The most appropriate strategy to communicate with a preschooler before a procedure is to:

• Provide abstract explanations about risk vs. benefit

• Use medical jargon to increase realism

• Demonstrate with a doll and use simple, concrete terms

• Avoid showing equipment to prevent fear

Answer explanation

Demonstrating with a doll and using simple, concrete terms helps preschoolers understand the procedure in a relatable way, reducing anxiety and fear. Abstract explanations and medical jargon are not suitable for their developmental level.

Which is the best example of assent?

• Parent signs permission for surgery

• Adolescent states, “I understand and agree to the procedure”

• Court order mandates treatment

• Nurse explains risks to the caregiver

Answer explanation

The best example of assent is when the adolescent states, 'I understand and agree to the procedure.' This indicates their voluntary agreement and comprehension, which is essential for true assent.

During an emergency, therapeutic communication with caregivers should be:

• Detailed and lengthy to ensure full understanding

• Limited to written materials

• Clear, brief, closed-loop updates with a designated support person

• Deferred until after all interventions

Answer explanation

During emergencies, communication must be clear and concise. Closed-loop updates ensure understanding and accountability, making 'Clear, brief, closed-loop updates with a designated support person' the best choice.

A school-age child’s stage in Erikson most emphasizes:

• Initiative vs. guilt

• Industry vs. inferiority

• Autonomy vs. shame and doubt

• Identity vs. role confusion

Answer explanation

In Erikson's stages, school-age children primarily face the challenge of 'Industry vs. Inferiority,' where they develop a sense of competence through skills and achievements, contrasting with feelings of inferiority if they struggle.

An infant first achieving head control before sitting supports which pattern?

• Proximodistal

• Cephalocaudal

• Spiral

• Bidirectional

Answer explanation

The cephalocaudal pattern describes development from head to toe. Achieving head control before sitting illustrates this progression, as infants gain control of their upper body before their lower body.

A 15-month-old’s expected fine-motor skill is:

• Mature pincer grasp with neat handwriting

• Uses palmar grasp only

• Scribbles with a crayon, attempts tower of 2 blocks

• Copies a square

Answer explanation

At 15 months, children typically scribble with a crayon and can stack 2 blocks. The mature pincer grasp and neat handwriting develop later, while the palmar grasp is seen in younger infants.

In Kohlberg, a school-age child who follows rules to maintain social order operates at:

• Preconventional—punishment/obedience

• Preconventional—instrumental relativist

• Conventional—law and order

• Postconventional—universal principles

Answer explanation

In Kohlberg's theory, a school-age child who follows rules to maintain social order is operating at the Conventional level, specifically the 'law and order' stage, where adherence to rules is prioritized for societal stability.

Most accurate tool to screen autism at 18–24 months:

• Denver II

• M-CHAT-R/F

• SWYC screening only

• Visual observation without tools

Answer explanation

The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-Up) is specifically designed for screening autism in children aged 18-24 months, making it the most accurate tool compared to the other options.

Freud’s stage emphasizing toilet training conflicts is:

• Oral

• Anal

• Phallic

• Latency

Answer explanation

Freud's anal stage focuses on toilet training conflicts, where children learn to control their bodily functions. This stage is crucial for developing autonomy and can lead to issues if not navigated properly, making 'Anal' the correct answer.

Which teaching best matches a concrete operational child?

• Abstract models of immunity

• Hands-on demonstration with simple cause-effect

• Metaphors about cells as “factories” for protein synthesis

• Discussion of hypothetical scenarios only

Answer explanation

Concrete operational children learn best through hands-on experiences. A hands-on demonstration with simple cause-effect helps them understand concepts concretely, unlike abstract models or hypothetical discussions.