• Exercise
• Nutrition
• Safety habits
• Smoking
• Drug and alcohol use
• Sexuality
Help caregivers learn to discuss these issues with their children.
Help schoolchildren learn to resolve conflict peacefully.
Finally, emphasize the importance of preventive healthcare:
• Regular checkups
• Immunizations on schedule
Point 11 of 16
6012
Pharmacology and Related Care
Oral administration of medication is preferred.
Adult dosages based on body weight are used.
Keep all medications and medical equipment out of the reach of
schoolchildren.
Point 12 of 16
6013
Other Care Considerations
Additional considerations for the care of the schoolchild include:
• Plan procedures in advance
• Report suspected abuse or neglect to your supervisor
immediately
• Allow for expression of religious and cultural beliefs
Point 13 of 16
6014
Review
As avid learners who love to share their knowledge, schoolchildren
make many cognitive advances.
What are some of these advances? Type your thoughts in the box
below, then click Submit to compare your answer to ours.
Cognitive developments of the schoolchild include the
ability to:
• Use logic and deductive reasoning to arrive at
conclusions.
• Understand cause-and-effect.
• Recognize the existence of past and future.
• Understand death and its finality.
• Read and write.
• Use math skills.
Point 14 of 16
6015
Review
Select the answer that best fits the question.
Correct answer: B
Safety issues for the schoolchild are related to:
a. Impulsivity
b. Peer pressure
c. Inability to recognize danger
d. All of these
e. None of these
Feedback for A: Incorrect. For the schoolchild, safety issues are
related to peer pressure.
Feedback for B: Correct. For the schoolchild, safety issues are
related to peer pressure.
Feedback for C: Incorrect. For the schoolchild, safety issues are
related to peer pressure.
Feedback for D: Incorrect. For the schoolchild, safety issues are
related to peer pressure.
Feedback for E: Incorrect. For the schoolchild, safety issues are
related to peer pressure.
Point 15 of 16
6016
Summary
You have completed the lesson on schoolchildren.
NO IMAGE
Remember:
• Schoolchildren grow relatively slowly until a spurt at
puberty.
• Schoolchildren are very active. They make gains in
neuromuscular skills, balance, and muscular strength.
• Schoolchildren tend to prefer fast food and eating with
friends.
• The schoolchild faces the primary task of industry vs.
inferiority.
• Schoolchildren are avid learners who love to share their
knowledge.
• Safety issues for the schoolchild are related to peer
pressure, substance abuse, sexuality, conflict resolution,
and preventive healthcare.
• Consider these characteristics when caring for
schoolchildren.
Point 16 of 16
Lesson 7: Adolescents
7001
Introduction
Welcome to the lesson on the adolescent.
This lesson will describe the characteristics and needs of
individuals ages 12 to 18. This will include medical care practices.
Point 1 of 16
7002
Physical Characteristics and Changes
Adolescents experience dramatic physical change:
• Rapid increase in height
• Development of primary and secondary sexual
characteristics
• Development of body hair and facial blemishes
Point 2 of 16
7003
Physical Characteristics and Changes: Developmentally Appropriate Care
Adolescents are often critical, self-conscious, and confused about
their physical appearance and bodily changes. Be sensitive to this
issue when caring for the adolescent patient.
You should:
• Reassure patients regarding the normality of physical
changes and the variability in timing of these changes
• Allow for privacy
Teach the adolescent:
• Breast self-exam for females
• Testicular self-exam for males
Point 3 of 16
7004
Nutritional Needs
Adolescents have increased need for:
• Calories
• Protein
• Calcium
• Iodine
• Iron
• B-complex vitamins
Many teens do not get the nutrients they need. This is due to
factors such as:
• Eating a lot of fast food
• Dieting
• Snacking rather than eating balanced meals
Point 4 of 16
7005
Nutritional Needs: Developmentally Appropriate Care
To help improve nutritional status:
• Provide accurate information about nutrition
• Encourage healthy food choices
• Discourage food fads and fad diets
In addition, screen adolescents for nutritional disorders:
• Obesity
• Anorexia
• Bulimia
Point 5 of 16
7006
Psychosocial and Developmental Characteristics
The adolescent faces the challenge of identity formation vs. role
confusion.
Adolescents who achieve identity formation display:
• A strong sense of self
• Devotion to their duties and obligations
• A tendency to keep their word
Adolescents who do not may display role confusion:
• Poor sense of self
• Poor concept of their sexuality
Additional characteristics of the adolescent are summarized in the
table on the next screen.
Point 6 of 16
7007
Psychosocial and Developmental Characteristics: Table
INTERNAL: DESIRE FOR BOTH INDEPENDENCE AND DEPENDENCE
CONFLICTS
EXTERNAL: REBELLION AGAINST AUTHORITY
MOOD SWINGS
EMOTIONS
AND
ANGER
BEHAVIOR
OUTBURSTS
PEERS
IMPORTANT
RELATIONSHIPS
OPPOSITE SEX
PERSONAL APPEARANCE
FEARS
NOT BEING ACCEPTED
POOR SCHOOL PERFORMANCE
Point 7 of 16
7008
Psychosocial and Developmental Challenges: Developmentally Appropriate Care (1)
Recognize and respect the need for independence and selfdetermination:
• Treat the adolescent patient as an adult
• Avoid authoritarian[glossary] approaches
• Communicate directly with the adolescent and not through
the adolescent’s parents
• Encourage self-care and decision-making
• Demonstrate acceptance
• Be prepared to deal with resistance and rebellion
Point 8 of 16
7009
Psychosocial and Developmental Challenges: Developmentally Appropriate Care (2)
Be aware that:
• Hospitalization may threaten the patient’s evolving selfidentity
• Separation from peers may cause concern
• The patient may fear that treatment will affect his or her
appearance and relationships
To reassure the patient:
• Encourage peer contact during hospitalization
• Encourage questions and verbalization of fears
Point 9 of 16
7010
Cognitive Abilities and Related Care
Adolescents have fully developed cognitive abilities, including:
• Logical thought
• Abstract thought
• Deductive reasoning
• Analytical reasoning
Adolescents:
• Consider many options when solving problems
• Understand hypothetical situations
• Form independent decisions
Respect the cognitive abilities of adolescents. Explain all medical
procedures.
Point 10 of 16
7011
Safety Needs
Safety issues for adolescents are related to:
• Peer pressure
• Risk-taking behaviors
• Substance abuse
• Sexual activity
• Depression and suicide
Point 11 of 16
7012
Safety Needs: Developmentally Appropriate Care (1)
Be aware that peer pressure may lead to poor choices.
Guide the adolescent toward healthy choices.
Discuss:
• Risk-taking
• Smoking
• Drug and alcohol use
• Sexuality
With regard to sexuality, in particular:
• Correct any misinformation from peers
• Teach and encourage sexual responsibility
• Monitor for sexually transmitted diseases and pregnancy
Point 12 of 16
7013
Safety Needs: Developmentally Appropriate Care (2)
To help guard against the dangers of depression:
• Screen for depression
• Encourage the use of stress-reduction techniques
Point 13 of 16
7014
Review
Select the answer that best fits the question.
Correct answer: D
Adolescents tend to be ____ about their physical appearance and
bodily changes.
a. Unaware
b. Indifferent
c. Pleased and proud
d. Critical and self-conscious
Feedback for A: Incorrect. Adolescents tend to be critical,
self-conscious, and confused about their physical
appearance and bodily changes.
Feedback for B: Incorrect. Adolescents tend to be critical,
self-conscious, and confused about their physical
appearance and bodily changes.
Feedback for C: Incorrect. Adolescents tend to be critical,
self-conscious, and confused about their physical
appearance and bodily changes.
Feedback for D: Correct. Adolescents tend to be critical,
self-conscious, and confused about their physical
appearance and bodily changes.
Point 14 of 16
7015
Review
Select the answer that best fits the question.
Correct answer: A
Treat the adolescent patient as an adult. Avoid authoritarian
approaches.
a. True
b. False
Feedback for A: Correct. Recognize and respect the need
for independence and self-determination. Treat the patient
as an adult. Avoid authoritarian approaches.
Feedback for B: Incorrect. Recognize and respect the need
for independence and self-determination. Treat the patient
as an adult. Avoid authoritarian approaches.
Point 15 of 16
7016
Summary
You have completed the lesson on adolescents.
NO IMAGE
Remember:
• Adolescents experience dramatic physical and sexual
change and development.
• Adolescents have an increased need for calories and
nutrients. They often do not meet this need.
• The adolescent faces the challenge of identity formation
vs. role confusion.
• Adolescents have fully developed cognitive abilities.
• Safety issues for adolescents are related to peer pressure,
risk-taking behaviors, substance abuse, sexual activity,
and relatively high rates of depression and suicide.
• Consider these characteristics when caring for an
adolescent patient.
Point 16 of 16
Lesson 8: Development and Assessment of Competencies
8001
Introduction
Welcome to the lesson on development and assessment of agespecific competencies.
This lesson will discuss development and assessment of
competencies. This includes facility requirements.
Point 1 of 10
8002
Facility Responsibilities
Your facility must:
• Define age-specific competencies
• Educate and train staff members
• Assess employee competencies
Let’s take a closer look at each responsibility.
Point 2 of 10
8003
Defining Age-Specific Competencies
Each healthcare facility must define the exact competencies to be
achieved by its employees.
Exact definitions are important. All employees need a clear idea of
the knowledge and skills they are expected to have.
Your facility’s competencies may differ slightly from those
presented in this course.
Point 3 of 10
8004
Defining Age-Specific Competencies: Documentation
Age-specific competencies may be documented in:
• Position or job descriptions
• Addenda to position or job descriptions
• Unit or departmental policies
• Departmental scope-of-service documents
• Peer review standards
• Contracts between employers and provider groups
Ask your supervisor where to find documentation if needed.
Point 4 of 10
8005
Education
Your facility also should offer training:
• Orientation programs
• In-services
• Videos and other self-learning materials
• Computer-based programs
• Hospital-wide education programs
Completion should be documented in your employee record.
Point 5 of 10
8006
Assessment
Your facility also must assess age-specific competencies. Specific
criteria must be used.
Point 6 of 10
8007
Assessment: Methods
Assessment methods may include:
• Direct observation
• Return demonstration
• Medical record review
• Peer evaluation
• Patient satisfaction survey
CLICK TO REVEAL
Click on each method to learn more.
Return demonstration
A staff member observes a supervisor teach the proper
way to care for a patient. The staff member then
demonstrates the care procedure. This shows that he or
she has acquired the competency.
Direct observation
A supervisor watches a staff member provide care to a
patient. Developmentally-appropriate care (or lack of) is
noted by the supervisor.
Medical record review
A supervisor checks the medical records of patients.
Developmentally-appropriate care (or lack of) is noted.
Peer evaluation
Coworkers assess the knowledge and ability of a staff
member. They are in the best position to view performance
on an ongoing basis.
Surveys
Surveys provide information about patient perceptions of
the quality of age-specific care.
Point 7 of 10
8008
Review
Select the answer that best fits the question.
Correct answer: A
The direct observation method is used to assess age-specific
competencies. A supervisor watches as a staff member provides
care or services to a patient of a particular age group.
Feedback for A: Correct. A supervisor watches as a staff
member provides care or services to a patient.
a. True
b. False
Feedback for B: Incorrect. This statement is true. In direct
observation, a supervisor watches as a staff member
provides care or services to a patient.
Point 8 of 10
8009
Summary
You have completed the lesson on acquisition of age-specific
competencies.
NO IMAGE
Remember:
• Your facility must define age-specific competencies.
• Age-specific competencies may be documented in a
variety of places.
• Your facility must provide education and training. It must
be documented.
• Your facility is responsible for assessing age-specific
competencies.
Point 9 of 10
8010
References
•
•
•
•
•
Joint Commission. Comprehensive Accreditation Manual for Acute Care Hospitals.
2010.
CDC. Developmental Milestones. Available at:
http://www.cdc.gov/ncbddd/actearly/milestones/index.html. Accessed April 7,
2010.
Erikson EH. Identity and The Life Cycle. Psychological Issues vol 1, #1. New
York: International University Press. 1959. Available at:
http://www.archive.org/details/identityandtheli011578mbp. Accessed April 8, 2010.
Edelman CL, Mandle CL. Health Promotion Throughout The Life Span 6th edition.
St. Louis: Mosby. 2006.
American Academy of Child and Adolescent Psychiatry. Teen Suicide. Available
at: http://www.aacap.org/cs/root/facts_for_families/teen_suicide. Accessed April 8,
2010.
NO IMAGE
Please remember that compliance is the responsibility of each organization. Provision of
this list does not imply that the content of this course wholly or partially addresses the
guidelines and references provided here.
Point 10 of 10
Course Glossary
#
Term
assess
to determine the importance, size, or value through official evaluation
Definition
APGAR score
failure to thrive
numbered score used to assess a baby's physical state at the time of birth
description applied to children whose current weight or rate of weight gain is significantly
below that of other children of similar age and sex
autonomy
initiative
industry
authoritarian
neuromuscular
independence or freedom
ability or readiness to begin a series of behaviors directed toward a goal
determination to perform a task
Expecting obedience without question
pertaining to the nerves and muscles
Pre-Assessment
1. A care-giver demonstrates competency to provide age-related care by:
a. Determining a patient’s status from patient data
b. Providing care that is appropriate to a patient’s age and development
c. Both a and b
d. None of the above
Correct answer: C
Rationale: Knowledge and understanding of chronological age, developmental age, and maturity level supports the
ability to determine a patient’s status from the available data and to provide age-appropriate care.
2. An infant who is separated from a primary care-giver will show signs of fear and anxiety.
a. True
b. False
Correct answer: A
Rationale: Infants have a fear of separation from the primary care-giver(s).
3. Your pediatric patient is very inquisitive, can speak with a limited vocabulary, loves to explore the world through
taste, touch, listening, and smelling, and will follow simple commands. Your patient is a(n):
a. Infant
b. Schoolchild
c. Toddler
d. Adolescent
e. Preschooler
Correct answer: C
Rationale: Toddlers are eager learners who explore the world through tasting, touching, looking, listening, and
smelling. They have a limited vocabulary as their verbal skills improve.
4. Jason is a child under your care. In talking with his mother, you learn that he takes a bath every night before bed
and sleeps with a night light. His mother stays in his room with him until he drifts off to sleep. Based on your
knowledge of age-related psychosocial and developmental characteristics, Jason is in which pediatric age group?
a. Preschooler
b. Toddler
c. Schoolchild
d. Adolescent
e. Infant
Correct answer: A
Rationale: Preschoolers feel comfortable with rituals (such as a bath every night before bed). They have a fear of
being alone and a fear of the dark. Using a nightlight and having his mother stay with him until he falls asleep minimize
these fears.
5. Which of the following activities would NOT be appropriate in caring for a schoolchild?
a. Pull curtains and close the door to promote privacy.
b. Allow participation in decision-making and self-care.
c. Limit visitation or communication with friends.
d. Explain procedures using correct terminology.
Correct answer: C
Rationale: Privacy is important to the schoolchild; therefore pulling the curtain and closing the door provides this
privacy. The schoolchild has a desire for independence. Allowing participation in decisions and care supports a feeling
of independence. The schoolchild’s knowledge of anatomy, bodily functions, and illness is limited. Peers are important
relationships to the schoolchild. Peer contact should be encouraged during long hospitalizations. Explaining in clear,
accurate terminology helps the child understand what is happening to him/her.
6. Each healthcare facility is responsible for defining and describing the exact competencies required of its
employees. Regarding these definitions and descriptions, all of the following statements are true EXCEPT:
a. Exact definitions are important so that all employees have a clear idea of the knowledge and skills they need
to provide quality, age-appropriate care.
b. Descriptions of age-specific competencies may be documented in job descriptions or unit/departmental
policies.
c. Once a facility has defined and documented its competency expectations, it has no further responsibilities
with regard to the age-specific competencies of its employees.
d. Clear definitions and descriptions provide reliable guidelines for patient care, but all care should be
determined based on individual patient needs.
Correct answer: C
Rationale: In addition to defining age-specific competencies, facilities are responsible for training and assessing their
employees with regard to established competencies.
7. Which of the following is LEAST likely to be true of a 10-year-old girl?
a. One of her most significant fears is failure to meet the expectations of others.
b. She has a thorough understanding of anatomy, bodily functions, and illness.
c. She enjoys receiving praise from her parents, teachers, and other authority figures.
d. She is an avid learner who loves to share her knowledge.
Correct answer: B
Rationale: Schoolchildren have limited understanding of anatomy, bodily functions, and illness.
8. Jane, a 16-year-old patient in your care, has confided to you that she and her boyfriend are sexually active. She is
not taking oral contraceptives or using any form of barrier contraception. The best approach to discussing this
problem is to:
a. Encourage Jane’s parents to restrict Jane’s contact with her boyfriend.
b. Tell Jane that she should not be having sex because she is too young.
c. Tell Jane’s parents that she needs to start using birth control.
d. Provide Jane with accurate information regarding birth control and sexually transmitted diseases.
Correct answer: D
Rationale: When caring for adolescent patients, avoid authoritarian approaches, and communicate directly with the
patient, not through the parents. Education should focus on promotion of safe and healthy choices, including decisions
regarding
sexuality and substance abuse.
9. Infants require ____ and ____ than toddlers.
a.
b.
c.
d.
More calories, less protein
Fewer calories, more protein
Less milk, less food
More food, less liquids
Correct answer: A
Rationale: Toddlers need fewer calories than infants. They need more protein.
10. An infant fails to gain weight at an age-appropriate rate. Possible reasons for this include:
a. The infant and his mother are having trouble with breastfeeding.
b. The infant’s primary caregivers do not provide enough physical contact (i.e., hugging and cuddling).
c. The infant has not learned to trust his environment.
d. All of these are possible reasons.
e. None of these is a possible reason.
Correct answer: D
Rationale: Inadequate weight gain can be indicative of poor feeding. It also can occur with failure to thrive. This is a
condition sometimes associated with an infant’s failure to develop trust in his or her primary caregiver(s) and
environment. Trust and healthy infant-parent bonds develop in part through physical contact.
Exam
1. Age specific competencies are necessary for:
a. Improved quality of care
b. Providing care that meets a patient’s specific needs
c. Meeting The Joint Commission accreditation requirements
d. All of the above
Correct answer: D
Rationale: When a care giver is competent in age-related characteristics, quality of care is improved and the care is
specific to the age of the patient. This also meets The Joint Commission requirements.
2. Milestones in physical development for infants include responding to familiar faces and voices, crawling, and
raising the head.
a. True
b. False
Correct answer: A
Rationale: All of these are developmental milestones for the infant.
3. Which of the following should be considered when giving medication to a toddler?
a. Oral route is preferable.
b. Absorption and metabolism are predictable.
c. The dosage is determined by body weight.
d. A & C
Correct answer: D
Rationale: The absorption and metabolism of medication in a toddler is unpredictable.
4. Preschoolers develop the ability to:
a. Hop
b. Dress themselves
c. Walk on tiptoe
d. Feed themselves
e. All of the above
Correct answer: E
Rationale: Development during the preschool age includes all of these.
5. Peer pressure plays a significant part in decision making in schoolchildren.
a. True
b. False
Correct answer: A.
Rationale: Peer relationships are important to the schoolchild and peer pressure becomes a potential safety issue.
6. Which of the following care practices is (are) important for ALL pediatric patients?
a. Report suspected abuse or neglect of pediatric patients to your supervisor immediately.
b. Use toys, games, and puppets to educate pediatric patients about medical procedures.
c. Direct all healthcare education toward the pediatric patient’s primary caregiver(s).
d. All of the above
e. None of the above
Correct answer: A
Rationale: You are required to report suspected abuse or neglect of any pediatric patient, regardless of age. Toys,
games, and puppets are appropriate for toddlers and schoolchildren, but not for other pediatric patients. In most cases,
the primary caregiver should be included in the pediatric patient’s education. All education be directed to the caregiver
only for the infant. As a pediatric patient grows and matures, more and more education should be provided directly to
the patient.
7. As children grow, they demand greater and greater independence. Ensure their safety by limiting their ability to
make choices.
a. True
b. False
Correct answer: B
Rationale: It is important to encourage and promote independence. Allow for choice, when possible and appropriate.
Provide for safety in other, age-appropriate ways.
8. Depression and suicide are concerns for adolescents and schoolchildren.
a. True
b. False
Correct answer: A
Rationale: Suicide is the third leading cause of death for children and adolescents age 10-14 years old and
adolescents and young adults age 15-24 years old.
9. You can stop screening for abuse in:
a. Preschoolers
b. Schoolchildren
c. Adolescents
d. All of the above
e. None of the above
Correct answer: E
Rationale: Abuse can occur at any age; therefore, screening should be completed at all ages.
10. Adolescents may experience anxiety related to the timing of physical/developmental changes.
a. True
b. False
Correct answer: A
Rationale: Adolescents experience dramatic physical changes that occur at various times throughout adolescence.
Anxiety may result in those who begin to develop early as well as in those who develop later into adolescence.